Objective To analyze the clinical efficacy of internal rib fixation combined with external chest fixation and mechanical ventilation for traumatic flail chest with pulmonary contusion.Methods Sixty cases of traumatic flail chest with pulmonary contusion treated from January 2011 to December 2014 were assigned to experimental group (30 cases) and control group (30 cases) according to the random number table.Patients in control group received thoracic external fixation combined with mechanical ventilation.In experimental group the patients received the same care but in addition they had rib fixation.The two groups were compared with regard to general condition, arterial blood gas as well as vital signs before treatment and 24 hours after treatment, lung function 3 months after discharge, complication rate and mortality.Results ICU stay [(6.8 ± 1.0) d], hospital stay [(15.0 ± 1.8) d] and duration of mechanical ventilation [(4.8 ± 1.0) d] in experimental group were significantly lower than these in control group [(13.6 ± 2.5) d, (21.4 ± 2.6) d, (10.3 ± 1.3) d, respectively] (P ＜ 0.01).After treatment for 24 hours in either group, the pH value, PaO2, oxygenation index and systolic pressure (SBP) were significantly increased, and partial pressure of carbon dioxide (PaCO2), heart rate (HR) and respiratory rate (RR) were significantly lowered as compared to these before treatment (P ＜0.05).After treatment for 24 hours, experimental group demonstrated significantly enhanced levels in pH value,PaO2, oxygenation index and SBP but lowered levels in PaCO2, HR and RR as compared to control group (P ＜ 0.05).Three months after discharge, forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), 75％ forced expiratory flow (FEF75％) and total lung capacity (TLC) in experimental group were (81.7 ±2.6)％, (75.4 ±4.1)％, (83.2 ±4.6)％,(69.1 ±2.3)％, and (88.7 ±3.4)％ respectively, significantly higher than (69.0 ±3.6)％, (71.3 ± 3.9) ％, (78.9 ± 4.3) ％, (62.3 ± 3.3) ％, and (79.0 ± 4.6) ％ respectively in control group (P ＜0.01).In experimental group, there were four cases of pulmonary infection (13％), three pulmonary atelectasis(10％) and one intercostal neuralgia (3％).In control group, there were six cases of pulmonary infection (20％), five pulmonary atelectasis (17％), four intercostal neuralgia (13％) and four thoracocyllosis(13％)(P ＜0.05).There was no significant difference in mortality between the two groups.Conclusion Treatment effect of internal rib fixation for flail chest with pulmonary contusion is improved in combination with mechanical ventilation and external chest fixation.

OBJECTIVETo investigate the effects of pravastatin, fosinopril and their combination on ventricular remodeling, cardiac function, tumor necrosis factor-alpha (TNF-alpha) mRNA expression, and matrix metalloproteinases (MMPs) activities after myocardial infarction (MI) in rats.

METHODSAcute myocardial infarction (AMI) was established by ligation of the anterior descending coronary artery in male Sprague-Dawly (SD) rats. Twenty-four hours after the procedure, the 48 surviving rats were grouped randomly as AMI control, fosinopril (10 mg.kg(-1).d(-1)), pravastatin (20 mg.kg(-1).d(-1)) and a combined use of the 2 drugs. Sham-operated group (n = 8) was taken randomly as non-infarction control. Six weeks after treatment with the drugs by gastric gavage, heart function and left ventricular remodeling were assessed. Left ventricular weight (LVW)/body weight (BW) ratio was determined. The relative expression of myocardium TNF-alpha mRNA was assessed by reverse transcription-polymerase chain reaction. Left ventricular myocardium MMPs activities were assessed by Zymography.

RESULTSThere were no significant differences among the four AMI groups in infarction size (P > 0.05). In comparison with the AMI group, left ventricular end-diastolic pressure, left ventricular end-diastolic diameter, LVW/BW all decreased significantly (P < 0.05 - 0.01); while dp/dtmax, dp/dtmin, fractional shortening (FS) and ejection fraction (EF) increased significantly in all three drug-treated groups (P < 0.05 - 0.01); increments of FS, LVEF and dp/dtmax were more evident in the combination group than either the fosinopril or pravastatin group (P < 0.05). The levels of TNF-alpha mRNA in AMI rats treated with fosinopril, pravastatin and their combination reduced 29%, 26% and 33%, respectively (P < 0.01); MMP-2 activity reduced 25%, 30% and 35%, respectively (P < 0.01); MMP-9 activity reduced 20%, 18% and 24%, respectively (P < 0.01). There were no significant differences in other variables among the 3 treatment groups (P > 0.05).

CONCLUSIONPravastatin, fosinopril and their combination showed favorable effects on left ventricular remodeling after AMI in rats and demonstrated improved cardiac function. The combined treatment group yielded better results in the context of improving left ventricular systolic function. These effects could be relevant to the attenuation of increased MMP-2 and MMP-9 activities and left ventricular expression of TNF-alpha.

Angiotensin-Converting Enzyme Inhibitors ; therapeutic use ; Animals ; Drug Therapy, Combination ; Fosinopril ; administration & dosage ; therapeutic use ; Male ; Matrix Metalloproteinase 2 ; metabolism ; Matrix Metalloproteinase 9 ; metabolism ; Myocardial Infarction ; drug therapy ; pathology ; physiopathology ; Pravastatin ; administration & dosage ; therapeutic use ; RNA, Messenger ; analysis ; Rats ; Rats, Sprague-Dawley ; Tumor Necrosis Factor-alpha ; genetics ; Ventricular Remodeling ; drug effects

OBJECTIVE: To establish a simple, sensitive in vitro method to evaluate oxygen/glucose deprivation (OGD)-induced injury of brain hippocampal slices in rats. METHODS: Rat hippocampal slices were incubated in 2% 2, 3, 5-triphenyltetrazolium chloride (TTC) solution after oxygen/glucose deprivation. They were then soaked in a measured volume of ethanol and dimethylsulfoxide (50:50) to extract the TTC formazan Product which was then measured by spectrophotometry. OGD induced LDH release was simultaneously measured. RESULTS: Progressive prolongation of OGD induced hippocampal injury resulted in decreased formazan coloration as determined by spectrophotometry. There was a parallel increase in LDH release, thus a negative correlation in these two products was noted. (r=-0.933,P <0.01). The injury was attenuated in the brain slices pre-treated with nimodipine, dexamethasone, and ketamine, but not ONO-1078. CONCLUSION: Solvent extraction and spectrophotometric quantification of formazan represents an objective measurement of OGD-induced injury of rat hippocampal slices.

Adolescent ; Adult ; Cerebral Cortex ; surgery ; Female ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods

Objective To explore the effect of miR-126 on proliferation and apoptosis in colon cancer cells via targeting regulation of SOX2 expression. Methods miR-126 mimics and miR-126 NC were transfected into SW480 cells by liposome LipofectamineTM2000. The expression of miR-126 was detected by RT-PCR. Cell viability was determined by MTT staining. Cell apoptosis and cell cycle were detected by flow cytometry. The expression of SOX2 protein and mRNA was measured by western blot and RT-PCR. Luciferase reporter analysis was performed. Results Compared with miR-126 NC, the expression of miR-126 was upregulated(P< 0.01),cell viability was reduced(P< 0.01),early cell apoptosis rate and late apoptosis rate were increased(P< 0.01), cell cycle was arrested at G1 phase(P< 0.01), meanwhile, miR-126 mimics targeted downregulation of the expression of SOX2 protein and mRNA(P< 0.01). Conclusions miR-126 mimics can inhibit SW480 cell proliferation and induce cell apoptosis by targeting downregulation of expression of SOX2.

Objective To compare two different methods of pressure sores prevention in the pediatric (0-14 years old) neurosurgery operation which duration more than 6 hours.Methods A total of 193 pediatric brain tumors patients , which were in accordance with the inclusive criteria in October 2014 to December 2015 , were randomly divided into control group (96 cases) and observation group (97 cases).The patients of control group used conventional pressure sores nursing care plus foam dressings and the patients of observation group used conventional pressure sores nursing care plus homemade rubber water sac decompression pad .Instantly after the operation , 4 hours later and 24 hours after the operation , the situation of skin pressure sores was recorded respectively , and the maximum diameter of erythema was measured , and the process was put into phases .The skin pressure sores was compared between the two groups .Results Preoperative pediatric waterlow pressure sore risk rating scale was similar between the two groups , and there was no statistical significance ( P>0.05).In control group, 12 cases appeared different degree of erythema in the head , hip, tail lumbosacral region, heel, and other easy to pressure parts of the body , but no blister and burst .The with incidence of pressure sores 12.5%.In observation group, 4 cases appeared phase I pressure sores .The difference was statistically significant between two groups (P<0.05).Conclusions For pediatric neurosurgery, especially the operation time is more than 6 hours, the rubber decompression homemade water sac mat can reduce the pressure of surgery in children with skin effectively , improve local blood circulation , prevent the occurrence of pressure sores, and also reduce the treatment cost .It eases to use, and is worth of promoting .

BACKGROUNDMyofibroblastic sarcoma was used to be a controversial neoplasm. This study investigated the clinicopathological features of 20 cases of myofibroblastic sarcoma arising in different locations.

METHODSThe paraffin-embedded tissue samples from 20 cases of patients with myofibroblastic sarcoma were stained immunohistochemically, and 5 cases examined by electron microscopy. Student's t test was used to analyze the difference of Ki-67 labeling index between grade 1 and grade 2 myofibroblastic sarcomas.

RESULTSHistologically, the tumors were composed of slender spindle cells with eosinophilic cytoplasm, and fusiform, tapering, wavy, or plump ovoid; vesicular nuclei and a small central eosinophilic nucleoli. Immunohistochemically, the tumor cells expressed smooth muscle actin (18/20), muscle specific actin (16/20), fibronectin (20/20) and desmin (2/20). Ultrastructurally, the tumor cells revealed abundant rough endoplasmic reticulum and longitudinally arranged fine filaments with focal densities in the cytoplasm. A clinical follow-up of 19 patients showed that 2 cases experienced local recurrence and distant metastasis 6 months to 4 years after the initial operation. Nine cases recurred locally 17 to 46 months after the initial excision, and 9 cases were alive with no evidence of disease.

CONCLUSIONSMyofibroblastic sarcomas, which exhibit diverse histological appearance, can easily be misdiagnosed as benign tumors. Myofibroblastic sarcomas are local destructive lesions with frequent recurrence, and may metastase distantly.

Adolescent ; Adult ; Child ; Desmin ; analysis ; Female ; Fibrosarcoma ; chemistry ; pathology ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Myosarcoma ; chemistry ; pathology ; Recurrence ; Soft Tissue Neoplasms ; chemistry ; pathology

Objective:To observe the clinical effect of acupuncture for persistent allergic rhinitis (PAR).Methods:A total of 154 PAR patients were randomized into a treatment group and a control group,78 cases in the treatment group received acupuncture at meridian points,while 76 cases in the control group received acupuncture at non-meridian points.The treatment was done every other day,3 times a week for a total 4 weeks.The total nasal symptom score (TNSS),the total non-nasal symptom score (TNNSS) and the rhinoconjunctivitis quality of life questionnaire (RQLQ) were measured before the treatment and after 2 weeks and 4 weeks of treatment,as well as 1 month and 3 months after the treatment to compare the clinical effect between the two groups.Results:After 4 weeks of treatment,the total effective rate in the treatment group was 92.3％,versus 76.3％ in the control group,showing a statistically significant difference (P＜0.05).Intra-group comparisons of TNSS,TNNSS and RQLQ scores after 4 weeks of treatment showed statistically significant differences (all P＜0.05).Between-group comparisons of TNSS,TNNSS and RQLQ score after 4 weeks of treatment and in follow-up visits showed statistically significant differences (all P＜0.05).Conclusion:Acupuncture is effective for PAR,and acupuncture at meridian points can produce a better effect than acupuncture at non-meridian points.

OBJECTIVETo study the changes to surfactant proteins in the serum and bronchoalveolar lavage fluids (BALF) of children with Mycoplasma pneumoniae pneumonia (MPP) and their significance.

METHODSSelf-control method was used in the study. Forty-seven MPP children were divided into single lung infected (n=32) and bilateral lung infected groups (n=15) according to lung CT results. Surfactant proteins SP-A, B, C and D were measured using ELISA in the serum and BALF in the two groups. The correlations between SP-A, B, C and D content in the serum and BALF were evaluated by Spearman correlation analysis.

RESULTSSP-A, B, C and D content in BALF from the majorly infected or infected lung were significantly higher than from the opposite lung and serum (P<0.01). SP-A, B and C content in serum was significantly lower than in BALF from the non-infected lung in the single-side infected lung group (P<0.01 or 0.05), but there was no significant difference between serum SP-D content and BALF SP-D content from the non-infected lung. There were no significant differences in SP-A, B, C and D content in serum and BALF from the minorly infected lung in the bilateral lung infected group. Serum SP-D content was positively correlated with BALF SP-D content from the majorly infected lung in the bilateral lung infected group (P<0.01).

CONCLUSIONSSerum SP-D content may serve as a biomarker for evaluating the severity of pulmonary infection in children with community-acquired pneumonia.

Bronchoalveolar Lavage Fluid ; chemistry ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Pneumonia, Mycoplasma ; metabolism ; Pulmonary Surfactants ; analysis ; blood

BACKGROUNDStandard superficial temporal artery-middle cerebral artery (STA-MCA) bypass surgery is an effective treatment for moyamoya disease, but recent evidence suggests that postoperative cerebral hyperperfusion can occur. In this study, the trendline of changes in regional cerebral blood flow (rCBF) after surgery were continually monitored near the site of anastomosis in order to investigate both the efficacy of the procedure for improving rCBF and the possible risk of hyperperfusion.

METHODSStandard STA-MCA bypass surgery was performed on 13 patients. rCBF was measured continually using laser Doppler flowmetry (LDF) until the 5th day after the operation with the LDF probe implanted adjacent to the area of the anastomosis. The trendline of rCBF changes postoperatively was recorded for the analysis performed using SPSS 13.0.

RESULTSThe baseline LDF value of cortical rCBF was (84.68 + or - 14.39) perfusion unit (PU), which was linear relative to absolute perfusion volume before anastomosis and (88.90 + or - 11.26) PU immediately after anastomosis (P > 0.05). The value changed significantly from before to after anastomosis (P < 0.05); it was (417.72 + or - 21.35) PU on the 1st day after surgery, and (358.99 + or - 18.01) PU, (323.46 + or - 17.38) PU, (261.60 + or - 16.38) PU and (375.72 + or - 18.45) PU on the following 4 days, respectively. The rCBF decreased gradually from the 2nd day until the 4th postoperative day, but still was at a high level (P < 0.05). However, on the 5th postoperative day the rCBF increased again to the second highest level, which was significantly different compared with the baseline value (P < 0.05), but not significantly different compared with the values on the other 4 days (P > 0.05).

CONCLUSIONSSTA-MCA anastomosis improves the cerebral blood supply significantly in the early stage after surgery, however, the risk of symptomatic hyperperfusion may exist, which may possibly occur on the 1st day and 5th day after surgery. A LDF is useful for postoperative monitoring for both the efficacy of bypass and possible risk of neurologic deterioration or bleeding from hyperperfusion.

Adolescent ; Adult ; Cerebral Revascularization ; methods ; Child ; Female ; Humans ; Laser-Doppler Flowmetry ; Male ; Middle Aged ; Middle Cerebral Artery ; surgery ; Moyamoya Disease ; surgery ; Regional Blood Flow ; physiology ; Young Adult