Objective To analyze the treatment principles of burn patients with fractures and the clinical application of external fixation.Methods The treatment methods and efficacy in 48 patients with bum complicated fracture were summarized.Limb fractures were 53,femoral shaft 21,tibia and fibula 28,humerus 13,ulnar bone torsion 5.Closed 44,open 23.All limbs received external fixation,with single-arm multifunctional external fixator in 47,bilateral 17,Monteggia 3.Burn wound dressing was dealed with the situation in accordance with surgical debfidement or skin flap.Results The 48 cases were found no deaths,and 67 fractures healed and discharged healing time 2.5～5 months,3.1 months on average.Limb and joint function showed a good recovery.Conclusions External fixation showed fixation stability,simple operation,mild tissue injury,easy handling and anti-burn scar contracture and other advantages.Clinical results were satisfactory.

Objective Clinical effects of dot from body skin irradiated xenogeneic skin improved composite graft.Methods Selected 80 patients with severe burn patients randomized after admission on the basis of conventional treatment,3-5 days line Crust treatment group transplanted autologous point-like skin irradiation pigskin coverage.Results Treatment of patients in group one week dressing see irradiated pigskin Tiefu full two weeks the pigskin was dry scab-like.Wound healing treatment group (29 ± 5) days (P ＜ 0.01) was significantly shorter than the control group(39 ±4) days.Wound healing rate of treatment is significantly higher than the control group (P ＜0.01).Wound infection rate reduced greatly reduce labor intensity and dressing,and reduce pain.1 year after scar formation in patients with good flexibility and functionality.Conclusions Punctate since improved composite body skin irradiated xenogeneic skin transplantation can improve skin graft survival rate,promote wound healing,treatment of a large area of the burn wound repair is feasible and effective.

Objective To enhance the understanding of clinical characteristics and genetic testing of chromosome 4q21/q22 deletion syndrome. Methods Chromosomal microarray analysis was used to detect genetic change in a child with special facial appearance and development delay. Results A 15.26-Mb deletion containing 76 geinges in chromosome 4q21.21q22.2 was identiifed. Thus, this girl was diagnosed as chromosome 4q21/q22 deletion syndrome. Conclusions Chromosome 4q21/q22 deletion syndrome has varied clinical manifestations including typical characteristics (such as absolute or relative macrocephaly, megalencephaly with a characteristic head shape and facial appearance, profound hypotonia, small hands and feet, short limbs, feeding difficulties), mental retardation/severe developmental delay, and other system abnormalities ( such as congenital heart disease, seizure, kidney cysts, etc). The diagnosis of chromosome 4q21/q22 deletion syndrome relies on chromosomal microarray analysis.

BACKGROUND:Previously deep burn wound or skin defects are generaly repaired with skin grafting or flap of skin grafting. Obvious scar hyperplasia usualy appears after operation, which requires multiple surgeries. Meanwhile, patients have to suffer from great pain and bear high cost. OBJECTIVE: To observe the clinical effects on deep wounds by continuous traction of self-designed skin-stretching device (patent No. ZL 2012 2 0022443.7). METHODS: Thirty patients with deep burn wound, skin defect or funicular scar were enroled, including 22 males and 8 females, aged 18-49 years, and randomly divided into two groups. Skin-stretching device was adopted for skin traction treatment. Twenty cases underwent skin traction from 1 kg puling force to 5 kg, with an increase of 1 kg per 2 days, 6 hours a day for 10 days. Blood flow at the beginning, 1, 5, 10, 15, 20, 30, 60 minutes of the skin traction, and the changes of wound edge skin as wel as histological changes of the skin were observed. Of the remaining 10 cases, 2, 6, and 2 cases underwent skin traction of 2, 4, 7 kg, respectively. Blood flow and skin changes were also observed to find out the most suitable and safe force. RESULTS AND CONLUSION:Al the 30 cases achieved primary healing without necrosis of skin, infection or peripheral circulatory disorders, and the appearance and function recovered wel. The healing time was 8-24 days. The skin-stretching device was most safe under 4 kg puling force, by which, there was neither blood circulation obstacle nor tear of skin. After traction, the skin blood flow and the number of cels increased, especialy the epithelial basal cels. The colagen fibers became thicker and denser, and the elastic fibers regenerated significantly; the fibroblasts and capillary density increased. It has been proved that we can better close the wound and reduce scar formation effectively with the self-designed skin-stretching device for skin traction.

Objective To establish the rep-PCR DNA fingerprinting technique for typing K. pneumoniae strains and apply it in the epidemiological investigation.Methods The 39 strains of K. pneumoniae were typed by plasmid profile analysis, then their chromosomal DNA were extracted and purified by NaI-lyses-glass-powder absorption method for rep-PCR. Results Different strains of K.pneumoniae showed different rep-PCR fingerprint patterns. Phylogenetic analysis showed that they could be classified into six types, mainly type 1, type 2, and type 3. Otherwise, plasmid profile analysis suggested that there were four types; mainly type 1 which contained only one plasmid.Conclusions (1) Rep-PCR DNA fingerprinting technique developed in this study is enough for epidemiological studies with its high typeability, strong discrimination, simplicity and rapidness. (2) There were three predominant K. pneumoniae transmitted between patients in Taihe Hospital during the last two years, and there might be serious cross-infection among different types.

Objective To investigate the efficacy and safety of compound lysostaphin disinfectant solution in the latter stage of the treatment of bum wounds infection,and to evaluate its clinical value.Methods The selected 60 cases of bum wound infection were grouped into treatment and control group at random.The treatment group recieved compound lysostaphin disinfectant solution(Shanghai Hi-tech Co.bio-engineering,Ltd.)with debridement and wet,once a day;the control group with normal saline+gentamicin wet gauze,once a day.After cleaning the wound two groups 40 cases of underwent regular skin debridement,20 cases in each group.The bacteria changes in the wound were detected,of bacteria removal the accumulated rate of wound healing time and healing rate were compared.Results 3,6,9 days after treatment the accumulated rate of bacteria removal was 45.8%,73.9%, 89.5%higherthan the control group(13.8%,27.6%,57.4%)respectively(P＜0.01).Wound healing time in the treatment group was(12±5)d,shorter than the control group(16±4)d Was significantly(P＜0.01). The rate of wound healing in the treatment group was significantly higher(P＜0.01).No adverse reactions were found.Conclusion The treatment application of compound iysostaphin disinfectant in the later stage of bum wound is effective in control of infection,increases the survival rate of skin and shortens wound healing time,so it is safe and effective.

Objective: To evaluate the efficacy of the third-generation instrumentation including TSRH, CD and ISOLA in the treatment of adult scoliosis. Methods:Thirty-five adult patients with idiopathic or degenerative scoliosis who received treatment with third-generation instrumentation (TSRH,CD and ISOLA) between July 1999 to January 2003 were retrospectively reviewed. The mean preoperative cobb angle of major curves of the frontal plane was 58.1°(42°-95°). The patients received a combined anteroposterior approach or a single posterior procedure. The mean follow-up time was 20 months(10-48 months). Preoperative and postoperative Cobb angles of the frontal plane and sagittal plane and the distance between C7 and CVLS were measured. The subjective assessment was judged by questionnaire. Results: Postoperative clinical appearance of all patients improved significantly. Mean correction of major curves of the coronal plane was 53.2%. Mean loss of correction of the coronal plane in the last follow-up was 4.3°. The distance between the midline of C7 and CVSL was corrected from 2.6 cm to 0.24 cm. The results of follow-up showed that 89.3% patients were satisfied with the outcome. Pneumatothorax and haematothorax occurred in 2 patients. Three patients still complained of low back pain one year after operation because of adjacent degeneration in 2 patients and pseudoarthrosis in the remaining 1 patient. Conclusion: Imageologic findings and subjective assessment of the patients showed that the third-generation instrumentation can achieve good correction and trunk balance in the treatment of adult scoliosis with fewer complications.

Objective To investigate the copy number changes on chromosome 3q26. 1 in urothelial carcinoma of the bladder, and to explore its potential clinical significance. Methods The microarray-based comparative genomic hybridization (Array-CGH) approach was used to analyze the genome-wide copy number changes of 35 tumor tissue samples of bladder cancer. To confirm the loss of a small fragment in 3q26. 1 detected by Array-CGH, real-time fluorescent quantitative polymerase chain reaction (real-time PCR) was performed with 57 frozen tumor tissue samples and 34 formalinfixed paraffin-embedded (FFPE) tumor tissue samples. The urine sediment cells collected from 15 healthy volunteers and 29 bladder cancer patients were checked as above. Results The Array-CGH data showed that the copy number loss of a small fragment in 3q26. 1 was detected in 77.1% (27/35)of the tumor tissue samples investigated. Real-time PCR analysis validated this loss of a small fragment of 3q26.1 with high frequencies in both 57 frozen tumor samples and 34 FFPE tumor samples.The percentage of samples exhibiting loss was 78.9% (45/57) and 100. 0% (34/34) respectively.Furthermore, the relative copy number of the 3q26.1 small fragment was significantly lower in the urinary sediment cells of the patients (median=0. 0020), comparing with that of healthy controls (median=0. 0030) (P＜0.01). Conclusions Loss of the small fragment in 3q26.1 could be a characteristic genetic change of urothelial carcinoma of the bladder. It may serve as a potential molecular marker for bladder cancer.

AIDS-Related Opportunistic Infections ; diagnosis ; Humans ; Oral Medicine ; Sarcoma, Kaposi ; diagnosis

Adult ; Female ; Humans ; Male ; Medical Staff, Hospital ; Middle Aged ; Occupational Diseases ; epidemiology ; Urticaria ; epidemiology ; Young Adult