OBJECTIVETo investigate clinical effects of strategy by stages for preventing respiratory complications of patients with acute cervical spinal cord injury (ACSCI).

METHODSFrom September 2009 to May 2013,the clinical data of 91 patients with ACSCI underwent surgery were retrospectively analyzed. Among the patients, 42 patients were divided into in-stages group, including 30 males and 12 females with an average age of 50 years old (ranged 28 to 76) which were treated with strategy by stages for preventing respiratory complications; others 49 patients which were not treated with the strategy regarded as control group, including 38 males and 11 females with an average age of 47 years old (ranged 30 to 77). All of them had definite history of trauma, and were admitted to orthopaedics within 48 h after trauma. In in-stages group, respiratory muscle strength training, high-dose ambroxol using and other treatment were performed to prevent respiratory complilcations according to preoperative, intraoperative and postoperative stage. While in control group, there were no systematic and effective measures utilized. Chi-square test was used to evaluate the difference for respiratory complications rate, the rate of tracheostomy or intubation and mortality caused by the respiratory complications between two groups.

RESULTSTen patients developed with respiratory complications in in-stages group (7 patients with pneumonia, 1 with atelectasis and 2 with respiratory failure), among which 3 patients underwent tracheostomy or intubation. In control group, 24 patients developed with respiratory complilcations (15 with pneumonia,3 with atelectasis and 6 with respiratory failure), among which 11 patients underwent tracheostomy or intubation. There was significant difference between two groups (χ2 = 6.12, 4.07; P = 0.013, 0.044). Five patients died because of respiratory complications, one case were in in-stages group and 4 in control group. There was significant difference between two groups (χ2 = l.39, P = 0.238).

CONCLUSIONThe strategy by stages is an effective method for preventing respiratory complications of ACSCI and can reduce the respiratory complications rate and improve the prognosis of respiratory complications.

Acute Disease ; Adult ; Aged ; Cervical Cord ; injuries ; Female ; Humans ; Male ; Middle Aged ; Pneumonia ; prevention & control ; Pulmonary Atelectasis ; prevention & control ; Respiratory Insufficiency ; prevention & control ; Retrospective Studies ; Spinal Cord Injuries ; complications ; Tracheostomy

The purpose of this study is to investigate the Sal I, Nru I and Mse I restriction fragment length polymorphisms (RFLPs) of factor IX gene in Chinese Han people. The frequencies of FIX-192 and FIX-793 for A and G, and FIX-698 for T and C were analyzed by polymerase chain reaction (PCR) in unrelated normal Chinese Han people. A sample of 214, 210 and 206 unrelated X chromosomes were analyzed for FIX-192 and FIX-793 and FIX-698, respectively. The results showed that the frequencies for FIX-192 were 0.878 for A and 0.122 for G, with a heterozygosity rate of 0.213, and the frequencies for FIX-793 were 0.552 for A and 0.448 for G, with a heterozygosity rate of 0.494, the frequencies for FIX-698 were 0.311 for T and 0.689 for C, with a heterozygosity rate of 0.429. It was concluded that the SalIand NruI and MseI RFLPs of FIX gene may be useful markers for carrier detection and prenatal diagnosis in Chinese families with hemophilia B patients.
China ; DNA ; genetics ; metabolism ; Deoxyribonucleases, Type II Site-Specific ; metabolism ; Factor IX ; genetics ; Female ; Gene Frequency ; Heterozygote ; Humans ; Male ; Polymorphism, Restriction Fragment Length

OBJECTIVETo investigate clinical features and treatments of cervical spinal injury in aged patients.

METHODSFrom July 2006 to October 2011, 27 patients with cervical spinal cord injury were divided into experiment group, including 20 males and 7 females with an average age of 69 years old (ranged 65 to 78 years old). The other 22 patients with the same degree of cervical spianl cord injury and the same period hospitalization were chosen to regard as control group, including 16 males and 6 females with an average age of 47 years old (ranged 38 to 65 years old). All of them had clear history of trauma, and were admitted to hospital within one week. Clinical data and result of follow up were evaluated between two group. The function of the spinal cord was measured by Frankel classification at admission and final follow-up.

RESULTSAll patients were followed up for 1 year except 6 died in aged group, among which 3 paients with complications were died during hospitalization and others were out of hospital. Twenty-three cases had accompanied diseases and 24 cases occurred complications in aged group. Contrast to control group, this difference was statistically significant. At the final follow-up, there were 2 cases at Frankel grade E in aged group and 6 cases in control group.

CONCLUSIONIn comparison with control group, there are more accompany diseases and higher complications and mortality rates in aged group, while poor improvement of spinal cord function. This patients were mainly treated with operation, but operation method should simplify and mainly focus on effective decompression and reconstuction stability and avoid expansion operation. It's nesscerry to pay more attention to prevent and treatment of respiratory complication.

Adult ; Aged ; Cervical Vertebrae ; injuries ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications ; epidemiology ; mortality ; therapy ; Spinal Injuries ; physiopathology ; surgery

OBJECTIVETo construct a DNA vaccine as a prophylactic model to prevent condyloma acuminatum and detect its immunogenicity in mice.

METHODSThe major capsid protein (L1) gene of human papillomavirus (HPV) 6b was inserted into an eukaryotic expression plasmid (pcDNA3.1). The recombinant plasmid was transfected into COS-7 cells. Western blot were performed to detect whether L1 protein can be expressed in eukaryotic cells. Eighteen female BALB/c mice were tested for immunogenicity study.

RESULTSThe recombinant plasmid (pcDNA3.1-HPV6bL1) was verified as HPV6b L1 gene by sequencing. Western blot showed specific strip. Anti-L1 protein antibodies could be detected in the mice's sera inoculated with pcDNA3.1-HPV6bL1. Similarly, IL-4, IL-2, and IFN-gamma were increased in the same mice.

CONCLUSIONHPV6b L1 recombinant plasmid was constructed successfully which had immunogenicity for BALB/c mice. It provided experimental evidence for the research of DNA vaccine of condyloma acuminata.

Animals ; Antibodies, Viral ; blood ; COS Cells ; Capsid Proteins ; Cercopithecus aethiops ; Condylomata Acuminata ; immunology ; prevention & control ; Female ; Humans ; Immunization ; Interferon-gamma ; secretion ; Interleukin-2 ; secretion ; Interleukin-4 ; secretion ; Mice ; Mice, Inbred BALB C ; Oncogene Proteins, Viral ; biosynthesis ; genetics ; immunology ; Papillomaviridae ; genetics ; Plasmids ; Recombinant Proteins ; biosynthesis ; genetics ; Transfection ; Vaccines, DNA ; immunology

OBJECTIVETo evaluate clinical effects of pedicle fixation without bone fusion in treating thoracolumbar fractures through paraspinal approach.

METHODSFrom January 2006 to January 2009, 25 patients (15 males and 10 females) with thoracolumbar fractures were treated. The average age was 39.3 years,ranged from 17 to 49 years. According to classification, flexion fracture in 7 cases, brust fracture in 18 cases. There were no nervous injury, and radiology information showed the angle of sagittal vertebral body >20 degrees or collapse of vertebral body >40%,without vertebral injury. The operation were performed at 3 to 7 days after injury (mean 5 day). Internal fixation implants were removed at 8 to 12 months after operation. The height, kyphosis angle were measured before operation, 1 week and 24 months after operation,and Oswestry disability index (ODI) were compared before and after operation.

RESULTSAll patients were followed up for 24 months. Among them, 1 case was followed up at 30 months after operation. The operation time ranged from 70 to 110 (mean 90) minutes, the blood loss was 120 to 280 (mean 200) ml. The height of vertebral body and kyphosis angle were obviously corrected, and had significant differences between postoperation immediately and at the final follow-up (P<0.05). There were no differences after remove of internal fixation (P>0.05). The final ODI was (5.36 +/- 1.21)%, had statistical differences compared with preoperation (P<0.05).

CONCLUSIONFor flexion and burst thoracolumbar fractures without nervous injury, pedicle fixation without bone fusion is a good method,which has advantages of minimally invasive, rapid recovery, and maintain spinal motion segment.

Adolescent ; Adult ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Lumbar Vertebrae ; diagnostic imaging ; injuries ; surgery ; Male ; Middle Aged ; Spinal Fractures ; diagnostic imaging ; surgery ; Spinal Fusion ; methods ; Thoracic Vertebrae ; diagnostic imaging ; injuries ; surgery ; Tomography, X-Ray Computed ; Treatment Outcome ; Young Adult

OBJECTIVETo evaluate the efficacy and safety of 585 nm flashlamp-pumped pulsed dye lasers (PDL) in the treatment of port-wine stains (PWS).

METHODSA retrospective review was performed in 2 317 patients with PWS who visited the Dermatology Laser Centre of PUMC Hospital and accepted treatment with 585 nm PDL. The correlation between the treatment efficacy and the treatment sessions, lesion types, and usage of other therapies were analyzed. The adverse effects were also observed.

RESULTSAll the 2 317 patients with PWS received 1-13 consecutive treatments with PDL at 2-3-month intervals. The median number of treatment was 4.93 and the median energy density was 8.29 J/cm2. The response rate after 8 treatments sessions were 84%. The response rate in patients whose lesions are characterized as purple plaques with proliferation and treated with isotope, CO2, cryotherapy, and other treatments was significantly lower than the total response rate (P < 0.05). Superficial scar, hyperpigmentation, and hypopigmentation were found in 5.2%, 2.5%, and 4.0% of these patients, respectively.

CONCLUSION585 nm PDL is effective and safe in treating PWS.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Infant ; Infant, Newborn ; Low-Level Light Therapy ; adverse effects ; methods ; Male ; Middle Aged ; Port-Wine Stain ; radiotherapy ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo evaluate the clinical efficacy and safety of Q-switched Alexandrite laser in the treatment of pigmentary skin, diseases ( PSDs).

METHODSTotally 4 656 patients with PSDs were treated with Q-switched Alexandrite laser. These PDSs included nevus of Ota, seborrheic keratosis, tattoo, naevus fusco-caeruleus zygomaticus, cafe-au-lait-spots, lentigo, naevus of Ito, and spilus naevus. The outcomes and adverse events after treatment were oberserved.

RESULTSThe response rate was 92.31% and the cure rate was 55.39% for nevus of Ota after six times of treatment, and the cure rate was 100% after nine times of treatment. The response rate was 100% for freckles, seborrheic keratosis, and naevus fuscocaeruleus zygomaticus after four times of treatment. The response rate was more than 77.18% and the cure rate was more than 50% for tattoos after three times of treatment, including amateur tattoo, artificial eyebrow, eyelid lines, and traumatic tattoo. However, after four times of treatment, the response rate and the cure rate were only 50. 00% and 21.43% for cafe-au-lait spots, and 50.00% and 25.00% for spilus naevus, respectively. The response rate was 35.29% for lentigo and 25.00% for naevus of Ito/ spilus naevus after four times of treatment.

CONCLUSIONQ-switched Alexandrite laser is effective in the treatment of nevus of Ota, seborrheic keratosis, tattoo, and naevus fusco-caeruleus zygomaticus, but has limited efficacy for cafe-au-lait-spots, lentigo, naevus of Ito, and spilus naevus.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Infant ; Infant, Newborn ; Low-Level Light Therapy ; adverse effects ; methods ; Male ; Middle Aged ; Pigmentation Disorders ; radiotherapy ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo investigate the skill and evaluate the accuracy for application of guide combined with probing the internal wall of pedicle screw trajectory for subaxial cervical pedicle screw placement.

METHODSSubaxial cervical pedicle screw was inserted in 11 patients by the guide combined with probing the internal wall of pedicle screw trajectory from January 2014 to October 2016, including 7 males and 4 females with an average age of 48.1 years(ranged 32 to 63 years). There were 4 cases with cervical spondylotic myelopathy, 4 with fracture and dislocation of cervical vertebrae, 1 with cervical cord injury without fracture and dislocation, and 2 with atlantoaxialfracture and dislocation. The target pedicle's diameter, optimal entry point, sagittal angle and cross-sectional angle were measured by CT before operation. During operation, the pedicle screw inserted angle was controlled by a guide with a self-designed protractor and probed the internal wall of pedicle screw trajectory as medial safety margin of insertion screw. The accuracy of cervical pedicle screw was evaluated by CT with classification of four grades and assessed whether there was injury of spine cord or vertebral artery postoperatively.

RESULTSSeventy-one cervical pedicle screws were placed among 11 patients, and no one had been found with clinical manifestations of injury of spine cord (or nerve root) or vertebral artery after operation. According to postoperative CT scan for evaluating the grade of screw position, 52 screws were in grade 0, 13 in grade 1, 4 in grade 2, 2 in grade 3, and 91% (65/71) located in good position. In total, 6 screws were incorreted in placement, and 4 cases of them broke medial wall and 2 cases broke lateral wall.

CONCLUSIONSThe method of probing the internal wall of pedicle screw trajectory for subaxial cervical pedicle screw placement is safe and reliable, but the studying curve is long. Probing the internal wall of pedicle screw trajectory and controlling the insertion angle by guide with a protractor are key points of this technology.

OBJECTIVETo evaluate the effectiveness and safety of long-pulsed Alexandrite laser for hair removal.

METHODSHair removal was performed in 1702 hirsute patients with long-pulsed Alexandrite laser. Among them 1603 patients received two or more operations.

RESULTSIn patients who received 2, 3, 4, 5, and > or =6 operations, the effectiveness rates were 9.79%, 18.33%, 29.10%, 37.64%, and 82.68%, respectively. The number of operation correlated with the effectiveness, and > or =6 operations resulted in superior outcomes. Pigmentation occurred in 0.94% of the patients (16/1702).

CONCLUSIONThe long-pulsed Alexandrite laser system is effective and safe in removing hair.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; Hair Removal ; methods ; Hirsutism ; radiotherapy ; Humans ; Low-Level Light Therapy ; methods ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome

Objective: To evaluate the efficacy and safety of a domestic human plasma derived coagulation Factor Ⅸ concentrate (pd-FⅨ) in patients with hemophilia B. Methods: The study was a multicenter, open-label and single-arm study. The efficacy of pd-F Ⅸ was evaluated by objective performance criteria. The doses of pd-FⅨ were calculated according to the bleeding symptom and disease severity. The infusion efficiency of pd-FⅨ and improvement of bleeding symptoms were measured at 30 minutes and (24±4) h after the first infusion, respectively. Adverse events were recorded. Viral infection and FⅨ inhibitor were detected 90 d after the first infusion. Results: All 36 subjects with hemophilia B were enrolled in the study. The median age of these patients was 31 years old and the median injection doses were 4 (1-17) times. The hemostatic effect of 27/36 (75.00%) and 9/36 (25.00%) acute bleeding events were rated as "excellent" and "better" , respectively. The recovery rate was 111.92% (65.55%-194.28%) at 30 minutes after infusion of FⅨ. There was no adverse event related to FⅨ. No reactivation of HBV, HCV or HIV and FⅨ inhibitor was detected at 90-104 d after the first FⅨ infusion. Conclusion: This domestically made human plasma derived FⅨ concentrate is safe and effective in the treatment of acute bleeding in patients with hemophilia B. Clinical trial registration: China food and Durg Administration, 2016L08027.
Adult ; China ; Factor IX ; Hemophilia A ; Hemophilia B/therapy* ; Hemorrhage ; Humans ; Plasma