OBJECTIVETo investigate of the value of monitoring of saturation of blood oxygen of the injured extremity on prevention of osteofascial compartmental syndrome.

METHODSTwenty patients of osteofascial compartmental syndrome included 13 male and 7 female with an average age of 32 years ranging from 13 to 60. There were 13 cases of tibial and fibual fractures, 3 cases of tibial plateau fractures, 4 cases of femoral shaft fractures. SpO2 on the end of injured extremities were dynamic monitored and osteofascial compartmental pressure was measured by modified Whiteside method. The data of two group were compared.

RESULTSAmong 20 cases, it's negative correlation between the data of pulse blood oxygen saturation and osteofascial compartmental pressure.

CONCLUSIONThe method of dynamic monitor extremity SpO2 can reflect indirectly the ischemia in muscle and nerve and report the early diagnosis and management of osteofascial compartmental syndrome.

Adolescent ; Adult ; Compartment Syndromes ; blood ; diagnosis ; metabolism ; physiopathology ; Female ; Heart Rate ; physiology ; Humans ; Ischemia ; metabolism ; physiopathology ; Male ; Middle Aged ; Muscles ; metabolism ; Nerve Tissue ; metabolism ; Oximetry ; methods ; Oxygen ; blood ; Regional Blood Flow ; physiology ; Young Adult

Adult ; Anti-HIV Agents ; therapeutic use ; Familial Primary Pulmonary Hypertension ; HIV ; pathogenicity ; Hepacivirus ; pathogenicity ; Hepatitis B virus ; pathogenicity ; Humans ; Hypertension, Pulmonary ; drug therapy ; virology ; Male ; Sulfonamides ; therapeutic use

In this study,we aimed to study the pattern visual evoked potentials (P-VEPs) in two eyes with varying visual acuity in one eye and to provide an objective estimation of visual acuity by comparing P-VEPs in one and two eyes.Thirty subjects were chosen,who had one eye with an acuity of 5.0,4.85,4.6,4.0,or scieropia and obstructed vision and the other eye with an acuity of 5.0,respectively.P-VEPs were detected under the large grating stimuli at 3×4 spatial frequency,moderate grating stimuli (12× 16 spatial frequency) and small grating stimuli (48×64 spatial frequency).Under large grating stimuli,there was no significant difference in P100 peak latency between the groups,nor was there a significant difference between the amplitude of two eyes and the amplitude of one normal-vision eye.Under moderate and small grating stimuli,there was a significant difference in P100 peak latency between the group with both eyes having an acuity of 5.0 and the group with visual acuity below 4.0 in one eye.There was a significant difference in P100 amplitude between the group with visual acuity of 5.0 in both eyes and the group with one normal-vision eye.There was no significant difference in the amplitude of two eyes and the amplitude of one normal-vision eye between any other two groups.In forensic identification,characteristics and variability of P-VEPs in one and two eyes can be used to identify malingering or decline in visual acuity.

OBJECTIVETo investigate the risk factors for anastomotic infectious complications after bowel resection in patients with Crohn disease.

METHODSClinical data of 124 patients with Crohn disease undergoing bowel resection between January 1990 and October 2012 were analyzed retrospectively. The risk factors were identified by χ(2) test and Logistic regression.

RESULTSFourteen patients (12.3%, 14/114) developed anastomotic infectious complications in the postoperative period, including anastomotic leak (n=7), intra-abdominal abscess (n=6), and enterocutaneous fistula (n=1). Crohn disease activity index (CDAI)>150 (OR=2.185, 95%CI:1.098-6.256, P=0.040), steroid usage (OR=2.674, 95%CI:1.118-8.786, P=0.027), and the presence of preoperative abscess/fistula (OR=3.447, 95%CI:1.254-10.462, P=0.014) were identified as independent risk factors of anastomotic infectious complications. In the absence of these 3 risk factors, the rate of anastomotic infectious complication was 5.7% (3/53), which increased to 11.4% (4/35) when one risk factor was present, 21.1% (4/19) when two risk factors were present, and 42.9% (3/7) when all the 3 risk factors were present.

CONCLUSIONSCDAI>150, steroid usage and preoperative abscess/fistula are associated with higher rates of anastomotic infectious complications following bowel resection for Crohn disease. A prudent management should be carried out if risk factors can not be eliminated preoperatively.

Abdominal Abscess ; pathology ; Adolescent ; Adult ; Aged ; Anastomosis, Surgical ; adverse effects ; Anastomotic Leak ; pathology ; Chi-Square Distribution ; Colectomy ; adverse effects ; Crohn Disease ; surgery ; Female ; Humans ; Intestinal Fistula ; pathology ; Logistic Models ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Steroids ; therapeutic use ; Surgical Wound Infection ; etiology ; surgery ; Young Adult

OBJECTIVETo evaluate the predictive value of quantitative examination via contrast-enhanced ultrasonography on the activity of Crohn disease at endoscopy.

METHODSA total of 59 cases with Crohn disease in People's Hospital of Lishui City between January 2009 and December 2010 were collected prospectively and underwent both colonoscopy and contrast-enhanced ultrasonography. According to the Simple Endoscopic Score, Crohn disease was divided into inactive and active disease by colonoscopy. To assess the vascularization of the involved bowel loop in a region expected to be seen at colonoscopy, the contrast agent uptake was measured by using quantitative analysis. Measurement of contrast enhancement was assessed as the percentage of increase in wall brightness in regions of interest (ROI). The receiver operating characteristic curve was used to evaluate the value of contrast agent uptake in predicting the severity determined at endoscopy.

RESULTSColonoscopy showed active lesions in 45 cases and inactive lesions in 14 cases, in whom the percentages of increase of brightness were (90±32)% and (41±29)% respectively. At a threshold value of 45% for the percentage of increase of brightness, sensitivity, specificity and accuracy of predicting the severity at endoscopy were 95.6%, 78.6% and 91.5%, the Youden index was 0.74, and area under curve was 0.846.

CONCLUSIONSQuantitative measurement of bowel enhancement by using contrast-enhanced ultrasonography can discriminate between active and inactive Crohn disease at endoscopy. Contrast-enhanced ultrasonography may be a useful technique to monitor the activity of Crohn disease.

Adult ; Aged ; Colonoscopy ; methods ; Crohn Disease ; diagnostic imaging ; pathology ; surgery ; Female ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Sensitivity and Specificity ; Ultrasonography ; methods

Chronic spinal cord lesions (CSCL) which result in irreversible neurologic deficits remain one of the most devastating clinical problems. Its pathophysiological mechanism has not been fully clarified. As a crucial factor in the outcomes following traumatic spinal cord injury (SCI), the blood-spinal cord barrier (BSCB) disruption is considered as an important pathogenic factor contributing to the neurologic impairment in SCI. Vascular endothelial growth factor (VEGF) is a multirole element in the spinal cord vascular event. On one hand, VEGF administrations can result in rise of BSCB permeability in acute or sub-acute periods and even last for chronic process. On the other hand, VEGF is regarded to be correlated with angiogenesis, neurogenesis and improvement of locomotor ability. Hypoxia inducible factor-1 (HIF-1) is a primary regulator of VEGF during hypoxic conditions. Therefore, hypoxia-mediated up-regulation of VEGF may play multiple roles in the BSCB disruption and react on functional restoration of CSCL. The purpose of this article is to further explore the relationship among HIF-1, hypoxia-mediated VEGF and BSCB dysfunction, and investigate the roles of these elements on CSCL.
Animals ; Chronic Disease ; Humans ; Hypoxia-Inducible Factor 1 ; physiology ; Neovascularization, Physiologic ; Neurogenesis ; Spinal Cord ; physiopathology ; Spinal Cord Injuries ; physiopathology ; Vascular Endothelial Growth Factor A ; physiology

OBJECTIVETo evaluate the diagnostic value of Crohn disease activity indices (CDAI) in assessing symptomatic recurrence following ileocolic resection for Crohn disease.

METHODSA total of 85 patients who underwent ileocolic resection between March 2003 and March 2010 were included. Clinical and endoscopic evaluation were performed within 12 months after operation. Endoscopic appearance was assessed using Rutgeers score and endoscopic recurrence was defined as endoscopic score ≥i2. Symptomatic recurrence was defined by the composite of symptom severity warranting medical therapy and endoscopic recurrence. The receiver operator characteristic (ROC) curve was used to explore the utility of CDAI in determining the presence or absence of symptomatic disease.

RESULTSNineteen patients had symptomatic recurrence within 12 months postoperatively. The mean CDAI of patients with symptomatic recurrence was 205±93, significantly higher than those with sustained remission(97±44, P<0.01). The area under the ROC curve for symptomatic recurrence and CDAI was 0.786. Symptomatic recurrence was best predicted by a CDAI cutoff of 150 and the sensitivity, specificity, and accuracy was 73.7%, 81.8% and 80.0% respectively. When a combined endoscopic and CDAI was applied, the specificity and accuracy was markedly improved to 95.5% and 90.6%. In comparison to CDAI alone, the combined use of CDAI and endoscopic evaluation had a higher level of agreement on symptomatic recurrence(Kappa value, 0.718 vs. 0.462).

CONCLUSIONSCDAI is effective to predict symptomatic recurrence. A combination of CDAI and endoscopic evaluation can further improve the accuracy of assessing symptomatic recurrence.

Anastomosis, Surgical ; Colectomy ; Crohn Disease ; diagnosis ; surgery ; Endoscopy ; Humans ; Postoperative Period ; ROC Curve ; Recurrence ; Sensitivity and Specificity

PURPOSETo evaluate the clinical outcomes of locking calcaneal plate in treating calcaneal fracture (Sanders II-III) in elderly patients.

METHODSFrom October 2012 to December 2013, 23 elderly patients suffering from calcaneal fracture (Sanders II-III) were treated and followed up. There were 15 males and 8 females with the mean age of 68.5 years (range: 65-79 years). According to Sander's classification, 16 cases (16 feet) were type II fractures and 7 cases (7 feet) were type III fractures. Anteroposterior, lateral and axial views of X-ray were taken to detect the calcaneum. CT scan was done to assess the amount of comminution and articular depression. Radiological assessment was performed using Bohler's angle and Gissane's angle. Functional outcome was assessed using the Maryland foot score.

RESULTSAll the patients were followed up for 13.7 months on average (10-20 months). The mean time of bone union was 3.2 months (3-4 months). The mean time of complete weight bearing was 3.2 months (3.1-4.0 months). The soft tissue necrosis was found in 1 case. The mean Bohler's angle and Gissane's angle were 25.31° and 117.5°respectively. The overall excellent to good rate was 82.6%.

CONCLUSIONOpen reduction and internal fixation with locking calcaneal plate can obtain good functional outcome for Sanders II-III calcaneal fractures in elderly patients.

Aged ; Bone Plates ; Calcaneus ; injuries ; Female ; Fracture Fixation, Internal ; adverse effects ; methods ; Fractures, Bone ; surgery ; Humans ; Male ; Postoperative Care ; Postoperative Complications ; epidemiology ; Surgical Wound ; therapy

OBJECTIVETo review the updated research progress about the application of echocardiography in resynchronization treatment of chronic heart failure patients.

DATA SOURCESThe data used in this review were from PubMed, published in English and using the key terms "heart failure", "echocardiography" and "cardiac resynchronization therapy".

STUDY SELECTIONRelevant articles were reviewed and selected to address the stated purpose.

RESULTSIncreasing numbers of studies have suggested the importance of echocardiography in resynchronization treatment of chronic heart failure patients. Echocardiography can evaluate atrioventricular, inter- and intra-ventricular mechanical dyssynchrony before cardiac resynchronization therapy (CRT), as a guidance to assess the optimal left ventricular (LV) pacing location, optimize the atrioventricular and interventricular delays and predict response to CRT.

CONCLUSIONSEchocardiography is both non invasive and easily repeatable, and plays a crucial role in appraisal of heart synchronism, instruction of actuator placement, optimization of the device procedure, and prediction of the response to CRT.

Cardiac Resynchronization Therapy ; methods ; Echocardiography ; methods ; Heart Failure ; diagnostic imaging ; therapy ; Humans ; Radiography

A new viral sampling concentration device was designed which was equipped with a new cationic filter membrane-Nanoceram suitable for field sampling. Norovirus Genegroup II was detected from environmental water with the aid of this device. The effects on virus recovery of prefiltration, various second-concentration methods, and different eluants were investigated through pre-experiment. The concentration optimized process, and the optimal concentration process were then determined. The results showed that the prefiltration had a profound effect on virus recovery, and two second-concentration method: PEG-NaC1 precipitation and celite adsorption, had almost the same concentration effects. The Na2 HPO4 solution of 0.15 mol/L was selected as the final eluant to elute the adsorbed Nuorovirus from the celite. The virus recovery of Nanoceram was determined to be 3.02%. Finally, successful detection of Norovirus GII in sewage from Yangqiao River, Fengtai District, Beijing was acheived. All these data had shown that the Naneceram filter concentration method could concentrate Norovirus from environmental water with a steady effects.
Filtration ; instrumentation ; methods ; Fractional Precipitation ; instrumentation ; methods ; Genotype ; Norovirus ; classification ; genetics ; isolation & purification ; Rivers ; virology ; Water Microbiology