Research progress in the relationship between intestinal flora and tumor immunotherapy / 国际生物医学工程杂志

There are various bacterial colonies in the human intestine, which play an important role in the maintenance of human intestinal function and the maintenance of the systemic immune system. After years of research, researchers have found that intestinal flora are closely related to a variety of inflammatory and immune diseases. In recent years, immunotherapy has attracted more and more attention in the treatment of malignant tumors. In these immunotherapy researches, researchers have found that the composition and changes of intestinal flora can affect the efficacy of tumor immunotherapy to a certain extent. In this paper, the literatures related to intestinal flora and tumor immunotherapy were reviewed from four aspects including the relationship between intestinal flora and body's immune mechanism, current status of tumor immunotherapy, correlation research between intestinal flora and tumor immunotherapy, and related factors that affect changes in intestinal flora composition. The researches on intestinal flora and tumor immunotherapy in the past ten years were mainly summarized. The analysis results showed that the intestinal flora plays an important role in the body's immune mechanism and is closely related to the efficacy of tumor immunotherapy.

Etiology, clinical manifestations, and prognosis of liver failure in pregnancy / 临床肝胆病杂志

ObjectiveTo investigate the etiology and clinical manifestations of liver failure in pregnancy and the value of TPL predictive model based on total bilirubin (TBil), prothrombin activity (PTA), and lactic acid (LACT) in evaluating the prognosis of liver failure in pregnancy. MethodsA total number of 69 pregnant patients who were diagnosed with liver failure in The Third Affiliated Hospital of Guangzhou Medical University from January 1, 2009 to December 31, 2019 were enrolled, and according to prognosis, they were divided into death group with 22 patients and survival group with 47 patients. The two groups were compared in terms of etiology, clinical manifestation, laboratory markers, and prognosis. A multivariate logistic regression analysis was used to investigate the independent risk factors for death in patients with liver failure in pregnancy, and a TPL predictive model was established. The t-test was used for comparison of normally distributed continuous data between two groups, and the Wilcoxon signed-rank test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups. The receiver operating characteristic (ROC) curve was plotted, and the area under the ROC curve (AUC) was used to analyze the value of TPL model in predicting the prognosis of patients with liver failure in pregnancy. ResultsOf all 69 patients, 22 died and 47 survived, with a mortality rate of 319%. Acute fatty liver of pregnancy (AFLP) was the most common cause of liver failure in pregnancy (37.7%), followed by viral hepatitis (27.5%). There was no significant difference in mortality rate between the patients with different etiologies (χ2=4.013, P＞0.05). Jaundice was the most common clinical manifestation of liver failure in pregnancy (79.7%), followed by poor appetite (63.8%) and edema of both lower limbs (52.2%). There were no significant differences in clinical manifestations between the survival group and the death group (P＞0.05). Compared with the survival group, the death group had significantly higher TBil, LACT, and international normalized ratio and significantly lower PTA and platelet count (Z=-2.691, Z=-1.998, Z=-2.640, t=-2.545, Z=-2.222, all P＜0.05). The multivariate logistic regression analysis was used to include TBil, PTA, and LACT into an equation and establish the TPL model (all P＜005), and the TPL model had a sensitivity of 90.9%, a specificity of 68.1%, a positive predictive value of 57.1%, and a negative predictive value of 94.1%. The TPL model had an AUC of 0.833 (95% confidence interval ［CI］: 0.771-0.965, P＜0.05), and the TPL model had a significantly higher AUC than the TBil model (AUC=0.702, 95% CI: 0.594-0.805, P＜0.05), PTA model (AUC=0673, 95% CI: 0.550-0.796, P＜0.05), and LACT model (AUC=0.650, 95% CI: 0.494-0.772, P＜0.05). According to the cut-off value of the ROC curve, patients’ mortality rate increased with the increase in the score of the TPL model(χ2=20.312, P＜005). ConclusionAFLP and viral hepatitis are common causes of liver failure in pregnancy, and jaundice, poor appetite, and edema of both lower limbs are common clinical manifestations of liver failure in pregnancy. The TPL predictive model is more accurate than the single index in predicting the prognosis of liver failure in pregnancy and has a better clinical guiding value.

Relationship between the radiation dose of different anatomic bony sites and neutrophil toxicity in three-dimensional radiotherapy concurrent chemotherapy for cervical cancer / 中华放射肿瘤学杂志

Objective:To investigate the correlation between radiation dose of the pelvic bone marrow of different anatomical bony sites and the incidence of neutrophil toxicity during the three-dimensional radiotherapy concurrent chemotherapy for cervical cancer.Methods:Clinical data of 117 cervical cancer patients who received three-dimensional radiotherapy concurrent chemotherapy from 2016 to 2018 were retrospectively analyzed. The dosimetric parameters included D mean, V 5Gy, V 10Gy, V 20Gy, V 30Gy, V 40Gy and V 50Gy. The correlation between the dosimetric parameters and the lowest neutrophil count was analyzed by linear regression analysis. Clinicopathological features and dosimetric parameters were included into the multivariate regression analysis model. Results:The incidence rates of neutrophil toxicity (grade 1-4) were 10.3%, 27.4%, 11.1% and 10.3%, respectively. The linear regression analysis showed that the D mean and V 50Gy of lumbosacral vertebrae (LS), the D mean, V 5Gy, V 10Gy, V 20Gy, V 30Gy, V 40Gy and V 50Gy of the ilium were significantly correlated with the grade 2-4 neutrophil toxicity ( P=0.035、<0.001、<0.001、=0.001、=0.003、=0.001、<0.001、<0.001、<0.001). Multivariate analysis demonstrated that the V 20Gy, V 30Gy and V 50Gy of the LS, the D mean, V 5Gy, V 10Gy, V 20Gy and V 30Gy of the ilium were significantly correlated with the grade 2-4 neutrophil toxicity ( P=0.046、0.038、0.049、0.041、0.039、0.029、0.036、0.029). Conclusion:During the process of three-dimensional radiotherapy concurrent chemotherapy for cervical cancer, the volume of medium-and high-dose of LS and the volume of low-and medium-dose of ilium are significantly correlated with the risk of neutrophil toxicity.

Positioning error analysis of intensity modulated radiation therapy after modified radical mastectomy for breast cancer patients with modified head neck and shoulder thermoplastics mask / 中华放射医学与防护杂志

Objective:To analyze the difference of positioning accuracy by cone beam CT(CBCT) between modified head neck shoulder thermoplastic mask and breast bracket in intensity modulated radiotherapy for breast cancer patients after modified radical mastectomy.Methods:A total of 68 cases of breast cancer treated with IMRT after modified radical mastectomy were selected from August 2015 to December 2018. According to the different immobalization methods, the patients were divided into two groups: modified head neck shoulder thermoplastic mask group (body mask group, 42 cases) and breast bracket group (bracket group, 26 cases). After the first, sixth, 11th, 16th and 21st treatment, the patients were scanned by CBCT. The positioning errors in left and right (RL), anterior and posterior (AP) and head and foot (SI) directions were obtained, and the duration of radiotherapy positioning was recorded. The positioning error, distribution ratio and positioning duration were compared between two groups, and the respective MPTV margin were calculated. The influence of various factors on the setup error of patients was analyzed in the mask group. Results:There were 210 scans in the body mask group and 130 in the bracket group. The setup errors of the body mask group and bracket group in RL, AP and SI directions were (2.12±2.01) and (2.38±1.92) mm, (3.29±2.46) and (3.88±2.76) mm, (3.47±2.29) and (4.11±3.15) mm, respectively, and the differences in AP and SI directions were statistically significant ( t=-2.05, -2.16, P<0.05). The proportion of setup errors less than or equal to 3 mm in the direction for body mask group was higher than that of bracket group ( χ2=4.97, P<0.05). The proportion of setup errors more than 5 mm in AP and SI directions for body mask group was lower than that of bracket group ( χ2=5.21, 9.29, P<0.05). The positioning duration of mask group was shorter than of bracket group ( t=-2.16, P<0.05). The MPTV margins of the mask group in RL, AP and SI directions were smaller than those of the bracket group. The modified head, neck and shoulder thermoplastic mask immobalization method led to large setup errors in AP and / or SI directions for the elderly (≥ 60 years old), the patients with body mass index (BMI) ≥ 24 kg/m 2 and the patients who were relatively unfamiliar with the radiotherapy process (treatment time≤ 2 weeks). The setup error for patients aged < 60 years old in SI direction was smaller than that for the elderly (≥ 60 years old) patients ( t=-2.43, P<0.05). The setup error for patients with BMI <24 kg/m 2 in AP and Si directions was smaller than that with BMI ≥24 kg/m 2 ( t=-2.21, -2.04, P<0.05). The setup error for treatment time > 2 weeks in AP direction was smaller than that for treatment time ≤ 2 weeks ( t=2.23, P<0.05). Conclusions:In IMRT radiotherapy for breast cancer patients after modified radical mastectomy, the application of modified head neck shoulder thermoplastic mask can reduce the setup error in the anterior-posterior and superior-inferior directions, and shorten the positioning duration. For the elderly (≥ 60 years old), BMI ≥ 24 kg/m 2 and the patients who are not familiar with the radiotherapy process (treatment time ≤ 2 weeks), attention should be paid to the setup of anterior-posterior and superior-inferior directions to ensure the treatment effect of radiotherapy.

Treatment of patients with orthopaedic trauma during COVID-19 epidemic / 中华创伤骨科杂志

Objective:To report our experience in treatment of patients with orthopaedic trauma during COVID-19 epidemic.Methods:We retrospectively analyzed the 67 patients with orthopedic trauma who had been treated at Department of Orthopaedics, Peking Union Medical College Hospital from February 1 to March 31, 2020. After screening for COVID-19 infection was performed under strict protection, the patients were diagnosed and assigned to outpatient emergency treatment or hospitalization according to their specific condition. Twenty-six patients were treated at the outpatient emergency department. They were 8 males and 18 females with an average age of 69.5 years. Of them, 6 with vertebral compression fracture were placed on bed brakes, 14 with limb fracture immobilized after close reduction, 2 with skin laceration treated with debridement and suture, and 4 with hip fracture immobilized in bed. In the 41 hospitalized patients, there were 14 males and 27 females with an average age of 68.5 years. In them, hemiarthroplasty was performed for 7 femoral neck fractures, kyphoplasty for 5 vertebral compression fractures, total elbow arthroplasty for one humeral intercondylar fracture, exploration and suture for one case of Achilles tendon rupture, and internal fixation surgery for the remaining 27 cases.Results:Most of the patients had osteoporotic fractures which accounted for 61.5% (16/26) of the outpatients and 68.3% (28/41) of the inpatients, respectively. The duration from injury to surgery averaged 2.3 days and the length of hospitalization 4.5 days for the 41 hospitalized patients, decreased compared with the corresponding data (3.1 days and 11.5 days) for the similar inpatients in the same period last year. In the 41 inpatients, fever was observed upon hospitalization in 4 cases and after operation in 26 cases, and related to their primary injury or surgical trauma in all. Acute pulmonary embolism happened during operation in one patient with femoral shaft fracture.Conclusions:The prevention and control of COVID-19 should be continued. The awareness and behavior of health care providers are expected to be enhanced by strict screening protocol, protection and supervision. The proportion of elderly patients with osteoporotic fracture increased during the COVID-19 pandemic. Shortage of blood was the major problem affecting the treatment. Timely surgical treatment should be indicated for the patients with orthopedic trauma, especially those with lower extremity fracture.

Influencing factors for short-term prognosis of liver failure in pregnancy / 临床肝胆病杂志

Liver failure in pregnancy is one of the most serious complications that greatly threaten the safety of pregnant women and parturients, with a high mortality rate and poor prognosis. The short-term prognosis of liver failure in pregnancy can be predicted based on etiology, clinical type and stage of liver failure, dynamic changes of laboratory markers, liver ultrasound, type and number of complications, selection of obstetric treatment, and whether artificial liver support therapy was performed. It is pointed out that it is necessary for clinicians to comprehensively evaluate the short-term prognosis of liver failure in pregnancy, which helps to guide clinical treatment, optimize medical resource allocation, and improve resource utilization.

Research advances in the etiology of liver failure during pregnancy / 临床肝胆病杂志

Liver failure during pregnancy is a serious liver injury caused by various pathogenic factors during pregnancy and is a critical disease that threatens the life of the mother and the fetus. The causes of liver failure during pregnancy are classified into viral factors, non-viral factors, pregnancy-specific factors, and unknown causes. This article describes the research advances in the incidence rates, deaths, and geographical distribution characteristics of liver failure during pregnancy of different etiologies and compares the clinical features of liver failure during pregnancy of different etiologies. It is pointed out that liver failure during pregnancy of different etiologies has entirely different treatment regimens and prognoses, and the etiological diagnosis has important guiding significance in the treatment of this disease. Further examination should be performed for critically ill pregnant women suspected of this disease to determine the etiology, and appropriate treatment should be given as early as possible.

Expert Consensus on Evaluation, Treatment and Rehabilitation of Traumatic Spinal Cord Injury / 中国康复理论与实践

Spinal cord injury is a catastrophic injury causing lifelong severe disabilities, and poses a great burden to the individuals, families and society. In order to promote the standardization in treatment of traumatic spinal cord injury, the consensus on the evaluation, treatment and rehabilitation of traumatic spinal cord injury was suggested by experts, who came from authoritative multicenter in China. The expert consensus, which formed a standardization process from the first aid clinical treatment to rehabilitation of spinal cord injury, shall give a better practical guide for clinic and rehabilitation physicians.

Treatment of distal tibial fractures with a hybrid external skeletal fixator / 中华创伤骨科杂志

Objective To report the clinical results of managing distal tibial fractures with a hybrid external skeletal fixator.Methods From January 2006 to June 2013,39 patients with distal tibia fracture were managed with limited-close or limited-open reduction and a hybrid external skeletal fixator.They were 26 men and 13 women,with an average age of 40.1 years (range,from 23 to 65 years).According to AO classification,15 fractures were of type A3,8 of type B2,10 of type B3,2 of type C2 and 4 of type C3.According to Gustilo classification,of the 12 open fractures,8 were of type Ⅱ,3 of type Ⅲ a and one of type Ⅲ b.According to Tscherne classification of soft tissue injury,4 cases were of grade l,24 of grade 2,and 11 of grade 3.Open fractures were managed first with radical debridement.Those complicated with fibular fracture were managed first with open reduction and internal fixation of distal fibula followed by close or limited-open reduction and minimal internal fixation depending on the position of distal tibial fracture.Next,the hybrid external skeletal fixation was applied.Five cases were immobilized with trans-articular fixators.The data were recorded regarding interval from injury to surgery,operation time,perioperative blood loss,hospital stay,time of external fixation,time of bony union,and complications.The ankle function was evaluated clinically with the Maryland Scale system at the final follow-ups.Results The 39 patients were followed up for 12 to 18 months (average,14.5 months).Primary incision healing was achieved in 37 cases,but the other 2 patients with open fracture suffered delayed wound healing which was cured by dressing changes for 4 weeks.Altogether,38 cases achieved normal fracture union and their average time of external fixation was 13.5 weeks.The time for complete infusion of fracture lines on X-rays averaged 19.7 weeks.Delayed union occurred in one case whose fracture united after removal of the external fixator,internal fixation with a locking plate and autogenous bone grafting.One case was complicated with pin track infection which was healed after debridement,drainage for 8 weeks and removal of the external fixator.No neurovascular complications were observed.According to the Maryland Scale system,the ankle function was excellent in 8 cases,good in 24 and fair in 7,with an excellent and good rate of 82.1％.Conclusions The hybrid external skeletal fixator is good for distal tibial fractures,because it can cffectively protect the skin and minimize invasion to the soft tissues,reducing incidences of skin necrosis and wound infection.Moreover,since it is flexible in screwing and structure formulation,it facilitates wound management,eslpecially in the management of open fractures.

Relationship between the curative effect of chemoradiotherapy and brain metastasis in limited-disease small cell lung cancer / 中国肿瘤临床

Objective:To determine the relationship between the curative effect of chemo radiotherapy and brain metastasis in limited-disease small cell lung cancer (LD-SCLC). Methods:Data of 149 patients with LD-SCLC who had undergone chemoradiother-apy between April 2009 and April 2012 were analyzed. The curative effect of chemoradiotherapy was evaluated using RECIST version 1.1, which includes complete response (CR), partial response (PR), stable disease (SD), and progression of disease (PD). The objective relief includes CR and PR. Survival was analyzed using Kaplan-Meier method.χ2 text was used to analyze the correlation between the factors. Results:The median overall survival (OS) was 20.0 months, and the 3-year OS rate was 33.0%. Brain metastasis occurred in 43 (28.8%) out of the 149 patients. Among the 43 cases, 12 (29.3%), 9 (11.8%), and 22 (68.8%) had CR, PR, and SD/PD, respectively (P=0.007). The curative effect of chemoradiotherapy correlates with the rate of brain metastasis (17.8%vs. 68.8%, P=0.027). Signifi-cant differences were found between the curative effect and the brain metastasis-free survival (BMFS) (P=0.005). The 2-year BMSF for CR patients was 79.5%, and the corresponding 2-year BMSF for PR, SD, and PD patients was 71.9%, 45.8%, and 49.6%, respectively. Further analysis showed that the performance of prophylactic cranial irradiation (PCI) had an important effect on the OS (P=0.007) of patients who achieved objective relief. Conclusion:The BMFS of patients with LD-SCLC who achieved CR after chemoradiotherapy is favorable, with low rate of brain metastasis. Patients who received PCI had a better OS. Thus, we suggest that timely PCI should be considered for the patients who achieved CR.

The prognostic value of a combined pattern of mediastinal lymph node metastasis for pIIIa-N2 non-small-cell lung cancer / 中国肿瘤临床

Objective:To comprehensively investigate the prognostic significance of nodal skip metastasis and lobe-specific me-tastasis for patients with IIIa-N2 non-small-cell lung cancer (NSCLC). Methods:A total of 218 completely resected pN2-NSCLC cases with systematic lymph node dissections from 2008 to 2009 at Tianjin Medical University Cancer Hospital were enrolled. Mediastinal lymph node metastasis was subdivided into continuous metastasis and skip metastasis according to whether N1 lymph nodes were in-volved. Mediastinal lymph node metastasis was also classified into extensive metastasis and lobe-specific metastasis on the basis of whether the lymph nodes involved were within or beyond lobe-specific regions. Overall survival (OS) and disease-free survival (DFS) were compared. Results:For the whole cohort, 5-year OS was 21.6%and 5-year DFS was 16.8%. The 5-year OS for patients with skip metastasis or continuous metastasis were 37.6%and 22.0%, respectively (P=0.008). The 5-year DFS of patients with skip metastasis or continuous metastasis were 29.1%and 15.0%, respectively (P=0.022). The 5-year OS of patients with lobe-specific metastasis and ex-tensive metastasis were 38.3%and 20.4%, respectively (P=0.005). The 5-year DFS of patients with lobe-specific metastasis and exten-sive metastasis were 28.4%and 15.1%, respectively (P=0.009). According to the two patterns, patients were subdivided into three sub-groups:Group A (presence of both skip metastasis and lobe-specific metastasis), Group B (presence of skip metastasis only or lobe-spe-cific metastasis only), and Group C (presence of non-skip metastasis and non-lobe-specific metastasis). The 5-year OS of the three sub-groups were 47.1%(Group A), 28.1%(Group B), and 16.6%(Group C) (P=0.001), and the 5-year DFS of these subgroups were 35.2%(Group A), 20.8%(Group B), and 11.2%(Group C), respectively (P=0.002). Multivariate analysis demonstrated that the combined pat-tern was an independent prognostic factor for both OS and DFS. Conclusion:This combined pattern of lymph node metastasis was a strong prognostic factor for IIIa-N2 NSCLC. This pattern should be considered when predicting prognoses and during the selection of patients that will receive postoperative treatments.

Expression of anti-avian influenza virus H5N1 secretory IgA in Chinese hamster ovary cells / 生物工程学报

Secretory IgA (SIgA) antibodies in external secretions play an important role in mucosal immune response. Polymeric SIgA was advantageous over monomeric IgA (mIgA) and IgG in several aspects. To express secretory IgA antibody against H5N1 virus, we constructed the secretory component and immunoglobulin J expressing plasmids and co-transfected the plasmids into the Chinese hamster ovary cells (CHO) stably expressing immunoglobulin A. Then we used Zeocin to select the positive clone cells, monoclonal cells stably secreting SIgA was screened through fold dilution method at last. The SIgA antibody secreted from the CHO cells was confirmed by Western blotting, which demonstrated that we had got the complete SIgA molecular. The successful expression of this polymeric anti-H5N1 SIgA in CHO cells will contribute to the production of recombinant SIgA as a preventive agent for infectious disease control.

Construction of anti-H5N1 virus chimeric igA antibody gene and its expression in CHO cells / 生物工程学报

Abstract: To express human-mouse chimeric IgA antibody directed against H5N1 virus, an anti-H5N1 chimeric IgA antibody gene was constructed by joining the light and heavy chain variable region genes and the corresponding signal peptide coding sequences of the anti-H5N1 mouse monoclonal antibody H5N1-HA with the coding sequences of the constant region of the human IgA2 heavy chain and Kappa chain respectively. Then the full-length chimeric light and heavy chain expressing plasmids pEF-IGHA9 and pEF-IGK9 were constructed and transfected into the CHO/dhfr cells. The chimeric IgA antibody expression was confirmed by ELISA, SDS-PAGE and Western blotting. The successful expression of this anti-H5N1 chimeric IgA may help to provide a stand for developing passive immunological agents for H5N1 virus infection prophylaxis.

Rapid site-directed mutagenesis on full-length plasmid DNA by using designed restriction enzyme assisted mutagenesis / 生物工程学报

To use the designed restriction enzyme assisted mutagenesis technique to perform rapid site-directed mutagenesis on double-stranded plasmid DNA. The target amino acid sequence was reversely translated into DNA sequences with degenerate codons, resulting in large amount of silently mutated sequences containing various restriction endonucleases (REs). Certain mutated sequence with an appropriate RE was selected as the target DNA sequence for designing mutation primers. The full-length plasmid DNA was amplified with high-fidelity Phusion DNA polymerase and the amplified product was 5' phosphorylated by T4 polynucleotide kinase and then self-ligated. After transformation into an E. coli host the transformants were rapidly screened by cutting with the designed RE. With this strategy we successfully performed the site-directed mutagenesis on an 8 kb plasmid pcDNA3.1-pIgR and recovered the wild-type amino acid sequence of human polymeric immunoglobulin receptor (pIgR). A novel site-directed mutagenesis strategy based on DREAM was developed which exploited RE as a rapid screening measure. The highly efficient, high-fidelity Phusion DNA polymerase was applied to ensure the efficient and faithful amplification of the full-length sequence of a plasmid of up to 8 kb. This rapid mutagenesis strategy avoids using any commercial site-directed mutagenesis kits, special host strains or isotopes.

Operative treatment of intertrochanteric fractures in the elderly / 中华创伤杂志

Objective To analyze the fracture characteristics, operative indicators, complications and treatment results of intertrochanteric fractures of femur in over 80 years old cases. Methods A total of 87 cases (90 hips) of intertrochanteric fractures with mean age over 80 years treated with operative methods from October 1996 to October 2004 were reviewed upon fracture types, preoperative primary diseases, operative methods and postoperative complications. Results The average age was 83.5 years. Of all, 74 cases had different physical diseases included cardiovascular, cerebrovascular, respiratory, digestive system and others (average 2.4 diseases per person). Treatment methods included DHS and intramedullary interlocking nail such as Gamma nail, PFN and reconstructive nails. A follow up for six months in 63 cases showed that excellence rate of functional evaluation was 84%(53/63). Conclusions The full evaluation and treatment of preoperative diseases are the prerequisite for the intertrochanteric fractures in the elderly, for the intertrochanteric fractures in the elderly have high incidence and many preoperative diseases and severe complications.

Complication and its Prevention during the Treatment of Femoral Shaft Fracture with Interlocking Intramedullary Nail / 中华骨科杂志

Objective: In order to popularize the use of interlocking nail, the authors reviewed 81 femoral shaft fractures in 80 patients who were treated with interlocking nail from July 1988 to October 1997. Material and Method: There are 60 males and 20 females. Forty-one fractures were of left femur and 40 of right. The average age was 33 years(range 15-79 years) . Results: The results showed that 60 cases of fractures that followed up over half a year had bony union. The complications included one bone union failure due to incorrect indication. two fractures during the operation, misinserting the proximal screw in 2, and misinserting the distal screw in 3, lengthening of the extremity in 2, valgus knee in 2, deep infection in 1, delayed infection in 1, nail broken in 3, proximal screw broken in 1, distal screw broken in 1, distal screw loosening in 2. Conclusion: 1) The indication must be correctly chosen. 2) Well-trained operative technique for interlocking nail is necessary to reduce the compli cation. 3 )The patient with old or comminuted fracture fixed with G - K nail should properly delay the time to start weight bearing.

Changes on monoamine neurotransmitter in cerebral cortex motor area of traumatic asphyxia canine / 临床神经病学杂志

Objective To investigate the change on monoamine neurotransmitter in cerebral cortex motor area of traumatic asphyxia canines and provide scientific basis for its therapy.Methods The model of canine traumatic asphyxia was established,the change on monoamine neurotransmitter in cerebral cortex (motor area) and the products of metabolism during different time were tested with HPLC DC method.Results At 2 h after damage in cerebral cortex 5 hydroxyindolecetic acid (5 HIAA) elevated remarkably; At 8 h after da mage 5 hydroxytryptamine (5 HT), homovanillic acid (HVA) elevated; but there was no obvious change on norepinephrine(NE) and 3,4 dihydroxyphenyl acetic acid (DOPAC).Conclusion The monoamine neurotransmitters might play an important role in the pathological course of secondary brain injury after traumatic asphyxia.The utilization of 5 HT antagonists or compound inhibitor at early stage was a reliable method for treating brain injury after traumatic asphyxia.