Adult ; Arsenic Poisoning ; Arsenicals ; Humans ; Indium ; Male ; Occupational Exposure ; Young Adult

Adult ; Gasoline ; poisoning ; Humans ; Middle Aged ; Occupational Diseases ; Solvents ; poisoning ; Young Adult

Adult ; Female ; Fluoride Poisoning ; Humans ; Male ; Middle Aged ; Occupational Diseases

Treatment modalities of gastric variceal bleeding are endoscopic injection sclerotherapy, endoscopic variceal ligation, combined above two method, operation, TIPS, and percutaneous transhepatic embolization. Recently, Histoacryl was introduced as a new sclerosant of acute variceal bleeding failed by others. So, we studied 18 cases of acute gastric variceal bleeding uncontrolled by EIS using Ethanolamine oleate. Intravariceal injection of Histoacryl is considered as a safe and effective method for hemostasis of intractable acute gastric variceal bleeding uncontrolled by other sclerosants. But, it is important that endoscopist should be in harmony with assistant at injection of Histoacryl. And its shooting speed should be fast because of clogging within the catheter. It is necessary to do long term study for evaluation of eradication effect in acute gastric variceal bleeding.
Catheters ; Cyanoacrylates ; Enbucrilate ; Esophageal and Gastric Varices* ; Ethanolamine* ; Hemostasis ; Ligation ; Oleic Acid* ; Sclerosing Solutions ; Sclerotherapy*

OBJECTIVETo compare the therapeutic effects between close reduction and plaster slab fixation combined with plaster external traction and operation for the treatment of pediatric closed Gartland type III supracondylar humerus fractures without neurovascular injury complications.

METHODSFrom June 2009 to June 2012, 151 children with closed Gartland III supracondylar humerus fractures were retrospectively studied and divided into two groups, including 87 boys and 64 girls, ranging in age from 1 to 12 years old with an average of 5.3 years old. Among them, 76 children (conservative group) were treated with close reduction and plaster slab fixation combined with plaster external traction; 75 children (operation group) underwent surgical operation. The time of elbow joint function exercise, the healing time of fracture, the function recovery of elbow joint and carrying angle was recorded and analyzed. The therapeutic effects were evaluated by the Flynn criteria system.

RESULTSAll patients were followed up from 6 to 36 months (18.3 months on average). The average time of fracture healing and elbow joint functional exercise of the conservative group was shorter than those of operation group (P < 0.001). Motion range of the elbows and carrying angle of two groups were no statistical difference (P > 0.05). According to Flynn criteria system, in conservative group, the result was excellent in 31 cases, good in 35, fair in 7, and poor in 3; in operation group, 27 in excellent, 30 in good, 17 in fair and 1 in poor; there was no significant difference between two groups in therapeutic effects (P > 0.05).

CONCLUSIONClose reduction and plaster slab fixation combined with plaster external traction in treatment of pediatric closed Gartland type III supracondylar humerus fractures without neurovascular injury complications,which has similar effect to surgical treatment, and the time of fracture healing and elbow joint function exercise are significantly shorter.

Case-Control Studies ; Casts, Surgical ; Child ; Child, Preschool ; External Fixators ; Female ; Fracture Healing ; Humans ; Humeral Fractures ; surgery ; Infant ; Male ; Traction ; methods

Objective To investigate the dynamic changes of lymphocyte subsets (lymphocyte count, CD3 +T,CD4 +T,CD8 +T,CD19 +B,CD56 +NK)in children with septic shock.Methods Peripheral blood lymphocyte subsets were analysed in 25 cases with severe septic shock and 24 cases with mild septic shock on day 1 ,3,8,and compared with those of 25 healthy volunteers.Children with severe septic shock were divided in-to survival group and dying group according to the outcome.The detection data were compared.Results In the first day of admission,peripheral blood lymphocyte subsets in children with septic shock decreased significantly compared with the normal children,and there was significant difference in the three groups(P <0.05 ).In the third day of admission,children with mild septic shock had statistical increase of CD4 +T,CD3 +T and lympho-cyte count(P <0.05),and children with severe septic shock had statistical decrease of lymphocyte subsets ex-cept CD56 +NK.In the eighth day of admission,children with mild septic shock had no significant difference in CD4 +T lymphocyte count compared with control group(P >0.05),but children with severe septic shock had statistical increase of CD4 +T,CD3 +T and lymphocyte count(P <0.05).There were 5 cases died who had se-vere septic shock in day 2 to day 5 after admission.The count of lymphocyte subsets were detected significantly lower in dying group than survival group in the third day of admission(P <0.05).Conclusion The continuous low level of lymphocyte subsets indicates bad outcome.The patientˊs condition improved with increase of CD4 +T,CD3 +T,lymphocyte count.CD4 +T is the most sensitive.Dynamic detection of lymphocyte subsets in the pe-ripheral blood of children with septic shock is of great clinical significance in judging the severity of disease and cura-tive effect.

Objective To examine the clinical effect and learning curve of endoscopic thyroidectomy via chest-areolar approach in the treatment of benign thyroid nodules. Methods From January 2012 to May 2016,49 patients underwent endoscopic thyroidectomies via chest-areolar approach in Xuanwu Hospital ,Capital medical university. The clinical characteristics ,prognosis and operation time were retrospectively analyzed. The patients were divided into 9 groups according to the surgical sequence ,and the learning curves were analyzed by using moving average method. Results 49 endoscopic thyroidectomies via chest-areolar approach were performed successfully. The average size of the nodules was(2.80 ± 0.62)cm. 10 patients underwent bilateral thyroidectomy and 39 underwent unilateral thyroidectomy. The average operation time was(157.49 ± 21.23)min. 2 cases received re-operation due to postoperative pathology of malignancy. There were no postoperative recurrent laryngeal nerve injuries. 11 patients suffered from asymptomatic hypocalcemia with parathyroid hormone in the normal range. All of the patients were satisfied with the cosmetic results. The learning curves indicated that 35 endoscopic thyroidectomies were needed to be performed in the early study stage. Conclusions For surgeons with experience of conventional thyroidectomies,endoscopic thyroidectomy via chest-areolar approach is feasible and safe for selected patients. There is a significant learning curve in the application of endoscopic thyroidectomy. In the early study stage of endo-scopic thyroidectomy,35 cases are basically required for beginning surgeons to practice the surgical operation.

Objective To investigate the static postural balance of patients with lumbar disc herniation (LDH). Methods From January to September, 2015, thirty patients with LDH were as observation group, and thirty healthy adult people were as control group. Their bal-ance function were detected and compared. Results The sway length, sway area and anteroposterior sway velocity were higher in the obser-vation group than in the control group (t>2.262, P<0.05), but there was no significant difference in mediolateral sway velocity between two groups (t=1.946, P=0.057) in eye-open condition. All of the indexes were higher in eye-closed condition in the observation group than in the control group (t>2.767, P<0.01), as well as the Romberg values (t>2.326, P<0.05). Conclusion Impairment of the proprioception and lower back pain affected the postural control of patients with LDH, who relied more on vision input to maintain postural stability.

Objective To investigate the expression of stromal cell-derived factor-1(SDF-1)and its clinical significance in blood plasma of patients with breast tumor.Methods The level of SDF-1 protein was examined by enzyme linked immunosorbent assay(ELISA)in blood plasma of 26 patients with breast benign tumor and 52 patients with breast cancer.Results The SDF-1 protein in blood plasma was detected in both breast benign tumor patients and breast cancer ones.The level of SDF-1 protein in patients with breast cancer was higher than that in ones with breast benign tumor,and there was a statistical difference between them(P=0.000).In patients with breast cancer,the level of SDF-1 protein in axillary lymph node(ALN)metastasis positive patients was significantly higher than that in ALN metastasis negative ones(P=0.036).Conclusion The level of SDF-1 protein in blood plasma may be a specific tumor marker.Its level is correlated with lymph node involvement in breast cancer.

Objective To explore the extent of axillary lymph node dissection in breast cancer patients with positive sentinel lymph nodes.Methods In this series,95 patients underwent complete axillary lymph node dissection (CALND) following positive sentinel lymph nodes identified and 97 patients underwent partial axillary lymph node dissection (PALND) at the absence of positive sentinel lymph nodes.The influence of different extent of axillary lymph node dissection was evaluated.Results The positive rate of level(Ⅰ + Ⅱ) non-sentinel lymph nodes (NSLN) and level Ⅲ lymph nodes was 68.4％ and 29.5％,respectively,in CALND group.In PALND situation,57.9％ CALND cases would have changed pathologic stage from pN1 to pN2 or pN3.But with level Ⅲ lymph node dissection followed PALND,only 2.1％ cases had changed pathologic stage from pN2 to pN3.Multivariate logistic regression showed that the number of positive SLNs (OR =2.157) and positive rate of SLNs (OR =10.374) were risk factors for having positive level Ⅲ lymph nodes.CALND needed longer operation time and larger postoperative drainage volume.Conclusions In cases of breast cancer with ≥ 3 positive sentinel lymph nodes,complete axillary lymph node dissection should be considered.