Objective To explore the treatment of hemangioma associated with thrombopenia(Kasabach-Merritte syndrome,KMS) in infant.Methods The clinical manifestation and the therapy of 14 cases patients with KMS in hospital from 2003 to 2006 were collected ang analyzed,the 400 g/L urea(manufactured by ourself)combined with methylprednisolone local injection were used and followed 0.5 to 1.0 year.Results Two in 14 cases were emergency exairesis,7 cases were recurred for several times,12 cases were cured,1 case was improved,1 case was loss the connection.Conclusions It is an ideal therapy method to use the urea combined with glucocorticoid to treat infancy KMS,little trauma,definite effective,low side effect,high cure rate.

AIM: To observe the therapy effect of standard prescription on ametrop amblyopia in hyperopic children.
METHODS: This study included 270 cases ( 54 eyes ) with complete data, and followed up 24mo. All the amblyopic children were given standard prescription and were divided into progressive addition glass group, under corrected group and full corrected group. And all were observed for their therapy effect and the average healing time in low hyperopic, moderate hyperopic and high hyperopic children with ametropic amblyopia respectively.
RESULTS: In low hyperopic children, the difference of the therapy effect of the three corrected methods were insignificant in two years. The meam cure time of the three corrected methods were ( 7. 33 ± 2. 11 ) mo in progressive addition glass group;(9. 0±3. 71)mo in under corrected grope;(12. 5±5. 17) mo in full corrected group. Three groups of independent samples by paired t-test showed: the difference between progressive addition glass group and under corrected grope (t=1. 66, P>0. 05) was statistically insignificant; the difference between progressive addition glass group and full corrected grope ( t = 3. 92, P < 0. 01 ) was statistically significant; the difference between under corrected grope and full corrected grope ( t = 2. 33, P < 0. 05 ) was statistically significant. In moderate hyperopic chileren, the differences of the therapy effect of the three corrected methods were significant in two years (χ2=6. 75;P<0. 05). The difference between progressive addition glass group and under corrected grope (χ2 = 6. 3; P < 0. 01 ) was statistically significant; the difference between progressive addition glass group and full corrected grope (χ2=8. 1;P<0. 005) was statistically significant. The mean cure time of the three corrected methods were ( 14. 0±4-87) mo in progressive addition glass group; ( 16. 93±4-58)mo in under corrected grope; (17. 93±4. 42) mo in full corrected group. Three groups of independent samples by paired t-test showed: the difference between progressive addition glass group and under corrected grope (t=2. 88, P<0. 01) was statistically significant; the difference between progressive addition glass group and full corrected grope ( t= 3. 9, P<0. 01 ) was statistically significant;the difference between under corrected grope and full corrected grope ( t = 1. 01, P > 0. 05 ) was statistically insignificant. In high hyperopic amblyopic children, the difference of the therapy effect and the healing time of the three corrected methods were insignificant in two years. (χ2=2. 43, P>0. 05. t=1. 49, P>0. 05;t=1. 46,P>0. 05;t=1. 11, P>0. 05).
CONCLUSION:Under standard prescription, application of progressive multifocal glasses provides a new effective treatment for ametropic amblyopia in hyperopic children, and makes up the deficiency of the whole straightening and under correction in clinical treatment.

OBJECTIVETo investigate the protective effect of hypothermia combined with dexamethasone on spermatogenesis and the expression of intercellular adhesion molecule 1 (ICAM1) after testicular torsion-detorsion.

METHODSWe made unilateral testicular torsion models in 100 pubertal male Sprague-Dawley rats by 720 degree torsion of the left testis and then randomly divided them into four groups of equal number to be treated with normal temperature + physiological saline (group A), hypothermia + physiological saline (group B), normal temperature + dexamethasone (group C), and hypothermia + dexamethasone (group D). After 48 hours, we collected the testes, observed pathological changes of the testicular tissue by HE staining under the light microscope, detected the apoptosis of spermatogenic cells by TUNEL, and determined the expression of ICAM1 by Western blot.

RESULTSHE staining showed different degrees of testicular tissue injury in the four groups of rats, most obvious in group A, but mild in the other three. The ICAM1 protein expression was significantly higher in group A (0.68 +/-0. 03) than in B (0. 49 +/- 0. 06, P <0. 05) , C (0. 46 +/- 0. 09, P < 0.05) , and D (0.17 +/- 0.08, P <0.01). The nuclei were deep brown or brown. Lots of apoptotic spermatogenic cells were seen in the torsion testis of group A, with a significantly higher apoptosis index ( [33. 13 +/- 3.21 ]%) than in B ( [ 17. 12 +/-5.23 ]%, P < 0.05), C ([14.13 +/- 2.03]%, P <0.05), and D ([9.05 +/- 1.03]%, P <0.01).

CONCLUSIONHypothermia combined with dexamethasone can protect the testis from injury as well as the reproductive function of the testis after testicular torsion-detorsion and reduce the expression of ICAM1.

Animals ; Dexamethasone ; pharmacology ; Disease Models, Animal ; Hypothermia, Induced ; Intercellular Adhesion Molecule-1 ; metabolism ; Male ; Rats ; Rats, Sprague-Dawley ; Spermatic Cord Torsion ; metabolism ; physiopathology ; Spermatogenesis ; drug effects

Child ; Diagnosis, Differential ; Humans ; Lung ; pathology ; Lung Diseases, Interstitial ; diagnosis ; therapy ; Male ; Treatment Outcome

Objective To evaluate the minimally invasive surgery in coronary artery bypass grafting and the feasibility for revascularization of triple vessel coronary artery disease.Methods Nine female patients, aged 49.1 to 81.6 years (mean 64.3), were operated on for triple vessel disease through minimally invasive surgical techniques. The surgeries were performed through limited left parasternal incision under femorofemoral extracorporeal circulation. The myocardium was protected by antegrade infusion of cold blood cardioplegic solution while the aorta was cross-clamped. Under direct vision, the left saphenous vein grafts were connected sequentially to the diagonal branch, obtuse marginal branch and posterior descending branch, and the left internal thoracic arterial graft was anastomosed to the left anterior descending artery in each patient. Results The number of distal anastomoses was 3 to 4 with a mean of 3.7. The aortic crossclamp time was 52 to 130 minutes (82±25 minutes). The duration of extracorporeal circulation was 78 to 151 minutes (115±29 minutes). The postoperative course was uneventful in all patients. The postoperative length of stay was 4 to 12 days (7.2±2.0 days). Follow-up (4.2 to 8.7 months, mean 6.4) was complete in all patients and there were no late deaths or angina. Coronary angiography of 2 patients showed patent grafts. All patients were satisfied with the good cosmetic healing of the incision.Conclusion Our experience demonstrates that minimally invasive surgery in coronary artery bypass grafting is technically feasible and may be an alternative approach in surgical revascularization of triple vessel coronary artery disease, especially in female patients.

PURPOSE: This study aims to gain in-depth understanding of nurses' perspectives of working in an overcrowded emergency. METHODS: Symbolic interactionism and Charmaz's construction of grounded theory were used. Purposive sampling at the start of the study and a further theoretical sampling by snowball technique were used to recruit 40 registered nurses (RN) to participate in in-depth, semi-structured interviews betweenMay and November, 2014. Data analysis included analytic techniques of initial, focused and theoretical coding. RESULTS: Study findings showed searching for work role is derived by the themes of Finding the role of positioning in Emergency Department (ED), Recognizing causes of ED overcrowding, and Confined working environment. Nurses' work experience which represents the RNs not gained control over their work, as care actions influenced by the problematic overcrowded circumstance of the ED environment. CONCLUSION: The findings fill a gap in knowledge about how RNs experience their work role in the context of an overcrowded Emergency Department in Taiwan. Arising from the study result include taking account of nurses' perspectives when planning staff/patient ratios, strategies to reduce waiting time and ensure that clients receive appropriate care.
Clinical Coding ; Crowding ; Emergencies* ; Emergency Service, Hospital* ; Grounded Theory ; Humans ; Nurses ; Statistics as Topic ; Taiwan*

Administration, Sublingual ; Bacterial Vaccines ; administration & dosage ; immunology ; Child ; Child, Preschool ; Double-Blind Method ; Female ; Humans ; Immunoglobulin A ; blood ; Immunoglobulin A, Secretory ; analysis ; Male ; Pseudomonas Vaccines ; Recurrence ; Respiratory Tract Infections ; immunology ; prevention & control ; Treatment Outcome

OBJECTIVECOL9A1 gene is located in the susceptibility region of idiopathic congenital talipes equinovarus (ICTEV) (6q12-13). This study aimed to investigate the expression of the COL9A1 gene and the distribution of single nucleotide polymorphism (SNP) of COL9A1 gene in patients with ICTEV and normal controls.

METHODSImmunohistochemistry was used to detect the expression of COL9A1 in 25 children with ICTEV and 5 normal controls. The frequencies of genotypes and allele of two SNPs in COL9A1 gene rs35470562 and rs1135056 were investigated by PCR-restriction fragment length polymorphism (PCR-RFLP) and DNA sequencing in 118 patients with ICTEV and 100 normal controls.

RESULTSThe COL9A1 protein expression was significantly higher in 22 (88%) out of 25 children with ICTEV than normal controls. There were significant differences in the frequencies of genotypes and allele of rs1135056 in COL9A1 gene between the ICTEV and the control groups: the G allele frequency was higher, the frequency of AA genotype was lower, and the frequencies of AG and GG genotypes were higher in ICTEV patients than those in healthy controls (P<0.05).

CONCLUSIONSCOL9A1 protein is highly expressed in patients with ICTEV and rs1135056, which is located in the coding region of COL9A1 gene, may be associated with the pathogenesis of ICTEV.

Adolescent ; Child ; Child, Preschool ; Clubfoot ; etiology ; genetics ; Collagen Type IX ; analysis ; genetics ; Humans ; Immunohistochemistry ; Infant ; Polymorphism, Single Nucleotide

Adult ; Aged ; Female ; Fracture Fixation ; Humans ; Male ; Middle Aged ; Tibia ; injuries ; surgery ; Tibial Fractures ; surgery ; Treatment Outcome

OBJECTIVETo explore the feasibility of percutaneous vertebroplasty for the treatment of acute burst thoracolumbar fracture.

METHODSFifty-eight patients (male 38 and female 20, ranging in age from 38 to 70 years, with an average of 56.8 years) with acute burst thoracolumbar fracture were treated by percutaneous vertebroplasty. The injuried vertebrae were T11 in 3 cases, T12 18 cases, L1 29 cases, L2 5 cases and L3 3 cases. All suited cases were classified into 3 types according to injuried vertebral shapes,type I (safe type 26 cases), type II (risk type 21 cases), and type III (marginal type 11 cases).

RESULTSAll the patients were followed up ranging from 1 to 2.5 years (mean 1.6 years). Fifty-three patients could walk in 1 to 3 days after operation. Among 55 patients who obtained complete recovery (CR), 39 patients could do daily works and 16 patients could do houseworks. The CR rate was 95%. Three patients who obtained partial recovery (PR), could live by themselves and felt slight lumbago after movements. The PR rate was 5%.

CONCLUSIONPercutaneous vertebroplasty for the treatment of acute burst thoracolumbar fracture is a feasible and effective method even for particular risks.

Acute Disease ; Adult ; Aged ; Female ; Humans ; Lumbar Vertebrae ; injuries ; surgery ; Male ; Middle Aged ; Radiography ; Spinal Fractures ; diagnostic imaging ; surgery ; Thoracic Vertebrae ; injuries ; surgery ; Vertebroplasty ; methods