Objective To investigate an early diagnostic method and a rapid efficient treatment method to teat osteofascial compartment syndrome(OCS). Methods From January 2007 through December 2008,16 male patients with OCS were treated in our department.They were aged from 15 to 55 years (average,32 years).Twelve patients had OCS at the leg and 4 at the foot.All patients had no vascular or nerval injury.The modified Whiteside method was used to measure the pressue of the osteofascial compartment.All patients were treated with open decompression and vacuum sealing drainage (VSD).After swelling subsided,the wounds were directly sutured,decompresively sutured or treated with skin grafting. Merchant scoring was used to evaluate the postoperative efficacy in terms of limb-affected function,pain,gait,joint function,joint stability and range of motion. Results All patients were followed up for 12 to 14 months (average,13 months).All incisions closed up.Fourteen patients obtained excellent recovery of the function and sensation of the distal limb-affected;one patient had hypoesthesia and numbness at the the distal limb-affected; one patient had contracture,numbness and functional disturbance.By the Merchant scoring system,9 cases were excellent,5 good and 2 fair,giving a good to excellent rate of 87.5％. Conclusions The modified Whiteside method used to meausre the interstitial pressure is a reliable early diagnostic method for OCS.Decompression plus VSD may lead to rapid and efficient treatment of OCS and a reduced disability rate of the limb-affected.

Objective To better understanding the clinical presentations of phaeohyphomycosis,and improve the diagnosis and management of the disease.Methods We reported a case of pulmonary phaeohyphomycosis caused by Exophiala jeanselmei at the First Affiliated Hospital of Guangzhou Medical University in 2008,and reviewed the relevant literature.The clinical,radio-logical and etiological features were summarized based on this case and the other 23 phaeohyphomycosis patients reported in China from January 1995 to August 2013.Results 24 Chinese cases of phaeohyphomycosis have been reported to date,including 15 males and 9 females.The age of these patients ranged from 4 to 76 (mean 40.0±21 .8)years old.Seventeen patients were otherwise healthy.The other 7 patients had complications.Clinical presentations of phaeohyphomycosis vary widely,including cutaneous and subcutaneous infection in 18 cases,pulmonary and central nervous system involvement in two cases each,para-nasal sinus and palpebral conjunctiva infection one case each.The diagnosis of 18 cases were confirmed both microbiologically and histologically.One case was confirmed histologically alone.Five cases were identified microbiologically alone.The samples for culture were collected from skin abscess (1/5 ),pulmonary tissue (2/5 ),and cervical spinal fluid (2/5 ),respectively. Twenty-two strains of causative organisms were identified,7 of which were Exophiala jeanselmei .Twenty-three patients received treatment.They were cured by antifungal agents alone (18)or in conjunction with surgical resection (4 ),or assisted with XD-635AB-based photodynamic laser therapy (1).Specifically,10 pa-tients were cured by itraconazole alone.Conclusions In China, most patients of phaeohyphomycosis have concurrent conditions or have previously received immunosuppressive agents and cor-ticosteroids.Cutaneous and subcutaneous infection were most common,located mainly on limbs,face,chest and abdominal skin.The most frequently isolated pathogen is Exophiala jeanselmei ,followed by Phialophora verrucosa and Exophiala spinifera .Itraconazole therapy would be very effective.Susceptibility testing is very useful in case of refractory infection.

ObjectiveTo investigate the clinical features and risk factors of patient with Wegener's granulomatosis complicated with pulmonary infection.Methods Patients with Wegener's granulomatosis admitted to our hospital in the past 11 years were retrospectively analyzed.Comparisons between groups were performed by t tests or Fisher test.ResultsPulmonary infection occurred in 27 cases with an incidence rate of 29％.Twenty-six percent of pulmonary infections occurred at the initial diagnosis,and 44％ occurred within 6 months,while 30％ occurred later than 6 months.The clinical manifestations of pulmonary infection were productive cough (89％),hemoptysis (63％),fever and fatigue (56％),chest pain and pactoralgia (33％).The most common causative pathogen were bacteria(59％ ),fungi(37％ ),and tubercle bacillus(37％ ).Sinus infection(P=0.01),hypoproteinemia(P=0.03),hypoimmunoglobulinemia (P=0.007),and methylprednisolone pulse therapy(P=0.002) were the risk factors for pulmonary infection.ConclusionThe occurrence of Wegener's granulomatosis complicated with pulmonary infection is high within 6 months.The most common clinical manifestation is productive cough.The most common causative pathogens are bacteria,tubercle bacillus and fungi.Sinus infection,hypoproteinemia,hypoimmunoglobulinemia,and methylprednisolone pulse therapy are risk factors of pulmonary infection.

Objectives To search for the pathogenesis of vaseular endothelial injury and its clinical significance.Methods 36 patients with acute lower respiratory trect infection(ALRI)and 30 healthy controls were envolved. Circulating endothelial cells (CEC)and nitric oxide (NO) levels were tested.Results Circulating nitrite/nitra levels,the stable metabolic products of NO,were found to be significantly higher in the patients with ALRI (44.6?22.6umol/L) than that in the controls (24.5?14.1umoI /L, P

Objective To evaluate the efficacy of locally administered dexamethasone for prevention of low back pain after labor epidural analgesia.Methods Two hundred nulliparous parturients who required labor epidural analgesia,of ASA physical status Ⅰ or Ⅱ,were randomly divided into 2 groups (n =100 each) using a random number table:control group (group C) and dexamethasone group (group D)).In group D,lidocaine 4 ml and dexamethasone 1 ml (5 mg) were injected around the puncture site.In group C,lidocaine 4 ml and normal saline 1 ml were injected around the puncture site.Epidural puncture was performed after local administration.According to the results of epidural puncture,each group was further divided into two subgroups:single puncture group (Cs subgroup,Ds subgroup) and repetitive puncture group (Cr subgroup,Dr subgroup).The patients were followed up for 72 h,and the development of low back pain was recorded.Results Compared to group C,the incidence of low back pain was significantly decreased,and pain was reduced in group D.The incidence of low back pain was significantly lower in Ds group than in Cs group,and in Dr group than in Cr group.Conclusion Locally administered dexamethasone 5 mg is helpful in reducing low back pain after labor epidural anesthesia.

Objective To investigate the clinical features and risk factors of primary Sjogren's syndrome (pSS) patients with malignancies.Methods The clinical features of 29 pSS patients with malignancies from January 1985 to March 2008 were retrospectively analyzed.Results The ratio of pSS with malignancies to all hospitalized pSS patients from January 1985 to March 2008 was 2.2%.In these patients,8 were lymphoma,4 were breast cancers,2 were myeloma,2 were thymoma,2 were lung cancer,2 were gastric carcinoma,2 were hepatoma,2 were colon carcinoma and 2 were tongue cancer.Uterine cervix cancer,renal carcinoma,thyroid carcinoma and carcinoma of parotid gland each were fund in this series of patients.Conclusion The most common malignancy in pSS is lymphoma and the major of pathological type is B cell non-Hodgkin's lymphoma.

The endophytic microorganisms found widely in many kinds of plants mediate various effects to theirs hosts. In this study, seven different dominant endophytes (SDE01 to 07) isolated from a Hy-peraccumulator-Solanum nigrum L. were resistant to Cd2+, and the strain SDE06 survived even in the medium containing 80 mg/L of Cd2+. Bacteria strain SDE06 was identified as Bacillus sp.. The removal of Cd2+ of SDE06 in different conditions were studied. Under the optimal conditions, the incubating time was 36 h, the solution pH 6.0, the temperature was 37?C and the Cd2+ concentration of medium was 20 mg/L, the highest removal rate was up to 80.2% at this condition.

39℃)developed at the progressive stage of this disease.Physical examination showed variously sized,round or oval,atrophic and variola-like scars along with scattered erythematous patches,papules, necrosis and crusts on the face and extremities.The face was edematous,and there were some edematous and erythematous plaques with a necrotic center on the legs and arms.Histological examination revealed a massive infiltration with atypical CD8~+lymphocytes around the vessels and appendages in dermis.A diagnosis of CD8~+cutaneous T-cell lymphoma(CTCL)was made.Glucocorticoid and immunosuppressants were effective in controlling the condition.Up to the time of the writing,there has not been any definite evidence of systemic involvement.

Purpose To analyze the correlations between PD-L1 expression and clinicopathological factors and their prognostic values in esophageal squamous cell carcinoma (ESCC) patients.Methods PD-L1 expression in the primary tumors from 253 patients with ESCC was evaluated using tissue microarray and immunohistochemistry (IHC).PD-L1 positivity was defined as positive staining of 1％ and 5％ tumor cells.Survival curves were constructed by using the Kaplan-Meier method.Univariate and multivariate Cox proportional hazard regression models were performed to identify associations with outcome variables.Results Overall,tumoral PD-L1 expression was potentially associated with favorable DFS and OS.When the patients were stratified into stage Ⅰ + Ⅱ (60.9％,154/253) and stage Ⅲ + Ⅳa (39.1％,99/253),the prognostic role was not consistent.In patients with stage Ⅰ + Ⅱ disease,tumoral PD-L1 expression was associated with better DFS and OS upon multivariate analysis (1％ as the cutoff:P =0.046 and 0.021,5％ as the cutoff:P=0.011 and0.004).However,PD-L1 expression was not correlated with prognosis in patients with stage Ⅲ + Ⅳa disease (1％ as the cutoff:P =0.586 and 0.682,5％ as the cutoff:P =0.807 and 0.620).Conclusion The prognostic role of tumoral PDL expression is variable in different stages of ESCC,and tumoral PDL expression is an independent favorable predictor in ESCC patients with Stage Ⅰ-Ⅱ disease,but not in stage Ⅲ-Ⅳa or lymph node metastasis.

OBJECTIVETo explore the effects of noise exposure level and cumulative noise exposure (CNE) on the relationship between rs2070424 and rs10432782 SNPs in SOD1 and the susceptibility to noise-induced hearing loss (NIHL).

METHODSA case-control study was performed for investigating the effects of environmental risk factors on the susceptibility to NIHL in 201 sensitive workers and 202 resistant workers.A questionnaire was utilized to investigate the occupational health and to identify the occupational risk factors. The noise exposure levels were detected according to the Chinese standard Measurement of noise in the workplace (GBZ/T 189.8-2007). The peripheral blood samples (5 ml blood for each sample) were from sensitive workers and resistant workers. Genomic DNA was extracted on the basis of the standard procedures of Takara kit. SNPs were detected using standard procedures of TaqMan probe allele identification method.

RESULTSIn group exposed to 85 - 92 dB noise (A), the risk of NIHL in the subjects with the AA genotype of rs2070424 was lower than that in the subjects with the GG genotype, OR = 0.37 (95%CI: 0.17∼ 0.80). In group exposed to > 82 dB CNE (A), the AA genotype of rs2070424 is a protective factor of NIHL, as compared with the GG genotype, OR = 0.25 (95%CI: 0.09 ∼ 0.70). In group exposed to 85 - 92 dB noise (A), the risk of NIHL in the subjects with the GG genotype of rs10432782 was compared with the risk of NIHL in the subjects with the TT genotype, OR = 3.17 (95%CI: 1.16 ∼ 6.89). The GT genotype was compared with TT genotype, OR = 2.39 (95%CI: 1.16 ∼ 4.97). In group exposed to 75 ∼ 82 dB CNE (A), the risk of NIHL in the subjects with the GG genotype was compared with the risk of NIHL in the subjects with the TT genotype, OR = 2.35 (95%CI: 0.96 ∼ 5.72), P = 0.06. The GG genotype may bea risk factor of NIHJ.

CONCLUSIONThe noise exposure level and CNE may influence the relationship between rs2070424, rs10432782 SNPs in SOD1 and noise-induced hearing loss.

Adult ; Case-Control Studies ; Female ; Genetic Predisposition to Disease ; Genotype ; Hearing Loss, Noise-Induced ; etiology ; genetics ; Humans ; Male ; Noise, Occupational ; adverse effects ; Polymorphism, Single Nucleotide ; Superoxide Dismutase ; genetics ; Superoxide Dismutase-1 ; Surveys and Questionnaires