Objective To explore the MRI findings of Wernicke encephalopathy so that to improve the knowledge of this disease.Methods MRI data of Wernicke encephalopathy in 7 cases were retrospectively analyzed.Results Symmetrical abnormal signal intensity was appeared in bilateral thalamus and the area around the third cerebral ventricle in 6 cases,in the area around aqueduct and pontine in 7 cases and in mammillary body,hypothalamus,fornix and the four cerebal ventricles in 2 cases.Above mentioned lesions showed long T1 and long T2 signal intensity and high signal intensity on fluid-attenuated inversion recovery(FLAIR),and high signal intensity on DWI in 2 cases.The lesions were enhanced in 2 cases and small vessels were radial enhancement around lateral ventricle in 1 case after administration of Gd-DTPA.Conclusion Wernicke encephalopathy has definite MR imaging findings,which is of important value in clinical diagnosis and treatment.

Severe acute biliary pancreatitis can be treated by nonsurgical and surgical approaches,and choice of the surgical techniques as well as its timing are the keys points to the whole therapy.Early enteral nutrition via placing nasointestinal feeding tube plays an important role in the nutritional support for patients with severe acute pancreatitis.This paper intends to explore the experience in standardizing the therapy for all similar cases via reviewing and summarizing the treating process of a typical patient with severe acute biliary pancreatitis.

Objective To explore the application of arm infusion port in breast cancer patients with chemotherapy and the effect of remote management. Methods From May 2016 to September, 25 cases of female breast cancer patients treated with chemotherapy in our hospital were studied. Implanted arm port for chemotherapy drug infusion, the patient's bedside guidance given by a case nurse during hospitalization, after the discharge from the hospital to accept the management of arm port remote education and consultation project group. Results A total of 25 patients implanted with arm port have not occurred phlebitis, deep vein thrombosis, central venous catheter infection and other complications;Patient′s satisfaction degree of quality of life were 100%(25/25);patients and their families on the nursing staff to track service satisfaction were 100%(25/25), too. Conclusions The application and remote management of arm port in patients with breast cancer chemotherapy is worthy of clinical research.

Objective To explore the clinical characteristics and influencing factors of primary nephrotic syndrome (PNS) combined with hypercoagulability in children. Methods The clinical data of 57 children with primary PNS were analyzed retrospectively. The clinical features and treatment were compared among high coagulation state group, non high coagulation state group and control group (20 children). At the same time, the differences between the simple nephrotic syndrome group (SNS) and nephritic syndrome group (NNS) in hypercoagulable state were analyzed. In addition, the correlation analysis was performed. Results Among 57 patients, there were 50 patients in high coagulation state group and 7 in non high coagulation state group. There was no significant difference in gender, age and clinical manifestations between two groups (P>0.05). The platelet (PLT) count, platelet aggregation (PCT), albumin (Alb), fibrinogen (Fib), D-dimer (D2) were significantly higher than those in the control group, and there were statistically significant differences (P all<0.01). There were significant differences in the levels of PLT, Fib, D2 and complement C4 between hypercoagulable state group and non hypercoagulable state group (P all<0.05). There were significant differences in HCT, TC, LDL, PT and complement C3 levels between SNS group (n = 32) and NNS group (n =18) in 50 patients with high coagulation state (P<0.05). There was positive correlation between HCT and complement C3 (r=0.30, P<0.05), while there was no correlation between PLT and other indices (P>0.05). All of the 57 patients were improved and has no thrombosis after the treatment. Conclusion Children with primary PNS were usually associated with different degrees of hypercoagulable state, and PLT, Fib, D2 could be used as reference indices for the severity of hypercoagulable state, and the activation of complement system might be related to the occurrence and development of hypercoagulable state.

Objective To investigate the MRI features of supratentorial solid hemangioblastoma and to improve its diagnostic accuracy.Methods MRI image manifestations of 7 cases with supratentorial solid hemangioblastoma confirmed by operation and pathology were analyzed retrospectively.Results 7 cases of supratentorial solid hemangioblastoma were solitary.All tumors appeared as round or quasi-round masses with clear boundary, and showed equal or long T1 signal and slight long or long T2 signal,the obvious enhancement was seen in all tumors.There was mild to moderate edema around the tumors.The blood vessel was found within or around the tumors.Conclusion MRI manifestations of supratentorial solid hemangioblastoma have certain characteristics.

Objective To explore the pathogenesis mechanism of hyperoxic lung injury and the effective means for its clinical treatment,the difference of the gene expressions between lung tissues of hyperoxic lung injury and normal lung was compared.Methods The differentially expressed genes between lung tissues of hyperoxic lung injury and normal lung were obtained from PubMed.The dysregulated genes in lung tissues of hyperoxic lung injury were analyzed by a series of bioinformatics methods,including pathways,gene ontology and functional annotation clustering analysis.Results 467 lines of differentially expressed genes were found and genes more than 2-fold regulated were 189.We sought the mapping of genes in the KEGG databases through functional annotation tools,and we discovered there were 5 lines of pathways with difference having outstangding statistical significance through metabolic pathways enrichment degree analysis.It reflected the pathways were closely related to hyperoxic lung injury (the 2-fold upregulated genes were 14,the 2-fold down-regulated genes were 6).GO analysis revealed that these genes were involved in hematopietic cell lineage,axon guidance,adherens junction,T cell receptor signaling pathway and focal adhesion.Conclusions Therefore,it is believed that the above-mentioned 20 lines of gnes are the major ones for the hyperoxic lung injury and the research on them will provide effective means for revealing the molecular mechanism of hyperoxic lung injury and identifying the targeted therapy.

OBJECTIVETo research the effect of polysorbate 80 (Tween 80) on Yuxingcao injection and volatile oils from Houttuynia cordata.

METHOD1H-NMR spectra of aldehydic and new matter in Yuxingcao injection, volatile oils of H. cordata, and solutions of Tween 80 and volatile oil of H. cordata are determined and compared from various angles of growing origin, storage temperature, and storage time.

RESULTThree aldehydic singlets in 1H-NMR spectra of every volatile oil from 4 aerial part of H. cordata were observed. These aldehydic peaks were basically disappeared and a new peak at delta 8.30 was found in 1H-NMR spectra of the volatile oil solutions in tween 80. Any obvious aldehydic peak in 1H-NMR spectra did not be observed in Yuxincao injection. A weak peak at 8 8.30 was found in 1H-NMR spectra in Yuxincao injection, and the peak high of delta 8.30 was remarked gone up when the injection was stored in 40 degrees C for 1 to 3 months.

CONCLUSIONTween 80 might cause the obvious reduce of aldehydic compounds contents and the production of a novel singal at delta 8.30 in 1H-NMR spectra when it was mixed with the volatile oil from the aerial part of H. cordata. The novel signal at delta 8.30 in 1H-NMR spectra existed in Yuxincao injection and was very small, but was increased remarkably when the Yuxincao injection was stored at 40 degrees C for 1 month at least.

Chemistry, Pharmaceutical ; instrumentation ; Drugs, Chinese Herbal ; chemistry ; Houttuynia ; chemistry ; Oils, Volatile ; chemistry ; Plant Oils ; chemistry ; Polysorbates ; Temperature

Objective To analyze common complications of arm port and chest port using meta-analysis and to investigate the safety of ann port.Methods Randomized controlled trials,cohort studies and well-designed casecontrol trials published in CNKI,Wanfang,VIP,PubMed,CINAHL and Embase regarding complication comparison between arm port and chest port were searched.Review Manager 5.3 software was applied to analyze outcome indicators.Results Nine retrospective cohort studies and 2511 patients were included.The results of meta-analysis showed that the incidence of thrombosis in ann port group was lower than that in chest port group,and the difference was statistically significant [0R=0.51,95％CI (0.28,0.92),P=0.03].However,there was no significant difference in incidence of infection[OR=0.85,95％CI(0.53,1.38),P=0.52],incidence of obstruction[OR=1.05,95％CI(0.37,3.01),P=0.92],incidence of sepsis [OR =0.44,95％ CI (0.10,1.87),P=0.27],incidence of skin incision [OR =0.28,95％ CI (0.07,1.17),P=0.08].Conclusion The incidence of thrombosis in ann port was lower than that in chest port,and there was no obvious advantage in the incidence of infection,obstruction,sepsis and skin incision.

Objective: To explore application effects of CT angiography (CTA) and three-dimensional reconstruction technique in repairing scar around the mouth and chin with expanded forehead axial flap. Methods: From June 2013 to October 2017, 9 patients with hyperplastic scar around the mouth and chin after deep burns on face were admitted to our unit. The sizes of scars of patients ranged from 8 cm×7 cm to 13 cm×8 cm. One cylindrical skin soft-tissue dilator with nominal volume of 400 to 500 mL was implanted in forehead area of each patient. Five to six months after the dilator was implanted, scar around the mouth and chin was resected, and the dilator was removed. The secondary wound after scar resection was repaired by expanded forehead axial flap with bilateral superficial temporal vessel pedicles. Three of the nine patients received microstomia diorthosis at the same time. Before the operation, CTA and three-dimensional reconstruction were applied to obtain three-dimensional images of superficial temporal arteries and the branches in the donor site, which could identify the travel, adjacent location, and vascular anastomosis of the above-mentioned vessels to guide flap design. The sizes of flaps of patients ranged from 25 cm×9 cm to 30 cm×8 cm. Two to three weeks after the operation, flap pedicles were cut off, restored, and trimmed. The donor site was sutured directly. Ten to twelve days after the flap repair operation, the flap site received depilation treatment with semiconductor freezing point laser once a month for 4 to 6 times. Results: Flaps of all patients survived well, with no blood circulation disorder. The flaps of three patients were slightly bulky, while they were with natural appearance after flap thinning operation in 3 months post flap repair operation. During follow-up of 6 months to 2 years after the operation, color, texture, and thickness of the flaps were close to normal skin around scars. The appearance of perioral and mental region, and opening function of mouth improved significantly, with no recurrence of scar. Frontotemporal incision was hidden, hair on head grew normally, and reconstructed hairline was natural. Conclusions Scar around the mouth and chin repaired with expanded forehead axial flap were with good appearance and function in operation area and good shape in donor site. CTA and three-dimensional reconstruction technique can provide clear three-dimensional images of superficial temporal arteries and the branches in expanded forehead axial flaps, which can provide reliable basis for preoperative designing of flap, reduce operative risk, and improve survival rate of flap, thus having clinical application value.

Objective: To investigate the effect of Meek skin grafting on patients with extensive deep burn at different age groups. Methods: Eighty-four patients with extensive deep burns conforming to the study criteria were hospitalized in our unit from April 2011 to April 2015. Patients were divided into children group (C, with age less than 12 years old), young and middle-aged group (YM, with age more than 18 years and less than 50 years old), and old age group (O, with age more than 55 years old) according to age, with 28 patients in each group. All patients received Meek skin grafting treatment. The use of autologous skin area, operation time, wound healing time, and hospitalization time were recorded. The survival rate of skin graft on post operation day 7, complete wound healing rate in post treatment week 2, and the mortality were calculated. Data were processed with one-way analysis of variance, t test, and χ² test. Results: The use of autologous skin area of patients in group C was (5.1±1.0)% total body surface area (TBSA), significantly less than (8.3±1.0)%TBSA and (8.3±1.4)%TBSA in groups YM and O, respectively (with t values 32.900 and 52.624, respectively, P values below 0.05). The operation time, wound healing time, and hospitalization time of patients in group C were (1.368±0.562) h, (9.6±0.6) and (32±11) d, significantly shorter than those in group YM [(3.235±0.011) h, (16.9±2.6) and (48±12) d, respectively] and group O [(3.692±0.481) h, (17.3±2.6) and (46±13) d, respectively, with t values from 4.350 to 21.160, P values below 0.05]. The survival rate of skin graft of patients on post operation day 7 in group C was (92±15)%, significantly higher than (81±10)% and (72±12)% in groups YM and O, respectively (with t values 5.509 and 3.229, respectively, P values below 0.05). The above indexes in groups YM and O were similar (with t values from 0.576 to 22.958, P values above 0.05). Complete wound healing rate in post treatment week 2 and the mortality of patients in group C were similar to those in groups YM and O (with χ² values 0.365 and 0.122, respectively, P values above 0.05). Conclusions Meek skin grafting can be used in the treatment of patients with extensive deep burns at different age groups, compared with the young and middle-aged and old patients, the effect in children was better.