Animals ; Biomarkers, Tumor ; analysis ; Electrophoresis, Gel, Two-Dimensional ; Humans ; Neoplasm Proteins ; secretion ; Neoplasms ; etiology ; pathology ; secretion ; Proteome ; secretion ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization

AIM: To systemically evaluate the clinical efficacy and safety of intraocular implants for vitreous retinal surgery.METHODS: We performed a comprehensive search for studies reporting vitreous surgery with intraocular implants randomized controlled and a retrospective controlled clinical trials from China Hownet ( CNKI ), Wanfang database, and VIP literature database. Studies obtained from those database were filtered according to the criteria, and data were retrieved from eligible studies for further analysis. Then we performed a meta-analysis to evaluate the efficacy and safety of intraocular implants using comprehensive Meta - analysis software version 2 (Biostat, Englewood, NJ).
RESULTS: In total 36 studies were recruited for our Meta - analysis, including 5 092 cases. Meta analysis showed: 1) regarding the efficacy of repairing the retinal detachment, silicone oil was a better intraocular implants than C3 F8(OR= 1. 76; 95% CI: 1. 19-2. 60, P = 0. 0047) and SF6( OR = 4. 68; 95% CI: 1. 48 - 14. 81, P = 0. 0087); 2) regarding the risk of postoperative cataract, silicone oil showed significant higher risk than BBS (OR = 3. 24; 95%CI: 2. 10-4. 99, P= 1. 09 e-7), and C3 F8(OR= 3. 03; 95% CI:1. 50 - 6. 10, P = 0. 0019 ); 3 ) regarding the risk of postoperative intraocular pressure, silicone oil showed significant higher risk than BBS (OR= 6. 74; 95% CI: 3. 38-13. 41, P= 5. 67 e-08), and C3 F8 also showed a higher risk than BBS (OR= 4. 79; 95% CI: 2. 37-9. 68, P = 1. 29 e-05). In addition, silicone oil showed significant lower risk as compared with heavy silicone oil (OR= 0. 16; 95% CI: 0. 08-0. 53, P= 0. 0026).
CONCLUSION: The intraocular implants for the treatment of retinal detachment in vitreous retinal surgery are mainly divided into two major categories, liquid and gas implants. The silicone oil, a major liquid implant, shows higher efficacy in terms of treating retinal detachment than the gas implants. However, the silicone oil is associated with a higher risk of postoperative cataract and intraocular pressure as compared with gas implants.

Fibrolase is a non-hemorrhagic zinc metalloproteinase isolated from southern copperhead snake venom (Agkistrodon contortrix contortrix) and is capable of degrading fibrin clots resulting from purified fibrinogen or from blood plasma. Alfimeprase, a truncated form of fibrolase, as a clinical agent was successfully completed PhaseII clinical trials.The cDNA of alfimeprase was amplified by recursive PCR, digested with BamHI and HindII, and cloned into pET43.1a, pMALp2X and pMALc2X vectors to generate fusions with NusA, MBP and sMBP(with signal peptide), respectively. Nus/alfimeprase was expressed in soluble form by co-expressing with chaperone FkpA and inducing with1mmol/L IPTG. The fusion protein accounted for about 25 % of total protein following cell lysis. Alfimeprase was successfully purifiesd by Ni-NTA affinity chromatography and cleaved by enterokinase. The results demonstrate the fibrinolytic activity of recombinant alfimeprase using fibrin plate assays and fibrinogen hydrolysis.

OBJECTIVETo summarize the clinical application result of the selective nerve root blocks in limited operation of the lumbar spine.

METHODSFrom January 2008 to October 2012,68 patients with lumbar spinal canal stenosis with multiple levels were underwent the selective nerve root blocks in limited operation of the lumbar spine,including 47 males and 21 females with an average age of 56 years old ranging from 45 to 80. After never roots blocks,64 cases were positive for limited operation of the lumbar spine; the other 4 cases were negative and abort the operation.

RESULTSThe nerve roots block operation smoothly and no complications related to the nerve roots block occurred. There was no neurologic injury complication in this study. Follow-up period ranged from 16 to 45 months postoperatively (means, 32 months). The recovery effect was calculated with Macnab scores, the result was excellent in 44 cases, good in 18 cases, poor in 1.

CONCLUSIONOperative treatment for lumbar spinal canal stenosis with multiple levels is focused on the areas causing symptomate neural compression rather than prophylactic decompression at areas of nonsymptomatic disease. Application of selective nerve root blocks can accurately judge the responsible vertebral body and pain source and improve the curative effect of limited operation of the lumbar spine

Aged ; Aged, 80 and over ; Female ; Humans ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Nerve Block ; methods ; Spinal Nerve Roots ; Spinal Stenosis ; surgery

OBJECTIVETo summarize the clinical application results of the repair soft tissue defect in contralateral leg with a cross-leg soleus muscle flap pedicle transplantation.

METHODSFrom January 2008 to January 2013, 8 patients with soft-tissue defect in lower leg underwent reconstruction with a cross-leg soleus muscle flap pedicle transplantation (without microvascular anastomoses). There were 7 males and 1 female, aged from 20 to 49 years old with an average of 31.8 years. The operative time after injury was from 2 to 8 weeks with the mean of 46 days. The soleus muscle flap was transposed across to the contralateral leg defect area, then immediate to perform the coverage of the muscle flaps by a meshed split-thickness skin graft. The donor site was closed directly.

RESULTSAll the muscle flaps had survived completely. In one case, recipient area edge had a less exudate from drainage hole everyday, the incision spontaneously was healed after 2 week's changing dressing. Follow-up period ranged form 1.5 to 4 years with an average of 2.5 years postoperatively. The tibia and fibula fractures were healed well. A good contour was achieved at the recipient area. According to LEM standard, 2 cases got excellent results, 5 good and 1 fair.

CONCLUSIONSoleus flap pedicle transplantation is very suitable to repair the soft tissue defect of the injuried leg only one main blood vessel, and can reduce the damage of donor area.

Adult ; Female ; Humans ; Leg Injuries ; surgery ; Male ; Middle Aged ; Muscle, Skeletal ; Soft Tissue Injuries ; surgery ; Surgical Flaps

Objective To assess the effect of ursodeoxycholic acid on postoperative outcomes in biliary atresia (BA) patient undergoing Kasai procedure.Methods Correlative english articles published until Jun.2013 were searched by computer in Medline (PubMed),EMBASE,Cochrane library,Wanfang Database,China Knowledge Resource Integrated Database and China Biology Medicine Database,the output articles were screened according to inclusion and exclusion criteria.The selected articles were evaluated with the of Review Manager 5.2 software.Results Nine articles were obtained,but only 4 articles were included,including 284 patients with BA were conformed to the inclusion and exclusion criteria.The sensitivity analysis indicated that the total effective rate in ursodeoxycholic acid group was superior to that in the control group,and the difference between the 2 groups was notable significant (OR =7.24,95 ％ CI:2.42-21.68,Z =3.55,P =0.0004).There was no significant difference between ursodeoxycholic acid group and control group in the effect of ursodeoxycholic acid on outcome of patients who had BA(OR =5.50,95％ CI:0.96-31.64 ; Z =1.91,P =0.06).Conclusions Ursodeoxycholic acid has certain effect on alleviating jaundice after Kasai procedure,but it has no advantage on improving the long outcomes as comparison with control group.

From January 2013 to January 2015, 19 patients of traumatic hemothorax with hemorrhagic shock were treated in our department by thoracoscopic surgery combined with autologous blood transfusion. This study retrospectively analyzed the therapeutic effect and shared our experience. The average amount of blood transfused back was 662.41 ml ± 269.15 ml. None of the patients developed transfusion reaction and were all discharged uneventfully. Thoracoscopic surgery combined with autologous blood trans- fusion is effective in the rescue of patients with progressive hemothorax and hemorrhagic shock. When corresponding indications are well managed, treatment for these patients is quicker, safer, and more effective.
Blood Transfusion, Autologous ; Female ; Hemothorax ; surgery ; Humans ; Male ; Retrospective Studies ; Thoracic Injuries ; surgery ; Thoracoscopy ; methods

Objective To find out the iodine nutritional status of Longyan downtown residents,evaluate the effectiveness of control measures and provide a scientific basis for developing control strategies.Methods Infants aged 0 to 2 year-old,children aged 8 to 10,adults aged 18 to 45 and pregnant and lactating women were selected as survey subjects.Children goiter was detected with B ultrasound.Residents per capita daily salt intake was investigated by weighing method.Three urinary samples and a milk sample of lactating women were randomly collected.Urinary iodine and milk iodine content were determined by arsenic cerium catalytic spectrophotometric assay.Blood samples were collected and thyroid function (including serum TT3,FT3,TT4 and FT4) and thyroid stimulating hormone(TSH) were measured with direct chemiluminescence immunoassay,and thyroglobulin antibody(TgAb),thyromicrosome antibody(TMAb),and thyroglobulin (Tg) were measured with radioimmunoassay (RIA) in serum.ResultsThe goiter rate of children aged 8 to 10 was 1.8％ (2/110),and median thyroid volume was 2.75 ml.Household iodized salt coverage rate was 100.00％(318/318),and qualified iodized salt was 94.03％ (299/318).The daily per capita salt intake was (6.13 ± 3.56)g.The average medians of urinary iodine of the infants,children,adults,pregnant and lactating women were 181.8,315.2,196.6,158.7,136.4 μg/L,respectively.The median of milk iodine of lactating women was 155.6 μg/L.The proportions of serum TT3,FT3,TT4,FT4 and TSH which higher than normal were 3.6％ (11/308),0.6％ (2/309),23％ (7/309),1.0％ (3/313) and 1.3％ (4/312),respectively.While the proportions of serum TT3,FT3,TT4,FT4 and TSH that lower than normal were 2.3％ (7/308),11.7％(36/309),2.3％(7/309),12.8％(40/313),and 1.6％(5/312),respectively,of which 16 cases of both TgAb and TMAb were higher than normal.ConclusionsExisting salt iodine level is appropriate for 0 to 2 year-old infants and young children,18 to 45 year-old adults,pregnant and lactating women in downtown Longyan city.The iodine intake of children aged 8 to 10 is excessive.Thyroid function monitoring is recommended to be included in the routine monitoring.

Objective To evaluate the condition of rebuilding stove for preventing coal-buming fluorosis in Ankang City of Shaanxi Province in 2006.Methods Guided by local health administration department in Shaanxi.five counties-Zhengping,Langao,Hanyin,Ziyang,Shiquan-were chosen as rebuilding stove regions in Ankang City.Fifteen housewives were chosen randomly in each village in each county,they were quizzed for the knowledge of health.Fifty students were chosen randomly in each school in each county,they were quizzed for the knowledge of health too.Data of rebuilding stove were refferred.Results Ninty-seven point two per cent(243/250)of the ovens were appropriately sealed,96.8%(242/250)were efficiently exhausted,the rate of oven correctly used was 97.2%(243/250),the awareness rates of healthful knowledge were 85.6%(214/250)in adults and 97.8%(485/496)in children.Data of rebuilding stove were documented systemically,completely and precisely.ConelusionFive model counties in Ankang City have fulfilled the demand.

BACKGROUND:The treatment of acute myocardial infarction (AMI) is thought to restore antegrade blood flow in the infarct-related artery (IRA) and minimize ischemic damage to the myocardium as soon as possible. The present study aimed to identify possible clinical predictors for no-reflow in patients with AMI after primary percutaneous coronary intervention (PCI). METHODS:A total of 312 consecutive patients with AMI who had been treated from January 2008 to December 2010 at the Cardiology Department of East Hospital, Tongji University School of Medicine were enrolled in this study. Inclusion criteria were:(i) patients underwent successfully primary PCI within 12 hours after the appearance of symptoms; or (ii) patients with ischemic chest pain for more than 12 hours after a successful primary PCI within 24 hours after appearance of symptoms. Exculsion criteria were:(i) coronary artery spasm; (ii) diameter stenosis of the culprit lesion was ≤50％ and coronary blood flow was normal; (iii) patients with severe left main coronary or multivessel disease, who had to require emergency revascularization. According to thrombolysis in myocardial infarction (TIMI), the patients were divided into a reflow group and a no-reflow group. The clinical data, angiography findings and surgical data were compared between the two groups. Univariate and multivariate logistic regressions were used to determine the predictors for no-reflow. RESULTS:Fifty-four (17.3％) of the patients developed NR phenomenon after primary PCI. Univariate analysis showed that age, time from onset to reperfusion, systolic blood pressure (SBP) on admission, Killip class of myocardial infarction, intra-aortic balloon pump (IABP) use before primary PCI, TIMI flow grade before primary PCI, type of occlusion, thrombus burden on baseline angiography, target lesion length, reference luminal diameter and method of reperfusion were correlated with no-reflow (P<0.05 for all). Multiple logistic regression analysis identified that age >65 years [OR=1.470, 95％ confidence interval (CI) 1.460–1.490,P=0.007], long time from onset to reperfusion >6 hours (OR=1.270, 95％CI 1.160–1.400,P=0.001), low SBP on admission <100 mmHg (OR=1.910, 95％CI 1.018–3.896,P=0.004), IABP use before PCI (OR= 1.949, 95％CI 1.168–3.253, P=0.011), low (≤1) TIMI flow grade before primary PCI (OR=1.100, 95％CI 1.080–1.250,P<0.001), high thrombus burden (OR=1.600, 95％CI 1.470–2.760,P=0.030), and long target lesion (OR=1.948, 95％CI 1.908–1.990,P=0.019) on angiography were independent predictors of no-reflow. CONCLUSION:The occurrence of no-reflow after primary PCI for acute myocardial infarction can predict clinical, angiographic and procedural features.