OBJECTIVETo study the influence of actual defect length and gap width of the limbs main artery on the method selection of repairing and reconstruction.

METHODSRetrospective study was carried out for 32 patients with extremity main artery injury from 1996 to 2009, including 30 males and 2 females; 30 adults with an average age of 36 years old ranging from 18 to 51 years, 2 children of 4 and 5 years old respectively. Injured body parts involved axillary artery in 4 cases,brachial artery in 7 cases,radial artery in 2 cases, femoral artery in 4 cases, popliteal artery in 13 cases, posterior tibial artery in 2 cases. Main arterial injury defect gap width of all cases were observed and the reasons were analyzed. All cases were repaired by the method of end to end anastomosis after vessels stretch.

RESULTSThe artery defect width was 3 cm to 7 cm with an average of (4.375 +/- 1.200) cm. Defect width of the upper extremity brachial artery and axillary artery group was (5.73 +/- 0.63) cm,the lower extremity femoral and popliteal artery group (3.80 +/- 0.73) cm, the posterior tibial artery group (3.25 +/- 0.35) cm, the radial artery group (3.00 +/- 0.00) cm. Defect width of upper extremity brachial artery and axillary artery group was larger than that of the other three groups (P < 0.01). End to end anastomosis was performed successfully in all cases. Blood supply recovered well. Because of the severe limb infection 2 patients had amputation in the late. All patients received follow-up. The patients without fracture were followed up to 2 weeks postoperatively, all patients with fractures were followed up to 1 year at least. Limb blood supply was good in all patients during the follow-up.

CONCLUSIONBlood vessel defect gap width is different from the actual vessel defect, but is larger than the actual vessel defect. Misjudgment of the vascular defect length will lead to more vascular transplantation. The vast majority of vascular defect can be directly repaired by the method of end to end anastomosis after the vessel free and stretch.

Adolescent ; Adult ; Arm ; blood supply ; surgery ; Axillary Artery ; injuries ; surgery ; Female ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; Retrospective Studies ; Vascular Surgical Procedures ; Young Adult

OBJECTIVETo study the ischemic times of the main artery injury in the limbs and the influence on the limbs survival rate, and to analyze the reasons for the formation of the ischemia time.

METHODSFrom June 1996 to November 2012, 83 patients with completely severed limb main artery treated in our hospital were retrospectively studied. There were 77 males and 6 females, including 81 adults (ranging in age from 16 to 52 years old, with a median age of 35 years old) and 2 children (4 and 5 years old respectively). Seventy-five patients were treated with end to end anastomosis, 7 patients were treated with great saphenous vein transplantation, and 1 patient was treated with artificial blood vessel transplantation. The prior to admission ischemia time, after admission ischemia time and total ischemia time for successful and unsuccessful patients, as well as the causes of the formation of the ischemia time were studied. Limb survival rate of different ischemic time was counted. Sharpness injury or blunt injury ischemia time and amputation rate were researched statistically. All data were analyzed using SPSS statistical software.

RESULTSThere were 72 limbs survived, 11 amputated. The average ischemia time was (7.45±5.94) h for limb-salvage group and (13.73±14.00) h for amputation group. Prior to admission ischemia time between amputation and limb-salvage group had no significant difference. After admission the ischemia time in amputation group was longer than limb-salvage group. The amputation rate for ischemia time 21 to 44 h group was higher than other three groups (≤ 5 h, 6 to 10 h, 11 to 20 h) (P=0.023, 0.038, 0.044). Amputation reasons can be divided into anastomosis failure in the operation, vascular thrombosis 2 to 4 days after operation and late infection.

CONCLUSIONVascular injury limbs can tolerate longer ischemia time and the limb salvage succeed. Only too long ischemia time (> 20 h), limb amputation rate increases significantly. The main cause of long time ischemia is delayed diagnosis in the hospital. Whether limb-salvage success mainly depends on the degree of trauma and the quality of the anastomosis than ischemia time.

Adolescent ; Adult ; Amputation ; Extremities ; blood supply ; Female ; Humans ; Ischemia ; surgery ; Limb Salvage ; Male ; Middle Aged ; Retrospective Studies ; Time Factors ; Vascular System Injuries ; surgery

Objective To summarize the clinical features,neuroimaging findings and pathological characteristics of demyelinating pseudotumors(DPT)of the brain,and to differentiate it from glioma. Methods The clinical features,neuroimaging findings and pathological characteristics of 35 patients with demyelinating pseudotumors of the brain were summarized,and the diagnosis for 18 of them was confirmed by bioscopy.Results Demyelinating pseudotumors affected adults of both sexes.The onset age of patients ranged from 9 to 69 years old.There was no definite antecedent,and the clinical syndromes were atypical. Neuroimaging scans showed multiple lesions in cerebral hemisphere,while the lesion in brain stem and spinal cord was single.The symptom and neuroimaging were not parallel.While with many or large lesions, the symptoms and signs were less.The lesions were not enhanced on CT scan,but appeared round or patch enhancement on MRI scan.Nine patients with DWI all appeared high density.The myelin basic protein was useful for diagnosis.The typical pathological changes were demyelination,perivascular inflammatory infiltration and reactive gliosis.The Creutzfeuldt cells were also found in these patients.The lesions might become small or disappear after treatment,but could not serve as the criterion to exclude brain neoplasm. Conclusions DPT is a distinct demyelination disease entity,which is confusable with brain neoplasm.It is difficult to distinguish DPT from brain neoplasm with the clinical features and conventional neuroimaging scan.But DWI scan is useful.The pathological changes accord with demyelination,and Creutzfeuldt cells are also found.It is important to apply corticosteroid treatment or biopsy rather than being anxious to excise the lesions.

Objective To explore the effect of clinical pharmacist on clinical rational use of antineoplastic drugs after participating in treatment group.Methods Retrospective research was used.According to whether there was a clinical pharmacist directly or indirectly involved in,all medical teams of the oncology department were divided into intervention group,advisory group and control group in our hospital.Intervention group was the medical team that had a specialist clinical pharmacist who could intervene irrational use of antineoplastic drug in the treatment on the spot.Advisory group was in the same area with the intervention group,and didn't have a specialist clinical pharmacist, but used to communicate with clinical pharmacist and take his medication advice,where clinical pharmacist indirectly involved in treatment.The control group was the medical group in the other area without clinical pharmacists of oncology department.The control group one and two were with the most beds among the control group.Randomly selected lung cancer,breast cancer,esophageal cancer,gastric cancer,colorectal cancer,gynecological cancer,liver/gallbladder/pancreatic cancer and other tumors patients from intervention group,advisory group,control group one and control group two,from January 2015 to December 2015,10 copies of each case,80 copies of each group.And antineoplastic drugs were commented specially.The information such as sex,age,clinical diagnosis,irrational antineoplastic drug use,adverse reaction and unexpected events and hospitalization time were recorded.Results The rate of irrational antineoplastic drug use of the intervention group (41.25%)was lower than the advisory group(80%),and was significantly lower than two control groups(147.50%,161.25%),advisory group was also lower than two control groups,but no significant differences between the two control groups(χ2 =0.193,P>0.05).Irrational chemotherapy, inappropriate usage and dosage and inappropriate indications were prominent problems in intervention group and advisory group.In addition,there were more improper solvent and contraindicated or adverse interaction problems in two control groups.Adverse events and incidence of unexpected events in intervention group (46.25%,12.50%) were significantly lower than those in two control groups[(73.75%,22.50%),(23.75%,18.75%)].Furthermore, the length of stay of intervention group patients was shortest in four groups (F=8.766,P<0.05).Conclusion By participating in the treatment group,clinical pharmacists can discover the irrational drug use and security risks in treatment,can provide medication guidance,consultation,publicity and other pharmaceutical service for specialist medical staff and patients.They will be more and more prominent in the treatment of cancer.

AIM: To explore the effect of hypertonic sugar eyes drops with local to the oxygen therapy for severe corneal edema after cataract surgery.METHODS: Totally 68 patients (68 eyes) with severe corneal edema after phacoemulsification were selected from January 2014 to December 2015 in our hospital, who were aged 53-80(64.45±4.24), including 30 males and 38 females.According to different treatment, they were divided into treatment group (34 cases) given conventional therapy + hypertonic sugar eyes drops with local to the oxygen therapy, the control group (34 cases) given conventional treatment + hypertonic sugar eyes drops.Visual acuity and corneal situation were observed during the treatment.RESULTS: Corneal edema fade time of treatment group was 11.62+0.53d, that of control group was 15.23±0.62d, the difference between the two groups was significant (P<0.05).Preoperative best corrected visual acuity (BCVA) and corneal endothelial cell count had no significantly difference between the two groups while the corneal endothelial cell count were significantly different compared with postoperative of the two groups (P<0.05).At 7d after treatment, the BCVA and corneal endothelial cell count had significantly difference between the two groups (P<0.05), which did not have significant difference at 1mo after treatment (P>0.05).The effective rates of the two groups was significantly different (P<0.05).CONCLUSION: Hypertonic sugar eyes drops with local to the oxygen therapy is effective for severe corneal edema after cataract surgery.

Objective To research the method and effect about the bronchoscopic lung volume reduction by ?-cyanoac- rylate in the therapy of chronic obstructive pulmonary disease (COPD).Methods The 14 patients had been examined bosoms by CT before the operation and determined the type of emphysema and the distributing of pneumatocele,had blood gas analyzed and pulmonary function checked.The operation was carried through trachea cannula and intravenous anesthe- sia.When the bronchoscope came to the goal bronchia,we infused the meglumine diatrizoate through the biopsy orifice and approved the location of pneumatocele forward。Then,we infused erythromycin and ?-cyanoacrylate in turn through the biopsy orifice by silica del tube.Results The 3 pneumothorax patients had been removed the drainage tube in 3 days af- ter the operation.8 cases had been counterchecked sternite in one week and the pneumatocele was just like before,among which,1 case developed exudation.1 case had shown pleural thickening in the right-up lung counterchecked sternite 9 months later.1 case been checked the pulmonary function,the FEV_1 enhanced from 24.7% pred before operation to 32. 9% pred after operation one week.3 cases felt polypnea improved greatly and 7 cases felt polypnea improved a little.Con- clusion The bronchoscopic lung volume reduction by ?-cyanoacrylate is a safe,effective and economical method in the therapy of COPD.

A bacterium which can effectively degrade LAS (Linear Sodium Alkylbenzenesulfonate) was isolated from washing powder manufacturing effluent and was preliminarily identified as Corynebacterium jeikeium GZ6. The bacterium can degrade LAS up to till 700 mg/L, and the optimum pH, temperature and concentration of LAS are 7.0, 30℃ and 400 mg/L, respectively. The biodegradation rate can reach 98.7% after 24 hours'cultivation in the suitable conditions. Experiments also showed that some heavy metal ions such as Hg2+ , Co2+ , Cd2+ can differently inhibit the degradation of LAS.

This study aims to establish an HPLC method for simultaneous determination of gastrodin and eight nucleosides and nucleobases components in Gastrodia elata. The separation was carried out on an Agilent Zorbax Bonus-RP (4.6 mm x 250 mm, 5 μm) column with a methanol-(0.04% acetic acid) water solution gradient elution program at a flow rate of 1.0 mL x min(-1). The column temperature was 36 degrees C, and the detection wavelength was 254 nm. The volume of injection was 20 μL. The nine components including gastrodin, cytosine, uracil, cytosine, adenine, thymine, uridine, guanosine and adenosine were well separated. The calibration curve was well linear in the range of 2.04-262.00 mg x L(-1), 0.20-24.67 mg x L(-1), 0.18-23.75 mg x L(-1), 0.20-25.83 mg x L(-1), 0.20-26.67 mg x L(-1), 0.16-20.00 mg x L(-1), 0.22-27.71 mg x L(-1), 0.20-24.29 mg x L(-1), 0.24-30.58 mg x L(-1), respectively, and the correlation coefficient was between 0.998 9-0.999 9. The average recovery of gastrodin and eight nucleosides and nucleobases were 96.4%-99.6%, RSD less than 2.7% (n = 6). The contents of gastrodin in all the seven Tibet cultured Gastrodia elata samples were over 2 mg x g(-1). Further, all samples contain higher contents of adenosine, guanosine, uridine and cytidine compared to low contents of cytosine, uracil, adenine and thymine. The established method is accurate, reproducible and suitable for the determination of gastrodin and eight nucleosides and nucleobases comppnents in Gastrodia elata.
Benzyl Alcohols ; analysis ; Chromatography, High Pressure Liquid ; methods ; Drugs, Chinese Herbal ; analysis ; Gastrodia ; chemistry ; Glucosides ; analysis ; Nucleosides ; analysis ; Nucleotides ; analysis

OBJECTIVE:To establish the Evaluation Criteria on Rational Use of Human Serum Albumin(HSA)in our hospi-tal,and to provide refereuce for rational use of HSA. METHODS:Referring to drug utilization evaluation(DUE)criteria of WHO and developed countries,based on the guideline of HSA use,Human Serum Albumin,Non-protein Colloid and Crystalloid Solu-tion Guidelines of USA University Hospital Consortium,Blood Products Prescription Evaluation Guideline of Beijing area,etc., Evaluation Criteria on Rational Use of HAS was established through experts discussion,and the use of HAS in 420 patients of our hospital were evaluated. RESULTS:The Evaluation Criteria on Rational Use of HSA mainly included indication,contraindication, usage and dosage,drug combination,incompatibility,etc. 414 patients (98.57%) detected serum albumin concentration before treatment;167 patients(39.76%)were in line with the indication;56 patients(13.33%)had contraindication in using HSA;352 patients(83.81%)met the criteria in usage and dosage,duration of treatment;there were 17 cases(4.05%)of unreasonable drug combination and 3 cases(0.71%)of incompatibility. CONCLUSIONS:The established criteria has strong practicability,and some problems and insufficiencies can be found in the clinical practice,is conducive to promote rational drug use in the clinic.

Objective - （ ）- （ ） To observe the effects of renin angiotensin Ang aldosterone system RAAS in workers exposed to Methods - - occupational noise. Forty five workers with suspected occupational noise induced deafness were selected as noise ， ， exposure group using convenient sampling method. According to their tinnitus symptom noise exposure intensity and work age - ， ， they were divided into no tinnitus and tinnitus subgroups <90 dB and ≥90 dB subgroups work years <10 years and ≥10 years subgroups. Another 45 workers with no occupational noise exposure history were selected as control group. The levels of plasma （ ）， ， ， renin activity PRA AngⅠ AngⅡ and aldosterone of the two groups were detected and the aldosterone to renin activity Results ratio was calculated. The diastolic blood pressure of the noise exposure group was higher than that of the control group ［（ ）vs（ ） ，P ］ ， 80±7 76±8 mmHg <0.05 . However there was no significant difference in systolic blood pressure between the two （P ） （ ： groups >0.05 . The level of plasma AngⅡ in the noise exposure group was higher than that in the control group median vs ，P ） （ P ） 100.98 65.43 μg/L <0.05 . There was no statistical significance in other indexes between the two groups all >0.05 . The （ ： plasma AngⅡ level in < 90 dB subgroup in the noise exposure group was higher than that of the control group median 123.16 vs ，P ） 65.43 μg/L <0.05 . There was no statistical significance in other indexes among the two subgroups of tinnitus symptom or （ P ） work age in the noise exposure group and the control group all >0.05 . There were no significant differences in the abnormal ， （ P ） rates of PRA AngⅡ and aldosterone in plasma between the noise exposure group and the control group all >0.05 . Conclusion Occupational noise exposure may affect RAAS and lead to increased plasma AngⅡ levels in the workers. - Tinnitus and work age may not affect RAAS in occupational noise exposure workers.