Face ; surgery ; Humans ; Mouth ; surgery ; Reconstructive Surgical Procedures ; Retrospective Studies

Objective To evaluate the feasibility,safety,and efficacy of endovascular repair combined with second-stage surgical debridement for ruptured femoral pseudoaneurysms (RFP).Methods All patients who underwent emergency repair of an RFP in our institution between 2009 and 2013 were identified.Case notes were retrieved for clinical data.Results Seven patients were identified.All the patients were treated with emergent percutaneous stent-graft implantation and secondary surgical debridement.The procedure time was (55 ± 6.32) min,blood loss was (93.33 ± 25.03) ml,hospital stay was (9.5 ± 0.84) d,and no postoperative complications occurred.Conclusions stent graft implantation for the treatment of RFPs is safe and effective in short-or middle-term outcome.It is an alternative for RFPs and may be the better option,which makes the secondary surgical debridement feasible and viable.

Objective To investigate the clinical outcome and treatment of portal vein thrombosis (PVT) following partial splenic embolization (PSE).Methods From April 2006 to April 2010,105patients with hypersplenism caused by cirrhotic portal hypertension were treated with PSE.Contrastenhanced abdominal computed tomography or magnetic resonance imaging was performed routinely in 60patients before PSE and 1 -3 months after PSE.PVT was detected in 10 patients on images after the procedures.After PVT was diagnosed,4 patients received anticoagulant therapy immediately,and the other 6 patients did not receive therapy.Clinical data of these 10 PVT patients were analyzed retrospectively.Results 3 of 4 patients who received anticoagulant therapy had complete or partial resolution of the thrombus,and one developed mild ascites without thrombosis progression.Of the 6 patients who did not receive anticoagulant therapy,follow-up studies (6- 48 months,mean 16.9 months) demonstrated partial clot calcification in one,thrombosis progression in 5.Among those 5 patients with thrombosis progression,two experienced hematemesis due to variceal rupture and underwent transjugular intrahepatic portosystemic shunt,2 developed cavernous transformation,extensive collateral circulation,ascites and variceal progression,and one had variceal progression with melena during the follow-up period.Conclusions PVT is a severe complication of PSE.Early diagnosis and prompt anticoagulant therapy is effective in preventing PVT.

Objective To study the setup errors in three-dimensional conformal radiotherapy (3DCRT) for thoracic esophageal carcinoma using electronic portal imaging device(EPID) and calculate the margins from CTV to PTV. Methods Forty-one patients with thoracic esophageal carcinoma who received 3DCRT were continuously enrolled into this study. The anterior and lateral electronic portal images (EPI) were aquired by EPID once a week. The setup errors were obtained through comparing the difference between EPI and digitally reconstructed radiographs(DRR). Then the setup margins from CTV to PTV were calculat-ed. By using self paired design,22 patients received definitive radiotherapy with different margins. Group A: the margins were 10 mm in all the three axes;Group B: the margins were aquired in this study. The differ-ence were compared by Paired t-test or Wilcoxon signed-rank test. Results The margins from CTV to PTV in x,y and z axes were 8.72 mm, 10.50 mm and 5.62 mm, respectively. Between the group A and group B, the difference of the maximum dose of the spinal cord was significant(4638.7 cGy±1449.6 cGy vs. 4310.2 cGy±1528.7 cGy; t=5.48, P=0.000), and the difference of NTCP for the spinal cord was also significant (4.82%±5.99% vs. 3.64%±4.70%;Z=-2.70,P=0.007). Conclusions For patients with tho-racic esophageal carcinoma who receive 3DCRT in author's department,the margins from CTV to PTV in x, y and z axes were 8.72 mm, 10.50 mm and 5.62 mm, respectively. The spinal cord could be better protected by using these setup margins than using 10 mm in each axis.

Objective To analyze the mutation of PreS-S region in occult hepatitis B virus(OHBV) in HBV infected persons with positive HBsAb and investigate the biological mechanisms of the special infectious model.Methods A total of 38 HB-sAb positive OBI serum samples were amplified by Nested PCR and sequenced,HBV genotype and serotype were determined.The amino acid sequences of OHBV were compared to the corresponding sequence of wild-type strains of similar genotype obtained from the GenBank database.Results PreS-S segment of 11 samples were obtained and 8 samples were sequenced successfully.Among which,5 were genotype C and 3 were genotype B.Genotype B were all serotype adw,while genotype C were 1 adw and 4 adr.The mutation rates of PreS-S region,the immunoreactive area and the major hydrophilic region (MHR) were higher in OHBV than the wild-type strains (2.6％ vs 0.8％,x2 =40.23,3.2％ vs 0.3％,x2 =52.13,3.6％ vs 0.6％,x2 =13.25,all P＜0.01) and the substitutions of I126T,Q129R,M133T,F134I,D144E,G145K in α determinant were found in OBI samples.The mutation rate of amino acids in PreS-S region was higher in genotype C than genotype B (3.5％ vs 1.2％,x2--15.98,P＜0.01),meanwhile,the mutation rates in MHR,α determinant and immunoreactive region were higher in genotype C too,but no statistical significance was attained (4.7％ vs 1.7 ％,x2 =2.96,3.6 ％ vs 2.9％,x2 =0.25,4.1％ vs 2.3％,x2 =3.59,all P ＞0.05).Conclusion Mutations in PreS-S region,especially in immunoepitope,might change the virus'immunogenicity leading to escape from immune response and cause OBI with HBsAb positive.

Objective To explore the value of Doppler tissue imaging(DTI) in assessing the left ventricular diastolic function of patients with essential hypertension.Methods Twenty healthy person(group A),35 essential hypertension(EH) patients with normal left ventrecular mass index(LVMI,group B) and 30 EH patients with left ventricular hypertrophy(LVH,group C) were included.The mitral annular velocity in early diastole(Ea) and late diastole(Aa) were detected by DTI,meanwhile the mitral inflow velocity E and A were detected.Results The E,E/A,Ea,Ea/Aa of group B and group C were lower than those of group A(P0.05).The Ea,Ea/Aa of group C were lower than those of group B(P

Objective To explore the danger of lead exposure in newborns who accepted the blood stored in blood bank for blood change treatment.Methods The lead level of blood was examined before and after blood change treatment for 37 neonates with hyperbilirubinemia who accepted 53 cases blood stored in blood bank during Jun.to Dec.2006.The level of blood lead was measured by graphite stove atom absorb spectrum method.Results The average lead level of 53 cases blood stored in blood bank was 101.02 ?g/L,which had attained the level of lead poisoning.There were 15 cases(28.5%) whose blood lead levels was very high(≥100 ?g/L),3 cases whose blood lead level ≥200 ?g/L.After blood change treatment,the percentage of the blood lead level ≥100 ?g/L rose from 2.9% to 19.0%.The average level of blood lead after blood change treatment was higher than before(P

Objective: To analyze the current status and equity of mental health resources allocation in Shanghai Municipality, so as to provide data supports to formulate mental health action plans and relevant policies. . Methods: The data pertaining to mental health institutions, actual beds opened, certified or assistant psychiatrists and registered nurses was collected from the Survey of the Current Status on Mental Health Resources in Shanghai Municipality in 2020. The equity of mental health resources allocated by population and geographical area in Shanghai Municipality was evaluated with Lorenz curve and Gini coefficient Results: There were 96 mental health institutions, 15 060 actual beds opened, 257 certified or assistant psychiatrists and 2 887 registered nurses in Shanghai Municipality in 2020, with a physician-to-nurse ratio of 1∶2.30. The greatest numbers of actual beds opened in the department of psychiatrics, the number of certified or assistant psychiatrists and the number of registered nurses per 10 000 residents and per km2 were all found the central urban areas. The numbers of actual beds opened in the department of psychiatrics, the number of certified or assistant psychiatrists and the number of registered nurses per 10 000 residents were 6.06 beds, 0.51 physicians and 1.16 nurses, with Gini coefficients of 0.36, 0.42 and 0.44, respectively, and the numbers of actual beds opened in the department of psychiatrics, the number of certified or assistant psychiatrists and the number of registered nurses per km2 were 2.38 beds, 0.20 physicians and 0.46 nurses, with Gini coefficients of 0.72, 0.76 and 0.75, respectively. Conclusions There was a gross equity in mental health resources allocated by population and geographical area in Shanghai Municipality in 2020, which showed an improvement as compared to 2015. The equity in mental health resources allocated by geographical area was lower than that by population in Shanghai Municipality.

Abdominal Pain ; etiology ; Female ; Humans ; Liver ; diagnostic imaging ; pathology ; Liver Neoplasms ; diagnostic imaging ; pathology ; surgery ; Teratoma ; diagnostic imaging ; pathology ; surgery ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVETo investigate the application and mechanism of tissue-engineered skin with mouse embryonic fibroblasts (MEFs) for the full-thickness skin defects on mice.

METHODSThe MEFs and fibroblasts were cultured and seeded in scaffold made of rat tail collage. ELISA method was used for detection of secretory function. The full-thickness skin defects were created on mice and covered by MEFs-scaffold complex (experimental group), or FBs-scaffold complex (control group 1), or scaffold only (control group 2). The process of wound healing was evaluated by observation of the re-epithelization rate. Microvessel density (MVD) and vimentin within the wound sites were also detected with immunohistochemistry staining technique to describe the characteristics of wound healing. Hoechst 33342 staining was performed to trace MEFs'fate.

RESULTSMEFs scaffold group had higher level secretion of IL-6 and lower of TGF-beta1 than FBs scaffold group (P<0.05). Compared with wounds in control groups, the wounds in MEFs group healed markedly fast (P<0.05) and the MVD was significantly higher (P <0.05). The fibroblasts in the wounds of MEFs group were arranged regularly and the MEFs decreased during the healing process.

CONCLUSIONSThe MEFs-scaffold complex can promote wound healing with less scar formation. MEFs may have an inducing effect on the wound healing.

Animals ; Female ; Fibroblasts ; cytology ; Interleukin-6 ; metabolism ; Pregnancy ; Rats ; Rats, Sprague-Dawley ; Skin, Artificial ; Tissue Engineering ; Tissue Scaffolds ; Transforming Growth Factor beta1 ; metabolism ; Wound Healing