Objective To investigate the optimal surgical timing for rib internal fixation.Methods The clinical data of 143 patients with rib fracture were retrospectively analyzed.The patients were divided into early phase fixation group (62 cases) and late phase fixation group (81 cases) according to the time from trauma to internal fixation.The ratio blood lose and body surface area,pulmonary complications and the changes of C reactive protein level before and 5 days after operation were recorded and compared.Results All the patients were healing.The median C reactive protein before operation in late phase fixation group was 45 mg/L,in early phase fixation group was 23 mg/L,there was statistical difference (P ＜ 0.01).The ratio blood lose and body surface area in early phase fixation group was (334.19 ± 37.53) ml/m2,the rate of pulmonary complications was 22.6％(14/61),in late phase fixation group was (438.99 ± 55.24) ml/m2 and 38.3％ (31/81),there were statistical differences (P ＜ 0.01 or ＜ 0.05).The median C reactive protein 5 days after operation in early phase fixation group was 189 mg/L,in late phase fixation group was 258 mg/L,there was statistical difference (P ＜ 0.05).Conclusion Early phase (72 hours) rib internal fixation is expected to reduce patient trauma of systemic reactions,reduce the incidence of bleeding and pulmonary complications.

Objective To assess the clinicopathological and confocal microscopic features of porokeratosis.Methods This study included 186 patients with porokeratosis.The clinical and pathological findings from the patients were retrospectively analyzed.Confocal laser scanning microscopy(CLSM)was used to observe the lesions of disseminated superficial porokeratosis in 16 patients.Results Most of the patients had characteristic lesions of porokeratosis,i.e.,papules or plaques with a thread-like elevated border.Comoid lamella was observed in all of the cases,which was unassociated with sweat glands or hair follicles in most cases(171/186),and located in sweat pore or hair follicles in a few cases(15/186).There were dyskeratocytes as well as vacuolized and degenerated basal cells beneath the cornoid lamella.Varying amounts of lymphocytes and melanophages were observed in the superficial dermis.Amyloid was deposited in the papilla dermis in 2 cases.CLSM showed dyskeratocytes in a characteristic arcuate arrangement in spinous cell layer.Conclusions The CLSM images of porokeratosis are consistent with its histopathological manifestations,and CLSM may serve as a sensitive and specific noninvasive method for the diagnosis of porokeratosis.

OBJECTIVETo observe the characteristics of sperm single-stranded DNA breaks (SSB) and double-stranded DNA breaks (DSB) in infertile men, explore the association of DSB with male infertility, and provide a new observation index and idea for the diagnosis and treatment of the disease.

METHODSThis study involved 60 infertile men (infertility group) and 30 normal healthy males with infertile wives (control group). We comparatively analyzed the seminal parameters of the two groups, determined sperm concentration and viability using the computer aided sperm analysis system, measured the sperm survival rate by hypoosmotic swelling (HOS) test, examined sperm morphology by Diff-Quick staining, and detected sperm DNA damage by two-tail comet assay.

RESULTSNine two-tail comet models were established for detecting sperm DNA integrity. Comparisons between the fertility and control groups showed that the sperm DNA fragmentation index (DFI) was (33.8 ± 13.1) vs (16.3 ± 7.9)% (P < 0.01), the SSB-DFI was (19.2 ± 11.4) vs (14.9 ± 7.6)% (P > 0.05), the SSB-DFI/DFI was (56.8 ± 32.4) vs (91.4 ± 27.8)% (P < 0.01), the DSB-DFI was (23.9 +13.4) vs (6.1 ± 2.7)% (P < 0.01), and the DSB-DFI/DFI was (70.8 ± 19.5) vs (37.4 ± 11.3)% (P < 0.01). The optimal cut-off value of DSB-DFI/DFI in the diagnosis of male infertility was 39.5%, with the AUG, sensitivity, and specificity of 0.969, 98.3%, and 90%; that of DSB-DFI was 15.85%, with the AUC, sensitivity, and specificity of 0.912, 86.7%, and 80%; and that of DFI was 18.65%; with the AUC, sensitivity, and specificity of 0.861, 90%, 70%, respectively. In the infertile men, neither SSB-DFI nor SSB-DFI/DFI exhibited any correlation with semen parameters (P > 0.05); DFI was correlated negatively with the percentage of progressively motile sperm, sperm survival rate, and the percentage of morphologically normal sperm (P < 0.05 or P < 0.01), but not correlated with sperm concentration (P > 0.05); both DSB-DFI and DSB-DFI/DFI showed a negative correlation with sperm concentration, sperm survival rate, and the percentages of progressively motile sperm and morphologically normal sperm (P < 0.05 or P < 0.01).

CONCLUSIONDouble-stranded, rather than single-stranded DNA breaks, may be a factor inducing male infertility. The type of sperm DNA strand damage is of much reference value for the assessment of male fertility.

Case-Control Studies ; Comet Assay ; DNA Breaks, Double-Stranded ; DNA Breaks, Single-Stranded ; DNA Fragmentation ; Fertility ; Humans ; Infertility, Male ; diagnosis ; genetics ; Male ; Semen Analysis ; Sensitivity and Specificity ; Sperm Count ; Spermatozoa ; Staining and Labeling

Objective To analyze clinical characteristics of pemphigoid nodularis. Methods Seven cases of pemphigoid nodularis were included in this retrospective study. The clinicopathological features of pemphigoid nodularis were retrospectively analyzed, including patients′gender, age at onset, clinical manifestations, treatment and follow?up. Results Of the 7 patients, 4 were female and 3 were male, with the median age at onset being 59 years. Clinical manifestations mainly included markedly pruritic prurigo?like lesions and nodular lesions with or without blisters. The most common misdiagnoses were nodular prurigo and eczema. Pathology showed epidermal hyperplasia and subepidermal clefts, collagen hyperplasia in the papillary dermis, and perivascular infiltration of lymphocytes and eosinophils in the superficial dermis in all the patients. Direct immunofluorescence assay showed linear deposition of IgG and C3 in the basement membrane zone, and indirect immunofluorescence was positive in 2 patients. Glucocorticoids combined with immunosuppressants were effective in all the patients. Conclusions Pemphigoid nodularis is easy to be misdiagnosed, and immunopathology is helpful for its diagnosis. Glucocorticoids combined with immunosuppressants appear to be effective for its treatment.

Objective To investigate the relationship between refractory hypertension and renal hemodynamics in end stage renal diseases (ESRD) patients.Methods ESRD patients were classified into:patients with refractory hypertension (group A) and patients with normal blood pressure(group B).Renal hemodynamic indices were ex- amined by duplex ultrasonography.Fasting serum lipid (TC,TG,HDL-C,LDL-C,Lp(a),ox-LDL) and serum parathyroid hormane (PTH) were determined in all patients.Results Significant differences were found in renal hemodynamic indices such as peak systolic velocity (PSV),mean flow velocity (MV),pulsatility index (PI),renal- aortic ratio (RAR) and in clinical index such as Lp(a) and ox-LDL between the two group.Refractory hyperten- sion patients had lower renal hemodynamic indices and higher Lp(a) and ox-LDL levels than in patients with con- trolled BP.Logistic regression analysis revealed that refractory hypertension was related with PSV,EDV,Pl and RAR,but not relevant with sex,age,dialysis time,hematocrit,BUN,creatinine,TC,TG,HDL-C,LDL-C, PTH,MV and RI.Conclusion Atherosclerotic renal artery stenosis and severe disorder in renal hemodynamics is likely the cause for refractory hypertention in ESRD patients.The rise of serum Lp(a) and ox-LDL might acceler- ate renal artery atherosclerosis.

Objective To investigate and analyze the related factors influencing the quality of life in patients with epilepsy, and provide a theoretical basis for taking appropriate measures to improve the quality of life in patients with epilepsy. Methods Sixty-five patients with epilepsy visiting our hospital from July 2007 to December 2008 were chosen in our study. The table-31 for quality of life in patients with epilepsy (Chinese version) was performed on them. The age, gender, education degree,seizure types, course of disease, cognitive function, medication compliance and fear of attack were considered as the independent variable; related factors in the table-31 for quality of life were adopted as dependent variable; multiple linear regression analysis was performed on these 2 variables. Results Education degree and course of disease could affect the memory of patients with epilepsy (standardized regression coefficients were 0.380 and 0.264, respectively). Age could affect the social activities of the patients (standardized regression coefficient was -0.303). Gender could affect the attack of the patients (standardized regression coefficient was 0.332). Conclusion The influencing factors of quality of life in patients with epilepsy are age, gender, education degree, course of disease; and education degree and course of disease enjoy the greatest influence.

Animals ; Gene Expression Profiling ; Mitochondria, Heart ; genetics ; metabolism ; Myocardial Reperfusion Injury ; genetics ; metabolism ; Random Allocation ; Rats ; Rats, Sprague-Dawley

The in vitro release behavior, in vivo biodistribution and antitumor activity of N-(2-hydroxypropyl) methacrylamide (HPMA) copolymer-5-fluorouracil conjugates (P-FU) were studied. The in vitro release behavior was evaluated by determining the amount of 5-fluorouracil (5-FU) released from P-FU in mice plasma at 37 degrees C. The in vivo biodistribution and therapeutic evaluation were investigated with Kunming mice bearing hepatoma 22 (H22). The in vitro half-life (t1/2) of P-FU in mice plasma was 32.4 h. It appeared that the circulation life time of the conjugates were 166 times longer than that of 5-FU. The AUC and t1/2 of P-FU in tumor were 3.3 times and 2.3 times more than those of 5-FU, respectively. Therapeutic evaluation also demonstrated that the treatment with P-FU displayed stronger inhibition of the tumor growth when compared with that of 5-FU (P < 0.05). HPMA copolymer is a potential carrier for 5-FU for effective treatment of cancer.
Acrylamides ; pharmacokinetics ; pharmacology ; Animals ; Antimetabolites, Antineoplastic ; pharmacokinetics ; pharmacology ; Area Under Curve ; Cell Line, Tumor ; Drug Carriers ; Drug Compounding ; Female ; Fluorouracil ; pharmacokinetics ; pharmacology ; Liver Neoplasms, Experimental ; metabolism ; pathology ; Mice ; Neoplasm Transplantation ; Random Allocation ; Tissue Distribution ; Tumor Burden ; drug effects

OBJECTIVEThe study was designed to investigate the relationship between the accuracy of Root ZX and the size of apical foramen, when the apical constrictions were intact or not. Methods Lengths were taken when the needle reached the '0.5' mark and 'APEX' mark on the Root ZX. The electronic apex locator (EAL)-measured canal working length (L2) and EAL-measured canal length (L1) were then compared with the actual canal working length (L') and actual canal length (L). Besides, the areas of apical foramens CS) were measured when the apical constriction were intact or not. Then the measurement deviations and the areas of apical foramens were analyzed by linear correlation and linear regression using the software SPSS 12.0. Statistical significance was considered at P < 0.05.

RESULTSThere were no significantly correlations between the area of apical foramen and the accuracy of Root ZX if the apical constriction was intact (P > 0.05). However, the accuracy of Root ZX and the size of apical foramen had significant negative correlation when the apical constriction was destroyed (P < 0.001). Then the linear regression was completed, and the linear regression equation was deltaL2 = -0.623 + 6.5965, so the critical area of the apical foramen was 0.135 mm2 if the tolerant error was set at 0.5 mm according to the statistic control.

CONCLUSIONThe size of apical foramen has little effect on the accuracy of Root ZX if the apical constriction is intact. However the measurements of Root ZX should be used carefully when the apical constriction was destroyed.

Dental Pulp Cavity ; Humans ; In Vitro Techniques ; Odontometry ; Root Canal Preparation ; Tooth Apex ; Tooth Root

Objective To investigate the activity change pattern and corresponding significance of gly- colytic enzymes including alsolase A(ALDA)and lactate dehydrogenase M(LDH-M)regulated by hy- poxia-inducible factor 1?(HIF-1?)in spinal cord injury(SCI)of rats.Methods SD rats were ran- domly divided into control group and groups at 12 hours,1,2 and 3 days,1 and 2 weeks after compres- sive SCI,in which the activity changes of ALDA and LDH-M in the injured spinal cord were observed at different time points by means of enzyme histochemistry.Results Opitical density(A)value of AL- DA continued significant increase from two days to one week after SCI(P＜0.05)and decreased gradual- ly at 2 weeks after SCI.A value of LDH-M began significant increase at day 1 after SCI and recovered to normal level at 2 weeks after SCI(P＜0.05).Conclusion Activities of ALDA and LDH-M regulated by HIF-1?in spinal cord injury is significantly increased.