Objective To evaluate the efficacy of gentamicin solution in transurethral ureteroscopic lithotripsy to prevent postop- erative infection.Methods Prospective clinical randomized control study was conducted.From July 2003 to June 2006,116 ca- ses of ureteral stones at high risk of postoperative infection were randomized into control group or gentamicin group.Patients in gentamicin group received gentamicin solution for washing in the operation.All the patients undergoing operation were followed up for 2 weeks after operation.Diagnosis of postoperative infection was based on clinical manifestations.Results A total of 109 patients received operation in all the 116 cases,including 58 cases in gentamicin group and 51 cases in control group.Thirteen cases of postoperative infection were identified in all the patients receiving operation (11.93%),3 cases in gentamicin group and 10 in control group.The incidence of postoperative infection was significantly different between the two groups (X~2= 5.3342,P=0.0209).Eight cases had positive bacterial culture.Of the microbiological isolates,2 were gram-positive bacteria, 5 gram-negative bacteria and 1 Candida albicans.Conclusions The most common pathogen causing postoperative infection after transurethral ureteroscopic lithotripsy is gram-negative bacteria.The use of gentamicin solution for washing in the operation can reduce the incidence of postoperative infection.

OBJECTIVETo explore effective approaches of treating elderly patients with distal tibiofibular fractures.

METHODSFrom August 2008 to October 2012,175 elderly patients with distal tibiofibular fractures were treated with locking compression plate (LCP) through anterior tibial. There were 112 males and 63 females with an average of 71.3 (ranged 60 to 83) years old. Of them,89 cases were treated by anterior tibial tension reduced incision with LCP,including 62 males and 27 females with a mean age of (71.8 +/- 6.4) years old. Eighty-six patients were treated by distal tibial incision with LCP,including 58 males and 28 females with a mean age of (70.3 +/- 6.7) years old. Swelling time, operation time, intraoperative blood loss, hospital stay, healing time, complications and AOFAS scores were compared between two groups after operation.

RESULTSSwelling time in anterior tension reduced incision with LCP and distal tibial incision with LCP was (5.6 +/- 1.3) and (9.7 +/- 2.1) days, healing time was (4.2 +/- 1.4) and (5.4 +/- 1.9) months,and complications were found 3 in tension reduced incision and 10 in distak tibial incision respectively;and all data shown statistically significant differences between two groups (P < 0.05). At 12 months after operation,AOFAS score was 89.0 +/- 9.7, 87.9 +/- 9.4; and there was no statistically significant difference between two groups (P > 0.05).

CONCLUSIONTension reduced incision through anterior tibial combined with locking compression plate fixation in treating elderly patients with distal tibiofibular fractures can provide good clinical effects with quick fracture healing and low complications.

Adult ; Aged ; Aged, 80 and over ; Bone Plates ; Female ; Fibula ; injuries ; surgery ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Tibia ; injuries ; surgery ; Tibial Fractures ; surgery ; Treatment Outcome

Prominent problems of clinical teaching in Tibet University school of medicine were analyzed and countermeasures were proposed from aspects of management system construction, facul-ty construction, curriculum construction, base construction and quality evaluation system construction. The aim was to increase students' opportunity, enhance students' learning interest and improve stu-dents' ability of analysis and problem solving so as to improve the practical effects of clinical teaching. All countermeasures taken above laid the foundation for future clinical work and provided help for clinical medical personnel in Tibetan border areas.

Objective To investigate the therapeutic effect of large dose mucosolvan combined variant flow rate continuous positive airway by nasal mask on neonatal respiratory distress syndrome(NRDS).Methods One hundred and fourteen newborns with NRDS were randomly divided into treatment group(58 cases) and control group(56 cases),on the base of same combined therapy,the cases in control group only underwent oxygen-absorbing by head set with the flow rate 4-6 L/min,and the cases in treatment group were given large dose mucosolvan(Ambroxol Hydrochloride) 30 mg/(kg?d) + 5%GS 20 mL,for two times and variant flow rate continuous positive airway by nasal mask(NCPAP),the parameter setting flow rate 6-8 L/min,FiO_2 0.4-0.6,pressure 5-8 cm H_2O.The clinical symptom and blood gas analysis after 12 and 48 hours were observed and compared the changes of pa(O_2),pa(CO_2),pa(O_2)/FiO_2 in two groups.Results The dyspnea and groan in 44 cases in the treatment group lessoned or vanished,pa(O_2) rised and pa(CO_2) lowered,the oxygenation index obviously increased,the cases with RDS grade Ⅰand gradeⅡ had better therapeutic effect,and the cases with RDS grade Ⅲ(X-ray)and Ⅳ had not manifest effect,the total effective rate was 75.8% in treatment group and 26.7% in control group.There were significant difference in therapeutic effect and oxygenation index between two groups.Conclusions Large dose mucosolvan(combi)-ning variant flow rate continuous positive airway by nasal mask can significantly improve the ventilation and oxygenation function and there are significant therapeutic effect in NRDS,especially in the NRDS grade Ⅰand gradeⅡ,the trachea cannula may be avoided and mechanical ventilation rate may be decreased if the therapeutic method can be used in earlier period.

Background Corneal parameters (such as curvature,thickness,etc) are essential to the diagnosis of corneal related diseases,contact lenses fitting and corneal refractive surgery.Objective The aim of this study was to assess the repeatability and accuracy of corneal parameters obtained by RTVue Fourier-domain optical coherence topography (FD-OCT).Methods In this prospective study,77 eyes of 43 subjects with the refraction from-1.25 D to-10.00 D and astigmatism ＜2 D were enrolled in keratorefractive surgery center,Eye Hospital of Wenzhou Medical College.The anterior and posterior corneal curvature in 3 mm central zone (Ranterior and Rposterior),the ratio of posterior and anterior curvature (Rposterior/Ranterior),corneal central thickness (CCT),total corneal power(Knet),the simulated corneal power (Sim K),the anterior and posterior corneal power (Kanterior,Kposterior)were measured by FD-OCT.Corneal power (Km) was obtained by Topolyzer topography based on Placido ring.Three consecutive scans were acquired in every tested eye.Repeatability of FD-OCT measurement was assessed using the coefficient of variation CV),Cronbach Alpha and intra-class correlation coefficient (ICC).Repeated measure ANOVA was used to analyze the differences among SimK,Knet and Km.Pearson correlation analysis was used to analysis the correlation between SimK and K Knet and Km,SimK and Km.The agreement between Sim K and K Knet and Km,SimK and Km was assessed by Bland-Altman plots analysis.All the subjects understood the purpose of this investigation and written informed consent was obtained prior to the medical examination.Results The Ranterior,Rposterior,Rposterior/Ranterior,Kanterior,Kposterior,Sim K,Knet and CCT were (7.691 ±0.302) mm,(6.532±0.276) mm,0.849±0.014,(48.97±1.92)D,(-6.13±0.26)D,(43.95±1.72) D,(42.95±1.68) D and (545.20± 35.04) μm,respectively.The CV of all parameters was less than 1％.The Cronbach Alpha and ICC were both more than 0.9 except 0.802(ICC)of the Rposterior/Ranterior.SimK was (0.27±0.34) D higher than Km,and Knet was (0.73±0.37) D lower than Km.SimK was (1.01 ±0.11) D higher than K and all the differences showed a statistical significance (P＜0.001).There were close positive correlations between SimK and Km,Knet and Km,SimK and Knet(all r ≥ 0.976,P＜0.001).The Bland-Altman analysis showed a poor agreement between SimK and Km,Knet and Km,SimK and Knet.Conclusions The RTVue FD-OCT measuring corneal curvature and CCT performes good repeatability.The Sim K obtained by RTVue FD-OCT is slightly greater than that obtained by corneal topography,and the Rposterior/Ranterior obtained by RTVue FD-OCT is slightly lower than that from Gullstrand model eye.These results offer a basis for establishing a more accurate standardized model eye.

In this study we present our experiences with the reverse sural fasciocutaneous flap to reconstruct the distal lower limb soft tissue defects caused by traumatic injuries. These flap graftings were carried out from Oct. 2010 to Dec. 2012 in our department. The series consisted of 36 patients, including 21 men and 15 women with an average age of 46.2 years (14-83 years) and with a medium follow-up period of 18 months (12-24 months). Of all the cases of acute trauma, there were 10 cases of trauma of distal tibia, 9 cases of trauma of perimalleolus, and 17 cases of trauma of midfoot and forefoot. Related risk factors in the patients were diabetes (2 cases), advanced age (>65 years, 3 cases) and cigarette smoking (6 cases). The reverse flow sural island flap irrigation depended on lower perforators of the peroneal artery. The fasciocutaneous pedicle was 3-4 cm in width and the anatomical structures consisted of the superficial and deep fascia, the sural nerve, short saphenous vein, superficial sural artery together with an islet of subcutaneous cellular tissue and skin. The most proximal border of the flap was only 1.5 cm away from the popliteal skin crease and the pivot point was 5-7 cm above the tip of the lateral malleolus. All the flaps survived. No arterial crisis occurred in any case. The venous congestion occurred in 2 cases and got better after raising the limbs and bloodletting. Only in an old man, 1.5 cm necrosis of distal margin of his flap occurred and finally healed after continuous dressing change. One-stage skin grafting was performed, and all the donor sites were sutured and successfully healed. It was concluded that the reverse sural fasciocutaneous flap is safe and reliable to extend to the proximal third even near the popliteal skin crease. We also concluded this flap can be safely and efficiently used to treat patients with large and far soft-tissue defects from the distal leg to the forefoot with more versatility and it is easier to reach the recipient sites.

OBJECTIVETo assess the association of the A260G and A386G single nucleotide polymorphisms (SNP) of the DAZL gene with male infertility in the Chinese population of Zhejiang Province.

METHODSWe collected the peripheral blood samples from 317 idiopathic infertile males with azoospermia or oligozoospermia and 246 normal fertile men, and genotyped the polymorphic loci of the A260G and A386G polymorphisms of the DAZL gene using the SNaPshot technique.

RESULTSThe DAZL gene A260G was found genetically polymorphic in the Chinese population of Zhejiang Province, with the gene frequencies and their distribution consistent to the Hardy-Weinberg equilibrium. The frequencies of the AA, AG and GG genotypes of the A260G polymorphism were 92.3%, 7.3%, and 0.4% respectively in the normal controls and 94.3%, 5.7%, and 0% in the infertile patients, with no statistically significant differences between the two groups (P = 0.43, OR = 0.78, 95% CI 0.413-1.46). Heterozygosis (AG) of A386G was found in 1 of the control males but not in the infertile patients, while homozygosis (GG) of A386G was not observed in either group (P = 0.259, OR = 0.698, 59% CI: 0.374-1.306).

CONCLUSIONA260G and A386G SNPs of the DAZL gene are not associated with spermatogenic failure and neither represents a molecular marker for the genetic diagnosis of male infertility in the Chinese population of Zhejiang Province.

Asian Continental Ancestry Group ; Azoospermia ; genetics ; China ; Gene Frequency ; Genetic Markers ; Genotype ; Humans ; Infertility, Male ; genetics ; Male ; Oligospermia ; genetics ; Polymorphism, Genetic ; Polymorphism, Single Nucleotide ; RNA-Binding Proteins ; genetics

OBJECTIVETo observe the improvement effects of puerarin on glycated brain damages in rat model induced by D-galactose.

METHODThe model rats of protein glycation were induced by intraperitoneal administration of D-galactose (150 mg x kg(-1) x d(-1)) for 8 weeks, and all rats were treated with puerarin (high dose 300 mg x kg(-1), middle dose 150 mg x kg(-1), low dose 75 mg x kg(-1)) for 6 weeks. The activity of aldose reductase in red blood cells, the amount of glycated products (fructosamine in serum, glycohaemoglobin, advanced glycation end-products) and AGEs in brain tissue, calcium ion in brain cells were measured. Moreover, mitochondria in brain hippocampus cells were observed under electronic microscope.

RESULTHigh dose and middle dose of puerarin can decrease the activity of aldose reductase in red blood cells (P < 0.01), and inhibit the formation of glycation products significantly in model rats induced by D-galactose (P < 0.01). Also, puerarin can decrease the content of AGEs in brain and the level of calcium ions in brain cells (P < 0.05, P < 0.01), and decrease lesions degree in mitochondria in brain hippocampus cells.

CONCLUSIONPuerarin can produce the protective effects on glycated brain damages through inhibiting the glycation reaction in rats induced by D-galactose.

Aldehyde Reductase ; metabolism ; Animals ; Brain ; metabolism ; pathology ; Calcium ; metabolism ; Erythrocytes ; enzymology ; Female ; Fructosamine ; blood ; Galactose ; antagonists & inhibitors ; Glycated Hemoglobin A ; metabolism ; Glycation End Products, Advanced ; metabolism ; Hippocampus ; ultrastructure ; Isoflavones ; isolation & purification ; pharmacology ; Male ; Mitochondria ; ultrastructure ; Neuroprotective Agents ; pharmacology ; Plants, Medicinal ; chemistry ; Pueraria ; chemistry ; Random Allocation ; Rats ; Rats, Sprague-Dawley

To investigate the influence of Anxin granules combined with tirofiban on acute myocardial infarction (AMI) Patients after elective percutaneous coronary intervention (PCI). One hundred and twenty AMI patients were randomly divided into treatment group and control group. The patients in the two groups were all given Tirofiban 30mins before PCI . The treatment group was added Anxin granules 30 mins before and after PCI. Tissue factor (TF) and von willebrand factor (vWF) were tested at 6 hours after operation. Syndromatology alteration of traditional Chinese medicine (TCM) and bleeding complications were observed at 4 weeks after operation. Both TF and vWF at 6 hours after operation of the treatment group was lower than the control group significantly (P < 0.01), while the condition of myocardial ischemia at 90 mins after operation of the treatment group was better than control group with significance. The syndromatology alteration of TCM especially spontaneous perspiration and hypodynamia of the treatment group were improved significantly compared to control group 4 weeks after operation. All patients in both groups had no bleeding complications and thrombopenia. The study suggests that Anxin granules combined with tirofiba can improve the clinical efficacy and the endothelial function of AMI patients after PCI with no increase in bleeding events.
Aged ; Angioplasty, Balloon, Coronary ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Middle Aged ; Myocardial Infarction ; complications ; metabolism ; surgery ; Postoperative Hemorrhage ; drug therapy ; etiology ; metabolism ; prevention & control ; Thromboplastin ; metabolism ; von Willebrand Factor ; metabolism

OBJECTIVETo establish a method for SNP genotyping of multi-genes by allele-specific oligonucleotide probe ligation mediated by a thermostable ligase, and to explore the genetic polymorphisms of drug-metabolizing enzymes in breast cancer patients and their association with chemotherapeutic responses.

METHODS10 SNP loci of enzyme genes related to chemotherapeutic drugs such as taxanes, anthracyclines and cyclophosphamide were selected, and were genotyped for blood samples from 126 breast cancer patients by the established method. Their correlations with therapeutic responses were retrospectively evaluated.

RESULTSThe lower detection limit of genomic DNA by this developed method was 6.25 ng. The fluorescent peak locations of ligation products on ABI PRISM 377 DNA sequencer were accurate and consistent with prospective sizes in bases (Bias range 0.08 - 0.69 bp, x(-) = 0.31 bp, s = 0.18 bp). Same genotyping results were obtained for repeat tests of 8 random samples, which were further confirmed by sequencing analysis. The 10 SNP loci were polymorphic of different frequency in the breast cancer patients. The combinations with GSTP1 genotypes and GSTM1 genotypes were related to anthracycline-based chemotherapy efficacy (P = 0.037), and the low GSTs activity group (GSTP1 variant allele + GSTM1 null) showed the best effects (85.7%). GSTM1 genotypes and their combinations with GSTP1 and/or CYP3A5*3 genotypes were related to taxane-based therapy efficacy (P < 0.05 for all), and both the low GSTs activity group and the drug slow-metabolising group (low GSTs activity group + CYP3A5*3 wild allele) showed better effects (100%).

CONCLUSIONThe established method is reliable and applicable in multiplex SNPs genotyping of multi-genes. SNPs combination may have a better clinical application value for prediction of chemotherapeutic responses.

Adult ; Aged ; Anthracyclines ; therapeutic use ; Antineoplastic Agents ; therapeutic use ; Breast Neoplasms ; drug therapy ; genetics ; Cyclophosphamide ; therapeutic use ; Cytochrome P-450 CYP3A ; genetics ; DNA Mutational Analysis ; methods ; Female ; Gene Frequency ; Genotype ; Glutathione S-Transferase pi ; genetics ; Glutathione Transferase ; genetics ; Humans ; Middle Aged ; Polymerase Chain Reaction ; methods ; Polymorphism, Single Nucleotide ; Retrospective Studies ; Taxoids ; therapeutic use ; Treatment Outcome