Congenital Hyperinsulinism ; diagnosis ; Humans ; Infant, Newborn ; Male

Objective To investigate the diagnosis and treatment of ruptured hepatic cystic echinococcosis (HCE).Methods The clinical data of 109 patients with HCE who were admitted to the First Affiliated Hospital of Xinjiang Medical University from January 1994 to December 2009 were retrospectively analyzed.The diagnosis was based on the results of serological examination,epidemiological history,clinical manifestation and imaging findings.Of the 108 patients who received surgical treatment,67 received classic endocystectomy(classic group)and 41 received improved endocystectomy(improved group).The operation time,operative blood loss,length of postoperative hospital stay,time of drainage,effusion and infection of residual cavity,biliary fistula,pleura]effusion,local recurrence,dissemination and implantation of HCE,and death of the 2 groups were compared.All data were analyzed using the t test and chi-square test.Results The diagnostic rates of ultrasound,computed tomography and magnetic resonance imaging were 93%(101/109),99%(70/71)and 7/7,respectively.The positive rate of serological examination was 100%(61/61).Of the 109 patients,1 died of anaphylactic shock.The operation time and operative blood loss were(3.2 ± 0.3)hours and(104.0 ± 11.5)ml in the classic group and(3.3 ±0.4)hours and(110.0 ±23.8)ml in the improved group,respectively.There were no significant differences in the operation time and operative blood loss between the 2 groups(t =-1.474,-1.758,P ＞0.05).The length of hospital stay and time of drainage were(15.3 ± 4.3)days and(28.0 ± 4.6)days in the classic group and(9.3 ± 1.2)days and(7.6 ± 0.8)days in the improved group,respectively.There were significant differences between the 2 groups in the length of hospital stay and time of drainage(t = 8.628,28.088,P ＜0.05).The incidence rates of effusion and infection of residual cavity,biliary leakage,local recurrence,dissemination and implantation of HCE of the classic group were significantly higher than those in the improved group(x2 =4.335,3.888,5.691,4.581,10.153,P ＜0.05).Twenty-one patients received reoperation because of HCE recurrence or severe complications.Conclusions Epidemiological history,clinical manifestation,imaging findings and serological examination are important for the diagnosis of ruptured HCE.Improved endocystectomy + peritoneal lavage with hypertonic saline + administration of anti-HCE drugs is the optimal treatment for ruptured HCE.

Objective To study the results of emergency treatment of ruptured hepatic cystic echinococcosis (HCE).Methods A standardized management protocol for hepatic echinococcosis was introduced by the First Hospital of Xinjiang Medical University in 2002.This study included 185 patients who received emergency treatment for ruptured HCE between 1994 and 2009.The patients were divided into group A (from 1994 to 2001) and group B (from 2002 to 2009).The clinical characteristics and surgical treatment results were compared retrospectively.Results In patients with ruptured HCE into the abdomen,classical endocystectomy (Group A1 ) resulted in significantly more postoperative complications in residual hepatic cavity,time of drainage,postoperative hospital stay,recurrence and peritoneal seeding than improved endocystectomy (Group B1 ) (P＜0.05).The operation time and blood loss were not significantly different between group A1 and B1 (P＞0.05).For patients with ruptured HCE into the biliary tree,classical endocystectomy (Group A2 ) resulted in significantly higher postoperative complications in residual hepatic cavity,time of drainage,postoperative hospital stay and recurrence than improved endocystectomy (B2) (P＜0.05).Operation time,blood loss and peritoneal seeding were not significantly different between group A2 and B2 (P ＞ 0.05). Only one patient (0.54％) died from allergic shock in this series of patients.Conclusions Improved endocystectomy was an efficacious surgical treatment for ruptured HCE and it is recommended for emergency surgery.

Objective To study the stability of micro-implant orthodontic anchorage(MA)with different pitch in the case of immediate loading.Method Employing 3D finite element analysis method,the stress and dis-placement distribution on the bone interface of MIA with different pitch(0.3 mm、0.5 mm、0.7 mm and 1.0 mm,respectively),which was 1.47 N loaded vertically in the major axis direction,were analyzed.Result The pitch affected the stress distribution significantly,because the maximum stress increased with the pitch decreasing and the impact of pitch on stress distribution on neck and central locations of MIA were different;to decrease the pitch could reduce the max displacement of the jaw,but the impact of pitch on displacement distribution of MIA was not significant.Condusions In the case of immediate loading.MIA with pitch 0.5 mm-0.7 mm is suggested to be selected as orthodontic anchorage in the clinic.

Objective To study the stability of micro-implant orthodontic anchorage(MA)with different pitch in the case of immediate loading.Method Employing 3D finite element analysis method,the stress and dis-placement distribution on the bone interface of MIA with different pitch(0.3 mm、0.5 mm、0.7 mm and 1.0 mm,respectively),which was 1.47 N loaded vertically in the major axis direction,were analyzed.Result The pitch affected the stress distribution significantly,because the maximum stress increased with the pitch decreasing and the impact of pitch on stress distribution on neck and central locations of MIA were different;to decrease the pitch could reduce the max displacement of the jaw,but the impact of pitch on displacement distribution of MIA was not significant.Condusions In the case of immediate loading.MIA with pitch 0.5 mm-0.7 mm is suggested to be selected as orthodontic anchorage in the clinic.

Objective To compare the efficacy of ultrasound-guided fine-needle aspiration(US-FNA)biopsy in diagnosing solid and complex thyroid nodules with different size. Methods One hundred and seventy-five thyroid FNA biopsies were prospectively performed on 168 patients ranging from 4 to 75 years of age. Sixty-three nodules were surgically excised and the others were clinically followed-up. The cytology diagnoses were categorized into four groups: benign, malignant, suspicious and unsatisfactory. Results There was no significant complication in the all 115 solid and 60 complex thyroid lesions and there were 36and 3 malignant nodules respectively in solid and complex thyroid nodules. The nondiagnostic rates of solid and complex nodules were 7％ and 8％. The accuracy of US-FNA in diagnosing complex thyroid nodules was comparatively equal to that of in solid thyroid nodules. In solid thyroid nodules, the sensitivity and accuracy in ≤1 cm group were similar to that of in ＞1 cm group. Conclusions US-FNA was an accurate and reliable method to diagnose thyroid solid and complex lesions.

To prepare Zhitong micro-emulsion in this study, with the empirical formula of Zhitong preparation as the model medicine, the essential oil in the formula as the oil phase, and the water decoction as the water phase. The types of surfactant and co-surfactant were investigated. The changes in micro-emulsion conductivity and construction, the water percentage in the micro-emulsion system, the changing curve of conductivity and the fine pseudo-ternary phase diagram of micro-emulsion were drawn to determine the surfactant-co-surfactant mass ratio (K(m)). Subsequently, the D-mixture design was used to optimize Zhitong Micro-emulsion formula, with particle size and surface tension of micro-emulsion as the indexes. Finally, efforts were made to determine part of physical parameters of Zhitong micro-emulsion and preliminarily detect its stability. The results showed that the micro-emulsion was optimal with the EL-35-tween 20 ratio of 4:1 in surfactant, whereas the absolute ethyl alcohol was recommended as the co-surfactant. The ratio between surfactant and co-surfactant (K(m)) was 1.5. The finalized micro-emulsion formula contains 12% surfactant, 8% co-surfactant, 70% 1 g x mL(-1) water decoction and 8% oil. The results of the preliminary stability experiment showed a better stability of Zhitong micro-emulsion.
Chemistry, Pharmaceutical ; methods ; Drugs, Chinese Herbal ; chemistry ; Emulsions ; Surface-Active Agents ; chemistry ; Temperature

OBJECTIVETo investigate the effects of antibiotic-PMMA (polymethyl-methacrylate) beads combined with external fixator in treatment of infected fracture nonunion.

METHODSTwenty-two cases of infected fracture-nonunions were reviewed involving 20 male and 2 female with an average age of 34.68 years (ranging 21 to 74 years). The data consisted of 9 cases of tibial fractures, 2 distal fractures of the femur, 6 femoral shaft fractures, 3 intertrochanteric fracture of the femur and 2 humeral shaft fractures. The procedure included thorough debridement to wipe out dead bone and granulation tissue, then antibiotic-PMMA bead chains imbedded into the dead space. One week later, secondary debridement was performed, antibiotic-PMMA bead chains were changed according to result of bacterial culture and susceptibility test, and fractures were stabilized with external fixator. Three months after debridement, antibiotic-PMMA bead chains were taken out and bone graft with autogenous iliac cancellous bone chips was performed.

RESULTSThe mean follow-up period was 19.98 months (ranging 15 to 28 months). Infection was controlled in 20 cases. One tibial fracture and 1 intertrochanteric fracture of the femur needed repeated debridement 2 and 3 months after bone grafting respectively,because of infection recurrence and sinus formation. All 22 cases achieved bony union averaged 15.09 weeks after bone grafting with a range of 8 to 24 weeks.

CONCLUSIONThorough debridement, imbedding antibiotic-PMMA bead chains combined with external fixator and staged bone grafting has proven to be effective and simple for treatment of infected fracture nonunion. The antibiotic bead delivers high tissue levels,obliterates dead space, aids bone repair.

Adult ; Aged ; Anti-Bacterial Agents ; therapeutic use ; Bone Diseases, Infectious ; drug therapy ; microbiology ; surgery ; Bone Transplantation ; External Fixators ; Female ; Follow-Up Studies ; Fractures, Bone ; complications ; drug therapy ; surgery ; Fractures, Ununited ; complications ; drug therapy ; surgery ; Humans ; Male ; Middle Aged ; Polymethyl Methacrylate ; chemistry ; Young Adult

OBJECTIVETo study composition, distribution and causes of acute occupational hand injuries in Beijing Jishuitan Hospital.

METHODSFrom April 1st 2005 to September 30th 2005, all patients with acute hand injuries were investigated by questionnaire focusing on all related epidemiological elements.

RESULTSTwo thousand six hundred fifty eight cases with acute hand injuries were about 17.3 % of patients with acute orthopedic injuries. Their mean age was (30.4 +/- 10.8) years old. The radio of males to females in cases with acute hand injuries was 57:1. The cutting and crushing injuries were the main causes of acute hand injuries. Most of cases with acute hand injuries were engaged in work related to machines. The acute hand injuries were mainly involved in index and middle figures of both hands, 94.9 % of acute hand injuries were opening, and 87.6% of acute hand injuries were involved in the deep tissues.

CONCLUSIONAcute hand injuries are the common occupational severe injuries for young male workers. The acute hand injuries occur in patients engaged in work related to machines. The prevention of acute hand injuries should be emphasized.

Adolescent ; Adult ; China ; epidemiology ; Emergency Service, Hospital ; Female ; Hand Injuries ; epidemiology ; Humans ; Male ; Middle Aged ; Occupational Injuries ; epidemiology ; Surveys and Questionnaires ; Young Adult

OBJECTIVETo observe the role of tumor necrosis factor α (TNF-α) in endothelial-mesenchymal transition (EnMT), and to explore the mechanism of fibrosis disease.

METHODSHuman umbilical vein endothelial cells (HUVEC) from umbilical cord of healthy fetus were isolated by enzymatic digestion and identified by immunofluorescence assay. The third to fifth generations of cultured HUVEC in logarithmic phase were harvested and seeded in 12-well plates and 6-well plates, and they were divided into control group (ordinary culture without any stimulation), 5, 10, 25, 50, and 100 ng/mL TNF-α groups (5, 10, 25, 50, 100 ng/mL of TNF-α was respectively added into the nutrient solution) according to the random number table, with three samples in each group. After being cultured for 72 hours, the cell morphology was observed under inverted phase-contrast microscope; the expression levels of coagulation factor VIII and α smooth muscle actin (α-SMA) were detected by immunofluorescence assay, and the ratios of numbers (absorbance values) of cells with expression of both factors were calculated. The mRNA expression levels of cadherin, α-SMA, and type I collagen were detected by RT-PCR (denoted as gray value ratio). Data were processed with one-way analysis of variance and LSD test.

RESULTS(1) The shape of primary HUVEC was round, short-spindle, or flat, and cells grew vigorously in cobblestone appearance after passages. After being subcultured for 1, 2, 3, 4, 5 passage (s), the positive rate of coagulation factor VIII of HUVEC was respectively (85.5 ± 1.8)%, (88.1 ± 5.0)%, (93.6 ± 3.7)%, (92.9 ± 4.8)%, (89.5 ± 1.1)%, and they were significantly higher than that of primary HUVEC [(81.4 ± 3.8)%, with F values all equal to 7.481, P values all below 0.05]. (2) As compared with that in control group, the appearance of cells in 5, 10, 25, 50, and 100 ng/mL TNF-α groups was gradually transformed from round, short-spindle, or flat shape to long-spindle shape with reduced intercellular junction and larger intercellular gap along with the increase in the concentration of TNF-α. (3) The ratios of numbers and the absorbance values of coagulation factor VIII and α-SMA double positive cells in control group (0.055 ± 0.015, 0.078 ± 0.017) were significantly lower than those in 5, 10, 25, 50, and 100 ng/mL TNF-α groups (0.257 ± 0.106, 0.280 ± 0.129, 0.505 ± 0.059, 0.817 ± 0.035, 0.929 ± 0.101 and 0.437 ± 0.040, 0.456 ± 0.097, 0.496 ± 0.082, 0.787 ± 0.131, 0.885 ± 0.087, with F value respectively 45.009, 50.099, P values all below 0.01). (4) The expression levels of cadherin mRNA in 5, 10, 25, 50, and 100 ng/mL TNF-α groups were 0.70 ± 0.05, 0.63 ± 0.06, 0.60 ± 0.10, 0.45 ± 0.16, and 0.26 ± 0.14, and it was significantly lower in the latter four groups than in control group (0.83 ± 0.03, with F values all equal to 11.593, P < 0.05 or P < 0.01). The mRNA expression levels of α-SMA and collagen I in 5, 10, 25, 50, and 100 ng/mL TNF-α groups were 0.45 ± 0.10, 0.51 ± 0.16, 0.49 ± 0.12, 0.60 ± 0.09, 0.76 ± 0.03 and 0.38 ± 0.18, 0.45 ± 0.15, 0.52 ± 0.12, 0.66 ± 0.17, 0.76 ± 0.20, and they were significantly higher in the latter three groups than in control group (0.37 ± 0.14, 0.31 ± 0.12, with F value respectively 7.839, 2.898, P < 0.05 or P < 0.01).

CONCLUSIONSTNF-α can obviously promote EnMT in a dose-dependent manner. EnMT may be another significant source of myofibroblasts that contributes to fibrotic tissue in scar formation.

Cell Differentiation ; Cells, Cultured ; Epithelial-Mesenchymal Transition ; drug effects ; Human Umbilical Vein Endothelial Cells ; cytology ; Humans ; Stromal Cells ; cytology ; Tumor Necrosis Factor-alpha ; pharmacology