Objective To explore the clinical features,diagnosis and treatment of serious pyogenic infection in deep neck. MethodsFrom January 2002 to April 2005,the clinical data of 22 patients hospitalized with serious pyogenic infection in deep neck were collected and retrospectively analysed. Results All the patients suffered unilaterally.Besides the symptoms of infection,dyspnea,pain in swallowing,limitation of mouth opening and progressive limitation of cervical activity were presented.Bacterial cultivation were performed in 14 patients and positive results were detected in six.Fourteen of all the 22 patients were cured with antibiotics,and abscess incision drainage was carried out in the other eight.Preoperative cervical PA-LAT X-ray photography and contrast-enhanced CT scanning were performed on one and seven patients,respectively,all of which indicated the formation of abscess.All the patients were cured except one who died of cerebral infarction and multiorgan dysfunction. Conclusion Imaging evaluation plays a significant role in the preoperative diagnosis and systemic treatment of serious pyogenic infection in deep neck.Bacterial cultivation provides reliable evidence for the etiopathogenisis and helps to make the effective treatment.

Carotid Artery, Internal ; diagnostic imaging ; Cerebrovascular Disorders ; diagnostic imaging ; physiopathology ; Extremities ; physiopathology ; Humans ; Ischemic Attack, Transient ; complications ; diagnostic imaging ; drug therapy ; Male ; Middle Aged ; Middle Cerebral Artery ; diagnostic imaging ; Thromboembolism ; diagnostic imaging ; physiopathology ; Ultrasonography, Doppler, Transcranial

Mg2Ni0.8Cr0.2-x wt.% CoO/Al2O3 (x=0.5, 1, 2 and 3) composites were prepared by mechanically milling sintered Mg2Ni0.8Cr0.2 alloy and CoO/Al2O3 compound for 45 h. The addition of CoO/Al2O3 compound resulted in the good kinetics properties of hydriding/dehydriding reaction of the composites. The composite with 1.0 wt.% CoO/Al2O3 catalyst could reach the maximum hydrogen absorption capacity (2.9 wt.%) within 5 min at 393 K under H2 pressure of 4 MPa, and can desorb rapidly at 493 K. The decomposition and synthesis of hydrogen molecule on Mg2Ni0.8Cr0.2 alloy surface was promoted by addition of CoO/Al2O3 catalyst. In addition, the formation of metallic Ni particles, strain and defects during the ball milling process also resulted in the improved hydrogenation performance of Mg2Ni-based alloys.
Absorption ; Aluminum Oxide ; analysis ; chemistry ; Hot Temperature ; Hydrogen ; analysis ; chemistry ; Kinetics ; Magnesium Compounds ; analysis ; chemistry ; Manufactured Materials ; analysis ; Materials Testing ; Molecular Conformation ; Nitrogen Compounds ; analysis ; chemistry ; Pressure ; Temperature

UNLABELLEDobjective: To investigate effects of buyang huanwu decoction (BYHWD) on the rats' myocardial hypertrophic model induced by abdominal aortic constriction, and to clarify the molecular regulatory mechanisms for sarcoplasmic reticulum calcium uptake.

METHODSHypertrophic myocardium rat model was induced by abdominal aorta constriction (AAC). Four weeks after modeling, rats were randomly divided into the sham-operation group (Group S), the AAC model group (Group M), the Enalapril group (Group E), and the BYHWD treatment group (Group BYHWD), respectively. The left ventricular systolic pressure (LVSP), left ventricular end-diastolic pressure (LVEDP), + dp/dtmax,-dp/dtmax, cardiac output (CO), heart mass index (HMI), and left ventricular mass index (LVMI) were observed in each group after 12-week medication. The serum contents of the atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) were detected using ELISA. The SERCA2a activity, the ex- pressions of SERCA2a, phospholamban (PLN), and PLN phosphorylation were observed finally.

RESULTSCompared with Group S, LVSP and LVEDP significantly increased,-dp/dtmax and CO obviously decreased, the myocardial tissue was obviously thickened, the serum contents of ANP and BNP increased, the activity and expression of SERCA2a decreased, the SERCA2a/PLN ratio and PLN phosphorylation degree decreased in Group M (all P <0.05). Compared with Group M, LVEDP obviously decreased, -dp/dtmax and CO obviously increased, the hypertrophy myocardial tissue was obviously lessened, the serum contents of ANP and BNP decreased, the activity of SERCA2a increased, the relative expression contents of SERCA2a, Ser16, and Thrl7 were elevated in Group BYHWD (all P <0.05). BYHWD had significant roles in elevating the SERCA2a/PLN ratio and PLN phosphorylation degree (P <0.05).

CONCLUSIONBYHWD could significantly improve hemodynamics of heart failure rats, elevate CO, lessen cardiac hypertrophy, and improve the capabilities for sarcoplasmic reticulum calcium uptake.

Animals ; Aortic Aneurysm, Abdominal ; metabolism ; pathology ; Calcium ; metabolism ; Constriction, Pathologic ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; Hypertrophy, Left Ventricular ; metabolism ; pathology ; Male ; Myocardium ; pathology ; Rats ; Rats, Wistar ; Sarcoplasmic Reticulum ; metabolism

Omega-3 polyunsaturated fatty acids (or omega-3 PUFAs, n-3 PUFAs) are essential nutrients throughout the life span.Recent studies have shown the importance of n-3 PUFAs supplementation during prenatal and perinatal period as a potential protective factor of neurodevelopmental disorders. N-3 PUFAs have been reported to be lower in youth with attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD) and major depressive disorder (MDD).N-3 PUFAs supplementation has shown potential effects in the improvement of clinical symptoms in youth with ADHD, ASD, and MDD, especially those with high inflammation or a low baseline n-3 index. Moreover, it has been suggested that n-3 PUFAs had positive effects on lethargy and hyperactivity symptoms in ASD. For clinical application, the following dosage and duration are recommended in youth according to available randomized controlled trials and systemic literature review: (1) ADHD: a combination of eicosapentaenoic acid (EPA) ＋ docosahexaenoic acid (DHA) ≥ 750 mg/d, and a higher dose of EPA (1,200 mg/d) for those with inflammation or allergic diseases for duration of 16−24 weeks;(2) MDD: a combination of a EPA ＋ DHA of 1,000−2,000 mg/d, with EPA:DHA ratio of 2 to 1, for 12−16 weeks;(3) ASD: a combination of EPA ＋ DHA of 1,300−1,500 mg/d for 16−24 weeks as add-on therapy to target lethargy and hyperactivity symptoms. The current review also suggested that n-3 index and inflammation may be potential treatment response markers for youth, especially in ADHD and MDD, receiving n-3 PUFA.

Objective　To explore the characteristics of the changes of several metabolic and biochemical indices in dogs with both hindlimbs injured by kinetic weapon. Methods　12 animals were divided into 4 groups (Group Ⅰ, injured by regular weapon; Group Ⅱ,Ⅲ,Ⅳ injured by imitative kinetic weapons with different energy respectively). Levels of plasma Na+,Ca2+,K+ glucose, AMY, LDH, CK and serum T3,insulin,TSH were determined before and after injured. Results　①Local wounding conditions and distant organs' injuries in group Ⅱ,Ⅲ, and Ⅳ were more serious than those in group Ⅰ. ②Levels of plasma glucose in group Ⅱ,Ⅲ and Ⅳ were inereased significantly after injury than before(P<0.05), but not in group Ⅰ. Levels of Na+,Ca2+,K+,AMY,LDH in 4 groups had similar changes after injury while levels of CK in group Ⅱ,Ⅲ and Ⅳ were inereased significantly than that in group Ⅰ (P<0.05). ③After injury, levels of T3 in serum of all animals showed a decreased tendency and that of insulin decreased more significantly (P<0.05). There was no difference between every two groups. Levels of TSH in group Ⅱ,Ⅲ and Ⅳ were increased significantly after injured than before (P<0.05), but not in group Ⅰ. Conclusion　Not only local severe injury but also more serious injury in distant organs and more obvious changes of metabolic and biochemical indices can be induced by kinetic weapons than regular weapons.

OBJECTIVETo explore the clinical effect of talar neck fractures treated by open reduction and internal fixation with screws.

METHODSAmong 28 cases in the study, 20 cases were males and 8 cases were female. The age ranged from 22 to 72 years with an average of 38 years. Based on the Hawkins classification,there were 6 cases of type I,18 of type I and 4 of type II. They were treated by open reduction and internal fixation with screws.

RESULTSTwenty-eight cases were followed up for 1 to 7 years(mean 2.8 years). The evaluation of the results by Hawkins functional rating scale revealed excellent in 14 cases,good in 9 cases, fair in 3 cases and poor in 2 cases. The excellent and good rate were 83.2%. Osteonecrosis occurred in 5 cases with 3 of type II and 2 of type III fractures. Two of 3 cases with talar displacement were found with osteonecrosis or painful arthritis. The subtalar arthritis occurred in 6 cases, 3 of which were associated with ankle arthritis. Two cases underwent arthrodesis because of painful arthritis of the subtalar joint or osteonecrosis of the talar body. Wound infection and anteromedial skin necrosis of the ankle were not found.

CONCLUSIONTreatment of talar neck fractures could obtain satisfactory clinical results through open reduction and internal fixation with screws. Protection of the residual blood supply, anatomically reduction and stable fixation are essential for successful treatment of talar neck fractures.

Adult ; Aged ; Bone Screws ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; diagnostic imaging ; surgery ; Humans ; Male ; Middle Aged ; Radiography ; Talus ; injuries ; surgery

BACKGROUND/AIMS: Only moderate to severe Crohn's Disease (CD) patients without a satisfactory conventional therapy effect are eligible to get reimbursement from the National Health Insurance of Taiwan for using adalimumab. These are more stringent criteria than in many Western countries and Japan and Korea. We aim to explore the efficacy of using adalimumab in CD patients under such stringent criteria. METHODS: A retrospective analysis was conducted in nine medical centers in Taiwan and we collected the results of CD patients receiving adalimumab from Sep 2009 to Mar 2014. The clinical characteristics, response measured by CDAI (Crohn's Disease Activity Index), adverse events and survival status were recorded and analyzed. CR-70, CR-100, and CR-150 were defined as attaining a CDAI decrease of 70, 100 or 150 points compared with baseline. RESULTS: A total of 103 CD patient records were used in this study. Sixty percent of these patients received combination therapy of adalimumab together with immunomodulators. CR-70 was 68.7%, 74.5% and 88.4% after week 4, 8 and 12 of treatment, respectively. The steroid-free rate, complications and survival were 47.6%, 9.7% and 99% of patients, respectively. In considering the mucosal healing, only 25% patients achieve mucosal healing after treatment for 6 to12 months. Surgery was still needed in 16.5% of patients. Combination treatment of adalimumab with immunomodulators further decreased the level of CDAI at week 8 when compared with the monotherapy. CONCLUSIONS: Even under the stringent criteria for using adalimumab, the response rate was comparable to those without stringent criteria.
Adalimumab ; Crohn Disease* ; Humans ; Immunologic Factors ; Inflammatory Bowel Diseases* ; Japan ; Korea ; National Health Programs ; Retrospective Studies ; Taiwan*

OBJECTIVETo report the modified technique and the short-term results of simultaneous pancreas-kidney transplantation (SPK) with the enteric drainage (ED) of exocrine secretions.

METHODSFrom June 2000 to August 2006, thirty-eight patients with diabetes complicated with uremia underwent SPK. The pancreas graft was placed intraperitoneally with exocrine secretions drained into the proximal jejunum without Roux-en-Y procedure. The mean cold ischemic times of pancreas and kidney were (10 +/- 2.0) h and (7 +/- 2.0) h, respectively. Quadruple immunosuppressive therapy with antilymphocyte globulin or anti-CD25 monoclonal antibody, tacrolimus, mycophenolate mofetil and steroids was adopted except one patient.

RESULTSThe 6-month survival rates of patients and grafts were both 97.4% after transplantation. All patients achieved insulin-free euglycemia at (7 +/- 6.9) d postoperative except one. For preoperative patients, mean fasting insulin and C-peptide values were (9 +/- 8.1) mU/L and (6 +/- 4.5) mU/L. After operation, fasting insulin and C-peptide values of patients were (12 +/- 5.8) mU/L and (6 +/- 4.7) mU/L, respectively, which peaked to an insulin level of (57 +/- 43.0) mU/L and a C-peptide level of (11 +/- 6.8) mU/L with stimulation. There were eight cases of delayed renal graft function. All other patients achieved immediate renal graft function. No graft losses occurred due to leakage or intra-abdominal infection. The most common surgical complications were wound infection (n = 12), enteric anastomostic hemorrhage (n = 5) and perirenal hemorrhage (n = 2). Three patients (7.9%) had been reoperated for the reasons of intra-abdominal hemorrhage and perirenal hemorrhage.

CONCLUSIONSSPK is an effective treatment option for selected patients with diabetes mellitus and approaching end-stage renal disease. Enteric exocrine drainage by direct side-to-side anastomosis (without Roux-en-Y) seems to be a simple and reliable technique.

Diabetes Mellitus ; surgery ; Drainage ; methods ; Female ; Follow-Up Studies ; Graft Rejection ; prevention & control ; Graft Survival ; Humans ; Immunosuppressive Agents ; therapeutic use ; Jejunum ; surgery ; Kidney Transplantation ; methods ; Male ; Middle Aged ; Pancreas Transplantation ; methods ; Postoperative Complications ; prevention & control ; Treatment Outcome ; Uremia ; surgery

Objective To investigate the natural history of HIV infection caused by contaminated plasma donation among former commercial plasma donors in China. Methods Ambispective cohort study among HIV/AIDS cases and suspected AIDS deaths was conducted from January 1,1995 to March 31,2008 in 7 administrative villages in Shangcai county of Henan province.Information regarding diagnostic criteria, deaths and anti-retrovirus treatment was collected.Incubation and survival time were calculated using Kaplan-Meier and life-tables method. Sensitive analysis on the time of outcome was conducted. Results A total number of 2569 cases of HIV infection including 483 suspected AIDS deaths were involved in a cohort. 200 patients with rapid progress (7.8%) and 337 long-term but non-progressive patients (13.1%) were identified. Results from the sensitive analysis showed that the median incubation period from HIV infection to AIDS was between 8.5 and 8.9 years, with incidence as 11.7-12.0 cases/100 person-years and the median survival time for HIV progression to death was from 8.8 to 10.7 years, with the death rate as 6.9-8.3 cases/100 person-years. The median survival time for AIDS patient was from 1.2 to 2.0 years, with death rate as 34.9-51.5 cases/100 person-years. Conclusion According to sensitive analysis, the incubation period for HIV progression to AIDS, the median survival time for HIV progression to death and the median survival time for AIDS patient to death were 8.8 years, 1.2 years and 9.8 years,respectively.