Objective To evaluate the role of autologous septal cartilage in the rhinoplasty of the wide and bulbous nasal tip. Methods A big piece of autologous nasal septal cartilage was removed and transplanted to the front of nasal septum, acting as a septal extender to fix the nasal alar cartilage,and then the shape of nasal tip was reconstructed by middle crus suture technique, excessive soft tissue under skin of tip and a part of lateral crura cartilage were removed to stand out the shape of the nasal tip. Results After one year follow-up, 118 of 126 cases achieved satisfied effects, but 8 cases dissatisfied because of their undue thick skin. Conclusions This method is reliable in the correction of the wide and bulbous nasal tip.

Objective To investigate calcineurin signaling pathway which mediates myocardium apoptosis of right heart in rats with chronic hypoxia and the potential mechanisms of it.Methods A rat model of right ventricular hypertrophy(RVH) was established induced by chronic hypoxia(95-105 mL?L-1 O2).Used randomized block design based on different brood,30 rats were divided into 3 groups:treatment group with cyclosporine A(CsA,10 mg?kg-1?d-1,intraperitoneal injection),chronic hypoxia group,normal control group(with normal oxygen).The rats in CsA treatment group and chronic hypoxia group were exposed to normobaric chronic hypoxia(95-105 mL?L-1 O2,21 days).Apoptotic index(AI),calcineurin A?(CnA?) mRNA levels,Bcl-2 mRNA levels and the protein expression levels of CnA?,nuclear factor 3 of activated T cells(NFAT3) and Bcl-2 in right ventricle were investigated.Results 1.The AI of treatment group with CsA was higher than that in chronic hypoxia group(P

Objective To discuss the effect of transplanting autogenous rib cartilage in correction of short and upwardly rotated nose.Methods A piece of autogenous rib cartilage was transplanted into the front of nasal septa to lengthen it,leading to the nasal tip moving forwards and correcting the short and upwardly rotated nose.For low nose cases,simultaneous implants was used into the nasal back.Results The nasal tips were prolonged 0.75 cm on average after operation in 56 patients with short and upturned noses.The nasolabial angle and extent of nostril exposure were normal after operation.The operational consequences were fine in 54 patients,while 2 case were not satisfactory.Efficacy was stable during one year follow-up.Conclusions This method is reliable,and it can be recommended in rhinoplasty of patients with short and upwardly rotated nose.

Objective Toinvestigatetheriskoflong-termrecurrenceofstrokeanditspredictorsin youngpatientswithischemicstroke/transientischemicattack(TIA).Methods Theclinicaldataofthe consecutive young patients (18-45 years)with ischemic stroke/TIA (within 2 weeks after onset)admitted to the department of neurology in the First Affiliated Hospital of Sun Yat-Sen University between August 2008 and July 2013 were enrolled prospectively. All patients were regularly followed up for a long time (The patients were followed up at the 1 st,6 th,and 12 th month after onset;then they were followed up once for every 6 months)in order to investigate stroke recurrence. The Kaplan-Meier curves were used to analyze the cumulative stroke recurrence rate of all patients. The last contact time for patients lost to follow was used as censored data to be enrolled in the analysis. The univariate analysis of the related risk factors for stroke recurrence using Log-rank test. Multivariate Cox proportional hazard regression was used to detect the related risk factors associated with stroke recurrence (adjusting for age and sex). The variables of the results of Log-ranktestP≤0.1wasselectedandenrolledinthemultivariateregressionanalysis.Results Atotalof 312 patients were enrolled in the analysis,including 294 with ischemic stroke and 18 with TIA. Their mean follow-up time was 34 ± 19 months. Thirty-four patients had recurrent stroke,including 23 with ischemic stroke,7 with TIA,and 4 with cerebral hemorrhage. The cumulative recurrence rates of stroke at 1 ,3 , and 6 years after onset were 6. 2%,10. 3%,and 16. 4%,respectively. The results of multivariate Cox proportional hazards regression analysis showed that hypertension (risk ratio [RR]2. 159;95% confidence interval [CI]1. 048-4. 447,P=0. 037)and cardioembolism (RR,2. 869;95%CI 1. 119-7. 357,P=0.028)weretheindependentpredictorsforstrokerecurrence.Conclusion Theoverall6-yearriskof recurrent stroke is not high in the Chinese young patients with ischemic stroke/TIA,but the risk of stroke recurrence is relatively higher in the first year. Hypertension and cardioembolism are the potential predictors of stroke recurrence;therefore,attention should be paid in clinical practice.

Objective To investigate the risk factors, diagnostic evaluation, etiology, and treatment in young patients with ischemic stroke. Methods The clinical data of young patients (age range 18 - 45 years) with ischemic stroke (within 2 weeks of stroke onset) admitted to the Stroke Center, the First Affiliated Hospital of Sun Yat-sen University from August 2008 to July 2013 were registered prospectively. Results A total of 300 patients were enroled, their age was 37. 8 ± 6. 8 years. There were 227 males (75. 7% ). The age of 84 patients (28. 0% ) was ≤35 years. The most common risk factors were smoking (43. 3% ), hypertension (38. 7% ), and hypercholesterolemia (38. 0% ). The positive result detection rates were lower in the antinuclear antibody (8/278), anticardiolipin antibody (34/250), 24-h Holter monitoring (2/60 ), and transthoracic echocardiography (38/232). According to the MRI findings, the detection rate of the white matter changes, old infarcts, single acute infarcts, and multiple acute cerebral infarcts were 40/282, 77/282, 145/282, and 137/282, respectively. The stroke subtypes of TOAST: large artery atherosclerosis (26. 7% ), smal artery occlusion (18. 0% ), cardioembolism (10. 0% ), other determined etiology (23. 0% ), and undetermined etiology (22. 3% ). Large artery atherosclerosis was mainly involved in anterior circulation (69/80) and intracranial arteries (75/80). In other definite causes, cerebral artery dissection was most common (36/69), and other causes included moyamoya disease (7/69) and infectious vasculitis (7/69), etc. The average length of hospital stay was 15. 4 d. The mean National Institutes of Health Stroke Scale score on admission was 7. 0, and the mean modified Rankin scale score at discharge was 2. 5. The complication rate during hospitalization was 9. 7% . 80. 3% and 48. 3% of patients received anti-platelet drugs and statins therapy during hospitalization.Conclusions This study used a prospective single-center method. It conducted a comprehensive analysis of risk factors, diagnostic evaluation, treatment, and etiology in current Chinese young patients with ischemic stroke. Its research data wil provide useful information for establishing a diagnostic strategy of high performance cost ratio, in-depth understanding of its pathophysiological mechanisms, and improving treatment strategies in Chinese young patients with ischemic stroke.

This is a case study of a 22-year-old National Serviceman presenting with the main complaint of insomnia. This case demonstrates possible gaps in the integration of care between public and National Service healthcare. We illustrate a pathway which primary physicians may use to improve communication with National Service healthcare.

Objective Based on the theory of Service Quality to develop a scale for measuring personal digital assistant satisfaction by nurses and to detect the reliability and validity of this scale. Methods Through the literature research, cross-sectional study and present satisfaction evaluation tool for using personal digital assistant by nurse to build the item pool. The items were selected by 15 experts consultation and the pilot survey of 666 nurses. Results The satisfaction evaluation tool for using personal digital assistant by nurse scale consisted of 41 items;the exploratory factor analysis identified 8 principal factors and explained for 65.22%. Pearson correlation coefficient between each dimension was 0.213-0.684(P<0.01). Pearson correlation coefficient between each dimension and total scale was 0.574-0.798(P<0.01). The Cronbach α coefficient of the scale was 0.928 and test-retest reliability was 0.934. Conclusions The satisfaction evaluation tool for using personal digital assistant by nurse scale has good validity and reliability. It can be used as a tool to measure the satisfaction for using personal digital assistant by nurse.

Objective To observe dopamine transporter (DAT) binding capacity using 99Tcm-TRODAT-1 in drug-naive patients with Tourette's syndrome (TS) on SPECT imaging, and explore possible correlations between 99Tcm-TRODAT-1 uptake ratio and TS patient's age, disease duration, and tic severity.Methods Eighteen drug-naive TS patients, male 14, female 4, as well as 8 age- and gender-matched healthy subjects were recruited. Brain SPECT imaging was performed 2. 5 h after intravenous injection of 11.1 - 14.8 MBq/kg 99Tcm-TRODAT-1. ROI was drawn on the striatum including its sub-regions of caudate and putamen, with cerebellum as the background. Striatum/cerebellum ratio was calculated. Comparisons of the ratios between TS patients and controls were carried out by independent-sample t-test. Pearson correlation analysis was performed between DAT uptake ratios of striatum and patients' age, disease duration, tic severity. Results Compared with the control, higher symmetrically striatum uptake of 99Tcm-TRODAT-1 in TS patients was observed (2.17±0.23 vs 1.87±0.24, t =2.957, P＜0.05). Age (r= -0.320, P＞0.05)and tic severity(r = 0. 345, P ＞ 0.05) scores were not significantly correlated with specific uptake ratios measured in the striatum. But there was significant negative correlation between disease duration and the specific uptake ratios (r = - 0. 483, P ＜ 0. 05). Conclusions 99 Tcm-TRODAT-1 SPECT imaging may play an adjuvant role for initial evaluation of untreated TS.

Objective: To investigate the use of new types of drugs among HIV/AIDS patients in Ningbo City, Zhejiang Province, so as to provide insights into surveillance and interventions for use of new types of drugs among HIV/AIDS patients. Methods: The HIV/AIDS patients in Ningbo City were randomly sampled from the HIV/AIDS Prevention and Control Information System of Chinese Disease Prevention and Control Information System. Patients' demographics, use of new types of drugs and sexual behaviors were collected using questionnaire surveys. Patients' hair samples were collected, and new types of drugs were determined in hair using liquid chromatography-mass spectrometry (LC-MS). In addition, factors affecting the use of new types of drugs were identified using a multivariable logistic regression model. Results: A total of 254 HIV/AIDS patients were enrolled, including 214 men (84.25%), 31 cases aged under 25 years (12.20%), 66 cases aged 25 to 30 years (25.98%), and 157 cases aged 31 to 75 years (61.81%). There were 30 cases reported previous use of new drugs (11.81%), including 27 cases reported previous use of methamphetamine (90.00%). There were 48 cases tested positive of new types of drugs, with a positive rate of 18.90%, including 44 cases tested positive for methamphetamine (91.67%). Multivariable logistic regression analysis identified age (25 to 30 years, OR=6.926, 95%CI: 1.412-33.969), occupation (students/teachers/cadres/employees/retirees, OR=6.971, 95%CI: 2.123-22.889; housekeeping and housework servants/unemployed, OR=3.356, 95%CI: 1.289-8.739; business/public place servants, OR=2.447, 95%CI: 1.033-4.448) and syphilis infection during recent six months (OR=3.491, 95%CI: 1.664-7.326) as factors affecting the use of new types drugs among HIV/AIDS patients. Conclusions The use of new types of drugs exists in HIV/AIDS patients in Ningbo City. Age, occupation and syphilis infection were associated with the use of new types of drugs among HIV/AIDS patients.

OBJECTIVETo study the result of less invasive fixation in treating comminuted fracture of distal tibia.

METHODSFrom 2002 to 2008, 48 patients with comminuted fracture of distal tibia were treated with surgery. The closed reduction and less invasive fixation were done to stable broken fibula, and the reduction by Kirschner wire to pick was used for relatively larger debris of tibia. The Kirschner wire or screw were used to fix fracture after the restore of the ankle cavity position and the alignment of the tibia. Partial weight loading and functional exercise of ankle joint were done at 6th week after operation.

RESULTSForty-eight patients were followed up for 1-24 months with an average of 12 months. All the fractures were united. According to Johner-Wruhs standard to value the result by factors of pain, deformity, motion range of joint,with or without injury of nerve and blood vessel. Thirty-eight cases obtained excellent result, 8 good, fair 2. The rate of excellent and good were 95.8%.

CONCLUSIONLess invasive fixation has ascendancy such as easy operation, less injury of soft tissue, reliable fixation, which can maximally protect periosteum. It is a choice for treating comminuted fracture of distal tibia.

Adult ; Aged ; Bone Wires ; Female ; Fracture Fixation, Internal ; Fractures, Comminuted ; surgery ; Humans ; Male ; Middle Aged ; Tibia ; injuries ; surgery ; Tibial Fractures ; surgery ; Young Adult