Adult ; Calmodulin-Binding Proteins ; metabolism ; Desmin ; metabolism ; Diagnosis, Differential ; Female ; Humans ; Leiomyoma ; metabolism ; pathology ; surgery ; Leiomyosarcoma ; pathology ; Spinal Canal ; Spinal Neoplasms ; metabolism ; pathology ; surgery ; Young Adult

OBJECTIVETo investigate the result of hip arthroplasty for failed internal fixation of femoral neck fractures.

METHODSFrom June 2007 to January 2014, 29 cases who underwent hip arthroplasty for failed of internal fixation of femoral neck fractures were reviewed. There were 12 males and 17 females. The mean age was 60.3 years (ranged 43 to 83 years) at the time of the fracture. Left hip was in 16 cases, right hip was in 13 cases. The average interval from fracture to arthroplasty was 23.3 months (ranged, 3 to 48 months).

RESULTSAll of 29 cases were performed total hip arthroplasty. There were 20 cases of cementless cup,7 cases of cementless cup with bone graft, 2 cases of cemented cup with bone graft; 13 cases of cementless stem, 16 cases of cemented stem. There were no complications occurred such as intraoperative fracture of the greater trochanter. The average operative time was (115 ± 38) minutes,the mean intraoperative blood loss was (420 ± 175) ml, the average postoperative drainage volume (240 ± 119) ml, intraoperative blood transfusion was (200 ± 220) ml, intraoperative fluid volume was (2,200 ± 400) ml, the average postoperative blood transfusion was (300 ± 200) ml. There was 1 case get postoperative dislocation. All patients were followed up for 14.7 months in average (ranged, 5 to 24 months). There was no revision for mechanical failure. Harris Hip Score significantly was improved from 51.1 ± 7.5 before the conversion to 88.5 ± 6.4 points at the final follow-up.

CONCLUSIONThe effect of the hip replacement for patients with failed internal fixation of femoral neck fractures was confirmed. This method can shorten the time on the bed and reduce the complications. It benefits the patients earlier functional recovery, but it must control operation indication. The long term efficacy is necessary to further observation.

Adult ; Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip ; methods ; Female ; Femoral Neck Fractures ; surgery ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Treatment Failure

OBJECTIVETo explore the efficacy and feasibility of dog days moxibustion plaster therapy in treatment of allergic rhinitis of different patterns/syndromes.

METHODSAllergic rhinitis of lung deficiency and invasion of cold, spleen qi deficiency and kidney yang deficiency, 56 patients for each pattern/syndrome were randomized into a plaster therapy group and a nasal spray group, 28 cases in each one. In the plaster therapy group, according to the pattern/syndrome differentiation, with literature retrieval method, 3 acupoints of high frequency utility in clinic were selected as one group in acupoint plaster therapy. For lung deficiency and invasion of cold pattern/syndrome, Feishu (BL 13), Fengmen (BL 12) and Hegu (LI 4) were selected. For spleen qi deficiency pattern/syndrome, Pishu (BL 21), Zusanli (ST 36) and Dazhui (GV 14) were selected. For kidney yang deficiency pattern/ syndrome, Shenshu (BL 23), Dingchuan (EX-B 1) and Bailao (EX-HN 15) were selected. Separately, on July 13, 2013, July 23, 2013, August 2, 2013 and August 12, 2013, the aucpoint plaster therapy was applied, 2 to 4 h (1 to 2 h for children) each time. In the nasal spray group, beclometasone dipropionate aqueous nasal spray, 2 presses one nostril each time, 2 to 3 times a day, continuously for 4 weeks. The symptom score and efficacy were compared before and after treatment in the patients of the two groups.

RESULTSThe symptom scores of 3 patterns/syndromes were all apparently improved after treatment as compared with those before treatment in the patients of the two groups (all P<0.05), and the result in the plaster therapy group was better than that of the nasal spray group (P<0.05, P<0.01). For lung deficiency and invasion of cold pattern/syndrome, the total effective rate was 87.3% (20/24) in the plaster therapy group, better than 84.6% (22/26) in the nasal spray group (P<0.05). For spleen qi deficiency pattern/syndrome, the total effective rate was 83.3% (20/24) in the plaster therapy group, obviously better than 76.9% (22/26) in the nasal spray group (P<0.05). For kidney yang deficiency pattern/syndrome, the total effective rate was 79.2% (19/24) in the plaster therapy group, better than 76.9% (22/26) in the nasal spray group (P<0.05).

CONCLUSIONThe dog days moxibustion plaster therapy achieves definite efficacy on allergic rhinitis at the acupoints selected based on the differentiation of different patterns/syndromes and the efficacy is better than beclometasone dipropionate aqueous nasal spray.

Acupuncture Points ; Administration, Cutaneous ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Animals ; Child ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Male ; Middle Aged ; Rhinitis, Allergic ; drug therapy ; therapy ; Yang Deficiency ; drug therapy ; Young Adult

AIM: To further investigate the etiology and treatment strategies of diabetic macular edema(DME)by studying the correlation between responses to intravitreal injection of Ranibizumab(IVR)and diabetic retinopathy(DR)extent in DME patients.

METHODS: This study comprised 33 eyes of 27 non proliferative diabetic retinopathy(NPDR)patients with DME and 34 eyes of 32 PDR patients with DME, who had been followed for at least 6mo after IVR. We compared the responses to the anti-VEGF treatment between the two groups.

RESULTS: NPDR patients had strong statistical improvement in best corrected visual acuity(BCVA)and central macular thickness(CMT)after both 3-month treatment and 6-month treatment(P<0.05), While PDR patients had not(P>0.05). There were also statistical differences(P<0.05)in BCVA and CMT between NPDR group and PDR at a time when the patients had received both 3-month treatment and 6-month treatment.

CONCLUSION: Different extents of DR have influence on DME responses to anti-VEGF.

OBJECTIVETo investigate the results of hip arthroplasty for the treatment of severe comminuted proximal femoral fracture with ipsilateral acetabulum fracture.

METHODSFrom June 2007 to September 2013, 8 patients (8 hips) with severe comminuted proximal femoral fracture combined with ipsilateral acetabulum fracture were treated with hip arthroplasty. All patients were male and using biological prosthesis. Aged from 33 to 64 years old with an average of 41.9 years. According to Harris score in aspect of pain, function, range of motion to evaluate clinical effects.

RESULTSThere was no untoward reaction in 8 patients. And bed rest at 3 months after operation, waiting for acetabulum fracture healed to out-of-bed activity. There was no complications such as pneumonia, bedsore and so on in the patients. Follow-up time was from 9 to 72 months with an average of 35.8 months, the wound healed, there was no the subsidence and loosening of prosthesis, no dislocation and infection. The mean of Harris score was 87.5 points after operation.

CONCLUSIONThe effect of the hip replacement in treating severe comminuted proximal femoral fracture with ipsilateral acetabulum fracture is confirmed. It can restore motor function and reduce traumatic complication, may serve as a substitute for internal fixation of difficult operation. The long-term efficacy is necessary to further observe.

Acetabulum ; injuries ; surgery ; Adult ; Arthroplasty, Replacement, Hip ; methods ; Femoral Fractures ; physiopathology ; surgery ; Fractures, Comminuted ; physiopathology ; surgery ; Humans ; Male ; Middle Aged ; Range of Motion, Articular

OBJECTIVETo study the feasibility of applying expanded forehead axial flaps with fascia pedicles carrying bilateral frontal branches of superficial temporal artery and vein (expanded forehead axial flap with double pedicles in brief, EFAF-DP) in repairing scars in submaxillary region.

METHODSSixteen patients with mandibular scars hospitalized in Department of Burns and Plastic Surgery of the First Hospital Affiliated to Fuzhou General Hospital in Nanjing Military Area Command from July 2005 to December 2009 were repaired with EFAF-DP. The operation consisted of 3 stages. Before operation, the location and course of superficial temporal arteries and veins (STAV) and their frontal and parietal branches were identified with Ultrasonic Doppler blood flow detector. In stage I, STAV were dissected from the frontalis muscle as a pedicle to form a skin soft tissue space to hold the dilator of a proper size. In stage II, after gradual dilation by repeated filling with saline, the dilator was removed. EFAF-DP was dissected to repair mandibular scar. Donor site was closed with sutures. In stage III, flap pedicles were divided and pruned.

RESULTSFlap sizes ranged from 25 cm × 6 cm to 33 cm × 16 cm. The duration of dilation was 3-5 months, with 3.6 months in average. Ten patients underwent the operation of EFAF-DP transplantation and cervical skin dilatation. All flaps survived with healing of wounds. Disorder of venous return at the distal end of one flap was seen after second stage surgery, and it was corrected after comprehensive treatment including relieving spasm and improving venous return. Donor site wounds healed with normally grown hair without cicatricial alopecia along the hairline. Few hairs grew around mandible in one female patient out of the three (no hair grew on flaps of other two patients). This female patient and two male patients requesting for beard plasty received laser depilation treatment 1 to 3 months after discharge, with good result. Other male patients received no special treatment for their beard, and they shaped their beard with shaver. Sixteen patients were followed up for 6 to 24 months, and the shape of the flaps and beard (excluding female patients) were satisfactory with good appearance, satisfactory skin color and texture. The mobility of neck was obviously improved.

CONCLUSIONSEFAF-DP provides bigger areas of a thin flap besides promoting vascularization of new vessels of flap. Extra expanded skin can be directly sutured at the fringe of hairline, which makes skin grafting unnecessary, and decreases the incidence of secondary deformity in donor sites. Some hair carried by the flaps can be directly used for beard reconstruction after rotation to help the male patients have a better appearance.

Adolescent ; Adult ; Cicatrix ; surgery ; Female ; Humans ; Male ; Surgery, Plastic ; methods ; Surgical Flaps ; blood supply ; Temporal Arteries ; transplantation ; Tissue Expansion ; Veins ; transplantation ; Young Adult

OBJECTIVETo investigate the clinical effect of spanishneedles leaves on middle and severe xerophthalmia of menopausal females.

METHODThis study was a prospective random controlled trial. Ninty-six menopausal females diagnosed with xerophthalmnia (aged from 40 to 50) were randomly divided into in two groups: group A' the spanishneedles leaves group (n=48) and group B' the control group (n=48). Both groups were treated with Forte eye drops. All patients were detected at 3, 7, 28 h before and after treatment to evaluate subjective symptoms, OSDI and four tear film indicators. Variance analysis and differential analysis on sample average or median were made on both groups before and after treatment.

RESULTThere were no significant difference in symptom and diction indicators between both groups before treatment. For 28 d after treatment, among middle and severe xerophthalmia samples of the spanishneedles leaves group, the mean differences showed significant improvement compared with that before treatment , OSDI and four tear film indicators also showed improvement to varying degrees. For 28 d after treatment, among middle and severe xerophthalmia samples of the vitamin C group, the mean differences showed no significant improvement compared with that before treatment , OSDI and four tear film indicators also showed no remarkable improvement. There were significant differences in OSDI, BUT, SIT, height of tear meniscus and FL between both groups.

CONCLUSIONSpanishneedles leaves can effectively improve symposiums and signs of middle and severe xerophthalmia among menopausal females and thus showing clinical significance to some extent.

Adult ; Female ; Humans ; Menopause ; Middle Aged ; Plant Leaves ; chemistry ; Plants, Medicinal ; Treatment Outcome ; Xerophthalmia ; drug therapy

ABO Blood-Group System ; Erythroblastosis, Fetal ; epidemiology ; Humans ; Infant, Newborn

OBJECTIVETo evaluate the status of lymph node metastasis (LNM) and reasonable procedure in early gastric cancer (EGC).

METHODSTwo hundred and ninety-two patients with histologically proven mucosal or submucosal gastric cancer who underwent gastrectomy/lymphadenectomy were included in this study. The numbers of total dissected lymph node were all above 15 in all patients. The clinical characteristics, pathologic features, and LNM were assessed by univariate and multivariate analysis.

RESULTSLNM were observed in 43 of 292 cases (14.7%), and 6.4% in mucosal lesions and 22.4% in submucosal lesions. The LNM was identified in 12.7% at the first level, 7.2% at the second level and 0.34% at the third level. The LNM frequency was found in the 6, 3, 4, 1, 5 lymph node (from high to low) consequently at the first level and the 7, 8a lymph node at the second level. The EGC with nodal involvement and the tumors < 2.0 cm in diameter were all depressed type. The diameter of elevated type with LNM was no less than 3.0 cm in this series. The depth of invasion and lymphatic vessel involvement were independent influencing factors in LNM on multivariate analysis (P<0.05).

CONCLUSIONSLess extensive surgery might be considered for the elevated type EGC, and tumors 3.0 cm in diameter. With respect to the depressed type EGC/tumors > 3.0 cm in diameter, gastrectomy with D2 lymphadenectomy is proper.

Adult ; Aged ; Aged, 80 and over ; Female ; Gastrectomy ; methods ; Humans ; Lymph Node Excision ; methods ; Lymph Nodes ; pathology ; surgery ; Lymphatic Metastasis ; Male ; Middle Aged ; Multivariate Analysis ; Retrospective Studies ; Stomach Neoplasms ; pathology ; surgery

Objective To explore the association of body mass index (BMI),waist circumstance (WC)and the risk of hypertension among residents.Methods Multi -stage stratified random sampling was conducted to recruit the study objects in Huai'an City.The questionnaire investigation and body measurement were conducted to collect relevant data. Results The prevalence rates of hypertension in male and female residents of Huai'an City were 28.73% and 28.08%, respectively,with the standardized rates were 20.22% and 19.39%.Influencing factors of hypertension were gender (OR=0.88,95%CI :0.815 -0.952),age(OR =1.55,95%CI :1.503 -1.601),WC(OR =1.40,95%CI:1.294 -1.518),BMI (OR =1.50,95% CI:1.417 -1.578 ),respectively.Conclusion BMI and WC were related to hypertension.The control of BMI and WC can prevent hypertension effectively.