Adult ; Carcinoma, Papillary ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Middle Aged ; Thyroid Gland ; pathology ; surgery ; Thyroid Neoplasms ; pathology ; surgery ; Thyroidectomy ; methods ; Video-Assisted Surgery ; methods ; Young Adult

Abstract: Objective To establish an animal model of BALB/c mice infected with Burkholderia pseudomallei through the nose (inhalation route), provides a reliable animal model for the follow-up studies on the virulence of melioidosis and the pathogenesis of acute melioidosis. Methods　The experiment was carried out through infecting with Burkholderia pseudomallei through the nose (inhalation route). The pathophysiological response, visceral pathological damage and bacterial colonization of the mice infected with Burkholderia pseudomallei were observed by gross anatomy, histopathology and tissue homogenate count, and the biological characteristics of the mouse model of acute melioidosis were analyzed accordingly. Then we compared the physiological responses in BALB/c mice between the Burkholderia pseudomallei and non-pathogenic Burkholderia thailandensis. Results　In the model of acute nasal infection with Burkholderia thailandensis, most death happened between the 3rd to 5th day after infection, 3×105-3×106 CFU was the suitable dose for acute fatal melioidosis model of BALB/c mice, and the medium lethal dose was about 3×104-3×105 CFU. Both gross anatomy and tissue HE staining showed that abscesses or necrosis were found in the lung, spleen and liver, especially in the spleen and lung, which was positively correlated with the challenge dose. Viable bacteria was isolated from the blood, lung, spleen and liver of Burkholderia pseudomallei-infected mice, and the bacteria account colonization was related to tissue specificity. The concentration of live bacteria isolated from in the blood was the highest [Log2 value: (10.28±0.34) CFU/mL], and the organ with the maximum quantity of bacteria was the lung [Log2 value: (7.54±2.11) CFU/total organ]. It has been reported that the biological effects of Burkholderia pseudomallei and its homologous non-pathogenic Burkholderia thailandensis were similar at the cellular level, like multi-nuclear giant cell formation and active intracellular replication, while it is still unclarrified in the differences of virulence in mice. In this study, it was proved that Burkholderia thailandensis was not fatal to mice even at a high dose (8×107CFU), or detected from mice infected with it via nasal. Conclusion　We successfully established a reliable BALB/c mouse model (acute lethal model) of melioidosis via nasal infection, described its biological characteristics, and identified the different biological responses between Burkholderia pseudomallei and its homologous non-pathogenic Burkholderia thailandensis in mice.

OBJECTIVETo investigate the clinical application of free superficial iliac circumflex artery skin flaps, as well as the management of donor site defects.

METHODS17 free superficial iliac circumflex artery skin flaps were applied for the traumatic defects or deformities on face, neck, foot, hand, ankle and lower leg, respectively. The donor site defects were closed directly or covered by paraumbilical island flaps.

RESULTSThe 17 flap size ranged from 5 cm x 3 cm to 19 cm x 14 cm. 16 flaps survived completely except 1 flap with partial necrosis, which was closed by free skin graft. The donor site defects were closed directly in 10 cases, and covered by paraumbilical island flaps in 7 flaps without no flap necrosis. The abdomen had a good appearance.

CONCLUSIONSGood appearance can be achieved with free superficial iliac circumflex artery skin flaps for the defects on face, neck, foot, hand, ankle and lower leg. Paraumbilical island flap can be used for the donor site defects.

Arteries ; Foot ; Free Tissue Flaps ; blood supply ; transplantation ; Humans ; Reconstructive Surgical Procedures ; Skin ; Skin Transplantation ; Transplant Donor Site ; surgery ; Wounds and Injuries ; surgery

Objective:To summarize our experience in perioperative anesthetic management for fulminant hepatic failure (FHF)patients receiving liver transplantation.Methods:The clinical anesthetic data of 48 FHF patients receiving orthotopic liver transplantations(OLT)from January 2006 to January 2007 were retrospectively analyzed,and the anesthetic management expe- rience was summarized.General anesthesia was applied;the hemodynamics was monitored during the operation and doses of adrenaline and phenylephrine were adjusted according to the monitoring results.Blood samples were obtained before operation, before anheptic,30 min after anhepatic phase,5 min before neohepatic phase,and 5 min,30 min and 60 min after neohepatic phase for blood gas and electrolyte analysis and for determination of coagulation function;the drugs were subsequently adjusted according to analysis results.Results:All the 48 patient underwent successful anesthetic management and there was no death dur- ing opearation.The average blood loss during operation was(5 219?478)ml.Mild alkalosis,hypokalemia,hyponatrium,and hy- pocalcemia were present before operations,pH,BE and HCO_3~- were obviously reduced 30 min after anhepatic phase and in- creased 60 min after neohepatic phase.Kalemia was obviously increased 30 min following anhepatic phase and began to increase 60 min following neohepatic phase.Calium concentration was decreased at the end of preanhepatic phase(P

AIM: To investigate the effect of intravitreal injection of ranibizumab on the surgical outcomes and complications of PDR patients.

METHODS: We selected 84 patients with 106 eyes who were scheduled to undergo PPV surgery in our hospital from 01-2016/01-2018. According to the random number table method, the observation group and the control group were divided into 42 cases. Both groups were treated with PPV surgery, and the observation group was given a vitreous injection of ranibizumab before surgery. The BCVA, macular foveal thickness, serum VEGF, GAS6, SDF-1, and surgical complications were compared between the two groups before and after surgery.

RESULTS: There was no difference in BCVA between the two groups before operation(P>0.05). At 3mo after operation, the BCVA of the observation group was significantly better than that of the control group(P<0.05). At 1wk postoperatively, the foveal thickness of the observation group was smaller than that of the control group(P<0.05). At 3mo after operation, there was no difference in the thickness of the foveal fove between the two groups(P>0.05). There were no differences in serum VEGF, GAS6 and SDF-1 levels between the two groups before surgery(P<0.05). At 1wk postoperatively, the serum levels of VEGF, GAS6 and SDF-1 in the observation group were lower than those in the control group(P<0.05). The complication rate of the observation group was lower than that of the control group(5.9% vs 20.0%, P<0.05).

CONCLUSION: Intravitreal injection of ranibizumab in patients with PDR can significantly reduce macular thickness, serum VEGF, GAS6, and SDF-1 levels, improve visual acuity after surgery, and reduce the incidence of surgical complications.

The sequences of ITS, matK, rbcL and psbA-trnH of 9 Gynostemma species or variety including 38 samples were compared and analyzed by molecular phylogeny method. Hemsleya macrosperma was designated as outgroup. The MP and NJ phylogenetic tree of Gynostemma was built based on ITS sequence, the results of PAUP phylogenetic analysis showed the following results: (1) The eight individuals of G. pentaphyllum var. pentaphyllum were not supported as monophyletic in the strict consensus trees and NJ trees. (2) It is suspected whether G. longipes and G. laxum should be classified as the independent species. (3)The classification of subgenus units of Gynostemma plants is supported.
Gynostemma ; classification ; genetics ; Molecular Sequence Data ; Phylogeny ; Plant Proteins ; genetics ; Sequence Analysis, DNA

Canrenone is an important intermediate for the synthesis of eplerenone,a cardiovascular drug.C_ 11 ?-hydroxylation of canrenone is the key reaction,which can be done by microbial transformation.Rhizopus sp.SIPI-0602,kept in our lab,could high selectively transform canrenone to a compound named SIPI-11.By determining and analyzing the MS,UV,NMR etc.spectra of compound SIPI-11,its chemical structure was elucidated to be 11?-hydroxycanrenone.The study on flask transformation technology showed that the transformation ratio exceeded 90% when the substrate concentration was not more than 6g/L.

OBJECTIVETo evaluate the clinical efficacy of mini-open repair for the treatment of acute closed achilles tendon ruptures.

METHODSFrom April 2012 and October 2013,14 patients (14 feet) with acute closed achilles tendon ruptures were treated in our department. They were 9 males and 5 females, with an average age of 30.5 years old (ranged, 25 to 49 years old). The interval between injury and operation ranged from 1 to 13 days (8 days on average). A longitudinal incision approximately 1.5 to 2.0 cm in length was made around the ruptured achilles tendon for mini-open repair after insertion of oval clamp. Postoperative rehabilitation was carried out.

RESULTSThe wounds healed at the first stage except 2 cases with slow recovery. All the patients were followed up for 6 to 24 months, with an average of 11 months. According to the ankle-hindfoot scoring system of American Orthopaedic Foot & Ankle Society (AOFAS),the score was 92.71 ± 6.58 (82 to 100).

CONCLUSIONThe surgical treatment of acute achilles tendon rupture with mini-open repair has advantages of little invasion, a low rate of incision problems, quick function recovery, and simple operation, and it is suitable for primary hospital.

Achilles Tendon ; injuries ; physiopathology ; surgery ; Adult ; Female ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Tendon Injuries ; physiopathology ; surgery ; Treatment Outcome ; Wound Healing

OBJECTIVETo investigate the clinical effect of penile augmentation with superficial fascia retrocession.

METHODSThe first annular incision line was designed, reserving the inner plate 0.5 -0.8 cm. The second annular incision line was determined, according to the length of penile erection. The skin tissue between the double loops was stripped, reserving the superficial fascia and the superficial dorsal veins. Before the closure of two annual incision with no tension, the superficial fascia tissue was pushed proximally and fixed sectionally to augment penis.

RESULTSFrom Jun 2009 to Jun 2011, 60 patients with redundant prepuce or phimosis were treated with this method. During 3 to 12 months follow-up, the postoperative penile perimeter increased significantly. The glans were exposed and the prepuce looked smooth. The function of the penis maintained undamaged.

CONCLUSIONSThe penile augmentation with superficial fascia retrocession can make full use of autologous tissue to augment penis, meanwhile, redundant prepuce can be resected. It is very practical for clinical application.

Adolescent ; Adult ; Circumcision, Male ; methods ; Humans ; Male ; Middle Aged ; Penis ; surgery ; Subcutaneous Tissue ; surgery ; Transplantation, Autologous ; Young Adult

Objective:To summarize our experience on perioperative anesthesia management of patients with crush syndrome caused by earthquake under field condition.Methods:The clinical anesthesia data of 10 patients with crush syndrome caused by China Wenchuan earthquake,who were treated under field condition,were retrospectively analyzed,and our experience on perioperative anesthesia management was summarized.Results:After volume therapy,urine alkalization,and stabilization of internal environment,the 10 patients underwent dehridement,decompression by fasciotomy or amputation under epidural anesthesia or brachial plexus block plus psychological therapy and moderate tranquillizer.During the operation,the patients showed smooth respiratory and cardiovascular characteristics without pain.Conclusion:Under field condition,regional anesthesia can provide adequate analgesic effect during and after the surgery.Early fluid resuscitation and life support are vital to the safety and life of patients.