Equipment Design ; Facial Injuries ; therapy ; First Aid ; instrumentation

Objective To investigate the feasibility,security,indication and prophylactic measures of postpartum hemorrhage during the fetalintrapartum operation by analyze the maternal prognosis after intrapartum fetal operation(IFO) performed.Methods We performed a retrospective evaluation of 10 cases that has been performed intrapartum fetal operation(IFO group,n=10) successfully between August 2008 and October 2009 at Department of Obstetrics and Gynecology,Shengjing Hospital,China Medical University.Healthy pregnant women(n=10) were chosen as control group,who received Caesarean section for refusing to vaginal delivery.Between the two groups,we compared the indexes including blood lose during the operation and 24 hours post-operation,the hemoglobin level pre-operation and 24 hours post-operation,the involution of uterus,the puerperal infection,and the follow-up at 42 days post-operation.Results Good involution,no primary and secondary postpartum hemorrhage and no puerperal infection were found in both of the 2 groups.Intra-operation,24 hours post-operation and the total volumes of blood lose,the hemoglobin level before operation,24 hours post-operation and 42 days post-operation had no statistic significant difference between the IFO group and control group(P>0.05).No significant difference was found in the operation time between IFO group and the control group(66.40±53.40 minutes and 34.50±4.97 minutes,respectively.Intra-operation,24 hours post-operation and the total volume of blood lose had no relation to the maternal age and gestational weeks(P>0.05).The blood lose of intra-operation in IFO group had positive linear correlation to the operation time.(Pearson relation coefficient R=0.458,.P=0.021).The linear recurrence equation was:the volumes of blood lose intra-operation(ml)=172.68+1.342x(operation time).Conclusion IFO was safe to the mother.It did not affect the involution of uterus and could not increase the blood lose of postpartum and the puerperal infection morbidity.Through the effective measures of preventing postpartum hemorrhage,the postpartum blood lose of the patients that performed intrapartum fetal operation could be no more than that of the patients that had normal Caesarean section.Improving the technique of the intrapartum fetus operation and shortening the operation time are important to prevent postpartum hemorrhage.

Acupuncture Analgesia ; methods ; Adult ; Anesthesia, Intravenous ; methods ; Brain Neoplasms ; physiopathology ; surgery ; Female ; Follow-Up Studies ; Glioma ; physiopathology ; surgery ; Humans ; Male ; Middle Aged ; Young Adult

OBJECTIVETo analyze the results of clinical and bacteriological examinations in patients with crush syndrome who suffered infectious complications after an earthquake in Sichuan, China.

METHODSA total of 313 bacteriological samples among 147 patients with crush syndrome were collected. Infectious complications, results of microbiological examinations, potential risk factors of infection and mortality were analyzed statistically.

RESULTSIn the obtained database, 112 out of the 147 (75.7%) patients had infectious complications, in which, wound infection, pulmonary infection, and sepsis were most common. The time under the rubble and the time from injury to treatment were related to the occurrence of wound infection (P equal to 0.013, odds ratio 2.25; P equal to 0.017, odds ratio 2.31). Sepsis and wound infection were more common in patients who underwent fasciotomy or amputation than in those who did not (P equal to 0.001).

CONCLUSIONQuick rescue and injury treatment can decrease the infection risk in crush syndrome patients. It is better to obtain microorganic proofs before applying antibiotics, and bacteriological and drug sensitivity data should be taken into account, especially considering that most of these infections are hospital-acquired and drug resistance. Emphasizing the accuracy and efficiency of wound management in emergency situations, cautiously assessing the indications for fasciotomy to avoid open wounds from unnecessary osteofascial compartment decompression incisions may decrease the incidence of infection and ameliorate the prognosis.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bacterial Infections ; etiology ; Child ; Child, Preschool ; China ; Crush Syndrome ; complications ; microbiology ; Earthquakes ; Female ; Humans ; Male ; Middle Aged ; Risk Factors

AIMTo study the antitumor peptide components in the stems and leaves of mistletoe (Viscum coloratum (Kom.) Nakai), the primary structure of the novel peptide was elucidated.

METHODSCation exchange, gel filtration and HPLC were employed for isolation and purification. Matrix Assisted Laser Desorption Ionization-Time of Flight-Mass Spectrometry was used to determine the mass. The complete amino acid sequence of the novel peptide was obtained by Edman degradation combined with enzyme digestion. The antitumor activity of the peptide in vitro was studied with MTT method.

RESULTSThe primary stucture of the peptide named as viscotoxin B2 is KSCCKNTTGRNIYNTCRFAGGSRERCAKLSGCKIISASTCPSDYPK. The IC50 value of viscotoxin B2 on the Rat Osteoblast-like Sarcoma 17/2.8 cells in vitro is 1.6 mg x L(-1).

CONCLUSIONViscotoxin B2 in V. coloratum, which has high similarity with viscotoxins from V. album, showed antitumor activity.

Amino Acid Sequence ; Animals ; Antineoplastic Agents, Phytogenic ; chemistry ; isolation & purification ; pharmacology ; Bone Neoplasms ; pathology ; Inhibitory Concentration 50 ; Molecular Sequence Data ; Molecular Weight ; Osteosarcoma ; pathology ; Peptides ; chemistry ; isolation & purification ; pharmacology ; Plant Leaves ; chemistry ; Plant Proteins ; chemistry ; isolation & purification ; pharmacology ; Plant Stems ; chemistry ; Plants, Medicinal ; chemistry ; Rats ; Tumor Cells, Cultured ; drug effects ; Viscum ; chemistry

OBJECTIVETo study the state of oxidative stress in patients with acute coxsackie virus myocarditis (ACM), and to investigate the pathological chain reactions of a series of free radicals and oxidative and lipoperoxidative damages in their bodies.

METHODSEighty ACM patients and 80 healthy adult volunteers (HAV) were enrolled in a case-control study, in which concentrations of nitric oxide (NO) in plasma, lipoperoxides (LPO) in plasma and LPO in erythrocytes (RBC), vitamin C (VC), vitamin E (VE) and beta-carotene (beta-CAR) in plasma as well as activities of superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GSH-Px) in RBC were determined by using spectrophotometric assays.

RESULTSCompared with the average values (AV) of the above biochemical parameters (BP) in the HAV group, the AV of NO in plasma, and LPO in plasma and RBC in the ACM group were significantly increased (P = 0.0001), while the AV of VC, VE, beta-CAR, SOD, CAT and GSH-Px in the ACM group were significantly decreased (P = 0.0001). The values of the above BP were used to estimate the relative risk ratio (RR) between the ACM group and the HAV group; the RR and its 95% confidence interval were 12.467 (5.745-27.051), 4.333 (2.126-8.834), 6.517 (3.225-13.618), 3.310 (1.598-6.858), 31.000 (12.611-76.201), 4.663 (2.228-9.759), 11.769 (5.440-25.462), 3.043 (1.486-6.229) and 6.594 (3.045-14.281) respectively, and their P levels ranged from 0.002 to 0.0001. The results were as follows: D = 22.143 - 0.017SOD + 0.008NO + 0.244LPO in RBC, Eigenvalue = 13.659, Canonical correlation = 0.965, Wilks' lambda = 0.068, chi 2 = 420.212, P = 0.0001. The correct rate of discrimination to the ACM group and to the HAV group was 87.5% and 95.0%, respectively, and 91.3% of originally grouped cases was correctly classified.

CONCLUSIONThe findings in this study suggested that the oxidative stress in bodies of ACM patients was severely aggravated, and marked high oxidative constituents and low antioxidants and antioxidases in the human body might increase the relative risk of inducing acute coxsackie virus myocarditis, and measuring the values of NO in plasma, SOD and LPO in RBC might increase the correct rates of discriminatory analysis of the ACM.

Adolescent ; Adult ; Antioxidants ; analysis ; pharmacology ; Case-Control Studies ; Coxsackievirus Infections ; physiopathology ; Female ; Free Radicals ; Humans ; Lipid Peroxidation ; Male ; Middle Aged ; Myocarditis ; pathology ; virology ; Oxidative Stress

Objective To analyze the region cluster and risk factors of hypertension in the Chinese adult population and to explore the application of multilevel regression model in the risk factors of hypertension. Methods Multi-stage random sampling technique was used to choose 15 540 individuals aged 35-74 years from 10 regions in China. Two-level logistic regression models were fitted under MLwiN 2.02 software. Results The region cluster of hypertension existed and variance portion coefficient was 3.1%. After adjusting for the age and gender, overall obese people (BMI≥28 kg/m2) were 4.50(95%CI: 4.00-5.06) times, overweight people (BMI=24-27.9 kg/m2) were 2.26 (95%CI: 2.07-2.46) times more likely to be hypertensive as compared with those of normal BMI (18.5-23.9 kg/m2), and those centrally obesive people (Waist circumference≥85 cm in male or 80 cm in female) were 2.62 (95%CI: 2.42-2.83) times more likely to be hypertensive as compared with those of normal WC. The age-and gender-adjusted odds ratios (Ors) of triglyceride (TG), serum total cholesterol (TC), glucose, low-density lipoprotein cholesterol (LDL-C) , high-density lipoprotein cholesterol (HDL-C) and drinking alcohol were 2.10 (95% CI: 1.89-2.33) , 2.08 (95% CI: 1.84-2.35) , 1.85 (95% CI: 1.60-2.14) , 1.58 (95% CI: 1.38-1.81), 1.49(95%CI: 1.32-1.69) and 1.15(95%CI: 1.05-1.27), respectively. Conclusion The prevalence of hypertension was not only affected by individual risk factors, such as obesity, drinking alcohol, abnormal glucose and serum lipids profile, but also affected by the geographic environment where people resided in. Population-and risk factors targeted strategies, proved a promising way to reduce individual risk of hypertension in the primary prevention of hypertension.

OBJECTIVETo study the effect of internal fixation performed at different times on therapeutic outcomes of Schatzker IV-VI tibial plateau fractures.

METHODSThe clinical data of 42 cases of Schatzker IV-VI tibial plateau fractures treated in our department were analyzed retrospectively. Among these 42 patients, 21 received surgical treatment within 12 h after injury (Group I), the other 21 were first treated by traction or plaster fixation followed by a delayed internal fixation after soft tissue swelling subsided (Group II). The surgical time, complications, length of hospital stay, cost of hospitalization, and time for fracture union, as well as functional recovery were analyzed and compared between the two groups.

RESULTSAfter 10-28 months follow-up (mean 16.5 months), except 5 cases who lost to follow-up, no differences were found between the two groups regarding surgical time, preoperative and postoperative complications, healing time or the Hospital for Special Surgery (HSS) score at the end of follow-up, but significant differences were found in the length of hospital stay, cost of hospitalization and HSS score at 3 months after operation (P less than 0.05).

CONCLUSIONUnder certain conditions, early internal fixation for Schatzker IV-VI tibial plateau fracture is feasible, which can shorten the length of hospital stay, decrease the cost of hospitalization and promote early functional rehabilitation.

Fracture Fixation, Internal ; Humans ; Length of Stay ; Postoperative Complications ; Retrospective Studies ; Tibial Fractures ; surgery

OBJECTIVETo evaluate the patients with bone injury in Wenchuan earthquake.

METHODSFrom May 12th to June 15th 2008 the data of 1410 patients with bone injury in Wenchuan earthquake were analyzed to evaluate clinical intervention and remedy-managing experience.

RESULTSThe 1410 patients average age was from 4 to 103 years old. And 744 cases (52.7%) suffered from blunt injuries, 379 cases (26.9%) from buried injuries, 287 cases (20.4%) from falling injuries; And 1317 cases were with fracture, 93 with limbs soft tissue injuries; 261 patients combined with other parts of injuries including 45 cases with paralysis; 66 cases were with crush syndrome, 25 with gas gangrene, 76 with acute kidney failure, 26 with multiple organ failure. And 912 operations were performed including 402 fracture fixation, 224 debridement, 152 debridement and suture, 85 amputation, 29 implant skin, 8 fixation of joint dislocation, 5 surgical flaps transplantation, 4 nerve and tendon suture, 2 arthroscopes, 1 joint replacement. Among the 66 crush syndrome patients, 49 accepted continuous renal replacement therapy, in which 9 cases were bleeding from named arteries and 20 blood vessels were getting embolism. Among the 1410 cases, 1 died from multiple organ failure.

CONCLUSIONSAmong the patients with bone injury in Wenchuan earthquake, the elderly patients are more than the youth; The injuries are always combined with other complications; Opened injuries are polluted severely; It is difficult to deal with the crush syndrome; Paraplegia cases are less, but the amputees are more.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Earthquakes ; Female ; First Aid ; Humans ; Male ; Retrospective Studies ; Wounds and Injuries ; surgery

OBJECTIVEThe purpose of this study was to analyze the electrocardiographic features of the people living in the area with high incidence of unexplained sudden deaths in Yunnan province.

METHODThe electrocardiograms of 338 residents from three villages (Dayao, Ninglang, Heqing) with high incidence of unexplained sudden deaths and one control village (Dali) were analyzed [averaged age was (33.4 +/- 11.7) years, 175 men and 163 women].

RESULTSThe incidence of cardiac arrhythmias was similar low in all groups. The left ventricular hypertrophy was observed in 34.6% of residents from Dayao. QTc significantly prolonged in the residents from all 3 high incidence areas compare the control area of Dali [control (386.8 +/- 27.22) ms, Ninglang (428.92 +/- 25.71) ms, Heqing (440.67 +/- 28.03) ms, Dayao (417.7 +/- 24.00) ms, P < 0.05 vs. control]. Incidence of U wave was significantly higher in Heqing village than that in control village (P < 0.05). The QUc of these 3 villages was: (613.67 +/- 37.34) ms, (597.19 +/- 46.47) ms, (608.59 +/- 39.59) ms respectively, and also significantly longer than the control village of Dali (589.33 +/- 41.27) ms (P < 0.05). The typical pattern of U wave presents as enlarged U wave and apparent T-U complex. In the 7 residents who have the family history of unexplained sudden death, 6 residents have U wave, and 4 of them present typical U wave pattern.

CONCLUSIONThe significant ECG changes in villages with high incidence of unexplained sudden death in Yunnan province were prolonged QTc, enlarged U wave and apparent T-U complex and these ECG features suggested the repolarization abnormalities of the heart in these subjects.

Adolescent ; Adult ; China ; epidemiology ; Death, Sudden ; epidemiology ; etiology ; Electrocardiography ; statistics & numerical data ; Female ; Humans ; Long QT Syndrome ; physiopathology ; Male ; Mass Screening ; Middle Aged ; Young Adult