Objective:To analyze the occurrence and therapeutic results of dialysis-related acute arrhythmias in pa-tients undergoing maintenance hemodialysis (HD).Methods:A total of 83 cases undergoing maintenance HD from Jun 2012 to Jun 2013 Were selected.Type,frequency and duration of dialysis-related acute arrhythmias Were recor-ded;risk factor and therapeutic results of dialysis-related acute arrhythmias Were analyzed.Results:The 83 HD pa-tients received a total of 8964 hemodialysis and 1046 acute arrhythmias occurred (11.67%)during hemodialysis,in-cluding 306 cases (29.3%)of premature ventricular beats,228 cases (21.8%)of sinus tachycardia,179 cases (17.1%)of premature atrial beats,138 cases (13.2%)of atrial fibrillation,81 cases (7.7%)of paroxysmal su-praventricular tachycardia,75 cases (7.2%)of ventricular tachycardia and 39 cases (3.7%)of sinus bradycardia. The rate of arrhythmia Was most during 1~2h after hemodialysis and sustaining to 4h.Logistic regression analysis indicated that risk factors of dialysis-related acute arrhythmias Were potassium disorder,heart disease (OR 4.46~18.96,P<0.05 all).After taking comprehensive treatment measures,the success rate terminating arrhythmia Was 95.3%.Conclusion:Dialysis-related acute arrhythmia is a frequent complication during hemodialysis,ventricular tachycardia rate may reach 7.2%,rate of acute arrhythmia reaches peak during 1~2h after hemodialysis,its risk factors are potassium disorder and heart disease, adequate treatment can effectively prevent and cure arrhythmia.

Due to the restriction of the specific situation in China and the concrete conditions of universities,Problem-based learning teaching method failed to gain its popularity in medical education in China.In the era of information globalization,the web-based teaching method relying on the network and taking the PBL as the dominant has many advantages and there is nothing comparable to this.To establish a network of PBL platform in the area of medical education will provide medical education with a new chapter.

OBJECTIVETo explore the curative effect of Z-plasty without skin grafting for correction of cryptotia.

METHODSTwenty-five cases (29 ears) with cryototia were corrected by Z-plasty without skin grafting in our department from June 2009 to January 2014. A Z-shaped incision with one arm on the back of antihelix and the other arm on the edge of hair was made on the back of ear and scalp. The adhesion on the back of antihelix cartilage was dissected and the cartilage framework was lifted and re-positioned. The postauricular flap was transferred to cover the wound on the back of antihelix. The other flap was transferred to cover the remnant wound and correct the malformation of cryptotia.

RESULTSAll the patients were followed up from 6 months to 1 year with stable and symmetric appearance.

CONCLUSIONSThe shape of auricle is natural after operation without skin grafting. It is a simple and ideal method for the treatment of cryptotia.

Ear Cartilage ; abnormalities ; surgery ; Ear, External ; abnormalities ; surgery ; Humans ; Skin Transplantation

OBJECTIVETo investigate the feasibility and advantages of total auricular reconstruction with single big expander at dual plane through incision at remnant ear.

METHODS52 patients with microtia were treated. Through incision at remnant ear, one big expander (150 ml) was implanted in the post-auricular area beneath the superficial facial in the hairless area, and above the superficial fascia in the area with hair. In the second stage, total auricular was reconstructed with autologous cartilage framework and expanded skin. Skin graft was not necessary. Another 32 paitents with single big expander above the superficial fascia were used as control. The downward shift distance of expanders, the appearance of auriculocephalic sulcus and complication were recorded in order to assess the effect of these two methods.

RESULTSThe downward shift distance of expanders in the dual plane group (0.7 ± 0.3) cm were lower than that in the control group (1.3 ± 0.4) cm, showing significant difference (P < 0.05). After a follow-up period of 6-12 months, shallow auriculocephalic sulcus was presented in 5 patients of the dual plane group and 12 patient of the control group. The shallow auriculocephalic sulcus was cut to make it deeper and covered with full skin graft.

CONCLUSIONSDual plane skin expansion could reduce the downward shift distance of expander. Adequate skin on the upper part of expander could make satisfactory auriculocephalic sulcus.

Cartilage ; transplantation ; Congenital Microtia ; surgery ; Feasibility Studies ; Hair ; Humans ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; methods ; Subcutaneous Tissue ; Surgical Flaps ; trends ; Tissue Expansion ; methods ; Tissue Expansion Devices

Objective Prepare biomimetic muitilayered scaffold which has similar structure of natural cartilage.Method By lyophilizing the scaffolds which were prefrozen at-20℃ and in liquid nitrogen successively,we prepared double-layered spongy scaffolds.By partially thawing the prefrozen samples and refreezing them in liquid nitrogen before the final liyophilization,we prepared biomimetic multilayered scaffolds with about 2mm thickness.XRD and FT-IR were used to confirm the interaction between collagen and chitosan.SEM was used to observe the morphologies of the scaffolds.The mechanical properties of pure chitosan scaffolds,pure collagen scaffolds,composite single-layered scaffolds and biomimetic multilayered scaffolds were compared both in dry and wet conditions.Results There was chemical interaction between collagen and chitosan.Composite materials will form better pore structure.The biomimetic multilayered scaffolds have upright pores,round pores and a dense layer from bottom to top of the scaffolds.The scaffolds have quite different mechanical properties between dry and wet state.Under wet state,the different layers of the biomimetic muitilayered scaffold have different mechanical properties.Results The biomimetic structure of the multilayered scaffold is very close to that of the natural articular cartilage,and the different layers of the biomimetic muitilayered scaffold had different mechanical properties under wet state.These are hopefully beneficial to help maintain the phenotypes of chondrocytes and promote the repairing effect of cartilage defects.

OBJECTIVETo investigate the application of intense pulsed light (IPL) depilation in the auricular reconstruction with totally expanded skin and its suitable parameter.

METHODSFrom February 2009 to September 2013, one tissue expander(100 or 150 milliliters) were implanted under the skin of mastoid in 126 patients who suffered from microtia. During the skin expanding, the hair on the expanded skin was depilated by JPL technique. The parameter, operation, interval, the depilation result and the complication were recorded. The autologous rib cartilage frameworks were implanted in the second phase of auricular reconstruction.

RESULTSThe energy of IPL was 20 - 35 J/cm2 (mean 25. 3 J/cm2), the width of pulse was 26 - 30 ms ( mean 27. 9 ms), the interval between two operations was 4 weeks. Ninety-six patients were cured(76. 2%, 96/126). The total depilation efficient is 96. 8% (122/126). A fine banding blisters was found in one patient whose depilation areas was marked by black pen. Skin erythema was found in five patients and skin pigmentation was found in 7 patients. There were no skin necrosis and expander exposure in all patients. During 6 - 12 months of follow-up period, ninety-two patients were cured (73.0%, 92/126) and the total depilation efficient is 92. 9% (117/126).

CONCLUSIONSIPL depilation during the skin expanding is feasible and safe with careful procedure. The hairless expanded skin is enough to cover the framework, as well as the post-auricular area. The appearance of reconstructed ear is better without hair.

Congenital Microtia ; surgery ; Costal Cartilage ; transplantation ; Ear, External ; Erythema ; etiology ; Hair Removal ; methods ; Humans ; Mastoid ; Phototherapy ; adverse effects ; methods ; Reconstructive Surgical Procedures ; Skin Pigmentation ; Surgical Flaps ; Tissue Expansion ; Tissue Expansion Devices

Objective To evaluate the therapeutic effect of lentinan combined with conventional antituberculous therapy in women with pelvic tuberculosis.Methods A total of 90 women with pelvic tuberculosis were enrolled and recruited into a control group and a treatment group by random number table,45 in each group.The control group was treated with anti-tuberculosis program (2HRZE/4HRE),while the treatment group was treated with lentinan tablets on the basis of the control group.Both groups were treated for 6 months.Serum levels of carbohydrate antigen 125 (CA125) and erythrocyte sedimentation rates (ESRs) were determined before and after treatment,and the therapeutic effect was evaluated.Results After treatment,the serum CA125 level (28.61 ± 9.08 U/ml vs.39.72 ± 12.13 U/ml;t=4.919,P＜0.01) and the ESR (36.13 ± 8.33 mm/h vs.41.35 ± 12.45 mm/h;t=2.338,P＜0.05) in the treatment group were significantly lower than those in the control group.The negative rate of serum CA125 after treatment than before treatment in the treatment group (93.3％ vs.20.0％;X2=46.335,P＜0.01) and the control group (82.2％ vs.8.9％;X2=37.396,P＜0.01);but there was no difference in negative rate of serum CA125 after treatment between two groups (X2=1.6571,P=0.198).The total effective rate in the treatment group was significantly higher than that in the control group (93.3％ vs.77.8％;X2=4.406,P=0.036).Conclusion Lentinan combined with conventional antituberculous therapy is effective in treatment of pelvic tuberculosis in women.

AIM:To investigate the effect of the N-terminal 24-amino acid (N24) overexpression in p55γre-gulatory subunit of phosphatidylinositiol 3-kinase ( PI3K) on the cell adhesion of human gastric carcinoma cell MGC 803. METHODS:MGC803 cells, which stably expressed GFP-N24 fusion protein and GFP alone , were generated by transfec-tion with pEGFPN-24 plasmid and control plasmid pEGFP-C1, respectively.The morphological change of the cells was ob-served under inverted microscope .The expression of GFP-N24 fusion protein was detected by Western blot .The adhesion of the cells was determined by cell adhesion assay .The effects of GFP-N24 fusion protein on the expression of E-cadherin andβ-catenin were analyzed by Western blot .The expression and secretion of matrix metalloproteinase 9 (MMP9) and u-rokinase-type plasminogen activator ( uPA ) in the MGC803 cells were detected by gelatin zymography .RESULTS:MGC803/GFP-N24 cell line steadily expressed GFP-N24 fusion protein and MGC803/GFP cell line steadily expressing GFP were successfully established , but the expression of fusion protein GFP-N24 was lower than that of the control protein GFP.The morphological changes of the transfected cells from paving stone to fibroblast cell form after gene transfection , and the cytoplasm secretory granules were increased significantly .The cell adhesion to fibronectin and collagen decreased after GFP-N24 transfection .GFP-N24 fusion protein increased the expression of cell adhesion molecule E-cadherin and de-creased the wnt signal pathway molecule β-catenin in the MGC803 cells.However, it did not affect the expression and se-cretion of tumor metastasis-related proteins MMP9 and uPA.CONCLUSION:Overexpression of N24p55γinhibits cell ad-hesion by influencing the expression of E-cadherin and β-catenin in the MGC803 cells.

Objective:To observe the feature of Lorenz plots of dual parasystole ,and explore its differential diagnosis significance .Methods :Lorenz plot data of seven patients diagnosed as dual parasystole was retrospectively analyzed . They were compared with those of single source premature beat ,dual premature beat and single source parasystole . Results :All case data were divided into six groups (seven cases in each group) ,its features were :group 1 [ (single source atrial premature beat (APB)] ,plots were characterized with three distribution and sinus rhythm located on 45° line ;group 2 (dual source APB) were five distribution with the same sinus rhythm location ,the points set before and after premature were located on its two sides ,the plot was symmetry ,slopes of line B were within 0~1 in group 1 and 2 and its slopes were no significant difference (P>0.05);group 3 was single source ventricular premature beat (VPB) ,show four distribution pattern ,sinus rhythm was located on 45° line ,the points set before and after prema-ture were almost parallel to X and Y axis ;group 4 ( dual source VPB) were in six distribution with the same sinus rhythm location ,its difference with single source VPB was the points set before and after premature were symme-try;slopes of line B all trends to 0 in group 3 and 4 ,their slope also no significant difference (P>0.05);Group 5 (single source parasystole ) was characterized as four distribution vertical to 45° line ,premature point set was vertical to 45° line ,point set before and after premature were vertical to axis X and Y respectively ;group 6 (dual parasysto-le) were seven distribution vertical to 45° line ,were similar to that of single source parasystole ,the difference was figure of group 6 was dual distribution ;slopes of line B were close to ∞ in group 5 and 6 ,and its difference were no significant (P>0.05) .The line B slopes in group 5 and 6 were significantly higher than those of group 1&2 [ (∞ ) vs .(4.78 ± 0.19)] ,and those of group 1&2 were significantly higher than those of group 3&4 (0.36 ± 0.06) ,P<0.01 all .Conclusion:There are significant difference in Lorenz plot features among single (dual) source atrial/ven-tricular premature beats ,single source parasystole and dual parasystole .Lorenz plot is helpful to differential diagno-sis of parasystole .

AIM:To investigate the principle of function of Stomach-Clearing Powder (Radix Rehmanniae, Radix Angelicae Sinensis, Cortex Moutan Rhizoma Coptidis, etc.) on clearing the stomach-heat. METHODS: 5% alcohol water were used as drink water of mice to make model. In the treatment group, "Stomach-Clearing Powder" was administed. Three weeks later, the anal temperature, the evacuation time of active carbon powder,stomach cAMP, SOD, MDA and the pathological changes in stomach and tongue were observed and recorded. RESULTS: "Stomach-Clearing Powder" could can obviously improve the pathological changes of the model group with stomach-heat syndrom. CONCLUSION: The established pathological model of stomach-heat syndrome accorded with traditional Chinese medicine; "Stomach-Clearing Powder" has the effect on clearing the stomach-heat on the experimental mouse.