Objective To investigate the clinical efficacy of laparoscopic diaphragmatic hernia repair.Methods The clinical data of 15 patients who underwent laparoscopic repair for acquired diaphragmatic hernia at the People's Hospital of Xinjiang Uyghur Autonomous Region from August 2011 to June 2015 were retrospectively analyzed.Two-side composite patch at the hernia ring-center was fixed on the diaphragm using laparoscopic hernial screw nail for defect repair.The follow-up was performed by telephone interview and outpatient examination till August 2015, which included postoperative recurrence of hernia and complications.Measurment data with normal distribution were presented as mean value (range).Results Fifteen patients received successful laparoscopic repair for tension-free diaphragmatic hernia.The operation time, volume of intraoperative blood loss and average duration of hospital stay were 134.5 minutes (range, 120.0-150.0 minutes), 25.6 mL (range, 10.0-50.0 mL) and 5 days (range, 10-12 days), respectively.No postoperative complications of respiratory and digestive system in 15 patients were detected, and there were the remissions of preoperative respiratory symptoms (cough, cough sputum, wheezing and suffocating) and digestive symptoms (nausea, vomiting and acataposis) of some patients.All the 15 patients were followed up for 2-48 months without severe postoperative complications and recurrence.Conclusion Laparoscopic diaphragmatic hernia repair is safe and feasible.

Objective To investigate the relationship between brain natriuretic peptide (BNP)and heart function in elderly patients with acute myocardial infarction.Methods All data were taken from the hospitalized cases with acute myocardial infarction from December 2008 to August 2010.100 patients aged from 60 to 97 were enrolled.The data were divided into 4 groups (group 1,24 cases; group 2,32 cases,group 3,23 cases; group 4,21 cases) respectively according to Killip's classification.Left ventricular function was measured by echocardiography.Plasma BNP was determined with enzyme immunoassay.Results Compared with non heart failure group and normal group,heart failure group had much higher plasma BNP concentrations.The plasma BNP level had positive correlation with left ventricular end diastolic diameter (r =0.27,P ＜ 0.01) and left ventricular end-diastolic dimension (r=0.37,P＜0.01),while,had a negative correlation with left ventricular ejection fraction (r =-0.38,P ＜ 0.01).Conclusions Plasma BNP level was significantly elevated which could evaluate the heart function in elderly patients with acute myocardial infarction.

OBJECTIVE: Aim of the study is to report the unique clinicopathologic feature, treatment outcome and prognostic factors of head and neck hemangiopericytoma (HNHPC). METHOD: A retrospective data collection of reported HNHPC cases, in which therapy, follow-up and outcome data were available, was performed from the electronic database of PubMed, Embase, Google scholar, China National Knowledge Infrastructure, Wan Fang and Wei Pu until on December 31, 2013. RESULT: A total of 213 HNHPC cases were identified from 122 peer-reviewed articles. The recurrence rate was 24.4% (51/209). The positive surgical margin (OR= 3. 977, P<0. 01) and poor pathologic differentiation (OR=l. 890, P<0. 01) were associated with increased local recurrence. The metastasis rate was 15.8% (22/139). The positive surgical margin (OR=13. 833, P<0. 01), poor pathologic differentiation (OR=4. 661, P<0. 01) and non-surgical treatment (OR=2. 000, P<0. 01) were associated with increased distant metastasis. The mortality rate was 15. 0% (32/213). The tumor size >5. 0 cm in diameter (OR= 2. 860, P<0. 05), positive surgical margin (OR=9. 833, P<0. 01), poor pathologic differentiation (OR=4. 061, P<0. 01) and non-surgical treatment (OR=2. 032, P<0. 01) were associated with worse mortality. The treatment included surgery alone 139 cases, multiple treatments 64 cases and non-surgical treatment 10 cases. The overall survival (OS) of the 213 cases was 85%, and the 3-year, 5-year and 10-year OS were 86%, 78% and 74%, respectively. The 3-year, 5-year and 10-year OS for surgery alone were 95%, 88% and 84%, respectively. The 3- year, 5-year and 10-year OS for surgery plus radiotherapy were 90%, 80% and 80%, respectively. The 3-year, 5- year and 10-year OS for surgery plus chemotherapy were 75%, 25% and 25%, respectively. The 3-year, 5-year and 10-year OS for surgery plus radio-chemotherapy were 67%, 58% and 46%, respectively. There were signifi- cant survival difference in recurrence-free survival (RFS), metastasis free survival (MFS) and OS depending on surgical margins (P<0. 01). RFS, MFS and OS difference were identified depending on pathologic differentiation (P<0. 01). MFS and OS differences were observed on the different treatment modality (P<0. 01). OS differences was observed on the different tumor sizes (P<0. 05). Positive surgical margins was correlated with disease recurrence (HR= 3. 680, P<0.01), while poor pathologic differentiation was correlated with metastasis and death (HR=2. 619, P<0. 05 and HR=3. 188, P<0. 05). The tumor size >5. 0 cm in diameter and non-surgical treatment was correlated with death (HR= 5. 461, P<0. 01 and HR= 8. 563, P<0. 01, respectively). CONCLUSION The surgical resection was the mainstream treatment and it was superior to multiple treatments. The tumor size, surgical margins, pathological differentiation and non-surgical treatment were independent prognostic factors.
Head and Neck Neoplasms ; mortality ; pathology ; therapy ; Hemangiopericytoma ; mortality ; pathology ; therapy ; Humans ; Neoplasm Recurrence, Local ; Prognosis ; Retrospective Studies ; Treatment Outcome

Objective To access the effectiveness of modified early warning score (MEWS) and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) in predicting the degree of injury and outcome for emergently admitted polytrauma patients.Methods In this single-center prospective study,266 polytrauma patients hospitalized from June 2012 to January 2013 were enrolled.MEWS and APACHE Ⅱ score were collected and compared for the rate of ICU admission,high dependency unit admission,outpatient therapy,death,and discharge within 30 days.Diagnostic and predictive performance of MEWS and APACHE Ⅱ were assessed by the receiver operating characteristic curve (ROC).Results A higher values in MEWS and APACHE Ⅱ were linked to much severe injury,increased likelihood of admission to the ICU or high dependency unit and high mortality.Patients with MEWS value ≥5 had increased risk of death as compared with those with MEWS value ＜ 5 (x2 =90.749,P ＜0.01).MEWS =5,for injury severity evaluation,showed a sensitivity of 85.7％ and specificity of 84.8％.MEWS value≥5 predicted ICU admission with a sensitivity of 80.0％ and specificity of 91.1％ and high dependency unit admission with a sensitivity of 67.9％ and specificity of 79.9％.APACHE Ⅱ score ≥ 21 was associated with increased rate of death,with significant difference from that among patients with APACHE Ⅱ score ＜ 21 (x2 =73.518,P ＜ 0.01).APACHE Ⅱ score =21,for injury severity evaluation,showed a sensitivity of 90.5％ and specificity of 79.5％.APACHE Ⅱ score ≥ 21 predicted ICU admission with a sensitivity of 95.0％ and specificity of 73.6％ and high dependency unit admission with a sensitivity of 88.2％ and specificity of 72.8％.In prediction of prognosis,ICU admission and high dependency unit admission,area under the ROC curve with 95％ CI for NEWS was 0.889 (0.830-0.948),0.937 (0.900-0.975) and 0.946 (0.916-0.977) respectively and for APACHE Ⅱ was 0.939 (0.898-0.979),0.761 (0.677-0.845) and 0.832 (0.782-0.883) respectively.MEWS and APACHE Ⅱ score in death group were (6.4 ± 2.7) points and (29.9 ± 6.4) points,but lowered to (3.0 ± 1.5) points and (16.8 ± 5.7) points respectively in survival group (P ＜ 0.01).Conclusions Both APACHE Ⅱ and MEWS have the ability to discriminate the severity of polytrauma patients and identify the potential of seriously ill patients.MEWS is more suitable for early identification of critically ill trauma patient due to its easy and quick operation as well as low cost,while APACHE Ⅱ is more suitable for evaluation of emergency observing patients and ICU patients.

BACKGROUND:The most advanced and representative diagnosis techniques for perforating branch of blood vessels include digital subtraction angiography, CT, MRI and other imaging techniques. These methods can visualize blood vessels clearly and have a high precision, but there are some trauma and less popular.
OBJECTIVE:To apply high-frequency ultrasound for detection of thoracic dorsal artery and perforating branch, and provide a reference for preoperative design of thoracic dorsal artery perforating flap.
METHODFifteen patients candidate for thoracic dorsal artery perforating flap were included in this study. Before surgery, we used high-frequency ultrasound to detect the perforating branch, including vascular contorts, diameter, the location of the perforators and surface markers. The thick, superficial, paral el perforating branch was selected as the main blood vessels, to design and cur the skin flap.
RESULTS AND CONCLUSION:In the involved 15 cases, thoracic dorsal artery were derived from the subscapular artery, thoracic dorsal artery and its main branches, as wel as more than 1 mm main perforating branch in 13 cases were clearly visible. It was consistent with intraoperative measurement results. The perforating branch less than 1 mm only showed strip-like blood flow signal or no blood flow and spectrum signal, and there was an unclear boundary to surrounding tissue. One case appeared distortion and variation of blood vessels before surgery, thus changed to other surgery. Two cases had no perforating branch by preoperative detection, which was then confirmed by intraoperative anatomy. High-frequency ultrasound has a significant effect on preoperative position of perforating branch, and the combination with computer tomography angiography and magnetic resonance angiography can support a more comprehensive and reliable reference.

Objective To evaluate the safety and efficacy of super mini-percutaneous nephrolithotomy (SMP) by ultrasound-guided renal access in pediatric with renal calculus.Methods From May to August 2015, 20 pediatric patients with upper tract stones underwent the SMP by ultrasound guidance.The patients aged 11-144 months , median age 31.5 months, The stone size ranged 0.8-2.5 cm, mean(1.48 ±0.59) cm.Among the 20 children, single pelvis stones were in 8, multiple stones in 10 and upper ureter stones in 2.All patients had no previous surgery treatment.The SMP system consists of a F6.0 -7.5 nephroscope and a modified F12-14 access sheath with suction-evacuation function.Nephrostomy tract dilation was performed up to F12-14 and lithotripsy procedure was performed by using pneumatic lithotripter.Nephrostomy tube or double J stent was placed only if clinically indicated.Results The stone size was 0.8-2.5 cm ,mean (1.48 ± 0.59)cm.Among the 20 children, there were 8 patients with single pelvis stone, 10 with multiple stones and 2 with upper ureter stones.All the patients were completed successfully without surgery conversion.Mean operative time ranged 6-40 minutes ,mean(17.6 ± 11.6) minutes.The stone free rate was 100％ after the evaluation in the postoperative day.The hemoglobin drop was 2-16 g/L,mean (7.6-± 4.1) g/L.No major complications occurred, neither patient required transfusion.The tubeless PCNL without double J stents and nephrostomy tubes placed were achieved in all patients.Only 14 patients had a ureter catheter placement for one day.The average hospital stay ranged 1-4 days, mean (2.4 ± 0.8) days.Conclusions SMP could be a safe and effective treatment for kidney stone up to 2.0 cm in pediatric cases with advantages of short recovery time, high stone free rate and no catheter placement.SMP could be the ideal procedure for children with upper urinary tract calculus.

BACKGROUND:Vacuum sealing drainage is currently considered as a safe and effective for fasciotomy wounds in the treatment of compartment syndrome. But the wounds after treatment are often not self-closed, which needs skin grafts that can cause secondary injury. Studies have shown that shoelaces technology is useful for leg fasciotomy wounds in the surgical treatment of lower leg compartment syndrome, but so far there are few domestic reports. OBJECTIVE:To compare the vacuum sealing drainage and shoelace technique for treatment of leg fasciotomy wounds. METHODS:A total of 36 patients, with 46 leg fasciotomy wounds, were randomized into vacuum sealing drainage and shoelace technique groups, 23 wounds in each group. In the vacuum sealing drainage group, patients were subjected to vacuum sealing drainage after fasciotomy based on fracture reduction and external fixation;in the shoelace technique group, the fasciotomy wounds were covered with polyethylene/ethanol hydrated seaweed salt foam fol owed by shoelace technique. After 1 month, wound size, wound closure time, infection, further intervention and daily treatment cost were compared between the two groups. RESULTS AND CONCLUSION: Wound closure time was significantly higher in the vacuum sealing drainage group compared to the shoelace technique group (P < 0.05). Eight wounds in the vacuum sealing drainage group required skin grafts; while, no skin graft was necessary in the shoelace technique group. In the shoelace technique group, the vessel loops had to be replaced in five wounds. There was no wound infection, increased compartment pressure and skin flap necrosis postoperatively in both two groups. Both vacuum sealing drainage and the shoelace technique are safe, reliable and effective methods for closure of leg fasciotomy wounds. Vacuum sealing drainage requires longer time to definite wound closure and is far more expensive than the shoelace technique, especially when additional skin grafting is required.

Objective To investigate the brachial plexus injury patients regional and national characteristics,epidemiological characteristics.Methods Reference to foreign brachial plexus injury epidemiology survey methodology,retrospective analysis of five representative hospitalsthe trauma center in Urumqi,Xinjiang during January 2010 and May 2013 were treated 166 cases of patients with brachial plexus injury medical records.Results The incidence rate of brachial plexus injury was 1.17％ in this 5 trauma center.From 20 to 49 age group accounted for 69.87％,the ratio of male to female was 4.53:1.Workers and farmers accounted for 51.8％,Uygur,Han accounted for respectively 62.04％,24.69％.Kashi,Aksu,Urumqi accounted for respectively 22.89％,12.04％,8.43％.Motor vehicle accidents,high-altitude fall injury and injuries caused by birth trauma accounted for respectively 33.73％,31.92％ and 9.67％.Injury type:root,trunk,bundle/bundle branch injury cases accounted for respectively 28.91％,27.10％,40.36％.Conclusion Brachial plexus injury occurs mainly in young men with low income,motor vehicle accidents,and high-altitude fall injury are dangerous injury factors,different nationalities,different areas occurs constitutes obvious difference,neonatal birth trauma caused by brachial plexus injury constitute relatively high.

Chalcones are polyphenolic flavonoid substances with various pharmacological effects and low toxicity.In this study, 15 novel trifluoromethyl chalcone derivatives (3a-3o) were designed and synthesized using the chalcone nucleus of natural licorice chalcone as the lead compound skeleton in order to find the candidate drugs with high efficiency and low toxicity against cervical cancer.The structures of the target compounds were confirmed by 1H NMR, 13C NMR and HRMS. The inhibitory activities of compounds 3a-3o, licorice chalcone, cisplatin and Nutlin3a on SiHa, HeLa and C-33A human cervical cancer cells and H8 and HaCaT normal cells were determined by MTT assay, and the structure-activity relationship was analyzed.Transwell and flow cytometry methods were used to assess the target compounds'' ability to inhibit cell migration and invasion, promote apoptosis, and arrest the cell cycle.Molecular docking technology was used to further study the binding characteristics of the target compound with MDM2 protein.The results showed that the compounds had different degrees of inhibitory activity against the three types of cervical cancer cells.Compound 3n showed the strongest activity against HeLa cells (IC50 = 11.69 μmol/L), which was superior to the lead compound, and had lower toxicity against the two normal cells.Compound 3n was found to significantly inhibit the migration and invasion of HeLa cells, induce apoptosis and arrest the cell cycle at G2/M phase.The results of molecular docking showed that the effective binding of compound 3n to MDM2 protein may be one of its anti-tumor mechanisms.This study provides an experimental basis for the screening of new anti-cervical cancer candidate drug from chalcone derivatives.

Objective To investigate the expression of NADPH oxidase Nox-4 induced by stress in gastric mucosa and its role in inflammation.Methods Twenty male SPF Kunming mice were randomly divided into chronic restraint stress group(stress group) and control group.Stress mice were restrained in selfmade restraint device for 2 hours each day.The rest of the time,the mice in the two groups had free access to food and water normally,experiment lasted 14 days.The histopathological changes of gastric mucosa were assessed by HE staining under light microscope.The expression of Nox-4 in gastric mucosa of mice was carried out by immunohistochemical method.The relative expression levels of Nox-4,antioxidant protein (Mn-SOD,GSH,Catalase) and inflammatory factors(IL-8,IL-1β,TNF-α) in gastric mucosa were detected by real-time quantitative RT-PCR and ELISA.Results Basal cell proliferation,neutrophil,eosinophil and plasma cell infiltration and inflammatory changes were observed in the lamina propria and glandular epithelium of stress mice,while no obvious abnormalities were found in control mice.The expression of Nox-4 in stress group was deeper and more abundant than that in control group,mainly expressed in lamina propria and glandular epithelium.The mRNA expression levels of Nox-4 in gastric mucosa of stress group was(2.42±0.51) times higher than that of control group,and blood concentration of stress group was(2.23±0.67) times higher than that of control group(t=-46.32,P＜0.001).The RT-PCR of antioxidant proteins in gastric mucosa showed that the transcription levels of Mn SOD,GSH and Catalase in stress group were significantly lower than that of control group (Mn-SOD:0.59± 0.10,GSH:0.58± 0.11,Catalase:0.57± 0.09),and there were significant differences between the two groups(t=13.57,11.67,15.01,P＜0.01).RT-PCR results showed that the transcription levels of IL-8,IL-1β,TNF-α in stress group were significantly higher than those in control group (IL-8:1.47±0.34,IL-1β:1.48 ± 0.42,TNF-α:1.51 ± 0.37),and there were significant differences in two groups(t=-18.45,-19.14,-20.85,P＜0.01).ELISA results showed that the serum levels of inflammatory factors in stress group were significantly higher than those in control group(2.25±0.37,3.59±0.45,3.41±0.34),and the differences were statistically significant(t=-47.11,-79.36,-96.32,P＜0.01).Pearson correlation analysis showed that there was a positive correlation between serum concentration of Nox-4 and inflammatory factors(IL-8,IL-1β,TNF-αt) in stress group(r=0.97,0.99,0.98,P＜0.01).Spearman rank correlation analysis showed that the grade of gastric mucosal inflammation was positively correted with serum levels of Nox-4 and inflammatory factors (IL-8,IL-1β,TNF-α) (r =0.96,0.92,0.91,0.94,all P＜ 0.01)Conclusion Stress may lead to gastric mucosal lesion by overexpression of proinflammatory factors through destroying the balance of oxidation/antioxidant system in gastric mucosa.