1.Abdominal compartment syndrome in patients with pelvic fracture
Chinese Journal of Orthopaedic Trauma 2016;18(8):729-732
Abdominal compartment syndrome (ACS) has been increasingly recognized as a cause for significant morbidity and mortality in many diseases.Great advances have been made in many researches that are dedicated to the treatment of ACS.However,in the field of orthopedics,it has still not aroused enough attention from the orthopaedic surgeons,as the occurrence and development of ACS are occult following pelvic fracture trauma.This review introduces the relevant data and researches about ACS resulting from pelvic fractures.
2.Experimental investigation on therapy of intravenous transplantation of neural stem cell for spinal cord injury
Zuyuan XU ; Huang FANG ; Yongxiang LUO
Orthopedic Journal of China 2006;0(06):-
[Objective] To investigate the immigration and differentiation of neural stem cell in vivo after intravenous transplantation into adult rats with spinal cord injury.[Method]Lower ventricle tissue was obtained from new-born rats aged 14 to 16 days,and the target cells were identified after cultured in vitro,neural stem cells signed by Brdu was injected into model rats of full-cut spinal cord via tail vein one week after injury.CSEP test and BBB function evaluation were conducted 8 weeks later after transplantation.The specimens made from the injured spinal cord of rats were affused with 8% poly formaldehyde,which aimed to get pathology section and imunnohistochemical staining.[Result](1)According to BBB scores,functional recovery was found in injury group and transplantation group but did not reach normal level,while in transplantation group the functional recovers got the better.(2)cerebro-spinal evoked potential(CSEP)in control group and injury group disappeared,and the latency period of CSEP in transplantation group was prolonged,but control group was not interfered.(3)Compared with injury group,a large amount of Brdu positive cells existed at the injured part of spinal cord in the transplant group,which indicated that the engrafted NSCs could survive and migrate into the injured part,and some of them could differentiated into the glial fibriuary acidic protein(GFAP)and NF-200 positive cells that had characteristics of neuron or glial cell.[Conclusion]Neural stem cell can reach the injured part of spinal cord and replace the injured neuron or glial cell via intravenous transplantation,which enable the injured spinal cord to functionally recover to some extent.
3.Treatment for upper limb neuritis of unknown cause by neurolysis
Yongxiang LUO ; Tipei WANG ; Huang FANG
Chinese Journal of Microsurgery 2000;0(02):-
Objective In order to make a definite diagnosis and raise the therapeutic level for the upper limb neuritis of unknown cause Methods A study on upper limb neuritis of unknown cause was carried out on eight patientsThere were six men and two women,with a mean ages of 34 yearsFindings were initially restricted to the ulnar nerve distrbution in six patients,and radial nerve in two patientsClinical course was from five months to four yearsAll the patients were subjected to neurolysis or interfascicular neurolysis combined with perineural prednisolone acetate injection at the same timeMicroscopically,it appears the nonspecific in resecting epineurium Results Neuritic pain was first to disappearSix patients showed sensory and motor function recovery,except one patient appears the same symptoms as involving ulnar nerve at the other limb one year laterThe another patient involved radial nerve only relieved severe pain Conclusions The diagnosis of limbs neuritis without any known cause is going to make a thorough inquiryNeurolysis is a satisfactory method,the result is distinctly better than nonsurgical treatments
4.Treatment for upper limb neuritis of unknown cause by neurolysis
Yongxiang LUO ; Tipei WANG ; Huang FANG ;
Chinese Journal of Microsurgery 2001;24(2):104-106
Objective In order to make a d efinite diagnosis and raise the therapeutic level for the upper limb neuritis of unknown cause. Methods A study on upper limb neuritis of unknown cause was carried out on eight patients.There were six men and two women,with a mean ages of 34 years.Findings were initially restricted to the ulnar nerve distrbution in six patients,and radial nerve in two patients.Clinical course was from five months to four years.All the patients were subjected to neurolysis or interfascicular ne urolysis combined with perineural predni solone acetate injection at the same time.Microscopically,it appears the nonspec ific in resecting epineurium. Results Neuritic pain was first to disappear.Six patients showed sensory and motor function recovery,except one patient appears the same symptoms as involving ulnar nerve at the other limb one year later.The another patient involved radial nerve only relieved severe pain. Conclusions The dia gnosis of limbs neuritis without any known cause is going to make a thorough inquiry.Neurolysis is a satisfactory method ,the result is distinctly better than no nsurgical treatments.
5.Application of case-based learning in course of Clinical Biochemistry and Diagnosis for medical ;postgraduates with professional degree
Songmei LIU ; Yongxiang PENG ; Xin ZHOU ; Fang ZHENG ; Jiancheng TU
Chinese Journal of Medical Education Research 2013;(12):1219-1222
Case-based learning model was applied in teaching the course of Clinical Biochem-istry and Diagnosis for postgraduates with professional degree. Dyslipidaemia was chose as teaching content and one distinctly characterized case along with four typical cases were selected. Information of cases and core problems were submitted to students to prepare before the class. In the class, stu-dents were grouped and discussed independently. Students put forward the pathogenesis of the disease and the clinical laboratory test items for diagnosis and differential diagnosis. Teachers should adhere to the following principles: making the class student-centered and highlighting consciousness of stu-dents; creating clinical environment to stimulate enthusiasm for learning; problem-oriented and taking capacity building as the priority. After the class, teaching evaluation was designed to promote the con-tinuous improvement of teaching cases.
6.Modified subinguinal approach for treatment of acetabular anterior column and wall fractures
Feng GAO ; Xiaodong QIN ; Xiang LI ; Yongxiang FANG ; Feng YANG
Chinese Journal of Orthopaedic Trauma 2016;18(2):102-107
Objective To discuss the efficacy of the modified subinguinal approach for the treatment of acetabular anterior column and wall fractures.Methods A clinical retrospective study was performed of the 5 patients who had been treated at our department from January 2011 to April 2015 for acetabular anterior column and wall fractures and conformed to follow-ups.They were 3 males and 2 females,aged from 19 to 45 years (mean,35.6 years).The duration from injury to surgery averaged 7.6 days (range,from 4 to 10 days).The subinguinal ligament approach was adopted in the 5 cases,through which the inguinal ligament was preserved intact after sharp dissection of its insertion at the anterior superior iliac spine and medial-upper advancement,the advantage of expanded exposure of the first window by the Farid sub-ilioinguinal approach was retained,and additional lesions due to iliac osteotomy were avoided.The operation time,intraoperative bleeding,postoperative reduction and time for fracture union were documented.Merle d' Aubigne and Postel scoring system was used to assess the hip joint function of the affected limb at the final follow-ups.Results The operation time ranged from 110 to 150 minutes (mean,125 minutes);the intraoperative bleeding ranged from 415 to 550 mL (mean,450.2 mL).By the Matta's criteria,the postoperative reduction was rated as excellent in 4 cases and good in one.The 5 patients were followed up for an average of 32.4 months (range,from 6 to 43 months).Their fractures united clinically after an average of 4.6 months (range,from 3 to 6 months).The hip joint function was rated as excellent in 2 and good in 3 by the Merle d' Aubigne and Postel scoring system at the final follow-ups.Follow-ups observed no serious complications like inguinal hernia,internal fixation failure,myositis ossificans,or avascular necrosis of the femoral head.Conclusions As the modified subinguinal approach can provide a broad surgical exposure,lead to minimal injury to the inguinal ligament,avoid lesions caused by iliac osteotomy,and decrease operation time and bleeding,it may be a better approach for acetabular anterior column and wall fractures.
7.Relationship between serum cortisol level and cancer-related fatigue
Zhongxing LI ; Denghai MI ; Fang YANG ; Zhizhen WEN ; Xiaorong LIU ; Yongxiang WANG ; Weiwei REN ; Zheng LI
Chinese Journal of Clinical Oncology 2014;(17):1089-1093
Objective:To investigate the relationship between cancer-related fatigue and cortisol in cancer patients and elucidate the underlying mechanism. Methods:A total of 80 cancer cases were divided into two groups:fatigue group (50 cases with cancer-related fatigue) and non-fatigue group (30 cases without fatigue). The scores were evaluated through the Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF) and the Fatigue Symptom Inventory (FSI) report. Serum specimens were examined through electrochemiluminesence immunoassay and enzyme-linked immunosorbent assay. Serum cholesterol was examined through the CHOD-PAP method, and serum total protein and albumin were determined via the Biuret method. Agarose gel electrophoresis was conducted to determine alpha 2 globulin ratio and to calculate serum alpha 2 globulin concentration. Results: The cortisol level in the fatigue group was significantly lower than that in the non-fatigue group[(119.68±5.34) nmol/L vs. (163.45± 31.49) nmol/L, P<0.05], and the adrenocorticotropic hormone (ACTH) level in the fatigue group was significantly higher than that in the non-fatigue group [(104.50 ± 17.15) ng/L vs. (51.43±13.24) ng/L, P<0.05]. Cortisol negatively correlated with MFSI-SF (r=-0.867, P<0.001) but positively correlated with ACTH (r=0.809, P<0.001). Furthermore, cortisol negatively correlated with FSI (r=-0.747, P<0.001) but positively correlated with ACTH (r=0.70, P<0.001). The levels of serum cholesterol [(1.25±0.70) mmol/L vs. (3.28±0.73) mmol/L, P<0.05], albumin[(18.24 ± 7.03) g/L vs. (37.40 ± 8.05) g/L, P<0.05], and alpha-2 globulin [(2.25±1.07) g/L vs. (5.36±1.09) g/L, P<0.05]were significantly lower in the fatigue group than in the non-fatigue group. Conclusion:The patients with cancer-related fatigue exhibited increased MFSI-SF score, decreased serum cortisol level, and enhanced ACTH level. The low serum cortisol levels caused a disorder in the serum ACTH and cancer-related fatigue of malignant tumor patients. The mechanism underlying the reduction in serum cortisol level correlated with the insufficient amounts of serum cholesterol, the composite material of cortisols, and of serum albumin, particularly alpha-2 globulin, the carrier protein of serum cholesterol.
8.Risk factors of electrocoagulation syndrome after endoscopic submucosal dissection in patients with colorectal lesions
Mingzhu WANG ; Shiyun TAN ; Hesheng LUO ; Ming LI ; Pengbo WU ; Fang GUO ; Yongxiang SHU
Chinese Journal of General Practitioners 2016;15(9):698-701
Objective To investigate the risk factors of electrocoagulation syndrome after endoscopic submucosal dissection (ESD) in patients with colorectal lesions.Methods Clinical data of 145 patients with colorectal mucosal lesions undergoing ESD in People's Hospital of Wuhan University between September 2010 and September 2015 were retrospectively studied.Results Among 45 patients,post endoscopic submucosal dissection electrocoagulation syndrome (PEECS) was developed in 32 cases (22%).The median age in PEECS group was higher (t =-5.783,P =0.000),the median lesion size was larger(t =-5.590,P =0.000),the median length of hospital stay was longer (t =-6.841,P =0.000) than those in non-PEECS group.Univariate regression analysis showed PEECS was associated with the age,lesion size,lesion location,length of hospital stay,malignant tumor,polyps type,resection modality.Multivariable logistic regression analysis showed that the independent risk factors for the development of electrocoagulation syndrome were age >65 year (OR =1.123,95% CI:1.013-1.244,P =0.027),lesion size > 3.5 cm (OR =1.173,95% CI:1.015-1.357,P =0.031),malignant tumor (OR =3.498,95 % CI:1.460-8.379,P =0.005),hospital stay > 10 d (OR =2.480,95% CI:1.346-4.569,P =0.004),non-rectal lesions (OR =12.612,95% CI:3.446-46.157,P =0.000).Conclusion Attention should be paid for colorectal lesion patients with high risk of PEECS,when endoscopic submucosal dissection is performed.
9.Management practice of the hospital for the medical insurance lump-sum prepayment
Lehui ZHANG ; Yongxiang WEI ; Fang CHEN ; Ying CHEN ; Hongbin ZHENG ; Xiuyun SONG
Chinese Journal of Hospital Administration 2014;30(12):910-912
2013 witnessed the full coverage of the medical insurance lump-sum prepayment management at all hospitals above secondary level in Beijing.As a result,medical insurance management of the hospital turned its focus from“ expense settlement” to“ expense management”,with a multidimensional,multi-method,multi-sectoral and multi-index lump-sum prepayment of medical insurance management system set up.Methods and concepts introduced included diagnosis related groups (DRGs) management tools in hospitalization service management; equivalent hospital departments comparison in outpatient service for post management; the concept of total budget management concept,and the “market-operations-finance-performance” linkage mechanism for priority control of drug expenses; and focused management on key patient groups and drug/consumable suppliers.
10.Genetic structure and diversity of T cell receptor alpha chain genes in Hezuo minipig
Jianping GAO ; Wansheng LI ; Shuang ZENG ; Yongxiang FANG ; Haiyan FENG ; Xiaopu YANG ; Zhizhong JING
Acta Laboratorium Animalis Scientia Sinica 2014;(6):1-8
Objective To analyze the complexity of molecular structure in porcine T cell receptor gene and its similarity compared to humans.Method Based on the gene of porcine T cell receptor alpha chain ( TCRα) from the Gen-Bank database, 93 swine T cell receptor alpha chain genes ( STA) were cloned by reverse transcription-polymerase chain reaction (RT-PCR) from porcine peripheral blood lymphocytes, lymph nodes and spleen.Result Sequence analysis showed that STA genes all contain a domain of variable signal peptide and V, hypervariable J and conservative C.Howev-er, nucleotide sequence of STA was not completely identical with only 68.4%to 98.7%homology among genes, and had extremely sophisticated polymorphism and diversity.This was accord with the genetic structure of TCRαchain.Molecular structure, genetic evolution and classification of these genes were carried out according to the homology of TCRαgene, which all have several sites and zones of mutation on the domain of signal peptide, FR1 and CDR1, FR2 and CDR2, FR3 and CDR3.Analysis of similarity and classification of TCRαV domain(STAV)and J domain (STAJ) of Hezuo minipig u-sing IMGT/V-QUEST tools compared with those of humans found the genetic evolution relationship that was closer, and each of TRAV and TRAJ also found to have a corresponding fragment of humans, ever in 92% of similarity of TRAV be-tween swine and humans.Conclusion Our results indicate that inbred Hezuo minipig possesses genetic diversity against complicated environment of microbes in healthy status, and Hezuo minipig is suitable as an animal model for research on human immunology and diseases.