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Objectives To understand the effects of different doses of vitamin D supplementation on serum calcium,phosphorus,alkaline phosphatase and 25-hydroxyvitamin D levels in very low birth weight infants (VLBWI) and to provide guidance for early prevention of metabolic bone disease in VLBWI.Methods A total of 90 VLBWI hospitalized in the Department of Neonatology,Huzhou Maternal and Child Healthcare Hospital between January 2014 and January 2016 were enrolled and randomly divided into two groups:highdose group and low dose group.High-dose group was given vitamin D 900 U/d orally and low-dose group was given 400 U/d since the eighth day after birth.Serum calcium,phosphorus and alkaline phosphatase levels were detected at 1,7,21 and 42 days of age and serum 25-hydroxyvitamin D levels were detected at 7,21and 42 days of age.Two-sample t-test,Chi-square test,one-way analysis of variance and LSD or Dunnett's T3 test were used for statistical analysis.Results No significant differences in serum calcium,phosphorus and alkaline phosphatase levels were found between the two groups at 1 and 7 days of age,nor were found in serum 25-hydroxyvitamin D level at 7 days of age (all P＞0.05).At 21 days of age,high dose group had higher serum calcium,phosphorus and 25-hydroxyvitamin D levels than low-dose group [(2.38 ± 0.09) vs (2.04 ± 0.15) mmol/L,t=2.421;(1.80±0.50) vs (1.71 ±0.60) mmol/L,t-0.637;(45.58± 18.43) vs (42.53± 16.33) nmol/L,t=0.421],but lower alkaline phosphatase level [(505.12± 185.61) vs (588.32± 168.72) U/L,t=5.314] (all P＜0.05).The same trends were found at 42 days of age.In high-dose group,serum calcium level increased at 7,21 and 42 days of age as compared with that at 1 day of age [(2.43±0.13),(2.38±0.09),(2.39±0.08) vs (2.06±0.57) mmol/L];serum phosphorus level at 7 days of age was lower than that at 1,21 and 42 days of age [(1.31 ±0.26) vs (1.89±0.39),(1.80±0.50),(1.98±0.30) mmol/L];serum alkaline phosphatase level at 7,21 and 42 days of age was higher than that at 1 day of age [(475.18± 133.73),(505.12± 185.61),(538.43 ± 168.16) vs (296.15 ± 99.41) U/L] and a significant increase was observed at 42 days of age as compared with that at 7 days of age;serum 25 hydroxyvitamin D level at 21 days of age was higher than that at 7 days of age,and that at 42 days of age was higher than that at 7 and 21 days of age [(73.55±23.65) vs (30.63± 12.66) and (45.58 ± 18.43) nmol/L];the differences were all statistically significant (LSD or Dunnett's T3 test,all P＜0.05).Conclusions Vitamin D supplementation from the eighth day after birth can improve calcium and phosphorus metabolism in VLBWI and the dose of 900 U/d is more effective than 400 U/d.
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Objective To compare the initial stability between anterior transpedicular screw (ATPS) fixation,anterior plate (AP) fixation and combining anterior and posterior (CAP) fixation for subaxial cervical three-column injury.Methods Six specimens of cervical spine were prepared.After measurement of the range of motion (ROM) of the intact cervical spine,the specimens were made into models of three-column injury.After the models were simulatively reconstructed using an anterior cervical cage,they were stabilized by ATPS,AP and CAP.After the ROMs of the models in the 3 fixation states were measured,the data were normalized by standardizing them to the intact state ROM which was set at 100％.The normalized ROMs of the models in the 3 fixation states were compared.Results The normalized ROMs of AP fixation state in flexion,extension,lefi lateral bending,right lateral bending,left axial rotation and right axial rotation were 119.68±8.34％,119.63±6.74％,115.20±7.91％,117.47±7.81％,120.67±5.99％ and 112.35 ± 8.42％,respectively,significantly larger than those of the intact state (P ＜ 0.05).The normalized ROMs of the other 2 states in all directions were significantly smaller than those of the intact state (P ＜0.05).The normalized ROM of ATPS state in flexion was 87.48 ± 5.31％,significantly larger than that of CAP state (69.60 ± 2.06％) (P ＜ 0.05).There were no significant differences between the normalized ROMs of ATPS state and those of CAP state in extension (65.53 ± 4.36％ versus 67.17 ± 3.10％),in left lateral bending (82.13 ± 2.85％ versus 82.30 ±4.69％),in right lateral bending (81.78 ± 3.42％ versus 81.27 ± 2.79％),in left axial rotation (83.20 ± 2.30％ versus 82.95 ± 2.40％),or in right axial rotation (83.03 ± 1.30％ versus 83.60 ± 6.56％) (P ＞ 0.05).Conclusions In subaxial cervical three-column injury,the initial stability of ATPS fixation may be superior to that of AP fixation and similar to that of CAP fixation.We believe that ATPS can provide enough initial stability for subaxial cervical three-column injury.
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Objective To observe the effect of pidotimod,zinc gluconate,bifico on immune function in the treatment of infants with persistent chronic diarrhea,and to provide new options for clinical treatment.Methods The infants with persistent chronic diarrhea were selected as study objects,all patients were randomly divided into 40 patients of the observation group and 40 patients of control group,both group were given conventional treatment, which including ORS oral rehydration,vitamin supplements,electrolytes,correct acid -base balance,smecta.The con-trol group were given zinc gluconate and bifico(Bifico 20mg/kg,tid;oral zinc gluconate,10 -20mg/d (zinc compu-ting),tid),the observation group were given pidotimod(400mg/times,qd)on the basis of the control group.Both group had been treated for three weeks and been followed for 12month.The symptoms improvement was observed be-fore and after treatment,the time of stool frequency normalization and stool Characters normalization were recorded,the blood were extracted for detecting immunoglobulin (IgA,IgG)and T lymphocyte subsets (CD +3 ,CD +4 ,CD +8 ),the effect and Diarrhea relapses of follow -up of 6 months were evaluated.Results The time of stool frequency normali-zation and stool characters normalization in the observation group and the control group were (4.5 ±1.5 )d and (7.8 ±2.2)d,(4.3 ±1.6)d and(7.5 ±2.0)d,the observation group were significantly shorter than the control group,t =7.146,8.108,all P <0.01.The number of diarrhea relapses of follow -up of 6 months in observation group and the control group were (2.05 ±1.62)times and (3.73 ±1.65 )times,(3.38 ±2.12)times and (5.15 ± 2.32)times,the observaiton group were significantly less than the control group,t =3.845,3.636,all P <0.05.The IgA,IgG,CD +3 ,CD +4 ,of observation group and control group after treatment were (1.75 ±0.10)g/L vs.(1.50 ± 0.11)g/L,(8.95 ±1.42)g/L vs.(8.02 ±1.25)g/L,(57.5 ±6.6)% vs.(50.5 ±6.0)%,(39.5 ±3.5)% vs. (35.6 ±3.6)%,the observation group were significantly higher than before treatment (t =3.633,5.835,9.534, 6.427 and 3.274,3.643,4.732,3.658,all P <0.05).The IgA,IgG,CD +3 ,CD +4 of observation group after treatment was significantly higher than the control group (t =3.553,3.434,3.568,3.336,all P <0.05).The total effective rate of observation group was 90.0%,the control group was 72.5%,the difference was statistically significant(χ2 =6.664,P <0.05).Conclusion The method containing pidotimod,zinc gluconate and bifico can adjust the immune dysfunction,improve immune and humoral immunity,prevent secondary infection,improve nutrition,promote mucosal tissue repair,improve treatment efficacy and reduce the long -term recurrence,worthy of clinical use in the treatment of infants with persistent chronic diarrhea.
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ObjectiveTo investigate the effect of Glutamine (Gln) on the expression of PCNA in intestinal tissue of neo-natal rats with necrotizing enterocolitis (NEC), and to explore the protective mechanism of Gln in intestinal mucosa.Methods Forty-eight neonatal rats at the age of 48 hours were selected, and divided into 4 groups, control group, Gln group, NEC group, NECGln group. Each group had 12 rats. Control group were fed mice milk substitutes; Gln group were fed mice milk substitutes mixed with Gln; NEC group were fed mice milk substitutes and had cold/ hypoxia exposure twice a day for 3 days; NECGln group were exposed to cold stress, hypoxia and treated with Gln mixed in the milk. The expression of PCNA was detected using immunohistochemical method.Results Compared with control group were and Gln group, the general condition was worse, and the weight was decreased in NEC and NECGln group. The inifltrated inlfammatory cells, congestion, edema, intrinsic layer separation were observed in intestinal mucosa in NEC and NECGln group. The intestinal villus was lost in severe in NEC and NECGln group. The PCNA index was 34.17±5.78, 34.42±5.38, 15.00±1.94, 30.67±3.14 in control, Gln, NEC and NECGln group respectively, with signiifcant difference between each groups (H=24.32,P=0.000). The expression of PCNA in NEC group was lower than that in normal, Gln, and NECGln group (P0.008).Conclusions The expression of PCNA in intestinal mucosa was decreased in NEC rats. Gln supplement could raise the expression of PCNA in intestinal mucosa of NEC rats, and accelerate the speed of intestinal mucosa repair.
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Objective To investigate the method and effect of monosegment pedicle instrumentafinn on thoraeolumbar vertebral fracture.Methods Sixteen patients with thoracolumbar vertebral fractures treated by open reduction and monosegment pedicle instrumentation through posterior approach.Posterolateral bone grafting was done in all cases,9 cases were quite decompressed using laminectomy.The follow-up time Was 8-24 months.The spine radiographs and CT scan were taken pre-and post-operation.The parameters used for clinical evaluation were the Denis pain scale,neurological evaluation by the Frankel scale and bone graft healing evaluation by the Suk scale.Results All of the fractures were reduced satisfactorily during the follow-up.The height of the injured vertebral improved rate was 30.8%,kyphosis of the injured vertebral segment rectified obviously.There was no implant break,and no signs of losing were observed in any patient.Nine patients which had neurological deficiency had average improvement more than one degree by the Frankel scale.After operation the pain score was P1 in 14 patients and P2 in 2 patients.Condnsion For the appropriate patients with thoracolumbar vertebral fractures,open reduction and internal fixation of monosegment pedicle instrumentation through posterior approach is a safe and effective method.