Objective To explore the diagnosis and topical treatment of diabetic foot in patients with burns.Methods Sixty-five patients with burns complicated with diabetic foot were admitted from Jan.2002 to Dec.2006.Bacterial culture of wound excretion,peripheral nerve electromyography and vascular ultrasonography of both lower extremities were performed in a part of patients.Twenty-four patients received topical treatment,including immersion bath with hypertonic saline solution and the application of epidermal growth factor,fibroblast growth factor and complex lysozyme disinfectant.Forty-one patients underwent surgical treatment.The operation methods,surgical treatment included debridement followed by direct closure,split-thickness skin grafting,repair with local skin flap or cross leg skin flap,or amputation of foot,as determined according to the condition of the wound.Results The positive rate of bacterial culture of wound excretion was 88.7%(47/53)on admission and 30.2%(16/53)one week after topical treatment.There were abnormal findings of peripheral nerve electromyography in all 31 cases.Vascular ultrasonography revealed pathological findings in both lower extremities of all 12 patients with vascular lesion,and 9 in 16 cases without vascular lesion.The lesions in all patients except 2,who were discharged in advance,healed and the cure rate was 96.9%.Conclusion Peripheral nerve electromyography and vascular ultrasonography of both lower extremities are promising auxiliary examinations for the diagnosis of diabetic foot in patients with burns.Topical treatment,which includes immersion bath with hypertonic saline solution and the application of growth factors and complex lysozyme disinfectant,as well as appropriate surgical management,plays an important role in the wound healing.

An animal model of encephalitis B was successfully established with Jin Wei Yan I strain virus in mice,which made it possible to study the ultrastructural pathology as well as the morphogenesis and release of encephalitis B exerimentally.The ultrapathological changes occurring to the brain tissues especially in the neuron cells were described systematically.A preliminary hypothesis about the morphogenesis and release of encephalitis B virus (Jin Wei Yah I strain) was proposed on the basis of these changes.Replication of the virus was also found to occur in the oligodendroglia but not in the microglia,which maintained its phagocytic function.This fact evidently shows that the micrioglia is not controlled by the mRNA of the virus.According to the literature available to the authors,it seems that the ultrastructural pathological changes of encephalitis B with typical histological lesions in animals had not been reported previously.

Objective To explore influencing factors of the individual entrepreneurship from as-pects of entrepreneurial intention, entrepreneurial cognition and entrepreneurship education. Methods Questionnaire of entrepreneurial cognition was conducted for 1860 students in Southern Medical Universi-ty. SPSS was used to analyze the data. Results ①Entrepreneurship intention among university students were strong.②There was a lack of awareness of college students entrepreneurship policy among college students. ③Students never receiving entrepreneurship education accounted for 65%, but 89%students held that entrepreneurial education courses was necessary. Conclusions Due to arduous professional tasks, medical students have compelling and demanding need for personalized entrepreneurship educa-tion. Initiative participation of library in integrating of entrepreneurship education information by using advantageous resources plays a important role in entrepreneurship education.

Objective To introduce a method of comprehension correction for secondary lip-nasal deformities after operation of the completely unilateral cleft lip. Methods The correction consisted of the following procedures: reposition of the columella and nasal alar crus by one tractional suture with nostril base narrowing; modification of flat nostril by a MT-plasty at the edge of naris; arising of the nasal alar and nasal dorsor by ePTFE implantation; reconstruction of the Cupid's bow by M type incision and vermilion advancement; repair of the vermilion deficit with the hinge mucosal flap and bipedicle mucosal flaps of the lower lip. Results Twenty-one cases with secondary lip-nasal deformities were successfully corrected by these comprehensive methods. Ten of them were followed-up for three months to 1 year with satisfactory effects. Conclusion The comprehensive methods can be used to correct satisfactorily the secondary lip-nasal deformities after operation of the completely unilateral cleft lip.

Objective To observe the therapeutic effect of Shenluo'an Decoction(SD) for the treatment of obese patients with early diabetic nephropathy and to explore the possible mechanism.Methods A total of 68 obese patients with early diabetic nephropathy were randomly assigned into control group and treatment group,34 cases in each group.Both groups were given conventional western medicine treatment including lifestyle regulation,dietary control,and medicine for lowering blood pressure,blood glucose and blood lipids.Additionally,the control group was given oral use of Irbesartan,and the treatment group was given oral use of SD combined with Irbesartan.Before and after treatment,we observed the traditional Chinese medical syndrome scores,body mass index(BMI),blood levels of cystatin C (Cys C),β2-microglobumin(β2-MG),homocysteine (Hcy) and fasting blood glucose (FBG),and urine parameters of urinary monocyte chemoattractant protein-1 / urinary creatinine (UMCP-1/UCR),urinary factor of regulated on activation in normal T cell expressed and secreted / urinary creatinine (URANTES/UCR),urinary albumin-to-creatinine ratio (UACR) and urinary albumin excretion ratio (UAER) before treatment and after treatment for 16 weeks.After treatment,the clinical efficacy and safety were also evaluated.Results (1) During the treatment,5 cases were dropped out,and a total of 63 cases (32 from the treatment group and 31 from the control group) completed the experiment.(2) The total effective rate of the treatment group(90.6％) was significantly higher than that of the control group(67.7％),the difference being significant(P ＜ 0.05).(3)BMI of the two groups after treatment was significantly lower than that before treatment (P ＜ 0.05).(4) After treatment,the traditional Chinese medical syndrome scores,blood parameters (Cys C,β2-MG,Hcy,FBG) and urine parameters (UMCP-1/UCR,URANTES/UCR,UACR,UAER) in the treatment group were decreased as compared with those before treatment and those in the control group after treatment(P ＜0.05).(5) A positive correlation was present among the parameters of UMCP-1/UCR,URANTES/UCR,UACR and UAER.(6) No abnormal changes took place in the blood and stool routine examination,hepatic function,or electrocardiography of the 63 cases.Conclusion SD combined with western medicine exerts certain therapeutic effect for obese patients with early diabetic nephropathy,and is effective on relieving clinical symptoms anddecreasing BMI,Cys C,β2-MG,UACR,UAER,UMCP-1 and URANTES.Its mechanism is probably related with the inhibition of chronic renal inflammation.

Objective To investigate the application and effect of hydrocortisone during perioperation of retroperitoneum laparoscopic surgery for Cushing's syndrome.Methods Data of 56 cases of Cushings's syndrome treated by hormone replacement therapy of hydrocortisone were retrospectively analyzed .The hormone replacement therapy was as the following:no hormone before surgery, intravenous drip of hydrocortisone during and the 1st and 2nd day after surgery, oral intake of hydrocortisone from the 2nd after surgery.Clinical symptoms were observed and plasma,24h urine cortisol levels were intermittently measured after the surgery to evaluate the effects of treatment . Results 2 cases had slight cortical dysfunction symptoms, then back to normal after receiving larger dose of hydro-cortisone.6 cases had blood cortisol levels below the normal range , but they did not have cortical dysfunction symp-toms, and at the same time their 24h urine cortisol levels were normal .Urine cortisol concentration significantly de-creased on the 7th day after surgery, and had significant difference compared with that before surgery .Plasma cortisol concentration significantly decreased on the 6th, 7th day after surgery, and had significant difference compared with that before operation.All the cases recovered well.Conclusion Perioperative hydrocortisone replacement in retroper-itoneum laparoscopic surgery for Cushing's syndrome is safe.

OBJECTIVETo screen SNP information of keloid pedigrees through whole genome sequencing.

METHODSWe Collected information and clinical data of the keloid pedigree and constructed charts of the pedigree. The DNA was extracted from peripheral venous blood samples of the pedigree to sequence the whole genome.

RESULTS27 SNP and 8 disease-associated genes were screened out.

CONCLUSIONSWhole genome sequencing technology can select new genetic mutations associated with keloid, and provide a new way for the research of keloid.

China ; ethnology ; Genome, Human ; Humans ; Keloid ; genetics ; Mutation ; Pedigree ; Polymorphism, Single Nucleotide ; Sequence Analysis, DNA

Objective To investigate the level of thyroid hormone in Xinjiang Uygur and Han old people with mild cognitive dysfunction (MCI),and to provide basis for early intervention of MCI.Methods Case control study was carried out among 5398 residents who was above 60 years old in Xinjiang,Han and Uyghur,from July 2008 to October 2010.According to the diagnosis of MCI by American Psychiatric Society and DSM-Ⅳ,314 patients were diagnosed with MCI matching 299 healthy people as control group.Serum T3 (triiodothyronine),T4 (thyroxine) and TSH (thyroid stimulating hormone) level was determined and compared between control group and MCI group with different nationalities and genders SPSS 17.0 statistical software was used to depict median and quartile of the data,two groups of distribution between the location of the median use Wilcoxon compares the rank of testing and analysis.Results (1) the level of serum T3 in MCI group was lower than that of the control group (1.26 μg/L vs.1.28 μg/L,Z=2.41,P＜0.05),serum TSH level of MCI group was 5.37 mIU/L higher than that of the control group (Z =4.13,P ＜ 0.05).(2) Male serum TSH level of MCI was 5.74 mIU/L higher than that of the control group (Z =5.09,P ＜ 0.05).Women serum T3 level of MCI was 1.29 μg/L lower than that of the control group 1.53 μg/L (Z =2.62,P ＜ 0.05).(3) Serum TSH level of MCI in Han nationality was 6.79 mIU/L higher than that of the control group (Z =4.95,P ＜ 0.05).Serum T3 level of MCI in Uygur nationality was 1.29 μg/L lower than those of the control group 1.39 μg/L (Z =2.58,P ＜0.05),and T4 level was 82.37 μg/L lower than that of the control group 92.71 μg/L (Z =4.28,P ＜ 0.05).(4) Uygur's T4 level was 82.3 μg/L,higher than the 42.12 μg/L in Han nationality (Z =9.83,P ＜ 0.05),level of TSH in Uygur with MCI was 6.79 lower than that of the Han nationality (Z =4.28,P ＜ 0.05).(5) The unconditional Logistic regression analysis showed hypertension,sugar metabolism disorders,hyperlipidemia,low level of T3 were independent risk factors for MCI (OR values were 2.014,2.466,2.096,0.470,respectively,95％ CI were 1.361-2.981,1.649-3.687,1.396-3.149,0.334-0.663,respectively,P ＜ 0.05).Conclusions (1) Thyroid hormone level in old people related to the occurrence of MCI ; (2)Aside recognized independent risk factors for MCI as hypertension,sugar metabolism disorders,hyperlipidemia,low T3 level may be one of the MCI independent risk factors.

Hepatic myelopathy is one of special category changes of nervous system,which was secondary to the end-stage hepatic diseases and is a syndrome of myeleterosis.It usually occurred after portosystemic shunt surgery or collateral circulation of portosystemic vein.The prognosis of hepatic myelopathy is poor,and the progression of this disease is slow.Surgical approaches such as dissociation of colon and anastomosis of ileum and rectum aimed at reducing the absorption of toxic substance and thus to breakdown the blood ammonia and improve the symptoms of nervous system,but the effects are not satisfactory.The clinical data of 1 patient with hepatic myelopathy who received liver transplantation at the Second Affiliated Hospital of Dalian Medical University in April 2012 were retrospectively analyzed.The clinical symptoms and physical signs were improved,and muscle strength was effectively recovered in the patient.Liver transplantation might be an effective method for the treatment of hepatic myelopathy.

Objective To prepare porcine acellular dermal matrix(PADM) without cytotoxicity,to evaluate its biological safety,and investigate its end result in vivo.Methods A piece of porcine split-thickness skin of 0.3-0.4mm was obtained,the epidermis was removed by hypertonic saline immersion,and then the skin was immersed in sodium hydroxide solution,and dermal cells were removed by shaking water bath at normal temperature to harvest PADM.After cross-linking and sterilization,bacteria and porcine virus were examined in the PADM.The PADM were embedded beneath the Sprague-Dawley(SD) rat's skin,and then the general and histological changes were observed after transplantation.Result The obtained PADM was soft and elastic,easy to be moulded,and convenient for operation.No cellular component was found in PADM,the collagen was regularly arranged and elastic fibers were abundant.Bacteria and virus examination of all specimens was negative.No immunologic rejection of PADM was found after being embedded beneath the skin of SD rat.The PADM adhered to the wound firmly,and it was difficult to detach 3 weeks after implantation,and the general structures of PADM beneath rat skin were discernible 24 weeks after implantation.The PADM was infiltrated by inflammatory cells in the early stage,fibroblasts and capillary vessels increased in number along with the time,and collagen fibers gradually gained a regular and compact arrangement in PADM.Conclusions The PADM prepared by hypertonic saline/sodium hydroxide method is a simple preparation process,and there is no cytotoxicity.It has a high biological safety and can be used as dermal scaffold with long-term existence in vivo.