Objective To explore the relevant factors of hematoma enlargement in patients with hypertensive intracerebral hemorrhage(CH) at acute stage.Methods The clinical data of 208 patients with CH(29 patients with hematoma enlargement) were retrospectively analyzed.Results 27 cases(93.1%)of hematoma enlargement group onset at ≤ 24 h after CH.Compared with non-hematoma enlargement group,systolic blood pressure in the hematoma expansion group was significantly increased;and the rates of Glasgow coma scale(GCS) score decreased,basal ganglia hemorrhage,hepatic dysfunction,long-term alcohol drinking,taking Aspirin and diabetes in hematoma expansion group were significantly higher than those in the non-hematoma enlargement group(P

Objective To detect and investigate the expression and the effect of Prohibitin (PHB) in rats with renal interstitial fibrosis (RIF) induced by unilateral ureteral obstruction (UUO) .Methods Forty-eight Wistar male rats (6-weeks-old) were randomly assigned into 2 groups,sham-operated and model group.The model group rats were subjected to left ureteral ligation after anesthesia and the sham-operated group rats were subjected to sham operation.Six rats were killed 7,14,21,28 days after operation respectively.The renal tissues were collected.The index of RIF was calculated.The expressions of mRNA and protein of PHB were assayed by real time polymerase chain reaction and immunohistochemistry. Results Compared with sham-operation group,at each time point,the model group had significantly increased index of RIF (P < 0.01) and the obstruction for a longer period showed the higher index; the model group had significantly decreased expression of mRNA and protein of PHB (P < 0.01) and the obstruction for a longer period showed the lower expression; the model group had significantly increased expression of mRNA and protein of TGF-β1 (P < 0.01) and the obstruction for a longer period showed the higher expression.Correlation analysis showed that the index of RIF was negatively correlated with FHB (γ = -0.825) and positively correlated with TGF-β1 (γ = 0.995),while there was a positive correlation between PHB and TGF-β1 (γ = -0.786).Conclusions The lower expression of PHB in renal tissue of UUO rats might suggest that it play an important role in RIF.

One hundred and seventeen patients with newly diagnosed autoimmune thyroid diseases(AITDs)and 30 normal controls(NCs)were selected.All the patients were divided into 5 groups:hyperthyroidism group(n=33),subclinical hyperthyroidism group(n=21),hypothyroidism group(n=25),subclinical hypothyroidism group(n=23)and euthyroidism group(n=15).Plasma malondialdehyde(MDA),superoxide(SOD)and inflammatory factors levels were measured.Our results showed that plasma MDA level in dysthyroidism groups was significantly higher than that in NCs group(P＜0.05 or P＜0.01).SOD/MDA ratio in AITD groups Was significantly lower than that in NCs group(P＜0.05 or P＜0.01).In a multiple step-wise regression analysis,serum hishly sensitive C-reactive protein(hs-CRP)and tumor necrosis factor-α(TNF-α)were independent factors of MDA.This study might suggest that plasma MDA level in AITD patients receiving no treatment may increase.MDA may be correlated with hs-CRP or TNF-α levels.

Objective To study the effective hemostatic method for treating multiple trauma accompanied with hemorrhagic shock to increase the existence rate. Methods In treating 5 patients of multiple tauma accompanied with hemorrhagic shock, We used radiological embolism to injuried parenchymatous organs and injuried vessels to arrest the bleeding at first. After shock recovered, prompt exploration was made to repair injuried hollow viscus. Results After embolism and bleeding arrested, shocks in all 5 patients were corrected in short time; and no serious active hemorrhage was found after abdominal operation to repair the hollow viscus. All 5 patients survived after the operation. Conclusions The radiological embolism is simple,and has the little trauma and a good hemostatic effect,and needs short time. The method for treating multiple trauma can improve the salvage rate of multiple trauma accompanied with hemorrhagic shock and fit the treatment principle of multiple trauma.

Objective To investigate the effect of pregnancy and spontaneous delivery on the morphologic characteristics of the levator ani muscle and innervation of the vaginal mucosa. Methods Eight nullipara without pelvic floor dysfunction (PFD) and 64 normal primipara undergoing spontaneous delivery were enrolled in this study during July to December 2006 in Peking Union Medical College Hospital. Biopsy specimens of levator ani muscle (LAM) and anterior and posterior vaginal walls were obtained from the puerpera as well as from the 8 nullipara undergoing vaginal operation. The structures of LAM were examined with histological techniques. Vaginal mucosa specimens were examined using immunohistochemistry staining for protein gene product 9. 5 ( PGP 9. 5), vasoactive intestinal poptide (VIP) and ne uropeptide Y ( NPY),and the positive stained nerve fibers were calculated respectively. Results The LAMs of the puerpera undergoing spontaneous delivery presented myogenetic and neurogenetic changes, both acute and chronic.Type Ⅰ muscular fibers were predominant(79% )with both types increasing in diameters [ (86±9)μm and (79±15) μm]. Significantly different ( P < 0. 05 ) innervation of PGP 9. 5, VIP, and NPY nerve fiberswas observed between epithelial lamina of anterior vaginal wall(5.9±3. 3, 7. 6±3. 1 and 8. 2±3. 2, respectively) and that of posterior vaginal wall (3. 8±2. 9, 5.9±3. 1 and 6. 0±3.0, respectively), with the nerve fibers being more in epithelial lamina of anterior vaginal wall, while no difference in the innervation of nerve fibers was observed in the lamina propria. Significantly different( P <0. 05 ) innervation of PGP 9. 5 and VIP nerve fibers was observed in the lamina propria of the anterior vaginal wall in puerperal undergoing vaginal delivery (6.9±3.2 and 4.9±2. 1) compared with those in nullipara (3.9±3.6 and 3. 1±1.2). Conclusions Pathologic changes occur in LAMs and pelvic floor nerves during labor and delivery. LAM fibers become hypertrophy to adapt to the physiological changes during pregnancy. Richer innervation of PGP 9. 5 and VIP nerve fibers in the lamina propria of the anterior vaginal wall in puerpera undergoing spontaneous delivery is beneficial for dilation of the blood vessels and smooth muscles and makes preparation for delivery.

Objective To assess prenatal heart disease screening program by ultrasound. Methods A total of 11 544 second-trimester screening scans were performed before 24 weeks′ gestation on 11 410 women between February 2004 and May 2007 in Obstetrics and Gynecology Hospital of Fudan University. Fetal heart screening was based on four-chamber and outflow tract views( left ventricular outflow + three vessel view). The sensitivity and specificity of different views were evaluated. Follow-up data of newborns was obstained. Results (1) Among 11 544 cases, 48 cases of congenital heart disease (CHD) were diagnosed in utero. Six cases were false negative, and 2 cases were false positive. The incidence of CHD was 0.47% (54/11 544). (2) Thirty-three CHDs were detected based on the four-chamber view, including 18 ventricular septal defect (9 with conotroncal anomalies),6 anomalous atrioventricle valve, 9 disproportion of left/right ventricle. The sensitivity of the four-chamber view alone was 61.11% (33/54), and the specificity was 99. 98% ( 11 488/11 490). Fifteen CHDs were detected based on the left ventricular outflow and three vessel views, including 1 pulmonary atresia, 3 pulmonary valve stenosis, 2 transposition of the great arteries ( TGA ), 1 pulmonary stanosis with TGA, 6 tetralogy of Fallot, and 2 pulmonary stenosis. The sensitivity of the combination of the four-chamber and outflow tract views was 88. 89% (48/54), and the specificity was 99. 98% (11 488/11 490). (3)Of 48 CHDs,11 cases were eceompanied by other malformations. Eleven cases were performed amniocentesis, amony whom 5 cases were trisemy 21. Conclusion The screening program based on four-chamber and outflow tract views shows good sensitivity and excellent specificity. Our prenatal heart screening program is clinically feasible.

OBJECTIVETo prove if it is possible for using the shattering extraction with solvent to extract ingredients of traditional Chinese medicine.

METHODThe shattering extraction with solvent, the refluxing extraction and the ultrasonic extraction were used to extract paeoniflorin from Radix Paeoniae rubra, and to extract baicalein from Radix Scutellariae, and to extract chlorogenic acid from Flos lonicerae japonicae respectively, using ingredient content and extract yield as the measuring indexes.

RESULTThe content of each every ingredient obviously higher by using shattering extraction with solvent than using refluxing extraction or the ultrasonic extraction.

CONCLUSIONThe shattering extraction with solvent is a high efficiency, simple and quick extraction. It may be used to extract the ingredient of three kinds of traditional Chinese medicine.

Benzoates ; isolation & purification ; Bridged-Ring Compounds ; isolation & purification ; Chemical Fractionation ; methods ; Chlorogenic Acid ; isolation & purification ; Drugs, Chinese Herbal ; chemistry ; Flavanones ; isolation & purification ; Glucosides ; isolation & purification ; Monoterpenes ; Solvents ; chemistry ; Time Factors

OBJECTIVETo explore the clinical effect between two approaches for the treatment of supracondylar fractures of humerus by K-wires in children.

METHODSFrom Jan. 2004 to Dec. 2006,117 children with supracondylar fractures of humerus were divided into two groups according to different methods of the K-wires fixation involving two K-wires group and three K-wires group. In two K-wires groups,there were 45 children including 31 boys and 14 girls with an average age of 5.6 years ranging from 1 to 11 years; according to Garland classification, 19 cases were type II, 26 cases were type III. In three K-wires groups, there were 72 children including 47 boys and 25 girls with an average age of 6.8 years ranging from 2 to 12 years; according to Garland classification, 22 cases were type II, 50 cases were type II. The movement and carrying angle of elbow joint were measured for all these patients. According to Flynn criteria for supracondylar fracture the results of two approaches with K-wires were compared.

RESULTSAll patients were followed-up from 2 to 24 months (means 15.4 months). In two K-wires group, the results of Flynn were excellent in 27 cases, good in 12 cases, fair in 4 cases and poor in 2 cases, 41 cases gained bony healing, however, fail of fixation arosed in 4 cases and cubitus varus arosed in 2 cases. In three K-wires group, the results of Flynn were excellent in 60 cases, good in 11 cases and poor in 1 case, all cases of three K-wires group achieved bony healing after 6 weeks of operation, the function of joints recovered through exercise and cubitus varus arosed in one case after operation.

CONCLUSIONThe technique of fixation with K-wires is a stable and reliable methods for unstable supracondylar fracture but medial-lateral three-pin fixation is better than one with two pins.

Bone Wires ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; methods ; Humans ; Humeral Fractures ; surgery ; Infant ; Male

Objective To investigate the prevalence of influenza virus infections in infants and young children during the pandemic period of 2009 influenza A(H1N1)in Beijing.Methods Throat swabs were collected from children visited the affiliated Children's Hospital to Capital Institute of Pediatrics for influenza-like illness from June 1,2009 to February 28,2010.The specific gene segments of 2009 pandemic influenza H1N1 and seasonal influenza viruses were amplified from samples by real-time RT-PCR recommended by WHO and National Influenza Reference Center of China.Results Out of 4363 clinical samples tested by real-time RT-PCR,the total positive rate of influenza A viruses was 29.3%,including 623(14.3%)identified as 2009 pandemic influenza A(H1N1)and 657(15.1%)influenza A viruses without subtype identity.Among those pandemic influenza H1N1 positive,23 were severe cases with 5 deaths.The ages for 618 pandemic influenza H1N1 infected children with completed information were from 14 days to 16 years.The ratio of male to female wag 1.3:1.Among them,25.2% were patients in age group of 1 to 3 years old and distribution of children in age groups of 3 to 6 years old and 6 to 12 years old were similar(about 30.0%).During the survey period,it appeared only one prevalence wave of pandemic influenza H1N1.The positive rate of pandemic H1N1 increased in September and the peak(36.5%of positive rate)was in November and then declined to 2.7%in February 2010.The data from routine influenza virus surveillance from 20-30 clinical samples collected each week indicated an alternative prevalence of seasonal H3N2,pandemic H1N1 and influenza B during this study period.Respiratory syncytial virus(RSV)became predominant in children after the circulating of pandemic H1N1.Conclusion There was an epidemic of pandemic influenza H1N1 in children in Beijing from June 2009 to February 2010,especially in those of preschool and school aged children.Seasonal influenza viruses and pandemic influenza H1N1 were contributed alternatively.

OBJECTIVETo expore the prevention of ulnar nerve injury during fixation of supracondylar fracture in children by a medial-lateral three-pin fixation technique.

METHODSEighty-one patients including 54 boys and 27 girls with average age of 6 years old (2.5 to 11 years)were treated by a three-pin fixation technique with insertion of two Kirscher wires from the lateral side and the third wire through the medial side. They were followed-up without any complications related to the ulnar nerve. According to Garland system, there were 25 cases of type II supracondylar fracture and 56 of type III. All patients were treated by a medial-lateral three-pin fixation technique, and external fixation with plaster for 3 weeks.

RESULTSAll cases achieved immediate stability and long-term bony fusion postoperatively and no iatrogenic ulnar nerve injury happen.

CONCLUSIONThe technique is a stable and reliable methods for unstable supracondylar fracture and the iatrogenic injury ulnar nerve can be avoided completely.

Bone Nails ; Child ; Child, Preschool ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Humeral Fractures ; complications ; surgery ; Humerus ; injuries ; innervation ; surgery ; Internal Fixators ; Intraoperative Complications ; prevention & control ; Male ; Trauma, Nervous System ; prevention & control ; Ulnar Nerve ; injuries