Sister chromatid exchange (SCE) frequencies were investigated in 35 diabetics and 24 controls. The spontaneous and MMC-induced SCE frequencies in diabetics were obviously higher than those in controls. There was a significant positive correlation between the spontaneous and MMC-induced SCE frequencies in either diabetics or controls. No correlation was found between the spontaneous SCE frequencies and HbA1 . High concentrations of glucose or regular insulin in the culture medium could not increase SCE frequencies of the controls. No significant difference was found between the untreated patients and patients treated with tolbutamide. The increased SCE frequency in diabetics may account for higher incidence of fetal stillbirth, abortion and malformations in diabetic pregnancies.

Objective To study the functional mechanism of Naoxin tong Capsule (Ca psule for cerebral and heart diseases) on a cute coronary syndrome (ACS). Methods Totally 105 ACS p atients diagnosed with coro nary angiography were randomized into a treatment group (55 cases), and a control group (50 cases). The control group was treated routin ely with western medicine while the treatment group treated with Naoxintong Capsule, 2 capsules each time, 3 times a day, in addition to the routine western medicine. Before and 4 weeks after treatment, the serum hypersensitive C-react ive protein (hs-CRP) was measured. Before and six months af ter treatment, changes of carotid intima-media thickness (IMT) and carot id plaque were examined with Color Doppler Ultrasonography. Resu lts Four weeks after treatment, the hs-CRP level in the treatment grou p was significantly lowered than before treatmen t, and the effect was more significant than that of the control group (P

Objective To evaluate the effect of a nurse-led case management intervention on arm function and uncertainty for women with breast cancer.Methods 90 women with breast cancer were divided into the intervention group and the control group according to their nurses,with 45 patients in each group.All participants were followed six months after surgery.The intervention group attended a 6-month nurse-led case management program,while the control group received the routine care and follow-up only.Questionnaires on arm function and uncertainty were administered 1 month,3 months and 6months after the surgery respectively.Score changes were compared by repeated-measure ANOVA and MANOVA.Results The arm function of the intervention group was better than the control group,except for the 10th day after the operation,there were significant differences at other three time points.The disease uncertainty level of the intervention group was better than that of the control group,except for the dimension of unpredictability,there were evident differences in other dimensions at other three time points.Conclusions The nurse-led case management intervention could improve arm function recovery and decrease the uncertainty to disease of breast cancer survivors.

BACKGROUND: It is reported that there is special physiological effect of Neiguan (Luo-connecting point, P6) acupuncture on the cardiovascular system. Instead of acupuncture, irradiation of the Neiguan point with He-Ne laser can improve the cardiac function of senile patients with coronary heart disease (CHD).OBJECTIVE: To study the effect of irradiation of Neiguan acupoint with He-Ne laser on the circulatory system of senile patients with coronary heart disease.DESIGN: Auto-control study.SETTING: Henan Provincial General Hospital of the Chinese People's Armed Police Force.PARTICIPANTS: Forty senile patients with coronary heart disease hospitalized in the General Hospital of Henan People's Armed Police Force for rehabilitation from 2000 to 2001 were selected. There were 28 males and 12 females, aged from 66 to 85 with the average age of 70. The course of their disease was from 2 years to 20 years. Among the patients, 15 were complicated with essential hypertension and 7 were with hyperlipemia.METHODS: He-Ne laser, with wavelength of 632.8 nm and power of 5 mw, was used to irradiate directly the Neiguan acupoint once a day, 15 minutes in each time and 20 times as a whole course. Indexes of hemodynamics were detected before the treatment, just after the first treatment and after the first course of treatment.MAIN OUTCOME MEASURES: ① Cardiac work total (CWT), left heart work effective (LWE) and left cardiac index (LCI); ② Left heart total pumping force (LTPF), left heart jetting pressure (JP), left heart effective pumping force (LEPF) and pressure of efflux (EPE); ③ Consumption myocardium oxygen (CMO) and coronary compliance (CMR); ④ Modulus of elasticity of the cardiac muscle (VE).RESULTS: All 40 senile patients with coronary heart disease entered the final analysis without any loss. ① Comparison between the first time of post-treatment and the pre-treatment: The data of CWT, LCI, and LWE were decreased [(534.086 ±90.923), (616.587 ±137.426) J/minute;(4.821±0.622), (5.469±1.144) L/minute.m2; (116.528±22.476), (136.603 ±30.796) J/minute, P ＜ 0.05 or P ＜ 0.01]. Parameter of CMO was decreased but parameter of CMR was increased [(22.783±4.174), (25.255±6.125) mL/minute,(180.108±31.210), (157.031±35.056) g/cm4s2, P ＜ 0.01]. ② Comparison between post-first course and pretreatment: Parameters of CWT were decreased [(489.291±118.434), (616.587±137.426) J/minute, P ＜ 0.05],those of CMO were also decreased but th ose of CMR were increased [(22.472±6.011), (25.255±6.125) mL/minute, (193.757±51.704),(157.031±35.056) g/cm4s2, P ＜ 0.01].CONCLUSION: The treatment of coronary heart disease with He-Ne laser beam instead of needling may induce heating effect, biological effect and electromagnetic field, which can excitated the physiological function of meridian in order to improve cardiac load and myocardial oxygen consumption, to increase the oxygen supply and the utilization rate of tissue, improve relaxation-contraction function of coronary artery and promote the blood supply and circulation of coronary artery.

Objective To explore the clinical outcome of atlantoaxial pedicle screw instrument in treatment of extension-type odontoid fracture combined with aflantoaxial subluxation. Methods From December 2002 to December 2006, seven patients with extension-type odontoid fracture combined with at-lantoaxial subluxation were reduced and fixed with atlantoaxial pedicle screw instrument of Vertex system under general anesthesia. There were five males and two females, at mean age of 39.2 years (range 21-59 years). All odontoid fractures were fresh type Aderson Ⅱ. JOA scores of spinal core function was 8.6-14.9 (average 10.7) preoperatively. The X-ray examination, CT scanning and skull traction were performed in all patients preoperatively. Results There found no severe complications such as injuries of vertebral artery, nerve root and spinal cord postoperatively. All patients obtained complete reduction and healing of the fracture and dislocation. The mean off-bed time was four days (3-6 days) after opera-tion. A follow-up for 12-36 months (average 22 months) in all patients showed that the clinical symptom was improved significantly six months postoperatively and that all screws were in proper position verified by X-ray and CT scanning. All patients obtained solid bony union on radiographs, with no loosing or breakage of instrument. The postoperative JOA scores was 13.5-16.9 (average 15.8). Conclusions Allantoaxial pedicle screw fixation has advantages of intraoperative reduction, reliable fixation and high fusion rate and can be used as an effective method for extension-type odontoid fracture combined with at-lantoaxial subluxation.

AIM: To explore the effect of melatonin (MLT) on the apoptosis of thymocytes and splenocytes in mice induced by ionizing radiation and its mechanism. METHODS: The percentages of apoptotic bodies and the DNA lytic rates of thymocytes and splenocytes in mice in vitro and in vivo were detected with flow cytometry and fluorospectrophotometry, respectively. RESULTS: The apoptosis of mouse thymocytes and splenocytes in vitro increased with significant dose-dependence in 0 5-6 0 Gy X-irradiation. When MLT of 2 mmol?L -1 was added into thymocytes or splenocytes in vitro before irradiation with 0 5-6 0 Gy X-rays, the percentages of apoptotic bodies and the DNA lytic rates all decreased significantly as compared with those in the irradiation group. The percentages of apoptotic bodies in these two kinds of cells were 86 25% and 89 22% of those in the irradiation group, respectively, and the DNA lytic rates were 87 23% and 89 16%, respectively. When MLT was injected into intraperitonium in mice 60 min before whole-body irradiation with 2 Gy X-rays, the percentages of apoptotic bodies and the DNA lytic rates were significantly lower than those in the irradiation group, and near or lower than those in the sham-irradiation group. MLT of 0 1-2 5 mg/kg decreased the lymphocyte apoptosis, but without significant dose-dependence. CONCLUSION: The protective effects of MLT on mouse lymphocytes damaged by irradiation in vivo are obvious than those in vitro. [

AIM: The effect of low dose radiation (LDR) with different doses of X-rays on apoptosis and its related gene P53 expression were studied in spermatogenic cells of male Kunming mouse testis. METHODS: The different kinds of spermatogenic cells were separated using density gradient centrifugation and their apoptosis was measured by flow cytometry. At meantime, P53 protein and P53 mRNA was measured with immunohistochemical SABC and in situ hybridization, respectively. RESULTS: The apoptosis in all kinds of spermatogenic cells induced by LDR had a remarkable regularity. When the doses were 0 025 and 0 05 Gy, spermatogone apoptosis was domaint. With the increase in irradiation dose (0 075-0 2 Gy), spermatocytes also showed an apoptotic change, but the apoptotic percentage of spermatogonia was significantly higher than that of spermatocytes. Moreover, the apoptosis of spermatids and spermatozoa scarely occurred after LDR. P53 protein expressed in spermatogonia and spermatocytes in varying degrees, and the former was significantly higher than that of the latter after LDR. With the increase in irradiation dose, P53 protein expression showed a upregulated tendency, but that of spermatids and spermatozoa scarcely occurred. P53 mRNA primarily expressed in spermatids and spermatocytes when the dose was 0 025 Gy. With the increase in irradiation doses (0 05-0 2 Gy), that of spermatogonia also showed an enhancement. P53 mRNA expression in spermatogonia and spermatocytes showed a remarkable dose-effect relationship. CONCLUSION: The apoptosis of spermatogenic cells was selectively induced by LDR of X-rays, which had remarkable the dose-effect and time-effect relationships. The mechanism of the selective apoptosis in spermatogenic cells by LDR is closely related to the upregulation of P53 .

Objective To evaluate specific clinical and imaging features of osteogenesis imperfecta V and to improve diagnostic accuracy of this disease. Methods Data of 15 patients with osteogenesis imperfecta type V were retrospectively analyzed for their clinical and imaging features. There were 10 males and 5 females, aged from 1 year and 30 years old (median age,12.5 years ). All 15 patients had plain X-ray, and 4 of 15 had CT. All data were analyzed by 3 experienced deputy chief doctors in OI according to OI V standard. Results X-ray:calcification of the interosseous membrane between radius-ulna was detected in all patients and calcification of the interosseous membrane between tibia-fibula was detected in 2 of 15 patients. Dislocation of the radial head was seen in 13 of 15 patients,bilateral in 9 and utilateral in 4.All patients showed restriction in the pronation and supination of the forearm and restricton in the flexion and extention of the elbow joint. Patients with dislocation of raidal head were associated with large coronoid process and olecranon of the ulna. Hyperplastic callus of the extremities were detected in 7 of 15 patients (7 at femur , 3 at humerus, 1 at tibia.In early stage, hyperplastic callus showed thin cortice, and clear boundares with the diaphysis showing and low density, irregular, mesh-like lamellation inside. In the later stage, there were dense calcification inside hyperplastic callus, and no difference in density with the diaphysis. Diaphysis surrounded by hyperplastic callus had clear boundaries with the hyperplastic callus. No cortical destruction was detected. CT:there were sparse needle-dot calcification inside hyperplastic callus, with the patterns of granular, ring-and-arch,irregular streaky mineralization. The cross section of proximal femoral shaft showed irregular shape , flat square shape and tiny medullary cavity, with no calcification on the edge of hyperplastic callus. CT value:-91 HU inside hyperplastic callus; 283 HU in femoral shaft. Conclusions Interosseous membrane between radius-ulna or tibia-fibula, hyperplastic callus ,dislocation of the radial head are specific features in osteogenesis imperfecta V. X-ray can make a definitive diagnosis of osteogenesis imperfecta V. CT scan is helpful in the differential diagnosis of osteogenesis imperfecta V from osteosarcoma.

Objective To evaluate the possibility and curative effect of total en bloc spondylectomy (TES) for the treatment of primary tumors of the lumbar spine. MethodsBetween June 2005 and July 2009,nine cases of primary tumor of the lumbar spine were treated with total en bloc spondylectomy through a single posterior approach performed in seven cases(L1 giant cell tumor, L1 osteosarcoma, L2 giant cell tumor,L2 solitary plasmacytoma, L2 chondrosarcoma, L2 chordoma, and L3 histiocytic sarcoma), and two cases through a single stage anterior and posterior combined approach (L4 giant cell tumor with paraspinal mass and L4 fibrosarcoma). They were performed a single stage reconstruction after removing tumors of vertebra. Neurofunction was evaluated perioperatively and recurrence of tumor was tracked for all cases.ResultsThe follow up was obtained for 3-49 months (averaging 19 months). All patients attained significant clinical improvement after surgery without any severe complications. There was no local recurrence and distal metastasis in shortterm follow-up. ConclusionThe treatment by TES to remove tumors and reconstruction of spine are reliable for primary tumors of the lumbar spine. The curative effect of short-term follow-up is satisfactory. However, the long-term curative effect remain to be further follow-up.

Objective To explore the perioperative management and surgical outcomes of fracture-dislocation of the upper cervical spine complicated with vertebral artery injury.Methods We retrospectively analyzed the clinical data of 19 patients diagnosed with fracture-dislocation of the upper cervical spine complicated with vertebral artery injury who had been treated at our department from January 2008 through December 2012.They were 14 males and 5 females,aged from 22 to 53 years (mean,35.2 years).All the patients had fractures of the atlas and/or axis,and disordered atlanto-axial relationship as well.According to Frankel grading system,8 cases were Grade D and 11 Grade E.The cervical posterior fixation with pedicle screws was adopted for all and hemostasis was conducted for those with bleeding from the broken vertebral artery.Their Frankel grade,Japanese Orthopedic Association (JOA) score and visual analogue scale (VAS) score were compared between preoperation and final follow-up.Results Intraoperative hemorrhage occurred in 2 patients from the injured vertebral artery.Hemostasis was achieved through direct tamponade with bone wax and gelatin sponge in one and through endovascular intervention after bleeding control by direct tamponade in another.Neither of them presented with symptoms of posterior circulation ischemia after operation.The mean operation time was 153.5 min,and the mean blood loss was 542.1 mL.All the patients were followed up for an average time of 28 months.Bony union was obtained in all after an average time of 13.5 weeks.Follow-ups revealed no ischemic stroke in this series.Symptoms of transient ischemic attack,like transient dizziness and blurred vision,appeared in 2 patients.At the final follow-up,all the patients were assessed as Frankel Grade E.Their mean JOA and VAS scores were significantly improved from 8.1 ± 1.2 and 7.0 ± 1.7 preoperatively to 12.7 ± 1.6 and 1.3 ± 1.2,respectively (P ＜ 0.05).Conclusions Angiography examination is routinely indicated for the patients with fracture-dislocation of the upper cervical spine perioperatively.Preoperative evaluation of the vertebral artery and its adjacent structures and effective intraoperative hemostasis can avoid uncontrollable bleeding during operation,reduce postoperative complications,and improve surgical outcomes.