OBJECTIVETo investigate an effective method for the correction of the narrow nostril secondary to cleft lip.

METHODSA "bird wing shape" incision was made on the nasal tip to form a "W-shape" flap for repairing the nasal deformities secondary to cleft lip, especially for the cases with narrow nostril.

RESULTSTwenty-eight patients were treated with this method. All the cases achieved a symmetry shape of nasal ala, nostril, nasal columella and a normal height of nasal tip except for 2 cases with malformation at nasal tip who achieved improvement after reoperation. 21 cases were followed up for 6-12 months with good cosmetic result and no recurrence.

CONCLUSIONS"W-shape" flap at the nasal tip is an ideal way for the correction of mild to moderate narrow nostril deformity secondary to cleft lip.

Adolescent ; Adult ; Cleft Lip ; surgery ; Female ; Humans ; Male ; Nose ; abnormalities ; surgery ; Nose Deformities, Acquired ; etiology ; surgery ; Rhinoplasty ; methods ; Skin Transplantation ; Surgical Flaps ; Young Adult

OBJECTIVETo investigate the effect of a modified technique for repairing secondary defect of unilateral cleft lip.

METHODSThe incision line was designed along the oral-nasal contour line. The lateral crus of nasal alar were rotated and repositioned in order to reconstruct the nasal sill and base. V-Y plasty was performed with a muco-cartilage flap inside the nasal cavity to reset the alar cartilage backwards and correct the nasal deformity.

RESULTSSatisfactory results were achieved in all 69 patients with this modified technique. The post-operative scar was inconspicuous.

CONCLUSIONSThis modified technique with advantages of contour line incision and alar cartilage backward re-reposition is a good option for the repair of secondary defect of unilateral cleft lip.

Adolescent ; Adult ; Cleft Lip ; complications ; surgery ; Female ; Humans ; Lip ; abnormalities ; Male ; Nose ; abnormalities ; Nose Deformities, Acquired ; surgery ; Reconstructive Surgical Procedures ; methods ; Young Adult

OBJECTIVETo determine the change of P-selectin in avulsion-injured vessels.

METHODSDifferent stretch forces of 60, 70, 80 and 90 g were applied to a vascular injury model. The expression changes of P-selectin were evaluated by RT-PCR.

RESULTSThe expression of P-selection mRNA in the injured vessels increased with the stretch force.

CONCLUSIONThe result associated with our previous study indicated that P-selectin may be involved in thrombosis.

Animals ; Endothelium, Vascular ; P-Selectin ; metabolism ; RNA, Messenger ; metabolism ; Vascular System Injuries ; genetics ; metabolism

OBJECTIVETo explore the methods for repair of facial and cervical scars after burn.

METHODSOne hundred and two patients with facial and cervical scars as a result of burn injury were repaired by unilateral or bilateral deltopectoral flaps after expansion with pedicles. First, facial scars were excised and contractures were released to restore eye, mouth and nose to normal anatomical position. The facial scar flaps were overturned to join with the pedicles of deltopectoral flap for closing the wounds. The residual wounds were repaired by delayed flaps without pedicles 3 weeks later.

RESULTSAmong 102 patients, the flaps survived well in 94 cases, and blood supply insufficiency was found in distal end of unilateral flap in 7 cases (depigmentation after primary healing ). Necrosis of unilateral flap occurred in one patient, and it healed after skin grafting.

CONCLUSIONExpanded deltopectoral flap is efficacious procedure for repair of massive cervical and facial scars.

Adolescent ; Adult ; Burns ; complications ; Child ; Cicatrix ; etiology ; surgery ; Face ; pathology ; Facial Injuries ; Humans ; Male ; Neck ; pathology ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; methods ; Surgical Flaps ; Thorax ; Young Adult

OBJECTIVETo evaluate the efficacy and safety of Capsule metadoxine in the treatment of alcoholic liver disease.

METHODSA randomized double blind multicenter placebo-controlled clinical study was performed to evaluate the therapeutic effectiveness and safety of capsule metadoxine. Patients in metadoxine group received capsule metadoxine 500mg tid po. Patients in placebo group received placebo 2 pillows tid po. The treatment duration was 6 weeks. Patients were followed up 2 weeks after the treatment. Patients were visited once every 3 weeks during the treatment period. Clinical symptoms and liver function were evaluated in all the patients before treatment, at week 3, week 6 and 2 weeks after therapy. CT scan was done in some patients before treatment and at the end point of therapy.

RESULTS254 patients were recruited in the study, 126 in metadoxine group and 128 in placebo group. Median ALT, AST, GGT level in metadoxine group were decreased from 80.0 U/L, 59.2 U/L, 123.0 U/L (before treatment) to 41.1 U/L, 36.0 U/L, 57.0 U/L (after 6 weeks therapy). The improvement in liver function was more significant in metadoxine group than in placebo group (P less than 0.05). For the patients who stopped drinking during the study, the total effective rate of improvement in liver function was 82.8% in metadoxine group, much higher than that in placebo group (55.7% , P=0.0000). For the patients who did not stop drinking during the study, the total effective rate of improvement in liver function was 65.4% in metadoxine group, which is not significantly higher than that in placebo group (44.8%, P=0.1767). The CT value ratio of liver to spleen was significantly improved in metadoxine group (P=0.0023), and there was no significant difference between the two groups (P=0.6293). The rate of adverse was 1.6% in both of groups.

CONCLUSIONCapsule metadoxine is an effective and safe treatment for alcoholic liver disease.

Administration, Oral ; Adult ; Aged ; Alanine Transaminase ; blood ; Alcohol Deterrents ; administration & dosage ; therapeutic use ; Analysis of Variance ; Aspartate Aminotransferases ; blood ; Capsules ; Double-Blind Method ; Drug Combinations ; Fatty Liver, Alcoholic ; blood ; drug therapy ; pathology ; Female ; Follow-Up Studies ; Humans ; Liver ; diagnostic imaging ; pathology ; Liver Diseases, Alcoholic ; blood ; drug therapy ; pathology ; Liver Function Tests ; Male ; Middle Aged ; Pyridoxine ; administration & dosage ; therapeutic use ; Pyrrolidonecarboxylic Acid ; administration & dosage ; therapeutic use ; Treatment Outcome ; Ultrasonography ; Young Adult ; gamma-Glutamyltransferase ; blood

OBJECTIVETo investigate the perioperation medication on the first patient who was operated facial allotransplantation, including immunosuppressive drug and adjunctive drug, so that to search a effective medication schedule to the patient operated facial allotransplantation.

METHODSFK506, MMF, Prednisone and Zenapax was performed as immunosuppressive regiment in perioperative treatment; meanwhile, anti-infectives was administered to take precautions against all sorts of infections, such as bacterium, virus and fungus. Furthermore, all kinds of adjunctive drug, Losec, glucurolactone and so on, was administered to protect those function of stomach, liver, kidney and so on. Clinical observations were made on the signs and symptoms of graft survival or rejection, as well as immunological indexes were tested in laboratory. Biopsies of graft were also made at 30 d after operation. Side effect and complication of drug was monitored, in case the body suffered harm.

RESULTSFacial allograft was survived, and the temperature and color of skin were normal. Swelling of tissue was gradually subsidise after 4 days, and recovered in a half month. The count and ratio between Th and Ts were normal, skin Biopsies of every time had no found of hyperacute or acute rejection, and side effect and complication of drug had no monitored.

CONCLUSIONSThe regiment of perioperation medication was successfully performed.

Adult ; Face ; surgery ; Humans ; Immunosuppressive Agents ; therapeutic use ; Male ; Tissue Transplantation ; methods ; Transplantation, Homologous

OBJECTIVETo investigate the treatment outcome and risk factors for intractable seizures in children with tuberous sclerosis complex(TSC)complicated by epilepsy.

METHODSThe medical data of 66 cases of TSC were retrospectively studied.

RESULTSOf the 66 children with TSC, 47 cases were available for follow-up. The follow-up period ranged from 7 months to 9.3 years (average 4.5 + or - 2.6 years). The patients' present average age was (7.7 + or - 4.1) years (median 8 years). Among the 47 cases, 19 (40%) had infantile spasms, 24 (51%) had tonic seizures, 15 (32%) had partial seizures, and 3 (6%) had tonic-clonic seizures, and additionally, multifocal seizures, atonic seizures, atypical absence seizures and hypomotor seizures each appeared in 1 case (2%) respectively. The average number of antiepileptic drugs used was 1.9 + or - 0.86 (median 1). Among the 47 patients, 12 (26%) still had epileptic seizures and 33 (70%)were seizure-free, and 4% were dead. Three cases underwent surgery and continued to receive medication after surgery. The three patients were seizure-free in a 1.5 years follow-up. Among the 30 children over 7 years old, 17 cases (57%) were enrolled in ordinary schools, 3 cases (10%) in special schools and the other 10 cases were off-school for disabilities of intelligence and speech. The non-conditional logistic regression showed that the age of onset (RR=1.8, 95% CI 1.0- 3.2, P=0.050), administration of multiple antiepileptic drugs (RR=4.8, 95% CI 1.2-18.6, P=0.024), tonic seizures (RR=0.003, 95% CI 0.0- 0.2, P=0.04) and sex (RR=0.016, 95% CI 0.0-0.5, P=0.017) were risk factors for intractable seizures.

CONCLUSIONSThe majority (70%) of children with TSC complicated by epilepsy can be seizure-free with suitable treatment. The risk factors of poor outcome in seizure control may involve in the early onset age, tonic seizures and the administration for multiple anti-epileptic drugs.

Adolescent ; Child ; Epilepsy ; etiology ; surgery ; Female ; Follow-Up Studies ; Humans ; Logistic Models ; Male ; Recurrence ; Retrospective Studies ; Risk Factors ; Tuberous Sclerosis ; complications

OBJECTIVETo study the predictive value of ALT, HBeAg and HBV DNA levels at baseline and HBV DNA levels at week 12 adefovir dipivoxil (ADV) treatment to the efficacy of it at week 52 in patients with HBeAg-positive chronic hepatitis B (CHB).

METHODSNinety-eight HBeAg-positive CHB patients with serum HBV DNA>or=1x10(6) copies/ml and ALT levels between 1.5 to 10 times of upper limits of normal (ULN) were enrolled in the study. Ten mg/d of ADV was administered for 52 weeks. Line serum samples were collected for measuring HBV DNA and HBV markers. The efficacy of the treatment at week 52 was evaluated in patients with different ALT, HBeAg and HBV DNA levels at baseline and HBV DNA levels at week 12 after treatment.

RESULTSAt week 52 of ADV treatment, the rates of HBV DNA<10(3) were 72.7%, 66.7% and 53.0% respectively in patients with ALT>5xULN, HBeAg350 s/co (30.2%, P<0.01) and HBV DNA>10(8) copies/ml (34.4%, P<0.05) at baseline. HBeAg seroconversion rates were 42.2% and 7.5% (P<0.01) in patients with HBeAg titer350 S/co at baseline. In patients with HBV DNA<10(3), 10(3)-10(5) and >10(5) copies/ml at week 12, the ratios of them with HBV DNA<10(3) less than 1000 copies/ml at week 52 were 82.6%, 57.1% and 17.5% and significant differences were found between these groups (P<0.05); HBeAg seroconversion rates were 52.2%, 25.7% and 5.0% (P<0.05); ALT normalization rates were 100%, 83% and 75%, significantly higher in patients with HBV DNA<10(3) copies/ml than those with HBV DNA>10(5) copies/ml (P<0.05) at week 12. HBV DNA and HBeAg seroconversion at week 52 correlated with HBV DNA levels at week 12 (r=0.6 and r=0.5 respectively, P<0.01).

CONCLUSIONSIn HBeAg-positive CHB patients treated with adefovir dipivoxil, HBV DNA levels at week 12 can be used to predict the efficacy at week 52. HBV DNA<10(3) copies/ml at week 12 predict a better treatment result at week 52.

Adenine ; analogs & derivatives ; therapeutic use ; Adult ; Antiviral Agents ; therapeutic use ; DNA, Viral ; blood ; Female ; Hepatitis B e Antigens ; blood ; Hepatitis B, Chronic ; blood ; drug therapy ; Humans ; Male ; Organophosphonates ; therapeutic use ; Predictive Value of Tests ; Treatment Outcome ; Young Adult

OBJECTIVETo investigate the pathogenesis, clinical characteristics and treatment of benign infantile convulsions with mild gastroenteritis (BICG).

METHODSThe clinical manifestations and laboratory findings were observed in 40 children with BICG. The antigen and antibodies of rotavirus and calicivirus in stool and cerebral spinal fluid (CSF) were tested by the golden standard method and ELISA. The neurological outcome was evaluated by a follow-up of six months or more.

RESULTSAll of the 40 children had mild gastroenteritis with or without minor dehydration. Cluster convulsions were observed in these children. There were normal findings in blood biochemistry (Na+, K+, Ca2+, Cl-, HCO3-, glucose) and cerebral CT or MRI examinations. The interictal EEG showed sprinkle central or frontal epileptiform discharges in 8 children; clear central and parietal epileptiform discharges in 1 child; and no abnormal findings were observed in the other 31 children. Positive rotavirus antigen was detected in 11 children and positive calicivirus antigen in stool samples in 4 children. Positive antibodies of rotavirus and calicivirus in CSF were not seen. Seizures recurred in 22 of 28 children who received prophylactic injections of phenobarbital(5-10 mg/kg). In a 6 months follow-up, one child developed epilepsy and the other 39 children had no seizures and neurological sequelae.

CONCLUSIONSThe digestive system manifestations are mild in children with BICG. Convulsions are always clustered in these children. The mechanism underlying convulsions is not clear. Conventional dose of phenobarbital is not effective for prevention of seizures. Most of children with BICG have a good prognosis.

Child, Preschool ; Female ; Follow-Up Studies ; Gastroenteritis ; complications ; Humans ; Infant ; Male ; Seizures ; drug therapy ; etiology

Blood donor recruitment models have changed from paid donors to employer-organized donors and to voluntary donors in China. Reports on the hepatitis C virus (HCV) infection among voluntary blood donors in China have been rarely found at present. The prevalence of anti-HCV and genotypes among the first-time voluntary blood donors was investigated in Chongqing area of China. A total of 13,620 serum samples were collected from the first-time voluntary blood donors in Chongqing, China. Anti-HCV antibody was tested by ELISA. The Core/E2 region of HCV RNA from HCV seropositive samples was amplified by RT-PCR for genotyping. The results indicated that the prevalence of anti-HCV averaged 0.49% (67/13,620), and the highest rate (0.86%) was obtained in the group aged 40 to 49. A higher prevalence was observed among the more educated donors, and metropolitan donors. The ratios of following genotypes 1b, 2a, 3a and 3b were 4 (18%), 5 (23%), 9 (41%) and 4 (18%) in all the 22 samples respectively. Genotype 3 (3a and 3b) was the predominant genotype. In conclusion, the prevalence of anti-HCV was low among the population of voluntary blood donors in Chonqing area. The genotyping results showed the possibility of presence of druggies among the voluntary blood donors. Therefore, more attention should be paid to exclude those high-risk persons from the volunteers.
Blood Donors ; China ; epidemiology ; Genotype ; Hepacivirus ; genetics ; isolation & purification ; Hepatitis C ; epidemiology ; transmission ; Hepatitis C Antibodies ; blood ; Humans ; Incidence ; Seroepidemiologic Studies