Objective To introduce a safe and practical approach for the treatment of severe muscular torticollis. Methods In an axis of the spasmodic sternocleidomastoid muscle, the author designed a five-valve flap with two valvae inside, which ended at the mastoid point and inferior clavicular part of sternocleidomastoid muscle, respectively. The arm length of each valve was approximately half of its axis. Each valve was separated bluntly in naked eyes in order not to detach the platysma myoides from the skin, and to release the webbed neck. Under the flap, the thinned and fibrosed sternocleidomastoid muscle and spasmodic neck sheath and superficial cervical vein were easily found. The sternocleidomastoid muscle was disconnected at the median point, and the two ends were retracted, the superficial cervical vein was cut and ligated, the neck sheath was released to uncover the spasmodic cervical artery and nerve. The head was right positioned, and then the surrounded fascial tissues were released under the protection of the arteries and veins. The flap was sutured to cover the arteries, veins and muscles. Results Reasonably good effect was achieved in one case and intermediate effects in other 4 cases. Surgical results were satisfactory. All the flaps were survival with insignificant scar formation. Conclusions Webbed skin deformity in the neck can be corrected by using five-valve plastic surgery of platysma myoides, which is able to cover the exposed nerves and vessels. This procedure prevents the adhesion of the operated area, ensures the blood supply of the distal portion of the flap, and also avoids the damage of other tissues in the flap area.

Objective:To evaluate the reliability of localization of the impacted teeth by assessing various conventional radiographies. Methods:32 patients with impacted teeth were included. The impacted teeth were localized by conventional roentgenographic techniques including panoramic radiography (PR) and linear tomography (LT).Results:Dentomaxillary orthopantomographic solution (PR,LT and PR combined with LT) clearly presented the position of the impacted teeth. Serial cross-section linear tomography also ensured the shape and axis of the impacted teeth captured on the radiograph. The accuracy of the localization was further verified by the surgical exposure in 5 cases. Conclusion:Orthopantomographic assessing can directly and precisely localize the buccal and lingual position of the impacted teeth.

Objective In this study,we cooperated CVVH(continuous veno-venous hemofiltration)in treatment of Acute Respiratory Distress Syndrome(ARDS)and investigated the efficacy of CVVH in treatment of ARDS.Methods From May 2002 to Nov.2005,76 ARDS patients were involved.CVVH was carried out continuously for at least 24 hours.During CVVH,the patients' conditions were observed.Blood gas analysis and serum concentrations of endotoxin were detected.Results After CVVH,the patients' symptoms such as panting and cyanosis were remission.APACHE Ⅱscore decreased significantly.After six hours of CVVH,serum concentration of endotoxin was decreased significantly.Conclusion CVVH is effective in redressing the hypoxemia and relieving the patients' condition.

Objective To compare the serum index after colonoscopy high-frequency electric snare combined with nylon cord ligation and high-frequency electric resection in treating broad pedicle polyps. Methods 70 cases of broad pedicle polyps patients from July 2012 to May 2016 were chosen as research object. The operation methods and laboratory examination results of all the patients were reviewed. All patients were divided into observation group (n = 37) and control group (n = 33). Patients in observation group were treated by colonoscopy high-frequency electric snare combined with nylon loop ligation, while patients in control group were treated by high-frequency electric resection only. The blood loss and related indexes of the two groups were recorded. Before and after operation, stress hormones and acute phase proteins in serum was determined. Results Intraoperative blood loss of observation group was less than that in control group, postoperative hemoglobin levels was higher than that in control group, postoperative early bleeding rate, postoperative delayed bleeding rate of observation group were lower than that in control group (P < 0.05); 1 hour after surgery, Cor, ACTH, AT II, NE, CRP, SAA, AAT in serum were lower than those in control group (P < 0.05). Conclusion Through colonoscopy high-frequency electric snare combined with nylon cord ligation can reduce bleeding during and after surgery, relieve stress and inflammation.

Objective To evaluate potential clinical risk factors for the development of early-onset myocardial damage following multiple trauma (MT), and to determine whether early-onset myocardial damage was caused by the combined effects of thoracic and systemic injury factors in MT patients.Methods A total of 231 patients with MT over the last 3 years were retrospectively reviewed. With myocardial damage being a dependent variable and other twenty factors being independent variables, univariate and multivariate logistic regressions were applied to investigate the risk factors for early-onset myocardial damage and to identify the association of thoracic and systemic risk factors with early-onset myocardial damage.Results Multivariable logistic regressions showed that acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ ) score ≥10, injury severity score (ISS) ≥ 25, shock index ≥ 2,coexisting chest trauma, abbreviated injury scale (AIS) of chest≥3, and hypoxia time ≥ 0.5 h were risk factors. The risk of earlyonset myocardial damage following MT obviously increased when thoracic and systemic injury risk factors were coexisting.Conclusion Our results indicated that thoracic injury combined with systemic injury increased the overall risk of early-onset myocardial damage following MT. Prospective validation of these findings in other clinical settings is warranted.

Objective To investigate acquired carbapenemases and prevalence of carbapenem- resistant gram-negative bacill.Methods The antimicrobial susceptibility was determined by agar dilution method.Metallo-B-lactamase(MBLs)were screened by EDTA-disk synergy tesL The encoding genes of MBLs were amplified by PCR followed by sequencing.Strain homology Was investigated by pulsed-field gel electronphoresis(PFGE).Results In 141 carbapenem-resistant Pseudomonas aeruginosa(P.aeruginosa), there were three resistant patterns which were imipenem(IMP)-resistant+meropenem(MEM)-resistant (66.7%),IMP-resistant+MEM-sensitive(32.6%),and IMP-resistant+MEM-sensitive(0.7%).AⅡthe carbapenem-resistan Acinetobacter baumannii(A.baumannii),Acinetobacter lwoffi(A.lwoffi),Citrobactor freundii(C.freundii),Klebsielta pneumoniac(K.pneumoniac)and Serratia were resistant to imipenem and meropenem.Four strains of 141 P.aeruginosa were positive by EDTA-disk synergy test,and they produced VIM-2-type Metallo-B-1actamase.Of 34 carbapenem-resistan A.baumannii,30 strains produced OXA-tllrpe.Among them, OXA23, OXA24 and OXA66 accounted for 79.4%,38.2% and 67.6%,respectively.And 22 of 34 strains(64.7%)produced multiple OXA-carbapenemases.All 7 strains A.lwoffi produced OXA-23-type carbapenemases.A11 11 strains C.freundii,5 strains k pneumoniac and 1 strains Serratia produced KPC-2-type carbapencmases.And 6 of 11 strains C.freundii produced new subtype IMP-8.Of 15 PFGE type in 34 strains A.baumannii,14 strains belonged to A-type,7 strains belonged to B-type.Seven A.lwoffi strains distilbuted in difierent PFGE type.Four strains of P.aeruginosa producing VIM-2.type Metallo-8-lactamase did not have the same PFGE type.Eleven C.freundii strains had the same PFGE type.Five k pneumoniae strains had the sanle PFGE type.Conclusions Drug resistance to 12 common antibiotics in carbapenem-resistant gram-negative bacill was higher than non-carbapenem-resistant gram-negative.The former produced many kinds of carbaponemases and the strains prducing carbapenemases were prevalent in the C.freundii, A.baumanii, and k pneumoniae.

Objective: To study the efficacy,safety and relative characteristics of formulated Chinese medicinal herbs as a vascular embolizing agent. Methods: We prepared a mixture as a vascular embolizing agent from several Chinese medicinal herbs,they served as anticarcinogen and/or coagulant according to the Chinese Pharmacopeia.We studied the characteristics of the mixture through embolizing the hepatic artery in eight pigs with it. Results: The mixture was prepared as a suspension.It was easily injected through catheters and showed good histocompatibility and hemo-compatibility without pyrogenetic response and toxicity.The mixture mainly embolized peripheral arteries,maintaining occlusion for 5 weeks and without formation of collateral circulation.We found injuries of normal hepatic tissues as slight hepatocyte hydrops and focal endochyloma necrosis through optical and electronic microscope. Conclusion: This suspended mixture of Chinese medicinal herbs is safe and effective as a potential peripheral embolizing agent.

Objective To observe the effects of labor analgesia on maternal and neonatal outcome by epidural application of 0.125% bupivacaine combined with anisodamine on the labor stage, and modes of delivery and neonatal Apgar's score. Methods A total of 220 primiparaes with full-term pregnancy, monocyesis and fetal head presentation without any obstetrical or systematic complications were chosen and divided into analgesic group and control group (110 in each group). The mixture of bupivaeaine and anisodamine was injected into the epidural space of the parturients in the analgesic group while those patients in the control group did not receive any analgesics. Results The analgesic effect was satisfactory (91.8 %), and no side effects occurred in the second stage of labor. The instrument delivery rate was lower in the analgesic group, and there was no significant difference between the two groups in neonatal Apgar's score. Conclusion The method is feasible in clinic for labor pain relief without increasing the rate of dystocla and complications of delivery.

Objective To investigate the efficacy of combined intravenous rt-PA and free-radical scavengen (edaravone) on Chinese patients with acute ischemic stroke. Methods Eighty-nine subjects with ultra-acute ischemic stroke were assigned to the group treated with intravenous rt-PA and another group treated with a combination of intravenous rt-PA and edaravone. The NIH Stroke Scale (NIHSS) and Barthel Index (BI) in 30 days and 90 days after thrombolysis were compared between two groups. Results There were statistically significant differences between the group of rt-PA thrombolysis and the group of combined with rt-PA and edaravon in the ratio of NIHSS 0-1 of 30 days after therapy (25.0% vs35.6%, χ2=8.259,P=0.041) and 90 days (27.3%vs 40.0%, χ2=9.158,P=0.027),as well as in the proportion of BI 95-100 of the same time points(30 days:20.5%vs33.3%,χ2=8.833,P=0.032;90 days:25.O%vs37.8%,χ2=8.221,P=0.042).The rates of hemorrhagic conversion and mortality in two groups were similar. Conclusion rt-PA combined with free radical scavenger edaravone safely and effectively decreases the loss of neurofunctions and reserves more self-dependence capability in patients with acute ischemic stroke 30 days and 90 days after treatments.