Objective To investigate the influence of dexmedetomidine on expressions of protein kinase c (PKC)γ, cal?cium/calmodulin-dependent protein kinase (CaMK)Ⅱαand pCaMKⅡαin spinal cord in rats with incisional pain (IP) and remifentanil-induced hyperalgesia. Methods Forty male Sprague-Dawley rats, aged 2-3 months, weighing 240-260 g, were randomly divided into 5 groups (n=8 each):blank control group (group C), remifentanil+incisional pain group (group R+I), dexmedetomidine + remifentanil + incisional pain group (group D+R+I), dexmedetomidine + remifentanil + incisional pain+phorbol myristate acetate+DMSO group (group D+R+I+P+DMSO) and dexmedetomidine+remifentanil+incisional pain+DMSO group (group D+R+I+DMSO). The incisional pain rat model was established by a plantar incision in left hind paw. Remifentanil was infused at a rate of 1.2μg·kg-1·min-1 for 90 min via the caudal vein. Dexmedetomidine was adminis?tered subcutaneously at a dose of 50μg/kg at 30 min before plantar incision. Phorbol myristate acetate and DMSO were intra?thecally injected at a dose of 10 μL. Paw withdrawal latency (PWL) to thermal stimulation and paw withdrawal threshold (PWT) to von Frey hair stimulation were measured 24 h before remifentanil infusion (T0) and at 2, 6, 24 and 48 h (T1-4) after intraveonus remifentanil injection. The rats were sacrificed after the last behavioral test and the L 4-6 segment of spinal cord was removed to determine the expressions of PKCγ, CaMKⅡαand pCaMKⅡαin spinal cord by Western blot analysis. Re? sults Compared with group C, the value of PWL was significantly shortened and PWT was significantly decreased except T0, and the expressions of PKCγ, CaMKⅡαand pCaMKⅡαwere up-regulated in other groups. Compared with group R+I, the value of PWL was significantly prolonged and PWT was significantly increased, the expressions of PKCγ, CaMKⅡαand pCaMKⅡαwere down-regulated in group D+R+I and group D+R+I+DMSO. Compared with group D+R+I, the value of PWL was significantly shortened and PWT was significantly decreased, the expressions of PKCγ, CaMKⅡαand pCaMKⅡαwere up-regulated in group D+R+I+P+DMSO. Compared with group D+R+I+P+DMSO, the value of PWL was significantly prolonged and PWT was significantly increased, the expressions of PKCγ, CaMKⅡαand pCaMKⅡαwere down-regulated in group D+R+I+DMSO. Conclusion Dexmedetomidine can reduce the expressions of PKCγ, CaMKⅡαand pCaMKⅡαin spinal cord in rats with IP and hyperalgesia induced by remifentanil.

Objective To explore the effects of different processing parameters of mobile digital radiography (DR) on image quality of bedside chest radiography.Methods Post processing parameter on 150 cases bedside DR chest image like multi frequency laplasse transform (MLT),image processing (IP) were modified,and the optimization scheme of post-processing parameters were analyzed and summarized.The paired sample t test was used to compare the difference of the imaging quality score and optical density between the default parameter group and the post processing parameter optimization group through measure the optical density of lung related area.Results Brightness,contrast and the low density in dynamic range were the main factors affecting the quality of bedside chest radiography.After modifying and optimizing the post-processing parameters,the density value of the second intercostal area was 1.68±0.04,the density value of the hilum was 0.77±0.46,the density value of pulmonary peripheral (near chest wall 1 cm and overlap with a single rib) was 0.62± 0.06,the density value of cardiac shadow was 0.44 ± 0.04,the density value of subphrenic was 0.37 ± 0.04,the lung markings was clearly showed in the lateral field of lung and was visible in the spine and heart shadow area which meet the diagnostic requirement.The density value of those parts before modify were lower than the modify value which was more closer to the reference density value,and the difference had statistically significant.The image quality score of the postprocessing parameter optimization group was 3.53 ± 0.14,which was higher than 3.02 ± 0.23 of the default parameter group,and the difference had statistically significant.Conclusion The appropriate post-processing parameters is the key to guarantee the reasonable density of lung areas image quality and the optimization post-processing parameter can improve the image quality of bedside chest radiography by the mobile DR.

Objective To observe the effects of eye acupuncture and body acupuncture on tumor necrosis factor-α(TNF-α) expression in the cerebral cortex of rats after ischemia-reperfusion injury,in order to investigate the differences in therapeutic function between eye acupuncture and body acupuncture against acute cerebral ischemia-reperfusion injury. Method 48 Rats established by suture method were randomly divided into control group,sham operation group,model group,eye-acupuncture in point area group,eye-acupuncture outside point area group and body acupuncture group. After reperfusion 24 h,the neurophysical behaviours were accessed by ZeaLonga neurophysical impairment marks;the levels of plasma TNF-αwere determined by ELISA method;the expression of ischemic cerebral cortex TNF-αmRNA was measured by RT-PCR method;the expression of ischemic cerebral cortex TNF-αprotein was detected by western blot. Results After reperfusion 24 h,compared with control group,neurologic impairment marks of eye-acupuncture therapy in point area group and body acupuncture group both decreased obviously (P<0.01),however there were no significant differences between the eye-acupuncture in point area group and body acupuncture group;the levels of plasma TNF-αin rat cerebral cortex after the eye acupuncture therapy and body acupuncture therapy were obviously decreased (P<0.01),however there were no significant differences between the eye-acupuncture in point area group and body acupuncture group; the expressions of TNF-α mRNA and protein in rat cerebral cortex after the eye acupuncture therapy and body acupuncture therapy were also obviously down-regulated (P<0.01),however there were no significant differences between the eye-acupuncture in point area group and body acupuncture group.Conclusion The eye and body acupuncture therapy show the same effects on treating cerebral ischemia reperfusion. The mechanisms of these two therapies may be related to up regulating TNF-αexpression in rat cerebral cortex with ischemia-reperfusion injury.

Objective To explore the safety of unilateral percutaneous kyphoplasty (PKP) in treating osteoporotic vertebral burst fracture.Methods All 25 osteoporotic vertebral burst fracture cases (25 fracture segments) treated from April 2014 to July 2015 were analyzed retrospectively.In 25 cases,there were 17 males and 16 females,aged from 58.0 to 88.0 years with a mean age of 76.6 years.All patients included in the study had preoperative thoracic or lumbar X-rays,CT reconstruction and MR fatsuppression sequence scan in order to definite fracture sites and the integrality of the posterior wall of fracture vertebral.The unilateral PKP were performed by the same operator.All patients included in the study had postoperative thoracic or lumbar X-rays,and CT reconstruction to observe the bone cement leakage.After patients were out of hospital,X-rays were done regularly.The types of bone leakage were recorded.The pre-and post-operational anterior and posterior wall and the kyphotic angle were measured by one doctor.Results The scores of VAS at the first day after operation and the end of follow up decreased compared with the pre-operative scores:(2.8 ± 1.2),(2.4 ± 1.6) scores vs.(6.4 ± 2.6) scores,and there were significant differences (P ＜ 0.05).The kyphotic angle at the first day after operation and the end of follow up decreased compared with the pre-operative,but there were no significant differences (P ＞ 0.05).The post-operative height of vertebral anterior wall increased at the first day after operation and the end of follow up compared with the pre-operative:(21.7 ± 5.0),(21.4 ± 4.1) mm vs.(20.3 ± 3.8)mm,and there were significant differences (P ＜ 0.05).The post-operative height of vertebral posterior wall increased at the first day after operation and the end of follow up compared with the pre-operative,but there were no significant differences (P ＞ 0.05).The above index at the first day after operation and the end of follow up had no significant differences (P ＞ 0.05).Conclusions The unilateral PKP in treating osteoporotic vertebral burst fracture is safe and reliable.Clear image display,skillful puncture techniques and suitable injection timing are necessary factors for a successful operation.

The efficacy of vertebroplasty and percutaneous kyphoplasty in treatment of osteoporotic compression fracture was widely recognized recently.But the complication of bone cement pulmonary embolism was severe and it can threaten life.In this article,the incidence,pathogenesy,risk factors,symptom,auxiliary examination,treatment and prevention of bone cement pulmonary embolism were reviewed.

Objective Less research has been done in the influence of two-child pohcy on mode of delivery.The article aimed to investigate the rates of cesarean section before and after two-child policy along with indications and complications in order to provide scientific basis and solution for improving the vaginal delivery rate.Methods Retrospective analysis was conducted on medical record data of 7044 puerperas in Nanjing General Hospital of Nanjing Military Region before (3,526 women from January 1,2012 to December 31,2013)and after (3,518 women from January 1,2015 to December 31,2016) two-child policy.Before the two child policy there were 3122 primiparas and 404 multiparas,after two-child policy there were 2546 primiparas and 972 muhiparas.Comparison was done between two groups in the aspect of vaginal delivery rate,cesarean section rate and the distribution of primiparas in choosing the mode of delivery.Results The vaginal birth rate of women before and after the policy was 59.22％ and 63.22％ respectively,among which the rate of vaginal delivery of primiparas increased dramatically from 60.57％ before the policy to 66.10％ after the policy(P＜0.05).After two-child policy,the primiparas cesarean section indication with social factors,macrosomia decreased,which was 12.67％ vs 5.68％、16.65％ vs 11.82％,respectively.However,the rate of cesarean section with in-vitro fertilization increased,which was 5.52％ and 10.10％ respectively (P ＜ 0.05).Conclusion After two-child policy,the puerperant,especially for the primiparas were more likely to choose vaginal spontaneous delivery.At the same time,the proportion of the primiparas caesarean section also changed.The mode of delivery should depend on corresponding indications properly.

Objective To analyze the character of Pol-specific T lymphocyte responses and identify immunodominant region recognized in Chinese HIV-1 recombinant subtype B/C infectors at different stages of diseases. Methods Eleven Chinese HIV-1 recombinant subtype B/C infectors infected in 18 months, 25 which infected time more than 3 years and 10 HIV-1-seronegative healthy individuals were enrolled. HIV-1-specific T lymphocyte responses were analyzed by an IFN-γ ELISPOT assay against 249 overlapping peptides spanning HIV-1 Pol protein in the present study. Results Pol-specific T lymphocyte responses of IFN-γsecretion were identified in 8 (72.73%) out of 11 infectors infected in 18 months, the specific T lymphocytes are mainly targe-ted at six peptides which amino acid position from Pol 481 to 631 in reverse transcriptase region: Pol5581, Pol5582, Pol5587, Pol5609, Pol5610 and Pol5615. There was a negative correlation between the breadth of re-sponse and peripheral CD4+ T cell count (P=0.0212, r=-0.762) ; Responses were identified in 15 (60%) out of 25 chronic infectors, the specific T lymphocytes are mainly targeted at four peptides which amino acid po-sition from Pol 241 to 295: Pol5521, Pol5525, Pol5526, Pol5531 and another peptide: Pol5638 which amino acid position from Pol 708 to 722 in reverse transcriptase region. There was a positive correlation between the magnitude of Pol-specific IFN-γ secretion T lymphocyte responses and plasma viremia (P = 0.006 95 , r = 0.660) . None of the seronegative healthy individuals gave the positive responses. Conclusion Chinese HIV-1 recombinant subtype B/C infectors at different stages of diseases mainly recognized different re-gions of Pol.

OBJECTIVETo summarize the methods and experiences in surgical treatment of hemifacial microsomia.

METHODSFifty-eight cases of hemifacial microsomia that have been treated by plastic and reconstructive surgery and followed-up in our department during last 20 years have been reviewed. Every patient's characteristic was assessed by physical examination, photography, craniofacial cephalometry before planned the method of surgery. Different surgical treatments were chosen according to the side and the structures involved in the abnormalities and the severity of hemifacial microsomia, and the cases were followed up since 3 months after the treatments. The follow-up lean of midline of the lower 1/3 face with that before treatment is compared. The degrees of patients' and surgeons' satisfactions with the treatments were evaluated respectively.

RESULTSThe average angle of lean of midline of skeletal and soft tissue of the lower 1/3 face decreased 4.2 degrees and 2.9 degrees respectively after treatment. Fifty (82.6%) cases satisfied with the outcome of the surgical treatment and surgeons satisfied with 84.5% of the outcome of all the cases.

CONCLUSIONSIndividual surgical treatment based on the side and the structures involved in the abnormalities can effectively correct facial asymmetry of hemifacial microsomia.

Adolescent ; Adult ; Child ; Child, Preschool ; Facial Asymmetry ; surgery ; Female ; Follow-Up Studies ; Humans ; Infant ; Male ; Middle Aged ; Orthopedic Procedures ; methods ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo establish the quantitative diagnostic criteria for cranio-orbito-zygomatic deformity (COZD).

METHODSComputer-assisted three-dimensional (3-D) CT measurement was performed in 30 cases with unilateral COZD. The differences of the measurement data between the affected and unaffected sides were analyzed. Then the patients were diagnosed and classified according to the affected bone, soft tissue and conjunctival sac. Based on the quantitative diagnosis, 8 patients underwent surgery to test the clinical practicability of the diagnostic criteria.

RESULTSThe quantitative diagnostic criteria for COZD could reflect the affected area and the corresponding severity of deformity. It helped to preoperative design and to predict movement of osteotomy segment and. the soft tissue volume needed for augmentation. Good postoperative results were achieved.

CONCLUSIONSThe quantitative diagnostic criteria for COZD can describe the affect area and severity of deformity in detail. It is very practical in the guidance of clinical treatment.

Adolescent ; Adult ; Bone Diseases, Developmental ; diagnostic imaging ; Child ; Diagnosis, Computer-Assisted ; standards ; Humans ; Imaging, Three-Dimensional ; Male ; Orbit ; abnormalities ; Tomography, X-Ray Computed ; methods ; Young Adult ; Zygoma ; abnormalities