Objective To introduce a new surgical method of reconstructing A ch illes tendon by transfer of the soleus tendon flap. Methods The method was desig ned on the basis of the anatomical characteristics of the superficial muscles as sociated with Achilles tendon. It was applied to treat 12 patients with Achilles tendon defects. These patients were followed up for 0.5 to 6 years (average 39 months). Results The curative effect of the method were assessed according to Ar ner-Lindholms evaluation criteria. 9 cases were rated as excellent, 2 fine an d 1 poor, with the total excellent and fine rate being 92%. Conclusions ①Misdi agnosis and improper initial treatment are the major causes of Achilles tendon d efects. ②Systematic training after operation is very important for good curativ e effects. ③The method mentioned above brings about less trauma, less negative effects on blood supply to Achilles tendon, and good healing after operation.

Nephrotic syndrome(NS)is the most frequent cause of glomerular disease in children,it can deve-lop many complications,including infection,thrombosis and acute kidney injury,while acute adrenocortical suppression is a complication of some drugs administration. This review focuses on the pathophysiology and management of common complications in patients with NS.

Objective To investigate the current status and influencing factors of falls self-efficacy among the stroke elderly patients.Methods Totally 170 elderly stroke patients were investigated using the Modified Falls Efficacy Scale (MFES),and they were tested with Berg Balance Scale (BBS) and Time Up and Go Test (TUGT).Results The average score of falls self-efficacy was 108.There were 50.6％ elderly stroke patients assigned to the group with low falls self-efficacy.Multiple Logistic regression analysis indicated that impairments of balance and mobility,severe stroke-related disability were the independent influencing factors associated with FOF,which could explain 52.0％ of variations.Conclusions Low falls self-efficacy among the stroke elderly patients is a common complaint,nurses and physicians should focus on this problem,interventions combining exercise and education of accidental falls should be taken to improve falls self-efficacy of elderly stroke patients,and prevent falls finally.

Objective To study risk factors of cardiovascular disease (CVD) and status of bone mineral density (BMD) in women with hypoestrogenism.Methods From Jul 2011 to April 2013,a total of 256 women with hypoestrogenism in the First Affiliated Hospital of Shanxi Medical University were enrolled in this retrospective study,which were divided into four groups:133 women in ppausal group,25 women in premature ovarian failure (POF) group,67 women in menopausal transition group and 31 women in premature ovarian failure transition group.General statue,CVD risk factors and BMD were compared among four groups.General statue include menopausal period,menopausal symptoms (Kupperman Index),CVD risk factors include body mass index,blood pressure,waist circumference,waist-hip ratio,blood lipids and glucose,BMD include left hip,lumbar spine bone mineral density and T or Z value.Results (1) The median menopausal period were 3.4 years in postmenopausal group and 3.6 years in premature ovarian failure group,which did not show no statistical difference (P ＞ 0.05).Kupperman Index in four groups were 12 in postmenopausal group,9 in POF group,9 in menopausal transition group and 8 in premature ovarian failure transition group,which reached statistical difference (P ＜ 0.05).(2) The difference of body mass index (BMI),waist circumference,waist-hip ratio,diastolic blood pressure were no statistically significant among four groups(P ＞ 0.05) ; the systolic blood pressure in four groups were 120,110,110,110 mm Hg (1 mm Hg =0.133 kPa),their differences were statistically significance (P ＜ 0.05); the high-density lipoprotein (HDL-C) was 1.6 mmol/L in postmenopausal group,and 1.3 mmol/L in premature ovarian failure transition group,their differences were all statistically significance (P ＜ 0.05) ; the difference of the fasting plasma glucose (FPG) was not statistically different in 4 groups (P ＞0.05).(3) The abnormal rate of lower bone mass in lumbar spine were 57％ (46/81) postmenopausal group,8/15 in POF group,32％ (9/28) in menopausal transition group,12/19 in premature ovarian failure transition group,and osteoporosis was 9％ (7/81),3/15,1％ (3/28)and 0 respectively,their differences were statistically different (P ＜ 0.05) ; the abnormal rate of BMD of left hip and lumbar spine of 11/15 and 12/16 in POF group was higher than 65％ (53/81) in postmenopausal group.In the mean time,the abnormal rate of BMD of left hip and lumbar spine were,12/19 and 10/20 in premature ovarian failure transition group,which were significantly higher than 43％ (12/28) and 39％ (12/31) in the menopausal transition group.Conclusions The menopausal symptoms resulting from hypoestrogenism in natural postmenopausal women are mostly remarkable.The decrease of BMD in lumbar spine is more significant than that of left hip among postmenopausal women.Women with earlier menopause was prone to cause the changes of blood fat and abnormal of BMD,especially HDL-C decreased significantly compared with those natural postmenopause,it is more likely to cause CVD and osteoporosis.

Objective To explore the effectiveness,feasibility and suitability of the guideline for nasogastric tube feeding in adult patients.Methods Based on the Ottawa Model of Research Use as framework,we screened relevant evidence from guidelines,and developed new nasogastric tube feeding nursing procedure.Nursing knowledge,the rate of compliance to new procedure and the incidence of complications of nasogastric tube feeding were used to evaluate the clinical effects of the guideline.Results Nurses' knowledge increased significantly(P＜0.05).Nurses had a high degree of implementation of the new procedure,with the rate of over 85％.Compared with the control group,the rate of complications of nasogastric tube feeing in the experimental group was lower than that in the control group.Especially,the rates of reflux and aspiration were significantly lower(P＜0.05).Both rates of tube shedding and skin damage in the intervention group were decreased significantly(P＜0.05).Conclusion The nasal feeding nursing guideline in our clinical scenarios has its effectiveness,feasibility and suitability.

Objective To evaluate the protective effect of leukocyte-depleted warm blood cardioplegia on immature myocardium in infant.Methods Thirty infants with congenital heart disease whose American Society of Anesthesiologists(ASA) were Ⅱ-Ⅲ,aortic clamping time and bypass time were more than 30,40 minutes were respectively selected and divided into 2 groups:Experimental group and control group.Experimental group were perfused with leukocyte-depleted warm blood cardioplegia while control group perfused with common warm blood cardiplegia.Under monitoring the hemodynamics at surgery,the serum levels of troponin I(cTnI) and intercellular adhesion molecule-1(ICAM-1) in heparinized anticoagulant blood samples from radial artery at different time points [anesthesia induction and before extracorporeal circulation(T1),30 min after aortic clamping(T2) and aortic declamping 5 min(T3),15 min(T4)]were detected.Three pieces of cardiac muscle were taken from right atrium at different time points and the levels of myeloperoxidase(MPO) were detected.Results 1.The serum cTnI and ICAM-1 levels after aortic declamping were higher than those before operation,and the levels in experimental group were lower than those in control group(t=2.358,2.533,2.30,2.639 Pa

Animals ; Astragalus Plant ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Liver Cirrhosis ; drug therapy ; Phytotherapy ; Pulmonary Fibrosis ; drug therapy ; Rheum ; Salvia miltiorrhiza ; chemistry

Objective To observe the immunostaining of endothelin-1(ET-1) and von Willebrand factor(vWF) in pulmonary vascular of ventricular septal defect(VSD) with pulmonary hypertension(PH),and the possible roles of ET-1 and vWF in the development of PH and remodeling in pulmonary artery.Methods VSD with non-PH were choosed as control group,20 cases with VSD with PH were divided into Ⅰgroup and Ⅱgroup according to mean pulmonary artery pressure. The specimens from middle lobe of right lung was obtained and stained by immunohistochemical technique.The degree of immunoreaction was measured with light density.Results The light density of ET-1 and vWF in small pulmonary arteries had significant statistical difference between every group,and Ⅱgroup was higher than those of Ⅰgroup,but no difference in small pulmonary veins.In every group,the light density of ET-1 and vWF had significant difference between small pulmonary arteries and pulmonary veins.There were statistical correlation among mean pulmonary pressure,VSD/A,ET-1 and vWF.Conclusions ET-1 and vWF are concerned with the development of PH and mediate pulmonary vascular remodeling.The data of small pulmonary veins suggest that the main origin of ET-1 in pulmonary tissue is small pulmonary artery.

Glioblastoma is a malignant tumor in central nervous system, which has strong invasion, poor prognosis and short survival time. At present, the main treatment strategy of glioblastoma is surgical excision, supplemented by radiotherapy and chemotherapy. However, due to incomplete resection and high recurrence rate, it is urgent to find novel therapeutic method for glioblastoma. Photodynamic therapy, as a promising non-surgical treatment, provides a new strategy for postoperative adjuvant therapy of glioblastoma. This review summarizes the mechanism and clinical application of photodynamic therapy mediated by various photosensitizers in glioblastoma, in order to provide help for the treatment of glioblastoma.