Objective To explore the clinical effects of Jiawei Bazhen in treatment of fracture nonunion in children .Methods 60 cases of patients with fracture nonunion from December 2014 to June 2015 in Weinan Maternity and Child Health Care Hospital were divided into experimental group and control group according to random number table, 30 cases in each group.The control group were treated by Shangke Jiegu tablet combined with staphylococcal enterotoxin C injection, and the experimental group were treated by Jiawei Bazhen combined with staphylococcal enterotoxin C injection, with a consecutive treatment of 6 weeks.The efficacy, arthritis symptom score, serum bone morphogenetic protein-7(BMP-7) and vascular endothelial growth factor( VEGF) were compared between two groups.Results The total effective rate in experimental group were higher than that in control group (χ2 =6.667,P<0.05).The arthritis symptom score in experimental group was lower than that in control group(P<0.05).The serum levels of BMP-7 and VEGF in experimental group were higher than those in control group(P<0.05).There was no significant difference in adverse reactions between two groups(χ2 =1.086,P>0.05).Conclusion Jiawei Bazhen could improve the clinical symptoms, increase the levels of BMP-7 and VEGF, and promote the bone fracture's concresc in children with fracture nonunion, with fewer adverse reactions, which has distinct clinical curative effect.

Objective To study the clinical characters and the prognosis of the sciatic nerve injury associated with acetabular fracture. Methods From January 1980 to January 2000, fourteen sciatic nerve injury resulted from acetabular fracture were observed. Three were treated with skeletal traction, eleven were treated with open reduction and internal fixation and neurolysis. Results All cases were followed-up for an average of 18 months. The anatomical reduction of acetabular fracture obtained in 57.1％ of the patients and satisfactory reduction in 42.9％ . The excellent and good nerve functional recovery was seen in 57.1％ according to MCRR. Conclusion Injury of the sciatic nerve associated with the acetabular fracture occurs most commonly when the hip is dislocated posteriorly. Injury of the common peroneal nerve, branching off from the sciatic nerve was more common and had poorer prognosis than that of the tibial nerve. Flexion of the knee and extension of the hip during the surgical reduction of acetabular fracture can reduce iatrogenic injury of the sciatic nerve. Early reduction of acetabular fracture and neurolysis is important for the recovery of function of the sciatic never.

Different materials for skull repair possess varying properties and clinical effects. Metal materials are the first to be applied, but most of them induce corrosion and heat conduction; Non-metal bone substitutes, such as organic glass, have ever been commonly used, but the poor biocompatibility and high infection rate of subcutaneous exudation limit their application; Bone cement shows good histocompatibility, but the repair scale is not complete; Medical silica gel is cheap and effective, but the appearance is not satisfactory resulting from local infections and material exposures; Titanium possesses good biocompatibility and well junctures with the skull, thus it is a promising materials although the shortages still remain. With the development of bioengineering research, the skull repair materials will open up concerning the study of bone tissue engineering, cartilage tissue engineering and cornea tissue engineering. This paper is aimed to search a well-biocompatible and clinically effective material for the skull repair by the comparison on the property and clinical application of varying materials.

Obejective To reform the electrocardiogram teaching mode under clinical pathophisioligy and therapy(CPPT) mode.Methods The junior students of Grade 2010 in Second Clinical Medical College of Wuhan University were selected as subjects.The students were randomly divided into experimental group (44 students) and control group(52 students).Control group was taught by using traditional methods for electrocardiogram(ECG) diagnostics theory,and by using Diagnostics department's own Atlas,while experimental group was taught by reformed teaching methods,and ECG reformed textbook was used in their theoretical lessons,strengthening electrocardiogram and electrophysiology,cardiovascular disease combined.Meanwhile,the practice of teaching was taught by using preview-speaking Figure-Picture stories-Case-Read figure,a way to strengthen the theory-practice-theory of the cycle.The questionnaire was carried out in two groups after ECG teaching.After the end of the course two groups were given packet electrocardiogram atlas test and ECG theoretical knowledge examination and the above evaluation results were statistically analyzed by using SPSS 10.Results The statistically significant differences between experimental group and the control group were in the right ventricular hypertrophy,ventricular fibrillation,WPW syndrome,et al(P＜0.05).The ratio of the experimental group students' liking electrocardiogram course and their recognition of electrocardiogram teaching mode was higher than that of the control group while the ratio of their thinking ECG difficult was lower than that of the control group and the difference was statistically significant difference(P＜0.05).The excellent rate and good rate of the experimental group students' theory knowledge examination results were higher than the control group,two groups of results distribution difference being statistically significant(P=-0.043).Conclusions CPPT teaching model can effectively help students overcome the difficulties in reading electrocardiogram and deepen their understanding of theoretical knowledge and memory.

OBJECTIVETo evaluate the radical effect and postoperative anal function of total mesorectum excision (TME) combined with different intersphincter resection (ISR) in treatment of T1 and T2 stage ultra-low rectal cancer.

METHODSClinical data of 102 T1 and T2 stage ultra-low colorectal cancer patients who received TME combined with different ISR from January 2004 to December 2013 in our department, including 33 cases of complete internal anal sphincter excision ISR (complete ISR group), 39 cases of partial internal anal sphincter excision ISR (partial ISR), 30 cases of partial dentate line reservation ISR (dentate line group). All the operation procedures followed the principles of TME. Radical conditions were compared and similarly, postoperative anal function was evaluated by Williams classification standard among 3 groups.

RESULTSThe general information, such as gender, age, BMI, maximum diameter of tumor, distance of tumor edge to dentate line, TNM staging, degree of differentiation among 3 groups had no statistically significant differences (all P>0.05). The operation time, intraoperative blood loss, length of removed intestinal canal, resection margin, the harvested number of lymph nodes, and postoperative complications among 3 groups also had no statistically significant differences (all P>0.05). Twelve months after surgery, good anal function rate in part ISR group and dentate line group was 100%, significantly better than that in complete ISR group (75.8%) with significant difference (χ2=4.654, P=0.015).

CONCLUSIONTME combined with ISR surgery in treatment of T1 and T2 stage ultra-low rectal cancer is safe and effective, which, as far as possible to preserve partial internal sphincter and dentate line on the premise of the guarantee of radical condition, can help to improve the postoperative anal function.

Anal Canal ; Digestive System Surgical Procedures ; Follow-Up Studies ; Humans ; Lymph Nodes ; Neoplasm Staging ; Operative Time ; Postoperative Complications ; Postoperative Period ; Rectal Neoplasms

In this study, the automatic segmentation of the irregular lesion region in the image of fundus fluorescence angiography was actualized by means of the modified Back Propagation (BP) neural network method. Combining the transfer scaling coefficient between pixel of the image and the actual size, the area of the irregular lesion region was measured. The results may provide valuable data for the clinical diagnosis, treatment and prognostic evaluation.
Algorithms ; Fluorescein Angiography ; methods ; Nerve Net ; Retinal Diseases ; diagnosis ; pathology

OBJECTIVETo compare the effect of rapid rehabilitation surgery (FTS) with the traditional operation method on postoperative immune function recovery, inflammatory reaction and the clinical efficacy in elderly patients with colorectal cancer.

METHODSA total of 144 elderly patients (older than 65 years) diagnosed as colorectal cancer in our department from February 2010 to August 2013 were prospectively enrolled in the study. According to the order of admission, patients were randomly divided into the fast track surgery group (72 cases, study group), and the traditional operation group (72 cases, control group). Preoperative and postoperative T cell subsets, inflammatory index and organ functional parameters were detected and compared.

RESULTBasal clinical data of the two groups had no significant differences (all P>0.05). Three days after operation, CD4+ and CD8+ in both groups increased compared to preoperative levels (P<0.05), while the study group had greater increasing amplitude of CD4+ (t=1.685, P=0.003), and lower CD8+(t=1.145, P=0.005) than the control group. CD4+/CD8+ increased in the study group compared to preoperation and significantly higher than that in the control group (P=0.001). Inflammatory stress indexes were significantly increased, while study group had smaller amplitude than the control group. Serum creatinine, B-natriuretic peptide and Troponin-T increased after operation, while the study group had smaller amplitude than the control group (P<0.05). The study group showed faster resumption of oral intake, quicker bowel function return, time to first defecation, hospital stay, lower incidences of nausea, vomiting, incision infection, and less cost of hospitalization. All the differences were significant (all P<0.05).

CONCLUSIONFast track surgery can effectively protect the perioperative organ function, increase postoperative immune function, decrease inflammation stress reaction, reduce perioperative morbidity of complication, improve efficacy for elderly colorectal cancer patients.

Aged ; Colorectal Neoplasms ; surgery ; Defecation ; Humans ; Inflammation ; immunology ; Length of Stay ; Postoperative Period

Objective:To review the experience of closure of the left-main-bronchial stump fistula using endoscopic liner cutter staplers through the right thoracic approach and I stage or staged treatment for the left pyothorax.Methods:6 patients with the left-main-bronchial stump fistula after left pneumonectomy combined with pyothorax were treated by closing the left-main-bronchial stump using endoscopic liner cutter staplers through the right thoracic approach, and pleura was used to cover the distal and proximal incisional margin of the stump respectively. The thoracic T-tube drainage was used in the I stage or staged treatment for the left pyothorax.Results:All patients were survived without recurrence of the bronchopleural fistula. 4 patients were observed to have no recurrence of pyothorax when 1 patient had recurrence of pyothorax and was treated with intermittent T-tube drainage.1 patient operated with left-thoracic fenestration in the past was treated with drainage waiting for secondary operation.Conclusion:The right thoracic approach seemed to be a safer and more effective method than the transsternal transpericardial approach in cases with the left-main-bronchial stump fistula combined with pyothorax. The use of endoscopic liner cutter staplers reduced the risk of bleeding, infection and recurrence of fistula. The T-tube drainage in the I stage or staged treatment for the left pyothorax was considered to be an easier way for treatment.

Objective To investigate the clinical value of 18 F?FDG PET/CT in staging multiple myeloma ( MM) and evaluating the glucose metabolic activity of MM. Methods A total of 25 MM patients ( 13 males, 12 females, age:39-67 years) from May 2010 to April 2015 were enrolled in this retrospective study. The SUVmax of each patient was recorded. D?S plus staging according to 18 F?FDG PET/CT was com?pared with the traditional D?S staging. The SUVmax and the percentage of plasmacytes of bone marrow of phase Ⅲ and non?phase Ⅲ ( phaseⅠand Ⅱ) according to D?S plus staging were compared. Two?sample t test and Wilcoxon rank sum test were used to analyze the data. Results In 25 MM patients, the range of SUVmax of lesions was 1.8-12?0 and the mean value was 5.15±2.74. According to D?S staging, the numbers of patients with phase Ⅰ,Ⅱ andⅢwere 7, 4 and 14, respectively. While the numbers were 3, 1 and 21 by D?S plus staging. Based on the D?S plus staging system, stages of 7 patients ( 28%, 7/25 ) were changed. According to the D?S plus staging system, the SUVmax between phaseⅢand non?phaseⅢpatients was significantly different (5.75±2.54 vs 3.00±0?70; t=2.12, P<0.05), while the percentage of plasma?cytes of bone marrow between the 2 groups had no significant difference ( 17. 50%( 4. 25%-41. 75%) vs 11?15%(10.25%-36.57%);z=0.05, P>0.05). Conclusion 18F?FDG PET/CT is of clinical importance for MM staging and metabolic activity assessment of MM.

OBJECTIVE: To explore the genetic basis for a child with Neurodevelopmental disorder with or without autistic features and/or structural brain abnormalities (NEDASB). METHODS: A child with NEDASB who presented at the Third Affiliated Hospital of Zhengzhou University in July 2021 was selected as the subject. Peripheral blood samples of the child and her parents were collected and subjected to high-throughput sequencing. Candidate variant was verified by Sanger sequencing and bioinformatic analysis. RESULTS: The child was found to harbor a heterozygous c.820_828delinsCTTCA (p.Thr274Leufs*121) variant of the NOVA2 gene, for which both of her parents were of wild type. The variant was predicted as pathogenic based on the guidelines from the American College of Medical Genetics and Genomics. CONCLUSION The heterozygous c.820_828delinsCTTCA (p.Thr274Leufs*121) variant of the NOVA2 gene probably underlay the disease in this child. Above finding has enriched the spectrum of NOVA2 gene variants and provided a basis for genetic counseling and prenatal diagnosis for this family.
Child ; Female ; Humans ; Pregnancy ; Autistic Disorder/genetics* ; Brain ; Computational Biology ; Genetic Counseling ; Mutation ; Nerve Tissue Proteins/genetics* ; Neuro-Oncological Ventral Antigen ; Neurodevelopmental Disorders ; RNA-Binding Proteins