Adult ; Cartilage ; surgery ; Cholesteatoma, Middle Ear ; surgery ; Ear Auricle ; surgery ; Esthetics ; Female ; Humans ; Male ; Middle Aged ; Otitis Media, Suppurative ; surgery ; Tympanoplasty ; methods

[ ABSTRACT] AIM:To evaluate the clinical application of single nucleotide polymorphism array ( SNP array) in prenatal diagnosis for screening the abnormality of women with Down’ s syndrome ( DS) .METHODS:The amniotic fluid samples ( n=312) collected by amniocentesis for the DS screening abnormality women were tested by karyotyping and SNP array analysis, respectively.The findings of karyotyping and SNP array analysis were compared.RESULTS:Two cases of trisomy 21 were identified by karyotyping and SNP array analysis, but SNP array analysis failed to identify 6 cases of chro-mosome balanced structural rearrangement.SNP detected 176 cases copy number variants ( CNVs) in 303 cases normal karyotype were detected by SNP, including 106 benign CNVs, 61 variants of unknown significance (VOUS), 9 de novo CNVs, and none of them was pathogenic.The distribution difference of CNVs in DS screening positive group and DS screening positive plus advanced maternal age group was not statistically significant ( P>0.05) .Furthermore, we reported 14 kinds of CNVs for the first time in population.CONCLUSION:SNP array can further assure chromosome microdupli-cation/microdeletion.In normal karyotype fetus of prenatal diagnosis, SNP can detect some clinical significant CNVs.

Objective To investigate the relation between the expression of toll receptor-4 (TLR-4) and the increase of blood brain barrier (BBB) permeability in the rats with acute pancreatitis.Methods Male Sprague-Dawley rats were randomly divided into 8 groups:control group;acute edematous pancreatitis (AEP) 2 h,6 h groups;acute necrotizing pancreatitis (ANP) 2 h,6 h,12 h,24 h,48 h groups with 8 rats in each group.The BBB permeability,pathological score of pancreas,TLR-4 expression were determined and the relationships between them were analyzed.Results The BBB permeability in control group;acute edematous pancreatitis (AEP) 2 h,6 h groups;ANP 2 h,6 h,12 h,24 h,48 h groups were 1.55±0.29,1.64±0.17,1.69±0.24,1.89±0.12,2.66±0.32,2.91±0.29,2.89±0.69 and 1.84±0.07,respectively;the pathological scores of pancreas were 0,2.38±0.92,3.13±0.64,8.50±1.07,9.75±0.71,10.25±1.28,11.13±1.25 and 10.13±1.13,respectively;there was no significant difference between AEP groups and control group,while there was significant difference between AEP groups and ANP groups (P＜0.05 orP ＜0.01).BBB permeability was correlated with pancreatic injury ( r = 0.626,P ＜0.01).There was no TLR-4 mRNA and protein expression in the control and AEP group,while they were significantly expressed in ANP groups,and the expression were positively related with BBB permeability ( r =0.208,P = 0.027 ).Conclusions BBB permeability was present in the course of ANP.Activation of TLR-4 signal pathway may be involved in the BBB permeability increase caused by ANP.

Objective This study evaluates the effectiveness for using acute plateletpheresis (APP) as a blood conservation method to reduce the need of blood transfusion and increase coagulation function in aortic arch surgery with deep hypothermic circulatory arrest (DHCA ). Methods Thirty-six type-A aortic dissections patients (male 31,female 5,age 23-65 years,ASA physical status II-IV)undergoing frozen elephant trunk with total arch replacement (Bentall plus Sun's surgery)were enrolled in the prospective randomized trial.The patients were randomized into two groups:regular blood conservation group (group control,n = 18)and group APP (n = 18).Blood sample was collected respectively after anesthesia induction (T1 ),before heparinization (T2 ),by the end of surgery (T3 )and 24 hours after surgery (T4 ).Data was collected and reviewed in terms of perioperative transfusion needs,normal laboratory examination,clinical outcomes including blood routine analysis (Hb,Plt,MPV,P-LCR)and thrombelastography (TEG-R,TEG-K,TEG-α,TEG-A,TEG-MA,TEG-EPL).Kaolin and heparinase detections were performed for TEG.Results Com-pared with T1 ,TEG-R,TEG-K,TEG-A,TEG-MA,TEG-EPL and Plt were significantly decreased while TEG-CI,MPV,P-LCR significantly increased in T4 in group APP (P <0.05 ).TEG-A,TEG-MA and Plt were significantly greater(P <0.05)in group APP than in group control at T2 ,and TEG-K,TEG-ELP and HBG were significantly less (P <0.05)in group APP than in group control at T3 . Conclusion The utilization of APP technique was associated with the improved coagulation function in aortic arch surgery with DHCA.

Objective To learn birth weight of newborn babies and its influencing factors to provide evidence for maternal healthcare.Methods A retrospective analysis was conducted among 5 055 newborn babies from January 2007 to December 2007 to learn their birth weight,gender,pregnant week,maternal age,parity and living areas.Univariate and multivariate Logistic regression analysis were used to explore factors that influenced birth weight.Results For those 5 055 infants,the average birth weight was (3128±675) g,and the incidence of low birth weight or fetal macrosomia was 14.6％ and 8.2％,respectively.In single factor Chi-square test,living area,pregnant week and maternal age were factors that influenced low birth weight and fetal macrosomia (x2 values were 223.807 and 34.120; 2 211.570 and 68.941; 92.199 and 18.745,respectively).Moreover,parity was related with the occurrence of low birth weight (x2=54.822),and gender was found to affect fetal macrosomia (x2=34.503,both P＜0.05).In Logistic regression analysis,preterm birth (odds ratio (OR)=37.140,95％ confidence interval (CI):30.094-45.853),rural residents (OR=0.390,95％ CI:0.310-0.492) and maternal age (OR=0.864,95％ CI:0.779-0.959) were risk factors of low birth weight,and baby boy (OR=0.524,95％ CI:0.423-0.650),urban residents (OR=0.616,95％ CI:0.501-0.758),postterm delivery (OR=4.175,95％ CI:2.918-5.974) and advanced maternal age (OR=1.229,95％ CI:1.104-1.368) were risk factors of fetal macrosomia.Conclusion This investigation suggests a relatively lower average birth weight and higher incidence of fetal macrosomia and low birth weight infant in Changzhi of Shanxi Province.Health interventions,maternal healthcare service programme and pre-and post-natal health education should be carried out to achieve normal birth weight.

Aim To explore the effects of clausenamide(Clau) on hippocampal heme oxygenase(HO-1 and HO-2) expressions in diabetic rats.Methods The diabetic rats model was produced by injecting streptozotocin (48 mg?kg-1). After 3 months,the HO-1 and HO-2 mRNA and protein expressions in hippocampus of diabetic rats were detected by RT-PCR and immunohistochemistry respectively.Results ① The results of RT-PCR showed that the protein expressions of HO-1 and HO-2 mRNA in hippocampus of diabetic group were higher than those of control group(P

Aim To explore the effects of Clausena-mide(Clau) on hippocampus cyclooxygenase-2 (COX-2) mRNA and protein expressions in diabetic rats. Methods The diabetic rat model was produced by injecting streptozotocin (STZ,48 mg?kg-1). After 3 months,the COX-2 gene and protein expressions in hippocampus of diabetic rats were detected by RT-PCR and immunohistochemistry respectively. Results ① The results of RT-PCR showed that the expression of COX-2 mRNA in hippocampus of diabetic group rats increased significantly (P

Objective To investigate the epidemiological characteristics of multiple-injuries of bone and joint in the belief that a better knowledge of such injuries may help their prevention and treatment. Methods A retrospective study was done on the data of 346 patients with multiple-injuries of bone and joint who had been ad- mitted to our department from January 2001 to December 2004. On the basis of CAI's classification, the following data were statistically analyzed: gender, age, cause of injury, injured part, number of injured parts, associated injuries and mortality. Results Of the 346 injured patients, there were 278 males and 68 females, with an av- erage age of 32.8 years (9months to 89 years). Two hundred and twenty-six cases resulted from traffic accidents, 65 from crush by a heavy object, and 52 from falling. There were 159 fractures of shaft of tibia and fibula, 96 fractures of femoral shaft, 87 fractures of shaft of ulna and radius, 58 fractures of ankle and foot, 57 chest injuries, 50 knee injuries, 50 hip injuries, 49 injuries at the pelvis region, 46 wrist and hand injuries, 36 injuries of shoulder, 36 skull fractures, 33 fractures of humeral shaft, 23 spinal fractures, and 17 elbow injuries. Two hundred and forty-two patients had two parts injured, 83 had three parts, 20 had four parts, and one had six parts. The average number of injured parts was 2.3. Two hundred and five patients suffered from close injuries, and 141 from open ones. The associated injuries included skull and brain injury in 51 cases, chest injury in 23, abdomen injury in five, urine system injury in three, nerve and vessel injury in 21, shock in 78, and fat embolism in six. Five patients died. Conclusions Male young people tend to be the majority of victims of multiple-injuries of bone and joint. Traffic accidents result in most of such injuries. Since multiple-injuries mostly involve lower limbs, they are easy to diagnose while the associated close injuries involving brain, chest, abdomen and pelvic are likely to be overlooked or misdiagnosed. Strengthening safety education and technical training of first aid is important to im- provement of treatment and to decrease of disability rate and mortality.

OBJECTIVETo discuss the clinical effect of closed reduction and interlocking intramedullary nailing in the treatment of femoral shaft fracture.

METHODSFrom March 2006 to December 2011,103 patients with femoral shaft fracture were treated by closed reduction and interlocking intramedullary nailing including 76 males and 27 females with an average age of 36 years old ranging from 19 to 55 years old. According to AO classification,there were 64 cases with type A,27 with type B, 12 with type C. Thirteen cases were open fractures including 5 cases with Gustilo type I , 8 with Gustilo type II . The time of bone healing were observed after operation, the knee function recovery was evaluated by HSS scoring standard at 1 year after operation.

RESULTSThe intraoperative complications included femoral neck fracture in 1 case and proximal femoral fracture in 1 case,both of the patients were treated with reconstructive intramedullary interlocking nail and the fractures healed postoperatively. One patient was suffered from common peroneal nerve injury,which were fully recovered at 4 months later after medical treatment. All the patients were followed up from 12 to 28 months (averaged 22 months). All of the fractures were healed well and the average healing time was 3 to 9 months (averaged 5 months). All the hip joints were recovered to normal function. The average HSS was 90.89±5.06 at 1 year after operation.

CONCLUSIONInterlocking intramedullary nailing is the preferred treatment for patients with femoral shaft fracture. Carefully operating and closed reduction can reduce the complications.

Adult ; Bone Nails ; Female ; Femoral Fractures ; surgery ; Fracture Fixation, Intramedullary ; instrumentation ; Fractures, Open ; surgery ; Humans ; Male ; Middle Aged ; Young Adult

Objective To investigate the minimum local analgesic concentration(MLAC)of epidural hydromorphone combined with bupivacaine for analgesia during the first stage of labor by establishing clinical model.Methods Sixty four labouring parturi-ents at 3-7 cm cervical dilation who requested epidural analgesia were allocated to one of two groups.After a lumbar epidural cath-eter was placed,study participants received 15 mL bupivacaine(n=30),bupivacaine with hydromorphone 200 μg(n=30).The con-centration of bupivacaine was determined by the response of the previous patient using 0 - 100 mm visual analog pain scores, with≤30 mm within 30 min defined as effective.Results Four women were excluded,leaving 30 patients in each of the two groups for analysis.The MLAC of bupivacaine alone was 0.103%(95% CI :0.094%-0.113%).The addition of hydromorphone at doses of 200 μg resulted in significant reduction(P <0.05)in the MLAC of bupivacaine to 0.044%(95% CI :0.034%-0.053%),the difference was significant (P <0.05).There was no significant difference in Bromage scores,HR,BP,FHR,UC and adverse reac-tion (P >0.05).Conclusion The study showed a significant reduction in the MLAC of bupivacaine by hydromorphone.Hydromor-phone could be safely used in epidural analgesia for labor.