Objective:Reporting a rare case with Kimura's disease and angiolymphoid hyperplasia with eosinophilia (ALHE), who also has nephrotic syndrome resulting from minimal change glomerulopathy. Methods: Histological manifestations, immunohistochemical staining, immunofluorescence staining, and electron microscope were performed. Results: One 37-year-old male patient with recurrent erythra, cutaneous node, painless cervical lymph node enlargement and nephrotic syndrome in 5 years. It's confirmed through biopsies that the subcutaneous node is ALHE, the cervical lymph node is kimura disease, and renal lesion is minimal change glomerulopathy. Conclusion: Kimura disease and ALHE may be different features of the same disease, and may complicate glomerulopathy.

OBJECTIVE: To study the effects of Anxin Granules on dyslipidemia in rabbits caused by high fat plus high cholesterol diet. METHODS: Thirty-two healthy New Zealand male white rabbits were randomly divided into 4 groups: normal control group, untreated group, Zhibituo Tablet-treated group and Anxin Granule-treated group. Rabbits in the normal control group were fed with regular chow, while rabbits in the other three groups were fed with high fat plus high cholesterol diet. Zhibituo Tablets and Anxin Granules were administered to the rabbits in Zhibituo Tablet-treated group and Anxin Granule-treated group at a daily oral dose respectively. At the end of the 10th week, the levels of serum total cholesterol (TC), triglycerides (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), apolipoprotein A(1) (ApoA1) and apolipoprotein B (ApoB) were tested in each group, and the ultrastructures of the aorta were also observed by an electron microscope. RESULTS: Anxin Granules could reduce the levels of TC, TG, LDL-C and ApoB. The results observed by electron microscope showed that, as compared with the untreated group and the Zhibituo Tablet-treated group, the atherosclerosis of aorta in the Anxin Granule-treated group was lighter. And it was found that there were few lipid droplet vacuoles in cytoplasm of the endothelial cells, and various cell organs and elastic membrane were existed, but no lipid droplet vacuoles in cytoplasm of the medial smooth muscle cells. CONCLUSION: Anxin Granules can regulate the metabolism of blood lipid and inhibit the formation of atherosclerosis caused by hyperlipidemia in rabbits.

Objective To evaluate the validity of stroke volume variation (SVV) for predicting fluid responsiveness in different grades of intra-abdominal pressure (IAP).Methods Forty pigs were involved in the study.Hypovolemia was made by blood withdraw of 30% of estimated blood volume from each animal via carotid artery.All the pigs were randomized into four groups namly 0 mm Hg (L0), 15 mm Hg (L15), 25 mm Hg (L25) and 35 mm Hg (L35).Nitrogen was inflated slowly till IAP to 0, 15, 25 and 35 mm Hg.Fluid loading was performed with 500 ml hydroxyethyl starch within 30 minutes.Hemodynamic parameters were evaluated by the thermodilution technique of pulse induced continuous cardiac output (PiCCO).SVV and stroke volume (SV) were measured before and after fluid loading.Results In groups L0 and L15, SVV was positive correlated with changes in SV (r=0.888, 0.942, respectively, P<0.05).In groups L25 and L35, there were poor correlations between SVV and changes in SV(r=0.068,-0.114, respectively).Conclusion When IAP was slightly increased up to 15 mm Hg, SVV remains an effectiveness index to predict fluid responsiveness index, however it failed to assess fluid responsiveness effectively when IAP is further raised up to 25 mm Hg or more.

Objective To investigate the augmentation plating for femoral fractures and postoperative femoral nonunion. Methods A retrospective analysis was conducted of 60 patients with femoral fracture or postoperative femoral nonunion who had been treated with augmentation plating from January 2008 to July 2015. They were 36 males and 24 females, aged from 15 to 79 years ( average, 43. 4 years ) . Of them, 20 cases suffered nonunion following intramedullary nailing of femoral shaft fracture, 18 nonunion following lateral plating for femoral distal or lower fracture, and 22 femoral distal or lower fracture complicated with comminuted fracture of medial column. An incision ranging from 6 to 10 cm was made around the fracture ends for augmentative plating for all the patients. Autogenous iliac bone graft was performed in patients with atrophic nonunion or ob-vious gap after reduction of the comminuted fracture. Operation time, intraoperative bleeding, healing time, complications, and functionary recovery of the affected knee were recorded. Results The operation time averaged 121. 5 min and the intraoperative bleeding 356. 3 mL. All the patients were followed up for 12 to 36 months ( average, 16. 9 months ) . All the fractures and nonunions healed after an average time of 4. 2 months ( from 3 to 4 months ) . The time for initial partial weight-bearing averaged 4. 5 weeks ( from 2 to 6 weeks ) and the time for initial full weight bearing 3. 3 months ( from 2 to 4 months ) . Evaluation according to the Karlstrom and Olerud criteria at the last follow-up revealed 29 excellent, 24 good and 7 fair cases, yielding an excellent and good rate of 88. 3％. No infection, loosening, bending or breaking of internal implants, or refracture was noted during follow-ups. Conclusion Augmentation plating through a small incision can lead to fine outcomes for femoral fractures and postoperative femoral nonunion, because it makes up the deficient stability of original in-ternal fixation, reduces the dislocated bone blocks and provides bone grafting to improve defective local bone structure and defective osteogenesis.

To understand the possibility of schistosomiasis transmission on the East Route Project of the South-to-North Water Diversion Project, a survey of endemic status of schistosomiasis in Weishan Lake area was conducted. A cluster sampling of 2086 boatmen were screened with DDIA Kit, and the positive ones were examined with Kato-Katz technique. Meanwhile, a questionnaire survey about schistosomiasis control was carried out to collect the data about the boatmen's general information and knowledge , attitude and practice (KAP). The results showed there were no schistosomiasis patients. However, there exist potential risk factors for schistosomiasis transmission because of the bad hygiene habits and the poor knowledge of schistosomiasis prevention in boatmen.

Objective To investigate the feasibility and practical value of the integration of humanistic concern into clinical problem-based learning ( PBL ) teaching . Methods A total of 112 undergraduate medical interns in Department of Colorectal Surgery were enrolled and randomly divided into experimental group receiving PBL teaching integrated with humanistic concern and control group receiving PBL teaching alone. Theoretical examination, operation examination, and patient satisfaction survey were performed after practice training to evaluate the teaching effect of the two groups . GraphPad Prism 6 software was used for statistical analysis of data, and the t-test was used for comparison of continuous data between the two groups. Results Compared with the control group, the experimental group had significantly higher scores of medical history collection (22.57±2.63 vs 20.87±3.08, t=3.124, P=0.002) and operation skills (31.42±2.89 vs 29.87±4.72, t=2.107, P=0.037), but there were no significant differences between the two groups in the scores of theoretical examination (90.60±3.19 vs 90.52±3.38, t=0.129, P=0.898) and medical record writing (20.78±2.79 vs 20.65±3.51, t=0.215, P=0.830). Compared with the control group, the experimental group had a significantly higher degree of patient satisfaction with service attitude (3.94±1.07 vs 3.22±1.09, t=3.256, P=0.002), trust (3.85±1.16 vs 3.22±1.05, t=2.759, P=0.007), and communication skills (3.92±1.03 vs 3.16±1.03, t=3.652, P=0.000), but there were no significant differences between the two groups in the scores of operating skills (3.60±1.09 vs 3.67±1.10, t=0.281, P=0.779) and arrangement of medical procedures (2.74 ±1.10 vs 3.02 ±1.02, t=1.312, P=0.193). Conclusion The integration of humanistic concern into PBL teaching of anorectal surgery can improve students' clinical operation ability and degree of patient satisfaction.

Air embolism is a rare complication of upper endoscopy and potentially causes life-threatening events. A 67-year-old man with a history of surgery of cardiac carcinoma and pancreatic neuroendocrine tumor underwent painless upper endoscopy because of tarry stools. During the procedure, air embolism developed, which caused decreased pulse oxygen saturation and delayed sedation recovery. He recovered with some weakness of the left upper limb in the intensive care unit without hyperbaric oxygen therapy. The etiology, clinical manifestations, and treatments of air embolism are discussed based on the literature reports. Although air embolism is uncommon in endoscopic examinations, the patients’ outcomes could be improved if clinicians are alert to this potential complication, and promptly start proper diagnostic and therapeutic measures.
Aged ; Embolism, Air ; Endoscopy ; Heart Neoplasms ; Humans ; Hyperbaric Oxygenation ; Intensive Care Units ; Neuroendocrine Tumors ; Oxygen ; Upper Extremity

Objective To explore the clinical application of antcrolateral thigh flap transplantation in repairing wound around the knee with descending genicular artery as the recipient vessel,when anterior or posterior tibial vessel could not be utilized.Methods From January,2015 to May,2017,free anterolateral thigh flaps obtained from anastomosis of descending genicular artery and great saphenous vein were transplanted to repair the skin soft tissue defect around the knee combined with tendon and bone exposure in 7 patients,after preoperative color Doppler sonography ultrasound (CDU) for precise positioning.There were 4 males and 3 females,with the flap area ranging from 18.0 cm×8.0 cm-38.0 cm×8.0 cm.All of the donor sites were sutured directly.Postoperative followedup was done termly.Results All the patients were followed-up for 6 to 14 months,with an average of 8.9 months.Typically,2 cases had large defect areas,with distal flap necrosis of 6.0 cm and 4.0 cm,respectively,which were resected and achieved secondary skin graft healing on the residual surface.Additionally,4 cases had completely survived flaps and achieved secondary skin graft healing on the residual surface.The remaining 1 case had completely survived flap,but the distal flap near the anteromedial tibia developed bone exposure as a result of the complicated osteomyelitis.As a result,the patient received gastrocnemius myocutaneous flap to repair the wound.Conclusion Anterolateral thigh flap transplantation in repairing skin soft tissue defect wound around the knee,with descending genicular artery as the recipient vessel,can achieve satisfactory clinical efficacy,which can serve as one choice for flap repair in wound around the knee.

Objective: This study’s objective is to assess the efficacy and safety of Pulsed Magnetic Therapy System (PMTS) in improving insomnia disorder. Methods: Participants with insomnia disorder were randomly assigned to receive either PMTS or sham treatment for four weeks (n= 153; PMTS: 76, sham: 77). Primary outcomes are the Insomnia Severity Index (ISI) scores at week 0 (baseline), 1, 2, 3, 4 (treatment), and 5 (follow-up). Secondary outcomes are the Pittsburgh Sleep Quality Index at baseline and week 4, and weekly sleep diary-derived values for sleep latency, sleep efficiency, real sleep time, waking after sleep onset, and sleep duration. Results: The ISI scores of the PMTS group and the sham group were 7.13±0.50, 11.07±0.51 at week 4, respectively. There was a significant group×time interaction for ISI (F3.214, 485.271=24.25, p<0.001, ηp 2=0.138). Only the PMTS group experienced continuous improvement throughout the study; in contrast, the sham group only experienced a modest improvement after the first week of therapy. At the end of the treatment and one week after it, the response of the PMTS group were 69.7% (95% confidence interval [CI]: 58.6%–79.0%), 75.0% (95% CI: 64.1%–83.4%), respectively, which were higher than the response of the sham group (p<0.001). For each of the secondary outcomes, similar group×time interactions were discovered. The effects of the treatment persisted for at least a week. Conclusion PMTS is safe and effective in improving insomnia disorders.