Objective To discuss influence of different disinfection solution on infection and pain of puncture hole in patients with open fracture of both tibia and fibula treated with external fixation.Methods 41 patients were divided into group A(21 cases)and group B(20 cases).Group A adopted 75% ethanol to sterilize the puncture holes.While the group B used 5%iodide instead.The incidence of infection and pain of puncture holes was observed separately at the 1st week,6th week after operation and removing of fixation pin.Results The incidence of infection of puncture holes was not apparently different from each other(P>0.05)at any other time points.The incidence of paint in group B was lower than group A at the 1st week and 6th week after operation(P<0.05).The incidence of pain was higher in patients with puncture hole infection than those without puncture hole infection(P<0.01).Conclusion No difference was seen in puncture hole infection with either 75% ethanol or 5% iodide.Infection of puncture hole was correlated with pain only at the 1st week after operation.Pain could be alleviated with application of 5% iodide.

Objective To provide the anetomic base for the transposition of spine of scapular flap pedicled with thoracoacromial artery Methods The course, branches and distribution of thoracoacromial artery were observed on 40 adult cadaver specimens Results The main branch of thoracoacromial artery was the acromial branch Its length was (5 1?0 1) cm, the originated diameter was (1 2?0 2) mm The deltoid muscular branch went outward intermuscular ditch between deltoid muscle anspectoralis major muscle, and anastomosed with anterior humeral circumflex artery constantly besides distributing to deltoid muscle and pectoralis major muscle, its diameter was (1 9?0 2) mm, the length form the originated dot to the entrancing muscular dot of deltoid muscle or pectoralis major muscle was (4 8?0 5) cm or (3,2?0 4) cm respectively Conclusion The transposition of lateral segment spine of scapular flap pedicled with the acromial branch of thoracoacromial artery or deltoid muscular branch acromial branch may be designed for repairing proximal humerus

We report a case of 46-year-old xanthoderm woman who was diagnosed as malignant peripheral nerve sheath tumors of right maxillary sinus, and have a literature review. Histology confirmed a diagnosis of malignant peripheral nerve sheath tumor. The woman had the right total maxillectomy and postoperative adjuvant radiotherapy. There is no local recurrence or metastasis of one year following up. Literature review revealed MPNST in the nasal cavity and para-nasal sinuses were not common with poor prognosis. The main cause of death is local recurrence and metastasis. Surgical resection showed more advantage than adjuvant radiotherapy and chemotherapy.
Female ; Humans ; Maxillary Sinus ; Middle Aged ; Neoplasm Recurrence, Local ; Nerve Sheath Neoplasms ; pathology ; therapy ; Neurilemmoma ; pathology ; therapy ; Paranasal Sinus Neoplasms ; pathology ; therapy ; Radiotherapy, Adjuvant

In order to investigate the effects of verapamil on the proliferation of meningiomas cells in vitro and in vivo, the cultured meningiomas cells were cultured with verapamil at different concentrations for 24 h and the inhibitory effects of verapamil on cell proliferation were observed by MTT method. The meningiomas model was established by implanting the newly removed tumor fragments into the nude mice subcutaneously. The nude mice with tumors were divided into two groups: verapamil-treated group and control group. Tumor volumes were measured and after 12 weeks the tumors were taken out and examined histologically. The expression of proliferating cell nuclear antigen (PCNA) in the tumors was detected by using immunohistochemistry. It was found that verapamil could inhibit the growth of cultured meningiomas cells in a concentration-dependant manner. The inhibitory effect could be observed in the concentration of 1 micromol/L verapamil and the most obvious effects appeared in the concentration of 100 micromol/L. Tumor volume in the verapamiltreated group was obviously smaller than that in the control group (211.40+/-5.50 vs 163.94+/-3.62, P<0.01) and the expression of PCNA was also lower (1.52+/-0.24 vs 2.86+/-0.53, P<0.05). Tumor inhibition rate was about 22.45%. It was suggested that verapamil could inhibit the proliferation and growth of meningiomas cells in vitro and in vivo.

Objective To investigate the depressive disorders in patients with respiratory diseases and analyze the countermeasures against it to provide reference for improving clinical treatment compliance. Methods 80 cases was selected according to the screening and exclusion criteria from 262 patients with respiratory diseases from January, 2014 to December, 2015. Then divided them randomly into treatment group and control group. The SDS and SAS show no statistical signiifcance before treatment (P>0.05). The control group with clinical disease symptomatic and supportive treatment, the treatment group combined with anti-anxiety treatment on the basis of clinical symptomatic and supportive group. Then compare the SDS, SAS and dyspnea improvement between the two groups before and after treatment. Results The SDS and SAS scores showed no significant difference before treatment (P>0.05). While after treatment, the SDS and SAS scores in treatment group were signiifcantly lower, and lower than the control group, the difference was statistically signiifcant (P<0.05). The condition of dyspnea of the two groups show no difference before treatment (P>0.05). After treatment, the condition of dyspnea improved greater in treatment group than the control group, the difference was statistically signiifcant (P<0.05). Conclusions Because the respiratory disease of patients suffered leads to psychological burden, negative emotional depression anxiety appears not well with the clinical work, by using Deanxit improve patient confidence and compliance, there is a certain positive to improve the clinical symptoms with good clinical value.

In modern hospital outpatient management, patients should be paid more attention to than hospital management and economic management. Automatic and paperless management is also important. So, the software and hardware all should be updated to gain great social and economic benefit.

Objective The clinical features of elderly patients with severe acute pancreatitis (SAP) were atypical and these patients were often misdiagnosed as having paralytic ileus. The clinical presentations of elderly patients with SAP whose first diagnosis as paralytic ileus were analyzed. Methods 18 patients of elderly SAP who were misdiagnosed as having paralytic ileus were included and the clinical data were compared with 58 elderly patients with SAP. Results Among the misdiagnosis group, the first symptom onset were fleus, abdominal distension, vomiting, constipation, abdominal pain, diarrhea for 5, 4, 3, 3, 2, 1 case, respectively. Among SAP group, the first symptoms onset were 2, 31, 9, 3, 11, 2 cases, respectively. For misdiagnosis group, 13 cases were correctly diagnosed by CT scan, 3 cases by ultrasound and 2 cases by serum amylase test. For SAP group, 32, 15, 11 cases were diagnosed by CT scan, ultrasound and serum amylase, respectively (P < 0.05). 4 and 13 patients died in misdiagnosis and SAP group, respectively; among these 13 patients, 10 were female and 3 were male. Conclusions The elderly patients with paralytic ileus should consider the possibility of SAP, and CT scan was valuable for correct diagnosis.

Objective To investigate the value of creatine kinase and computed tomography(CT)angiography to evaluate short-term prognosis of patients with superior mesenteric artery embolism(SMAE).Methods The retrospective cross-sectional study was adopted.The clinical data of 26 patients with SMAE who were admitted to the first Affiliated Hospital of Wenzhou Medical University between January 2008 and October 2015 were collected.The patients received serologic examination and CT angiography firstly,and then medicinal conservative method and surgical method were respectively conducted according to the results of above examinations.Observation indices:(1)clinical features,(2)serum indicators results,(3)CT angiography results:①location(main stem and non-main stem)of SMAE and development of distal branches of superior mesenteric artery(SMA),②indirect signs,such as bowel wall thickening,bowel dilatation combined with effusion and air accumulation and pneumatosis intestinalis,(4)therapy and prognosis.Measurement data with normal distribution were presented as-x±s,comparisons among groups were analyzed by one-way ANOVA.Measurement data with skewed distribution were presented as M(range)and analyzed by the Kruskal-Wallis rank sum test,and pairwise comparison was done using the Nemenyi test.Results(1)Clinical features:of 26 patients with SMAE,6 patients had intestinal ischemia,8 patients had partial intestinal necrosis and 12 patients had long segmental intestinal necrosis(postoperative short bowel syndrome in 5 patients and total small intestinal necrosis and partial colonic necrosis in 7 patients).Duration of symptoms before diagnosis was(1.7±0.8)days in 6 patients with intestinal ischemia and(2.1±1.1)days in 8 patients with partial intestinal necrosis and(1.5±0.7)days in 12 patients with long segmental intestinal necrosis,with no statistically significant difference(F=1.27,P＞0.05).(2)Serum indicators results:levels of serum creatine kinase in patients with intestinal ischemia,partial intestinal necrosis and long segmental intestinal necrosis were 68 U/L(range,50-86 U/L),98 U/L(range,54-244 U/L)and 300 U/L(range,40-873 U/L),respectively,with a statistically significant difference among patients(H=7.32,P＜0.05)and between patients with intestinal ischemia and with long segmental intestinal necrosis(H=7.21,P＜0.05),and with no statistically significant difference between patients with partial intestinal necrosis and with intestinal ischemia or long segmental intestinal necrosis(H=1.53,2.07,P＞0.05).(3)CT angiography results:①developments of SMAE(main stem and non-main stem)and distal branches of SMA:main stem embolism of SMA in 13 patients demonstrated hypodense shadow,with non-contrast of distal branches of artery,including 1 with intestinal ischemia,1 with partial intestinal necrosis and 11 with long segmental intestinal necrosis.Main stem embolism of SMA in 8 patients demonstrated hypodense shadow,with contrast of distal branches of SMA,including 3 with intestinal ischemia,4 with partial intestinal necrosis and 1 with long segmental intestinal necrosis.Main stem embolism of SMA in 2 patients demonstrated hypodense shadow,with non-contrast of distal branches of SMA,showing partial intestinal necrosis.Non-main stem embolism of SMA in 3 patients demonstrated hypodense shadow,with contrast of distal branches of SMA,including 2 with intestinal ischemia and 1 with partial intestinal necrosis.②Indirect signs:5 patients had bowel wall thickening,including 3 with intestinal ischemia and 2 with long segmental intestinal necrosis.Seventeen patients had bowel dilatation combined with effusion and air accumulation,with gas fluid level in local intestinal canal,including 2 with intestinal ischemia,5 with partial intestinal necrosis and 10 with long segmental intestinal necrosis.Two patients had pneumatosis intestinalis,with bubble shadow of bowel wall,showing long segmental intestinal necrosis.(4)Therapy and prognosis:of 6 patients with intestinal ischemia,1 underwent embolectomy of SMA and 5 underwent low-molecular-weight heparin anticoagulation and vasodilator alprostadil therapy.Eight patients with partial intestinal necrosis received resection of necrotic intestine.Of 12 patients with long segmental intestinal necrosis,5 with postoperative short bowel syndrome received resection of necrotic intestine combined with postoperative parenteral hyperalimentation.The above-mentioned patients were improved and discharged from hospital after symptomatic treatment and surgery.Twelve patients with long segmental intestinal necrosis,7 with total small bowel necrosis and partial colonic necrosis underwent only exploratory laparotomy and then were dead in a short time.Conclusion Elevated creatine kinase and main stem embolism of SMA combined with non-contrast of distal branches using CT angiography maybe predict poor short-term prognosis of patients with SMAE.

Objective To examine the relationship of coping style,psychological capital and vocational selection anxiety for female college graduates.Methods A sample of 330 female college graduates filled out measures for the simplified coping styles questionnaire (SCSQ),Psychological Capital Questionnaire (PCQ) and vocational selection anxiety Questionnaire(VSAQ).Results Correlation analysis showed that except the self-efficacy and positive coping style collected with concerns about job prospects was not significant (r=-0.08-0.05,P＞0.05),each dimensions of PCQ and SCSQ significantly correlated with the each dimensions of VSAQ (r=-0.44--0.13 or r=0.21-0.28,P＜0.01).Regression analysis showed that negative coping style,resilience,hope and positive coping style could directly predict vocational selection anxiety.Psychological capital were the mediators between positive coping styles and vocational selection anxiety.Conclusion Coping styles and psychological capital are closely related to the female college graduates' vocational selection anxiety,using appropriate coping styles and improving mental ability can effectively reduce vocational selection anxiety.

BACKGROUND: By now, safety of collagenase application is still controvertible and some scholars believed that collagenase might induce the peripheral tissue injury. It attracts much attention in clinic that whether there is nerve injury induced by collagenase chemonucleolysis (CCN) around the injection sites.OBJECTIVE: To observe the effects of collagenase on spinal nerve conduction velocity (NCV) of rats detected with evoked potential method so as to probe into the safetyof collagenase application and further demonstrate the safety of percutaneous intervertebral disc CCN. DESIGN: Randomly grouping design, animal experiment.SETTING: Department of Interventional Radiology, Affiliated First Hospital of Sun Yat-sen University. MATERIALS: The experiment was conducted in the Basic Medical College of Sun Yat-son University from July to September 2002. A total of 57 male SD rats were randomly divided into normal group (n=9), acute sham-operation group (n=10), subacute sham-operation group (n=8), chronic sham-operation group (n=7), acute experimental model group (n=9), subacute experimental model group (n=7) and chronic experimental model group (n=7). METHODS: After being anaesthetized by intraperitoneal injection of continal (45 mg/kg) to separate and identify dorsal root ganglion (DRG),rats in the experimental group were locally dripped with 1 mL of collagenase (300 U/ML) and those in the sham operation group locally dripped with 1 mL of normal saline. Stimulating electrode was placed in the A point of sciatic nerve and recording electrode in the B point of ganglionic central process segment of DRG in L5 nerve root. Evoked potentials A and B were simulated to continuously record latency twice, and the average value was calculated; Distance between A and B were measured and recorded. NCV = distance between A and B / latency. Evoked potential of a segment ofnerve including DRG was measured in the acute group at one hour after administration, in the sub acute group at one week after administration and in the chronic group at one month after administration. MAIN OUTCOME MEASURES: NCV of each group. RESULTS: A total of 57 enrolled animals were involved in the analysis. NCV in normal group, acute experimental group, acute sham-operation group, subacute experimental group, subacute sham-operation group, chronic experimental group, chronic sham-operation group were (45.4±10.7), (43.4±5.9), (46.3±6.5), (52.4±10.4), (49.7±8.1), (46.7±11.0) and (44.6±6.5) m/s respectively. There were no remarkable differences in NCV among all the groups by using one-way analysis of variance (F=1.010,P=0.430); It was showed that there were no marked differences in NCV between each two groups by using multiple comparisons (P=0.336). CONCLUSION: Collagenase at the therapeutic concentration applied in clinical CCN has no remarkable effects on NCV of rat spinal nerve, and to a certain extent, percutaneous intervertebral disc CCN is relatively reliable.