OBJECTIVETo investigate the treatment for tibial exposure wounds.

METHODS39 patients with tibial exposure wounds were divided into three groups according to the exposure location (upper, medium and below). The local muscular flaps were designed to cover the tibial exposure, followed by skin grafts and VSD. VSD was removed one week later.

RESULTSAll the muscular flap and skin graft survived. Mild epidermis erosion happened in 2 cases, which healed spontaneously after dressing. The patients were followed up for 3-6 months with good healing and no walking malfunction.

CONCLUSIONSThe local muscular flap combined with skin graft and VSD is a simple and effective method for tibial exposure wound with short healing time and high successful rate.

Humans ; Lacerations ; surgery ; Skin ; injuries ; Skin Transplantation ; Surgical Flaps ; Tibia ; Time Factors ; Treatment Outcome ; Wound Healing

Objective To give an empirical study on the interests claims of employees in public hospitals. Methods By questionnaire investigation, to sum up data using factor analysis and pairedsamples T test, and to compare difference between different kinds of patients using ANOVA. Results The interests claims of employees can be summed up to seven factors and there is some significant difference between different kinds of employees. Conclusion At current stage, public hospitals need pay more attention to material interests claims of employees.

Objective 　To investigate the factors associated with long-term efficacy of microvascular decompression for hemifacial spasm. Methods　253 cases of hemifacial spasm treated with microvascular decompression were followed 13 to 144 months (mean 73 months). Results　Hemifacial spasms were obliterated in 232 cases (91.7%) and were partially relieved in 10 cases (4%). However, hemifacial spasm recurred 11 cases (4.3%). We re-operated on those who had recurrent hemifacial spasm and found that the material used for previous decompression had moved. The movement of decompression material could be the cause of spasm recurrence. Conclusions　Upholding of depression material around the blood vessels against movement near the facial nerve plays an important role for improving the long-term efficacy of MVD for hemifacial spasm.

Objective:We aimed to explore the clinical features, computed tomography (CT) findings, treatment, and prognosis of bronchopulmonary carcinoid. Methods:Clinical data of 31 patients with primary carcinoid tumor of the lung were retrospectively re-viewed. The prognostic factors were analyzed via Cox univariate and multivariate analyses. Results: Clinical symptoms included coughing or expectoration in 17 of the 31 cases, hemoptysis or blood-stained sputum in 7 cases, and chest pains or shortness of breath in 8 cases. Six cases were asymptomatic. The CT scans showed round or oval nodules with clear boundaries, and enhancement CT scans indicated mild, homogeneous enhancement. Immunohistochemistry results revealed the positive expression rates of synaptophy-sin (Syn), chromogranin A (CgA), and neuron-specific enolase (NSE) were 90.3%(28/31), 87.1%(27/31), and 90.3%(28/31), respec-tively. Therapy and prognosis results were as follows:28 of the total number of patients underwent surgery, among which 3 underwent postoperative adjuvant therapy, 2 received chemotherapy; and only 1 refused treatment. The 1-year overall survival rates were 100%(18/18) and 92.3%(12/13), whereas the 3-year survival rates were 94.4%(17/18) and 69.2%(9/13) in the typical and atypical carcinoid cases, respectively. Cox univariate analysis results revealed that lymphatic metastasis (P=0.02), tissue types (P=0.017), TNM stage (P=0.005), and therapies (P=0.01) were the prognostic factors. Cox multivariate analysis results showed that lymphatic metastasis (P=0.032) and tissue types (P=0.002) were the independent prognostic factors. Conclusion:Compared with other lung cancers, the bron-chopulmonary lung carcinoid has no special clinical manifestation in clinical and radiographic images. The diagnosis was mainly based on histopathology results. Surgery was the main and effective treatment, whereas chemotherapy and radiotherapy showed unsatisfactory results. The overall prognosis was satisfactory. However, the atypical carcinoid was inferior to the typical carcinoid in terms of progno-sis. Pathological typing and lymph node metastasis were significant prognostic factors.

OBJECTIVETo investigate the clinical application of the vacuum-sealing drainage (VSD) in the prevention of lymph leakage after inguinal lymphadenectomy.

METHODSFrom September 2003 to September 2013, 60 cases who underwent inguinal lymph nodes dissection received VSD (n = 30), or traditional pressure dressing and drainage( control group, n = 30) after operation. The flap blood supply, healing process and incidence rate of lymph leakage were observed.

RESULTSTwenty-eight cases in VSD group were effective. Eleven cases were cured, ten cases were effective, and nine cases were invalid in control group. The cure rate, effective rate and healing period were significantly different between the two groups (P < 0.01).

CONCLUSIONSThe incidence of lymph leakage after inguinal lymphadenectomy can markedly decrease with VSD application. VSD could be an ideal preventive method for post-operative lymph leakage.

Adult ; Aged ; Female ; Groin ; surgery ; Humans ; Lymph Node Excision ; Lymph Nodes ; Male ; Middle Aged ; Negative-Pressure Wound Therapy ; Postoperative Complications ; prevention & control ; Surgical Flaps ; Young Adult

OBJECTIVE: To investigate the clinical characteristics of intractable epistaxis and the application of nasal endoscopic surgery as the treatment. METHOD: The clinical data of 163 patients with intractable epistaxis were retrospectively analyzed. RESULT: The bleeding points were found in the following different sites, superior wall of inferior nasal meatus (31.3%, 51/163), olfactory cleft area (21.5%, 35/163), postero-inferior wall of nasal septum (20.8%, 34/163), middle nasal meatus (10.4%, 17/163) and Little area (8.6%, 14/163). The results showed that the bleeding points had correlation with age. According to the frequency of nasal bleeding, patients under the age of forty in turn occurred in superior wall of inferior nasal meatus, olfactory cleft area, Little area, postero-inferior wall of nasal septum and middle nasal meatus; patients over the age of forty occurred in superior wall of inferior nasal meatus, postero-inferior wall of nasal septum, olfactory cleft area, middle nasal meatus and Little area. There was a significant difference between the two groups (P < 0.05). All cases stopped bleeding after 1 time of treatment, and there was no complication during a followed-up for 3 months after management. Seven cases reoccurred bleeding in half a year, but they were finally cured under nasal endoscopic surgery. CONCLUSION The results indicate that we should pay attention to different bleeding points in different age groups. In addition, nasal endoscopic treatment is a reliable, convenient and effective method for intractable epistaxis and is the first choice after failed nasal packing.
Adult ; Aged ; Endoscopy ; Epistaxis ; surgery ; Female ; Humans ; Male ; Middle Aged ; Nasal Surgical Procedures ; Retrospective Studies

Aim To explore the effects of astragaloside(AS)on the proliferation of neural stem cells(NSCs).Methods The NSCs of embryonic day(E)16 SD rat were cultured in vitro.The NSCs were identified by the immunocytochemical(ICC)staining of Nestin.The ICC staining of BrdU was adopted to characterize the proliferation of NSCs.The number of neurospheres and the ICC staining of BrdU were performed to identify their proliferation properties.Real time RT-PCR technique was used to investigate the proliferation mechanisms of the AS on the NSCs.Results Characteristic protein(Nestin)of NSCs labeling,BrdU labeling were positive showed by immunocytochemical staining.The ICC of BrdU labeling results showed that different dosages of AS could promote the proliferation of NSCs in vitro.The proliferation rate of NSCs was increased extremely significant(P

Purpose To investigate the effects of chemotactic factor CCR4 on the abi1ity of pro1iferation,ce11 cyc1e,invasion,and mi-gration of human ga11b1adder cancer ce11. Methods Western b1ot was used to detect the expression 1eve1 of CCR4 in ga11b1adder carci-noma ce11s. Ga11b1adder carcinoma ce11s was infected by means of s1ow virus,the CCR4 gene si1encing was conducted using siRNA-CCR4 interference techno1ogy. Ga11b1adder carcinoma ce11s GBC-SD were divided into three groups( GBC-SD,GBC-SD/CCR4-RNAi and GBC-SD/contro1). CCL17,a 1igand of CCR4,was used to act on these three groups of ce11s. CCK8 method was used to detect the ce11 pro1iferation abi1ity of three groups. F1ow cytometry was used to test ce11 cyc1e. Tanswe11 assay was app1ied to detect ce11 migration and invasion abi1ity. Western b1ot was performed to detect the expression of its corresponding 1igands CCL17 and CCL22 proteins. Re-sults CCR4 gene si1ence did not inf1uence ce11 cyc1e and pro1iferation of ga11b1adder ce11 GBC-SD,but can significant1y inhibit GBC-SD ce11 invasion and movement abi1ity,CCR4 gene si1ence had no inf1uence on the expression of CCL17 and CCL22 gene in tumor ce11s. Conclusion Ga11b1adder carcinoma ce11s GBC-SD express chemokine receptor CCR4,chemokine receptor CCR4 can promote the invasion and metastasis of GBC-SD ce11s.

Objective To confirm the connotation, constitution and classification of the stakeholders in public hospital. Methods The stakeholders of public hospital were proposed through the brainstorm method and literature search. On this basis, the expert consultation scale was developed by using the score-based approach for reference The stakeholders of public hospital were confirmed and classified through two-round expert consultation. Results The research confirms 16 stakeholders of public hospital on the 80% level of support ratio by experts. There were 10 core stakeholders, 5 latent stakeholders and 1 marginal stakeholder. Conclusion Appropriate stakeholder management strategy should be taken for different types of stakeholders.

Objective To give an empirical study on the interests claims of patients in public hospitals. Methods By questionnaire investigation, to sum up data using factor analysis and pairedsamples T test, and to compare difference between different kinds of patients using ANOVA. Results The interests claims of patients can be summed up to six factors and there is no significant difference between different kinds of patients. Conclusion At current stage, public hospitals need improve medical technique and cut down medical expenses.