Objective To develop an interlocking-style vascular shunt device for the treatment of distal limb ischemia resulting from vascular disconnection and defect.Methods A one-way interlocking buckle was designed with the space between the clamping teeth being 0.5 mm,which prevented the device from moving backwards and fixed the vessel and shunt tube conveniently.The interlocking buckle combined with silicone tube was used to connect the two ends of the defected vessel,which was compared with conventional method by suture ligation and silicone tube by the tests on vessel bursting pressure and tensile biomechanics.Results The vessel repaired with the developed device behaved better than that by the conventional method in the tests on vessel bursting pressure and tensile biomechanics (P＜0.05).Conclusion The vascular shunt device can be used for the treatment of distal limb ischemia resulting from vascular disconnection and defect,and thus facilitates the vascular graft in rear hospital after evacuation.

OBJECTIVETo introduce a better surgical approach for the resection of tumors involving the anterior and middle skull base and the fronto-orbito-ethmoidal area.

METHODSA "T" form incision was made in the fronto-orbito-ethmoidal region and along the nasal pyramid down. Parts of ethmoid sinus, lamina papyracea, fronto-orbito bone and behind wall of frontal sinus were resected in order to expose the tumors in the anterior skull base and the fronto-orbito-ethmoidal region. Then, the tumor was resected partly under the operation microscope, protecting the neighbouring important structures, for instance: optic nerve, internal carotid artery, sella, meninx, etc. The nasal pyramid was repaired and fixed to the frontal bone with titanium board and titanium nail in order to resume the appearance of a good face.

RESULTSThirteen patients received tumour resection through this approach. The patients were followed-up for 24 months, 11 patients showed no tumour recurrence, no severe complication, such as cerebrospinal rhinorrhea, meningoencephlocele, etc, in this series. The facial appearance was good.

CONCLUSIONSThe approach via the fronto-orbito-ethmoidal region is a good surgical procedure to resect the tumors involving the anterior and middle skull base and the fronto-orbito-ethmoidal area.

Ethmoid Bone ; surgery ; Female ; Frontal Bone ; surgery ; Humans ; Male ; Middle Aged ; Nose Neoplasms ; surgery ; Orbit ; surgery ; Skull Base Neoplasms ; surgery

Adolescent ; Adult ; Aged ; Brain ; blood supply ; diagnostic imaging ; Carbon Monoxide Poisoning ; diagnostic imaging ; Child ; Female ; Humans ; Male ; Middle Aged ; Tomography, Emission-Computed, Single-Photon

Objective: To investigate the changing laws of rest energy expenditure (REE) in intensive care unit (ICU) patients and the intervention effect for nutritional support. Methods: A prospective randomized control trial was conducted. Fifty-eight critically ill patients who were expected to be able to receive sustained enteral and (or) parenteral nutrition for more than 7 days admitted to ICU of the First Affiliated Hospital of Bengbu Medical College from December 2016 to June 2017 were enrolled. The patients were divided into REE group (n = 29) and HBREE group (n = 29) according to the random number table. On the 1st to 7th day after ICU admission, the indirect calorimetry and the Harris-Benedict (HB) formula were used to obtain the REE and HBREE values, and nutritional support was given according to REE and HBREE values respectively. The data of hemoglobin (Hb), albumin (Alb), prealbumin (PA), C-reactive protein (CRP), oxygenation index (OI) on 1st, 3rd, 5th, 7th and discharged day, and insulin dosage, vasopressor time, mechanical ventilation time, the length of ICU stay, and 28-day mortality were collected. Results: ① At the beginning, the REE level was high, and then decreased gradually with the extension of hospitalization, and the decline was obvious on the 2nd to 3rd day (kJ/d: 7 088.38±559.41, 6 751.34±558.72 vs. 7 553.44±645.55, both P < 0.05), and was stable from the 5th day, the changing laws showed high at first, then the low, the first rapid decline, then the slow decline, and then reached the steady, there was a 2-day plateau in the middle. During the first 2 days, the REE value was significantly higher than the HBREE value (kJ/d: 7 553.44±645.55 vs. 6759.21±668.14, 7 088.38±559.41 vs. 6 759.21±668.14, both P < 0.01); on the 3rd, 4th day, the REE value was almost the same as the HBREE value (kJ/d: 6 751.34±558.72 vs. 6 759.21±668.14, 6 568.03±760.19 vs. 6 759.21±668.14, both P > 0.05). After that, the REE value was significantly lower than the HBREE value (kJ/d: 6 089.55±560.70 vs. 6 759.21±668.14, 5 992.55±501.82 vs. 6 759.21±668.14, 5 860.84±577.59 vs. 6 759.21±668.14, all P < 0.01). ② After the initiation of nutritional support, Hb in the REE group (the first 3 days) and HBREE group (the first 7 days) all increased slowly in the early stage. It increased obviously on the 5th day in the REE group. Compared with the REE group, Hb increased more slowly in the HBREE group, however, there was no difference between the two groups at the time of discharge (g/L: 113.75±17.28 vs. 110.86±15.35, P > 0.05). PA and OI all enhanced significantly on the 3rd day since the nutritional support was initiated, but the daily increase of the REE group was significantly higher than that of the HBREE group [3rd day, PA (mg/L): 110.38±27.65 vs. 96.28±18.06, OI (mmHg, 1 mmHg = 0.133 kPa): 259.29±49.36 vs. 231.74±28.02, both P < 0.05]. The Alb and CRP in the REE group began to improve on the 3rd day, while the index in the HBREE group was delayed on the 5th day, overall, at the time of discharge, the PA, CRP and OI were lower in the HBREE group than in the REE group [PA (mg/L): 252.28±56.94 vs. 295.86±57.26, CRP (mg/L): 73.14±17.63 vs. 56.52±14.91, OI (mmHg): 353.59±70.36 vs. 417.52±71.58, all P < 0.01]. ③ The vasopressor was used in both groups for less than 3 days, but the REE group was shorter (days: 2.26±0.82 vs. 2.95±1.22, P < 0.05), the insulin dosage in the HBREE group was much more than that in the REE group (U: 101.97±21.05 vs. 84.59±22.21, P < 0.01); compared with the REE group, the time of mechanical ventilation and the length of ICU stay in the HBREE group were longer (hours: 113.07±25.96 vs. 93.41±27.25, days: 10.41±3.11 vs. 8.45±2.44, both P < 0.01). There was no significant difference in the 28-day mortality between the REE group and HBREE group (17.24% vs. 24.14%, P > 0.05). Conclusions Indirect calorimetry can more accurately grasp the changing laws of REE in critically ill patients. Nutritional support with REE value can make relevant nutritional indicators as good as possible, and reduce insulin dosage, shorten vasopressor use time, the length of ICU stay and mechanical ventilation time, but does not change the 28-day mortality.

Objective To assess the dietary pattern and quality of residents in Zhejiang province.Methods 21 52 residents aged 1 8 -79 years old were selected using multi-stage stratified cluster random sampling method and the data from Chinese nutrition status monitoring project during 201 0 -201 2 was used.The results were evaluated using Chinese diet balance index.Results 41.08% of the residents in Zhejiang province was mild diet imbalance and 50.79% was middle diet imbalance while insufficient and excessive intakes were coexist.Mild and middle insufficient intakes were accounted for 66.1 7%and 27.88%respectively,while mild excessive intake was accounted for 35.55%.The diet balance indexes including DBI-LBS,DBI-HBS and DBI-DQD were 46.00,26.00 and 57.00 respectively.The dietary quality of males,rural areas was lower while residents aged 40 -49 years had the lowest dietary quality.There was positive correlation between dietary quality and degree of education (P<0.05 ).The main dietary pattern of residents in Zhejiang was pattern B (62.41%)following by pattern A (26.44%).Conclusion Insufficient and excessive intakes coexist among residents in Zhejiang province.Male,living in rural areas,people aged 40 -49 years or with lower degree of education should be taken as target intervention subjects.

OBJECTIVETo evaluate the clinical value of (89)SrCl(2) (Ke xing Inc, Shanghai) as a palliative therapy modality for cancer patients with bone metastasis.

METHODSIn 504 cancer patients with painful limitation of movement due to bony metastasis, a dose of 1.48-2.22 MBq/kg (40-60 uCi/kg) iv infusion of (89)SrCl(2) was given.

RESULTSIn 97 patients (19.2%) there was no improvement in pain and life quality, 298 patients (59.1%) showed mild to moderate improvement (moderately effective), 109 patients (21.6%) became free of pain and were subsequently fully ambulatory (markedly effective). The pain relief appeared from D1-D46 after (89)SrCl(2) administration, most frequently from D5-D14. The palliative effect could last for about 56 days to 13 months. Repeated bone scans of some patients showed that the metastatic foci in the bone became smaller or even disappeared gradually after the administration of (89)SrCl(2). Approximately 55% of patients experienced grade I approximately III bone marrow depression attributable to (89)SrCl(2), which would return to the pre-treatment level within 3 approximately 9 months.

CONCLUSION(89)SrCl(2) is effective and safe for the relief of bone pain and improvement of quality of life in cancer patients with painful bony metastasis.

Adult ; Aged ; Aged, 80 and over ; Bone Neoplasms ; complications ; radiotherapy ; secondary ; Breast Neoplasms ; pathology ; Female ; Humans ; Lung Neoplasms ; pathology ; Male ; Middle Aged ; Pain Measurement ; Pain, Intractable ; etiology ; radiotherapy ; Quality of Life ; Strontium Radioisotopes ; therapeutic use

Objective To prepare T-helper cell(Th)epitnpe-modified human soluble B cell activating factor belonging to the tumor necrosis factor family(BAFF)mutants and evaluate their immune response in vaccinated mice.Methods Recombinant cDNAs were cloned and ligated into the prokaryotie expression vec- tor pQE-80L respectively.The recombinant proteins were induced to express by IPTG in E.coli DH5?and purified with Ni-NTA chromatography.BALB/c mice were immunized with recombinant proteins respectively and the titres of the antibodies that were cross-reactive with BAFF in sera were analyzed by ELISA.Inhibiting ability of the antibodies in sera was analyzed by MTT assay.Results The recombinant proteins were highly expressed in E.coli DH5?.After purification,the purity of recombinant proteins was more than 90%.BALB/c mice immunized with recombinant proteins produced high levels of BAFF-specific antibodies.Cell proliferation assay showed that the sera of immunized mice could inhibit the proliferation-inducing activity of recombinant sBAFF and natural sBAFF.Conclusion The immune inhibitors of human BAFF which can induce polyclonal antibodies that are cross-reactive with BAFF are successfully prepared.These results may provide the basis for further study of their therapeutic effects.

OBJECTIVETo study the efficacy and safety of multimodal prevention of postoperative venous thromboembolism for hip fractures.

METHODSFrom March 2009 to July 2011, preoperatively, patients were assigned to two groups on the basis of an assessment of their risk factors. One hundred and twelve patients were considered to be low risk, involving 47 males and 65 females,with an average age of (72.40 +/- 13.29) years ranging from 42 to 88,and were managed with aspirin (100 mg once daily for 14 days) as well as intermittent gasing compression devices. Twenty-six patients were considered to be high risk, involving 12 males and 14 females with an average age of (78.50 +/- 12.76) years ranging from 65 to 84,and were managed with low-molecular-weight heparin (0.4 ml,subcutaneous injection once daily for 14 days) and intermittent gasing compression. All patients were underwent Doppler ultrasonography within 24 hours before hospital discharge. All patients were followed-up for 3 months postoperatively. The incidence of deep venous thrombosis of lower limb, pulmonary embolism, gastrointestinal hemorrhage were recorded.

RESULTSOverall, there were no fatal pulmonary embolism, 1 case of symptomatic pulmonary emboli in low risk group, and none were detected in the high-risk group. Deep venous thrombosis was detected in association with 6 (6.25%) of the 112 procedures in the low-risk group and 2 (7.69%) of the 26 operations in the high-risk group. Paitents were selected in opened reduction and internal fixation, the quantity of bleeding, decrease of hemoglobin, hematoma rate, and gastrointestinal hemorrhage rate of low risk group were (538.10 +/- 390.20) ml, (30 +/- 19) g/L, 0, and 1 (1.03%) respectively; those of the high-risk group were (585.95 +/- 403.96) mL, (32 +/- 20) g/L,1 (4.76%), (4.76%), there were no significant different between the two groups, all P > 0.05.

CONCLUSIONThere were no statistic significances between the aspirin as well as intermittent gasing compression devices and the low-molecular-weight heparin and intermittent gasing compression in preventing venous thromboembolism (VTE) in postoperative postoperative venous thromboembolism for hip fractures. However, there are potential advantages to reduce complications of bleeding and cardiovascular disease. Multimodal prevention of postoperative venous thromboembolism can protect postoperative patients with hip fractures.

Adult ; Aged ; Aged, 80 and over ; Female ; Hip Fractures ; surgery ; Humans ; Male ; Middle Aged ; Postoperative Complications ; prevention & control ; Risk ; Venous Thromboembolism ; prevention & control

OBJECTIVETo explore the effective therapeutic method in the treatment of idiopathic sudden hearing loss (ISHL).

METHODSOne hundred and eighty-eight cases of ISHL were randomized into a warming-promoting needling group (74 cases), a conventional acupuncture group (56 cases) and a medication group (58 cases). In the conventional acupuncture group, the conventional needling technique was applied to Baihui (GV 20), Fengchi (GB 20), Yifeng (TE 17), Tinggong (SI 19), Touqiaoyin (GB 11) and Zhigou (TE 6) on the affected side. The treatment was given 5 times each week. Totally, the treatment of 6 weeks was required. In the warming-promoting needling group, on the basic treatment as the conventional acupuncture group, the warming-promoting needling technique was applied to Fengchi (GB 20). In the medication group, the intravenous drop with salvia injectio and mecobalamin was prescribed, once per day, for 10 days totally. Meanwhile, Erlong Zuoci Wan was prescribed for oral administration, 8 pills each time, three times a day for 30 days continuously.

RESULTSAll of the three therapeutic methods achieved the effect on ISHL. The total effective rate was 89.2% (66/74) in the warming-promoting needling group, which was better than 62.5% (35/56) in the conventional acupuncture group and 53.4% (31/58) in the medication group (both P<0.01).

CONCLUSIONThe warming-promoting needling techinque achieves the significant efficacy on ISHL. The hearing improvement is superior to that treated with either the conventional needling technique or medication.

Acupuncture Points ; Acupuncture Therapy ; instrumentation ; Adult ; Female ; Hearing Loss, Sudden ; therapy ; Humans ; Male ; Middle Aged ; Needles ; Treatment Outcome

OBJECTIVETo compare the efficacy of computer-navigated surgery and the 3-D skull models and guide plates for the treatment of unilateral delayed zygomatic fractures.

METHODSEleven patients with unilateral delayed zygomatic fractures were treated by computer-navigated surgery (test group) and another 12 patients were treated by 3-D skull models and guide plates as the control group. Quality of reduction was assessed by examination of postoperative axial CT scans through zygomatic arch, the malar prominence and the width of zygomatic arch were measured in both groups.

RESULTSThe difference between bilateral malar prominence was (0.94 ± 0.73) mm in the test group and (1.88 ± 1.82) mm in the control group, there was no significant difference between the two groups (P > 0.05). The difference between bilateral width of zygomatic arch was (0.77 ± 0.51) mm in the test group, less than (3.00 ± 1.81) mm in the control group (P < 0.05). Excessive malar prominence was observed in 6 cases (6/11) in the test group and in 7 cases (7/12) in the control group, whereas malar depression was observed in 5 cases (5/11) in the test group and in 5 cases (5/12) in the control group. Overcorrection of the width of zygomatic arch was observed in 6 cases (6/11) in the test group and in 12 cases (12/12) in the control group, whereas under correction was observed in 5 cases (5/11) in the test group and in 0 cases (0/12) in the control group.

CONCLUSIONSIn the treatment of unilateral delayed zygomatic fractures, symmetry of malar prominence can be achieved by application of computer-navigated surgery or the 3-D skull models and guide plates. Symmetry of the width of zygomatic arch achieved with the computer-navigated surgery is better than that achieved with 3-D skull models and guide plates.

Adult ; Female ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Surgery, Computer-Assisted ; Tomography, X-Ray Computed ; Young Adult ; Zygoma ; diagnostic imaging ; surgery ; Zygomatic Fractures ; diagnostic imaging ; surgery