BACKGROUND: The repair and functional reconstruction of peripheral traumatic nerves depend, on posttraumatic operation time and operative techniques which have certain referential value.OBJECTIVE: To explore the effects of related factors on the repair and functional reconstruction of common peroneal nerve (CPN) after injuries.DESIGN: A case analysis.SETTING: Department of Orthopaedics, Fourth Hospital Affiliated to China Medical University.PARTICIPANTS: Eighteen patients diagnosed with simple CPN injury received treatment in the Department of Orthopedic Surgery of the Fourth Affiliated Hospital, Chinese Medical University, between January 1991 and January 2001. There were 15 males and 3 females aged 12-61 years old with the mean age of 26.5 years; there were 9 cases of complete transection, 3 cases of incomplete transection, 1 case of compression, 4 cases of contusion, and 1 case of irreversible injury. Posttraumatic treatment at hospital was obtained 0.5 hour to 6 months after injury.METHODS: All patients were subjected to CPN explorative operation;neuroanastomosis was performed on 12 cases, neurolysis on 2 cases, tendon graft on 1 case and conservative treatment on 3 cases. Antibiotics were administered after operation together with blood activating medicine and neurotrophic medicine. Moreover, the patients were required to do passive functional exercise in order to avoid arkylosis and myoatrophy.MAIN OUTCOME MEASURES: Functional recovery of CPN was assessed at postoperative 6 months based on the myodynamia of the same side anterior tibia muscles (excellent: above grade 4; good: grade 3; passable: grade 2; poor: grade 1 or grade 0).RESULTS: All the 18 patients entered the results analysis; their outcomes were assessed as excellent in 10 cases, good in 6 cases, and passable in 2cases, with the excellent rate being 89% (16/18).CONCLUSION: Patients diagnosed with CPN injury should be treated with primary repair of traumatic nerves as early as possible, which will benefit the functional recovery of limbs.

Objective To improve the diagnosis and treatment effect of closing duodenal injury. Methods By reviewing the documents, the development in the diagnosis and treatment of duodenal injury were summarized. Results (1) Every patient with closing belly injury should be considered the possibility of duodenal injury; (2) According to the extent of duodenal injury, five common different operetion treatments wuld be adopted respectively; (3) Non-operation treatment should be given to those unable to be operated on, such methods as nutrition support, application of sandostatine etc. Conclusions Combine the operation treatment with the non-operation treatment can greatly improve the cure rate of the duodenal injury.

Objective To investigate the methods of isolation, cultivation of adipose derived stem cells (ADSCs) from the rats'adipose tissue and the feasibility of inducting differentiation to chondrocyte.Methods The adipose tissue was obtained from the wistar's male rats, and it was isolated, cultivated, and subcultured. The expression of CD29 in the subcultured ADSCs was detected by immunofluorescence. The 3rd generation ADSCs was cultured in the medium contained TGF-β, and the presence was identified by type Ⅱ collagen immunohistochemistry. Results The character of ADSCs'morphology could be observed by microscope, and it can be identified by immunofluorescence. Through the course of inducting the ADSCs to chondrocyte, the feasibility of inducting ADSCs to chondrocyte showed that type Ⅱ collagen was expressed.Conclusion We demonstrated the presence of stem cells in the adipose tissue, and the stability of biological feature in vitro. The chondrocyte could be obtained from the adipose tissue through the committed differentiation, induction, cultivation by exogenous transforming growth factor (TGF-β). The ability of the adipose stem cell differentiating to chondrocyte was also proved.

Phytochemical investigation of the roots of Scrophularia buergeriana Miq. (Scrophulariaceae), resulted in the isolation of a new iridoid derivative named as buergerinin (1). Its structure was elucidated as rel-(1R, 5R, 6R)-(2-oxa-bicyclo[3.3.0]oct-7-en-6, 7-diyl)dimethoxypropane based mainly on MS and 1D and 2D NMR spectroscopic analyses.

In contrast to the gradual reduction in the number of locally transmitted malaria cases in China, the number of imported malaria cases has been increasing since 2008. Here, we report a case of a 39-year-old Chinese man who acquired Plasmodium ovale wallikeri infection while staying in Ghana, West Africa for 6 months in 2012. Microscopic examinations of Giemsa-stained thin and thick blood smears indicated Plasmodium vivax infection. However, the results of rapid diagnostic tests, which were conducted 3 times, were not in agreement with P. vivax. To further check the diagnosis, standard PCR analysis of the small-subunit rRNA gene was conducted, based on which a phylogeny tree was constructed. The results of gene sequencing indicated that this malaria is a variant of P. ovale (P. ovale wallikeri). The infection in this patient was not a new infection, but a relapse of the infection from the one that he had contracted in West Africa.
Adult ; Azure Stains ; Base Sequence ; China ; DNA, Protozoan/chemistry/genetics ; DNA, Ribosomal/chemistry/genetics ; Ghana ; Humans ; Malaria/*diagnosis/parasitology ; Male ; Molecular Sequence Data ; Phylogeny ; Plasmodium ovale/*classification/genetics/isolation & purification ; Polymerase Chain Reaction ; Recurrence ; Sequence Analysis, DNA ; Travel

Objective:To investigate the effectiveness and safety of the allogeneic corneal stromal flap in reducing the exposure of the drainage catheter in the implantation of Ahmed glaucoma valve.Methods:Fifty-three patients(61 eyes) with refractory glaucoma treated by Ahmed glaucoma valve implantation from January 2017 to April 2019 were retrospectively analysed. The patients were divided into sclera tunnel group(routine group) and sclera tunnel with allogeneic corneal stroma flap covering(improved group). The cumulative success rate of surgery, preoperative intraocular pressure(IOP), IOP at the last outpatient follow-up, the best-corrected visual acuity(BCVA), BCVA at the last outpatient follow-up, drainage catheter exposure and other surgical complications were collected from both groups at 6, 12 and 24 months after surgery. The data between the 2 groups were statistically analyzed, P<0.05 was statistically significant. Results:The cumulative success rates of 6, 12 and 24 months after operation were 89.7%, 86.2% and 69.0% in the routine group, and 90.6%, 90.6% and 71.8% in the improved group, respectively. There was no significant differences between the 2 groups( P>0.05). The IOP and BCVA at the final follow-up were significantly improved in both groups, with a statistical significant difference( P<0.05). In the conventional group, the exposure of drainage catheter occurred in 4 eyes(13.8%). Further surgeries were carried out to cover the exposed drainage catheters with allogeneic corneal stroma flaps and amniotic membrane and all had good recovery. There was no drainage catheter exposure in the improved group. The difference between the 2 groups was statistically significant( χ2=4.724, P=0.030). There was no significant difference in other surgical complications between the 2 groups( χ2=0.160, P=0.689). No intraoperative or postoperative complications regarding the corneal stromal flap were observed. Conclusion:Implantation of Ahmed glaucoma valve with allogeneic corneal stromal flap sealing can effectively reduce the exposure of the drainage catheter. It is a safe method.

Objective To investigate the value of pulse oxygen perfusion index(PI)and blood lactic acid(BLA)concentration in early prediction of retinopathy of prematurity(ROP).Methods A retrospective case-control study was conducted on 128 preterm infants who met the inclusion criteria and were admitted to the neonatal intensive care unit of our hospital from September 2018 to December 2022.Among them,46 patients with ROP were in the ROP group,and 82 pa-tients without ROP were in the non-ROP group.Basic data of these preterm infants were recorded after admission.PI val-ues were continuously monitored with the Masimo Radical-7(USA)SpO2 blood oxygen saturation detector,and BLA con-centrations were detected with the ABL90FLEX blood gas analyzer.The receiver operating characteristic(ROC)curve and area under curve(AUC)were used to evaluate the value of PI and BLA concentration in early prediction of ROP.Results There were no significant differences in gestational age,birth weight,sex,and delivery mode between the two groups(all P＞0.05).The PI values after birth were significantly different between the two groups(Fgroup=15.393,Pgroup＜0.001).The PI values of preterm infants in the ROP group decreased significantly at 1 h,12 h and 24 h after birth and slightly at 48 h to 96 h after birth compared with the non-ROP group.The PI values of preterm infants in the two groups sta-bilized at 96 h after birth.The PI values of preterm infants in the ROP group were lower than those in the non-ROP group at all time points within 96 h after birth(all P＜0.05).The PI values showed interaction effects between the two groups at different time points(Finteraction=5.061,Pinteraction＜0.001).There was a significant difference in BLA concentration between the two groups after birth(Fgroup=91.158,Pgroup＜0.001).In the ROP group,the BLA concentration increased significantly at 1 h after birth and slightly at 12 h and 24 h after birth compared with the non-ROP group.The BLA concentration in the ROP group was higher than that in the non-ROP group at all time points after birth(all P＜0.05).The BLA concentration showed no interaction effects between the two groups at different time points(Finteraction=0.567,Pinteraction＞0.05).The AUC of PI values at 1 h,12 h and 24 h after birth and BLA concentration at 1 h after birth for predicting ROP was 0.77,0.82,0.83,and 0.82,respectively.The AUC of combined PI values at 1 h,12 h and 24 h after birth and BLA concentration at 1 h after birth for predicting ROP was 0.94,higher than the predictive value of a single indicator.Conclusion PI and BLA concentration have good clinical value for early prediction of ROP.

Objective:To analyze the difference of clinical characteristics and outcomes of infants with moderate and severe pediatric acute respiratory distress syndrome(PARDS)diagnosed according to baseline oxygenation index(OI) in pediatric intensive care unit(PICU).Methods:Second analysis of the data collected from the "Efficacy of pulmonary surfactant (PS) in the treatment of children with moderate and severe ARDS" program.Retrospectively compare of the differences in clinical data such as general condition, underlying diseases, OI, mechanical ventilation, PS administration and outcomes among infants with moderate and severe PARDS divided by baseline OI who admitted to PICUs at 14 participating tertiary hospitals from 2016 to December 2021.Results:Among the 101 cases, 55 cases (54.5%) were moderate and 46 cases (45.5%) were severe PARDS.The proportion of male in the severe group (50.0% vs.72.7%, P=0.019) and the pediatric critical illness score(PCIS)[72 (68, 78) vs.76 (70, 80), P=0.019] were significantly lower than those in the moderate group, while there was no significant difference regarding age, body weight, etiology of PARDS and underlying diseases.The utilization rate of high-frequency ventilator in the severe group was significantly higher than that in the moderate group (34.8% vs.10.9%, P=0.004), but there was no significant difference in PS use, fluid load and pulmonary complications.The 24 h OI improvement (0.26±0.33 vs.0.04±0.34, P=0.001) and the 72 h OI improvement[0.34 (-0.04, 0.62) vs.0.15 (-0.14, 0.42), P=0.029)]in the severe group were significantly better than those in the moderate group, but there was no significant difference regarding mortality, length of hospital stay and intubation duration after diagnosis of PARDS between the two groups. Conclusion:In moderate and severe(divided by baseline OI) PARDS infants with invasive mechanical ventilation, children in severe group have better oxygenation improvement in the early stage after PARDS identified and are more likely to receive high frequency ventilation compared to those in moderate group.Baseline OI can not sensitively distinguish the outcomes and is not an ideal index for PARDS grading of this kind of patient.