ObjectiveTo explore the effects of optional cesarean section on the level of plasma motilin and serum gastrin in umbilical blood and their relationship with gastroenteric symptoms of neonates. MethodsWe measured the concentrations of plasma motilin and serum gastrin in umbilical blood from neonates undergoing optional cesarean operation, emergency cesarean section and vaginal delivery by radioimmunoassay(RIA). ResultsFull-term deliveries undergoing optional cesarean section were with significant gastrointestinal symptoms. Plasma motilin and serum gastrin were significantly lower in neonates undergoing cesarean operation without birth initiate group(optional cesarean section)than that in cesarean section with birth initiate group and vaginal delivery group (P<0.05). ConclusionCesarean operation without birth initiate influences neonatal gastroenteric symptoms.Breast feeding which begins as early as possible will help to relieve those symptoms.

Methylmalonic acidemia(MMA) is one of the most common diseases of autosomal recessive inherited organic acid metabolic disorder,which can cause multiple organ involvement.It can be found in infants or even in the neonatal period and be manifested as feeding difficulty,repeated vomiting,convulsions,abnormal muscle tension,mental retardation,hemolytic uremic syndrome(HUS),etc.In which HUS caused by MMA is better and better known by pediatricians when treating renal diseases while the diagnosis rate is increasing year by year.This article reviews the epidemiology,etiology,pathogenesis,clinical manifestations and treatment of HUS associated with MMA.

0.05). There was significant difference between G_1, G_2and G_3(P0.05). Low expression levels in G_4 (Ⅲ,Ⅳ) were observed.Significant differences were noted between expression levels in G_4 (Ⅲ,Ⅳ) and in G_2, G_3 or G_4 (Ⅰ,Ⅱ; P

BACKGROUND: Biomechanical changes of the trunk might be an important factor contributing to the pathogenesis and poor recovery of lumbar disc herniation.OBJECTIVE: To study the biomechanical changes of the trunk of patients with lumbar disc herniation by isokinetic test of the protruded lumbar disc.DESIGN: Non-randomized controlled retrospective study of concurrent patients.SETTING: Department of Rehabilitation Medicine, Changhai Hospital, Second Military Medical University of Chinese PLA.PARTICIPANTS: Thirty patients with lumbar disc herniation, admitted in the clinic of Department of Rehabilitation, Changhai Hospital affiliated to Second Military Medical University between February 2001 and January 2002, were enrolled in this study, with another 30 concurrent patients without lumbar disc herniation serving as the control group. Informed consent was obtained from all patients involved.METHODS: A Biodex Multi-joint Testing System was employed for measuring the peak torque(PT), peak torque to body weight(PT/BW), time to peak torque(TPT), torque at 0. 2 s(T@ 0. 2), total work(TW), average power(AP) and flexion to extension(F/E) ratio of the trunk muscles of the patients. The results were analyzed by t test using SPSS 9.0 software.MAIN OUTCOME MEASURES: Main outcome: isokinetic evaluation of the lumbar and dorsal flexors and extensors; secondary outcome: F/E ratio.RESULTS: The strength of the trunk flexors and extensors decreased significantly in patients with lumbar disc herniation at each testing speed of retraction, and the bursting strength and indices for work efficiency of the muscles also exhibited obvious changes. The flexors showed greater reduction in muscle strength than the extensors. The F/E ratios during isokinetic concentric contraction at 60°/s and 180°/s were 57.99 ±5.68 and 65.74 ± 8.12, respectively, in patients with lumbar disc herniation, in comparison with the ratios of 95.25 ±5. 18 and 83.03 ±7.61 in the control patients, showing significant difference between the two patient groups( P ＜ 0.01 ).CONCLUSION: Biomechanical changes of the trunk muscles of patients with lumbar disc herniation are definite, and proper rehabilitative treatment of these patients should consists of specific training protocols to restore the mechanical balance of the trunk and break the vicious cycle on the basis ofaccurate evaluation of such changes.

Objectives To explore the clinical manifestations, treatment and prognosis of a case of blindness caused by nephrotic syndrome with cerebral venous sinus thrombosis (CVST). Methods The clinical manifestations, diagnosis and treatment of a case of NS with CVST were analyzed. The latest domestic and foreign reseach progresses in treatment for CVST in children were reviewed. Results Epilepsy suddenly appeared with diplopia, binocular vision loss and blindness in anticoagulant therapy for the child with NS. Brain magnetic resonance venography (MRV) suggested CVST. MRV reexam-ined showed that the intracranial thrombosis was completely dissolved after urokinase thrombolysis for one month followed by ineffective heparin anticoagulation. At present, international standards of anticoagulant therapy have been adopted in the treatment for CVST patients. Coagulation function (e.g.APTT) and international standardization ratio were monitored in order to prevent bleeding. Conclusions It is better to perform neural imaging examination early in suspected CVST patients. Anti-coagulation and thrombolytic therapy should be given immediately once the risk of bleeding was excluded and used for 3-6 months.

Objective To study the morphologic and pathological characteristics of cat scratch disease(CSD).Methods Eight cases with clinical data and tissue blocks were collected in Guangxi Zhuang Autonomous Region and Hainan Province.The tissues were successively stained by hematox- ylin and eosin,Warthin-Starry(W-S),acid fast and periodic acid-schiff(PAS)methods to study the histopathological changes and pathogens.Results W-S positive Bartonella henselae was the major pathogen of CSD and there was no acid-fast or PAS positive pathogen could be found in the tissues. There were three forms of histological representation as follows:plasmocytoid monocytes(PMO)and monocytoid B-cells(MBC)hyperplasia plus neutrophils immersion in lymphatic sinus(2 cases); MBC rich granuloma and micro-abscess formation(3 cases); starlit abscess with little or no bacteria in the granuloma(3 cases).Conclusions Bartonella henselae mainly transmits through cats.Contact histo- ry with cats and lymphadenectasis suggest the possibility of CSD.The diagnosis can be confirmed by the presence of W-S staining positive bacteria,MBC rich granuloma or micro-abscess and neutrophil reactions in histopathological exam.

Objective To investigate the effects of abnormal psychological factors on patients with different subtypes of gastroesophageal reflux disease(GERD)and on their natural history.Methods Patients with GERD symptoms were underwent 24 hour esophageal pH monitoring and endoscopy.They were enquired about frequency and severity of reflex symptoms and other informations,and filled in the Symptom Checklist 90(SCL-90).Twelve months later,they were enquired again about their symptoms and medication.Results One hundred and fifteen patients were followed up for(18.0?6.1)months (ranged from 12 to 37 months).The values of psychosomatic parameters including somatic,anxious, depression,compulsory and psychiatric scores in patients with GERD and RE were higer than normal values(both P

Objective To investigate the effect of different doses of ketamine on inflammatory cytokines in rabbits with severe burn at early stage and preliminarily approach its regulatory action on early stage of inflammatory reaction due to stress of trauma.Methods Forty healthy male New Zealand rabbits were randomly divided into four groups in accord with the random number table method: normal control group, scald model group, ketamine analgesia group and ketamine anesthesia group. Before scald, pentobarbital sodium was used for anesthesia, afterwards catheters were inserted into internal jugular vein and internal carotid artery respectively ready for use, and 24 hours later, Ⅲ degree scald at the animal back and buttocks occupying 30% total body surface area (TBSA) was performed as the scald model for all the rabbits except those in normal control group. In ketamine analgesia group, after scald for 0.5 hour, 0.5 mg/kg ketamine intravenous injection was given to the rabbits as the loading dosage and then persistent intravenous pump infusion of 9μg·kg-1·min-1 ketamine was applied for all together 24 hours. In ketamine anesthesia group, after scald for 0.5 hour, 1.5 mg/kg ketamine intravenous injection was given to the rabbits, and then persistent intravenous pump infusion of 45μg·kg-1·min-1 ketamine was applied for 4 hours to maintain systemic anesthesia. In normal control and scald model groups, only intravenous infusion of equal amount of normal saline was given to the rabbits. The amount of intravenous transfusion in each group and the total dosages of ketamine used in ketamine analgesia group and ketamine anesthesia group were recorded. Before scald and 0.5, 6, 12, 24 hours after scald, arterial blood gas analyses were made, and the levels of serum interleukins (IL-1, IL-6) and tumor necrosis factor-α (TNF-α) were determined.Results Although the indexes of blood gas analysis were changed in the four groups, they were all in the normal range, showing that the respiratory function was in the normal range and indirectly reflecting that the circulatory function was also in the normal range, thus the effects on cytokines by factors of respiratory and circulatory functions were ruled out. The levels of IL-1, IL-6 and TNF-α before scald showed no statistically significant differencesamong the four groups (allP > 0.05). From 0.5 hour after scald, the levels of IL-1, IL-6 and TNF-α were markedly higher in model group than those of normal control group [IL-1 (ng/L): 30.27±0.93 vs. 13.79±1.11, IL-6 (ng/L): 47.22±1.49 vs. 46.31±4.12, TNF-α (ng/L): 243.39±20.85 vs. 190.95±14.97, allP < 0.05], and the situation continued until 24 hours after scald; the levels of IL-1, IL-6 and TNF-α from 6 hours after scald were significantly decreased in ketamine analgesia and ketamine anesthesia groups compared with those in the model group, and from 12 hours after scald, the degrees of descent in levels of the above indexes in ketamine analgesia group were more obvious than those in ketamine anesthesia group [IL-1 (ng/L): 19.28±2.51 vs. 40.12±10.31, IL-6 (ng/L): 52.10±4.23 vs. 72.20±10.11, TNF-α (ng/L): 246.03±20.74 vs. 313.71±27.34, allP < 0.05].Conclusion The low-dose ketamine analgesia and ketamine anesthesia have certain degree of inhibitory effect on the expression and release of inflammatory cytokines at the early stage in rabbits with severe burn, the effect of long-term low-dose ketamine analgesia being more significant.

Objective:To identify the function of extracellular soluble vimentin that promotes proliferation, activation and chemotaxis of inflammatory cells. Methods: The proliferation of rat splenocytes stimulated with vimentin was evaluated in vitro. The lymphocyte counts and vimentin-antibody levels of peripheral blood in mice immunized with vimentin were detected in vivo. Peritoneal macrophages were collected and cultured with different concentrations of vimentin to detect the effect on phagocytosing chicken red blood cells. The chemotaxis of NIH3T3 fibroblast towards vimentin was observed in transwell chamber. Results:In vitro vimentin dose dependently promoted the proliferation of splenocytes. The proliferation indexes of primed and naive splenocytes cultured with 16μg/ml vimentin were reached up to ( 196. 0 ± 9. 7 )% and ( 208. 9 ± 4. 6 )% respectively without significant difference. In vivo vimentin significantly enhanced the lymphocytes number(109 L-1)of peripheral blood(5. 74±0. 51 vs. 1. 69±0. 13)and the levels of vimentin specific antibody( OD value 2. 31 ± 0. 06 vs. 0. 19 ± 0. 08 ) that shown no significant difference from immunization with vimentin plus CFA. In vitro vimentin dose dependently stimulated phagocytic ability of macrophages and performed the chemotactic effects on NIH3T3 fibroblasts. Conclusion:Extracellular soluble vimentin promotes the proliferation,activation and chemotaxis of concerned inflammatory cells and possesses the functions as an alarmin.

This review analyzed the effect of folic acid on pemetrexed efficacy and toxicity, especially high-does folic acid supplementation. The optimal duration for supplementation prior to the first dose of pemetrexed has not been defined. The review also explored whether total plasma homocysteine levels can be as a marker to predict and avoid toxicity from pemetrexed therapy.