[Objective]To investigate the pathogenesis,pathology,diagnosis and therapy of hyponatremia after acute spinal cord injury.[Method]Fifteen in-patients with hyponatremia after acute spinal cord injury from 2004 to 2006 were retrospectively analyzed.[Result]Serum sodium was lower than 130 mmol/L in all cases.Urine sodiumcanned was from 40 to 68 mmol/L and urine osmotic pressure was from 420 to 980 mmol/L.After limitation of water intake and appropriate salt intake,12 patients recovered at 2 to 3 weeks.Because of fever and avoiding limitation of water intake,the other 3 patients recovered slowly.[Conclusion]The more serious the acute spinal cord injury,the higher the frequency of hyponatremia;syndrome of inappropriate antidiuretic hormone secretion(SIADH) is its primary cause: appropriate measures should be taken to correct the hyponatremia according to the findings of serum sodium and urine osmotic pressure.

ObjectiveTo explore the possible molecular mechanisms of β-elemene combined with cisplatin and heat therapy for killing A549 cell line.MethodsThe protein expressions of Stat3,p21 Waf1/Cip1 and Survivin were detected with Western blot after treatment with β-elemene of different concentrations combined cisplatin and heat therapy.ResultsThe protein expressions of Stat3,and pStat3 and p21Waf1/Cip1 in A549 cell line were enhanced with increasing concentrations,and there was significant difference in the expressions between high and low concentration,but Survivin protein had no change at 37°C.After adding 4 μg/mL cisplatin,the expressions of p21Waf1/ Cip1,Survivin,Stats and pStat3 were reduced at β-elemene of high concentration.At 42°C,there was no significant difference in expression of Stat3 protein at 60 μg/mL elemene,but the expressions of pStat3,p21Waf1/Cip1 and Survivin proteins had sharply declined.When using 15 μg/mL elemene combined with 4 μg/mL cisplatin,the protein expressions of Star3 and pStat3 increased,and Survivin expression decreased.ConclusionsAt temperature of 37°C,β-elemene of high concentration may inhibit growth of A549 cells by higher expression of p21Waf1/Cip1 protein,and mainly by inhibiting expressions of Stat3 and pStat3 and Survivin after combined with cisplatin.At temperature of 42°C,β- elemene of highconcentrationmaypromoteapoptosispossiblythroughinhibition ofStat3 phosphorylation and expression of Survivin protein.β-elemene of low concentration combined with cisplatin leads to synergy killing effect by reducing expression of Survivin protein.

A novel 2-( 2’-hydroxy-5’-chlorophenyl )-6-chloro-4 ( 3 H )-quinazolinone ( ELF-97 )-based fluorescent probe (P1) for hydrogen peroxide was prepared from 5-chlorosalicylaldehyde, 4-(bromomethyl) phenylboronic acid and 2-amino-5-chlorobenzamide, and its structure was characterized by 1 H NMR, 13 C NMR and HRMS. Weak fluorescence intensity was observed at 425nm when the solution of probe P1 was excited by 360 nm UV light. After addition of H2 O2 , however, emission peak at 425 nm disappeared while strong peak emission at 515 nm appeared with the same excitation wavelength ( 360 nm ) . The fluorescence intensity at 515 nm was dependent on the concentration of H2 O2 in the linear response range of 5-45 μmol/L. The detection limit of H2O2 was 0. 1 μmol/L (S/N=3) and the recovery rates of added H2O2 in milk were in the range of 94 . 0%-106 . 0%. Probe P1 was potential to become a useful tool for rapid detection of hydrogen peroxide.

0bjective To summarize the experience of postoperative and mid-term echocardiographic evaluation of modified Blalock-Tasussig(BT)shunts. Methods During 2003-2006,thirty five consecutive patients received modified BT shunts and survived postoperative 6 months were enrolled in this study.Transthoracic echocardiography was utilized to evaluate the patency of shunts and the change of pulmonaryarteries(PA)and left ventricle(LV). Results Three patients received the emergence surgery for the intervention for the BT shunts. The follow-up was (21.2±11.3) months. During the follow up,the obstruction of shunts occurred in 7 cases. After the placement of shunts,the mean size of PA increased by 31.2%,meanwhile,the size of LV increased by 25.6%. Nineteen patients received the followed definitive repair or palliative operations. Compared with the patients still waiting for the growth of PA,the patients who receiving the second staged procedure achieved the more appropriate PA growth. Furthermore,for the above patients,there was no significant difference between the angiographic and echocardiographic evaluation for the PA size. Conclusions Echocardiography could accurately diagnose the patency of shunts and record the growth of PA and LV following BT shunts. Echocardiography is a highly reliable noninvasive approach for the perioperative evaluation and mid-term follow-up for the modified BT shunts.

Objective To investigate the expressions of erythropoietin(EPO)and its receptor(EPO-R)in the spinal cord after acute traumatic injury in adult rats.Methods Sixty-nine Wistar rats were randomly divided into three groups:normal control group(n=5),spinal cord injury group(n=32),and sham operation group(n= 32).The injury group and sham operation group were further randomly divided into eight subgroups respectively (n=4)(1h,6h,12h,24h,3d,7d,14d,28 dafter operation).The expressions of EPO and EPO-R at different time points were detected by RT-PCR,Western blot and immunohistochemical staining.Results EPO was nut detected at any time point in the normal control grnup,spinal cord injury group or sham operation group.The EPO-R expression was not found in the normal control group or sham operation group.RT-PCR and Western blot analyses revealed EPO-R mRNA and protein expressions in the injury group as early as 6 h after injury.The EPO-R mRNA and protein expressions sharply increased at 12 h,peaked at 24 h to 7 d,and gradually declined after 7 d. They were still higher than those in the control rats 28 d after injury.The EPO-R immunoreactivity was chiefly found in neurons,oligodendrocytes,vascular endothelial and ependymal cells.Conclusion The EPO-R expression can be up-regulated obviously in the injured spinal cord,which provides a molecular basis for the nerooprotection of exogenous EPO.

Objective To investigate the effect of continuous high volume hemofiltration (HVHF)on respiratory mechanics and hemodynamics in multiple organ dysfunction syndrome (MODS). MethodsForty-one adult patients with MODS who received mechanical ventilation were divided into HVHF group(21 cases) and continuous vein-vein hemofiltration (CVVH) group (20 cases) by envelople. The peak airway pressure (Ppeak), dynamic pulmonary compliance(Cdyn), cardiac output(CO ), systemic vascular resistance(SVR), pulmonary vascular resistance (PVR) and blood gas analysis before treatment and 24 hours after treatment were measured. Results Twenty-four hours after treatment, the levels of Ppeak, Cdyn, CO, PVR,SVR and oxygenation index were (31.32 ±2.23) cm H2O (1 cm H2O =0.098 kPa), (26.18 ±3.54)(220.41 ±21.41) mm Hg (1 mm Hg =0.133 kPa) respectively in HVHF group,significantly higher than those before treatment [(42.00 ±3.34) cm H2O, (17.91 ±4.31) ml/cm H2O, (8.68 ±1.17) L/min,(267.27 ± 16.29) dyn·s·cm-5, (805.32 ± 18.82)dyn ·s·cm-5, ( 119.41 ± 17.10) mm Hg] (P ＜ 0.01 ),as well as higher than those in CVVH group after 24 hours' treatment (P ＜ 0.01 ). ConclusionHVHF shows significant beneficial effects on respiratory mechanics and hemodynamics of MODS.

According to the designed specific primers of gene fragment based on the Salvia miltiorrhiza transcriptome data, with the method of reverse transcription polymerase chain reaction (RT-PCR), this study cloned full-length cDNA sequence of 1-hydroxy-2-methyl-2-(E)-butenyl-4-diphosphate synthase gene from Salvia miltiorrhiza bge.f.alba, this sequence is named as SmHDS and its GenBank registration number is KJ746807. SmHDS, 2 529 bp long, contains an ORF of 2 229 bp, encodes 742 amino acids, including 5' UTR 170 bp and 3' UTR 130 bp. Using bioinformatics software, having made a homology analysis of the obtained sequence, we can have a conclusion that SmHDS have a close genetic relationship with HDS of Salvia miltiorrhiza. Analysis result of prokaryotic expression revealed that in Escherichia coli, SmHDS expressed target proteins which in size are comparable with the protein predicted. Meanwhile, the 4 factors which can influence the protein expression were optimized, the 4 factors are inducing temperature, inducing time, IPTG concentrations and density of inducing host bacterium (A600). The optimal expression conditions of SmHDS were 30 degrees C until the A600 is 0.6, and add IPTG to a final concentration of 0.2 mmol x L(-1), and the induction time of 20 h. It provides theoretical basis for the further study of the function of 1-hydroxy-2-methyl-2-(E)-butenyl-4-diphosphate synthase in the biosynthesis of tanshinone compounds.

Objective To investigate and analyze risk factors of re-fracture after operation of osteoporotic hip fracture.Methods Two hundred forty-seven patients receiving operation of osteoporotic hip fracture were retrospectively studied and followed up,and all patients were divided into re-fracture group (54 patients) and no-re-fracture group (193 patients).The related factors such as sex,age,body mass index (BMI),affected side,initial fracture site,operation type,perioperative blood loss,postoperative delirium,postoperative bedridden time,medical complications,Charlson comorbidity index,antiostoporosis therapy,hip function scores with Harris and functional independence measurement (FIM) scores were compared by single factor analysis and multivariate Logistic regression analysis.Results Single factor analysis and multivariate Logistic regression analysis both showed that the risk factors of re-fracture after operation of osteoporotic hip fracture included age,postoperative delirium,hypertension,diabetes mellitus,cerebrovascular disease,antiostoporosis therapy,hip function scores with Harris and FIM scores (P ＜ 0.05 or ＜ 0.01).Conclusions Risk factors of re-fracture after operation of osteoporotic hip fracture include passive factors of age,postoperative delirium and medical complications,and subjective factors of antiostoporosis therapy,hip function scores with Harris and FIM scores.Patients should receive medical treatment positively,enhance antiostoporosis therapy and rehabilitation training of hip function to prevent re-fracture.

Objective To report the clinical result of repairing complex tissue defect in limb caused by traffic accident using both tissue flap transplantation and external fixer. Methods The vascular tissue flap including bone flap and muscular flap to repair the complex tissue defection(soft tissue, bones, joints) in forearm, hand, leg, ankle and foot were applied in 36 cases. At the same time in surgery, injured bones and joints were fixed by external fixer for stabilizing and accelerating cure. Results All 56 eases were applied successfully with transplanted tissue combined with external fixation. The external fixers were moved away about 10-16 weeks(upper extremity) or 6-8 months(lower extremity) later and all the cases recovered satisfactorily. Conclusion It is a reliable method for repairing the complex tissue defection in the limb caused by traffic accident by external fixer of traumarology and microsurgery technique. And it is also characterized as a minor injury method on transplanted bones, enables early exercise for joints, convenient observation of flap circulation and easy nursing.

Objective To explore the effect of quality control circle (QCC) in reducing the health examination report errors. Methods QCC was founded, activity themes were selected, activity schedule was planned, the reasons of health examination report errors were analyzed, goal setting, countermeasures were planned and implemented jointly by circle members. Totally 11 738 reports of health checkup were selected and analyzed the errors were analyzed during the activity, 6 892 were male, 4 846 were female, their average age was(38.01 ± 11.31)years, 5 000 reports were made before improvement, 5 120 reports during improvement, 1 618 reports after improvement and compared the report error rates were compared. Evaluation of QCC activity results and tracking effect were evaluated. Results Error rate of health checkup report from 17.80‰ decreased to 7.23‰ during improvement, dropped to 2.48‰ after improvement. The rate of standard was 141.9%, progress rate was 86.1%. Tracking results for 8 months, error rate remained below the target value of 3.40‰although error rate roise to 5.25‰in August 2016, the effect was good. The additional benefit, working efficiency of the doctors was improved; Average time for each written report was reduced to 4 minutes from 5 minutes;Saved about 1 hours per person a day to review the accuracy of the report and learning; Formed“communication model between clinical departments”;Established the error registration system for the report has been distributed;Similar error of ECG department has been avoided. Conclusions Application of QCC not only reduced the error rate of the health checkup report, but also ensured quality, objective, and accurate physical examination report; activities not merely help to improve the work efficiency of physician, team's mutual cooperation, and is beneficial to optimize the system of medical institution and avoid the error.