Objective To explore the nutritional status of vitamin D among healthy adults lived in Fuling district of Chongqing .Methods A total of 718 healthy adults aged 23-90 years old undergoing the physical examination in the physical ex‐amination center of our hospital from March 2012 to December 2013 were selected and divided into the 23-44 years old group and the ≥45 years old group .The tandem mass spectrometer was adopted to detect the level of serum 25(OH) vitamin D for evaluating the nutritional status of vitamin D .Results The proportions of lack ,insufficiency ,normal and excess of vitamin D in the 23 -44 years old group were 80 .79% ,19 .21% ,0% and 0% respectively ;which in the ≥45 years old group were 77 .91% ,18 .20% ,3 . 89% and 0% respectively .The average level of serum 25(OH) vitamin D in 23-44 years old group was lower than that in the ≥45 years old group ,the difference was statistically significant (P=0 .002 ,t=1 .98) .In these two groups ,the difference in serum 25 (OH) vitamin D level between males and females had no statistical significance (P>0 .05) .Conclusion The healthy adults in Ful‐ing district are lack of vitamin D in different degrees .

BACKGROUND: Nowadays, it is thought that transforming growth factorβ (TGFβ) is closely related with cicatrization. TGFβ that is a key active molecule can affect each phase of cicatrization. Theoretically, to inhibit the biological effect of TGF β can reduce cicatrization.OBJECTIVE: To explore the inhibitive effect of antisense TGF β1 deoxy-oligonucleotide on generation of cicatricle in intention of animal models with hyperplastic scars and observe the effective route of administration of using antisense TGF β1.DESIGN: Own control and animal study.SETTING: Department of Plastic Surgery, Anning Hospital of General Hospital, Lanzhou Military Area Command of Chinese PLAMATERIALS: The experiment was performed at the laboratory of anatomy,Lanzhou Medical College from September 2002 to July 2003. Totally 20flap-eared Japanese rabbits were selected.METHODS: Blood vessels could be seen in ventral surface of each rabbits' ear getting out of the way along long axis to establish two 1.0 cm×2.5 cm oblong full-thickness cutaneous deficiency raw surfaces that interval for 1.5 cm, to the surface of cartilage, totally 80, so asto establish ventral surface of rabbits' ear models with hyperplastic scars. After epithelizatio of raw surfaces of rabbits' ear (20 days, averagely), 5μL(1 g/L) antisense TGF β1 deoxy-oligonucleotide was closely injected into local endepidermis of each raw surface of left ear of each rabbit with microinjector, which was regarded as TGF β1 group. 5 μL saline was injected into each raw surface of right ears, which was regarded as saline control group. After injection for3, 7, 11, 20, 30 days, cicatricial tissues were cut, 4 rabbits in each time phase. Hematoxylin-esoin (HE) staining, Masson staining and TGFβ1 mRNA, type Ⅰ and Ⅲ collagen mRNA in situ hybridization histochemistry staining were applied.MAIN OUTCOME MEASURES: Results of HE staining, Masson staining and in situ hybridization histochemistry staining.RESUTLS: A total of 20 animals were included in the result analysis. ①HE staining showed that inflammatory cell infiltration and significant infiltrative zone of leukocytes occurred in hyperplastic scars of right ears in each group. There was inflammatory cell infiltration, but no infiltrative zone of leukocytes in hyperplastic scars of left ears after intervention with antisense TGF β1. ②Masson staining suggested that collagen fibers with deep blue-stain occurred in hyperplastic scars of right ears from the 3rd week after injury, till the 7th week there still was blue-stain collagen fibers,which was bulky (width of about 8-10 μm) and arranged in a great mess.The blue-stain collagenous fibers also appeared in hyperplastic scars of left ears at the 3rd week after injury by the intervention of antisense TGF β1,but till the 6th and 7th weeks the blue-stain became light and thin (width of about 3-5 μm), arranged in order. ③In situ hybridization revealed that expressive rates of TGF β1 mRNA, type Ⅰ collagen mRNA, type Ⅲ collagen mRNA positive cells decreased obviously.CONCLUSION: Antisense TGF β1 can inhibit the proliferation of hyperplastic scars of rabbits' ears and lighten markedly the fibrosis of cicatricial tissue. The local injection with naked DNA is feasible in the treatment of cicatricle.

Objective To assess the efficacy and safety of the Nuss procedure in the treatment of pectus excavatum in children. Methods The Nuss procedure was performed in 38 patients.Under thoracoscopy,a convex steel bar was inserted under the sternum through small bilateral thoracic incisions,with the convexity facing posteriorly.When the bar was in position,it was turned over,thereby correcting the deformity.Two lateral stabilizing bars were employed.Out of the 38 patients,imported bars were used in 5 patients and China-made bars were used in 33 patients.Results The procedure was completed under thoracoscopy smoothly in all the 38 patients.The operating time was 40~80 min(mean,50 min) and the intraoperative blood loss was 5~30 ml(mean,16 ml).A single bar was utilized in 36 patients,and a second bar was required in 2.Complications included postoperative pneumothorax in 4 patients,subcutaneous emphysema in 16 patients,bar displacement in 1 patient,and lateral stabilizer dislocation in 1 patient.The length of postoperative hospital stay was 7~21 days(mean,8 days).Follow-up checkups in the 38 patients for 3~22 months(mean,11 months) showed excellent outcomes in 36 cases and good outcomes in 2 patients,the rate of excellent or good results being 100%. Conclusions The Nuss procedure is safe and reliable for the treatment of pectus excavatum in children.The best age range for surgery was 3~12 years old.

Objective To assess the middle-term results of laparoscopy in resection of congenital choledochal cyst,hepaticojejunostomy,and extra-abdominal Roux-en-Y anastomosis. Methods We retrospectively studied 50 patients who had undergone laparoscopic choledochal cyst excision in our institute from 2005 to 2008.For large cysts,we dissected and separated the cyst at the middle portion,and then opened the inferior wall of the cyst to dissect the posterior wall of the cyst from the portal vein.For small cysts,we divided the cysts circumferentially and then completely excised the dilated bile duct.When the cyst was intensely inflamed,excision of the cysts was performed as Lilly's technique.Roux-en-Y jejunojejunostomy was performed extracorporeally through an umbilical incision(1.5 cm),afterwards,end-to-side anastomosis was carried out intracorporeally.The conversion to open surgery,and morbidity and mortality rates of the patients was analyzed.Results The cysts were completely excised in 16 cases,and Lilly's technique was performed on 34 cases.One patient was converted to open surgery due to hemorrhage resulted from recurrent inflammatory-caused tight adhesion between the cyst and surrounding tissues.The mean operation time was 226 minutes(range: 190 to 450 minutes).Eight patients received blood transfusion during the operation.The children were discharged from hospital in 6 to 16 days after the surgery(mean,8 days).A mean of 26 months follow-up was achieved in 49 patients(ranged 3 to 39 months).Four patients developed complications: one of them showed bile leakage and then were cured by intra-abdominal drainage;one patient developed acute pancreatitis and one suffered from adhesive small bowel obstruction,both recovered after conservative treatment;intestinal necrosis was detected in one patient,who received another operation for resection of the necrotic bowel and anastomosis of the bile duct and intestine.In the other 45 patients,no abdominal pain,fever,jaundice,etc.were detected.No patient showed bile duct stenosis or reflux gastritis,no one died because of the surgery.Conclusions Laparoscopic approach is effective for congenital choledochal cyst,hepaticojejunostomy,and extra-abdominal Roux-en-Y anastomosis.Dissection of the posterior cyst wall to avoid injury to the portal vein is the key to the procedures,while extra-abdominal Roux-en-Y anastomosis is one of the most difficult steps.

Objective To evaluate the value of laparoscopic-assisted cholangiography in diagnosing prolonged jaundice in infants.Methods Through an umbilical troear,an laparoscope was placed into the abdominal cavity to detect the gallbladder and liver.After confirming that the choleeyst is normal,we pulled out the fundus of the gallbladder through the right subcostal trocar,and then inserted a catheter into the gallbladder for cholangiography.If the fundus could not be exteriorized because of gallbladder atresia, the patient would be converted to an open surgery.Results Cholangiography showed infant hepatitis syndrome or cholestasis in 8 cases,biliary hypoplasia in 2,and biliary atresia in 2.In 5 patients,the gallbladder was dissected from the liver bed before cholangiography,2 of them had biliary hypoplasia and 3 showed biliary atresia.Cholangiography was given up in 21 children because of liver cirrhosis.These patients were diagnosed with biliary atresia and then were treated by Kasai portoenterostomy. Conclusions Laparoscopic-assisted cholangiography is a simple,accurate,and safe method in the diagnosis of prolonged jaundice in infants.By using the procedure,the whole biliary tree can be shown clearly without leading to serious injuries.

Objective To investigate the gene expression of vascular endothelial growth factor(VEGF) and ultrastructural changes in cultured endothelial cells from human cerebral microvessels under hypoxic conditions.Methods Human cerebral microvessels were isolated from freshly obtained specimens of normal brain adherent to resected cerebral arteriovenous malformations.The expression of factor Ⅷ-relative antigen(FⅧ-RA) in cultured cells was observed with immunocytochemistry.The level of VEGFmRNA in cells and released VEGF protein in cell supernatant were determined by RT-PCR analysis and ELISA respectively when they were exposed to hypoxic conditions(95% N_2,5% CO_2;two hours,four hours,eight hours) or maintained in basal condition.Ultrastructural changes in cells were also observed by electron microscopy.Results In inverted microscope the cultured cells showed contact inhibition and a rounded cobblestone appearance.More than 90% of them were stained strongly with antibodies against FⅧ-RA.Significant VEGF mRNA and protein accumulated when these cells were exposed to hypoxia for 4 hours.However,their VEGF expression was down-regulated after hypoxia for 8 hours and a number of vesicles and swollen mitochondria were present in the cytoplasm.Conclusion The level of VEGF expression may havesignificant relationship with ultrastructural changes in human cerebral endothelial cells under hypoxic conditions.

BACKGROUND: The observation of vascular endothelial growth factor gene expression of cerebrovascular diseases and ultrastructure of cells may be helpful to understand angiogenesis and its relative cellular factors involved in the pathogenesis at cellular and molecular levels. OBJECTIVE: To investigate the method of culture of human cerebral cap illary endothelial cell by separation of capillary fragment in vitro, and to ob serve vascular endothelial growth factor gene expression and ultrastructure of cells. DESIGN: A randomized controlled research on technique and method. SETTING: The neurosurgery department of a general hospital of a military area command of Chinese PLA and the neurosurgery department of a college hospital. PARTICIPANTS: Eighteen patients with arteriovenous malformation of brain(Spetzler Ⅱ-Ⅲ grade), as confirmed by aortocranial angiography before operation, in the Department of Neurosurgery, General Hospital of Shenyang Military Area Command of Chinese PLA were included. The material was obtained from fresh integrated specimen of arteriovenous malfor mation of brain with surrounding fresh brain tissues during the opera tion. Capillary endothelial cell was separated by homogenate, filtration and enzymatic digestion techniques. Cells grew well in culture flask and were divided into 4 groups(hypoxia state for 2, 4, 8 hours groups and control group). Each group contained four flasks.METHODS: Simulation of anoxia condition: volume faction 0.95 N2 and volume fraction 0.05 CO2. Expression of factor Ⅷ related antigen in cells was detected by immunohistochemistry. mRNA expression of vascular endothelial growth factor on endothelial in every group was observed by RT-PCR, protein content of vascular endothelial growth factor in supernatant detected by enzyme-linked immunoadsordent assay, and cellular ultrastructural change observed by transmission electron microscopy.MAIN OUTCOME MEASURES: mRNA expression of vascular endothelial growth factor on endothelial cell and protein content of vascular endothelial growth factor in supernatant in control group and every hypoxia groups; cellular ultrastructural changes.RESULTS: Under phase contrast microscope, cultured living cells had mono-layer pebble-like typical character. More than 90% of were factor Ⅷrelated antigen(FⅧ-RA) staining positive. mRNA and protein expression of vascular endothelial growth factor in hypoxia 4 hours group was 0.98 ±0. 19,( 180. 77 ± 20. 15) ng/L, which was significantly higher than in control group [0, (26. 20 ± 6.33) ng/L, P ＜ 0.01 ]. Eight hours later, expression decreased [(0. 35 ±0.07), (31.68 ±8.34) ng/L]; swollen mitochondrion, dilated endoplasmic reticulum, and lysosome vesiculation were found.CONCLUSION: Humane cerebral capillary endothelial cell can be cultured by separation of capillary fragment, which is easy to operate and the cellular purity is reliable. In the early stage of ischemia and hypoxia, expression of vascular endothelial growth factor is not enough to maintain cellular ultrastructure integrity. Cells may be injured along with the prolong of hypoxia.Zhao MG, Tang T, Gao YZ, Pu PY, Wei XZ. Culture of human cerebral capillary endothelial by separation of capillary fragment and the observation of vascular endothelial growth factor gene expression and cell ultrastructure. Zhongguo Linchuang Kangfu 2005; 9(21):211-3 (China) [www. zglckf. com]

Objective To explore the MR imaging of reverse and separation of meniscal articular capsule.Methods MR imaging of reverse and separation of meniscus articular capsule confirmed by surgery and arthroscope were analyzed retrospectively in 8 cases.Results The “Butterfly knot sign” disappeared and was replaced with fluid signal on the sagittal slice of meniscal body in 8 cases. Part of back angle remained in 3 cases. “Double anterior cruciate ligament sign” was showed on one side of middle sagittal slice in 7 cases. “Reverse meniscus sign” was revealed in intercondylar fossa on the coronary view in ~8 cases. Abnormal high signal was showed in the injured meniscus in 6 cases. Abnormal high signal was detected in the opposite meniscus in 5 cases.Conclusion The MR findings of reverse and separation of meniscus articular capsule include disappearance of “butterfly knot sign”, appearance of “reverse meniscus sign” and “double anterior cruciate ligament sign”. The diagnosis would be established if the former 2 signs were present or all the 3 signs were present simultaneously.

Objective To describe MRI findings of acute spinal cord decompression sickness.Methods MRI findings of 5 cases with clinical definite acute spinal cord decompression sickness were retrospectively analyzed.The main clinical informations included underwater performance history against regulations,short-term complete or incomplete spinal cord injury symptoms after fast going out of water,sensory disability and urinary and fecal incontinence,etc.Results Spinal cord vacuole sign was found in all 5 cases.Iso-signal intensity(n=3),high signal intensity(n=1),and low signal intensity (n=1)was demonstrated on T1 WI,and high signal intensity(n=5)was found on T2 WI.Owl eye sign was detected in 3 cases,and lacune foci were seen in 2 cases.Conclusion MRI findings of acute spinal cord decompression sickness had some characteristics,and it was easy to diagnose by combining diving history with clinical manifestations.

Objective To analyze CT and MRI manifestations of the aneurysmal bone cyst and to evaluate the value of its imaging diagnosis.Methods The manifestations of CT and MRI of the aneurysmal bone cyst confirmed by operation or puncture were analysed retrospectively.Results On CT images,there were obvious liqued-liqued level within the lesions in 16 cases,in which,the CT values in up part was lower than that in low part,and there were obvious soft tissue mass in secondary aneurysmal bone cyst.While,on MRI,all lesions appeared obvious liqued-liqued level except one secondary example,and the soft tissue mass of secondary aneurysmal bone cyst was clear showed.Conclusion Most of aneurysmal bone cyst appear liqued-liqued level within the lesions on CT and MRI,it is a characteristic sign,but not the only one.