Objective To examine and assess the clinical effect of Er ∶ YAG 2940 nm fractional laser resurfacing for skin wrinkles.Methods A total of 16 patients with Fitzpatrick skin type Ⅳ and facial wrinkles,were treated with Er ∶ YAG 2940 nm fractional laser resurfacing and follow-up were given every week after treatment,four weeks in all.Response to treatment was evaluated by observers and patients themselves.Photos were analyzed by the photoshop 12.0 software.Results During the four-week follow-up,the skin of patients was more and more better than pretreatment,and a large part of wrinkles was disappeared.The assessment of observers for wrinkle amelioration rose from (6.50--2.33) ％ to (34.80±5.24) ％ and the scores of content of patients was up to 4.00±0.27(generally satisfied),whereas no one satisfied at beginning.Analyzed by photoshop 12.0 software,the data of average and middle values were on the trend of increasing in all these four weeks while SD was basically on the trend of decreasing.Conclusions Fractional ablative photothemolysis using Er ∶ YAG 2940 nm laser is a promising option for skin wrinkles.

Objectives To investigate the parmacokinetic characteristics of Meropenem used during the shock phase of severely burned patients. Methods The concentration of Meropenem in the plasma, blister and urine of 11 burn patients during the shock phase (S group) were determined by high performance liquid chromatography after the iv injection of Meropenem. Pharmacokinetic parameters were thus produced by 3P97 software. 6 healthy volunteers served as control group (C group). The t test was used to analyze difference between pharmacokinetic parameters of burned patients and healthy volunteers. Results Compared to those in control group, pharmacokinetic parameters of Meropenem in S group showed significant difference, such as prolonged elimination half-life (t1/2?):[(2 29?0 54)h vs (1 34?0 16)h] and decreased clearance(CLs): [(11 34?3 08)L? h-1 vs (18 76?4 60)L?h -1 ], and enlarged area under the serum concentration versus time curve(AUC):[(47 85?16 15)?g?h?ml -1 vs (27 54?10 76)?g?h?ml -1 ]. Conclusions Meropenem at the dose 500mg iv 3/d can show good activity (both in plasma and wound tissues)against most of pathogens which are common in burn clinic. The intervals should be prolonged when maximum dosage of Meropenem was administered in burn patients during the shock phases.

Hypoplastic myelodysplastic syndrome(Hypo-MDS),with the derangement of BM texture,is characterized by the hypoplasia of bone marrow(BM)accompanied with the deterioration of MDS. Hitherto there isn't a definite therapeutic definition about Hypo-MDS. Is therapy should be paid more attention to. This article introduces the study of therapy of Hypo-MDS.

Objective To evaluate the effectiveness of spiral stone dislodger combined with pneumatic lithotriptor under ureteroscopy for managing upper ureteral stones. Methods 106 patients with upper ureteral stones with spiral stone dislodger combined with pneumatic lithotriptor under ureteroscopy were treated. The transverse diameter of the stones was 4～12mm and the vertical length 6～15mm. Results 87.7% (93/106) stones were fragmented for one session of treatment. 8 cases were pushed upward then undergoing extracorporeal shock wave lithotripsy(ESWL) after surgical operations. Operations in 5 cases had to be changed to open surgery,and ureteral perforations happened in 1 case. Conclusion Successful entrance of the uretersocop is a prerequisite for crushing the stone,appropriate fixation of the stone is the key to their crushing,spiral stone dislodger is an effective means of fixing ureteral stones.

Objective To study the risk factors for children with acute central nervous system(CNS)viral in-fection,so that pediatrician may identify children with poor prognosis at early stages of the disease,and provide them with a theoretical basis for clinical treatment. Methods The clinical data of a cohort patients of acute CNS viral infec-tion who were hospitalized at the First Affiliated Hospital of Fujian Medical University between January 2010 and June 2013 were retrospectively collected and analyzed. According to Glasgow outcome scale on discharge,children were di-vided into good prognosis group and poor prognosis group. Clinical data and outcomes were analyzed by using univariate analysis and binary Logistic regression multivariate analysis. Results Three hundred and one cases were enrolled,278 (92. 36% )patients were assigned to the good prognosis group,and 23(7. 64% )patients were assigned to the poor prognosis group. By univariate analysis,the patients in the poor prognosis group had longer duration of sickness before admission,longer time of fever,lower white blood cell count in cerebrospinal fluid,a relatively lower calcium level,con-scious disturbance at the early stage,multiple seizures,convulsive status epilepticus,meningeal irritation sign,muscle weakness,severe changes in electroencephalogram(EEG),and abnormal neuroimaging findings(computed tomography or magnetic resonance imaging,or both)had significant differences between the good prognosis group and the poor short - term outcome groups(all P < 0. 05). By binary Logistic regression multivariate analysis,factors indicating a poor prognosis during the early stage were conscious disturbance at the early stage(0R = 4. 885,95% CI:1. 523 - 15. 670, P = 0. 008),multiple seizures(0R = 6. 352,95% CI:1. 905 - 21. 178,P = 0. 003),severe changes in EEG( 0R =4. 269,95% CI:1. 708 - 10. 666,P = 0. 002),and abnormal neuroimaging findings( 0R = 9. 740,95% CI:2. 360 -40. 192,P = 0. 002). Conclusions Conscious disturbance at the early stage,multiple seizures,severe changes in EEG and abnormal neuroimaging findings are risk factors for acute viral infection of CNS in children.

BACKGROUND:Synthetic patch as an important substitute to pelvic tissue can replace damaged pelvic fascia tissue, and has been widely used in the pelvic floor reconstruction. OBJECTIVE:To observe the efficacy and complications of pelvic floor reconstruction with mesh, and to explore its safety and effectiveness. METHODS: Forty-five pelvic organ prolapse female patients were divided into two groups according to patient’s wilingness: experimental group, pelvic floor reconstruction with mesh (n=25); control group, transvaginal hysterectomy combined with vaginal wal repair (n=20). Perioperative conditions were recorded, and uterine prolapse staging, complications, pelvic floor function, pelvic discomfort, as wel as an objective cure rate were evaluated in the two groups during the folow-up. RESULTS AND CONCLUSION:Compared with the control group, the experimental group was characterized as shorter operative time, less amount of bleeding, milder infections, and faster recovery (AlP < 0.05). At 6 months of folow-up, the score on uterine prolapse staging was higher in the experimental group than the control group; at 12 months, the scores on pelvic floor function and pelvic discomfort as wel as the incidence of complications were significantly lower in the experimental group (P < 0.05), but the objective cure rate was higher compared with the control group (P < 0.05). These findings suggest that pelvic floor reconstruction with mesh for pelvic organ prolapsed can reduce the operative time and blood loss and promote postoperative recovery. Meanwhile, it can significantly improve pelvic floor function, pelvic discomfort, postoperative complications, the rate of exposure, and the objective cure rate, which is safe and effective during the short-term folow-up.

Objective To compare the image quality and scanning dose of time-subtraction and dual-energy-subtraction cerebral CT angiography, and to assess clinical application value of both methods. Methods Plain and enhanced scanning were performed on 60 patients suspected cerebral vessel diseases with dual-source CT. Dual-energy mode with tube voltages of 140 and 80 kV was used in enhanced scanning, and data of two different energy were collected in one scanning. ①Traditional removed-bone digital subtraction (time-subtraction) with plain and 80 kV enhanced scanning data were obtained. Volume render (VR) and maximum intensity projection (MIP) reconstruction were finished; ②Direct removed-bone digital subtraction (dual-energy subtraction) with 80 kV and 140 kV enhanced scanning data were obtained. VR and MIP reconstruction were finished. The image quality of VR and MIP was divided into 4 grades, and were compared as well as average effective radiological dose. All the diseases were confirmed with surgery or DSA. Average effective radiological dose was compared with time-subtraction and dual-energy subtraction. Results Internal carotid artery trunk and branch and Willis circles were displayed clearly with two methods in 60 cases. No significant difference was found (P>0.05) between total quality score of the two methods. The size, shape, neck and axis point of aneurysm in 24 cases were clearly displayed, so as the shape and extent of abnormal vessel bolus in 4 cases, while arteries and veins were also clear in artery-vein malformation; ③The average radiological dose was (26.60±0.50)mSv in time-subtraction and (22.40±0.50) mSv in dual-energy subtraction. Conclusion The normal, abnormal vessels and diseases can be clearly displayed at time-subtraction and dual-energy subtraction CTA. The effect of dual-energy-subtraction is better than that of time-subtraction CTA in no-cooperation patients, and the radiological dose is lower in dual-energy CTA.

Objective Candidas rank as the second factor of deep fungal infection .This study aimed to investigate the rela-tionship between Candidas and melanin by screening clinically isolated melanin -producing Candidas . Methods We incubated 360 strains of clinically isolated Candidas with caffeic acid , DOPA agar , and minimal medium at a temperature of 35℃, with Cryptococcus neoformans as the positive control .We observed the changes in the culture media using transmission electron microscopy (TEM) and electron spin resonance ( ESR) spectroscopy . Results Cryptococcus neoforman produced pigmentation in all the three types of medi -um.At 5 days, a standard strain of Candida albicans SC 5314 turned dark brown in the DOPA agar and minimal medium and , at 10 days, 12 and 15 of the 360 Candida strains turned dark brown in the DOPA agar and minimal medium , respectively, which were not shown to be melanin by TEM and ESR spectroscopy . Conclusion Culture media are not reliable enough for the identification of mel-anin-producing Candidas , and the observations need to be further verified by TEM and ESR spectroscopy .

AIM: To characterize the gene expression of sortilin on adipogenic and osteogenic differentiation in mesenchymal stem cells (MSCs) in vitro and explore its significance.METHODS: MSCs derived from human bone marrow were isolated and cultured in vitro ,then were stimulated in osteogenic medium and adipogenic medium,respectively. Osteopontin and lipoprotein lipase were detected by RT-PCR. Sortilin expression was analyzed by semiquantitative RT-PCR. RESULTS: 1.MSCs displayed the potential of differentiation into osteoblast and adipocyte. 2.Sortilin was upregulated one day after osteogenic induction and remained upregulated for a week. The expression of sortilin was significant increased on day 3( P 0.05).CONCLUSION: Sortilin may be useful to modulate the osteogenic differentiation and may not be necessary for adipocyte commitment in MSCs. The regulation of sortilin expression may provide new protocal and strategy for the treatment of osteoporosis and osteopenic disease.