Objective To provide an anatomical basis for repairing the defect of cervical tracheal wall with vascularized pectoralis major tendon flaps.Methods Thirty-two lateral thoracic necrotomies were studied for the following aspects.Measurement of pectoralis major tendons' length,width and thickness.Anatomy of thoracoacromialartery,pectoral branches:origin,distribution.Measurement of length of pedicle,rotated radius of flaps and length from recipient site.An imitative operation was undergone on a specimen of corpse.One patient was undergone the operation of repairing the 3.0 cm × 1.5 cm defect of anterior cervical trachea wall,accompanying with incision infection,with pectoralis major tendon flap.Results Length of pectoralis major tendon:(22.9 ± 0.9)mm.Width of tendon:(51.0± 2.4)mm.Thickness of tendon:(5.81± 1.35)mm.Length of pedicle:(89.3 ± 5.3) mm.The radius of pedicle pectoralis major myotendinous flap:(121.7± 8.2)mm.The distance from pivot point of flap to central point of recipient:(96.5 ± 8.9)mm.Patient possessed normal pronunciation,good appearance and no emphysema at 5 months' follow-up.Tracheal lumen,measured 2.6 cm in the anteroposterior dimension and 1.8 cm in the lateral dimension,showed no recurrence of obvious stenosis in cervical computed tomography at 3 month postoperatively.Conclusion Pedicle pectoralis major tendon flaps,originated from thoracoacromial artery pectoral branches can repair cervical tracheal wall defects effectively.

Objective To assess the efficacy and safety of urinary kallidinogenase combined with sodium ozagrel for cerebral infarction (CI), and provide references for clinical rational drug use. Methods Retrieved from Cochrane library, PubMed, CBM, FMJS, VIP, Wangfang database and CNKI ( published until January 2015), randomized controlled trails (RCT)about urinary kallidinogenase combined with sodium ozagrel for treatment of CI were included,then methodological quality were evaluated and statistical analysis of those studies were carried out by Rev Man 5.3.4 software. Results 19 RCTs were included,involving 1 747 patients. Results of Meta-analysis showed that urinary kallidinogenase combined with sodium ozagrel could significantly improve total effective rate[RR= 1.18, 95%CI(1.13, 1.23), Z= 7.97, P<0.000 01], cure rate[RR = 1.42, 95%CI(1.23, 1.64), Z= 4.86, P<0.000 1], neurological deficit scores[MD= -4.40, 95%CI(-5.36, -3.43), Z= 8.90,P<0. 000 01] and activity of daily living scores[MD = 19.14, 95%CI(17.39, 20.90), Z = 21.36, P<0.000 01]. Conclusion Urinary kallidinogenase combined with sodium ozagrel was effective in the treatment of CI, and no significant adverse reactions were observed. The combination therapy was worthy of clinical application.

Biomarkers, Tumor ; CD59 Antigens ; physiology ; Glycosylphosphatidylinositols ; physiology ; Humans ; Membrane Cofactor Protein ; physiology ; Neoplasms ; diagnosis ; therapy

OBJECTIVETo compare the clinical efficacy differences between fire needling technique of filiform needle at high stress points and regular acupuncture on chrondromalacia patellae so as to provide the better therapy for the treatment of this disease.

METHODSSixty cases of chrondromalacia patellae were randomized into a fire needling group (28 cases) and a routine acupuncture group (32 cases). In the fire needling group, 5 to 6 high stress points were localized according to the symptoms, palpation and imaging condition and were stimulated with fire needling technique of filiform needle. The treatment was given once every two days, 5 treatments made one session. In the routine acupuncture group, the regular acupuncture was applied at Dubi (ST 35), Xiguan (LR 7), Yanglingquan (GB 34), Yinlingquan (SP 9), Zusanli (ST 36), etc. The treatment was given once every day, 5 treatments made one session. Lysholm score, VSA score, patella title angle (PTA) and lateral patella angle (LPA) of the affected knees before and after treatment, as well as the clinical efficacy after treatment were observed in the two groups.

RESULTSAfter treatment, Lysholm score, VSA score, PTA and LPA were all improved apparently in the two groups (all P < 0.01). After the treatments, the improvements in Lysholm score, VSA score, PTA and LPA in the fire needling group were more obvious than those in the routine acupuncture group (all P < 0.05). The effective rate was 92.9% (26/28) in the fire needling group, better than 87.5% (28/32) in the routine acupuncture group (P < 0.01).

CONCLUSIONThe fire needling technique of filiform needle at the high stress points relieves the clinical symptoms of chrondromalacia patellae and recovers the biodynamical structure of patellae.

Acupuncture Points ; Acupuncture Therapy ; instrumentation ; methods ; Adult ; Chondromalacia Patellae ; therapy ; Female ; Humans ; Male ; Middle Aged ; Treatment Outcome ; Young Adult

Objective To investigate the prevalence and clinical features of fulminant type 1 diabetes.Methods Using data retrieved from Second Xiangya Hospital of Central South University,all patients diagnosed with type 1 diabetes from Jan.1,2001 to Dec.31,2007 were identified.The patients were divided into fulminant type 1 diabetes (F1D) group,typical type 1 diabetes (T1A) group,and idiopathic type 1 diabetes(T1B) group.Their clinical features were compared.Results Eight patients (9.1%) fulfilled the criteria for fulminant type 1 diabetes among 87 newly diagnosed type 1 diabetes,and the percentage of fulminant type 1 diabetes reached 14.0% among type 1 diabetic patients with age of onset of 18 years or older.Patients of F1D group had a markedly higher plasma glucose concentration compared with patients of T1A group and T1B group(P=0.004).Serum amylase was higher in F1D group than that in T1A group(P = 0.021).Four (50%) patients were GADA positive,among whom 1 patient was Coxsackie B virus (CVB) IgM positive and 1 patient was Herpes Simplex virus 1 (HSV1) IgM positive.Conclusions Fulminant type 1 diabetes accounts for about 10% of the type 1 diabetes in the Chinese individuals with ketosis-or ketoacidosis-onset.Patients with this subset of diabetes had severe metabolic derangement.Viral infection and autoimmunity may be involved in the pathogenesis of fulminant type 1 diabetes.

It is unanimously accepted that stroke is a highly heterogeneous disorder.Different subtypes of ischemic stroke may have different risk factors,clinical features,and prognoses.The aim of this study was to evaluate the risk factors,clinical characteristics,and prognoses of different subtypes of ischemic stroke defined by the Trial of ORG10172 in Acute Stroke Treatment (TOAST) criteria.We prospectively analyzed the data from 530 consecutive patients who were admitted to our hospital with acute ischemic stroke within 7 days of stroke onset during the study period.Standardized data assessment was used and the cause of ischemic stroke was classified according to the TOAST criteria.Patients were followed up till 30 and 90 days after stroke onset.It was found that large-artery atherosclerosis was the most frequent etiology of stroke (37.4％),and showed the highest male preponderance,the highest prevalence of previous transient ischemic attack,and the longest hospital stay among all subtypes.Small artery disease (36.4％) was associated with higher body mass index,higher plasma triglycerides,and lower plasma high-density lipoprotein cholesterol than cardioembolism.Cardioembolism (7.7％),which was particularly common in the elderly (i.e.,individuals aged 65 years and older),showed the highest female preponderance,the highest prevalence of atrial fibrillation,the earliest presentation to hospital after stroke onset,the most severe symptoms on admission,the maximum complications associated with an adverse outcome,and the highest rate of stroke recurrence and mortality.Our results suggest that ischemic stroke should be regarded as a highly heterogeneous disorder.Studies involving risk factors,clinical features,and prognoses of ischemic stroke should differentiate between etiologic stroke subtypes.

OBJECTIVETo evaluate the role and the performance of diffusion weighted imaging (DWI) for predicting the early response to neoadjuvant chemotherapy (NAC) in local advanced breast cancer (LABC) and to assess the accuracy of DWI in evaluating residual lesion after NAC.

METHODS88 women with LABC (89 lesions) underwent DWI before and after the first and final cycle of NAC. For each patient, the apparent diffusion coefficient (ADC) values were compared between the baseline and follow-up to predict the early response to NAC. The residual tumor volumes were obtained using 3D maximum intensity projections (MIP) of DWI map, and were compared with pathological findings to assess the accuracy of DWI in detecting and measuring residual tumor. All results were proved or analyzed comparing with the data from histopathology.

RESULTSThere were 68 lesions responding to NAC, while 21 non-responders. The baseline ADC values of responders and non-responders were (1.049 +/- 0.135) x 10(-3) mm(2)/s and (1.171 +/- 0.134) x 10(-3)mm(2)/s, respectively, with a significant difference (t = -2.731, P = 0.009 < 0.01). The ADC value measured prior to treatment was (1.087 +/- 0.146) x 10(-3)mm(2)/s, and the degree of the changes in tumor volume after NAC was (70.4% +/- 55.1)%. A negative correlation was observed (r = -0.430, P = 0.025 < 0.05). In the response group, there was a significant difference in ADC value between prior to NAC and 1st cycle of NAC, the final cycle of NAC, respectively (P < 0.001). While no significant differences were found in non-responders during NAC (P > 0.05). The tumor volume correlation coefficient between DWI and pathology measurements was very high (r = 0.749, P < 0.01).

CONCLUSIONDWI appears to provide functional information regarding changes in ADC value of tumors due to NAC. DWI may be useful in monitoring the early pathological response of tumor after the initiation of treatment and in evaluating the residual tumor after NAC.

Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Breast Neoplasms ; drug therapy ; pathology ; Carboplatin ; administration & dosage ; Carcinoma, Ductal, Breast ; drug therapy ; pathology ; Carcinoma, Lobular ; drug therapy ; pathology ; Diffusion Magnetic Resonance Imaging ; methods ; Female ; Humans ; Middle Aged ; Neoadjuvant Therapy ; methods ; Neoplasm, Residual ; pathology ; Paclitaxel ; administration & dosage ; Prospective Studies ; Young Adult

BACKGROUNDGammad-crystallin plays an important role in human cataract formation. Being highly stable, gammaD-crystallin proteins are composed of two domains. In this study we constructed and analyzed protein models of the mutant gammaD-crystallin gene, which caused a special fasciculiform congenital cataract affecting a large Chinese family.

METHODSgammaD-crystallin protein structure was predicted by Swiss-Model software using bovine gammaD-crystallin as a template and Prospect software using human betab2-crystallin as a template. The models were observed with a Swiss-Pdb viewer.

RESULTSThe mutant gammaD-crystallin structure predicted by the Swiss-Model software showed that proline23 was an exposed surface residue and P23T change made a decreased hydrogen bond distance between threonine23 and asparagine49. The mutant gammaD-crystallin structure predicted by the Prospect software showed that the P23T change exerted a significant effect on the protein's tertiary structure and yielded hydrogen bonds with aspartic acid21, asparagine24, asparagine49 and serine74.

CONCLUSIONThe mutant gammaD-crystallin gene has a significant effect on the protein's tertiary structure, supporting that alteration of gamma-crystallin plays an important role in human cataract formation.

Animals ; Cattle ; Computer Simulation ; Hydrogen Bonding ; Models, Molecular ; Mutation ; Protein Structure, Tertiary ; gamma-Crystallins ; chemistry ; genetics ; physiology

OBJECTIVETo research the effect of polysorbate 80 (Tween 80) on Yuxingcao injection and volatile oils from Houttuynia cordata.

METHOD1H-NMR spectra of aldehydic and new matter in Yuxingcao injection, volatile oils of H. cordata, and solutions of Tween 80 and volatile oil of H. cordata are determined and compared from various angles of growing origin, storage temperature, and storage time.

RESULTThree aldehydic singlets in 1H-NMR spectra of every volatile oil from 4 aerial part of H. cordata were observed. These aldehydic peaks were basically disappeared and a new peak at delta 8.30 was found in 1H-NMR spectra of the volatile oil solutions in tween 80. Any obvious aldehydic peak in 1H-NMR spectra did not be observed in Yuxincao injection. A weak peak at 8 8.30 was found in 1H-NMR spectra in Yuxincao injection, and the peak high of delta 8.30 was remarked gone up when the injection was stored in 40 degrees C for 1 to 3 months.

CONCLUSIONTween 80 might cause the obvious reduce of aldehydic compounds contents and the production of a novel singal at delta 8.30 in 1H-NMR spectra when it was mixed with the volatile oil from the aerial part of H. cordata. The novel signal at delta 8.30 in 1H-NMR spectra existed in Yuxincao injection and was very small, but was increased remarkably when the Yuxincao injection was stored at 40 degrees C for 1 month at least.

Chemistry, Pharmaceutical ; instrumentation ; Drugs, Chinese Herbal ; chemistry ; Houttuynia ; chemistry ; Oils, Volatile ; chemistry ; Plant Oils ; chemistry ; Polysorbates ; Temperature

OBJECTIVETo search for a therapy for edema of the affected limb in patients of hemiplegia after stroke.

METHODSEighty patients were randomly divided into a treatment group and a control group, 40 cases in each group. The treatment group were treated by blood-letting puncture at 12 Jing-well points of the hand combined with fuming and washing with herbal lotion, and the control group were treated by oral administration of diuretic. The therapeutic effect was observed after treatment for 10 days.

RESULTSThe total effective rate was 85.0% in the treatment group and 70.0% in the control group with a significant difference between the two groups (P < 0.05). The cumulative score of symptoms of edema, improvement of skin pitting, damp and cool sensation, the function of limbs and the total score in the treatment group were better than the control group (P < 0.05); the cumulative score of TCM syndrome after treatment, improvement of the symptoms of limb flaccid paralysis, shortness of breath, weakness, dark-pale tongue proper and the total cumulative score were better than the control group (P < 0.05).

CONCLUSIONBlood-letting puncture at 12 Jing-well points of the hand combined with fuming and washing with Chinese herbal lotion is effective for edema of the affected limb in patients of hemiplegia after stroke.

Acupuncture Points ; Adult ; Aged ; Drugs, Chinese Herbal ; therapeutic use ; Edema ; therapy ; Female ; Hand ; Hemiplegia ; therapy ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Phlebotomy ; methods ; Stroke ; complications ; therapy