[A multicenter study of reference intervals for 15 laboratory parameters in Chinese children].

Objective: To establish comprehensive laboratory reference intervals for Chinese children. Methods: This was a cross-sectional multicenter study. From June 2013 to December 2014, eligible healthy children aged from 6-month to 17-year were enrolled from 20 medical centers with informed consent. They were assessed by physical examination, questionnaire survey and abdominal ultrasound for eligibility. Fasting blood samples were collected and delivered to central laboratory. Measurements of 15 clinical laboratory parameters were performed, including estradiol (E2), testosterone(T), luteinizing hormone(LH), follicle-stimulating hormone(FSH), alanine transaminase(ALT), serum creatinine(Scr), cystatin C, immunoglobulin A(IgA), immunoglobulin G(IgG), immunoglobulin M(IgM), complement (C3, C4), alkaline phosphatase(ALP), uric acid(UA) and creatine kinase(CK). Reference intervals were established according to central 95% confidence intervals for reference population, stratified by age and sex. Results: In total, 2 259 children were enrolled. Finally, 1 648 children were eligible for this study, including 830 boys and 818 girls, at a mean age of 7.4 years. Age- and sex- specific reference intervals have been established for the parameters. Reference intervals of sex hormones increased gradually with age. Concentrations of ALT, cystatin C, ALP and CK were higher in children under 2 years old. Serum levels of sex hormones, creatinine, immunoglobin, CK, ALP and urea increased rapidly in adolescence, with significant sex difference. In addition, reference intervals were variable depending on assay methods. Concentrations of ALT detected by reagents with pyridoxal 5'-phosphate(PLP) were higher than those detected by reagents without PLP. Compared with enzymatic method, Jaffe assay always got higher results of serum creatinine, especially in children younger than 9 years old. Conclusion: This study established age- and sex- specific reference intervals, for 15 clinical laboratory parameters based on defined healthy children.

[Minimally invasive tarsal sinus incision combined with manipulative reduction and internal fixation for calcaneal fractures of Sanders typeâ ¡ and â ¢].

Objective: To evaluate the method and curative effect of plate fixation or percutaneous screws for the treatment of calcaneal fractures of Sanders type Ⅱ and Ⅲ via a minimally invasive sinus tarsi incision combined with a variety of manipulative reduction methods. Methods: Twenty-one patients with closed calcaneal fractures treated in the Department of Orthopedics, the First Affiliated Hospital of Nanchang University from January 2014 to January 2016 were collected. There were 15 men and 6 women, with an average age of 39.3 years(from 25 to 63 years). According to the Sanders classification, 16 cases were type Ⅱ and 5 were type Ⅲ.All cases were treated with internal fixation with plate and percutaneous screws via the mini-open sinus tarsi approach following reduction of the posterior articular surface of the subtalar joint and calcaneal length, width and height.Statistical analysis was performed on calcaneal width and Böhler angle, Gissane angle preoperatively and postoperatively (3 days and 3 months). All data were analyzed by ANOVA, functional recovery was evaluated according to the Ankle and Hind-foot Score of American Orthopedic Foot and Ankle Society (AOFAS). Results: Twenty one patients were followed up for a mean duration of 13.4 months(6 to 24 months). All cases gained primary incision healing, without complications such as skin necrosis, wound infection, tenosynovitis of peroneus longus and brevis muscles, or fracture displacement and hardware failure.Bone union was achieved at an average of 10.5 weeks(9 to 11 weeks). No obvious malunion occurred by the last follow-up. Compared to preoperative, calcaneal width(F=25.62, 38.90) were significantly improved 3 days and 3 months after surgery, Böhler angle(F=440.24, 272.42) and Gissane angle(F=91.86, 43.74) were normal, the differences were statistically significant (all P<0.05). Compared to 3 days after surgery, calcaneal width, Böhler angle and Gissane angle kept normal 3 months after surgery, there were no statistically differences (F=0.26, 1.35, 2.60, all P>0.05). By the AOFAS scoring, 10 cases were rated as excellent, 7 were good and 4 were fair. Conclusions: Fixation with plate and percutaneous screws via the mini-open sinus tarsi approach is an effective treatment for Sanders types Ⅱ and Ⅲ calcaneal fractures, which with the advantages of small wound, simple operation, reliable fixation, no incision complication, especially suitable for elderly patients and the patients with severe injury of local soft tissue.

Phosphorylation of mitogen-activated protein kinase is regulated by protein kinase C, cyclic 3',5'-adenosine monophosphate, and protein phosphatase modulators during meiosis resumption in rat oocytes.

Mitogen-activated protein (MAP) kinase, protein kinase C (PKC), cAMP, and okadaic acid (OA)-sensitive protein phosphatases (PPs) have been suggested to be involved in oocyte meiotic resumption. However, whether these protein kinases and phosphatases act by independent pathways or interact with each other in regulating meiosis resumption is unknown. In the present study, we aimed to determine the regulation of meiosis resumption and MAP kinase phosphorylation by PKC, cAMP, and OA-sensitive PPs in rat oocytes using an in vitro oocyte maturation system and Western blot analysis. We found that ERK1 and ERK2 isoforms of MAP kinases existed in a dephosphorylated (inactive) form in germinal vesicle breakdown (GVBD)-incompetent and GVBD-competent germinal vesicle intact (GVI) oocytes as well as GVBD oocytes at equivalent levels. These results indicate that MAP kinases are not responsible for the initiation of normal meiotic resumption in rat oocytes. However, when GVBD-incompetent and GVBD-competent oocytes were incubated in vitro for 5 h, MAP kinases were phosphorylated (activated) in GVBD-competent oocytes, but not in meiotic-incompetent oocytes, suggesting that oocytes acquire the ability to phosphorylate MAP kinase during acquisition of meiotic competence. We also found that both meiosis resumption and MAP kinase phosphorylation were inhibited by PKC activation or cAMP elevation. Moreover, these inhibitory effects were overcome by OA, which inhibited PP1/PP2A activities. These results suggest that both cAMP elevation and PKC activation inhibit meiosis resumption and MAP kinase phosphorylation at a step prior to OA-sensitive protein phosphatases. In addition, inhibitory effects of cAMP elevation on meiotic resumption and MAP kinase phosphorylation were not reversed by calphostin C-induced PKC inactivation, indicating that cAMP inhibits both meiotic resumption and MAP kinase activation in a PKC-independent manner.