Objective To outline the characteristics of fractures of the coronoid process of the ulna in children and distinguish them from that of the adult. Methods Twenty eight cases of fractures of the coronoid process of the ulna in children in the past five years were reviewed. There were 18(64%) boys and 10(36%) girls. According to the extent of involvement, the fractures were classified as 3 types based on modified Regan and Morrey method. Of those, 10 cases were associated with other injuries such as dislocation of the elbow, fracture of the radial neck, fracture of the olecranon and so on. In this series, open reduction and internal fixation were applied in only 2 cases with type Ⅲ injury and conservative treatment including immobilization of the elbow in flexion with long arm plaster splint were done in all of the rest cases. Results Seventeen patients were followed up for an average of 14 months(range, 4 months to 5 years). The clinical results were evaluated according to pain, range of motion, muscular strength and stability of the elbow. The overall excellent result were achieved in 94%of the patients. No complaint and late complication were found in this series. Conclusion There are some obvious differences in the coronoid process fracture of the ulna between children and adult: 1)fewer cases associated with dislocation of the elbow in the children than in the adult; 2)the clinical results were relatively better in children than that in the adult whatever the surgical or conservative treatment was performed; 3)the prognosis of fractures of the coronoid process of the ulna was better and the complications were less in children than that in the adults.

Objective To observe the effect of RNA interference binding immunoglobulin protein (BiP) on expression of bone markers and keytranscription factors in osteoblast exposed to fluoride.Methods MC3T3-E1 cells were used as osteoblast model in vitro.The cell viability was test with cell counting Kit-8 after cells were administrated with varying concentrations of fluoride [0.0 (control),0.1,1.0,2.0,4.0,8.0,16.0,20.0,32.0 and 64.0 mg/L] for different duration.Cells transfected with small interfering RNA (siRNA) BiP were exposed to fluoride (2.0,8.0 and 20.0 mg/L) for 2 days.Real-time PCR and Western blotting technique were used to determine the gene and protein levels of BiP.Meantime,the mRNA expression of bone markers and key transcription factors was investigated by real-time PCR.Results The difference of all viability in fluoride-dose groups was statistically significant exposed for 1,3,7 and 14 days (F =46.7,118.6,214.6,325.6,all P ＜ 0.05).Expression of BiP significantly increased in cells exposed to 20.0 mg/L compared to that of control (11.22 ± 3.25 vs.7.94 ± 1.31,P ＜ 0.05).The expression of alkaline phosphatase (ALP) elevated in cells exposed to 2.0 mg/L of fluoride (12.81 ± 3.62 vs.6.86 ± 2.13,P ＜ 0.01);conversely,it significantly reduced in cells exposed to 20.0 mg/L of fluoride (0.89 ± 0.17 vs.6.87 ± 2.14,P ＜ 0.01).Cells transfected with siRNA BiP significantly decreased the ALP expression in cells exposed to fluoride compared to that of cells only exposed to the same concentration of fluorine (12.81 ± 3.62 vs.7.43 ± 2.06;5.92 ± 2.38 vs.3.96 ± 0.21,all P ＜ 0.05).Cells transfected with siRNA BiP and administrated with 2.0 mg/L significantly reduced the osteocalcin expression (4.29 ± 0.99 vs.1.29 ± 0.86,P ＜ 0.01).Similarly,expression of runt-related transcription factor 2 (Runx2) significantly increased in cells exposed to 2.0 mg/L.However,expression of Runx2 significantly decreased in cells transfected with siRNA BiP and administrated with fluoride.Cells transfected with siRNA BiP significantly decreased the Runx2 expression in cells exposed to 2.0 mg/L and 20.0 mg/L compared to that of cells only exposed to the same concentration of fluorine (1.13 ± 0.22 vs.6.61 ± 0.48;0.02 ± 0.02 vs.1.50 ± 0.38,all P ＜ 0.01).As the downstream of Runx2,the expression of osterix in cells treated with different concentrations of fluoride was similar to that of Runx2.Conclusion BiP is not directly involved in the process of osteoblast differentiation induced by fluoride;instead,it affects the expression of bone markers and key transcription factors in osteoblast exposed to fluoride.

In this study, the vaporization ratio of the 2-mum laser in the prostatic tissue with benign prostatic hyperplasia was examined in vitro, to explore a technique to estimate the clearance rate of prostatic tissue during the transurethral vaporesection of the prostate. A total of 9 fresh prostatic tissue specimens were obtained by open surgery and the wet weight of the prostatic tissue were measured immediately after the sample collection. Under the simulated conditions of transurethral vaporesection of the prostate by 2-mum laser, each prostate gland was completely vaporesected into fragments with a diameter of less than 1.0 cm in vitro. After the vaporesection, the whole fragments of prostatic tissue were collected and measured. Then the lost weight of prostatic tissue, the weight of the collected prostatic tissue and the ratio of the lost weight of prostatic tissue to the wet weight of the prostate glandular organ specimen were calculated. The correlation between the weight of collected prostatic tissue and the weight of the whole glandular organ was analyzed. All the experimental procedures were carried out by one operator. Wet weight of the prostatic gland specimen and the weight of the harvested prostatic tissues after the procedure were recorded. With respect to the wet weight of prostate gland specimen, the percentage of the weight of collected prostatic tissue was (34.45+/-1.51) %, and the percentage of the lost weight of prostatic tissue was (65.55+/-1.51)%. Satisfactory linear relationship was observed between the weight of collected prostatic tissue and the wet weight of prostate gland specimen [y=3.245x-6.475 (t=15.097, P=0.000)]. It is concluded that under the simulated conditions of transurethral vaporesection of the prostate by 2-mum laser, the vaporization ratio of prostatic tissue can be calculated on the basis of the weight of collected prostatic tissue, and thereby the clearance of prostatic tissue during the formal operation by 2-mum laser could be quantitatively determined.

Objective To evaluate the efficacy of the RevoLix 70 Watt 2 micron continuous wave laser vaporesection for treatment of large volume benign prostatic hyperplasia(BPH,＞80 g).Methods Forty-five patients with obstructive BPH were treated with 2 micron continuous wave laser vaporesection.The age ranged from 57 to 88 years with a mean of 69 years.Nine patients had acute urinary retention.Mean prostatic volume was(96±1 3)ml(ranged from 80 to 128 m1).Eight cases were given suprapubic puncture.All cases were successfully anesthetized by using epidural anesthesia.At the beginning of the operation,the distal resection border close to the verumontanum was marked and laser incisions were performed at 5 and 7 o'clock lithotomy position.Firstly,median lobe was vaporeseeted closely along capsule from bladder neck to verumontanum.Secondly,prostate at 12 o'clock was vaporesected until the capsule was reached,and both lateral lobes were dissected downward.Thirdly,the apical position was enucleated by sheath,and then prostate was vaporesected from the tissue in 12 o'clock position to the tissue at 6.It was important to follow the 2 principles:inner to extra,up to down.Transfusion rate,resection time,time of indwelling catheter,improvement in urinary flow rate(Qmax),international prostate symptom score(IPSS)and quality of life(QOL)were measured.Results AIl cases were successfully operated.except one whose left lateral lobe was left due to heavy fluctuation of heart rate and blood pressure in operation.The mean operation time was (104±12)min.Transfusions were not necessary in any patients.The catheter was indwelled for 3 to 5 d postoperatively.One case had urethral stricture 3 weeks after operation,and urinated free after 22 times urethral sounding disj unctively.All cases were followed up for 3-1 2 months.All patients were satisfied with voiding outcome,none had incontinence.Mean Qmax increased from(3.3±0.5)ml/spreoperatively to(16.5±1.5)ml/s postoperatively.IPSS decreased from 28.6±5.5 to 8.3±2.3 and QOL score decreased from 4.5±0.4 to 2.7±0.2.respectively(P＜0.01).No hemorrhage occurred after the operation.Conclusion RevoLix 2 micron continuous wave laser vaporesection for treatment of large volume BPH is a safe and effective relief therapy,and that in combination with enucleation could improve the efficiency of vaporesection.

Aim To investigate the influence of sarpog-relate hydrochloride (SH)on the pharmacokinetic pro-file of dextromethorphan (DM),the typical substrate of CYP2D1 /2,in rats when they were administered co-instantaneously.Methods A total of 1 2 SD rats were randomly divided into two groups:the control group (DM,1 0 mg·kg-1 )and the sarpogrelate group (SH, 1 0 mg·kg-1 ;DM,1 0 mg·kg-1 ),which received in-tragastric administration.Plasma samples were collected immediately before and at different time points after drug administration.A LC-MS /MS method was used to determine the concentrations of DM in rat plasma. Pharmacokinetic parameters were analyzed using Drug and Statistics (DAS 2.0).Results There were signif-icant differences in the pharmacokinetic parameters of DM,including T1 2 (2.49 h ±0.93 h vs 1 .47 h ±0.20 h,P <0.05 ),Cmax (325.7 μg·L -1 ±1 33.2 μg· L -1 vs 1 04.5μg·L -1 ±52.4 μg·L -1 ,P <0.05), AUC0 -t(785.5 μg·L -1 ·h ±451 .9 μg·L -1 ·h vs 244.8 μg·L -1 ·h ±1 68.3μg·L -1 ·h,P <0.05) and AUC0 -∞(804.7 μg·L -1 ·h ±445.6 μg·L -1 ·h vs 251 .4 μg·L -1 ·h ±1 73.4 μg·L -1 ·h,P<0.05 )between the two groups.Conclusion SH could significantly inhibit the elimination of DM,the substrate of CYP2D1 /2 in rats.

Objective To determine the ED50 of dexmedetomidine for suppressing cardiovascular responses to placement of laryngeal mask airway (LMA) in patients undergoing gynecological laparoscopic surgery with induction of propofol. Methods ASA I or II Patients aged 18 to 55 undergoing elective gynecological laparoscopic surgery were enrolled. After an bolus dose of dexmedetomidine over 10 min , anaesthesia was induced with target-controled propofol, and then bolus of vecuronium of 0.1 mg/kg was injected when the BIS was between 45 and 55. LM palcement was performed 3 minutes after vecuronium injection. The modified Dixon ’ s up-and-down method was used to determine the bolus dose of dexmedetomidine , starting from 1.0 μg/kg (step size:0.1 μg/kg). Cardiovascular response was defined as an increase in SBP and/or HR by 15% of baseline within 2 min after placement of LMA. The test ended after at least 7 crossovers ( successive ‘response’ or ‘non-response’) were obtained. Probit analysis was used to calculate ED50, ED95 and 95% confidence interval (CI). Results The ED50 and ED95 (95% confidence interval) of dexmedetomidine for suppressing cardiovascular responses to placement of LMA was 0.65 μg/kg (0.44-0.80) μg/kg and 0.94 μg/kg (0.79-2.47) μg/kg. Conclusion Under induction of target-controled propofol , the ED50 of dexmedetomidine is 0.65 μg/kg for suppressing cardiovascular responses to placement of LMA in female patients.

Objective To study the efficacy of different anti-adhesion agents used in preventing tubal obstruction after recanalization.Methods Five hundred and eight patients with tubal obstruction were divided into 245 cases in control group,108 cases in chitosan group;113 cases in sodium hyaluronate group and 42 cases in lipiodol group.The patients in control group were injected with anti-inflammation agents after recanalizatian,while other groups were injected with chitosan,sodium hyaluronate or lipiodol at dose of 2-3 ml in every therapeutic group.The rate of location of tubal obstruction and tubal recanalization were recorded during operation.Then patients in every group were followed up on tubal patency after 3 months,and pregnancy rate after 12 months.Results Among 1016 fallopian tubes in 508 patients,there were 330 tubes occlusion at isthmus portion and 563 tubes occlusion at interstitial portion of fallopian tube.Thirtyseven fallopian tubes were ablated because of ectopic pregnancy,86 fallopian tubes were unobstructed.(1)The recanalization rate were 95.7% (179/187) in chitosan group,97.9% (191/195) in sodium hyaluronate group,98.7% (75/76) in lipiodol group and 97.7% (425/435) in control group,which did not show statistical difference (P＞0.05).(2) The rates of tubal patency after 3 months of 91.7% (99/108) in chitosan group and 88.5% (100/113) in sodium hyaluronate group were significantly higher than 71.4% (30/42) in lipiodol group and 74.3% (182/245) in control group (P ＜0.05).(3)The rates of intrauterine pregnancy after 12 months were 48.1% (52/108) in chitosan group and 41.6% (47/113) in sodium hyaluronate group,which were significantly higher than 23.8% (10/42) in lipiodol group and 24.1% (59/245) in control group (P ＜ 0.05).Conclusion Chitosan and sodium hyaluronate could be effective to prevent tubal obstruction after interventional recanalization and increase pregnancy rate.

Objective To investigate the expression variation of aquaporin in colon tissues in acute necrotizing pancreatitis (ANP).Methods ANP rat model was induced by the retrograde injection of sodium taurocholate into the biliopancreatic duct.The rats were killed at 4 h, 8 h, 12 h and 24 h after modeling with 6 rats for each time point.The pancreas and colon tissues were harvested for pathological examination.The levels of IL-6, TNF-α mRNA expression and AQR (aquaporin-3, aquaporin-4, aquaporin-8) mRNA expression in proximal and distant colon were detected by RT-PCR.The levels of aquaporin protein in colon were examined by immunohistochemistry.Results After the establishment of ANP SD rat model, the integrity of colonic mucosa was continuously damaged, the structure of epithelial cells was unclear and the colonic villus were broken and destroyed, and inflammatory cell infiltration in submucosa was observed.The pathological score increased with the time of modeling.In 4 h, except that the mRNA levels of AQP-4 in distal colon was not obviously changed, mRNA levels of IL-6 and TNF-α, mRNA and protein expression of AQP-3 and AQP-8 in the proximal and distal colon of ANP rats were significantly elevated compared with shame group (P<0.05).AQP-3 and AQP-8 mRNA in proximal colon of ANP rats reached its peak in 8 h after the establishment and AQP-4 mRNA peaked at 24 h.AQP-3 and AQP-4 mRNA in distant colon of ANP rats reached its peak in 8 h after the establishment and AQP-8 mRNA peaked at 24 h.Protein expression of AQP-3, AQP-4 and AQP-8 in proximal and distant colon was strongest in 12 h and 24 h after the establishment.Conclusions With the progression of the ANP, the expression levels of AQP-3, AQP-4 and AQP-8 in both proximal and distal colons were elevated in various degrees, indicating that the aquaporins may participate in water metabolism of colon during ANP.

Objective To explore the role of viral infection in the development of drug eruption in patients with HIV infection, and to evaluate the efficacy of antiviral treatment. Methods This study enrolled 87 HIV-positive patients, including 11 with and 76 without drug eruption, all of whom received highly active antiretroviral therapy(HAART). Clinical data on, baseline CD4+ and CD8+ T cell counts and CD4/CD8 ratio in these subjects were retrospectively analyzed. Results The severity of drug eruption was mild in the 11 HIV-positive patients, with a mean latency period of (14.00 ± 8.10)(range, 8 - 34)days. Of the 11 patients with drug eruption, 7 had liver function impairment, which was not in accordance with the severity of skin lesions. Drug eruption was controlled in all the 11 patients after anti-anaphylactic treatment without withdrawal of antiviral drugs. Compared with 75 HIV-positive patients without drug eruption, the 11 HIV-positive patients with drug eruption showed significantly increased baseline CD4 + T cell counts (493.00 ± 245.68 (range, 42 - 810)/μl vs. 347.81 ± 167.00 (range, 11 - 814)/μl, t = 647.50, P < 0.05), but decreased proportion of patients with baseline CD4+ T cell counts below the lower limit of normal(3/11 vs. 48/75(64.00%), X2 = 3.95, P < 0.05). There were no significant differences between 10 patients with drug eruption and 69 patients without drug eruption in the baseline CD8+ T cell count(1472.30 ± 858.55/μl vs. 1356.59 ± 684.06/μl, P > 0.05), CD4/CD8 ratio(0.40 ± 0.27 vs. 0.29 ± 0.16, P > 0.05), or percentage of patients with a CD4/CD8 ratio below the lower limit of normal (9/10 vs. 68/69 (98.55%), P >0.05). Conclusions The latency period of drug eruption seems to be long in HIV-positive patients receiving HAART, and mild drug eruption can be complicated by liver function impairment in the patients. Relatively high CD4 + counts may be a risk factor for the development and aggravation of drug eruption in HIV-positive patients.

In this study,the vaporization ratio of the 2-μm laser in the prostatic tissue with benign prostatic hyperplasia was examined in vitro,to explore a technique to estimate the clearance rate of prostatic tissue during the transurethral vaporesection of the prostate.A total of 9 fresh prostatic tissue specimens were obtained by open surgery and the wet weight of the prostatic tissue were measured immediately after the sample collection.Under the simulated conditions of transurethral vaporesection of the prostate by 2-μm laser,each prostate gland was completely vaporesected into fragments with a diameter of less than 1.0 cm in vitro.After the vaporesection,the whole fragments of prostatic tissue were collected and measured.Then the lost weight of prostatic tissue,the weight of the collected prostatic tissue and the ratio of the lost weight of prostatic tissue to the wet weight of the prostate glandular organ specimen were calculated.The correlation between the weight of collected prostatic tissue and the weight of the whole glandular organ was analyzed.All the experimental procedures were carried out by one operator.Wet weight of the prostatic gland specimen and the weight of the harvested prostatic tissues after the procedure were recorded.With respect to the wet weight of prostate gland specimen,the percentage of the weight of collected prostatic tissue was(34.45±1.51)%,and the percentage of the lost weight of prostatic tissue was(65.55±1.51)%.Satisfactory linear relationship was observed between the weight of collected prostatic tissue and the wet weight of prostate gland specimen[y=3.245x-6.475(t=15.097,P=0.000)].It is concluded that under the simulated conditions of transurethrai vaporesection of the prostate by 2-μm laser,the vaporization ratio of prostatic tissue can be calculated on the basis of the weight of collected prostatic tissue,and thereby the clearance of prostatic tissue during the formal operation by 2-μm laser could be quantitatively determined.