Objective To discuss the treatment and clinical outcome of open to the tarsometatarsal joint injury. Methods From April 2009 to April 2010,14 patients,10 males and 4 females,with open to the tarsometatarsal joint injury were treated in our department.They were 45 years old on average (from 21 to 67 years old).Five of them had the tarsometatarsal complex involved.According to Chiodo and Myerson's classification,all the injuries were of three-column type. Medial and lateral column shortening was respectively concomitant in 2 cases.Two patients had combined soft tissue defects and one patient degloved dorsal skin.A thorough debridement and Kirschner wire fixation following reduction were performed for all patients in the emergency room.A mini external fixator was applied in patients with medial or lateral column shortening.The degloved skin was thinned and grafted in situ,followed by vacuum sealing drainage (VSD) to cover the wound.The soft tissue defect was covered by VSD after debridement.All the patients had a definitive internal fixation after the soft tissue condition improved, and 3 of them had soft tissue coverage simultaneously.Functional outcomes were scored by American Orthopedic Foot Ankle Society (AOFAS) system. Results One patient with degloving injury had partial skin necrosis which was treated by debridement,definitive internal fixation and local flap transfer on the 13th day after emergency operation.A definitive internal fixation and skin graft were performed in 2 patients with soft tissue defects respectively on the 7th or 11th day post-operation.No wound infection or necrosis occurred in other patients.Twelve patients were followed up for an average period of 18 months (from 13 to 25 months).Solid union was obtained 12 weeks on average (from 10 to 16 weeks) after the secondary surgery.No flap necrosis,infection,nonunion or osteomyelitis occurred during the follow-up.Two patients had tarsometatarsal arthrodesis at the 12th or 14th month respectively due to severe pain and function limitation caused by post-traumatic arthritis.The mean AOFAS midfoot score at the last follow-up was 72 (from 61 to 89). ConclusionsAs tnanagement of open to the tarsometatarsal joint injury is a great challenge,surgeons must take soft tissue condition into consideration.Tenporary Kirschner wire fixation or in combination with external fixation after early thorough debridement,reduction and alignment restoration,followed by secondary definitive internal fixation until soft tissue condition improves is a safe and effective treatment strategy to decrease soft tissue complications and obtain stable fixation.

Objective To investigate the indications and efficacy of endovascular stenting for the treatment of thoracic aortic aneurysm.Methods From March 2005 to October 2008,21 patients with Stanford type B aortic dissection,5 cases of pseudoaneurysm,and 2 patient with intramural hematoma complicated with ulcer of the aortic wall were treated by endovascular stenting under general(2 cases) or local(26 cases) anesthesia in our hospital.Medtronic Talent stent was employed in 10 cases,Medtronic Valiant stent was used in 12,and microinvasive straight-type stent was used in 6 patients.Results The operation was completed successfully in all of the 28 cases.Angiography showed that the gaps in the aorta were closed without endoleak.No patient had chest pain or neurological complications.The patients were discharged in(4.5?1.1) days(range 3-7 days).Five patients developed fever after the operation and were cured by indomethacin in one month.One week after the surgery,in 21 cases,CT scan showed enlarged aortic dissection,improved blood supply,thrombus in the false lumen of the thoracic aorta,and a false lumen in the abdominal aorta.In the 5 cases with pseudoaneurysm,CT scan confirmed that the rupture was closed with thrombus being detected in the lumen.The aortic ulcers that were detected in the 2 cases,who had intramural hematoma,were covered by the stents.Of the patients,a follow-up of(21.3?10.2) months(range 1-40 months) was available in 23 patients,who had no complications during the period.Conclusions Endovascular stenting is a simple,safe and effective method for Stanford type B aortic dissection,pseudoaneurysm,and intramural hematoma,resulting in quick recovery,less complications,and short hospital stay.

AimTo study the effects of aspirin (Asp) and verapamil(Ver)alone or in combination on mesenteric microcirculation of rats. MethodsAcute microcirculation disturbance(AMD) was produced by highmolecular weight dextran(Mr 480, 000) 360 mg· kg-1 iv. Arteriol and venul blood flow velocity and diameter (ABFV, VBFV, AD, VD) and blood flow state(BFS) were observed by intravital microcirculation method. Results Asp 2.5, 5 mg · kg-i, Ver 0.3, 0.6 mg · kg-1,Asp+ Ver(1 + 0.15), (2. 5+ 0. 3) mg· kg-1 iv significant increase ABFV by 11.1%, 31.3%, 18.7%,19.5%, 26.5%, 37.3%, VBFV by 12.5%, 5.7%, 2.5%, 3.7%, 30%, 34.7%,AD by 4.3%, 17.9%, 31.5%, 35%, 20%, 38.1% and VDby 2.2%,4.2%, 25%, 31.5%,5.8%,23.5%espectively, and got a raise in the number of capillaries and a marked improvement of BFS. Asp + Ver(1+0.15, 2.5+0.3) mg · kg-1 iv could reverse AMD. Conclusion Asp is superior to Ver in the increase of BFV, but Ver is superior to Asp in expansion of blood vessel. Asp in combination with Ver produces marked synergistic action and protection againist AMD.

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[ ABSTRACT] AIM: To investigate whether L-carnitine ( LC) inhibits the eryptosis effect of uremic serum on erythrocytes.METHODS:Erythrocyte suspension (2%) was cultured and divided into 3 groups in vitro: control group ( C group) , uremic serum group ( U group, 30%uremic serum) , and uremic serum+LC group ( L group, 30%uremic serum+200 μmol/L LC) .Erythrocytes were collected at 24 h and 48 h.Eryptosis ( phosphatidylserine expression repre-sents eryptosis) was estimated by flow cytometry with Annexin V staining.The content of reactive oxygen species ( ROS) was also detected.Glutathione ( GSH) was measured by ELISA.RESULTS:Eryptosis in C group was increased as the in-cubating time extended.Eryptosis in U group was higher than that in C group, while that in L group was lower than that in U group.Meanwhile, ROS content was higher and GSH was lower in U group than those in C group.ROS content was low-er and GSH was higher in L group than those in C group.CONCLUSION:LC inhibits uremic serum-induced eryptosis by decreasing ROS and increasing GSH, thus attenuating oxidative stress.

An introduction to the Basic service module featuring holistic,full flow and seamless connection built by the hospital.Authors described their experiences in achieving homogenous clinical nursing care,and pointed out that integrating medical humanistic care into the daily nursing process,can improve doctor-patient relationship and patients satisfaction,thus raising medical service quality and efficiency.

Objective To separate NK cells of mice from NK cell separation medium and study inhibitory effect of proliferated NK cell induced by low dose radiation on the leukemia model of K562 cells.Methods Flow cytometry and 3H-TdR methods were respectively used to measure proliferation index and activity of NK cells treated with low-dose radiation( which means exposure dose in 20 cGy low LET beam or 5 cGy high LET beam).CD13 + cells were measured by flow cytometry and TNF-α content in blood-serum was detected by ELISA.In vivo,peripheral blood leucocyte count,index of liver,indexes of spleen and kidney were observed in control group and experimental group.Results The purity of NK cell separation was (82.54 ± 0.18)%.The proliferation index of NK cells at 24 hours after 80 mGy irradiated was 36.31 ± 1.32% ,(t =24.69,P ＜0.05).Killing activity of NK cell induced by low dose radiation to K562 cell was (12.59±0.63)%(t=6.63,P＜0.05)and the inhibition ratio was 29.52%.Conclusion The injection of proliferated NK cell induced by low dose radiation demonstrated significant inhibitory effect on the growth of leukemia nude mouse.

Using Dachengqi Tang (DCQT) as a model, high performance liquid chromatography (HPLC) fingerprints were applied to optimize machine extracting process with the Box–Behnken experimental design. HPLC fingerprints were carried out to investigate the chemical ingredients of DCQT; synthetic weighing method based on analytic hierarchy process (AHP) and criteria importance through intercriteria correlation (CRITIC) was performed to calculate synthetic scores of fingerprints; using the mark ingredients contents and synthetic scores as indicators, the Box–Behnken design was carried out to optimize the process parameters of machine decocting process under high pressure for DCQT. Results of optimal process showed that the herb materials were soaked for 45 min and extracted with 9 folds volume of water in the decocting machine under the temperature of 140 1C till the pressure arrived at 0.25 MPa;then hot decoction was excreted to soak Dahuang and Mangxiao for 5 min. Finally, obtained solutions were mixed, filtrated and packed. It concluded that HPLC fingerprints combined with the Box–Behnken experimental design could be used to optimize extracting process of traditional Chinese medicine (TCM).

The preparation and certification of five China Sea and continental shelf sediment reference materials MSCS-1- 5 are reported. The raw samples were collected separately from the East China Sea and the South China Sea. First,they were ground by a ball mill to a homogenous powder of less than 74μm,then these samples was further processed by an ultra-fine processing technique,a jet mill,to form an ultra-fine powder. The particle size distribution of the samples was determined with a laser particle-analyser,their average particle size is < 4μm. The homogeneity was tested by high-precision WD-XRF and the minimum sampling mass is 5 mg,which was confirmed by XRF,ICP-AES and ICP-MS. Twelve laboratories participated in the cooperative study and 60 constituents were determined. 50 and 51 components were certified as certified values and 1 and 2 components as reference values respectively for MSCS-1 and MSCS-2,52 constituents were certified as certified values for MSCS-3,4 and 5. The sum of the major and minor components in the five reference materials MSCS-1 -5 is 99.9% ,99.6% ,100.4% ,100.1% and 99.7% ,respectively.

Humans ; Jaw, Edentulous ; therapy ; Maxilla ; Prostheses and Implants