Reconstructing thumb opposition function using modified transfer of proper extensor tendon of the fifth digit is one of the methods to treat old median nerve injury-induced thumb opposition dysfunction. To explore the long-term effect of this method, 97 patients undergoing modified transfer of proper extensor tendon of the fifth digit to reconstruct thumb opposition function in Department of Hand Surgery, Affiliated Hospital of Beihua University between January 2003 and December 2007 were retrospectively analyzed, and 21 were followed up. The thumb opposition function postoperatively was evaluated using Changing of Hand Function Evaluation Standard. After reconstructing thumb opposition function, length of thumb (T), distance moving to (mo) and moving away from (Mo) centre of palm in opposition, i.e. during closing and leaving centre of palm distance between middle point of thumb interdigit transverse striation and middle point of middle finger MP joint transverse striation. In addition, their ratios were calculated. The patients were followed-up for 7.5 years (ranging 1-14 years). It is a good therapy to reconstruct thumb opposition function using modified transfer of proper extensor tendon of the fifth digit.

Reconstructing thumb opposition function using modified transfer of proper extensor tendon of the fifth digit is one of the methods to treat old median nerve injury-induced thumb opposition dysfunction.To explore the long-term effect of this method,97 patients undergoing modified transfer of proper extensor tendon of the fifth digit to reconstruct thumb opposition function in Department of Hand Surgery,Affiliated Hospital of Beihua University between January 2003 and December 2007 were retrospectively analyzed,and 21 were followed up.The thumb opposition function postoperatively was evaluated using Changing of Hand Function Evaluation Standard.After reconstructing thumb opposition function,length of thumb (T),distance moving to (mo) and moving away from (Mo) centre of palm in opposition,i.e.during closing and leaving centre of palm distance between middle point of thumb interdigit transverse striation and middle point of middle finger MP joint transverse striation.In addition,their ratios were calculated.The patients were followed-up for 7.5 years (ranging 1-14 years).It is a good therapy to reconstruct thumb opposition function using modified transfer of proper extensor tendon of the fifth digit.

Objective To observe the clinical effects of early use of neuromuscular blocking agents (NMBA) in patients with severe sepsis and acute respiratory distress syndrome (ARDS).Methods A prospective study was conducted.96 patients with severe sepsis and ARDS admitted from July 2012 to September 2013 to intensive care unit (ICU) of Liuzhou People's Hospital in Guangxi Zhuang Autonomous Region were enrolled and divided into severe ARDS group (n=48) and moderate ARDS group (n=48) according to the Berlin definition of ARDS.Then patients in each group were randomly divided into treatment group (n =24) and control group (n=24).All patients with diagnosis in accordance with the 2008 international septic shock and severe sepsis treatment guidelines were provided with comprehensive treatment and mechanical ventilation on the basis of analgesia and sedation.The patients in treatment group were given a loading dose of vecuronium during mechanical ventilation,started with 0.l mg/kg up to 0.05 mg ·kg 1 ·h 1 for continuous intravenous infusion for 24-48 hours.The acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score,sequential organ failure assessment (SOFA),arterial oxygenation index (PaOfFiO2),central venous oxygen saturation (ScvO2),arterial blood lactate (Lac),C-reactive protein (CRP) levels of two groups were compared before treatment and 48 hours after treatment,and 21-day mortality rate was finally compared.Results In moderate or severe ARDS group,there were no statistically significant difference in APACHE Ⅱ score,SOFA score,PaO2/FiO2,ScvO2,Lac and CRP before treatment between two groups.APACHE Ⅱ score,SOFA score,PaO2/FiO2,ScvO2,and Lac 48 hours after treatment were significantly improved in severe ARDS group compared with control group [APACHE Ⅱ score:16.58 ± 2.41 vs.19.79 ± 3.52,t=3.679,P=0.010; SOFA score:12.04 ± 2.17 vs.14.75 ±3.26,t=3.385,P=0.010; PaO2/FiO2 (mmHg,1 mmHg=0.133 kPa):159.31 ±22.57 vs.131.81 ± 34.93,t=3.239,P=0.020; ScyO2:0.673 ± 0.068 vs.0.572 ± 0.142,t=3.137,P=0.030; Lac (mmol/L):3.10 ± 1.01 vs.4.39 ± 1.72,t=3.161,P=0.030],while the value of CRP (mg/L) showed no significant difference (180.91 ±37.14 vs.174.66 ± 38.46,t=0.572,P=0.570).21-day mortality in treatment group was significantly lower than that in control group [20.8％ (5/24) vs.50.0％ (12/24),x2=4.463,P=0.035].In moderate ARDS group,each of the above clinical parameters were improved in both groups expect for CRP at 48 hours after treatment,but the indexes showed no statistically significant difference between two groups (all P＞0.05).21-day mortality rate in the treatment group was slightly lower than that in the control group which showed no statistically significant difference [16.7％ (4/24) vs.25.0％(6/24),x2=0.505,P=0.477].Conclusion The early use of NMBA treatment of patients with severe sepsis and severe ARDS cannot only improve the severity but also reduce 21-day mortality.

Objective:To observe the effects of veno-venous extracorporeal membrane oxygenation (VV-ECMO)combined with prone position ventilation (PPV) on oxygenation index (PaO 2/FiO 2), respiratory compliance (Crs) and vasoactive inotropic score (VIS) in severe acute respiratory distress syndrome (ARDS) patients. Methods:Eighteen patients with severe ARDS requiring VV-ECMO support in Liuzhou People's Hospital from June 2018 to April 2020 were selected for retrospective analysis, and 8 patients among of these cases received PPV after VV-ECMO. The differences in PaO 2/FiO 2, VIS and Crs before and 1, 2 or 3 days after treatment were compared between VV-ECMO group and VV-ECMO combined with PPV group, as well as the differences in these indices before PPV and 2 hours after PPV daily in VV-ECMO combined with PPV group. The incidence of adverse events in two groups were also observed. Results:Before treatment, there was no significant difference in PaO 2/FiO 2, Crs between two groups. Over time, PaO 2/FiO 2 and Crs increased and VIS decreased in both groups. Compared with before treatment, there were statistically significant differences in PaO 2/FiO 2 and VIS from 1 day after treatment [PaO 2/FiO 2 (mmHg, 1 mmHg = 0.133 kPa): VV-ECMO group was 197.75±39.80 vs. 75.57±7.44, VV-ECMO combined with PPV group was 255.20±31.92 vs. 68.24±11.64; VIS: VV-ECMO group was 5.51±3.72 vs. 10.20±7.10, VV-ECMO combined with PPV group was 6.73±3.32 vs. 14.50±2.48, all P < 0.05], up to 3 days after treatment [PaO 2/FiO 2 (mmHg): VV-ECMO group was 231.96±32.76 vs. 75.57±7.44, VV-ECMO combined with PPV group was 285.61±19.40 vs. 68.24±11.64; VIS: VV-ECMO group was 2.26±1.90 vs. 10.20±7.10, VV-ECMO combined with PPV group was 2.13±1.55 vs. 14.50±2.48, all P < 0.05], and the PaO 2/FiO 2 1 day and 3 days after treatment in VV-ECMO combined with PPV group were significantly higher than those in VV-ECMO group (mmHg: after 1 day of treatment was 255.20±31.92 vs. 197.75±39.80, after 3 days of treatment was 285.61±19.40 vs. 231.96±32.76, both P < 0.05). Before treatment, Crs of VV-ECMO combined with PPV group was significantly lower than that of VV-ECMO group (mL/cmH 2O: 17.91±0.82 vs. 20.54±1.26, P < 0.05). From 1 day after treatment, the Crs in VV-ECMO combined with PPV group was significantly higher than that before treatment (mL/cmH 2O: 21.20±1.50 vs. 17.91±0.82), the peak value was (24.93±2.18) mL/cmH 2O on 3 days after treatment, however, there was no significant difference between the two groups (all P > 0.05). In VV-ECMO combined with PPV group, compared with before PPV treatment, the PaO 2/FiO 2 and Crs of 2 hours after PPV treatment in 1, 2 and 3 days were significantly rose, and it reached the highest level in 3 days [PaO 2/FiO 2(mmHg): 285.61±19.40 vs. 189.91±28.34, Crs (mL/cmH 2O): 24.93±2.18 vs. 23.35±1.45, both P < 0.05]; the VIS was only increased in 2 hours after PPV treatment on the first day than before (6.73±3.32 vs. 6.38±3.22, P < 0.05). There were no related serious adverse events happened after PPV treatment. Conclusions:The combination of PPV during VV-ECMO could further increase PaO 2/FiO 2, improve hypoxemia and implement further protective lung ventilation to reduce the potential hazards during mechanical ventilation. In addition, no serious adverse events were observed in this study, suggesting PPV is safe during VV-ECMO.

Effect of scalding on secretory function of beta-endorphin neuron in the arcuate nucleus of the rat hypothalamus was studied semiquantitatively using immunocytochemistry and image analysis. The results showed that the number of beta-endorphin neurons and area of positive products reduced significantly (P

Objective To analyze the mortality in the aged patients with hip fractures who have been treated by operations. Methods We collected the clinical data of 349 aged patients (60 to 98 years old) with hip fracture who had been treated by operations from March 1999 to January 2008 in our hospital. Their overall mortality and one-year mortality were analyzed to find the causes for death. Results Thirty-one cases died and the overall mortality was 8.9% (31/349). Nineteen patients died within one year and the one-year mortality was 5.4% (19/349). Three patients died in hospital after surgery, 28 patients died in the follow-up period. Cardiac event, pulmonary dysfunction, cancer, cerebral vascular disease, hepatic cirrhosis, multiple organs dysfunction and infection were sequentially the major causes for death. Statistical results showed the factors which had definitely influenced the mortality were age and sex. Patients treated with proximal femoral nail anti-rotation (PFNA) had the lower mortality than with proximal femoral nail (PFN). Conclusions Operations can lead to a low mortality for aged patients with hip fractures. Ad-equate preparation and mini-invasive surgery can reduce the mortality.

Objective: To assess the health risk associated with drinking water in Hangzhou from 2016 to 2017,and to provide evidence for the safety of drinking water . Methods: The monitoring data of 5 genetic toxic substances（arsenic,hexavalent chromium,cadmium,chloroform,tetrachloromethane）and 13 body toxic substances（lead,mercury,selenium,cyanide,fluoride,nitrate,iron,ammonia nitrogen,manganese,copper,zinc,aluminum,volatile phenol）from 36 source water samples,36 finished water samples and 288 tap water samples in the main urban areas of Hangzhou were collected from 2016 to 2017. The health risk of drinking water containing the chemical pollutants mentioned above were assessed based on the evaluation models recommended by United States Environmental Protection Agency . Results: The concentrations of 5 genetic toxic substances and 13 body toxic substances in source water,finished water and tap water were all within the reference limits issued by Standards for Drinking Water Quality（GB 5749—2006）. The carcinogenic risk,non-carcinogenic risk and total health risk caused by the chemical pollutants in the source water were 2.18×10-5/a,7.75×10-9/a and 2.18×10-5/a. The carcinogenic risk,non-carcinogenic risk and the total health risk caused by the chemical pollutants in the finished water were 1.08×10-5/a,3.70×10-9/a and 1.08×10-5/a. The carcinogenic risk,non-carcinogenic risk and total health risk caused by the chemical pollutants in the tap water were 1.96×10-5/a,3.61×10-9/a and 1.96×10-5/a. The carcinogenic risk and total health risk caused by chemical pollutants ranged from high to low in the source water,tap water and finished water. The non-carcinogenic risks ranged from high to low in the source water,finished water and tap water . Conclusion The health risks of 18 chemical pollutants in drinking water in Hangzhou were at a low level,with the greater carcinogenic risk than the non-carcinogenic risk. Hexavalent chromium had the highest carcinogenic risk,while fluoride and aluminum had the highest non-carcinogenic risk.

ObjectiveTo compare the efficacy of three liver-protecting drugs commonly used in the treatment of drug-induced liver injury. MethodsThe clinical data of 90 patients with drug-induced liver injury who were treated in Yingcheng People′s Hospital from November 2012 to April 2015 were analyzed retrospectively, and according to the drugs administered, they were divided into groups A, B, and C, with 30 patients in each group. The patients in groups A, B, and C were treated with reduced glutathione, polyene phosphatidylcholine injection, and tiopronin injection, respectively. The efficacy, drug cost, and incidence of adverse events were compared between the three groups. An analysis of variance was used for comparison of continuous data between multiple groups, and the LSD t-test was used for comparison of continuous data between any two groups; the chi-square test was used for comparison of categorical data between multiple groups. ResultsGroup A had a significantly higher overall response rate than groups B and C (90.0% vs 73.3%/76.7%, χ2=2.78 and 3.75, both P＜0.05). Group B had a significantly higher drug cost than groups A and C (316.12±4.05 RMB vs 235.13±2.90 and 135.21±7.62 RMB, both P＜0.01). The incidence of adverse events showed no significant differences between the three groups (P＞0.05). ConclusionIn the clinical treatment of drug-induced liver injury, reduced glutathione has better efficacy compared with polyene phosphatidylcholine and tiopronin, as well as a reasonable cost. Therefore, this drug is preferred in the treatment of this disease.

OBJECTIVE: To determine the clinical value of transoral endoscopic adenoidectomy for the pediatric sinusitis. METHOD: Patients with chronic sinusitis and adenoid hypertrophy were divided into two group by undertaken with or without adenoidectomy, the operation group with 43 cases and the control group with 40 cases. Evaluation was performed in pretherapy and after 3 months therapy. Evaluation index included symptom scale for nasal obstruction and rhinorrhea, endoscopy score and CT score for chronic sinusitis. RESULT: There was a positive correlation (0.38) between the adenoid size and the symptom of nasal obstruction (P < 0.01). But there were no correlation between the adenoid size and the other index scores (P > 0.05). Whether in the operation group or the control group, all index scores in pretherapy were higher than in post-therapy (P < 0.05). After 3 month therapy, all index scores in the operation group were lower than the control group (P < 0.01). The decreased amplitude of all index scores in the the operation group were higher than the control group (P < 0.01). CONCLUSION Adenoidectomy combined with topical nasal treatment is one effective method for the pediatric sinusitis. Adenoidectomy play an important role in the treatment of pediatric rhinosinusitis.
Adenoidectomy ; methods ; Adolescent ; Child ; Endoscopy ; Female ; Humans ; Male ; Sinusitis ; surgery ; Treatment Outcome

Objective To study the therapeutic effect and safety of orthokeratology in the teenagers with high myopia.Methods A retrospective cohort study was carried out.The clinical data of 120 eyes from 60 high myopia patients wearing orthokeratology contact lens for 1 year in Henan Eye Hospital from June 2013 to June 2014 was analyzed,and the data of contemporaneous 118 eyes from 59 matched high myopia patients wearing conventional glasses were used as controls.The initial spherical equivalent (SE) of all the patients was-6.00 to-9.00 D.The maximum correction amplitude of the orthokeratology contact lens was set as 6.00 D based on the Regulation of China Food & Drug Administration.The contact lenses were worn for 1 month firstly and then the conventional glasses were used at daytime and contact lenses were consecutively worn at night for 1 year in the contact lenses group,and only glasses were worn in the conventional glasses group.The uncorrective visual acuity (UCVA),SE,corneal fluorescein staining were examined 1 week,1 month,3 months,6 months and 12 months after wearing lenses.The changes of corneal endothelial cells were examined 6 and 12 months after wearing lenses.Results The UCVA was improved and SE was reduced 1 month and 3,6 and 12 months after wearing lenses in comparison with 1 week after wearing lenses in the contact lenses group (all at P＜0.01);while no significant change was seen in UCVA in the conventional glasses group (all at P＞0.05).Compared with wearing contact lenses,the SE was increased in various time points after wearing glasses in the conventional glasses group (all at P＜0.01).The axial length and SE extended by (0.08±0.12)mm and (0.19±0.21)D in the contact lenses group and those in the conventional glasses group were (0.29±0.14)mm and (0.69±0.27)D,showing significant differences between the two groups (t =10.024,5.691,both at P＜0.01).No significant differences were found in corneal endothelial cell density,percentage of hexagonal cells and coefficient of variation of corneal endothelial cells in various time points after wearing contact lenses (corneal endothelial cell density:Fgroup =0.090,P =0.769;Ftime =0.133,P =0.563.percentage of hexagonal cells:Fgroup =0.071,P=0.836;Ftime =1.091,P =0.203.coefficient of variation:Fgroup =0.107,P =0.734;Ftime =1.948,P =0.156).The incidence of corneal fluorescein staining was 31.67％ in the contact lens group,which was much higher than 3.51％ in the conventional glasses group (x2 =97.910,P =0.001).Conclusions Compared with wearing only conventional glasses,orthokeratology can improve UCVA and control axial length extension in juvenile with high myopia,but orthokeratology is more likely to damage the corneal superficial layer.