Objective To investigate the influence of vitamin B supplementation on the plasma total homocysteine (Hcy), serum folate, serum vitamin B12, serum vitamin B6, and clinical state of senile epilepsy.Methods A total of 132 senile epilepsy patients with hyperhomocysteinemia, who visited the Second Affiliated Hospital of Soochow University from January 2013 to July 2015, were enrolled into this study.Eighty-three patients who accepted the therapy of vitamin B supplementation (folate 2.5 mg/d, vitamin B6 10.0 mg/d, vitamin B12 1.5 mg/d) were selected as treatment group, and 49 patients with no vitamin B supplementation were selected as control group.All patients were followed-up for one year.The differences of serum Hcy, folate, vitamin B12, vitamin B6 and seizure frequency, MMSE scores, Hamilton Depression Rating Scale (HDMA) scores between the treatment and the control groups were compared.According to the concentration of serum Hcy, 132 patients were divided into two groups: 75 patients (46 patients in the treatment group and 29 patients in the control group) with mild hyperhomocysteinemia (Hcy: 15.0-29.9 μmol/L), 57 patients (37 patients in the treatment group and 20 patients in the control group) with moderate-severe hyperhomocysteinemia (Hcy≥30.0 μmol/L).The differences of serum Hcy, folate, vitamin B12, vitamin B6 and seizure frequency, MMSE scores, HDMA scores between the treatment and the control group in the mild hyperhomocysteinemia group and in the moderate-severe hyperhomocysteinemia group were compared.And the influence factors of Hcy were analyzed.Results Correlation analysis revealed that Hcy was positively correlated with age (r=0.269, P=0.002), and negatively correlated with folate (r=-0.222, P=0.010).Hcy was associated with smoking (χ2=7.363,P=0.007), hypertension (χ2=6.187,P=0.013), and two or more antiepileptic drugs polytherapy (χ2=4.708,P=0.030).After vitamin B supplementation in the group of moderate-severe hyperhomocysteinemia, serum Hcy concentration ((15.68±4.85) μmol/L in the treatment group vs (31.14±11.18) μmol/L in the control group, t=5.890, P<0.01), seizure frequency (4.85±2.78 vs 6.15±1.95, t=2.028, P=0.047) and HDMA scores (15.22±7.55 vs 17.70±4.90, t=2.862, P=0.005) decreased, whereas serum folate ((9.08±3.33) ng/ml vs (5.87±2.91) ng/ml, t=3.618, P=0.001), vitamin B12 ((556.39±276.76) pg/ml vs (419.71±164.53) pg/ml, t=2.336, P=0.023), vitamin B6 ((22.94±5.59) μmol/L vs (21.09±4.87) μmol/L, t=2.029, P=0.047) and MMSE scores (26.89±1.94 vs 25.75±2.20, t=2.024,P=0.048) increased in the treatment group compared with the control group.While in the group of mild hyperhomocysteinemia, the differences of seizure frequency, HDMA and MMSE scores were not statistically significant between the treatment group and the control group (all P>0.05).Conclusions It is necessary to monitor serum Hcy for senile epilepsy.Vitamin B supplementation is a safe and inexpensive way to reduce the concentration of Hcy, assist to control seizures and improve the clinical symptom of depression and cognitive impairment for senile epilepsy with moderate-severe hyperhomocysteinemia.

To investigate the methods of learning coaxial microincision phacoemulsification and assess the related complications.METHODS:The clinical data of 1 080 eyes of coaxial microincision phacoemulsification performed by beginners from October 2011 to December 2013 was retrospectively analyzed. ln order of surgery dates, the patients were equally divided into groups A, B, C and D, 270 eyes in each group. Comparisons were made among the four groups in operation time, cumulative dissipated energy (CDE), rate of intraoperative, and postoperative complications at 1d; and best corrected distance visual acuity (BCDVA) at 1mo postoperatively.RESULTS:No significant differences were found in age, sex, lens grading, BCDVA at 1mo postoperatively among the four groups ( P> 0. 05 ). The operation time was significantly longer in group A than in groups B, C and D (25. 15 ± 3. 11min vs 15. 20 ± 3. 40min, 14. 71 ± 3. 02min and 14. 41±2. 91min, P<0. 05). No significant differences were found in the operation time among the other three groups (P>0. 05). The CDE of grade ‖ and Ⅲ was significantly higher in group A than that in groups B, C and D (95. 9%, 97. 8% and 98. 5%) (P<0. 01). The number of continuous curvilinear capsulorhexis ( CCC ) were performed successfully was significantly less in group A ( 80. 7%) than the other three groups (95. 9%, 97. 8% and 98. 5%) (P<0. 01). The incidence of posterior capasular rupture of group A (7. 8%) was higher than that of group B (3. 7%), group C (1. 1%) and group D (0. 4%) (P<0. 05), but there was no significant difference between group C and group D (P>0. 05). There were no significant differences both in the number of corneal edema and BCDVA at 1d between group A and group B. (P=0. 66, P=0. 53).CONCLUSlON: With learning step by step, appropriate training program, careful case selection, and accurate managing complications, coxial microincision phacoemusification can be safe for a beginner.

OBJECTIVETo investigate effects of elastic stable intramedullary nails for the treatment of radial neck fracture in children.

METHODSFrom July 2006 to December 2011, 25 children with radical neck fractures, which included 16 males and 9 females aged from 7 to 15 years old (means 10.7), were treated with elastic stable intramedullary nails. According to Judet classification, 6 cases were type II, 17 cases were type III and 2 cases were type IV (including 1 case with type IVa and 1 case with type IVb). The fracture healing, pain, deformity and range of motion of elbow were recorded.

RESULTSAll patients were followed up for 6 to 24 months with an average of 14 months. Twenty-five patients were obtained bone healing. According to Tibone and Stoltz evaluation standard, 18 cases got excellet results, 4 cases in good and 3 cases in moderate.

CONCLUSIONElastic stable intramedullary nails for the treatment of radial neck fracture in children has advantages of simple operation,less trauma and good results.

Adolescent ; Bone Nails ; Child ; Female ; Fracture Fixation, Intramedullary ; Humans ; Male ; Radius Fractures ; physiopathology ; surgery ; Range of Motion, Articular ; Treatment Outcome

OBJECTIVETo discuss the curative effect of traditional treatment and combination therapy for senile hip fracture.

METHODSUsing prospective methods to choose 300 cases of elderly patients with hip fractures from February 2011 to December 2012, which were randomly divided into comprehensive treatment group and conventional treatment group. After screening, 148 case were in comprehensive treatment group,including 62 males and 86 females with an average age of (78.76 +/- 7.32) years old ranging from 60 to 88; 45 cases were intertrochanteric fracture of femur, 103 cases were fracture of neck of femur; Singh index > or = IV in 74 cases, < IV in 74 cases;preoperative Harris score was 39.90 +/- 2.28. There were 146 cases in conventional treatment group,including 60 males and 86 females with an average age of (80.00 +/- 7.06) years old ranging from 66 to 96; 50 cases were intertrochanteric fracture of femur, 96 cases were fracture of neck of femur; Singh index > or = IV in 75 cases, < IV in 71 cases; preoperative Harris score was 40.10 +/- 2.81. Preoperative general situation,leaving bed time and hospital stay, the incidence of postoperative 12 weeks Singh index > or = IV and DPD/Cr value, Harris score at 12 months after operation and the incidence of fracture again of two groups were observed and compared.

RESULTSIn comprehensive treatment group 140 patients were followed up for 12 to 18 months with an anverage of 14.80 +/- 1.85. In conventional treatment group 132 patients were followed up for 12 to 14 months with an average of 12.75 +/- 0.79. There were no significant differences in age, gender, the classification of fracture, preoperative Harris hip score, preoperative Singh index > or = IV level and DPD/Cr value between the two groups (P > 0.05). Comprehensive treatment group had shorter leaving bed time and hospital stay, smaller postoperative 12 weeks DPD/Cr value and higher postoperative Harris score, higher incidence of postoperative 12 weeks Singh index > or = IV level, lower incidence of fracture again than conventional treatment group, there was statistically significant difference between two groups (P < 0.05).

CONCLUSIONFor the anti-osteoporosis effect, the comprehensive treatment group has more advantage than traditional treatment group in elderly hip fracture, which can further improve the elderly hip fracture treatment and provide the reference of evidence-based medicine cooperate with rehabilitation department.

Aged ; Aged, 80 and over ; Case-Control Studies ; Female ; Hip Fractures ; surgery ; Humans ; Incidence ; Length of Stay ; Male ; Postoperative Complications ; epidemiology ; Prospective Studies

Objective To investigate esophageal response to intraesophageal balloon-distention and acid perfusion stimuli and to evaluate the visceral hypersensitivity in non erosive reflux disease (NERD) patients.Methods Thirty-one NERD patients diagnosed by reflux disease questionnaire (RDQ) and endoscopy and 10 control subjects were enrolled in this study.Esophageal mechanical sensitivity was measured by esophageal barostat and recorded as initial perception threshold and maximal tolerated pain threshold by volume.The chemical sensitivity was measured by acid perfusion test,and quantified by two parameters (trigger time and acid related symptom score).Results Initial perception threshold and maximally tolerated pain threshold of NERD patients was (9.6?4.8) ml and (12.3?3.2) ml, significantly lower than those of controls,(13.2?7.5) ml and (21.6?5.7) ml,respectively (P

Objective:To investigate the prevalence and related factors of dental caries in 3-year-old children in the Development District in Dalian.Methods:A multi-stage,randomized,cluster sampling method was used in the cross-sectional study.All 3-year-old children in the selected 15 kindergartens were invited to take part in the oral health examination conducted by 3 calibrated examiners.The WHO recommended caries diagnosis criteria were used.The structured questionnaire including the information of children's oral hygiene habits,dietary habits,parents' oral health knowledge and socioeconomic status was completed by the parents.Results:1 220 3-year-old children completed the clinical oral examination and 964 children's parents(79.0％) finished the questionnaire.The caries prevalence in 3-year-old children was 62.8％,and the mean dmft and dmfs scores were 3.40 and 7.34,respectively.No differences in the prevalence of caries,mean dmft and dmfs scores were found between boys and girls(P ＞0.05).Logistic regression analysis showed that the frequency of sweets and sugar-containing beverages consumption(P＜0.05),parents'education level(P＜0.05) were significantly related to the caries prevalence.Conclusion:The prevalence and severity of dental caries in 3-year-old children in Dalian Development District were high and the frequency of consumption sugar-containing foods and beverages,parents'education level were related to the decay prevalence.

AIM: (1) To investigate the effect of amniotic membrane transplantation (AMT) on rabbit conjunctival surface reconstruction with severe alkali burns. (2) To evaluate the possibility of AMT treatment for ocular alkali burns during recovering stage.METHODS: Animal models were established on 30 eyes of rabbits by creating severe alkali burns on the conjunctiva from the upper corneal limbus to the upper conjunctival fornix.Preserved human amniotic membrane transplantations and reconstruction of conjunctival fornix were performed at one week after injury (recovering stage). Epithelium growth of burned area after transplantation was observed using light microscope at 1, 2, 3, 4, and 8 weeks. Conjunctival tissue in transplantation area was collected at 1, 4 and 8 weeks. The ultrastructure of the collected tissue was studied by electron microscope. The results were compared with control group,which received only vitamin C subconjunctival injection and antibiotic eye drops as treatment for alkali burn. Exterior eye pictures were also taken at the end of the observation, the width from upper corneal limbus to the edge of upper fornix was measured. Data was analyzed statistically.RESULTS: 1) Tn the transplant group, conjunctival epithelium growth was observed in the area of AMT under both light and electron microscope 1 week after surgery. At 4weeks, conjunctival epithelium with goblet cells that resembled normal conjunctival tissues was observed in the whole amniotic membrane area. At 12 weeks, the conjunctival epithelium on the amniotic membrane was well formed, and the connective tissue under the epithelium was loose at the fornix. No fibrosis was identified. In contrast, conjunctival epithelium necrosis was observed in the control group at 2weeks after alkali burns. Re-epithelization did not occur through the 12-week observation. Severe fibrosis with inflammatory cells infiltration was observed between 4 to 8weeks. At 12 weeks, fibrosis of the connective tissue at the fornix developed and there were no conjunctival epithelium covering the burned area. 2) In the transplant group, the conjunctiva in transplanted area had no scarring and appeared smooth at 12 weeks. Upper fornix was reconstructed. The depth of fornix was 7.9±0.3mm (7.6-8.2mm), which was approximate to the normal depth 8.2±0.2mm (8.0-8.4 mm,P＞.05). While in the control group, the burned area appeared rough with granuloma formation and severe scarring. Upper fornix became shallow. The depth of fornix was 3.1±1.7mm(1.0 to 4.5mm.), and significant difference was found between control and transplant group (P＜0.01).CONCLUSION: Human amniotic membrane preserved in glycerin can promote cell adhering, migrating and differentiating of normal conjunctival epithelium.Reconstruction of conjunctival surface in early stage of alkali burn can be achieved by AMT. AMT can effectively prevent symblepharon formation.

Objective:Discussion MKK4 protein expression in nasopharyngeal carcinoma and -1044 A/T polymorphism correlation.Methods:90 patients with nasopharyngeal carcinoma , MKK4 protein expression was determined by immunohistochemical staining,polymerase chain reaction-restriction fragment length polymorphism ( PCR-RFLP ) to detect the gene -1044A/T sites monocytes nucleotide polymorphism.Results:MKK4 protein expression in nasopharyngeal carcinoma (-) was 24.4%(22/90),(+) was 15.6%(14/90),(++) was 34.4%(31/90),(+++) was 25.6% (23/90).Low expression (-/+) patients with a total of 36 cases,-1044AA genotype accounted for 22 cases (61.11%),AT genotype accounted for 12 cases (33.33%),TT genotype accounted for two cases (5.56%),AT+TT gene type accounted for 14 cases (38.89%).The patients with high MKK4 expression of 54 cases,of which accounted for 38 cases of AA genotype (70.37%),AT genotype accounted with 15 cases (27.78%),TT genotype accounted for one case (1.85%),AT +TT genotype accounted for 16 cases (29.63%).Low expression and high expression of T gene mutation occurs no significant ( Z=0.323 , P=0.747 ) .Conclusion: MKK4 protein expression correlated with -1044 A/T gene promoter polymorphisms was no significant correlation .

To find the related syndrome factors of gouty arthritis with blood stasis syndrome by mathematical methods of set pair analysis and connection number so as to guide the diagnosis.

Objective To test the reliability and validity of the Chinese version of Profile of Fatigue Scale (PROF)among the patients with Sjogren′s syndrome. Methods The English version of PROF was translated into Chinese according to Brislin Translation Model. 107 patients with Sjogren′s syndrome were investigated to test its reliability and validity. Results The Cronbachαcoefficient , Guttman split-half coefficient, test-retest reliability and content validity of Chinese version of PROF were 0.976, 0.953, 0.872 and 0.875. Two factors were extracted by factor analysis and the cumulated variance was 80.75%. The structure of PROF was in line with the original scale. The criterion-related validity was 0.621 measured by comparing with visual analog scale of fatigue, and was -0.707 measured by comparing with vitality domain in the MOS item Short From Health Survey (SF-36). Conclusions The Chinese version of PROF has been proved to be reliable and valid. It can be used to measure the fatigue in Chinese patients with Sjogren′s syndrome.