Burns ; complications ; diagnosis ; prevention & control ; Humans ; Sepsis ; diagnosis ; etiology ; prevention & control

Objective To evaluate the diagnostic value of MRI in hepatic echinococcosis.Methods MRI features of 37 cases with hepatic echinococcosis proved by operation and pathology were analysed in comparison with that of CT.Results The hepatic echinococcosis could be divided into five types according to the manifestations of CT and MRI:simple cyst in 8 cases,multiple daughter cyst in 13 cases,ruptured cyst in 7 cases,consolidated and calcified cyst in 4 cases and mixed cyst in 5 cases.Conclusion MRI can clearly show and determine the location,size,form,number and types of hepatic echinococcosis,that are helpful for the plan of operation.

Objective To study the etiology,clinical characteristics,electroencenphalography(EEG),mental degree of Lennox-Gastaut syndrome(LGS). Method Retrospectively analyzed etiology,sex,age,seizure types,EEG,mental degree of 54 children diagnosed as LGS. Results The number of male was 36,female was 18,seizure onset from 1 month to 8 years,diagnosing age from 3 months to 11years. The EEG reveals 1.5-2.5 Hz spike-wave discharges and a slow baseline activity. Conclusions LGS is one of the most difficult epilepsys to treat and need frequently more than 2 antiepilepsy drugs. It is characterized by variable etiology,multiple types of intractable seizures, and has enormous detrimental effects on patient′s developmental health.

Objective To detect genetic polymorphism of Toll like receptor 2 (TLR2) R753Q and Toll like receptor 4 (TLR4) D299G and T399I ,and to analyze its role and mechanism in the occurrence and development of colorectal carcinoma .Meth‐ods Totally 256 cases of patients with colorectal carcinoma and 256 cases of healthy control individuals were collected .The geno‐types of TLR2 R753Q ,TLR4 D299G and TLR4 T399I were detected by using PCR‐RFLP method .The levels of IL‐1α,IL‐8 ,MIP‐1αand MCP‐1 protein were detected by using ELISA .Results It is shown that TLR4 T399I was associated with the risk of color‐ectal cancer .The frequency of CT combined TT genotype of T399I in case group and control group was 31 .2% and 18 .7% ,respec‐tively .The frequency of T allele in case group and control group was 18 .2% and 10 .2% ,respectively ,and difference was statistical‐ly significant(P<0 .05) .Individuals with T allele of T399I showed a 2 .534‐fold increase in colorectal cancer risk compared with the T399I C allele(95% CI:1 .462-2 .734 ,P<0 .01) .There were significant differences in the expression levels of IL‐1αand MCP‐1 in colorectal carcinoma tissues of different genotypes .The expression level of IL‐1α in patients with CT combined TT genotype of T399I and those with CC genotype was (36 .97 ± 21 .43) and (22 .27 ± 17 .89)pg/mg respectively ,and the expression level of MCP‐1 was (24 .57 ± 17 .74) and (12 .91 ± 9 .78)pg/mg respectively .Conclusion T399I TLR4 is associated with the occurrence and de‐velopment of colorectal carcinoma ,and the risk of colorectal carcinoma in individuals with T genotype is significantly increased ,in which monitoring the expression of IL‐1 and MCP‐1 in colorectal carcinoma tissues might be the mechanism .

Objective To comparison of the quality of life in children with migraine and quality of life in children with primary epilepsy(EP)or Tourette's syndrome(TS).Methods There were 239 children with moderate migraine,the time of which lasted from 6 to 36(12.14?4.67)months,headache index 4-20(9.98?3.74).There were 250 cases and 424 cases with EP or TS,respectively,both team members were under good control with single drug therapy,the diagnosed according to the international classification of headache disorders-Ⅱ.The pediatric quality of life inventory,version 4.0,age 8-12 years,and child report forms were used to evaluate the quality of life in children with migraine and the other two kinds of samples by Bonferroni and Mann-Whitney tests.Results The scores of quality of life in children with moderate migraine were lower than those in children with EP(total score 69.06?10.48 vs 81.26?13.80;physical function scores 67.43?14.37 vs 83.14?14.70;psychological function scores 69.92?10.56 vs 80.26?14.32;emotional function scores 66.76?14.09 vs 80.90?18.93;social function scores 76.81?14.67 vs 83.36?17.40;school function scores 66.20?13.62 vs 76.52?13.80).The scores of quality of life in children with moderate migraine were lower than those in children with TS(total scores 69.06?10.48 vs 79.18?11.45;physical function scores 67.43?14.37 vs 81.52?12.61;psychological function scores 69.92?10.56 vs 77.90?12.28;emotional function scores 66.76?14.69 vs 74.07?16.34;social function scores 76.81?14.07 vs 89.06?16.23;school function scores 66.20?13.62 vs 70.35?16.96).Two sets of data between children with moderate migraine and those with EP,TS showed statistical significance(Pa

OBJECTIVETo explore the clinical application of mandibular-driven simultaneous maxillo-mandihular distraction to correct hemifacial microsomia with rapid prototyping technology.

METHODSThe patient' s skull resin model was manufactured with rapid prototyping technology. The osteotomy was designed on skull resin model. According to the preoperative design, the patients underwent Le Fort I osteotomy and mandibular ramus osteotomy. The internal mandible distractor was embedded onto the osteotomy position. The occlusal titanium pin was implanted. Distraction were carried out by mandibular-driven simultaneous maxillo-mandihular distraction 5 days after operation.

RESULTSThe distraction in five patients was complete as designed. No infection and dysosteogenesis happened. The longest distance of distraction was 28 mm, and the shortest distance was 16 mm. The facial asymmetry deformity was significantly improved at the end of distraction. The ocelusal plane of patients obviously improved.

CONCLUSIONSRapid prototyping technology is helpful to design precisely osteotomy before operation. Mandibular-driven simultaneous maxillo-mandibular distraction can correct hemifacial microsomia. It is worth to clinical application.

Face ; abnormalities ; surgery ; Facial Asymmetry ; congenital ; surgery ; Goldenhar Syndrome ; surgery ; Humans ; Hyperplasia ; surgery ; Mandible ; surgery ; Maxilla ; surgery ; Osteogenesis, Distraction ; methods ; Osteotomy ; methods ; Osteotomy, Le Fort

Abstract?AlM:To evaluate the accuracy and practicability of three - dimensionally preformed Arbeitsgemeinschaft Osteosynthese AO titanium mesh plates for orbital fractures.?METHODS:Forty-seven patients with isolated blow-out orbital fractures were included in this study. Fracture locations were as follows: floor/medial wall ( n = 26, 55%), medial wall ( n = 12, 26%), and floor ( n = 9, 19%) . The floor fractures were exposed by a standard transconjunctival approach, whereas a combined transcaruncular transconjunctival approach was used in patients with medial wall fractures with temporary dissection of inferior oblique muscle. A three -dimensionally preformed AO titanium mesh plate was selected according to the size of the defect previously measured on the preoperative computed tomographic scan examination and fixed at the inferior orbital rim with 2 screws. The accuracy of plate positioning of the reconstructed orbit was assessed on the postoperative computed tomography ( CT) scan. The practicability of clinical use of AO three - dimensionally preformed titanium mesh plates was assessed on the preoperative and postoperative clinical data.?RESULTS: Postoperative orbital CT scan showed an anatomic three- dimensional placement of the orbital mesh plates in all of the patients. All patients had a successful treatment outcome without clinical complications. 40 patients ( 87%) had a successful enophthalmos correction. 25 patients ( 86%) had a successful recovery from diplopia.?CONCLUSlON: Three- dimensionally preformed AO titanium mesh plates for orbital fracture reconstruction results in an accurate anatomic restoration of the bony orbital contour with a high rate of success to correctenophthalmos and diplopia.

Objective To investigate the impact of enhanced recovery after surgery (ERAS) program on postoperative recovery in patients undergoing laparoscopic colorectal resection. Methods Eighty-four patients undergoing laparoscopic colorectal resection from March 201 5 to June 201 6 (55 males,29 females,aged 36-78 years,ASA physical status Ⅰ or Ⅱ),were randomly divid-ed into two groups (n = 38 each).Patients in group E were received epidural block combined with general anesthesia,and a series of perfect ERAS strategies,such as strengthen preoperative educa-tion, maintaining perioperative normothermia, perioperative goal-directed fluid therapy, intraoperative and postoperative analgesia.While the patients in group C received routine anesthetic management.The volume of fluid,the nasopharyngeal temperature,the time of recovery of bouel sound,first anal exhaust,eating fluid food,ambulation and remove of the catheter were recorded in two groups.Furthermore,time of PACU after surgery,the total days of hospitalization and total hos-pital costs were recorded.Results The volume of fluid [(1 328 ± 64)ml vs.(2 463 ± 135 )ml]in group E were significantly lower than group C (P <0.05),the nasopharyngeal temperature [(36.2± 0.2)℃ vs.(35.1±0.5)℃]was significantly higher in group E (P <0.05).Compared with group C,the time of recovery of bowel sound [(33.4 ± 12.5 )h vs.(42.8 ± 14.3 )h],first anal exhaust [(43.6±13.9)h vs.(60.7±1 5.4)h],eating fluid food [(26.8±4.1)h vs.(67.4±13.5)h],first ambulation [(7.4±1.6)h vs.(26.5±3.8)h]and remove of the catheter [(29.2±6.1)h vs.(5 1.8 ±7.6) h ], time of PACU [(26.4 ± 8.5 ) min vs.(37.2 ± 1 1.6 ) min ], the total days of hospitalization [(7.5±0.9)d vs.(9.7±1.2)d]were significantly shorter (P <0.05),and hospital costs [(2.1±0.6)ten thousand yuan vs.(2.6±0.8)ten thousand yuan]were significantly decreased (P <0.05).The incidence of adverse reactions such as nausea and vomiting (2.4% vs.21.4%),pru-ritus (7.1% vs.23.8%),agitation (4.8% vs.26.2%)and chills (0% vs.1 9.0%)were significantly lower in group E (P <0.05).Conclusion ERAS program applied to patients undergoing laparoscopic colorectal resection can reduce the intraoperative sufentanil consumption,avoid the occurrence of postoperative hypothermia, accelerate recovery of gastrointestinal function, which can obviously reduce the hospitalization costs and shorten the hospitalization time.

This case report discusses dumping syndrome in the postbariatric mother. Diagnostically a challenge, the symptoms of postprandial hypoglycaemia mimic common early gestation complaints and may go undiagnosed, thus requiring a high index of suspicion. As weight-loss surgery gains traction, it is pertinent to note at booking and followups. The pregnancy is at-risk and multidisciplinary team management is central. The mainstay of management remains diet modification. There have been case reports of successful medical treatment of dumping syndrome in pregnancy with good maternal and fetal outcomes. However, more data is needed regarding the usage of these medical treatments in pregnancy.
Dumping Syndrome ; pregnancy

Objective To study the effects of nerocutneous vessels on perforator flap blood supply and survival area. Methods Thirty SD rats were randomly divided into 3 groups. The study of the vasculature and nerve disposition of rat dorsum was performed with 10 rats of one group. According to the study,a distal rectangle neurocutaneous flap based on deep circumflex iliac artery perforator, 10 cm long and 3 cm in the width, was elevated on the rest rats, and sutured back to the original situation. The axis of the experimental group's flap paralleles the posterior median line,while the control group flap's angulated about 30° with it. The blood flow of the flap was assessed by fluorescein angiography on the 1st and 7th day after surgery. The surviving rate and the capillary density of flap were assessed on the 7th day after surgery. Results The rat deep circumflex iliac perforator artery was a constant perforator artery, with an nutrition area about 4 cm× 3 cm. The dorsal cutaneous nerves run along the dorsomedian line, nourished by rich vessels. The blood perfusion 1st day after surgery was 42.85% in the experimental group, 37.94% in the control group(P ＞ 0.01 ).On the 7th day, it was 84.07% in the experimental group, 58.55% in the control group (P＜ 0.01). The mean survival rate of the experimental group was 83.93%, higher than control group's 59.95% (P＜0.01),and the density of the blood vessels was higher in experimental group than control group's. Conclusion The neurocutaneous vessels can improve the flap survival condition, which make the perforator flap bigger and safer.