OBJECTIVE: To observe the efficacy of rhinoplasty with autogenous nasal septal cartilage for saddle nose caused by nasal bone and nasal septum fracture after trauma. METHOD: During the treatment process of 30 cases of nasal trauma, simple nasal bone fracture reposition and nasal septum correction was done, and rhinoplasty was done using the nasal septal cartilage. All the patients were followed up to evaluate subsequent effect. RESULT: All the patients were satisfied with the result of one stage repairment. After following-up for 3-42 months, 28 cases (93.3%) were of long-term satisfaction. CONCLUSION Rhinoplasty with autogenous nasal septal cartilage for saddle nose was an effective method to repair the nasal trauma.
Adolescent ; Adult ; Female ; Humans ; Male ; Middle Aged ; Nasal Cartilages ; transplantation ; Nasal Septum ; surgery ; Nose Deformities, Acquired ; surgery ; Rhinoplasty ; methods ; Transplantation, Autologous ; Treatment Outcome ; Young Adult

With the population ageing,increasing health needs and demands,changing family structure and the transformation of general hospital service model,home care as an important part of primary care,has been brought more and more attention.Home healthcare would relieve the pressure caused by increasing needs of elderly care and transformation of hospital functions,so it should have greater development in the future.This article reviews the present situation and the future development direction of home healthcare in China.

Objective To evaluate the X-ray signs of the ascending venography of the lower limbs.Methods The imaging findings of ascending venogaphy in 80 sides lower limb were reviewed retrospectively.Results According to the imaging findings,all patients were divided into normal groups and abnormal groups;unusual groups including simple venous valvular inadequacy 4 sides,traffic venous valvulor inadequacy 6 sides,primary deep venous valvular inadequacy 32 sides and secondary 5 sides,thrombosis 3 sides,congenital dysplasia 2 sides,phlebangioma 5 sides.Conclusion The ascending venoraphy of the lower limbs is a simple and effective method,it is valuable in diagnosis of venous disease.

Objective To investigate the clinical significance of antiendothelial cell antibodies (AECA) in systemic vasculitis. Method With Human umbilical vein endothelial cell (HUVEC) as substrate cell, sera from 129 systemic vasculitis patients [including 59 Behcet′s disease(BD), 28 Takayasu arteritis (TA), 20 Wegener′s granulomatosis (WG), 8 polyarteritis nodosa (PAN), 9 microscopic polyangiitis (MPA), 5 Churg-Strauss syndrome (CSS)] were screened for the presence of AECA by ELISA. Sera from SLE, RA and healthy donors were examined as controls. The association of AECA to clinical disease activity was analyzed. Result The prevalence of AECA by HUVEC cell-ELISA was 59% in systemic vasculitis [48% in BD,79% in TA, 65% in WG, 63% in PAN, 44% in MPA, 80% in CSS], 46% in SLE, 4% in RA, and 2.4% in control group. Compared with patients with RA and control group, AECA were more frequently found in patients with systemic vasculitis and SLE (P

Objective To study the image features and clinical significance of 3-dimensional (3-D)and multiplanar reconstruction with spiral CT(SCT) in cervical spinal fractures.MethodPlain film radiography and spiral CT scanning were taken for 26 cases of cervical spinal fractures.The type of fractures, diagnositic successful rate, parameter of scanning and late stage managing methods were investigated retrospectively to find out the effective difference between the diagnosis of plain X-ray and SCT. The imagin location of fractures,sequence of cenrum, heighth of centrum, fracture line, auxillary structure and rotation/dislocation of the fractures were emphasized to evaluate the advantages of 3-D imaging.ResultIn the 26 cases, there were 4 Jefferson fractures, (in which 1 combined with articular dislocations), 17 C2 spinous process fractures, (in which 1 had failure of plain X-ray diagnostic), 1 Hangman fracture, 2 C1～2 imbalance, (in which 1 had failure of plain X-ray diagnostic).There were 2 cases of axoid longitudinal fractures without obvious dislocation. The diagnositic successful rate were 100% in SCT group, while 65% in X-ray group in which 6 cases had diagnostic failure and 3 cases had fracture mis-diagnozing as dislocation.The anatomical structure of upper cervical spine was complicated and was significantly different from other cervical spine constructions. Spiral CT could reveal high resolution images of the upper cervical spine, morphosis of vertibral canal, dislocation information of fracture mass and its relation with neighbouring tissues. Especially in C1 burst fracture,C2 dens fracture and C1～2 dislocation, SCT could provide clear 3-D information of the size of collateral mass and the dislocation degree, furthermore, images could be rotated freely to observe the fracture in any proper section. That provides important information for the decision of operation, selection of operation types and evaluation of operation dager.ConclusionThe spiral CT scan and 3D reconstruction can reveal fracture better.The advantages of SCT are suggested that this diagnostic modality may be the standard method for the initial evaluation of the upper cervical spine injury.

Objective To investigate the expression of aquaporin-3 (AQP3) in tongue tissues of rats with experimental severe acute pancreatitis (SAP) and regulating effects of emodin. Methods Rat models with SAP were established by injecting 5% sodium taurocholate retrogradely into gallbladder and pancreas. SD male rats were randomly divided into sham-operation group, model group, and emodin group. After model establishment, rats in the emodin group received gavage with emodin 20 mg/kg each day, while rats in the model group and sham-operation group received gavage with normal saline. The mental state, thick greasy tongue fur and mortality of rats were observed every day after model establishment, and 5 days later, protein and genetic expression of AQP3 were detected by Western blot and RT-PCR. Results Compared with the model group, the mortality and the thick greasy tongue fur significantly decreased, the protein and genetic expression of AQP3 significantly decreased in the emodin group (P<0.05). On the 5th day, 11 rats in the model group survived, and 5 rats had thick greasy tongue fur. Compared with the sham-operation group, the protein and genetic expression of AQP3 in the model group were higher (P<0.05). Conclusion Emodin can improve the severity of SAP and decrease the incidence of thick greasy tongue fur significantly by reducing the protein and genetic expression of AQP3.

Objective To investigate the clinicopathologic characteristics of and HPV subtypes in vulvar condyloma acuminatum(CA)and subclinical HPV infection.Methods Eighty patients with a positive acetowhite test and suspected subclinical HPV infection were selected from 272 patients with typical CA lesions in perianal and external genital region.Tissue specimens were obtained from typical CA and suspected subclinical HPV-infected lesions followed by pathological examination and HPV-DNA detection.Finally,71 patients were confirmed to suffer from both CA and subclinical HPV infection.A comparative analysis was performed to assess the differences in histopathological manifestation and HPV genotypes between CA and subclinical infection lesions.Results Pathological examination revealed typical histological changes of CA in 71(88.75％)typical CA specimens and 4(5％)suspected subclinical infection specimens,as well as squamous dysplasia in 9(11.25％)CA specimens and 71(88.75％)suspected subclinical infection specimens.HPV-DNA was positive in all(80)of the CA specimens and 93.75％(75)of the suspected subclinical infection specimens,negative in 5(6.25％)suspected subclinical infection specimens.Obvious differences were observed in pathological manifestation,koilocyte number(P ＜ 0.05),but not in the distribution of HPV subtypes(P ＞ 0.05),between typical CA and concurrent subclinical HPV infection lesions in patients.Conclusion The diagnosis of subclinical HPV infection should be based on the result of acetowhite test,with the results of pathological examination and HPV DNA detection as an adjuvant.

Objective To evaluate the effect of stent implantation using Multimodal CT in patients with MCA and ICA stenosis. Methods Twenty-six patients with ischemic cerebrovascular disease who received MCA or ICA stent implantation in ChongQing xinqiao Hospital were recruited. Multimodal Stroke Assessment Using CT Score (MOSAIC) was used to evaluate the Neuroimaging data before stent implantation and Alberta Stroke Program Early CT Score (ASPECTS) to evaluate the time to peak (TTP) of CTP before and after stent implantation. Results Patients were divided into 4 groups based on scores: 4 scores, 5 scores, 6 scores, and 7 scores groups. the improvement degree was increase by 31.7%±14.17%、38.6%±15.73%、43.3%±10.3%、358.6%±13.45% in 4 scores, 5 scores, 6 scores, and 7 scores groups, respectively. The paired t test demonstrated that there were a statistically significant difference among four groups(H=10.673, P <0.05). Preoperative MOSAIC score was positively correlated with the improvement of ASPECT score for TTP, with a correlation coefficient of 0.579 ( P <0.002). Conclusions Multimodal CT is a sensitive assessment for the evaluation of ischemic cerebrovascular disease and patients with a higher MOSAIC score may benefit more from stent implantation.

Objective To analyze the clinical features of patients with hemophagocytic syndrome (HPS) in autoimmune diseases (AID). Methods We collected the data of 11 patients with AID complicated with HPS in Peking Union Medical College Hospital from 2004 to 2009. The underlying diseases, clinical features, laboratory findings and treatment outcomes were retrospectively analyzed. Results Of the 11 patients,3 were male,8 were female. Mean age was (30. 7 ± 18. 3) years. The underlying diseases included Still disease ( n = 4 ), systemic lupus erythematosus ( n = 3 ), and rheumatoid arthritis, primary Sj(o)gren's syndrome, Wegener granulomatosis and Crohn disease in each one case. HPS was associated with the onset of AID ( n = 4), active infection alone ( n = 1 ) and both factors ( n = 6 ). HPS was clinically characterized by high fever ( 100% ), hepatosplenomegaly ( 72. 7% ) , lymphadenopathy ( 63.3% ) and central nervous system involvement (36. 3% ). 4 patients presented with disseminated intravascular coagulation(DIC) (36. 3% ). Laboratory data mainly manifested with cytopenia ( 100% ), liver dysfunction ( 100% ), hypofibrinogenemia ( 62. 5% ), hypertriglyceridemia ( 81.8% ), serum ferritin ＞ 500 μg/L (100%), low NK-cell activity(80% ) and hemophagocytosis in bone marrow( 100% ). Based on treating underlying infections and use of corticosteroids and immunosuppressive agents in combination with intravenous immunoglobulins(IVIG) therapy, 5 patients recovered , 6 patients died. The mortality rate was 54. 5%. DIC were associated with mortality ( r = 0. 69, P = 0. 019 ). Conclusion The episode of HPS always occurs simultaneously with multiple system involvement that was often difficult to distinguish from active AID. The present of DIC on HPS related with poor prognosis and high mortality. Corticosteroids and immunodepressant and IVIG may improve the prognosis of HPS, while anti-infection therapy is very important and necessary for the patients accompany with active infection.

OBJECTIVE:To explore the method and role of clinical pharmacists in pharmaceutical care for nephrotic syndrome complicated with Pneumocystis carinii pneumonia (PCP). METHODS:Clinical pharmacists participated in the treatment for a pa-tient with nephrotic syndrome complicated with PCP,and implemented pharmaceutical care in terms of the development of anti-in-fective therapy regimens,glucocorticoid optimization,guardianship for drug use,the medication education for patients. Clinical pharmacists provided suggestion that primary anti-infective plan of azithromycin 0.5 g,ivgtt,qd+Compound sulfalene tablet 2 tab-lets,po,q12 h;which was not effective,was adjusted plan as Compound sulfalene tablet 3 tablets,po,q6 h+clindamycin 0.6 g, ivgtt,q8 h+caspofungin 50 mg,ivgtt,qd. The dose of Methylprednisolone for injection was adjusted 4 times according to disease progression. RESULTS:Physicians adopted the suggestions of clinical pharmacists. After 30 days of treatment, lung abnormal le-sion was absorbed basically and infection control was achieved. CONCLUSIONS:Clinical pharmacists participate in anti-infective treatment and pharmaceutical care,and assist physicians to develop therapy plan to promote rational drug use in the clinic and im-prove the effectiveness and safety of clinical treatment.