Objective:To repair the bone defect from gunshot wounds immediately with iliac bone graft with muscle pedicle or vascular pedicle.Methods:Fifteen bone defects of femur shaft from gunshot wounds of 15 patients have been repaired immediately with iliac bone graft with sartorius mus- cle pedicle or ascending branch of lateral femoral circumflex artery pedicle since 1985.There were 13 male patients and 2 female patients with an age range of 18 to 50.Of the 15 fractured,12 were classified as Winquis-Hansen type Ⅲ and 3 were type Ⅳ.Results:All of the patients were followed up for a period of 3 to 24 months and had a excellent bone union.The mean time to bone union was 16 weeks.The mo- tion range of knee was 100 to 132;with an average of 125.Conclusion:Iliac bone graft with sartorius muscle pedile or ascending branch of lateral femoral circumflex artery pedicle could be resected easi- ly.The vascularized iliac bone with independent blood supplies filled up the defected area of bone and improved the blood supplies of the local regions,thus accelerating bone union.

[Objective]To evaluate the method and curative effect of posterior internal fixation and bone grafting fusion for atlantoaxial fracture or dislocation.[Method]Posterior internal fixation and bone grafting fusion were made on 26 patients with atlantoaxial fracture or dislocation in condition of tracheal intubation anesthesia.Occipitocervieal fixation(Aixs) and bone grafting fusion were performed on patients with fracture of vertebral lamina-arch.Vertebral lamina splint fixation (Apofix) was performed on patients without fracture of vertebral lamina-arch and decompression of vertebral canal.[Result]Followed up for 5 to 60 months(averaged,16.8 months),the vertebral artery and spinal cord injury were not occurred and clinical symptom was relieved in all patients.X ray examination showed screws in vertebral articular process and occipital condyle were normotopic without laxation and fragmentation.The bone grafting transformed into osseous fusion after 3 months.[Conclusion]Aixs fixation and bone grafting fusion and Apofix fixation are effective methods for atlantoaxial fracture or dislocation.

1. Experiments were conducted to compare the blood glutathione peroxi-dase activity of rats fed low selenium diets (0.0042 and 0.0084ppm Se) mainly composed of rice, corn and soybean grown in Keshan Disease endemic areas with that of rats fed the contrast diets (0.073 and 0.074 ppm Se) composed of the same grains grown in non-endemic areas and with that of rats fed stock diets (0.307 ppm Se). The enzyme activities of the endemic grain-feeding groups were lower than that of the non-endemic grain-feeding groups, but the enzyme activities of these groups were significantly lower than that of the stock diet group. The difference of the percentage of ascorbic acid-induced oxidation of hemoglobin to methemoglobin, choleglobin and Heinz bodies in vitro in different groups were in the same trend as that of the glutathione peroxidase activity.2. When rats were fed the low selenium diets for three months supplementing with sodium selenite, both the blood selenium levels and glutathione peroxidase activities were increased to the levels of the stock diet group within 50 days.

Objective To report a case of superficial white onychomycosis caused by Nigrospora sphaerica. Methods Natl specimens were obtained from the patient and examined by direct microscopy, fungal culture and histopathology. Subsequently, the isolate was subjected to DNA sequencing analysis, gelatin liquefaction test, antifungal susceptibility test and nail-plate invasion test. Results A 21-year-old male presented with a 5-month history of whitening of the right hallux. Direct microscopy of nail scrapings showed spores, hyphae and lobiform conidiophores, and histopathology of decalcifying nail clippings revealed the presence of fungal elements including numerous spores and hyphae. A black woolly colony was formed in Sabouraud's dextrose agar (SDA). DNA sequencing analysis showed that the isolate was highly consis-tent with genus Nigrospora. Also, the isolate possessed the ability to liquefy gelatin and to invade normal nail plate. Antifungal susceptibility test showed that the isolate was highly susceptible to itraconazole, clotrimazole, amphotericin B and nystatin. The onychomycosis was cured after 5-month treatment with oral itra-conazole pulse therapy. Conclusions The isolate is identified as Nigrospora sphaerica by morphological features and DNA sequencing analysis. It is the first reported case of superficial white onychomycosis caused by N. Sphaerica in China, and it was effectively treated by itraeonazolc.

Objective To report a case of cutaneous infection due to Trichosporon dermatis. Methods Lesional discharge and tissue were obtained and subjected to microscopic examination, fungal culture and histopathology, respectively. The fungal isolate was then identified with DNA sequence analysis, API 20C AUX system, gelatin liquefaction test, thermal tolerance test. Antifungal susceptibility test was also performed for the fungus. Results A 70-year-old male presented with a 9-month history of ulcerated swelling of the right medial malleolus after plant puncture. Direct microscopic examination of lesional discharge showed no fungal elements, but histopathological biopsy revealed hyphae and spores in the dermis. Yellowish white yeast-like colony grew on Sabouraud dextrose agar (SDA). Slide culture showed pseudohyphae, true hyphae, arthroconidia and blastoconidia. The isolate was identified as Candida humicola by API 20C AUX system, but as T. dermatis by DNA sequence analysis. The strain was unable to liquefy gelatin, could grow at 25 ℃ to 40 ℃, and was sensitive to amphotericin B, itraconazole, voriconazole and nystatin. The skin lesion completely subsided after 4-month treatment with oral itraconazole. Conclusions The isolate is identified as T. dermatis according to morphological features and DNA sequence, which is sensitive to itraconazole.

Objective To determine the current prevalence and risk factors of metabolic syndrome (MS) among adult residents in Chinese developed areas.Methods The clinical data of 6614 adult residents,including 4051 women,from Guangdong and Jiangsu provinces from China Diabetes and Metabolic Disorders Study (2007-2008) were analyzed.Age and sex standardized prevalences of MS were calculated according to the criteria of Chinese Diabetes Society (CDS),US National Cholesterol Education Program Adult Treatment Panel Ⅲ (ATP Ⅲ),International Diabetes Federation (IDF) and Joint Interim Statement (JIS),respectively.Logistic regression analysis was performed to identify the risk factors of MS.Results Age and sex standardized prevalences of MS were 17.88％ (CDS),28.50％ (ATP Ⅲ),21.99％ (IDF) and 31.50％ (JIS),respectively.The prevalences of residents with at least one metabolic abnormality were 67.86％ (CDS) 79.56％ (ATP Ⅲ),79.62％ (IDF) and 80.74％ (JIS),respectively.MS was more common in female than in male by the ATPⅢ and IDF criterion (ATPⅢ:30.63％ vs 26.45％,P ＜0.01 ; IDF:26.04％ vs 17.91％,P ＜ 0.01),while the prevalence was higher in male by CDS criteria (15.94％ vs 19.87％,P ＜0.01).There was no significant difference in the MS prevalence between the rural and the urban residents.Kappa test showed ATP Ⅲ and JIS criteria were most homogenous (κ =0.95,P ＜ 0.01).The risk factors for MS by the logistic regression model were male,older age,lower degree of education,family history of hypertension and obesity,drinker as well as uncontrolled diet.Conclusion The prevalence of MS is high in the adult residents of Chinese developed areas (Guangdong and Jiangsu provinces),whatever diagnostic criterion was used.Effective measures should be taken to control the modifiable MS risk factors.

Objective To investigate the prevalence of mite sensitivity in patients with urticaria or other skin rashes, and to observe the clinical efficacy of a specific immunotherapy(SIT) by the Injectio dermatophagoidei farinae for the patients.Methods In 7-year period(1998-2005), skin prick test(SPT) with a dust mite(Df) allergen was carried out to detect the prevalence of mite sensitivity in OPD patients suffering from skin rashes.Among the patients sensitive to mite with SPT ≥++ response, 3 groups were established.In group A, routine SIT with Injectio dermatophagoidei farinae was conducted.In 9-week increasing dose phase, three stepwise increasing volumes(0.3ml, 0.6 ml and 1.0 ml) each case was injected subcutaneously with mite concentration of 1 ∶ 100 000(w/v) , 1 ∶ 10 000(w/v) or 1 ∶ 5 000(w/v) respectively once a week, followed by a maintenance dose phase for an injection with 1 ∶ 5 000(w/v) 1.0 ml/wk for 6 weeks.Group B received rush SIT with mite injections.A total of 15 injections in a course of therapy with same concentration and volume was given as those for the routine ones except shortened intervals, namely, 9 initial injections completed in 3 days by three injections of each concentration per day with two 30 min intervals, maintenancedoses were then provided in 6 days with 1 ∶ 5 000(w/v) 1.0 ml/d.Thereafter, both groups A and B were maintained for one year with a dose of 1 ∶ 5 000(w/v) 1.0 ml every 2 wk.Group C received antihistamine treatment as control, the patients received daily oral Ebastine 10 mg in the morning and Cetirizine dihydrochloride 10 mg in the evening for one week course and pro re nata later.Levels of serum tIgE and serum mite sIgE were detected by ELISA in 20 urticaria cases before and after one year mite SIT.Results Altogether, 2 685 cases with skin rashes were detected by Df allergen SPT.The prevalence of urticaria cases sensitive to mite was 70.3%(1 754/2 496), which was higher than that of eczema 63.5%(54/85) and anaphylactoid purpura 60.6%(63/104)(P

A 27-year-old woman who suffered from a 2-year history of systemic lupus erythematosus (SLE) presented with a 6-month history of nodules and ulcer on the right lower extremity. Direct microscopic examination of the pus showed branched and septate hyphae and spores in a chain-like arrangement.Histopathological examination revealed yellowish brown hyphae and spores. Dark green velvety colony grew on Sabouraud dextrose agar (SDA). Slide culture showed branched, septate hyphae and spine-like annellated conidiophores. The isolate was identified as Exophiala spinifera by DNA sequence analysis. The strain was unable to liquefy gelatin, could grow at 25 ℃ to 39 ℃, and was sensitive to itraconazole, amphotericin B and terbinafine. Animal test revealed that the infection induced by Exophiala spinifera in immunocompromised mice was more severe than that in normal controls. Based on the clinical features, histopathological, fungal culture and DNA sequencing results, the patient was diagnosed with systemic lupus erythematosus accompanied by subcutaneous phaeohyphomycosis caused by Exophiala spinifera.

Objective To study the proper perioperative nursing methods about patients who have accepted the procedure of prolapsed hemorrhoid operation. Methods Careful and finished before operative evaluation and the perioperative nursing cares were used for patients.Results Only one patients dead for lung cancer,others had successful operation without any complications.Conclusions Careful nursing intervention can effective reduce the incidence rate of postoperative complication for PPH,and then improve the quality of life for patients.