Humans ; Maxillary Sinus ; anatomy & histology ; surgery

Objective To study the influence of arachidonic acid (AA) on L-type calcium channel in rabbits sin-gle cardiomyocyte and its mechanism of antiarrhythmia. Method The single ventricular cardiomyocyte was isolat-ed by using enzyme dispersion method and whole-cell clamp-patch technique was used to record L-type calcium current.All data were analyzed using ANOVA. Results AA inhibited Ica-L in a concentration-dependent manner. The application of 3 μmol/L, 10 μmol/L and 20 μmol/L arachidonic acid reduced the density of peak Ica-L from (10.79±0.93)pA/pF to (8.99±0.43)pA/pF to (7.60±0.35)pA/pF and to (5.60±0.30)pA/pF, respctive-ly (n=7, P<0. O1 ). The Ica-Lpartially resumed after washout. The AA up-shifted the I-V curves of Ica-L without changes of their shape,peak and reverse potentials. The AA also markedly shifted the inactivation curve to left, and prolonged the recorvery time from inactivation,but did not change the curve of calcium channel activation. Con-clustions By acceleration of L-type calcium channel inactivation and prolongation of recorvery time from inactiva-fion,arachidonic acid can reduce the calcium ion influe and prolong effective refractory period, playing the role of antiarrhythmia.

Objective To observe the results of broth dilution method and disc diffusion method to test the synergistic effect of Reduning and cefoperazone sodium / sulbactam sodium(SCF) on extensive drug resistant Acinetobacter bauman (XDR-AB) in vitro environment ,and compare their compliance to guide the clinical medication .Methods A total of 12 strains of XDR-AB from infec-tion patients in our hospital in 2015 were collected ,the strain was sub cultured .Firstly ,observe the minimum inhibitory concentra-tion (MIC) of SCF and Reduning on XDR-AB alone and in combination by broth dilution method .And then judge the synergy effects through calculation .Secondly ,the inhibition ring diameter and the synergy effects was detected using the disc diffusion meth-od .Results The MIC of Reduning and SCF in combination on XDR-AB was declined compared with them alone .The Fractional in-hibitory concentration of Reduning and SCF in combination on XDR-AB were equal or less than 0 .5 ,they had synergistic effect on XDR-AB .The inhibition ring diameter of Reduning was 10 mm tested by disk diffusion method .Different strains of XDR-AB on SCF bacteriostatic annulus diameter difference ,5 strains were 15 mm ,3 strains were 16 mm ,and 4 strains were 17 mm .Reduning and SCF appeared synergistic effect according to the inhibition ring diameter expanded when they effected on XDR -AB in combina-tion .Conclusion In vitro ,Reduning combined with SCF on XDR-AB has good synergistic effect .Compared with broth microdilution checkerboard dilution method ,disk diffusion method is more simple and convenient ,but it has a certain subjective on judging re-sults ,which is better to operate by experienced person .

Objective To evaluate the effects of early and late tracbeostomy on patients with acute severe cerebral trauma.Methods In the retrospective study,167 patients with severe brain trauma ( GCS ＜ 9 ) requiring prolonged mechanical ventilation ( MV ) were managed by percutaneous dilational tracheostomy (PDT) from May 2001 to December 2010.According to the transoral incubation MV duration,the patients were divided into the early tracheostomy (ET) group ( MV duration≤7 d,81 cases)and late tracheostomy (LT) group (MV duration ＞ 7 d,86 cases).The basic clinical characteristics,pre-and post-PDT MV period,total MV duration,length of post-PDT ICU stay,length of ICU stay,length of hospital stay and mortality were compared between the two groups.Results The two groups showed no statistical differences in aspects of age,sex,acute physiology and chronic health evaluation Ⅱ (A-PACHE Ⅱ ) score,GCS,trauma index and craniotomy rate (P＞0.05).Compared with LT group,ET group significantly shortened the pre-PDT MV period [ (5.16 ± 1.33 ) d∶ ( 1 1.64 ± 4.25 ) d,P ＜ 0.01 ],post-PDT MV period ( median:15.0 d∶ 17.0 d,P ＜ 0.05 ),total MV duration ( median:18.0 d∶26.0 d,P＜0.05),length of post-PDT ICU stay (median:16.0 d∶21.0 d,P＜0.01 ) and length of ICU stay (median:21.0 d∶32.0 d,P ＜0.01 ).But the two groups had no statistical differences concerning the length of hospital stay ( P ＞ 0.05 ),ICU mortality ( 17％ ∶ 14％,P ＞ 0.05 ) and in-hospital mortality (25％∶28.4％,P ＞0.05).Kaplan-Meier curves showed that the frequency of MV and ICU stay rate within 60 days in ET group were significantly lower than those in LT group.Conclusions For patients with severe brain trauma,early tracheostomy shortens the duration of MV and length of ICU stay without affecting their prognosis.Thereby,tracheostomy can be performed at early stage when managing acute severe brain injury.

Anti-Bacterial Agents ; pharmacology ; therapeutic use ; Child ; Drug Resistance, Bacterial ; Humans ; Mycoplasma pneumoniae ; drug effects ; isolation & purification ; Pneumonia, Mycoplasma ; drug therapy ; microbiology

Objective To explore a new surgical approach for the renovation of laryngotracheal stenosis. Methods the anatomical structures of the anteroventral portion of the digastric muscle along with the blood supply, innervation and periosteal coverage of the mandibular were investigated by observing 23(46 sides) cadaver. Results The anteroventral portion of the digastric muscle rise from the fossae digastrica at the angle of 30.4°±3.5°. Its length was (4.8+0.7) cm and the periosteal coverage averaged (111.6+28.2) mm2. The puncta of rami digastricus stats (2.4+0.7) cm from the arteriae submentalis. Mylohyoid nerve together with rami digastricus enters the muscular tissue. Conclusion Designed with reference to sternocleidomastoid clavicular periosteal flap, the periosteal flap of the anterovent of the digastric muscle-mandible may offer a new way for largngotracheal renouation.

Objective To explore a new surgical approach for the renovation of laryngotracheal stenosis. Methods the anatomical structures of the anteroventral portion of the digastric muscle along with the blood supply, innervation and periosteal coverage of the mandibular were investigated by observing 23(46 sides) cadaver. Results The anteroventral portion of the digastric muscle rise from the fossae digastrica at the angle of 30.4°±3.5°. Its length was (4.8+0.7) cm and the periosteal coverage averaged (111.6+28.2) mm2. The puncta of rami digastricus stats (2.4+0.7) cm from the arteriae submentalis. Mylohyoid nerve together with rami digastricus enters the muscular tissue. Conclusion Designed with reference to sternocleidomastoid clavicular periosteal flap, the periosteal flap of the anterovent of the digastric muscle-mandible may offer a new way for largngotracheal renouation.

BACKGROUND: Operative correction of hallux valgus is one of the most procedures in foot and ankle department, but postoperative plaster slab immobilization often brings great inconvenience and pain. Off-loading forefoot shoes can theoretically help them to do activities off bed early, and prevent loading on the forefoot during walking. But its advantages and disadvantages compared with plaster slab are still unknown.OBJECTIVE: To compare the clinical effects of over-the-toe plaster slab and off-loading forefoot shoes after hallux valgus correction.METHODS: Patients with hallux valgus undergoing distal Chevron osteotomy or Scarf osteotomy in the Huashan Hospital of Fudan University between May 2012 and October 2013 were retrospectively reviewed. Group A patients had a below-knee and over-the-toe plaster slab while Group B had an off-loading forefoot shoe applied after surgery.Radiological assessment was done at 6 weeks postoperatively. Immobilization was removed once bone union was indicated. Clinical scales and subjective satisfaction investigation were performed at final follow-up, and complications during follow-up were noted. All values between groups were analyzed statistically.RESULTS AND CONCLUSION: Totally 125 patients (157 feet) were completely followed up, including 83 patients (95 feet) in Group A and 42 patients (62 feet) in Group B. There was no significant difference in demographics, pre-and-post operative radiological assessments, clinical scale, union time or general satisfaction rates between two groups. However,Group B patients had less chance to suffer metatarsophalangeal joint or inter-phalangeal joint stiffness, restricted ankle motion and supra-ankle pains of operated side in comparison with Group A (P < 0.05), and were more willing to accept the same treatment if they could choose again (P < 0.05). Compared with the plaster slab, the application of off-loading shoes not only maintains correction level, but also reduces such complications as stiffness or restricted motion of the joint, limb pains and so on, which makes patients more likely to accept, and should be given priority to in the rehabilitation following hallux valgus correction.

Objective To investigate the operative indications for polypoid lesions of gallbladder(PLG) and avoid cholecystectomy for PLG without operation signs.Methods Retrospective analysis of 828 cases of PLG confirmed by pathologic examination was made.Results (1)Cancer should be suspected when a patient is older than 50 years or has a polypoid lesion larger than 1.0 cm.(2)The cholecystectomies for PLG accounted for 2.7%-7.1%of all cholecystectomies in the corresponding period,and cholesterol polyps accounted for 86.11%of all PLG,and carcinoma of gallbladder accounted for 1.92%of all PLG.Conclusion At present most of PLG accepting cholecystectomy are cholesterol polyps,so the high-risk factors of the neoplastic polyps and the operative indications for PLG should be considered deliberately.

BACKGROUND:There are many methods to treat thoracolumbar fractures However,it remains unclear whether a simple operation to treat a thoracolumbar burst fracture can decrease the trauma and obtain better effect to avoid the enlargement of operation.OBJECTIVE:To investigate the clinical outcome of posterior short-segmental transpedicular screw system internal fixation in treatment of single-level thoracolumbar burst fracture without nerologic deficit.METHODS:A total of 186 patients with single.level thoracolumbar burst fracture but without nerologic deficit treated in the First Affiliated Hospital of Soochow University between September 2003 and January 2008,including 152 males and 34 females,aged18 10 65 years.were treated by posterior pedicle screw The intraspinal bone fragments were treated with indirect decompression.All patients were checked with radiography and CT scan before/after operation as well as before implant removal.The correction of anterior vertebral body height and the ratio of bone fragment to cross section area of spinal canal were measured.RESULT AND CONCLUSION:Compared with normal.the anterior vertebral body height was 42%before operation,98%after operation,and 98%before implant removal The ratio of bone fragment to cross section area of spinal canal was 34%before operation,13%after operation.and 8%before implant removal.Internal posterior short-segmental transpedicular screw fixation treating single-level thoracolumbar burst fracture without nerologic deficit can obtain stability of spinal column,and it is beneficial to recovery of body height,physiologic postu ral contour and canal volumn .