Animals ; Arteriovenous Malformations ; complications ; Child, Preschool ; Diaphragm ; blood supply ; Hemothorax ; etiology ; Humans ; Male ; Nematode Infections ; pathology ; Pleural Effusion ; etiology

Septic arthritis of the sternoclavicular joint(SCJ) is a rare condition and accounts for 0.5％-1.0％ of septic arthritis.SCJ infections often require surgical intervention.Diabetes mellitus,rheumatoid arthritis,intravenous drug use,intraarticular injection and immunosuppressive disorders are predisposing factors.Staphylococcus aureus and Pseudomonas aeruginosa are the most common bacteriologies.Early diagnosis of SCJ infection requires a high index of suspicion and a confirmatory CT or MRI scan.The characteristic imaging features include intramedullary and soft tissue gas,sequestra,soft tissue swelling and destruction or widening of joint space.Management strategies have ranged from conservative antibiotic therapy to en-bloc resection of the sternoclavicular joint with or without ipsilateral pectoralis major muscle transposition.The shoulder function in most patients were well preserved.

Literature review of the world on hospital brands, data collection in summary and comparison, and specialist consultancy were used to set the appraisal indicators, while the stratum analysis was used to calculate the weight coefficients of individual indicators, for building the appraisal indicators system for hospital brand effect. In addition, the indicators system and appraisal model were called into play to explore the use of hospital brands, offering scientific references for hospital management.

Modern pharmacological studies have shown that Cistanche deserticola (C. deserticola) has a protective effect on the liver, but its active fraction and mechanism are not clear. In order to identify the effective fraction of C. deserticola Y. C. Ma, an acute alcoholic liver injury model in mice was established with 56-proof Erguotou and different fractional extracts of C. deserticola Y. C. Ma (total glycosides, polysaccharides, and oligosaccharides) were administered. After 14 days of oral administration, liver pathology and lipid deposition were measured and the expression of nuclear factor E2-related factor (Nrf-2), kelch-like ECH-associated protein-1 (Keap-1), and plasmalemma vesicle-associated protein-1 (PV1) were measured by immunofluorescence. The levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), endotoxin (ET), diamine oxidase (DAO), and D-lactic acid (D-LA) in serum, and superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), catalase (CAT), and malondialdehyde (MDA) in liver were measured by ELISA. All animal experiments were carried out with approval of the Experimental Animal Welfare Ethics Committee of the Peking University Health Science Center. The results show that the total glycosides of C. deserticola Y. C. Ma (400 mg·kg^-1) could decrease liver pathology, decrease serum endotoxin, diamine oxidase, and D-lactic acid, and reduce hepatic lipid deposition. Total glycosides also promoted Nrf-2 transfer into the nucleus and decreased the expression of Keap-1 and PV1. In summary, the total glycosides of C. deserticola Y. C. Ma had a protective effect in acute alcoholic liver injury and the mechanism may be related to the activation of the Nrf-2/Keap-1 pathway, improvement of intestinal wall integrity, and inhibition of the transport of harmful substances into the liver.

Objective To investigate the clinical characteristics,the diagnosis and therapy of synchronous multiple primary esophageal carcinoma.Methods Thirty-two cases of synchronous multiple primary esophageal carcinoma were collected from January 1980 to December 2010 and their clinic data were retrospectively analysised.Results In the whole group,there were totally 66 lesions in 30 cases of double primary lesion and 2 cases of three primary lesion.The length of the lesions were 1 cm to 6.5 cm,and there were 22 lesions in cervical esophagus,10 in upper thoracic esophagus,19 in midthoracic esophagus and 15 in lower thoracic esophagus.Within the 66 lesions,65 lesions were squamous cell carcinoma and 1 was adenocarcinoma.The mucosa between the lesions were normal,with a distance of 4 cm to 9.5 cm,average 7.1 cm.Thirty-two patients with synchronous multiple primary esophageal carcinoma received surgery.Among 32 cases,26 of them were given definite diagnosis before operation.Four of them had exploratory operation,one patient underwent palliative resection,27 patients underwent radical resection.Two cases of the pathologic results of esophageal stump showed carcinoma after operation.The complications occurred in 8 patients.Twenty-eight cases were followed up after operation,the 1,3 and 5-survival rate were 76.9％,43.3 and 14.8％,respectively.Conclusion General pre-operation examination can significant helpful for the definite diagnosis of synchronous multiple primary esophageal carcinoma and surgical treatment is better choice for this disease.

AlM:To explore treatment efficacy of the lower eyelid twitch muscle transposition surgery in senile entropion.METHODS:Fifty cases (86 eyes) of senile lower eyelid entropion patients underwent lower eyelid twitch muscle transposition correction surgery as the experimental group, and the other 42 cases (68 eyes) of senile lower eyelid entropion patients received orbicularis muscle shortening correction as controls group. The correction rate, double eyelid symmetry and overcorrection rate of patients were observed one week after surgery. The patients were followed up for 6~12mo to be observed the long-term recurrence rate, double eyelid symmetry and overcorrection rate.RESULTS: One week after operation, eyelid symmetry, overcorrection rate of experimental group and control group had significant difference (P<0. 05); After followed up for 6 ~12mo, eyelid symmetry, overcorrection rate of experimental group and control group had significant difference (P<0. 05). CONCLUSlON: Folding and orbicularis muscle shortening treatment of senile entropion was compared with the lower eyelid twitch muscle transposition surgery treatment of senile entropion, We can find that clinical results in double eyelid surgery symmetry and overcorrection rate are of obvious advantage.

The number of projects and the amount of sponsoring funds have been increasing during the past years.Conventional research branches are respiratory tumor and digestive tumor.Emerging research branches are lung transplantation and lung preservation.Underdeveloped research branches are acute lung injury and acute respiratory distress syndrome and thymic tumor.The position and academic impact of domestic thoracic surgery has been more valuable with the increasing number,quality and achievements of SCI papers.Therefore,international cooperation and megamergers should be encouraged and more attention should be paid to the censorship,implementation and achievements to optimize the value of projects.The aim of this article is providing important information on projects sponsored by National Nature Science Foundation of China(NSFC) in the field of general thoracic surgery,promoting the development of thoracic surgery of China.

Objective To investigate the quality of life and its influencing factors of families primary caregivers of dementia patients .Methods The typically self made questionnaire ,WHO quality of life measurement profile (WHOQOL‐BREF) ,zarit bur‐den of care scale(ZBI) ,social support rating scale (SSRS) et al were adopted to investigate 64 caregivers of AD patients .Results (1) The overall quality of life of family caregivers of total subjective feelings were significantly lower than the general health status of subjective feeling score (t= -2 .217 ,P=0 .030) .The field of physiological and psychology points have no statistically significant difference in comparison with Chinese norm (t= -0 .252 ,-1 .994 ,P=0 .801 ,0 .050);the field of social and environment points have statistically significant difference compared with norm(t= -3 .830 ,3 .658 ,P=0 .000 ,0 .001) .(2) caregiver who have spouse , poor parent child relationship and patients with somatic diseases and mental behavior symptoms have lower quality of life(P<0 .05) .(3)Total score of Quality of life was negatively associated with total score of care burden (r= -0 .433 ,P=0 .000) ,while was significant positive associated with total score of the social support (r=0 .346 ,P=0 .005) .(4)Marital status ,parent‐child rela‐tionship ,physical illness and social support were the main factors affecting the quality of life(r2 =0 .409) .Conclusion Strengthen the social support and psychological intervention of dementia caregivers who has a spouse ,poor parent-child relationship and poor physical condition may help to improve the quality of life .

ObjectiveTo probe the indication,treatment algorithm,anesthesia method,safety and efficacy ofextracorporealshockwavelithotripsy(ESWL)incombinationwithendoscopicretrograde cholangiopancreatography (ERCP) for pancreatic duct stones.MethodsThe patients with chronic pancreatitis and large pancreatic duct stones ( ＞ 5 mm diameter) and receiving ESWL and ERCP between March and July 2011 in Changhai Hospital were prospective studied.The third generation of extracorporeal shockwave lithotripsy was applied in ESWL,and the localization of stone was determined by X-ray.No more than 5000 shocks were given per session,and ESWL was performed continuously till the calculi were fragmented,and then was cleared by ERCP.ResultsA total of 100 patients underwent ESWL during the 5 months,among whom 84 patients received ERCP treatment and 41 cases failed to deep cannulation (41/84,48.8％ ).Multiple stones were seen in 83 patients.Ninety five patients had radio-opaque stones,two patients had radiolucent calculi,while three patients had both radio-opaque and radiolucent stones.Seventy five percent,14％ and 11％ stones were located in pancreatic head,pancreatic head and body,pancreatic body and tail,respectively.A total of 175 ESWL procedures were performed,43 patients needed 2 or more sessions for successful fragmentation.Anesthesia method was mainly intravenous sedation,accounting for 96％ (168/175).ERCP was successful in 96 patients after ESWL,only 4 patients failed after ESWL. Forty one cases which failed ERCP procedures before ESWL underwent ERCP,and 37 patients (90.2％) achieved successful cannulation.Successful fragmentation ratewas 100％.Complete clearance was achieved in 78 patients,and complication rate of post-ERCP pancreatitis,fever was 1.71％ (n =3 ),0.57％ (n =1 ),and the overall complication rate was 2.28％.Conclusions ESWL is an effective,safe and necessary modality for fragmentation of large PD stones in the management of minimal invasive treatment of chronic pancreatitis.

OBJECTIVETo explore the efficacy of homemade hemostatics of injected gelatin matrix (HIGM) for immediately treating blunt hepatic trauma in canine model without additional pressure.

METHODSA total of 27 commercial hybrid dogs underwent celiotomy to establish hepatic trauma model after general anesthesia. The dogs were prospectively randomized into 3 groups: the treatment group (n=9, with the direct application of homemade hemostat), the positive control group (n=9, with thrombin solution), and the negative control group (n=9, with 0.9% normal saline). Time to hemostasis and intra-abdominal blood loss were recorded, and heart rate (HR), mean arterial pressure (MAP), and hematological parameters were compared among these three groups. Gross examinations were performed 30 minutes after surgery.

RESULTSSignificantly shorter time to hemostasis [(1.20±0.33) min] and less blood loss [(47.22±8.61) ml] were observed in the treatment group than in control groups (P 0.05). No cases of bleeding occurred in any animals in the treatment group, and no signs of infection and adhesion formation were evident due to exposure to HIGM. Two cases in the positive control group (22.22%) were found to have rebleeding. All animals in the negative control group experienced visible bleeding.

CONCLUSIONHIGM is effective for controlling bleeding after hepatic trauma without the additional compression, and therefore may be valuable in field surgery.

Animals ; Disease Models, Animal ; Dogs ; Gelatin ; administration & dosage ; Hemostatics ; administration & dosage ; Injections ; Liver ; injuries