The relationships between 105 bacterial counts of subeschar tissue of 40 burn cases and the success of failure of skin autografting are analysed in the present article.Data showed that the success rate of skin grafting was only 94.72% when there was no subeschar bacterial growth, and 90% even while the bacterial count of subeschar tissue reached 1010.This suggests that there are many factors influencing the success or failure of skin grafting.The bacterial count of subeschar tissue is one but not an unique determining factor .Therefore, it can not be used as a predicting factor of success or failure of skin grafting.The notion that subeschar bacterial count of 106 is a watershed of success or failure of skin grafting may lead to its misunderstanding for a contriandiction of skin grafting.Thereby the active treat- ment of local burn Woun wound will be influenced .This problem needs further deliberation.

The early changes in microcirculation of burns are of significant pathophsi-ologic importance. The experimental use of cimetidine, an antagonist of histamine H2-receptor, demonstrated its better effectiveness against the changes in microva-scular permeability. No observations on blood flowing state were made. The post-burn adherence of White blood cells to venules were noted recently by Eriksson, which was considered as a pathophysiologic mechanism of postburn tissue edema.A 20% body surface area third degree burn is produced in rats, which is designed an experimental model for observation of the changes in mesenteric microcirculation and a comparative relationship between the adherence of white blood cells and the tissue water content, a comparative therapeutic effect of early resuscitation with Ringer's lactate solution and the results of blood flow in microcirculation, adherence of white blood cells, and aggregation of red blood cells obtained by administration of cimtldine.The chief findings of mesentery microcirculation of burned rat are venule dilatation with progressive slowing and sludging of blood flow; preipheral rotation and adherence of white blood cells; progressive aggregation of red blood cells. No edema is found by measuring water content of remote tissue, better therapeutic effects are shown both by resuscitation of fluid and administration of cimetidine, with the former in predeminanee. The present study indicates:1.Hypovolemia caused by postburn fluid loss and venule dilatation is a major factor leading to worsening of microcircuration blood flow. In order to maintain normal flow state, to assure abetter tissue perfusion, the administration of cimetidine associated with fluid resuscitation may be beneficial.2.Low flow state of microcirculation is the underlying cause, but not the only one of adherence of white blood cells postburn.3.Adherence of white blood cells within venules does not lead to tissue edema, it is, therefore, not the cause of remote tissue edema. The point of view of Eriksson merites further discussion.4.The problems of aggregation of red blood cells and remote unburned tissue edema are also discussed in the present artical. The primary danger of aggregation of red blood cells is to make worsen of the microcirculation, which aggravates the deficiency of blood and oxygen; timely correction of hypovolumia is a preventive measure of primary importance. The experimental model revealed that if no fluid is administered, some, then shows slightly mild dehydration. This might probably be due to the compensatory responce of the remote area to hemoconcen-tration.

In this study, 119 adult wistar rats were used, and divided into four groups (control group, burn group, burn-cimetidine treatment group and burn-ranitidine reatment grup). 20% TBSA full thickness burn was produced by immersion of the clipped back of the rat in 100℃ boiling water for 15s. The rats of the control group were immersed in 37℃ water for 15 s. In the treatment groups, the animals were treated with cimetidine (0.1 mg/g) or ranitidine (0.05 mg/g) intraperitoneally every 12 h, respectively. All animals were given fluid therapy according to the TBSA and body weight. In the animals treated with cimetidine or ranitidine, the H+ concentration of gastric juice was greatly decreased as compared with that of the burn group (P

Objective To evaluate the clinical efficacy and complications of the covered stents in the treatment of malignant upper gastrointestinal tract stricture.Methods 53 cases with malignant upper gastrointestinal tract obstruction underwent treatment with covered stents.The therapeutic efficiency and the complications were observed.Results The procedures were successful in 50 cases in one time,the successful rate was 94.3%.The complications included chest pain and foreign body sensation,diarrhea,restenosis,stent migration,esophagus reflux,bleeding.Conclusion The treatment with covered stents was a safe,simple and effective management for the patients with malignant upper gastrointestinal tract obstruction who had lost the chance of surgical resection or refused to undergo operation.

Blood Vessel Prosthesis ; Coronary Aneurysm ; Coronary Artery Disease ; Embolization, Therapeutic ; Humans ; Stents

Combined antiretroviral therapy ( cART) is widely used for infections of human immune deficiency virus ( HIV) .However , some antiviral drugs can not reach the effective concentrations in central nervous system due to the hinder of blood-brain barrier ( BBB) , resulting in the formation of viral reservoir in central nervous system .BBB is formed by human brain microvascular endothelial cells ( HBMVECs ) , which are connected by tight junction and a thick basement membrane , and astrocytic end-feet.This paper reviews possible mechanisms of BBB hindrance and anti-HIV drug efflux by transport proteins , as well as effective methods to deliver antiretroviral drugs into brain , including the application of nano technology .

Objective: To observe the clinical efficacy of puncturing Renying (ST 9) in the treatment of poststroke dysphagia. Methods: Sixty cases of poststroke dysphagia were randomized into two groups, a control group in which 30 cases were given rehabilitation training, and a treatment group in which 30 cases were treated by puncturing Renying (ST 9) and rehabilitation training, with a course of four weeks. Results: The total effective rate for dysphagia was higher in the treatment group than in the control group (P<0.05). Conclusion: Puncturing Renying (ST 9) is quite effective for poststroke dysphagia.

Objective To investigate the relationship between HLA-DRB1 alleles and vascular anomalies in infants of Han nationality in Guangxi Zhuang Autonomous Region.Methods This study included 145 infants with vascular anomalies (99 cases of hemangioma (hemangioma group) and 46 cases of vascular malformation (vascular malformation group)) and 105 healthy infants (control group) of Han nationality residing in Guangxi Zhuang Autonomous Region.The genotypes of HLA-DRB1 alleles were determined by using PCR-sequence specific primers (PCR-SSP).Chi-square test was performed to analyze the difference in the frequency of HLA-DRB1 alleles between these groups by using the SPSS 16.0 software.Results There were significant differences in the frequency of HLA-DRB1*0901,*1401 and *16 alleles among the hemangioma group,vascular malformation group and control group (x2 =13.05,12.79,10.36,respectively,all P ＜ 0.01).Paired comparison revealed significant differences in the frequency of HLA-DRB1*0901 allele between the hemangioma group and vascular malformation group (RR =4.84,P ＜ 0.01) as well as between the hemangioma group and control group (RR =3.21,P ＜ 0.01),and in the frequency of HLA-DRB1*16 allele between the hemangioma group and control group (RR =2.25,P ＜ 0.01) as well as between the vascular malformation group and control group (RR =2.60,P ＜ 0.01).The frequency of HLA-DR*1401 allele was significantly lower in the hemangioma group than in the control group (RR =0.30,P ＜ 0.01).Conclusions HLA-DRB1*0901 and *16 may be the predisposing genes for hemangioma and vascular anomalies respectively,while HLA-DRB1*1401 appears to be protective against hemangioma,in infants of Han nationality in Guangxi Zhuang Autonomous Region.

Objective To explore the changes in serum concentrations of angiogenic factors in patients with unstable angina pectoris.Methods A total of 60 patients with unstable angina pectoris was eligible for study and divided into diabetes group ( A group, n =20) and non-diabetes group (B group, n =40).Another 30 general-matched healthy subjects from medical examination center were enrolled as control group .Serum samples were collected , and serum concentrations of vascular endothelial growth factor (VEGF), angiopoietin-1, angiopoietin-2, angiogenin, angiostatin, basic fibroblast growth factor (bFGF), and platelet-derived growth factor-BB ( PDGF-BB) were measured by cytokine array technology and compared between the groups .Results Compared with the control group, the serum concentrations of VEGF [(325.2 ±210.1)pg/ml] and angiopoietin-2 [(3031.3 ±1865.5)pg/ml] were sig-nificantly increased in patients with unstable angina pectoris (both P <0.05).Whereas,no significant differences in serum concentra-tions of angiogenin,angiopoietin-1,angiostatin,bFGF,and PDGF-BB were detected between control group and patient groups .There were no significant differences in serum concentrations of above all 7 biomarkers between diabetes group and non-diabetes group .Con-clusions Serum concentrations of VEGF and angiopoietin-2 were increased in patients with unstable angina pectoris ,and diabetes didn't affect the increases in serum concentrations of VEGF and angiopoietin-2 caused by unstable angina pectoris .

ObjectiveTo explore the influence of life events on the emotional state ot heart transplantation patients.Methods All the heart transplantation outpatients were interviewed by a certain psychiatrist in Zhongshan Hospital during Oct.2010 to Oct.2011.The demographic data,life events and the self-reported influenced degree were recorded by the same psychiatrist.A grounded theory-based approach with thematic content analysis of the field notes was used.ResultsEighty-eight patients were enrolled,including 69 males,and19 females.The average age of the patients was 46.5 ±14.3 years old.The average duration after operation was 39.3 ± 39.6 months.The life events were classified into 4 groups,which were medical financial problems,physical condition,family support and future life.The most frequently reported event was physical condition (50.2％ ) and the influenced degree was the highest (9.2 ±1.2),while most patients (96.6％) complained high medical and relevant cost and the influenced degree was (6.5 ± 2.1). Family support was reported by13.6％ patients and its influenced degree was (7.6 ±1.2).The age of the reporter of future life (6.8％) was under 33 years.ConclusionDifferent events have different influence to patients.Improving the social support of patients is helpful to improve quality of life.