Humans ; Laryngopharyngeal Reflux ; Sleep Apnea, Obstructive

Objective To compare the clinical effect of vacuum sealing drainage and traditional methods on open tibial fractures of Gustilo grade-Ⅲ.Methods Seventy-eight patients with open tibial fractures of Gustilo grade-Ⅲ were divided into two groups,43 patients in observation group were treated by vacuum sealing drainage,while 35 patients in control group were treated by traditional methods.The operative quality,postoperative recovery condition,clinical effect and rate of adverse reaction were analyzed between two groups.Results As for the hospital stays,healing time of wound and fracture,the observation group were significant shorter than control group (P＜0.05).The excellent and good rate of observation group was 83.72％,which was significantly higher than that of control group 65.71％ (P ＜0.01).The adverse reaction rate of observation group was 6.98％,which was significantly lower than that of control group 17.14％ (P＜0.05) Conclusions Vacuum sealing drainage used for treatment of open tibial fractures of Gustilo grade-Ⅲ can shorten wound and fracture healing time,reduce the incidence of adverse reaction and improve the clinical effect.It is worth of popularization and application.

Objective To investigate possible reasons of different incidence of femoral head necrosis between two populations exposed to corticosteroid: severe acute respiratory syndrome (SARS) and renal allograft transplantation. Methods 67 cases of SARS and 59 cases of renal allograft transplantation were enrolled in the study. The following relevant data were reviewed: cumulative dosage (intravenous methylprednisolone and oral prednisone respectively), maximum single dosage, corticosteroids-exposing days, body weight, weight-load index, and minimum arterial oxygen pressure. MRI of bilateral hips was taken in all the patients. Results The incidence of femoral head necrosis of SARS (23.9%) was significantly higher than the renal allograft transplantation patients (6.8%) (P0.05). There was a very significant difference in minimum arterial oxygen pressure between two groups (P

Objective To construct a novel VP 1 gene vaccine against coxsackievirus B 2 and to evaluate the effect of the cell-mediated immunity induced by it.Methods The immunodominant capsid protein VP 1 gene of CVB 2 was amplified by reverse transcript polymerase chain reaction (RT-PCR) and pcDNA 3-CVB 2VP 1was constructed by molecular cloning.The cytotoxic T lymphocyte (CTL) activity was measured by standard 51Cr-release cytotoxicity assay eight weeks after BALB/c mice were immuned by pcDNA 3-CVB 2VP 1.Results The eukaryotic expression vector was pcDNA 3 and subcloning fragment was CVB 2VP 1.The CTL activity of pcDNA 3-CVB 2VP 1 group was higher than that of the control (P

Objective To investigate the changes in plasma concentrations of IL-6 and IL-10, pHi and the difference between tissue and arterial PCO2 [(P(t-a)CO2 ] during pulmonary surgery and the effects of thoracic epidural anesthesia on cytokine production and gut mucosal perfusion. Methods Twenty ASA class Ⅰ - Ⅱ patients undergoing elective pulmonary surgery, were randomly assigned to be operated upon under general anesthesia (group GA , n = 10) or under general anesthesia combined with thoracic epidural anesthesia (group GEA, n - 10) . Premedication in both groups consisted of pethidine 50mg and scopolamine 0.3 mg im 30 min prior to surgery and oral ranitidine 150 mg the night and 1 h before operation. Anesthesia was induced with fentanyl 2 ug?kg-1 , droperidol 1 mg, propofol 1.5-2.5 mg?kg-1 and succinylcholine 1-2 mg?kg-1 and maintained with inhalation of 1%-2.5% isoflurane and 50% N2O in oxygen and intermittent iv boluses of fentanyl and vecuronium. In GEA group epidural catheter was inserted through the needl placed at T7-8 or T8-9 and advanced cephalad for 2.5-3.0 cm. A loading dose of morphine 2 mg was given followed by epidural infusion of 0.4% ropivacaine at a rate of 6 ml?h-1 during maintenance of anesthesia and the concentration of isoflurance inhaled was reduced to 0.6%-1. 5% . Postoperative analgesia was provided by epidural infusion of 0.25% ropivacaine at 6-8 ml/2h until the morning of the 3rd postoperative day. Blood samples were taken before induction, at incision and 2 h, 4 h and 6 h after the incision and on the 1st and the morning of the 3rd postoperative day for determination of IL-6 ( by radioimmunoassay) and IL-10 (ELISA) . P(t-a)CO2 and pHi were assessed by tonometry before induction, at incision and 1 h, 2 h, 4 h and 6 h after the incision. Results (1) IL-6 and IL-10 increased significantly during operation as compared with the baseline value before induction in both groups and there was no significant difference between the two groups. (2) pHi decreased significantly during operation in both groups and there was no significant difference between the two groups. pHi was negatively correlated with IL-6. (3) P(t-a)CO2 increased significantly during operation in both groups and was negatively correlated with pHi. P(t-a)CO2 was significantly higher in GA group than that in GEA group at 4h after skin incision. Conclusion Pulmonary surgery elicits both pro- and and-inflammatory cytokine response which is not affected by thoracic epidural analgesia. Thoracic surgery leads to gut mucosal hypoperfusion of which P(t-a)CO2 is an indicator. Thoracic epidural anesthesia can improve gut mucosal perfusion. There may be some correlation between cytokine production and gut mucosal hypoperfusion.

Glomus Tumor ; diagnosis ; etiology ; Humans ; Neoplasms, Connective Tissue ; complications ; Osteomalacia

Based on hydroxyapatite (HAP), a kind of antimicrobial ceramic, i.e. hydroxyapatite loading Ag+ ions (HAP-Ag), is prepared in a wet chemical process with the addition of AgNO3. The X-ray diffraction analysis shows that the HAP-Ag is mainly composed of nitrate-apatite, which is formed by the substitution of Ca2+ with Ag+. The antimicrobial effects of the HAP-Ag and its resistibility against the acrobic Escherichia coli and Staphylococcus aureus are tested respectively through the spread plate method. The results show that HAP-Ag is capable of inhibiting the growths of E.coli and S.aureus.

Objective To investigate the diagnosis and application value of Color Doppler Flow Imaging(CDFI)and Transcranial Doppler(TCD)on blood hemodynamics of carotid artery and cerebral arteries in patients with type 2 diabetes mellitus.Methods Sixty-seven patients with type 2 diabetes mellitus and 53 normal subjects were examined on blood hemodynamics of carotid artery and cerebral arteries by CDFI and TCD,and their ultrasonographic features were recorded and compared.Results Forty-six of 67 patients have atherosclerosis on carotid artery by CDFI,56 of 67 patients have abnormal on cerebral arteries by TCD,there were significant difference between the patients and normal groups(P

0.05). Conclusions Bacterial biofilm formation on the surface of the catheter is an important pathogenetic factor,which contributes to the recurrence and antibiotic resistance of urinary tract infection. Shortening the period of catheter dwelling and using closed drainage remain the predominant prevention and treatment of urinary tract infection.

Objective To study the relationship of Dll-1/Notch signal transduction pathway with the pathological characteristics of colorectal cancer and the effect on proliferation and apoptosis of colorectal cancer cells. Methods We assessed Notchl and Dll-1 protein levels in 63 cases of colorectal cancer and adjacent normal tissue by Western blotting.SW480 cells were treated with DAPT (γ-secretase inhibitor) at different treating times.MTT assay and flow cytometry were used to measure the proliferation and apoptosis of SW480 cells,seperately.The expression of the intracellular domain of Notch (NICD),Hes-1 and Bcl-2 were measured by Western blotting.Statistical methods were used including independent samples t test,paired sample t test and single factor analysis of variance. Results Notch1 and Dll-1 protein level increased in colorectal cancer tissues compared with adjacent normal mucosa,the mean values were 1.75-fold and 2.21-fold,respectively(t =2.554,P =0.012 and t =3.565,P =0.005).Also we found that the overexpression of Notch1 and Dl1-1 was related to the differentiation( t =2.463,P =0.017 and t =2.390,P=0.019),staging(t =2.675,P =0.007 and t =2.310,P =0.021) and lymph nodes metastasis(t =2.229,P =0.021 and t =2.210,P =0.023) of colorectal cancer.Treating SW480 cell with Notch pathway inhibitor (γ-secretase inhibitor,DAPT) resulted in growth inhibition,apoptosis induction and there was downregulation of NICD and Bcl-2 expression along with the treating time. Conclusions Overexpression of Notch1 and Dll-1 is related to the pathological characteristics of colorectal cancer.Blockade of Notch1 signal pathway may inhibit cell proliferation and induce cell apoptosis of colorectal cancer,as well as inhibit the expression of Bcl-2.