Objective To explore the diagnosis and treatment of compartment syndromes of the foot after calcaneal fractures. Methods Between October 1994 and June 1999, the intracompartmental pressures of foot were measured with the Whitesides method for 98 patients with calcaneal fractures. The interstitial pressures in 9 patients averaged 46 mmHg (range from 30 to 55 mmHg). All of the 9 patients were treated by fasciotomy through a hindfoot medial incision, then each intracompartment pressure were measured,respectively. An interosseous compartment pressure still was 40 mmHg. The patient whose foot had a severe crushing injury had fasciotomy of his interosseous compartment through two dorsal forefoot incisions. After a week, the wounds were covered with a split thinkness skin graft. The calcaneal fractures were treated with open reduction and internal fixation at 2 weeks after fasciotomy through a lateral incision. Results All of the 9 patients were followed up for a mean of 2 years (range from 18 to 35 months) after injury. Two patients had occasional hindfoot and ankle pain after walking or standing for a long time. One of them decreased pin stick sensation and two point discrimination. None of the cases developed stiffness of the forefoot or claw toes, nor soft tissue contracture and motor deficit. Conclusion It should not be neglected that the compartment syndromes of the foot may occur after calcaneal fractures. Intracompartment pressure measurements should be performed to confirm the diagnosis. Fasciotomy, which could be performed through a medial hindfoot incision, is the optimal way of treatment.

Aim To investigate the effect of osthole against thrombosis and platelet aggregation.Methods Rat model of artery-vein bypass thrombosis and mouse model of thrombosis by injecting collagen-adrenaline to the vein of the tail were used to measure the thrombus weight and to observe the number of dead mice in 5 min and the recovery mice from hemiplegia in 15 min. ADP,thrombin and arachidonic acid were used to induce platelet aggregation on human and the rate of platelet aggregation in 1,3 and 5 min and the maximum rate of platelet aggregation were detected.Results Osthole inhibited artery-vein bypass thrombosis and reduced thrombus weight in rats to defferent degrees,inhibited the thrombosis induced by collagen-adrenaline and reduced the death rate in 5 min and increased the recovery rate in 15 min. Osthole also inhibited human platelet aggregation induced by ADP,thrombin and arachidonic acid in vitro.The values of IC_(50 )(dose of the drug giving 50% inhibition) were 0.444 g?L~(-1) for ADP,0.186 g?L~(-1) for thrombin, 0.421 g?L~(-1) for arachidonic acid, respectively.Conclusion Osthole exert remarkable effects against thrombosis and platelet aggregation.

AIM: To observe the effect of Qingluo Tongbi Granule(QLTBG)——containing serum on the proliferation of osteoblasts(OB) and osteoclasts(OC),the activity of AKP of OB. METHODS: (1) OB were separated from the skull of SD rats aged 1 d and OC from the thighbone and shinbone of SD rats aged 5 d.(2) The proliferation of OB and OC was detected by MTT method,and the activity of AKP of OB was examined by diazol method. RESULTS: The proliferation capability of OB was strengthened markedly by the rat sera containing 7.2,14.4 g/kg QLTBG,which could reinforce the activity of AKP obviously as well,while the proliferation of OB was inhibited remarkably by the rat sera containing 3.6,7.2,14.4 g/kg QLT. CONCLUSION: The sera containing QLTBG could enhance the proliferation of OB and the activity of AKP,restrain the proliferation of OC simultaneously.

Objective To investigate the diagnostic values of model of end-stage with incorporation of serum sodium (MELD-Na) score, chronic liver failure-sequential organ failure assessment (CLIF-SOFA) score and APASL-ACLF research consortium score (AARC-ACLF) for evaluation of prognosis of hepatitis B virus related acute-on-chronic liver failure (HBV-ACLF). Methods A total of 72 consecutive patients with HBV-ACLF were included in the study and divided into two groups (group A and group B) according to the prognosis in three-month. Group A were included 29 patients with stable disease or better after medical treatment at least for 3 months, and group B included 43 patients who were dead after treatment or received liver transplantation as failure of medical treatment. When the patients were diagnosed as ACLF or after admission, the data were collected. Results of the laboratory examination were collected when the international normalized ratio (INR) was minimum. Data of total bilirubin (TBIL), prothrombin time (PT), INR, serum creatinine (Cr), serum sodium (Na), albumin (ALB), MELD-Na, CLIF-SOFA and AARC-ACLF scores were calculated respectively. The comparative analysis was performed. Areas under the receiver operating characteristic curve (AUC-ROC) of MELD-Na and CLIF-SOFA scores were used to assess the short-term prognosis in patients with acute-on-chronic liver failure. Results The values of TBIL, INR, MELD-Na, AARC-ACLF and CLIF-SOFA were significantly higher in group B than those in group A (P<0.05). The serum level of Na was significantly lower in group B than that of group A (P<0.05). The area under curve (AUC) values generated by the ROC curves was higher for CLIF-SOFA score (AUC 0.887) than that of MELD-Na score (AUC 0.764) (Z=2.255, P<0.0167). The AUC values generated by the ROC curves showed no significant differences between CLIF-SOFA score and AARC-ACLF score (AUC 0.825) or MELD-Na score and AARC-ACLF score (Z=1.361, 1.127, P>0.0167). The cut-off scores of MELD-Na, CLIF-SOFA and AARC-ACLF were 23.84, 8.50 and 8.50 respectively. Conclusion MELD-Na, CLIF-SOFA and AARC-ACLF scores have appreciable values to evaluate the prognosis in patients with HBV-related ACLF. AARC-ACLF is better than that of MELD-Na and CLIF-SOFA in assessing prognosis of HBV-related ACLF.

Objective To explore the value of combined use of laboratory indicators for diagnosis of early renal functional damage. Methods Eighty-six patients with various kidney diseases were enrolled in the Second Affiliated Hospital of Guangzhou Medical University. On admission,the serum Cystatin C(Cys C),creatinine(Cr), Urea,etc were determined. The value of using combined laboratory indicators in the diagnosis of renal functional damage was obtained through the analysis of the receiver operating characteristic curve(ROC curve);multiple variable indicators were grouped to establish multiple logistic regression models to be compared and evaluated. Results In the early and late renal injury groups(group B of 32 cases and group C of 12 cases),the serum levels of Cys C,Cr, and Urea were significantly higher than those in the normal renal function control group(group A of 42 cases),the elevation in level in group C being the most significant〔Cys C(mg/L):3.47±0.75 vs. 1.59±1.29,Cr(μmol/L):669±466 vs. 214±173,Urea(mmol/L):21.22±13.10 vs. 11.04±8.24,P<0.05 or P<0.01〕. The areas under the ROC curve(AUC)made by combinations of Cys C,Cr and Urea for the diagnosis of renal damage were 0.908,0.817 and 0.785. In the four different kinds of combination of the indicators,the AUC were sequentially arranged from large to small area as follows:Cys C+Cr+Urea=Cys C+Cr>Cys C+Urea>Cys C>Cr+Urea(0.920=0.920>0.911>0.908>0.809). In this sequence,the AUC made by Cys C+Cr+Urea and Cys C+Cr were equal,both 0.920, whose sensitivity was 75.0%,specificity 100.0%,positive predictive value 100.0%,negative predictive value 80.0%and diagnostic accuracy rate 87.5%. So,Cys C + Cr combination could be used to substitute Cys C + Cr + Urea, and the former clinical diagnostic effect was the best,much higher than that by using AUC whose curve was made by Cys C alone. Conclusion The value of using only one laboratory indicator for diagnosis of patients with early renal functional damage is not high,while applying Cys C+Cr combination can improve the diagnostic effect greatly,and its sensitivity and specificity are higher.

Objective To assess prevalence and risk factors of illness within the past 2 weeks among rural residents in Menglian,under the background of essential public health service implemented generally. Methods In February 2012, the questionnaire method was employed to investigate the two-week morbidity in 2011 rural residents sampled by multistage stratified random sampling from Menglian population. Results The prevalence, that of illness within two-week among 2011 rural residents in Menglian, was 97.5‰ (95%CI 84.5‰-110.5‰) . It was lower than that of the rural region IV in China (149.6‰, <0.05) .Its age trend was the same as that of the rural region IV in China,the prevalence in 0-14 years old children,however,was higher than the counterpart in the rural region IV in China. The diseases, which two-week morbidity ranked the top five, were acute upper respiratory infection, acute gastroenteritis, hyperostosis, acute tracheobronchitis and rheumatoid arthritis. The results of multilevel logistic regression model fitted by group-level explanatory variable mountainous area, individual-level random slopes variable gender and other individual background variables indicated that there were across-level interactions between mountainous area and gender ( <0.05), the family income lower than RMB 15000 (odds ration 3.2378, 95%CI 1.9014-5.5130) and age (odds ration 1.0163, 95%CI 1.0002-1.0327) had a positive effect to two-week morbidity, and contrasting to unmarried, married had a negative effect to two-week morbidity (odds ratio 0.4727, 95%CI 0.2534-0.8819) . Conclusions Comparing with that of the rural region IV in China before implementing essential public health service, the two-week morbidity in Menglian was lower. For further elevating the health level of population, the strategies, such as intensifying material and child hygiene in the mountain area, improving sanitary conditions of low income family, and updating health consciousness in single population,would be implemented.

Objective To study the inner diameter and hemodynamics of ophthalmic artery(OA)and central retinal artery(CRA)in hyperuricemia by Enhance-flow(eFlow)imaging and spectral Doppler.Methods One hundred and one patients with hyperuricemia and 30 volunteers were selected,the inner diameter in eFlow imaging and the peak systolic velocities(PSV),the end diastolic velocities(EDV),the resistive index(RI)were measured,and pulsatility index(PI)of OA and CRA were measured by spectral Doppler.The 101 patients were divided into two groups according to the time of diagnosing hyperuricemia,one group had a diagnosis of hyperuricemia for more than five years and the other had such a diagnosis for less than five years.The data were compared by t-test.Then,the patients were further divided into a group of hyperuricemia combined with hypertension and the other without hypertension.The differences between the experimental group and the group of volunteers were carried out by One-way ANOVA,the comparison between two groups were analyzed with SNK.Results The RI(0.68±0.09)and PI(1.3±0.4)of OA in patients who were diagnosed as hyperuricemia for more than 5 years was higher[RI:0.63±0.09,PI:1.1±0.3(t=3.504,P=0.001 ;t=3.164,P=0.002)],the EDV[(6±3)cm/s]of OA was lower than those patients with a diagnosis of hyperuricemia for less than 5 years[(8±5)cm/s,t=1.988,P=0.049].The PSV[(11.5±3.5)cm/s]and EDV[(3.7±1.1)cm/s]of CRA in hyperuricemia combination hypertension group was lower,and the RI (0.88±1.40)was higher than hyperuricemia without hypertension group[PSV:(13.5±4.0)cm/s,EDV:(4.1±1.2)cm/s,RI:0.67±0.08].Conclusion By eFlow and spectral Doppler,we have found that hyperu-ricemia could accelerate OA and CRA atherosclerosis.The eFlow and spectral Doppler are valuable methods to study the hemodynamics in ophthalmic artery of patients with hyperuricemia.

Objective To study the wavelet entropy of intracranial electrode recording electroencephalogram (EEG) during the seizure onset,and explore the prospect of applying it for automatic detection of EEG.Methods Twenty-eight seizure events of 9 epilepsy patients whose outcome were Engel class Ⅰ were retrospective analyzed,by comparing the pre-ictal,initial ictal and ictal wavelet energy entropy variations of both seizure onset zone (SOZ) contacts and non-SOZ contacts.Results The wavelet energy entropy of SOZ contacts increased from pre-ictal (0.053 ± 0.047 ) to initial ictal (0.326 ± 0.250),while it declined during the ictal (0.138 ± 0.097,F =30.904,P =0.000).There was no obvious change of the wavelet energy entropy of non-SOZ contacts in different periods.By further applying time-window wavelet entropy to the detection of intracranial EEG,the results showed that the time-window wavelet energy entropy could be sensitive to reflect the seizure onset time and electrodes.Conclusion The wavelet energy entropy of contacts inside SOZ increased significantly at scizurc onset,and this conclusion can be used to assist in presurgical localization of epilepsy.

Objective To assess the left ventricular (LV) systolic synchrony in patients with myocardial infarction using real-time three dimensional echocardiography(RT-3DE) and speckle tracking imaging(STI). Methods Twenty-five healthy subjects and thirty patients with myocardial infarction underwent two-dimensional echocardiography and RT-3DE examination. The systolic synchrony parameters derived from RT-3DE were the dispersion of time and the maximum difference of time to minimum regional volume for 16 LV segments (Tmsv-16-SD and Tmsv-16-Dif). When the Tmsv-16-SD was above the percent 99 of the control group distribution in patients with myocardial infarction were considered statistically different from those in the control group and were accordingly classified as LV systolic asynchrony. The time from the onset of QRS complexes to systole peak strain from the radial vectors was recorded using STI. The standard deviation and the maximal temporal difference of the radial (TRS-SD and TRS-Dif) of 18 segments were calculated as indicator of LV systolic synchrony. LV systolic asynchrony was defined as an interval≥130 ms for the absolute difference in time to peak radial strain for the anteroseptal wall versus the posterior wall (TAS-POST). Results All the systolic synchrony parameters derived from RT-3DE and STI were significantly larger in the myocardial infarction group than those of the control group (all P＜0.01 ).For Tmsv-16-SD and Tmsv-16-Dif,a moderate correlation with TRS-SD and TRS-Dif( r = 0.675 and 0.620,all P＜0.01) was found. No significant difference and general consistency were found between the systolic asynchrony parameters by RT-3DE and STI ( P = 0.125, Kappa = 0.60). Conclusions RT-3DE and STI provide effective tools to assess the LV systolic synchrony. There is no obvious correlation between these methods, thus it is essential of using different methods and parameters to evaluate the LV systolic synchrony.

Humans ; Nanoparticles ; toxicity ; Skin ; drug effects ; Skin Absorption