Asian Continental Ancestry Group ; Databases as Topic ; Humans ; Injury Severity Score ; Maxillofacial Injuries

Objective To establish mouse models of total body irradiation (TBI) with different doses of 60 Co radiation combined with skin defect, so as to investigate the influence of TBI on wound healing and the pathophysiological changes in combined radiation injury and skin defect. Methods A total of 180 female Kunming mice were irradiated with a single dose of 4, 6 or 8 Gy 60 Co ray. Within 30 min after irradiation,a full thickness square wounds (1.5cm×1.5cm) was made on the back of mice to establish animal models of TBI combined with skin defect (n=50), another 30 mice with pure skin defect were used as controls (n=30). Mice in each group were sacrificed on the 3rd, 5th, 7th, 10th and 14th day after injury, each time 6 mice, and the full thickness wounds were harvested. Histological method was used to evaluate the changes of inflammatory cells, fibro blasts and new blood capillaries in the wounds. Image analysis system was used to analyze the areas of the residual wounds. The survival rates and body weight changes of mice within 14 days were analyzed in all groups. Results On the 7th and 14th day after injury, the survival rates of mice in the 6 Gy group were 75% and 55%, respectively. While in the 8 Gy group the survival rate of mice was only 33% on the 7th day,and all the animals died by the 10th day. Within 14 days after injury, the body weight loss of mice demonstrated an increasing tendency with the increase of radiation doses (4,6,and8 Gy groups). TBI delayed wound healing in mice with the increase of irradiation dose.The unhealed areas in the 6 and 8 Gy groups were larger than that in the control group on the 2nd day (P<0.01), and that in 4 Gy group was significantly larger than that in the control group on the 8th day (P<0.05). H-E staining showed that the early inflammatory responses were inhibited, the increase of fibroblasts and new capillaries were greatly delayed, and the granulation tissue formation and reepithelialization were slowed down in the TBI group compared with the simple wound group.Conclusion Animal models of TBI with 6 Gy 60 Co ray combined with skin defect can serve as a platform to study the mechanism of difficult healing and early treatment of radiation injury combined with skin defect.

Abstract: Objective　To explore the correlation between levels of hypersensitive C-reactive protein (hs-CRP) and procalcitonin (PCT) in serum and alveolar fluid and severity of disease in children with lobar pneumonia. Methods　A total of 112 children diagnosed with lobar pneumonia from September 2020 to September 2021 were selected as the research subjects. The levels of hs-CRP and PCT in serum and alveolar fluid were detected by double antibody sandwich enzyme-linked immunosorbent assay (ELISA). The children were divided into severe group (clinical pulmonary infection score, CPIS≥6 points) and mild group (CPIS<6 points) according to the severity of disease, and further classified into good prognosis group (cured, improved) and poor prognosis group (uncured) according to their treatment outcomes. The correlation of levels of hs-CRP and PCT in serum and alveolar fluid with disease severity in children and their predictive value on prognosis were analyzed. Results　The levels of serum hs-CRP and PCT in severe group were (17.73±3.26) μg/L and (8.59±1.84) μg/L, which were significantly higher than corresponding (12.58±3.09) μg/L, and (5.62±1.59) μg/L in mild group (P<0.05); the levels of hs-CRP and PCT in alveolar fluid in severe group were (21.25±4.18) μg/L and (8.71±1.54) μg/L, which were significantly higher than corresponding (13.79±2.76) μg/L and (5.38±1.69) μg/L in mild group (P<0.05). The levels of hs-CRP and PCT in serum and alveolar fluid were positively correlated with CPIS scores (r=0.398, 0.441; 0.475, 0.586, P<0.05). The levels of hs-CRP and PCT in serum in poor prognosis group were (20.09±4.20) μg/L and (13.35±2.91) μg/L, which were significantly higher corresponding (8.75±2.19) μg/L and (6.28±1.31) μg/L in good prognosis group (P<0.05). The levels of hs-CRP and PCT in alveolar fluid were (23.70±4.29) μg/L and (10.73±2.04) μg/L, which were higher than corresponding (15.08±3.56) μg/L and (5.79±1.10) μg/L in poor prognosis group (P<0.05). There was no significant difference in AUC between combined detection of serum indicators and combined detection of alveolar perfusion fluid indicators in predicting the prognosis of children with lobar pneumonia (P>0.05). Conclusions　The levels of hs-CRP and PCT in serum and alveolar fluid of children with lobar pneumonia are significantly increased and positively correlated with the severity of disease. However, the predictive value of the combined detection of serum indicators and combined detection of alveolar perfusion fluid indicators for the prognosis of children with lobar pneumonia is comparable.

ObjectiveTo investigate the clinical effects of androgen blockade combined treatment for the elderly with middle and late prostate cancer.Methods 63 patients (average age of 69.3 years) with middle and late prostate cancer (above stage T3 ) were studied retrospectively from June 2001 to August 2009.21 cases were treated by operation of bilateral orchidectomy independently.15 cases were treated by castration independently (enantone 3.75 mg or zoladex 3.6 mg/month,hypodermic injection for one year).27 cases were treated by bilateral orchidectomy plus maximum androgen blockade (MAB) (bicalutamide 50 mg,qd,fulutimad 250 mg,rid,po.)Results The survival rates of 1,2,3 years were 100.0％,90.0％,75.0％ in operation group,100.0％,86.7 ％,73.3％ in drug group,and 100.0％,96.2％,84.6％ in MAB group,respectively.The survival rates of 3 years was higher in MAB group than the other groups(x2 =4.460,P＜0.05).The levels of PSA within 3 months decreased and urinary flow rates in three groups increased after treatment than before treatment (t =2.641,3.074,6.703,P ＜ 0.01 ) with no differences among the groups.The relieve period of validity was longer in MAB group than in other groups (F=16.57,P＜0.01 ).Conclusions MAB may be more effective for the elderly with middle and late prostate cancer than castration therapy independently.

Objective To study on the relationship of PTEN with clinicopathological parameters and prognosis of esophageal squamous cell carcinoma patients.Methods The expression of PTEN was detected in 62 cases of esophageal squamous cell carcinomas by immunohistochemistry.Results(1)PTEN expres- sion is negatively correlated with the depth of invasion,lymph node metastasis,distant metastasis,pTNM stage and degree of differentiation.(2)The difference of survival is significant between high and low expres- sion groups.Conclusion PTEN is correlated negatively with the clinicopathological parameters reflecting the malignant biological behavior,and is one of the significant prognostic predictors by univariate analysis.

Objective To explore the causes of bile duct injury during laparoscopic cholecystectomy and its treatment.Methods From January 1998 to February 2007,totally 8600 cases of LC were performed in our hospital.Bile duct injury occurred in 36 of them,among which,the common hepatic duct was cut in 20 cases,the common bile duct was severed in 4 patients,the common hepatic duct was cut and freed in 4;incomplete clipping of the common hepatic duct or common bile duct occurred in 3 and 1 cases respectively;3 cases had injury to the conjunction of the cystic duct and common hepatic duct;electrical burn injury happened in 1 patient.Thirty one of the injured cases were detected during the laparoscopic surgery,while the other five were found because of jaundice or biliary leakage.The patients received bile duct repair and T tube drainage(24),T tube drainage(4),Roux-en-Y bowel biliary anastomosis(4),bile duct anastomosis(1),or removal of the titanium clips after the accidents.Results One of the patients who received bile duct anastomosis developed biliary stenosis after the T tube was withdrawn in 2 months after the surgery,Roux-en-Y bowel biliary anastomosis was thus performed 3 months later.Two patients who underwent Roux-en-Y anastomosis developed anastomotic stenosis after the operation,and thus received a second anastomosis in 11 months.These 3 patients who received totally 3 operations,were followed up for 2 to 3 years,none of them developed cholangitis or biliary stones.One patient in this series had refractory cholangitis,jaundice,and liver function impairment,and was cured after 1-year anti-inflammation and liver support therapy.In the other 32 patients,an 8-to 36-month follow-up(mean,16 months) was achieved,during which none of them showed any complications.Conclusions Bile duct injury can be due to lacking experience and knowledge of the complications of laparoscopic cholecystectomy,inappropriate enrollment of the patients,inaccurate operation,misuse of the surgical instruments,or being unable to discern the Calot's triangle.Strict indications for the operation,advanced training for young doctors,and appropriate timing for conversion to an open surgery are necessary to decrease the rate of bile duct injury.

Objective To investigate the feasibility and clinical value of double-balloon endoscopy in subjects of failed conventional colonoseopy and gastro-intestinal tract modified surgery.Methods Doubleballoon endoscopy was performed in thirty-two subjects of failed conventional colonoscopy,three and nine patients of previous subtotal gastrectomy with BillrothⅡand gastro-intestinal modified surgery for various clinical manifestations.Suceessful intubation rates of terminal ileum or cecum in colonoscopic failure patients,afferent and efferent loop intubation in patients of BillrothⅡand alimentary tract modified surgery,were recorded and diagnostic yields in these patients were also observed.Results The endoscopy was successfully intubated into terminal ileum or cecum in 29 subjects,the intubated rate was 90.6%,the endoscopic diagnosis was obtained in 7 subjects,and endoscopic treatment was performed in 3 subjects.The endoscopy was successfully inserted in terminus of afferent loop and 150-180 cm of efferent below the anastomosis in all 3 patients of Billroth type Ⅱ gastrectomy,and the diagnosis was all clarified.And endoscopic retrograde cholangiopancreatography was performed in one patient.Five of nine patients with previous alimentary tract modified surgery had lesions detected after endoscopic procedure,and double-balloon endoscopy could have a thorough visualization on operated area and suspected region as needed.Abdominal pain and melaena were observed in 8 and 3 subjects respectively.Transient urine amylase elevation was found in one patient.The symptoms were alleviated and amylase was returned to normal after treatment.Conclusions Double-balloon endoscopy was a safe and feasible remediai endoscopic procedure with high diagnostic yields and endotherapeutic interventional capability,in patients of failed conventional colonoscopy and previous BillrothⅡgastrectomy and alimentary modified surgery.

AIM:To investigate the clinical effect of panretinal photocoagulation (PRP) combined with calcium dobesilate in treatment of diabetic retinopathy (DR).METHODS:Selected 120 cases (240 eyes) of DR diagnosed in our hospital from January 2011 to January 2016 were retrospectively analyzed.According to whether calcium dobesilate was used, the treatment group was divided into two groups.Sixty cases were treated with PRP combined with calcium dobesilate, and 60 cases in the control group were treated with PRP only.The BCVA, CMT and clinical efficacy of the two groups were compared.RESULTS:Before treatment, there was no significant difference on BCVA between combined group and control group (P>0.05).After treatment, BCVA of combined group was higher than that of the control group (P<0.01).Before the treatment, no statistically significant difference between combined group and control group on CMT, neovascularization and fluorescein leakage area were found (P>0.05);after treatment, the combination group on CMT, neovascularization and fluorescein leakage area value were less than the control group (P<0.01).After treatment, combined group was appearance effect in 65.0%, effective in 30.0%, invalid in 5.0%, the control group was 50.8%, effective 36.7%, invalid 12.5%, all statistically significant differences between the two groups (P<0.05).CONCLUSION:PRP combined with calcium dobesilate in treatment of DR has a more significant clinical effect than PRP alone.

The introduction of highly active antiretroviral therapy (HAART) has greatly changed the pattern and natural history of ocular diseases of HIV-infected patients, resulting from the immune recovery and reduction of opportunistic infections. However, ophthalmic complica-tion continues to be concern in AIDS even in the HAART era, especially in developing areas, where absolute majority of HIV-positive patients live. Lack of test facilities and experience, poor conditions of hygiene, different microbiological environment, absence of effective treatment etc., characterize the ophthalmic manifestation of HIV-infected patients in developing countries from that in developed regions and thus pose a great challenge to the ophthalmic treatment in developing area. Not only varied from region to region, ocular complications are distinctive between adults and children. At the same time, the side effects due to the application of HAART pose their own risks of ocular complication and should, therefore, be given more research attention.