Humans ; Lumbar Vertebrae ; surgery ; Spinal Diseases ; surgery ; Spinal Fusion

Objective To investigate the clinical features and prognosis of replantation of fingertips distal to the middle nail.Methods Between August 2001 and August 2005,16 fingertips amputated in the Ishikawa zoneⅠwere replanted.We anastomosed only the digital arteries,and adopted postoperative bloodletting.Results Fourteen fingertips survived,and two failed.The survival rate was 87.5%.Of the 14 successfully replanted fin- gertips,12 were followed up from 3 to 12 months.The length and appearance of the fingertips recovered and good joint motion were maintained.Their two-point discriminations ranged from 3 to 6 mm.Conclusion Fingertip replantation is an optimal treatment for fingertip amputation distal to the middle nail to regain satisfactory appearance and function of the digits with a high survival rate,but severe crush injury to the amputated part and high cost should be taken into consideration.

A comparison of plant and animal stem cells can highlight core aspects of stem-cell biology. In both kingdoms, stem cells are defined by their clonogenic properties and are maintained by intercellular signals. The signaling molecules are different in plants and animals stem cell niches, but the roles of argonaute and polycomb group proteins suggest that there are some molecular similarities.
Animals ; Plant Cells ; Signal Transduction ; Stem Cells ; cytology ; metabolism

BACKGROUND:Alginate-chitosan microcapsule can improve the mechanical property of sodium alginate hydrogels. How to obtain the ideal sodium alginate-chitosan microcapsule and the prospect for application of the microcapsule system is the key to this study.
OBJECTIVE:To investigate the preparation method and formation mechanism of alginate-chitosan microcapsules, to analyze several important factors affecting the strength of the microcapsule membrane, and to explore the prospects of alginate-chitosan microcapsules in immobilized celltechnology, in tissue engineering and as a drug carrier.
METHODS:The first author searched PubMed, Elsevier ScienceDirect, CNKI and Wanfang database (1987/2013) to retrieve literatures about the preparation method, formation mechanism and application prospect of alginate-chitosan microcapsules.
RESULTS AND CONCLUSION:Sodium alginate hydrogels have many advantages in drug release and tissue engineering, but its application is limited by gel dissolution phenomena and deficiencies in its mechanical properties. Chitosan-alginate microcapsules make up for the deficiency of sodium alginate hydrogels by electrostatic interactions to form polyelectrolyte complexes. By control ing the nature of the chitosan solution--the molecular weight of chitosan, pH and concentration of chitosan solution, we can prepare the microcapsules with high film strength. Alginate-chitosan microcapsules have shown broad application prospects in immobilization technology, drug release and tissue engineering.

Objective To investigate the prevalence of latent tuberculosis infection(LTBI),and to identify the risk factors in primary schoolchildren from Shanghai through the population-based field investigation combined with the tuberculosis infection enzyme-linked immunospot assay(T-SPOT.TB)assay.Methods The children in grade 4 and 5 were enrolled from four primary schools in Pudong new district and Yangpu district of Shanghai.Questionnaire interview was applied to investigate the soeiodemographic and clinical information related to LTBI.The T-SPOT.TB assay was used to detect LTBI in the enrolled subjects.Univaitate and multivariate analyses were used to identify the risk factors associated with LTBI among the primary schoolchildren.Results Totally 472 schoolchildren were enrolled in the present study,with 439(93.0%)being vaccinated with bacillus calmette-guerin (BCG) and ten (2.1%) having contact history with tuberculosis (TB) patients.Among the 472 eligible subjects,16(3.4%) children were T-SPOT.TB positive,who had no clinical symptoms andsigns relevant to TB and were defined as LTBI.The LTBI prevalence in BCG vaccinated and unvaccinated children were 2.7% and 12.1%,respectively (OR:6.972;95%CI:1.834-26.500);those in TB contacts and children without TB contact history were 30.0% and 2.8%, respectively (OR: 16. 38; 95% CI: 3. 692-72. 700). Conclusions The prevalence of LTBI among senior schoolchildren in Shanghai is 3.4%. BCG vaccination is protective for children from LTBI, while daily contacts with TB patients increases the risk of LTBI in schoolchildren.

Objective To investigate the effect and its significance of low-dose insulin on Nmethyl-D-aspartate receptor (NMDAR) level and its downstream signaling of c-Jun N-terminal kinase (JNK) and the extracellular signal-regulated protein kinase (ERK,p44/42MAPK) in streptozotocininduced diabetic rats.Methods Ten-week-old male SD rats were randomly divided into 3 groups:control group,diabetic group and insulin-treated diabetes group.Diabetes was induced by streptozocin (STZ,60mg/kg) injected intraperitoneally.Two weeks after STZ injection,insulin glargine (92u/day for 8 weeks) was subcutaneously injected in the insulin-treated diabetes group.Then,the rat lumbar spinal cords were collected.The protein levels of phospho-Insulin receptor substrate 1 (P-IRS1),phospho-NMDAR NR1 subunit (P-NR1),P-JNK and P-p44/42MAPK were evaluated by Western blotting.One week before the terminal of the study,paw thermal response latency was measured in all groups.Results Blood glucose levels were tremendously high in both the diabetic group and insulintreated diabetes group.Compared with the control group,paw thermal response latency was markedly shortened in the diabetic group (P＜ 0.001) and the insulin-treated diabetes group (P＜ 0.001),and the alteration was more pronounced in the diabetic group (P＜0.05).Compared with the control group,the protein levels of P-IRS1,P-NR1,P-JNK and P-p44/42MAPK were increased by 79.2％,35.1％,47.6 ％,64.3 ％ and 87.6 ％,respectively in diabetic group and 49.4 ％,19.1％,16.5 ％,31.8％ and 39.9％,respectively in insulin-treated diabetes group (all P＜0.001 or 0.05).In comparison with diabetic group,the increased amplitudes of above 4 parameters were decreased by 29.8％,16.0％,31.2％,32.5％ and 47.7％ respectively in the insulin-treated diabetes group (all P＜0.05).Conclusions NMDAR and its downstream signals,such as JNK and p42/44MARK,are involved in the pathogenesis of painful diabetic neuropathy.Although it could not efficiently control the blood glucose level,low-dose insulin treatment may partly inhibit the occurrence of thermal hyperalgesia through inhibiting NMDAR signal pathway.

Objective To identify the clinical and imaging characteristics in neonatal refractory purulent meningitis. Methods Clinical data of 70 cases of neonatal purulent meningitis admitted to the neonatal intensive care unit at Children's Hospital of Fudan University from January, 2009 to December, 2014 were reviewed retrospectively. The patients were divided into refractory group (n=28) and non-refractory group (n=42) according to the course of antimicrobial therapy.The clinical and brain MRI characteristics of neonatal refractory purulent meningitis were analyzed. Parameters were compared between the two groups using Chi-square or Fisher's exact tests, and Wilcoxon tests where appropriate. Risk factors of neonatal refractory purulent meningitis were investigated by univariate and multivariate Logistic regression analysis. Results Among the 70 cases, 31(44.3%) were positive for cerebrospinal fluid (CSF)/blood culture. The positive rate was higher in the refractory group than in the non-refractory group [75.0%(21/28) vs 23.8%(10/42),χ2=17.843, P<0.01]. The most common pathogenic bacteria isolated in the refractory group were Escherichia coli [8 cases (38.1%)] and group B streptococci [5 cases (23.8%)]. Compared to the non-refractory group, patients in the refractory group were more likely to have seizure, higher CSF white blood cell count, higher CSF protein concentration and lower CSF glucose concentration [53.6%(15/28) vs 7.1% (3/42), 965.0 (463.0-2 200.0)×106/L vs 116.5 (61.0-327.5)×106/L, 3 221.1(2 354.3-4 633.5) mg/L vs 1 487.6(988.2-1 924.1) mg/L, and 0.2 (0.1-0.8) mmol/L vs 1.5 (1.2-1.8) mmol/L; all P<0.01]. Multivariate Logistic regression analysis showed that seizure, low CSF glucose concentration on admission, and a positive CSF/blood culture result neonatal refractory purulent meningitis (OR=9.6, 95%CI: 1.2-76.0; OR=15.0, 95%CI: 5.6-63.3; and OR=7.3, 95%CI: 1.5-36.0, respectively). Abnormal brain MRI findings, including intracranial extracerebral space abnormality, ventricular dilatation and periventricular white matter injury, were more common in the refractory group [100.0%(28/28) vs 61.9%(26/42), χ2=13.827 totally; 64.3%(18/28) vs 21.4%(9/42), χ2=13.023 for intracranial extracerebral space abnormality; 60.7%(17/28) vs 19.0%(8/42), χ2=12.704 for ventricular dilation and 28.6%(8/28) vs 2.4%(1/42) for periventricular white matter injury; all P <0.01]. Compared with the non-refractory group, the refractory group had a longer hospital stay [(48.0±17.4) d vs (26.0±10.2) d, t=6.016, P<0.01] and more adverse events [67.9%(19/28) vs 31.0%(13/42), χ2=9.220, P=0.002], including hearing impairment and requirement of neurosurgical intervention [14/18 ears vs 10/46 ears (21.7%), χ2=4.292, P=0.038]. There was no death in both groups during hospitalization. Conclusions Neonates with seizure, low CSF glucose concentration and positive CSF/blood culture results are more likely to have refractory purulent meningitis. Brain MRI abnormalities are more common in neonatal refractory purulent meningitis.

Objective To investigate the clinical features of neonatal invasive fungal infection(IFI) so as to guide diagnosis,prevention and treatment of IFI.Methods Seventy-six neonates with IFI admitted to the Neonatal Intensive Care Unit (NICU) at Children's Hospital of Fudan University from 2004 to 2014 were included in the study.Pathogens,clinical manifestation,risk factor exposure,laboratory findings,complications,and clinical outcome of neonatal IFI were analyzed.Results Seventy-six cases were diagnosed as IFI between 2004 and 2014,with an yearly increasing trend.Sixty-eight patients were premature infants (89.5％).Of the 76 cases,except one with unknown birth weight,11(14.7％),34(45.3％),20(26.7％)and 10 (13.3％) cases had birth weight ＜ 1 000 g,(≥ 1 000-＜1 500) g,(≥ 1 500-＜2 500) g and ≥ 2 500 g,respectively.The pathogens were mainly Candida (74/76,97.4％),including 26 cases of Candida albicans (34.2％).However,the incidence of non-Candida albicans infection was increasing.Candida guilliermondii was the most common in nonCandida albicans,accounting for 29.2％ (14/48).All Candida albicans were sensitive to fluconazole.One strain of Candida glabrata was resistant to fluconazole.The most common risk factors included use of broad-spectrum antibiotics(93.3％,56/60),parenteral nutrition(70.0％,42/60),central vein catheterization(53.3％,32/60),invasive ventilation(40.0％,24/60) and history of abdominal surgery(21.7％,13/60).Clinical manifestations of IFI included temperature instability,frequent apnea,increased requirement of respiratory support and feeding intolerance.Among all cases,six were diagnosed as central nervous system infection.Of the patients who received cranial MRI,46.8％(22/47) showed multiple abnormal signals in cerebral parenchyma.Fiftytwo patients were cured and seven patients died before discharge,including one death due to fungal infection.Conclusions There is an increasing trend of IFI cases in NICU,especially in premature infants.Non-Candida albicans has become the main pathogenic fungus.There are no specific clinical manifestations in neonatal IFI.Use of broad-spectrum antibiotics,parenteral nutrition and central venous catheterization are common risk factors,and preventive measures should be taken in high-risk infants.In addition,IFI in neonates may affect important organs such as central nervous system,thus early treatment is necessary in suspected patients.

AIM: To observe the changes of AC activity and content of cAMP at different time point in hypothalamus of rats with fever and hypothermia. METHODS: Radioisotope method was used to measure the enzymatic activity of AC and the content of cAMP. RESULTS:(1)The fresh yeast caused fever after making model 4 h( P

AIM: To observe the changes of adengl cyclase(AC) and phosphodiesterase(PDE) activities of at different time point in hypothalamus of rats with fever and hypothermia. METHODS: Radioisotope method was used to measure the activity of AC and PDE. RESULTS:The fresh yeast caused rats fever after subcutaneous injection 4h( P