OBJECTIVETo explore therapeutic effects of minor external fixator for open comminuted phalangeal fractures with non-transarticular.

METHODSFrom January 2013 to December 2014,13 patients with open comminuted phalangeal fractures were treated by minor external fixator with non-transarticular, including 9 males and 4 females aged from 18 to 56 years old with an average of 35 years old. According to Gustilo classification, 8 cases were type II, and 5 cases were type III. The time from injury to operation ranged from 2 to 7 h averaged 5 h. Seven patients were diagnosed as phalangeal fracture, 6 patients were involved with joint surface of phalangeal, which 1 case combined with inherent nerve damage and 1 case combined with soft tissue defect repaired at stage II. The patients were fixed by plaster for 2 weeks and removal external fixtor from 6 to 8 weeks after operation and received functional exercise.

RESULTSAll patients were followed up from 3 to 12 months with an average of 7 months. One case occurred metacarpophalangeal joints stiffness. No screw breakage, inflammation occurred. Skin soft tissue recovered well and obtained bone healing, the average time of bone healing was (4.6 ± 1.0) weeks. According to TAM scoring system used by Hand Surery Association of Chinese Medical Association, 7 cases got excellent results, 4 good, 1 moderate and 1 poor.

CONCLUSIONMinor external fixator for open comminuted phalangeal fractures with non-transarticular has advantages of simple operation, good stability, and could adjust at the later stage, less damage for soft tissue periosteum, low inflammatory rate, earlier functional exercise. It is worth to be popularized and applied.

Adolescent ; Adult ; External Fixators ; Female ; Finger Phalanges ; injuries ; Fractures, Comminuted ; surgery ; Humans ; Male ; Middle Aged

Objective To evaluate the therapeutic efficacy of KTP Nd: YAG laser assisted dacryocystoplasty for lacrimal duct obstruction. Methods Specially made hollow lacrimal probe was used to examine the lacrimal ducts to the obstructed parts in a total of 827 eyes. Then KTP laser fibers were inserted into the lacrimal ducts to dredge the obstructed parts by laser. Instillation of different drugs or short term placement of lacrimal supporters was conducted after operation according to the symptoms such as degree of obstruction and with discharges or not. Results The cure rate, improvement rate, and ineffectiveness rate were 93.5%, 5.5%, and 1%, respectively. One therapy was conducted in 562 eyes, twice in 191 eyes. Conclusion KTP Nd: YAG laser assisted dacryocystoplasty is a safe and effective way for the treatment of lacrimal obstruction. Postoperative drug instillation or short term placement of lacrimal supporter can contribute to the clinical outcomes.

Objective To investigate whether terminal QRS distortion on the electrocardiogram in acute inferior myocardial infarction could be as a standard for the infarct-related artery,through comparing to coronary angiography.Methods Fifty-seven patients with acute inferior myocardial infarction were enrolled,among which,the right coronary artery (RCA) occlusion (RCA occlusion group) was present in 29 cases,and left circumflex coronary artery (LCX) occlusion (LCX occlusion group) was in 28 cases.The changes of electrocardiogram was analyzed in 12 hours after the acute episode.Results The incidence of terminal QRS distortion in leads Ⅱ,Ⅲ,aVF in RCA occlusion group was 44.8％(13/29) and 39.3％(11/28)in LCX occlusion group,and there was no significant difference (P ＞ 0.05).The incidence of terminal QRS distortion in leads V4R-V5R in RCA occlusion group was 17.2％(5/29) and 7.1％(2/28) in LCX occlusion group,and there was no significant difference (P ＞ 0.05).The incidence of terminal QRS distortion in leads V7-V9 in RCA occlusion group was 6.9％(2/29),which was lower than that in LCX occlusion group[53.6％(15/28)],and there was significant difference (P ＜ 0.05).For identifying LCX as the infarct-related artery of acute inferior myocardial infarction,the sensitivity,specificity,positive and negative value in terminal QRS distortion in leads V7-V9 were 53.6％ (15/28),93.1％ (27/29),88.2％ (15/17),67.5％ (27/40).The area under curve of terminal QRS distortion in leads V7-V9 in identifying LCX as the infarct-related artery of acute inferior myocardial infarction was 0.733 (95％ CI 0.599-0.868).Conclusion Terminal QRS distortion in leads V7-V9 may be of diagnostic value in identifying the infarct-related artery in acute inferior myocardial infarction.

Objective To investigate clinical characteristics of 48 cases verified to be infected with S.suis type 2.Methods 1.All data of 48 cases suffered from S.suis type2 infection were col- lected and analyzed.2.Pathogenic gene of S.suis type 2,Such as cps 2A,mrp,and sly et al.,were verified by PCR.Results 1.Pathogenic gene of S.suis type 2 were same from those patients and swine.Drug sensitivity test were carried on and showed resistance to tetracycline and streptomycin. 2.All 48 cases had history to butchering and/or direct contacting blood plasma composition of suffer- ing from or dead pigs.People with wound in the skin had higher risk to be infected.3.Four clinical types were classified as general,meningitis.Shock and both shock combined meningitis.Mortality rate was 14.58%.Conclusion 1.S.suis type 2 was the pathogen leading to the infections of 48 cases in this study.The swine of suffering from the disease or dead were the origins of the transmis- sion.2.Main route of infection was butchering or/and direct contacting the plasma composition of be- ing ill or dead pigs.No second generation of patients were found.3.The cases with shock should be treated as early as possible.4.Taking antibiotic were rational used seriously in human being and ani- mals.

Objective To evaluate the significance of ultrasonography in diagnosis and differentiation of morning glory syndrome. Methods Ultrasonography,CT and fundus fluorescein angiography(FFA) features were retrospectively analyzed in 6 cases of morning glory syndrome.Results Ultrasonography, CT and FFA characters of morning glory syndrome were as follow: on the B-type ultrasonogram, the dark area of vitreous cavity extended to the posterior pole and optic papilla, projecting to the basal part of muscle cones, thus the posterior part of vitreous cavity looked like a converted bottleneck. Sometimes the light ribbon of retinal detachment can also be seen. On the A-type ultrasonogram, both vitreous cavity and bottleneck showed no ultrasonic echo and acted as an equable baseline without any evident wave crest. The attachment spot of optic nerve of eye turned thin and vitreous body protruded to the posterior wall of eyeball with spherical shape on CT imaging. In the earlier period of FFA, hypofluorescence appeared on the optic disc; then ,the abnormal arteriae and vein around the optic papilla were diplayed clearly; In the later period, optic discs were dyed with fluorescein. Conclusions Ultrasonography, CT and FFA showed imageological features of morning glory syndrome from different aspects, which was helpful for differentiating similar diseases such as optic disc coloboma. Especially, ultrasonography was considered as a more safe and reliable imageological method than other imageological methods in precisely diagnosing and differentiating morning glory syndrome and superior to the traditional fundus check which gives no integrity.

Objective To evaluate the therapeutic efficacy of intraoperative mitomycin C(MMC) and TobraDex ophthalmic ointment(TDO) in transcanalicular Nd:YAG laser assisted dacryocystoplasty(LDCL). Methods A total of 204 patients (246 eyes) with lacrimal duct obstruction were divided into four groups: group treated with MMC, group treated with TDO, group treated with MCC plus TDO and control. Prospective control study was conducted. Results The healing rates of three drug groups were 88.7%, 88.6%, 89.5%, respectively, significantly higher than that of the control group (73.1) ( P

ObjectiveTo investigate the level of plasma stromal cell-derived factor-1 (SDF-1) in essential hypertension and the effect of angiotensin-converting enzyme inhibitor Enalapril on it. MethodsThe levels of plasma SDF-1 in 34 patients with hypertension and 28 normal healthy people were detected with ELISA. Hypertension patients were detected again after 2-week Enalapril treatment. ResultsThe level of SDF-1 in hypertension patients was （4.211±1.132） mmol/L, higher than control (3.568±0.936) mmol/L （P<0.05）, and became （4.950±1.050） mmol/L after treatment, higher than pre-treatment （P<0.05）. ConclusionThe level of SDF-1 increases in patients with hypertension, and Enalapril can further increase the level.

Humans ; Infant, Newborn ; Leukopenia ; complications ; congenital ; diagnosis ; Male

· AlM:To investigate the effect of compound anisodine on fundus blood circulation after vitrectomy with face-down position.
· METHODS: Sixty patients ( 60 eyes ) with rhegmatogenous retinal detachment received vitrectomy with silicone oil tamponade operation, who were randomized divided into treatment group ( 30 eyes ) and control group ( 30 eyes ) .The patients in the treatment group received the subcutaneously injection of compound anisodine hydrobromide by the superficial temporal artery once daily for 14d since postoperative first day.Retinal microcirculation blood flow parameters were recorded with Heidelberg retinal flowmeter postoperative 1d, 1 and 2wk, and were compared between two groups.
·RESULTS: The blood flow parameters ( Vol, Flw, Vel) of control group postoperative 1 and 2wk were significantly less than those postoperative 1d.Otherwise the parameters of treatment postoperative 1 and 2wk were significantly more than those postoperative 1d. The parameters between two groups were significant different ( P<0.01) .
· CONCLUSlON: Facing down after vitrectomy with
silicone oil tamponade may reduce retinal blood supply, consequently lead to retinal ischemia; compound anisodine can effectively improve the retinal and choroidal microcirculation after vitrectomy with face-down posture, reduce retinal ischemia, and enhance the visual function.

Background The primary management for nasolacrimal duct obstruction is the combination of lacrimal duct probing with lacrimal duct stent implantation.However,conventional implant is undegradable.New degradable lacrimal duct prosthesis based on biopolymer materials is a research hotspot.Objective This study described herein a preparation method of novel degradable lacrimal duct prosthesis and its application.Methods A new degradable lacrimal tube stent was prepared with compound of poly L lactic acid (PLLA) and polycaprolactone (PCL) (6:4) and 15％ polyethylene glycol (PEG).Thirty-two Japanese rabbits aged 3-4 months were randomized into postoperative 1-week group,postoperative 4-week group,postoperative 8-week group and postoperative 16-week group.The degradable lacrimal tube stents were inserted into the lacrimal ducts of the left eyes of the rabbits.The prosthesis was removed in corresponding time points according to grouping,and the integrity and weight of the prosthesis were evaluated.The mucosal findings of the operative eyes were examined under the endoscope,and the histopathological and inflammatory reaction was observed by hematoxylin & eosin stain.The ultrastructure of the lacrimal mucosal surface was examined under the scanning electron microscope.The use and care of the rabbits complied with the Regulations for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission.Results The new degradable PLLA:PCL+15％ PEG lacrimal duct stents were smooth,flexible and hydrophilic tubes.The removed tubes were intact in the postoperative 1-week group,however,the rupture of the tubes appeared in the postoperative 4-week group,while discrete pieces of the tubes were seen in the postoperative 16-week group.The weight-loss rates of the tubes were (13.44±6.59)％,(23.96±6.33)％,(55.08-± 6.55) ％ and (78.00±8.74) ％ in the postoperative 1-week group,postoperative 4-week group,postoperative 8-week group and postoperative 16-week group,respectively,and the weight-loss rate of the tubes was significantly higher in the postoperative 16-week group than those in the postoperative 8-week group (q =4.27,P＜0.05).No significant difference was found in the weight-loss rate of the tubes between postoperative 1-week group and postoperative 4-week group (q =1.71,P＞0.05).The edema,hyperemia and mild proliferation of the lacrimal mucosal were exhibited in the eyes of the postoperative 4-and 8-week groups,and the mucosal findings were almost normal in the eyes of the postoperative 16-week group under the endoscope.Histopathological examination showed a large number of inflammatory cells in the postoperative 1-,4-and 8-week groups.However,few inflammatory cells were seen in the postoperative 16-week group.Mucosal folds,microvillus decrease and disorder were displayed in the lacrimal duct of the postoperative 8-week group,and no evident abnormality was seen in the lacrimal duct mucosal surface.No postoperative complication occurred in all the rabbits.Conclusions PLLA:PCL+15％ PEG lacrimal duct stent has an appropriate degradation speed and good biocompatibility after implant in rabbits,and its decay period of mechanical strength could match lacrimal duct healing period.