A total of 20 patients with massive hemorrhage for pelvic fracture, underwent angiographic embolization with gelfoam sponge embolization agents in 3-8 hours after admitted at the Department of Orthopedics, Changhai Affiliated Hospital of Second Military Medical University of Chinese PLA between January 2001 and August 2003 were selected. The patients aged ranged from 18-70 years (mean 43.4-year-old), including 12 male and 8 female. Conduits were inserted into the internal iliac artery embranchment of 8 cases with method of ultraselection, and gelfoam sponge grain and contrast medium were injected together. Conduits combined with gelfoam sponge grain and contrast medium were inserted into 12 cases’ pathic internal iliac artery bole. The whole 20 cases were performed endovascular embolization, and blood pressures turned to normal level after operation gradually without serious complications of embolization. One case died of deterioration after blood pressure stabilization. The result reveals that anglo-graphic embolization with gelfoam sponge embolization agents is a safe, quick and effective method of controlling the severe hemorrhage caused by pelvic fracture.

In more than ten years, hematopoietic factors have been approved to be effective in the treatment of radiation sickness. But there are still some problems in the clinical application, such as suitable cases, dosage, administrative timing, and drug combination. Due to those problems, the efficacy was undermined. Our experimental treatment study showed that hematopoietic factors should be administered early after the radiation exposure. The efficacy of early administration group is better than the one treated in acute phase of radiation sickness. There is also a limit of application duration but not the longer the better. RhTPO along can not induce the granulocytopoiesis and rhG-CSF can not improve the recovery of megakaryopoiesis. Hematopoietic factors do not increase the chromosome mutation rate of tumor cells. We did not observe bone marrow stem cell or progenitor cell exhaustion after we treated those animals for a second cycle of hematopoietic factors or exposed those treated animals to radiation again. RhG-CSF is more effective in the recovery of granulocytopoiesis than rhGM-CSF. RhIL-11 can increase the recovery of three cell lines of bone marrow, especially megakaryopoiesis. We recommended the combination of hematopoietic factors in the treatment of acute radiation sickness. RhG-CSF plus rhIL-11 is a preferred combination.

Objective To investigate the effect of fluorescence in situ hybridization (FISH) in increasing the accuracy and detection rate of chromosome aneuploid from spontaneous abortion specimens.Methods Chromosome 13,21,16 and 22 single sequence probes and centromere probes of 18,X and Y chromosome probes were used to detect 100 cases of spontaneous abortion villi samples.The results were compared with conventional karyotype analysis.Results (1) Karyotype analysis:Among 89 successfully cultured villi samples,51 abnormal karyotypes (57.3％) were found,including 37 cases of autosomal aneuploidies,four sex chromosome aneuploidies,two triploids,one tetraploid,one 68,XX and six chromosome structural aberrations.(2) FISH:The detection rate of abnormal karyotype was 38.0％ (38/100),among which 25 cases were autosomal aneuploidies,five sex chromosome aneuploidies,three triploids,four XX chimeras and one triploid in chromosome 13,16,18 and 21.(3) Comparison of the two methods:Among the 11 samples which failed by conventional method,FISH found two abnormal samples.In specimens of 46,XY,three cases showed mosaicism by FISH.In specimens of 46,XX,two cases showed chromosomal abnormalities by FISH.FISH detected overall 65.5％ (38/58) of the chromosomal abnormalities.Conclusions FISH combined with conventional chromosome analysis could improve the accuracy and detection rate of abnormal karyotypes in spontaneous abortion specimens.

Objective:To analyze the early changes of gene expression levels and signaling pathways in 661W cell line under hypoxic conditions and to find potential functional target genes.Methods:The cultured mouse 661W cells were divided into hypoxia treatment group and normoxia control group. Cells in the hypoxia treatment group were cultured in a three-gas incubator with volume fraction of 1% and 5% CO 2 at 37 ℃. Cells in the normoxia control group were cultured in an incubator at 37 ℃ with volume fraction of 5% CO 2. High-throughput sequencing technology was used to sequence the transcriptome of 661W cell treated with hypoxia and normoxia for 4 hours to screen for differentially expressed genes (DEG). Clustering heat map analysis, gene ontology (GO) functional enrichment analysis, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis and protein-protein interaction network (PPI) analysis were performed. The reverse transcription-polymerase chain reaction (RT-PCR) was used to verify the accuracy of the sequencing results. Results:A total of 506 differentially expressed genes were screened, including 459 up-regulated genes and 47 down-regulated genes. GO functional enrichment analysis showed that the main biological processes of DEG were the cell's response to hypoxia, glycolysis, negative regulation of cell proliferation and apoptosis. hypoxia inducible factor (HIF)-1α pathway, glycolysis, Forkhead box O (FoxO) pathway, Insulin signaling pathway and Adenosine 5′-monophosphate-activated protein kinase (AMPK) pathway were involved in the above process. PPI analysis results showed that hub genes related to hypoxia were Aldoa, Aldoc, Gpi1, Hk2, Hk1, Pfkl, Pfkp, Vhl, Fbxo10 and Fbxo27. The RT-PCR results showed that the relative expression levels of 15 DEG mRNA in the hypoxic treatment group were higher than that of the normoxic control group, and the difference was statistically significant ( P<0.05). The mRNA expression levels of N-myc downstream-regulated gene-1 ( Ndrg1 ), Mt1, and vascular endothelial growth factor A ( VEGFA) were time-dependent on hypoxia. Conclusions:Under hypoxia, DEG is mainly related to glucose metabolism, cell response to hypoxia, regulation of proliferation and apoptosis. HIF-1α pathway, glycolysis, FoxO pathway and AMPK pathway are involved in the early changes of 661W cells under hypoxia. Aldoa, Aldoc, Gpi1, Hk2, Hk1, Pfkl, Pfkp, Vhl, Fbxo10, Fbxo27 may play key roles in the response of 661W cells to hypoxia. Ndrg1, Mt1 and VEGFA could be potential functional target genes for the study of ischemia and hypoxia-related fundus diseases.

Objective To explore coping strategies and influence factors in primary glaucoma patients through describing characteristics of their coping strategies.Methods From November 2007 to June 2008,data were collected from 120 primary glaucoma patients in three hospitals in Guangzhou and Shenzhen.The final sample consisted of 100 patients and the data underwent analysis.Results Among different coping styles of primary glaucoma patients,facing was lower than norm,avoiding and yielding were higher than norm.The factors related to coping style were age,different cohabitant,different economic condition,different occupation,different educational level and health payment mode.Conclusions Primary glaucoma patients usually took avoiding or yielding coping styles.Nurses should help patients with low income and education background to face the disease positively.Besides,fully consideration should be given to patients with different age,at the same time,marriage and family support should also exert active function.

In order to improve the efficacy of vibration expectoration and prevent secondary injury in patients with chest trauma,the body surface marking method was used in vibration expectoration.The exact injured locations and areas were identified via CT ot X-ray results.Then,the restricted and focused areas of expectoration were marked with red and green colors,which could guide the machines to avoid the fracture sites,reduce pain,prevent secondary injury and administrate effective expectoration in the areas of sputum and atelectasis.However,the dynamic CT or X-ray results must be used for reference to ensure the accuracy of the body surface marking.

BACKGROUND:Lightweight polypropylene mesh with lower content of polypropylene is added with some absorbable ingredients, and wil these ingredients cause adverse reactionsin vivo?
OBJECTIVE:To compare the effect of lightweight polypropylene mesh and standard polypropylene mesh on tension-freerepair ofinguinal hernia.
METHODS:Forty patients with inguinal hernia were randomly divided into two groups (n=20 per group):the patients were treated by lightweight polypropylene mesh as experimental group andthose treated by standard polypropylene mesh ascontrol group. At 2 daysafter surgery, white blood cel counts, neutrophils percentage and level of C-reactive protein were detected. Furthermore, pain scores as wel as discomfort incidence and complications were assessed and recorded at 2 days, 1, 3 and 6 months after surgery, respectively.
RESULTS AND CONCLUSION:There were no significant differences in postoperative complications between two groups. White blood cel counts and neutrophils percentage in the experimental group were significantly lower than those in the control group (P< 0.05), butthelevel of C-reactive protein had no significant difference. Besides, pain scores had no significant differencebetween the two groups, but the postoperative discomfort incidence in the experimental group was significantly decreasedcompared with the control group (P< 0.05). In conclusion, lightweight polypropylene mesh can reduce postoperative inflammation and discomfort incidence.

Objective To evaluate the impact of ghrelin on depleted uranium ( DU)-induced damage of the osteoblast MC3T3-E1. Methods MC3T3-E1 cells were treated with different doses of ghrelin for 1 h before DU (500 μM) treatment. After 24 hours,the cell via-bility,intracellular tartrate-resistant acid phosphatase (StrACP),alkaline phosphatase (AKP),osteoprotegerin (OPG),solvable receptor acti-vator of nuclear factor-κB ligand ( sRANKL) ,catalase ( CAT) and reactive oxygen species ( ROS) were measured. Results After DU expo-sure,ghrelin pretreatment increased the cell viability and CAT levels,and reduced intracellular StrACP,AKP,sRANKL/OPG and ROS in a dose-dependent manner. Conclusion Through maintaining the balance of OPG/RANKL and reducing the oxidative stress,ghrelin could pro-tect against DU-induced damage of MC3T3-E1 cells.

Objective To compare the rehabilitation effection between standard aerobic training and combined aerobic train-ing in patients with chronic heart failure.Methods Eligible 27 patients with chronic heart failure were collected and divided into two groups:AT group (standard aerobic training)and ARI group (combined aerobic training).Then two groups underwent differ-ent trainings in 12 weeks respectively.Various indexs such as PImax,QME,QMTpeak ,1RM,exercise time,MLwHFQ,and Borg Scale was analyzed before and after the training.Results QMTpeak ,IRM,QME,PImax and SPImax in ARI group were better than those in AT group(P <0.05).And all these index of ARI group also developed compared with before the training(P <0.05),while in AT group,only QME and PImax changed(P <0.05).Both group′s Peak VO2 ,excrcise time,VT increased significantly,and VE/VCO2 slope、SBPpeak and CP of them improved.Compared with AT group,the exercise time of ARI group was longer(P =0.01 ). The echocardiographic parameters of ARI group improved after training(P <0.05),while only LVEF and LVESD had significant different in AT group(P <0.05).MLwHFQ,Brog scale score of ARI group were better than those in AT group.And only MLwH-FQ NYHA in ARI group improved after training(P <0.05).Conclusion The strength of the upper limb and respiratory muscle cardiopulmonary function,and quality of life have been improved markedly in ARI group.

OBJECTIVETo explore the clinical effects of negative pressure wound therapy (NPWT) combined with artificial dermis grafting and autologous skin grafting on repair of open joint wounds and/or wounds with exposed bone fracture.

METHODSEleven patients with open joint wounds and/or wounds with exposed bone fracture, hospitalized from November 2008 to November 2014, were enrolled in the study. According to the differences of the first stage treatment, all patients were divided into experimental group ( n = 6, including 4 patients of open joint wounds, 1 patient of wound with exposed bone fracture, and 1 patient of open joint wound with exposed bone fracture), and control group ( n 5, including 2 patients of open joint wounds, 2 patients of wounds with exposed bone fracture, and 1 patient of open joint wound with exposed bone fracture). After debridement, the wounds in both groups were grafted with punctured artificial dermis, while NPWT was only used over the artificial dermis of experiment group for 1 week. In the operation at sacsod stage, autologous split-thickness skin was grafted on the vascularized artificial dermis in both groups. Results In 5 patients of open joint wounds in experimental group, the artificial dermis was vascularized well, autologous skin grafts survived, and wounds were healed. In 3 patients of open joint wounds in control group, the artificial dermis grafting all failed due to local infection, and then these wounds were repaired with local tissue flap grafting. Artificial dermis in 3 patients of wounds with exposed bone fracture in both groups was vascularized well after grafting, and the wounds were healed after autologous skin grafting, whether or not NPWT was used.

CONCLUSIONSNPWT combined with artificial dermis grafting and autolognus skin grafting can be used for repairing open joint wounds and/or wounds with exposed bone fracture.

Debridement ; Dermis ; transplantation ; Humans ; Negative-Pressure Wound Therapy ; methods ; Skin Transplantation ; methods ; Skin, Artificial ; Surgical Flaps ; Wound Healing