Objective To compare the response of haemodynamics and intraocular pressure (IOP) to laryngeal mask airway (LMA) and tracheal intubation (TT) in children with glaucoma.Methods A prospective,randomized study was conducted in 50 glaucomatous children,scheduled to undergo trabeculectomy and divided into LMA group (25 cases) and TT group (25 cases) by random digits table method.Endotracheal intubation or placement of the laryngeal mask operation time and the dosage of midazolam was noted in each patient.Heart rate (HR),mean arterial pressure (MAP),tip perfusion index (TPI),IOP were measured after anesthesia induction (T1),endotracheal intubation or placement laryngeal mask immediately (T2),endotracheal intubation or placement after laryngeal mask 1 min (T3),2 min (T4),3 min(T5),5 min(T6).Results There was no significant difference in endotracheal intubation or placement of the laryngeal mask operation time and the dosage of midazolam between two groups (P ＞ 0.05).Compared with T1,HR,IOP were increased at T2-T4,MAP was increased at T2-T3,TPI was decreased at T2-T5 in TT group,there was significant difference(P ＜ 0.05).There was no significant difference in HR,MAP,TPI,IOP among different points in LMA group (P ＞ 0.05).HR,MAP,IOP in LMA group at T2-T4 were lower than those in TT group [HR:(119.3 ±8.9),(117.6 ±8.5),(115.2 ±6.9) beats/min vs.(131.3 ±7.1),(128.1 ±6.8),(123.2 ± 8.6)beats/min,MAP:(36.9 ± 5.1),(37.1 ±4.8),(34.7 ±4.6) mmHg (1 mmHg =0.133 kPa) vs.(44.1 ± 4.9),(42.8 ± 5.5),(41.9 ± 7.1) mmHg,IOP:(27.6 ± 2.5),(27.0 ± 2.0),(25.9 ± 2.3) mmHg vs.(34.2 ± 2.2),(32.9 ± 1.6),(31.1 ± 2.2) mmHg],TPI at T2-T5 was higher than that in TT group (3.25 ± 0.28,2.99 ± 0.26,3.15 ± 0.31,3.40 ± 0.30 vs.2.69 ± 0.29,2.22 ± 0.27,2.41 ± 0.30,2.66 ± 0.33),and there was significant difference (P ＜0.05).Conclusion Insertion of LMA in glaucomatous children is not associated with significant changes in haemodynamics and IOP response and offers advantages over tracheal intubation.

Objective To improve the effect of clinical diagnosis and treatment of acetabular fracture with a femoral nerve injury by analyzing the causes of femoral nerve injury following acetabular fractures.Methods From January 1996 to November 2004,146 cases of acetabular fractures were treated operatively.Six cases of them were complicated with femoral nerve injury.The causes of femoral nerve injury were analyzed on the basis of clinical manifestations,CT scan and 3-dimensional reconstruc- tion.All the cases were classified according to Letournel and Judet classification.Three cases had hema- toma compression (2 cases with double column fractures and 1 with transverse-posterior wall fractures);2 cases had femoral nerve injury caused by fracture fragments (1 case with anterior wall fracture following anterior hip dislocation,the another with old fracture of anterior column combined with fracture of superior ramus of pubis);and one case had anterior column fracture combined with fracture of wing of ilium,and the femoral nerve was injured by traction in operation.Clearance of hematoma,nerve tract decompression and epineuria solution were performed in 5 cases,and 1 case was treated conservatively.Results The average follow-up period was 1.8 years(ranging from 1 to 3 years).The muscle power of quadriceps fem- oris recovered from 1-2 grade before operation to 4-5 grade after operation in 5 cases.The function of ex- tensor knee and gait was normal.The function of sensory completely recovered in 4 cases.One case was followed up for 2 years,which showed the patient still suffered from hypoesthesia in the lower 2/3 of the thigh and the medial of the leg.One ease of traction injury was followed up for 1.2 years,showing the muscle power recovered to normal,but still presented with sensory disability.Conclusion Acetabular fractures associated with femoral nerve injury are rare.For complex acetabular fractures and severe trau- ma,attention should be given to the possibility of femoral nerve injury.Fragment stabbing and compres- sion of hematoma around iliopsoas muscle are the common causes of femoral nerve injury following ace- tabular fractures.Iatrogenic injury should not be ignored.

Objective To determine the genes in which exist overlapping ORF in Merlin strains of human cytomegalovirus, and to reveal their structure and functional characteristics. Methods We search for overlapping genes of ORF in HCMV Merlin strains' whole genome by Bioinformatics methods, analyzing coding sequence CDS and starting and ending sites of ORF, calculating the length of CDS and ORF, analyzing the molecular weight of encoding protein, overlapping length and coding direction of protein, identifying overlapping sequences and overlapping types, analyzing the expression phase of overlapping genes and the function of proteins. Results There were 39 overlapping ORF genes in HCMV Merlin strains, accounting for 23% of total genes. Among these 39 genes, there are 13 IE genes, 9 E genes and 17 L genes, which can be divided into 16 contigs. There are 11 contigs when two genes overlap, with 3 contigs in three genes overlapping, and 2 contigs in four genes overlapping. The functions of overlapping genes are widely. Conclusion We found that there are a lot of complex overlapping genes in HCMV Merlin strains, which are basis for further study of the transcription and translation mechanism of overlapping genes.

OBJECTIVESubtrochanteric femoral fractures are severe injuries. Although many treatment methods have been developed, controversy exists regarding the optimal management of these fractures. This study evaluated the clinical outcome of subtrochanteric femoral fractures fixed with long proximal femoral nail antirotation (PFNA-long).

METHODSBetween October 2006 and February 2008, 25 patients with traumatic subtrochanteric fractures of the femur were treated with PFNA-long. Closed reduction and fixation were performed in 20 cases. In the remaining 5 cases, closed reduction was difficult, so limited open reduction was performed, with bone grafting in 4 cases and circumferential wiring in 4 cases.

RESULTSThe average follow-up time was 16.1 months. All subtrochanteric femoral fractures healed uneventfully except one case of delayed union. The mean union time was 26.2 weeks. Technical difficulties with nail insertion were encountered in 3 cases. No implant failure was observed.

CONCLUSIONPFNA-long is effective in treatment of subtrochanteric femoral fractures, with a high rate of bone union, minor soft tissue damage, early return to functional exercise and few implant-related complications.

Adult ; Biomechanical Phenomena ; Bone Nails ; Female ; Fracture Fixation, Internal ; instrumentation ; Fracture Healing ; Hip Fractures ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies

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 evaluate whether or not administration of folic acid and resveratrol have preventive effects on cleft palate formation as well as the comparison of the two drugs' s effects.

METHODSPregnant mice were randomly divided into 9 groups, with 8 mice in each group. The TCDD group mice were dosed with TCDD 28 microg/kg body weight on gestation day 10 (GD 10) animals in folic acid group were respectively dosed with folic acid 15, 10, 5 mg/kg and TCDD 28 microg/kg; resveratrol treated mice were divided into 3 groups: resveratrol 50 mg/kg were orally administered for 6 consecutive days, from gestational day GD 8 to GD13 in resveratrol (GD8-13 ) group; resveratrol 50 mg/kg were orally administered for 6 consecutive days, from gestational day GD 8 to GD13, followed hy an oral administered with TCDD on GD10 in resveratrol (GD8-13) + TCDD group; resveratrol 50mg/kg and TCDD 28 microg/kg were used by gavage administration at GD10 in resveratrol (GD10) + TCDD group. Control mice were treated with the same volume of water for 6 consecutive days from GD8 to GD13 and were given a single dose of corn oil on GD10. The pregnant mice weight and embryos, the number of live, cleft palate, dead and resorption fetal mice were recorded on GD 17.5. The coronal sections of the fetal mice heads were prepared at GD 17.5 and observed by microscopy.

RESULTSTotal frequency of clefts was 92.86% in TCDD group, 84.00% (15 mg), 73.08% (10 mg), 84.00% (5 mg) in folic acid + TCDD groups, 0% in resveratrol (GD10) group, 74.51% (GD10), 57.78% (GD8-13) in resveratrol + TCDD groups. The frequency of cleft was 0% in the control group. Compared with the control and the TCDD groups, there were significant differences in the number of live, dead and resorption fetal mice in TCCD + resveratrol (GD8-13) group (P < 0.05). No significant differences in embryonic weight, live fetuses weight, the number of live, dead and resorption fetal mice were found in the other groups (P > 0.05).

CONCLUSIONTest dose of folic acid and resveratrol both had certain antagonistic effect on cleft palate in mice induced by TCDD, with folic acid 10 mg/kg, resveratrol 50 mg/kg GD8-13 doses having stronger antagonistic action. Effects of both the two drugs have no significant difference, but resveratrol (50 mg/kg, GD8-13) significantly affects the fetal mice's growth and development under TCDD exposure in utero.

Abnormalities, Drug-Induced ; prevention & control ; Animals ; Cleft Palate ; chemically induced ; prevention & control ; Female ; Fetus ; Folic Acid ; administration & dosage ; pharmacology ; Humans ; Mice ; Mice, Inbred C57BL ; Polychlorinated Dibenzodioxins ; antagonists & inhibitors ; Pregnancy ; Random Allocation ; Stilbenes ; administration & dosage ; pharmacology ; Teratogens

OBJECTIVETo discuss the operative effects and evaluate how the waiting time before surgery influence the outcome of complex acetabular fractures.

METHODSFrom January 2006 to December 2008, 33 patients, 28 males and 5 females, with complex acetabular fractures were operated in our hospital. All of them were followed up for an average 24 months (ranged, 14 to 47 months). The average age was 42 years (ranged,27 to 57 years). According to the waiting time before surgery, all patients were divided into two groups, namely preoperative waiting time of more than 14 days group and preoperative waiting time of less than 14 days group. Postoperative reduction quality and long-term radiographic results were evaluated according to the Matta radiological systems. The modified Merle d' Aubigne-postel hip scoring system was used for evaluating the functional outcomes. The Mos SF-36 was used to evaluate the quality of life.

RESULTSAnatomical reduction in 28 cases, good in 4 cases, and poor in 1 case. According to the mean Merle d'Aubigne and Postel Score, 22 patients got excellent result, 4 good, 4 fair and 3 bad. Average score of the Mos SF-36 was (70.63 +/- 17.03). When time was measured as a categorical variable, an anatomical reduction and an excellent or good functional outcome were more likely if surgery was performed within 14 days. Postoperative complications: iatrogenic injuries of sciatic nerve in 2 cases, heterotopic ossification in 6 cases,traumatic osteoarthritis in 3 cases, and femoral head necrosis in 1 case.

CONCLUSIONGood image evaluation,correct approaches, appropriate time before surgery and approach, early functional rehabilitation are essential for better outcomes in the treatment of complex acetabular fractures, of which, time to surgery is a crucial and controllable prognostic factor.

Acetabulum ; injuries ; physiopathology ; surgery ; Adult ; Case-Control Studies ; Female ; Fracture Fixation, Internal ; adverse effects ; methods ; Fractures, Bone ; diagnostic imaging ; physiopathology ; surgery ; Humans ; Male ; Middle Aged ; Ossification, Heterotopic ; prevention & control ; Osteoarthritis ; prevention & control ; Postoperative Complications ; prevention & control ; Radiography ; Sciatic Nerve ; injuries ; Time Factors

Objective To etiologically diagnose and analyze a patient with suspected cases of brucellosis,and to provide a experimental basis for the confirmation of the first case of human brucellosis in Guizhou province.Methods Conventional and molecular techniques [genus specific Brucella surface protein 31 PCR (BCSP31-PCR)and Brucella suis species-specific PCR (AMOS-PCR)] were used to identify suspicious bacteria strains isolated from the suspected patient of brucellosis.Results The results showed that the Brucella suspicious colonies were identified as Brucella melitensis biotype 3 using conventional tests and were further identified as Brucella spp.by genus specific Brucella surface protein 31 PCR (BCSP31-PCR) and classified as Brucella melitensis with Brucella abortus,Brucella melitensis,Brucella ovis,Brucella suis species-specific PCR(AMOS-PCR).Conclusions Laboratory diagnostic results show that the bacteria strain isolated from the suspected patient of brucellosis is Brucella melitensis biotype 3.It is the first case of human brucellosis in Guizhou province.

OBJECTIVETo study surgical techniques for degenerative lumbar scoliosis associated with lumbar stenosis and evaluate their clinical significane.

METHODSThirty-two patients with degenerative lumbar scoliosis associated with spinal stenosis were treated by techniques of posterior lumbar interbody fusion or posterolateral fusion and pedicle screws. There were 18 male and 14 female with 56.8 years old on the average (ranging from 49 to 75 years). There were no evident change of lumberlordosis in 15 cases, and lumber lordosis were obvious loss associated with lumbar subluxation in 17 cases. The correcting, the improvement of back and leg pain, complications and followed-up results were analyzed retrospectively.

RESULTSThirty-two cases were followed-up for 6 to 39 months (the average time of 13 months). The average correction rate of scoliosis was 58.0% and the rate of pain relief was (80.2 +/- 5.8)%. There were two cases of dura sac laceration, two cases of nerve roots injury and a case of pseudoarthritis. During followed-up, correction rate and height of disc spaces were not lost. Shift of interbody cages were no displaced; all the internal fixation got well fusion and the rate of fusion for the bone graft was 96.9%.

CONCLUSIONPosterior pedicle screws combined with interbody fusion or posterolateral fusion is a safe and effective surgical treatment for degenerative lumbar scoliosis associated with lumbar stenosis.

Aged ; Bone Screws ; Female ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Scoliosis ; surgery ; Spinal Fusion ; Spinal Stenosis ; complications ; surgery ; Treatment Outcome

OBJECTIVETo study a new effective approach which repairs large defects of skin and soft tissue in neck and face.

METHODThis procedure accomplishes repetitive sub-platysmal expansion to form large musculocutaneous flap with underlying pedicel. The surgeon slides it toward neck and face to repair the defects of skin and soft tissue.

RESULTEleven patients, who had such defects in neck, face, cheek, chin or submental skin and soft tissue, underwent this treatment. All the flaps survive with no complications of blood supply deficiency or necrosis. The short-term and long-term results are both satisfying.

CONCLUSIONThis method, making repetitive sub-platysmal expansion to form musculocutaneous flap and then slide it toward neck/face to repair large defects of skin and soft tissue, proves to be safe and reliable. And appropriate cases and strict operations are important.

Adult ; Dermatologic Surgical Procedures ; Face ; surgery ; Female ; Humans ; Male ; Neck ; surgery ; Reconstructive Surgical Procedures ; methods ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; Treatment Outcome