Objective To evaluate the effect of Dermlin,an inorganic activity induced skin wound dressing,in combination with a nano-silver dressing,on chronic diabetic foot ulcer.Methods A total of 93 elderly diabetic patients with chronic foot ulcer were recruited and randomly assigned into the treatment group and the control group.In additional to routine systemic and topical treatment for both groups,the treatment group was given a combination of Dermlin and nano silver dressngs,while for the control group,iodophor gause was used to cover the ulcer.The two groups were compared on ulcer grading,wound healing time and positive rate of bacterial culture.Results The wound healing time in the treatment group was significantly shorter than that in the control group [(41.6±2.7) d vs.(61.9±2.9) d,t=-35.09,P=0.000].Positive rates of bacterial culture for the treatment group at admission,14 d after admission and 28 d after admission were 88.46％,23.07％ and 15.38％,respectively,in contrast to 88.89％,59.26％ and 40.74,respectively,for the control group at the same time points (x2 =0.01,6.88,7.34,P=0.065,0.008,0.006).The rate of effectiveness for the control group was 63.83％ (30/47),clearly lower than the 82.61％ for the treatment group (38/46) (x2=4.17,P=0.035).The patients' foot ulcers were graded using the Wagner system.In the treatment group,27 patients with grade 2 ulcers showed an 88.89％effectiveness rate (24/27),considerably higher than the rate of 67.86％ in the control group (18/28)(x2=4.60,P=0.032).For grade 3 ulcers,the effectiveness rate was 73.86％ (14/19) for the treatment group and 63.15％ for the control group (12/19),with no statistical difference between the two groups (x2=0.49,P=0.364).Conclusions The combination of Dermlin and Nanosilver can promote healing for grade 2 chronic diabetic foot ulcers,but has no obvious effect on grade 3 ulcers.

10.3969/j.issn.2095-4344.2013.26.012

Objective To present a method for breast reconstruction with the superficial inferior epigastric artery (S1EA) flap and to summarize the operative experiences. Methods The diameter and distribution were evaluated with multipledetector-row computed tomography (MDCT) angiography and doppler perfusion flowmeter. Bipedicle superficial inferior epigastric artery flap was designed below umbilicus. Superficial inferior epigastric artery and vein were anastomosed to the internal mammary artery and vein. Results Since 2007, we have used the superficial inferior epigastric artery flap in 4 cases of breast reconstruction. Four flaps survived completely. With the follow-up of 6-12 months, the reconstructed breasts were well-shaped and there were no complications such as abdominal hernia, bulge and weakness in donor sites. Conclusions Breast reconstruction using the superficial inferior epigastric artery flaps can not only preserve the advantages of the traditional method using the deep inferior epigastric perforator flaps, but also retain the maximal function of the fascia and the rectus abdominal muscle and prevent the occurrence of abdominal weakness and hernia. It is an ideal alternative method of breast reconstruction on condition that definitive preoperative assessment of vessels and skilled surgical technique are provided.

OBJECTIVE:To evaluate the effect of L-carnitine on serum total level of homocysteine (tHcy) in patients undergoing maintenance hemodialysis. METHODS: 60 patients undergoing maintenance hemodialysis were randomly divided into two groups (treatment group and control group): the patients in the treatment group were injected i.v. with 1.0 g of L-carnitine for 12 weeks,and those in the control group were injected i.v. with 5 mL normal saline for 12 weeks. Meanwhile,the healthy people were involved as normal control group(n=20). tHcy was detected by ELISA method;the fasting insulin was detected by radio-immunity method. Fasting blood glucose,total cholesterol,triglyeride,HDL and LDL were detected by routine method. The reciprocal of the multiplication product between fasting blood glucose and insulin concentration were computed as insulin sensitivity index(ISI). RESULTS: After treatment for 12 weeks,the treatment group showed increased ISI but significantly reduced tHcy(P

Gastric bronchogenic cysts （GBCs） is uncommon with atypical clinical features. It is difficult to diagnose by preoperative imaging examinations. Therefore , postoperative histopatho-logical examination is regarded as the golden bacteria in ultimate diagnosis. The treatment of GBCs：ultrasound-guided fine needle aspiration and endoscopic mucosal resection is only used for small GBCs with intra-cavity growth pattern. However , GBCs with extra-cavity growth pattern is featured with deeply anatomical position , large size , and prone on attaching to vital blood vessels and organs , which makes laparoscopic resection is the first choice in treatment. The authors introduce the diagnosis and treatment of a case of GBCs attaching to lesser curvature , in order to provide references for clinical diagnosis of GBCs.

Objective To investigate the effect of all-trans retinoic acid (ATRA) on expression of gap junction genes 26, 32 and 43 in two human hepatocellular carcinoma cell lines. Method Human hepatocellular carcinoma cell lines SMMC-7721 and BEL-7404 were cultured and inoculated in culture plate. Cells were divided into 2 groups and cultured respectively with normal medium and medium contains ATRA at a concentration of 10-mol/L. After 24, 48 and 72 hours, cells were collected and total mRNA were extracted. RT-PCR was used to detect the transcription of gap junction genes 26, 32 and 43. Result SMMC-7721 and BEL-7404 cultured under condition of normal medium do not express CX26 mRNA and CX32 mRNA. With the effect of ATRA for 48 and 72 hours, SMMC-7721 cell expressed CX26 mRNA and CX32 mRNA. BEL-7404 expressed CX26 mRNA and CX32 mRNA while cultured with ATRA for 72 hours. CX43 mRNA expression of the two cell lines was not altered by ATRA. Conclusion ATRA affects the expression of CX26 and CX32 in HCC cell lines SMMC-7721 and BEL-7404 at the transcription level.

OBJECTIVETo find out the optimal concentration, infusion rate and dosage of saline for resuscitation.

METHODSForty-five dogs were used to establish hypovolemic shock models. The dogs were resuscitated with saline of different concentrations and different dosages under different infusion rates, and the resuscitation results were compared.

RESULTSThe best concentration was 7.5%, the best rate of infusion 20 ml/min (a volume equivalent to 15% of the shed blood) and the best dosage 5.71 ml/kg. The method was effective for resuscitation, the mean arterial pressure (MAP) could be elevated to 89% of the baseline, and this MAP could be kept for more than one hour.

CONCLUSIONSUsing 7.5% sodium chloride solution equivalent to 15% of the shed blood at an infusion rate of 20 ml/min can achieve a best resuscitation result.

Animals ; Blood Pressure ; Blood Volume ; Body Weight ; Dogs ; Electrolytes ; blood ; Female ; Male ; Resuscitation ; Saline Solution, Hypertonic ; administration & dosage ; Shock, Hemorrhagic ; physiopathology ; therapy

Performance appraisal of public hospitals have given a guidance for the development of public hospitals at all levels.A Class A tertiary hospital reviewed the problems in the development of the hospital at the present stage and focused on the following four aspects:①insufficient fine management;②No clear orientation of discipline development;③The bottleneck of the improvement of medical operation efficiency;④New challenges in the reform of payment mode.The tertiary hospital launched a fine management practice in May 2022,in order to solve the problems by taking the Department of Surgery as a pilot area,laying the foundation for fine management through information system construction,improving the efficiency of medical operation through management process optimization,improving the overall competitiveness of disciplines through the construction of sub-specialty and Discipline Alliance and adjusting the performance appraisal index system to play the role of performance incentives.The measures effectively improve the overall capacity and efficiency of hospital medical services and help the hospital to achieve high-quality development.

OBJECTIVETo identify potential mutation of the ADAR1 gene in a Chinese family and a sporadic case affected with dyschromatosis symmetrica hereditaria(DSH).

METHODSClinical data and peripheral blood samples from the pedigree and the sporadic patient were collected. Following extraction of genomic DNA, all 15 exons and exon-intron flanking sequences of the ADAR1 gene were amplified by polymerase chain reaction and subjected to direct sequencing.

RESULTSA novel frame-shift mutation c.2638delG (p.Asp880ThrfsX15) from the patients of the pedigree was detected in exon 8 of the ADAR1 gene. And a novel nonsense mutation c.2867C>A (p.Ser956X) was detected in exon 10 of the ADAR1 gene from the sporadic case. Neither mutation was identified among the unaffected family members nor 100 unrelated healthy controls.

CONCLUSIONThe frame-shift mutation c.2638delG (p.Asp880ThrfsX15) and the nonsense mutation c.2867C>A (p.Ser956X) in the ADAR1 gene probably underlie the DSH in our patients.

Adenosine Deaminase ; genetics ; Adult ; Asian Continental Ancestry Group ; genetics ; Base Sequence ; China ; Codon, Nonsense ; Exons ; Female ; Frameshift Mutation ; Humans ; Male ; Molecular Sequence Data ; Pedigree ; Pigmentation Disorders ; congenital ; enzymology ; genetics ; RNA-Binding Proteins ; genetics

OBJECTIVETo identify pathogenic mutation of the TSC1 and TSC2 genes in a patient with tuberous sclerosis.

METHODSPeripheral venous blood samples and clinical data of a pregnant woman with tuberous sclerosis and 4 family members (parents, uncle and husband) were collected. Genomic DNA was extracted. All coding exons of the TSC1 and TSC2 genes and their flanking intronic sequences were amplified by polymerase chain reaction and subjected to direct sequencing.

RESULTSThe patient has presented facial angiofibroma and prefrons fibrous plaque for 20 years, and lumbar connective tissue nevus for 10 years. She also had mental retardation but no epilepsy. A novel frame-shift mutation c.4258-4261delTCAG was detected in exon 34 of the TSC2 gene, which had led to a premature stop codon TAG after the 55th amino acids. The same mutation was not found in the unaffected family members and 100 unrelated healthy controls.

CONCLUSIONThe novel frame-shifting mutation c.4258-4261delTCAG (p.Ser1420GlyfsX55) in the TSC2 gene may be responsible for the disease in the patient.

Adult ; Asian Continental Ancestry Group ; genetics ; Base Sequence ; China ; DNA Mutational Analysis ; Female ; Humans ; Male ; Molecular Sequence Data ; Mutation ; Pedigree ; Pregnancy ; Tuberous Sclerosis ; genetics ; Tumor Suppressor Proteins ; genetics ; Young Adult