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 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.

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

Humans ; Sutures ; Thyroid Neoplasms ; surgery

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

Objective To compare the difference of the microleakage repaired by direct method and indirect method of the funnel shaped root canal in the anterior teeth. Methods A total of 22 middle teeth at the similar size were collected, prepared into funnel root canal after finishing the root filling. The teeth were divided into A and B groups randomly, and there were 11 test pieces in each group. The root canal was repaired by direct method in group A and indirect method in group B. After 500 thermal-cold cycling and 240 000 dynamic cyclic loading,one tooth was selected in each group randomly. The microstructure were observed by scanning electron microscope (SEM). One piece of each group was randomly selected and the image of the core and the dentin was scanned by electron microscope. The remaining 20 pieces were dyed by India ink, dealt with transparent, compared and observed under the microscope. The degree of microleakage was recorded and analyzed in two groups. Results Under electron microscope, a gap can be observed in the bonding interface of group A. The gap was significantly bigger than that of group B. The leakage was significantly serious in group A than that in group B (P<0.05). Conclusion The level of microleakage of anterior teeth with flared canals, which is restored by fiber post core with the indirect method, is significantly better than that with the direct method. The indirect method has a good edge seal action and is more suitable for clinical application.

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 study the reactive oxygen level and the expression of anti-apoptotic protein Bcl-2 and pro-apoptotic protein Bax after treatment of DNA methyltransferase inhibitor 5-aza-2'-deoxycytidine (5-Aza-2'-dc) and paraquat in V79 cells.Methods Cultured V79 cells were divided into 5-Aza-2'-dc treatment group (group A),paraquat treatment group (group B),5-Aza-2'-dc and paraquat treatment group (group C,V79 cells were pretreated with 5-Aza-2'-dc for 12h followed by exposure to paraquat for 12h) and control group (group D).Reactive oxygen level in V79 cells was measured by DCFH-DA flow cytometry and expression of Bcl-2 and Bax was detected by Western blot.Results Reactive oxygen levels and expression levels of Bcl-2 and Bax in V79 cells were significantly different (P＜0.05) in 5-Aza-2'-dc and paraquat treatment group (group C),compared with 5-Aza-2'-dc treatment group (group A),paraquat treatment group (group B) and control group (group D).Expression levels of Bcl-2 and the ratio of Bcl-2 and Bax were lower while reactive oxygen levels and expression levels of Bax were higher in group C than in groups A,B and D.Conclusion 5-Aza-2'-dc regulates DNA methylation by the imbalancing the reactive oxygen metabolism and apoptosis,thus up-regulating the toxic effect of paraquat on V79 cells.