Objective To discuss the clinical feature ,diagnosis and treatment of the occult cerebrospinal fluid rhinorrhea after tracheotomy in patients with severe traumatic brain injury .Methods The clinical data of 18 cases of the occult cerebrospinal fluid rhinorrhea after tracheotomy in patients with severe traumatic brain injury were retro -spectively analyzed .Results 15 cases showed involuntary swallowing movements ,frequent stimulus-likecough, abnormal increased secretions in the oral and nasal;3 cases performance of aspiration ,hypoxemia ,respiratory distress . After a three -dimensional thin skull CT , cisternography , nasal endoscopic examination can confirm the diagnosis . After the treatment with replacing the tracheostomy tube with a balloon ,continuous lumbar drainage ,endoscopic repair leak,the cerebrospinal fluid rhinorrhea were cured .Conclusion Patients with occult cerebrospinal fluid rhinorrhea performance the diversity and easily missed ,early detection and timely treatment can prevent cerebrospinal fluid rhi-norrhea delayed healing and intracranial infection and promote patient recovery .

In this study, a novel resequencing pathogen microarray (RPM)-based multi-pathogen detection assay was developed to simultaneously detect 14 rotaviruses, 7 caliciviruses, 8 astroviruses, 28 enteroviruses, and 16 rare diarrhea viruses in patients with diarrhea syndrome. The specificity of the assay was examined using confirmed virus-positive specimens, and the sensitivity was evaluated by serial ten-fold dilutions of in vitro transcribed RNA. RPM assay could detect and differentiate virus types/subtypes at 20-2000 copies/microL. The detection threshold of RPM was determined by adjusting the reference concentration, and the detection steps were optimized to type Enterovirus. The nucleic acids of 10 stool samples from patients with unexplained diarrhea were screened, and 6 of them showed positive results. The RPM results were further verified by singleplex PCR followed by sequencing, and no difference was found between the two assays. In conclusion, we have established a high-throughput RPM assay with high specificity and sensitivity, which demonstrates a great potential for the identification of pathogens in patients with unexplained diarrhea and the management of emerging epidemic.
DNA Primers ; genetics ; Diarrhea ; virology ; Feces ; virology ; High-Throughput Screening Assays ; methods ; Humans ; Oligonucleotide Array Sequence Analysis ; methods ; Sensitivity and Specificity ; Viruses ; classification ; genetics ; isolation & purification

OBJECTIVETo investigate in vitro and in vivo anti-human herpes simplex virus effects of photodynamic therapy (PDT) using 5-aminolevulinic acid (ALA).

METHODSGuinea pigs model of cutaneous herpes virus infection was applied, and Vero cells infected by HSV-I and HSV-II were used as experimental systems to observe the antiherpes effect of ALA-PDT.

RESULTSThe in vitro experiments showed that ALA-PDT has antiherpes effect on HSV-I and HSV-II, its effect was similar to that of acyclovir. The results of animal experiments showed that ALA-PDT had significant therapeutic effect on guinea pigs model of cutaneous herpes virus infection, the effect was dose-related.

CONCLUSIONALA-PDT could be effective in treating HSV infections, which may provide a new approach to the treatment of viral infections.

Aminolevulinic Acid ; therapeutic use ; Animals ; Cercopithecus aethiops ; Disease Models, Animal ; Female ; Guinea Pigs ; Herpes Simplex ; drug therapy ; virology ; Male ; Photochemotherapy ; Random Allocation ; Simplexvirus ; drug effects ; Skin Diseases, Viral ; drug therapy ; Treatment Outcome ; Vero Cells

Aneurysm, Dissecting ; surgery ; Aorta, Thoracic ; surgery ; Aortic Aneurysm, Thoracic ; surgery ; Endovascular Procedures ; methods ; Humans ; Male ; Middle Aged

OBJECTIVETo approach the clinical curative effect of treatment of the disease of vertebral column by the arc-track private lock pedicle orthopedics fixation system (ALPF II).

METHODSEighty-six cases were treated by useing ALPF II. The average age of the cases was 36.8 years (range from 18 to 69 years),the male was 39 cases and the female was 37 cases. The results were evaluated and all the cases were followed-up.

RESULTSAll the patients were followed-up for 9 to 30 months. The amelioration of patients nerve function,spinal motion, low back pain and leg pain was 94.1%, 65.9%, 92.1% and 87.4% respectively. The height of anterior and posterior border after operation were improved greatly than that before operation (P < 0.01, P < 0.05). The X-ray films showed that the angle of kyphosis was also improved significantly (P < 0.01).

CONCLUSIONTo treat spinal column disease, ALPF II is a kind of operation safety simple, easy control, reset good, curative effect credibility, the complications little of treatment method.

Adolescent ; Adult ; Aged ; Female ; Humans ; Internal Fixators ; Male ; Middle Aged ; Orthopedic Fixation Devices ; Spinal Diseases ; surgery

OBJECTIVETo analyze the effects about inclinations of the second and the third molars in patients treated with or without premolar extractions.

METHODSFifty-six adolescents were chosen and divided into the first premolar extraction and non-extraction groups, 30 and 26 patients respectively. The pre-treatment and post-treatment panoramic radiographs were made. Angles between long axis of the third molar and the occlusal plane (the second molar alike), and long axis of the second and the third molar were measured and evaluated.

RESULTSThe maxillary and mandibular third molar angulations were all improved after treatment in two groups. Compared with non-extraction group, the average changes of angle between long axis of the third molar and the occlusal plane increased significantly in maxilla and mandible (P < 0.05). Average changes of angles between long axis of the second and the third molar decreased and had statistically significant difference (P < 0.05). The change of angle between long axis of mandibular second molar and the occlusal plane had statistically significant difference (P < 0.05), but there was no statistically significant difference in maxillary second molar (P > 0.05).

CONCLUSIONThe first premolar extraction in orthodontic treatment could improve the third molar angulations and it would promote the eruption of the third molar.

Adolescent ; Bicuspid ; Dental Occlusion ; Female ; Humans ; Male ; Mandible ; Maxilla ; Molar ; Molar, Third ; Radiography, Panoramic ; Tooth Eruption ; Tooth Extraction

Objective To study the risk factors related with progressive hemorrhagic injury (PHI)after severe head injury for a view to early diagnosis and treatment for this disease and providing a basis for effective prevention. Methods In a retrospective study of 262 patients with severe brain injury in considering the clinical data of the PHI, the occurrence is variable, and age, gender, bleeding site, type of bleeding, dilated pupils starus, level of systolic blood pressure on admission, time of CT for the first time,GOS scores, injured mechanism, interval between first and second time CT, application of high-dose mannitol, platelet (PLT) count, prothrombin time (PT), activated partial prothrombin time (APTT) were considered as independent variables. Results The incidence rate of having PHI was 47.7% (125/262);single-factor analysis revealed that, as compared with those in patients with non-PHI, 7 factors in patients with PHI were significantly different, namely, age, type of hemorrhage, interval between injury and first-time CT, GCS scores, PLT count, PT and APTT. Multivariate logistic regression analysis of the results showed that interval between injury and first-time CT, GCS scores, PLT count were the risk factors of having PHI, and their OR values were 3.5448, 3.2975 and 2.2361, respectively. Conclusion For patients with severe brain injury, the sooner the first time CT examination is performed, the lower the GCS scores are and the lower the PLT count is, the higher risk of having PHI is. Thus, dynamic CT formal review is suggested to improve the early diagnosis and treatment of PHI.

Objective To study the HIV-1 drug resistance (DR) situation among newly infected persons in Dehong.Methods 1048 HIV-1 positive blood samples from July to December in 2006 from Dehong prefecture of Yunnan,were collected.HIV drug resistance were tested using TruGene in newly infected people that were distinguished with BED-CEIA,while the subtype were determined with phylogenetic analysis using a set of reference sequences available on the Los Alamos Database.Results Of sixty-four successfully analyzed samples,drug resistance mutations were detected in 4 samples with the resistance rate as 6.25%.Minor mutation in PR region such as M36I/V,L63P and H69K appeared frequently and the rates were 81.25%,70.31%and 65.63%respectively.The predominantly prevalent strains were seen as C/CRF07_BC/08_BC(65.63%,42/64) in this study.Conclusion The prevalence of genotypic drug resistances in HIV-1 recent infections in Dehong prefecture appeared to be at moderate level.Drug-resistance surveillance program among HIV-1 infections should be continued and strengthened.

Objective To summarize the clinical characteristics and genetic variations in children with cystic fibrosis(CF)primarily presenting with pseudo-Bartter syndrome(CF-PBS),with the aim to enhance understanding of this disorder.Methods A retrospective analysis was performed on the clinical data of three children who were diagnosed with CF-PBS in Hunan Children's Hospital from January 2018 to August 2023,and a literature review was performed.Results All three children had the onset of the disease in infancy.Tests after admission showed hyponatremia,hypokalemia,hypochloremia,and metabolic alkalosis,and genetic testing showed the presence of compound heterozygous mutation in the CFTR gene.All three children were diagnosed with CF.Literature review obtained 33 Chinese children with CF-PBS,with an age of onset of 1-36 months and an age of diagnosis of 3-144 months.Among these children,there were 29 children with recurrent respiratory infection or persistent pneumonia(88％),26 with malnutrition(79％),23 with developmental retardation(70％),and 18 with pancreatitis or extrapancreatic insufficiency(55％).Genetic testing showed that c.2909G＞A was the most common mutation site of the CFTR gene,with a frequency of allelic variation of 23％(15/66).Conclusions CF may have no typical respiratory symptoms in the early stage.The possibility of CF-PBS should be considered for infants with recurrent hyponatremia,hypokalemia,hypochloremia,and metabolic alkalosis,especially those with malnutrition and developmental retardation.CFTR genetic testing should be performed as soon as possible to help with the diagnosis of CF.

OBJECTIVETo evaluate the effectiveness of free graft transplantation two-stage urethroplasty for hypospadias repair.

METHODSFifty-eight cases with different types of hypospadias including 10 subcoronal, 36 penile shaft, 9 scrotal, and 3 perineal were treated with free full-thickness skin graft or (and) buccal mucosal graft transplantation two-stage urethroplasty. Of 58 cases, 45 were new cases, 13 had history of previous failed surgeries. Operative procedure included two stages: the first stage is to correct penile curvature (chordee), prepare transplanting bed, harvest and prepare full-thickness skin graft, buccal mucosal graft, and perform graft transplantation. The second stage is to complete urethroplasty and glanuloplasty.

RESULTSAfter the first stage operation, 56 of 58 cases (96.6%) were successful with grafts healing well, another 2 foreskin grafts got gangrened. After the second stage operation on 56 cases, 5 cases failed with newly formed urethras opened due to infection, 8 cases had fistulas, 43 (76.8%) cases healed well.

CONCLUSIONSFree graft transplantation two-stage urethroplasty for hypospadias repair is a kind of effective treatment with broad indication, comparatively high success rate, less complications and good cosmatic results, indicative of various types of hypospadias repair.

Adolescent ; Adult ; Child ; Child, Preschool ; Humans ; Hypospadias ; surgery ; Male ; Mouth Mucosa ; transplantation ; Penis ; abnormalities ; surgery ; Retrospective Studies ; Scrotum ; abnormalities ; surgery ; Skin Transplantation ; Treatment Outcome ; Urethra ; surgery ; Urologic Surgical Procedures, Male ; methods