OBJECTIVE:To observe the effect of cinepazide maleate combined with Xueshuantong injection on the blood sup-ply of subcutaneous artery after flap transplantation. METHODS:68 patients with cross-regional combined with flap transplantation in extremity soft tissue injury were randomly divided into observation group and control group. The roast lamp irradiation in the flap transplantation and ambulation prohibited,alcohol and tobacco prohibited were carried out as rountine treatment. On this basis, control group was treated with cephalosporins,papaverine and low molecular dextran after flap transplantation. Observation group was treated with cinepazide maleate 8 ml adding into 0.9% Sodium chloride injection 250 ml by intravenous infusion,once a day+Xueshuantong injection 5 ml adding into 0.9% Sodium chloride injection 250 ml by intravenous infusion,once a day. The course for both was 14 d. The clinic data was observed,including blood rheological indicators (whole blood high cut,whole blood cut, whole blood low cut,plasma viscosity and RBC aggregation index),and coagulation function indicators [thrombin time(TT),acti-vated partial thromboplastin time(APTT),prothrombin time(PT)and GB normalized ratio(INR)] before and after 1,3 and 7 d of surgery,and the postoperative incidence of arterial vascular crisis within 7 d and adverse reactions. RESULTS:There was no sig-nificant difference in the incidence of arterial vascular crisis in 2 groups after 1 and 2 d of surgery(P>0.05);the incidence of arte-rial vascular crisis in 3,4,5,6 and 7 d in observation group was significantly lower than control group,with significant difference (P<0.05). After 3 and 7 d of surgery,blood rheological indicators and 1,3 and 7 d of coagulation function indicators in 2 groups were significantly better than before,and observation group was better than control group,with significant difference(P<0.05). There were no significant difference in the incidence of adverse reactions between 2 groups(P>0.05). CONCLUSIONS:Cinepa-zide maleate combined with Xueshuantong injection can effectively improve the blood rheological indicators and coagulation func-tion indicators of patients,reduce the incidence of arterial vascular crisis,with good safety.

Objective To investigate the long-term effects of propofol postconditioning on cerebral ischemia-reperfusion (I/R) injury in rats.Methods One hundred and forty-four healthy male SD rats,aged 7-8 weeks,weighing 250-280 g,were equally and randomly divided into 4 groups:sham operation group (group S),I/R group,propofol postconditioning group (group P) and intralipid group (group I).The animals were anesthetized with intraperitoneal 10％ chloral hydrate 300 mg/kg.Focal cerebral ischemia was induced by occlusion of middle cerebral artery for 60 min using a nylon thread with a rounded tip which was inserted into internal carotid artery in groups I/R,P and I.Two hour infusion of propofol was started at 20 mg· kg- 1· h- 1 immediately after the onset of reperfusion in group P,while the equal volume of normal saline was given instead in S and I/R groups,and 10％ intralipid was given instead in group I.Five rats in each group were chosen on day 1,14 and 28 after operation for assessment of neurological behavior and detection of cerebral infarct volume.Six rats in each group were chosen to perform Morris water maze test at day 9 and 23 after operation for 6 consecutive days.Five rats in each group were sacrificed on day 1,14 and 28 after operation and the hippocampal tissues were isolated for determination of the expression of GluR1-containing AMPA (GluR1-AMPA) receptor and GluR1-AMPA receptor in cell membrane.The ratio of GluR1-AMPA receptor in cell membrane/GluR1-AMPA receptor was calculated.Results Compared with group S,neurological behavior scores and the number of animals' swimming across the platform were significantly decreased,cerebral infarct volume was significantly enlarged,escape latency was significantly prolonged,and ratio of GluR1-AMPA receptor in cell membrane/GluR1-AMPA receptor was significantly increased ( P ＜ 0.05),while no significant change in the expression of GluR1-AMPA receptor was found in I/R group ( P ＞0.05).Propofol postconditioning inhibited cerebral I/R-induced changes mentioned above ( P ＜ 0.05).Conclusion The brain protection against focal I/R injury by propofol postconditioning can last for 28 days after operation and the inhibition of trafficking of GluR1-AMPA receptor from cytoplasm to cell membrane may contribute to this long-term brain protection.

Objective To investigate MRI signal features and MRI appearances of patients with advanced stage in polyacrylamide hydrophilic gel injection for facial plasty.Methods In this study,MRI of 11 cases with 23 polyacrylamide hydrophilic gel injection of facial plasty for 6 to 10 years were retrospectively reviewed.All images were acquired with GE 3.0T MR imaging unit.MR sequences,including FSE T1WI,FSE FS T2WI,and STIR were applied with 8-channel brain coil.MRIs sliced through the maxillofacial region in the transverse,coronal and sagittal planes.Results In 11 cases of 23 polyacrylamide hydrophilic gel injection,there were different degrees of capsule rupture and induration in 6 polyacrylamide hydrophilic gel injection,and the images showed sporadic callosities such as subcutaneous nodules and nodules in glands or muscles ; hydrogel migration in 8 polyacrylamide hydrophilic gel injection.Secondary deformity occured in 80 ％ cases,in which the most cases were induced by hydrogel migration.Conclusions Magnetic resonance imaging can make clear of the type of rupture and the distribution leakage of polyacrylamide hydrophilic gel for facial plasty and it is an ideal approach for advanced patients with polyacrylamide hydrophilic gel injection for follow-up.

Objective To discuss the effect of the bedside shielding protection on the first and second operators against position radiation in percutaneous coronary intervention.Methods The surface entrance dosage rate for the first and second operators at 125 cm height with and without radiation protection shielding (provided separately) were measured.The t-test was used for statistical analysis of arithmetic mean values of dosage rates.And the effect of bedside shielding protection was calculated.Results The position radiation dosage rate at which the first operator exposed was significantly higher than that for the second in the case of no bedside protection (t =97.1-2 263.0,P ＜ 0.05),whereas the dosage rate at which the first operator (except for the left foot position) exposed was significantly lower than that for the second in the case of no bedside protection (t =-80.9-275.1,P ＜ 0.05).The shielding effect of bedside protection on the first and second operators was in the range of 92.26％-99.36％ and 27.83％-97.90％,respectively.Conclusions The bedside protection may effectively reduce position radiation dose to patients and the use of bedside protection changed the trends in the dose distribution in operators' standing region.Attention should be focused on the radiation protection of the second operators in daily work by making full use of bedside protection.

Cause of Death ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Hand, Foot and Mouth Disease ; epidemiology ; mortality ; Humans ; Infant ; Male

Objective To investigate the content of cadmium in shellfish in Guangdong Province and make dietary exposure assessment of cadmium in shellfish.Methods The shellfish samples were collected from Pearl River Delta,Eastern and Western Guangdong Province using random sampling method.Point assessment method was used to evaluate the exposure of dietary cadmium intake from shellfish.The risk of dietary cadmium exposure from shellfish were evaluated.Results Three hundred and seven samples were included in the analysis.The median concentration of cadmium in shellfish was 0.630 mg/kg and the exceeding standard rate was 23.8％ (73/307).The exceeding standard rates in Eastern Guangdong,Western Guangdong and Pearl River Delta were 19.4％ (13/67),23.5％ (16/68),and 25.6％ (44/172),respectively.The corresponding median concentration of cadmium were 0.530,0.806 and 0.853 mg/kg,and the difference was not statistically significant (x2 =0.94,P ＞ 0.05).The average (P50) and high level (P97.5) daily intake of cadmium from shellfish by the total survey population was 0.957 μg/d,and 4.511 μg/d,respectively.The monthly intake of cadmium associated with shellfish calculated from average and P97.5 exposure doses accounted for 1.91％ and 9.02％ of PTMI,respectively.Conclusion The cadmium content of some shellfish in Guangdong Province exceeded the standard.However,the cadmium intake from shellfish by the survey population was not high.

Objective To analyze the relationship between plasma concentration and efficacy , adverse drug reactions by monitoring vancomycin serum concentrations for appropriately treating the infections caused by methicillin‐resistant Staphylococcus aureus or other gram‐positive cocci .Methods Vancomycin concentration was monitored in the patients with indications for vancomycin therapy .Blood sample was taken after vancomycin was administered for at least 4 doses .The blood sample collected within 30 minutes before dosing was used to determine the trough blood concentration .The samples were taken within 30 minutes to 1 hour after infusion of vancomycin were used to estimate the peak concentration by fluorescence polarization immunoassay .The clinical data were collected at the same time to analyze clinical efficacy and safety .Results Vancomycin trough concentration ranged from 3 .22 mg/L to 50 .79 mg/L in 25 patients ,specifically ,＜ 5 mg/L in 3 cases ,5‐＜10 mg/L in 11 cases ,10‐15 mg/L in 3 cases ,and > 15 mg/L in 8 csaes .Peak concentration ranged from 13 .57 mg/L to 60 .47 mg/L ,specifically ,＜ 25 mg/L in 14 cases ,25‐40 mg/L in 7 cases ,and > 40 mg/L in 4 cases .The infection was cured in 80 .0% (20/25) of the patients .The gram‐positive cocci were eradicated in 87 .5% (21/24) of the patients .The dosage of vancomycin was adjusted in 13 patients according to the results of blood concentration monitoring .Majority of these patients (12/13 ,92 .3% ) were cured .Renal impairment was observed in 4 patients .Conclusions Vancomycin is safe and effective in treatment of methicillin‐resistant Staphylococcus aureus and other gram‐positive bacterial infections . Vacomycin concentration varies from person to person . Serum concentration monitoring is required to achieve best outcomes and the goal of individualized treatment of vancomycin.

Objective To investigate the predictive value of heart rate variability to,and its correlation with ventricular arrhythmias in patients with structural heart disease.Methods 24 hours ambulatory electrocardiogram monitoring was administered during March 2012 and October 2013,and standard deviation of the NN interval (SDNN) in the time-domain analysis and sympathetic/vagal ratio in the frequency domain analysis were collected and retrospectively analyzed in 300 patients.Results The incidence rate of ventricular arrhythmias was higher in patients with structural heart disease in SDNN ＜100 ms group than in control group [4.1％ (3/74) vs.39.5％ (45/114),P＜0.01].The sympathetic/vagal ratio was significantly higher in group with structural heart disease and ventricular arrhythmia than in control group(19.9 ±2.3 vs.10.1 ±1.7,P＜0.01)The time-domain index SDNN was negatively correlated with the frequency domain index (sympathetic/vagal ratio) (r=-0.819,P ＜0.01).Conclusions SDNN ＜100ms and the increased sympathetic/vagal ratio can be considered as the predictors of ventricular arrhythmias in patients with structural heart disease.

OBJECTIVE: To explore the clinical characteristics, diagnosis method and treatment of petrous apex cholesteatoma. METHOD: A retrospective analysis was taken with respects to the clinical characteristics, diagnosis and surgical management of 38 patients who underwent surgery for petrous apex cholesteatoma in our department. RESULT: (1)31 patients had unilateral hearing loss and facial paralysis of different degree, 27 patients were firstly characterized with hearing loss, and followed by facial paralysis. 6 cases had facial paralysis as the main performance. (2)17 patients had syndrome of tinnitus, and 15 patients had syndrome of vertigo and 4 cases of severe pain of ear. (3)All patients had petrous bone destroy with high resolution CT scan, while MRI suggests the presence of pathological changes in petrous apex. (4)All patients were taken surgeries to remove the lesion, and translabyrinth approach was chosen for 23 patients, middle cranial fossa approach is 12, while 3 case has choose endoscopic approach. 8 cases were operated with facial nerve decompression. 7 cases was taken end to end anastomosis. 3 cases of great auricular nerve transplantation. There is no recurrence in follow-up of 1 years to 2 years. CONCLUSION The clinical manifestations of petrous apex cholesteatoma lack specificity, and high resolution CT and MRI has important value in the diagnosis of petrous apex cholesteatoma. The strategy of surgical operation should be taken according to the classification, location of petrous apex cholesteatoma as well as hearing level and facial nerve function with patients.
Cholesteatoma ; pathology ; surgery ; Cranial Fossa, Middle ; Decompression, Surgical ; Facial Nerve ; Facial Paralysis ; Hearing Loss ; Hearing Loss, Unilateral ; Humans ; Magnetic Resonance Imaging ; Petrous Bone ; Recurrence ; Retrospective Studies ; Tomography, X-Ray Computed

We identified the routes of infection and evaluate the effect of disinfection on the field of an outbreak of an-thrax in a village of Wengan County ,Guizhou ,China ,thus trying to provide with basis for the implementation of policies for pre-vention and control of anthrax .The authors gathered the cases information by searching and interviewing the targeted persons house by house ,and reviewed the medical records in hospitals .The samples including patient’s discharging fluid ,residues of died horse ,and soil from the places where the villagers dismembered horse were gathered and cultured for Bacillus anthracis . The technique of multiple-locus variable-number tandem repeat analysis (MLVA-8) was applied for revealing the genetic rela-tionships among those isolated Bacillus anthracis strains .Five cases of cutaneous anthrax occurred in the outbreak and the total attack rate was 7 .58% (5/66) among those contactors evolved in the activity of carrying ,dismembering ,washing ,chopping and eating the died horse .The attack rate was 100% (3/3) for those who carried ,dismembered ,washed ,chopped and ate that horse ,100% (1/1) for those who carried ,dismembered and ate ,and 7 .14% (1/14) for those who washed ,chopped and ate . The 25% (1/4) of the samples of discharging fluid from the cases with cutaneous anthrax were positive .After disinfection , 15 .38% (4/26) of the soil samples retained positive .The genetic similarity was 100% among the 5 isolate strains .The results suggested that the outbreak of anthrax in villagers occurred through the activities of carrying ,dismembering ,washing and chop-ping the died horse .Strengthening the risk communication and disinfection of the dismemberment places should be the crucial strategies to prevent and control anthrax epidemics in Guizhou in the future .