Objective To evaluate the application effect on preventing pressure ulcers of modern medical position pad in orthopaedic. Methods A total of 124 patients with congenital dislocation of the hip, pelvis fractures and femoral fractures were selected between January 2013 and December 2013. They were divided into 2 groups by random digits table method with 62 cases each. The observation group was given modern medical position pad nursing after operation, and the control group was given routine postoperative nursing. Postoperative 2 hours, 4 hours after operation, postoperative 1 day, 2 days, 3 days and before discharge pressure situation, children crushed area skin comfort, families of children with pain on pressure parts skin care satisfaction and turn the situation were analyzed and compared. Results The observation group postoperative 2 hours did not appear the skin red and bruised, there was no crushed in 4 hours, only 4 cases of skin red, no 1 case skin crushed before leaving hospital. Twelve cases of the control group in postoperative 2 hours appeared red skin pressure, 4 hour after crush skin in 4 cases, 6 cases of skin crushed before leaving hospital. The comfortable children for 56 cases, mild discomfort for 6 cases in the observation group,and 31, 23 cases in the control group. The satisfaction was 100.0%(62/62) in the observation group, and 93.5%(58/62) in the control group. The degree of turn the situation pain in the observation group was lower than that in the control group. Conclusions New medical position mat can effectively extend the pediatric orthopaedic congenital dislocation of the hip, pelvis fracture and femoral fracture with roll over time, reduce the stimulation of the skin, sweat for pressure parts effectively prevent the occurrence of pressure sores, improve the crushed area comfort children and families of children with satisfaction, greatly reduce the postoperative pain when rolled over, worth clinical promotion.

It is a conventional point of view that berberine is poorly absorbed following oral administration. But in recent years berberine is orally used in clinical practice for the treatment of arrhythmia and congestive heart farlure. In order to solve the problem, this paper established a HPLC method (limit of quantification is 2?g ? L-1), to study the pharmacokinetic property of berberine in Beagle dogs. P-K curves of 100 mg intravenous injection is a two-compartment model with its K. 10. 18?h-1, T1/2?0. 15h, T 1/2?12. 59h, CL 60.70 L ? h-1,AUC 1979.31 ?g ? h-1 ? L-1and Vd 699. 53 L. Vomiting happened after 280 mg ? kg-1oral administrationgroup. Its T max is 3. 17 h, C max 15. 46?g?L-1, AUC 777. 29 Mg ? h-1 ? L-1, Vd 125. 41 L, Ke 0. 02?h-1and CL 2. 64 L ? h-1. The plasma concentrations after 45 mg ? kg-1 given orally are always below 10 mg v L-1. So are the concentration after 45 mg ? kg-1 orally given two times a day for one week. Severe Vomiting and diarrhea happened in all dogs of 700 mg ? kg-1 oral adminstration group,so the plasma concentration is below 1 0 ng ? L-1and its P-K parameters can't be determined.

A 3-year-old boy presented with a 3-month history of brown-yellow papules scattered on the trunk.The first skin biopsy showed a dermal infiltrate of many mononuclear histiocytes,eosinophilic granulocytes and a small number of lymphocytes.Immunohistochemical examination of the lesions demonstrated positive reactions with anti-CD68,-S100 and-CD1a (partial) antibodies.After the biopsy,the skin lesions gradually turned dark and partially regressed leaving hyperpigmentation,but new lesions continuously appeared.Four months later,a second biopsy was performed,and showed a dermal infiltrate of histiocytes with eosinophilic granulocytes and a few multinucleated giant cells.Immunohistochemistry showed that the histiocytes stained positive for CD68,but negative for S100 and CD1a.Based on the above findings,the patient was diagnosed with juvenile xanthogranuloma.

In order to decrease the mortality of pre-hospital sudden death events(SDEs),their features especially those of cardiac sudden death were analyzed. 1030 pre-hospital emergent cases from 1973～1999 were analysed systematically. The total SDEs occurred in 106 cases, among the 68 cases of cardiovascular diseases, 89.7% had coronary heart diseases(CHD), AMI or OMI with re-infarction. There were two peak age stages of SDEs: the first was 46-55 years old stage(non-retaired age stage,22.6%), and the second stage was 66-75 years old(27.3%). The pre-hospital SDEs are the most emergent cases. Great attention must be paid to those with the history of cardiovascular diseases, especially those with the history of coronary cardiac events

A 37-year-old male patient presented with persistent generalized itching erythema and papules for more than 1 month.The patient had received surgical treatment for type B3 thymoma in stage Ⅳ.Five months prior to the presentation,he developed myasthenia gravis.He also complained of chronic diarrhea for two years.Physical examination revealed white patches in the oral mucosa as well as scaly erythema of varying size on the face,trunk and extremities.Lamellar scales could be seen after scratching,while removal of scales could not result in the appearance of bleeding points.There was scaly hyperkeratotic erythema of palms and soles.Histopathological examination revealed psoriasis-like epidermal hyperplasia and parakeratosis with multiple dyskeratocytes,and some of the dyskeratocytes were surrounded by lymphocytes.There was a perivascular infiltration with a small number of lymphocytes.Immunohistochemical study showed positive staining for CD3,CD4 (dermis),CD8 (epidermis) and CD45RO,but negative staining for CD20,CD68 and CD30.The patient was diagnosed as thymoma-associated graftversus-host-like disease,myasthenia gravis and mucosal candidiasis.After treatment with tacrolimus and prednisone,the condition was gradually relieved.

Objective To investigate the effect of sufentanil postconditioning on cardiomyocyte apoptosis during myocardial ischemia-reperfusion (I/R) in rats.Methods Thirty-six male Sprague-Dawley rats weighing 250-280 g were randomly divided into 3 groups ( n =12 each):sham operation group (group S),I/R group and sufentanil postconditioning group (group SP).Myocardial I/R was induced by occlusion of the left coronary artery for 30 min followed by 120 min reperfusion.Sufentanil 3.0μg/kg was injected iv at the beginning of reperfusion in group SP.HR and MAP were recorded during I/R.The rats were sacrificed at 120 min of reperfusion and their hearts were removed for determination of infarct size,number of apoptotic cardiomyocytes,and the expression of Bax mRNA and Bcl-2 mRNA,and apoptotic index was caculated.Results There was no significant difference in HR among the 3 groups ( P ＞ 0.05 ).Compared with group S,MAP and Bcl-2 mRNA expression were significantly decreased,apoptotic index and Bax mRNA expression increased in group I/R,and apoptotic index,and the expression of Bax mRNA and Bcl-2 mRNA were increased in group SP (P ＜ 0.05).Compared with group I/R,the infarct size,apoptotic index and Bax mRNA expression were decreased,and Bcl-2 mRNA expression was increased in group SP (P ＜ 0.05).Conclusion Sufentanil postconditioning can attenuate myocardial I/R injury in rats by up-regulating Bcl-2 expression,down-regulating Bax expression and inhibitting cardiomyocyte apoptosis.

Adult ; Angiofibroma ; Humans ; Male ; Nose Diseases ; Turbinates ; pathology

Objective To speculate the precipitating factors,clinical features and histopathological changes in patients with granuloma annulare (GA).Methods A study was performed in 53 patients with GA . Results The incidence of female was more prevalent than male in our study. The exposure of sunlight was found more relatedly in GGA than LGA.The onset age of GGA was inclined to be elder and GGA seemed to last longer.The histopathological study showed that palisading granuloma pattern accounted for 71.7% in all patients,and scattered histiocytic infiltration accounted for 28.3%.Such as cryotherapy,topical steroids were used for LGA and systemic administration was an alternative to GGA. Conclusions Ultraviolet may be associated with the development of generalized GA. The most common pattern is the palisading granuloma though the histopathological changes were variable.Topical therapy is effective in LGA,while the systemic therapy is mainly used for GGA.

Objective To assess the outcome of vesicoureteral reflux after augmentation cystoplasty in patients with neurogenic bladder.Methods Between January 2008 and January 2014,a total of 25 patients,with a hypocompliant bladder associated with vesicoureteral reflux confirmed by video-urodynamics preoperatively,were recruited in this study.They all had undergone bladder augmentation with a generous detubularized segment of bowel at our institution.No effort had been made to correct existing reflux.Preoperatively assessment included urinalysis,kidney function tests,ultrasonography,video-urodynamic evaluation.All patients had various degrees of vesicoureteral reflux.The status of vesicoureteral reflux and bladder function were studied by video-urodynamic.Results Mean follow-up was 2.2 years (range 0.5 to 5.5 years).The video-urodynamics manifested a significant improvement of bladder capacity,diminution of intravesical pressure and resolution of reflux after bladder augmentation.Of the 25 patients,20 (80％) no longer had reflux,3 (12％) had improvement,2 (8％) had no change.Sixteen of 18 with grades Ⅰ to Ⅲ (89％),all refluxing units with grade Ⅳ to grade Ⅴ (100％) showed complete cessation of reflux.Symptomatic urinary infection was not found after surgery.Conclusions Augmentation enterocystoplasty without ureteral reimplantation is effective and adequate for patients with high pressure and hypocompliant neurogenic bladder.Therefore,ureteral reimplantation is not necessary underwent when augmentation enterocystoplasty is recommended to patients with neurogenic bladder and vesicoureteral reflux.

Objective To investigate the efficacy of tertiary liver transplantation.Methods The clinical data of 4 patients with hepatobiliary disease who were admitted to the General Hospital of Chinese People's Armed Police Forces from April 2002 to December 2012 were retrospectively analyzed.All the patients received orthotopic liver transplantation,and received tacrolimus + mycophenolate mofetil (MMF) + hormone after operation.All the patients were followed up till May 2014,and their prognosis was learned.The measurement data were analyzed using the t test.Results Three patients with benign hepatic disease received tertiary liver transplantation due to biliary complications and chronic rejection,and 1 patient with hepatic cancer received tertiary liver transplantation because of hepatic cancer recurrence.The average interval between the primary and secondary liver transplantation was 16.0 months,which was shorter than 22.5 months of the interval between the secondary and tertiary liver transplantation.The mean operation time in the secondary liver transplantation was (11.4 ± 1.0)hours,which was significantly shorter than (14.1 ± 2.2) hours in the tertiary liver transplantation (t =3.644,P ＜ 0.05).The median volumes of blood loss in the secondary and tertiary liver transplantation were 1 300 mL and 1 800 mL,and the median volumes of blood transfusion were 1 400 mL and 3 100 mL.The hepatic function of the 4 patients recovered smoothly at the early time after liver transplantation.Two patients (3 cases) were complicated with infection postoperatively (1 patient was infected by pseudomonas aeruginosa within 30 days after liver transplantation,and was cured by active antimicrobial treatment),and they were cured after anti-infectional treatment.One patient died of hepatic failure at the 80th month after the primary liver transplantation,1 died of hepatic cancer recurrence complicated by pulmonary,bone and retroperitoneal lymph node metastasis at the 107th month after the primary liver transplantation,and the other 2 patients survived for 104 months and 26 months after the primary liver transplantation,respectively.Conclusion Tertiary liver transplantation is effective for the treatment of biliary complications and chronic rejection after liver transplantation,and it can extend the life span of patients with hepatic cancer recurrence if there are insufficient donor resources.