Humans ; Neck Dissection ; methods

Objective To analyse the characteristics of fundus fluorescein angiography(FFA)of iatrogenic retinal vascular occlu- sion.Design Retrospective case series.Participants 9 eyes of 9 patients with iatrogenic retinal vascular occlusion and 16 eyes of 16 patients with non-iatrogenic retinal vascular occlusion in Beijing Tongren Hospital in 2002-2005.Methods All patients were examined with FFA.The difference of circulation time of retinal vessels both in iatrogenic and non-iatrogenic retinal vascular occlusion patients was compared.Main Outcome Measures The starting perfusion time and the finishing time of retinal artery or vein.Results In pa- tients with iatrogenic(4 cases)and non-iatrogenic(12 cases)central retinal artery occlusion,the finishing perfusion time was separately 79.33?87.04s and 19.20?4.61s; the finishing time of retinal vein was separately 128.07?149.11s and 33.16?15.34s.In iatrogenic(4 cas- es)and non-iatrogenic(4 cases)central retinal artery together with central retinal vein occlusion patients,the finishing perfusion time of retinal artery was separately 211.67?371.26s and 30.07?17.26s;the finishing perfusion time of retinal vein was 232.43?358.52s and 48. 81?11.64s.One patient was ocular artery occlusion.FFA showed that choroidal background fluorescence and central artery were perfused slowly,the vascular fluorescence perfusion was interrupted before it came out of optic disk and the perfusion interruption continued until late stage with extensive peripheral non-perfusion areas.Conclusion The perfusion time of the retinal artery and vein in iatrogenic reti- nal vascular occlusion may be much longer than that in non-iatrogenic retinal vascular occlusion.

With increasing demands and recognition, emergency medicine has advanced rapidly in China in recent decades. The education and training of professionals in this field are important for the further development of emergency medicine. With an attempt to investigate the way to strengthen residency training system in emergency medicine, this article reviews its potential development direction, training modes, learning materials, and quality control.
China ; Emergency Medicine ; education ; organization & administration ; Internship and Residency ; methods ; standards ; trends

Objective To investigate the effect of the percutaneous autologous bone marrow stem cell transplantation for the treatment of nonunion of tibial fracture. Methods From 2007 to 2011,the data of 11 patients with tibial nonunion who received autologous bone marrow stem cell transplantation was analyzed retrospectively. Taking bone marrow,examine,isolation,cultivation and expansion marrow mesenchymal stem cells( MSCs) ,and then marrow needle was inserted into the site of the nonunion under the X-ray,the MSCs were injected into the site of nonunion. Compression bandage was applied after operation. X-rays following-up were reviewed. Results All 11 patients were followed up from 4~27 months,with average of 13 months,X-ray showed:fracture healed well,no adverse events happen. Conclusion Satisfactory out-come can be obtained by percutaneous autologous bone marrow stem cell transplantation in treatment of tibial nonunion. Clinical application value is high,especially to patients who had suffered from severe skin and soft tissue injury with keloids healed.

Objective To study the relationship between insulin induced gene 2 (INSIG2) variant and obesity or lipid metabolism in Chinese children and adolescents. Methods A total number of 2030 school students at the age from 7 to 18 years were selected in Beijing. Physical indicators, serum lipids and the rs13428113 polymorphism in INSIG2 gene were examined for all the subjects. Results The overall mutation rate of the rs13428113 polymorphism (T>C) was 49.3%.The differences of genotype and allele frequencies were not statistically significant among normal-weight, overweight and obesity groups (P>0.05). Among the overweight students, those with CC genotype had higher body mass index, waist-hip ratio, bronchial triceps skin-fold, and anterior superior lilac spine skin-fold than TT/TC carriers. Among the obese group, those with CC genotype had higher total cholesterol level than TT/TC careers (P<0.05). Conclusion The rs13428113 polymorphism in INSIG2 gene was associated with abnormal lipid metabolism in overweight and obese children, which increasing the degree of obesity and abnormal serum lipids.

Objective: To observe the clinical efficacy of DZWJY-1 type electronic moxibustion apparatus and traditional moxibustion in treating knee osteoarthritis (KOA). Methods: A total of 76 eligible patients were randomized into an electronic moxibustion apparatus group and a traditional moxibustion group, with 38 cases in each group. The electronic moxibustion apparatus group was intervened by DZWJY-1 type electronic moxibustion apparatus, and the traditional moxibustion group received moxa stick moxibustion for treatment. Neixiyan (EX-LE 4), Dubi (ST 35), Xuehai (SP 10) and Liangqiu (ST 34) were selected for both groups and the treatment was conducted 3 times a week for a total of 12 times. The visual analog scale (VAS) and the Western Ontario and McMaster Universities osteoarthritis index (WOMAC) scores were observed before treatment and after 6 and 12 sessions of treatment, respectively. Results: There were 4 dropout cases in the traditional moxibustion group. Therefore, this trial had 72 valid cases, including 38 cases in the electronic moxibustion apparatus group and 34 cases in the traditional moxibustion group, the differences in the baseline data between the two groups were statistically insignificant (P>0.05). After 6 and 12 sessions of treatment, the VAS scores decreased significantly with the increase of treatment sessions in both groups (all P<0.01), and the betweengroup differences were statistically insignificant at the same time points (both P>0.05). The pain intensity was evaluated using the weighted value of VAS score. The markedly effective rate was 47.4％ and the total effective rate was 89.5％ in the electronic moxibustion apparatus group, versus 50.0％ and 94.1％ in the traditional moxibustion group, and the betweengroup differences were statistically insignificant (both P>0.05). After 6 and 12 sessions of treatment, the total score and the component scores including pain, stiffness and difficulty moving in the WOMAC decreased significantly with the increase of treatment sessions in both groups (all P<0.01), and the between-group differences were statistically insignificant (all P>0.05). Conclusion: Electronic moxibustion apparatus and traditional moxibustion both are effective in reducing joint pain and improving joint function in KOA patients, and they are equivalent comparing the clinical efficacy.

Background and purpose:Ara-C is one of the most effective and common agents in the treatment of acute nonlyphocytic leukemia. Telomerase is a unique complex of ribonucleoprotein. It plays an important role in the pathogenesis and development of cancer. In this study, we investigate the changes of mRNA expression of telomerase subunits in HL-60 cells induced by Ara-c and try to come up with a theory that could help to assess the efficacy of Ara-C. Methods:The combinations of various Ara-C concentration and the incubation time were used to treat HL-60. The ratios of apoptotic cell to necrosis cell were determined by flow cytometry and the expressions of telomerase subunits mRNA were evaluated by RT-PCR.Results:① There was no influence on transcription of telomerase subunits gene after HL-60 cells was cultured with 0~0.2ug/ml Ara-C for 12 hours;② 2ug/ml and 10ug/ml of Ara-C could down regulate the expression of hTERT from 0.80+0.07 to 0.50+0.04 and 0.39+0.03, not hTR and hTP1;③ with longer incubation with 10ug/ml of Ara-C, the percentage of apoptosis could be increased. The maximal induction of apoptosis (18.16+4.25%) could be reached at 12hrs treatment of Ara-C, then gradually decreased later on. The rate of necrosis increased with time, the maximal percentage(57.94+12.03%) of necrosis was observed at 48hrs of incubation time with drug. The mRNA level of hTERT gene also decreased along with the cultured time , the lowest value (0.18+0.03) has been documented at 48hrs time point, but not hTR、TP1.Conclusions:① Ara-C could down-regulate the expression of hTERT mRNA in a dose-and time-dependent manner, but not hTR、hTP1;② There might be no relationship between the percentage of apoptosis induced by Ara-C apoptosis and the expression of telomerase hTERT gene mRNA, but a close relationship between necrosis and the expression of hTERT mRNA has been found.

Objective To evaluate the significance of CT assessment for extraarticular anatomy in treatment of displaced intraarticular calcaneal fractures.Methods(1)Measurement of normal calcaneum 40 pieces of adult calcaneum specimen were measured,items of measurement included height of culmination of posterior facet and tuberosity,width of posterior edge of sustentaculum and tuberosity.(2)CT measurement of calcaneum.Transverse(axial)and coronal CT scanning were obtained from 20 feet with displaced intraarticular calcaneal and 20 normal feet as control.Following items were measured in CT scanning:the height of culmination of posterior facet and tuberosity,the coronal talocalcaneal angle,in coronal scanning,the width of posterior edge of sustentaculum and tuberosity,the axial calcaneocuboid angle,in axial scanning.Results(1)Measurement of height of calcaneum height of culmination of posterior facet and tuberosity of calcaneal specimen were(43.07?2.85)mm and(44.69?3.67)mm respectively,and these two items from CT scanning of normal feet were(42.84?1.66)mm,(43.40? 3.01)nun,and from CT scanning of feet with calcaneal fractures were(34.76?3.24)mm,(40.41? 3.69)mm.There was a statistically significant different between these two items for normal calcaneal specimen and for CT scanning of feet with ealcaneal fractures(P

Objective To study the diagnosis and surgical treatment of adrenal cavernous hemangi -oma. Methods The data of one case with adrenal cavernous hemangioma was retrospectively reviewed .A 62-year-old female patient admitted in out hospital on 18th June, 2013 due to the paroxysmal hypertension for 10 years and finding the left adrenal mass for 2 months.Her highest blood pressure was 175/55 mmHg and the response for the drug treatment was poor .In recent 6 months, her blood pressure was unstable .Ab-dominal ultrasound showed a hypoechoic mass in left adrenal .Enhanced CT examination showed an irregular mass in the left adrenal gland , with the size of 4.5 cm ×2.5 cm ×3.9 cm,peripherally enhanced in arterial phase , contrast agent filling in portal venous phase , and high density in delay phase .Abdominal MR exami-nation showed a mass before abdominal aortic , with clear and smooth edge .The mass showed low signal in T1WI phase and high signal in T 2WI phase, which was considered as pheochromocytoma .24h urinary cate-cholamines showed that norepinephrine was 103.0 nmol, epinephrine was 9.8 nmol and dopamine was 18.9 nmol.Octreotide (99Tcm-TOC) showed slight high expression of somatostatin receptor .Preoperative diagnosis was left pheochromocytoma . Results After the preoperative medical preparation of phenoxybenzamine for 3 weeks, her blood pressure was maintained at 120-132/50-70 mmHg, with stuffy nose, warm hand and foot, and the weight gain of about 1 kg.The patient was undergone laparoscopic resection of left adrenal tumor under general anesthesia on June 24, 2013.The postoperative blood pressure returned to normal .And the left adrenal pathology was cavernous hemangioma .Following up for 5 months, the patient had normal blood pressure without the tumor recurrence . Conclusions The adrenal cavernous hemangioma is extreme-ly rare with high rate of misdiagnosis .For adrenal tumor with typical hemangioma imaging , the diagnosis of cavernous hemangioma should be considered .For tumors larger than 6 cm, surgery is recommended .The first choice of operative approach is laparoscopic resection of adrenal tumor , and normal adrenal tissue should be retained as far as possible.

Objective To study the relationship between neuropeptide Y2 receptor(NPY2R) gene rs1047214 polymorphism and obesity or metabolic syndrome in Chinese children and adolescents, in order to provide theoretical evidence for obesity control. Methods 2030 students at the age from 7 to 18 years were selected in Beijing. Physical indicators, blood pressure, serum lipids and fasting blood glucose and the rs1047214 polymorphism in NPY2R gene were tested for all the subjects. Results The mutation rate of the rs 1047214 polymorphism (T> C) was 18.6% and the CC genotype frequency was significantly higher in non-obese subjects (3.7%) than that in obese subjects (1.7%) (P<0.05). The differences of BMI, waist circumference (WC), waist-hip ratio (WHR) and waist-to-height ratio (WtHR) were statistically significant among the subjects with CC genotype having lower BMI, WC, WHR and WtHR than CT+TT carriers (P<0.05), shown in males, but not in females. There were no statistical significances for WC, WHR or WtHR levels between different genotypes under the general linear regression model, after adjusted for BMI. There were no statistical significances for blood pressure, serum lipids and FPG level between different genotypes. Conclusion The mutation rate of the rs1047214 polymorphism in NPY2R gene in Chinese adolescents was higher than that in foreign populations. Polymorphism seemed to be associated with obesity in males but did not seem to have significant association between polymorphism and other phenotypes of metabolic syndrome.