Objective:To explore the related factors of the psychological symptoms in males with traumatic urethral stricture and to test the mediating effect of social support and coping style on traumatic urethral stricture and psychological symptoms.Methods:Totally 43 male patientswith traumatic urethral stenosis and 1 ∶ 1 matched 43 healthy control subjects were selected as the study samples in the Urology Department of a Third Grade Hospital in Beijing.The Symptom Checklist 90 (SCL-90) was used to evaluate the psychological symptoms of the subjects.The Perceived Social Support Scale (PSSS) and Trait Coping Style Questionnaire (TCSQ) were used to assess the social support and coping styles of the subjects.The non-parametric percentile Bootstrap method was used to test the mediating effect of social support and coping style between traumatic urethral stricture and psychological symptoms.Results:The SCL-90 total scores were higher in patients with traumatic urethral stricture than in healthy controls [(2.9 ± 0.6) vs.(2.4 ± 0.7),P ＜ 0.01].The mediating effect of social support and coping style on psychological symptoms was not significant (P ＞ 0.05).Multiple linear regression analysis showed that the SCL-90 total scores were higher in males with traumatic urethral stricture than in normal controls (β =0.55,95％ CI:0.18 -0.92).PSSS family support scores were negatively correlated with SCL-90 scores (β =-0.10,95％ CI:-0.14--0.06).Conclusion:It suggests that male traumatic urethral stricture may cause psychological symptoms which may be associated with family support.

OBJECTIVETo explore clinical effect of vacuum sealing drainage (VSD) combined with discontinuous windowing technique for repairing large area exposed wounds of Achilles tendon.

METHODSFrom July 2009 to May 2014, 11 patients with large exposed wounds of Achilles tendon were treated, including 5 males and 6 females with an average age of 43 years old (aged from 7 to 65 years old). Among them, 4 cases were skin necrosis caused by heavy objects abrasion and contusion; 3 cases were caused by distal tibiofibula fractures; 3 cases were caused by bicycle-spoke injuries; 1 case was caused by diabetes. Areas of exposed Achilles tendon were from 6 cmx3 cm to 14 cmx5 cm without tendon rupture or bone exposed. After debridement, discontinuous fenestration on Achilles tendon was made by knife blade parallel with longitudinal axis of Achilles tendon, combined with Vacuum Sealing Drainage (VSD) treatment.

RESULTSAfter drainage treatment with one VSD cycle (5 to 7 days), abundant fresh granulation tissues were growing on all wounds and survived well after the second phase dermatoplasty. All patients were followed up for 12 to 24 months, the color of skin flap was good, the texture was soft without burst. At 3 to 4 months after operation, subcutaneous fat was appeared under the flap, the skin was sliding, movement of ankle joints was good. No delayed Achilles tendon rupture were occurred.

CONCLUSIONVacuum sealing drainage (VSD) combined with discontinuous fenestration is a simple, safe and effective method for repairing large area exposed wounds of Achilles tendon,which could minimize the secondary damage caused by wounds of skin flap grafting.

Achilles Tendon ; injuries ; surgery ; Adolescent ; Adult ; Aged ; Child ; Drainage ; methods ; Female ; Humans ; Male ; Middle Aged ; Vacuum

OBJECTIVETo investigate the incidence and variation of tunnel enlargement after anterior cruciate ligament (ACL) reconstruction with peroneus longus muscle combined with BMP and allogeneic bone.

METHODSACL reconstructions with peroneus longus muscle combined with BMP and allogeneic bone were performed in 18 patients (18 knees)in the study from March 2007 to July 2009. Among the patients,14 patients were male and 4 patients were female, ranging in age from 21 to 47 years, with an average of 35.5 years. Twelve patients had the injuries in the right knee and 6 patients in the left knee. The CT scans were taken in a consistent manner at the 1st week and the 3rd, 6th, 12th months after surgery to measure tibial and femoral tunnel expansion.

RESULTSTunnel enlargement didn't happen in 18 knees. The average enlargement of 18 cases of femoral tunnel was (1.10 +/- 0.42) mm; and the average enlargement of 18 cases of tibial tunnel was (1.00 +/- 0.51) mm. There was statistical significance of femoral tunnel between the 1st week and the 3rd month after surgery (P < 0.05); and there were no significant difference of the tunnel diameters among the 3rd, 6th, and the 24th months postoperatively (P > 0.05). There was statistical significance of tibial tunnel between the 1st week and the 3rd month after surgery (P < 0.05); there were no significant differences of the tunnel diameters among the 3rd, 6th, and 24th months postoperatively (P > 0.05).

CONCLUSIONAnterior cruciate ligament reconstruction with peroneus longus muscle combined with BMP and allogeneic bone could obviously reduce the incidence of tunnel enlargement. The tunnel diameter obviously increase in 3 months after surgery,and it remains basically unchanged later.

Adult ; Anterior Cruciate Ligament ; surgery ; Bone Morphogenetic Proteins ; administration & dosage ; Bone Transplantation ; Female ; Femur ; pathology ; Humans ; Knee Injuries ; surgery ; Male ; Middle Aged ; Muscle, Skeletal ; surgery ; Postoperative Complications ; pathology ; Reconstructive Surgical Procedures ; adverse effects ; Tibia ; pathology ; Transplantation, Homologous

OBJECTIVE1) To estimate annual direct medical costs of coronary heart disease (CHD) and stroke attributable to hypertension among Chinese adults aged 35-74 years in China, 2) to analyze the correlation between the hypertension awareness and hypertension treatment rate.

METHODS2003 National Health Services Survey (n = 93 018) was used to derive direct medical costs including costs for outpatient visits, physician services, inpatient stays, rehabilitation services, nurses fees, and medications. The medical costs of CHD and stroke attributable to hypertension were estimated by multiplying population attributable risk proportion by corresponding disease costs. Using 2002 National Nutrition and Health Survey (n = 148 804), the prevalence of hypertension awareness and hypertension treatment rate in 132 survey sites were calculated. Correlation was used to analyze the correlation between the two variables.

RESULTSThe direct medical costs of hypertension, CHD and stroke were 20.2, 15.7 and 24.3 billion Yuan, respectively. The medical costs attributable to hypertension were estimated at 19.1 billion Yuan (RMB), accounting for 47.7% of the total medical costs of the two chronic diseases. The prevalence of hypertension awareness is highly correlated with hypertension treatment rate (r = 0.9777, P < 0.0001).

CONCLUSIONThe economic burden of CHD and stroke attributable to hypertension is very high, reaching about 50% of the total medical costs of the two diseases. The prevalence of hypertension awareness could be used as an important indicator to evaluate the effectiveness of hypertension prevention and control at community level.

China ; Coronary Disease ; economics ; etiology ; Cost of Illness ; Data Collection ; Health Care Costs ; statistics & numerical data ; Humans ; Hypertension ; complications ; Stroke ; economics ; etiology

BACKGROUND: Adipose-derived mesenchymal stem cells (ADMSCs) have been reported to improve wound healing. However, type I collagen secreted by ADMSCs will contribute to scar formation. Therefore, inhibiting type I collagen secretion from ADMSCs will strengthen its clinical application. OBJECTIVE: To investigate the effect of 1,25(OH)2D3on secretion of type I collagen by ADMSCs and its mechanism. METHODS: Human ADMSCs were isolated by collagenase digestion, and identified by flow cytometry. ADMSCs at passage 4 were cultured in DMEM/F12 medium containing different concentrations of 1,25(OH)2D3(10-7, 10-8, 10-9, 10-10and 0 mol/L) respectively for 4 days. Then, the concentration of type I collagen in cell supernatant was measured by ELISA. Real-time PCR and western blot were used to detect the expression of Smad3 at mRNA and protein levels and phosphorylated protein Smad3 level in ADMSCs cultured with and without 1,25(OH)2D3. To analyze the contribution of Smad3 to the effect of 1,25(OH)2D3, Smad3 inhibitor was added to culture medium 30 minutes before adding 1,25(OH)2D3, and type I collagen in cell supernatant was detected by ELISA at 4 days after addition of SMAD3 inhibitor. RESULTS AND CONCLUSION: 1,25(OH)2D3inhibited the secretion of type I collagen by ADMSCs in a dose-dependent manner. The results of real-time PCR and western blot showed that the expression of Smad3 was upregulated by 1,25(OH)2D3, and the results of western blot showed that the phosphorylated Smad3 protein level in ADMSCs was significantly increased by 1,25(OH)2D3. Moreover, the inhibition of type I collagen secretion by 1,25(OH)2D3could be blocked by Smad3 inhibitor. These results indicate that 1,25(OH)2D3can inhibit the secretion of type I collagen from ADMSCs by up-regulating the expression of Smad3.

OBJECTIVETo evaluate curative effect of plate and xenogenic bony plate were applied in refracture in plate-screw fixation of femoral shaft.

METHODSThirteen cases of refracture in plate-screw fixation of femoral shaft included 8 males and 5 females, average age was 31.2 years ranging from 14 to 57. Fracture type was comminuted fracture in 7 cases, oblique fracture in 4 cases, transverse fracture in 2 cases. Fixation type used eight holes femoral LC-DCP in 5 cases, eight holes epipodite LC-DCP in 2 cases, six holes femoral LC-DCP in 2 cases, 8 holes La-Plate in 4 cases. All the patients were treated by femoral LC-DCP and xenogenic bony plate.

RESULTSAll of the patients were followed up from 16 to 40 months with average of 32 months. All cases had undergone only one operation and achieved bony union. Average time of bony union was 9 months. The lower limbs resumed walk and beared a heavy burden. According to criterion of Merchan, the results were excellent in 7 cases,good in 4,fair in 1 and poor in 1, the excellent and good rate of knee function was 84.6% (11/13) in one year after operation.

CONCLUSIONTreatment of refracture in plate-screw fixation of femoral shaft with armor plate and xenogenic bony plate is a reliable treatment.

Adolescent ; Adult ; Bone Plates ; Bone Screws ; Female ; Femoral Fractures ; pathology ; physiopathology ; prevention & control ; surgery ; Follow-Up Studies ; Fracture Fixation, Internal ; instrumentation ; Humans ; Male ; Middle Aged ; Recurrence ; Time Factors ; Young Adult

OBJECTIVETo investigate the effect of treatment methods of non-operation and surgical operation for scapular fracture.

METHODSA retrospective analysis of 52 patients (male 37, female 15, ranging in age from 20 to 48 years, meanly 31 years)with scapular fractures was done. According to Hardegger classification: the scapular body fracture in 24 cases, the surgical neck fracture in 12 cases, the anatomical neck fracture in 3 cases, the glenoidal lip fracture in 6 cases, the scapular spine fracrure in 7 cases. Of all 52 patients,17 cases were treated conservatively, and 35 were undergone surgical internal fixation. When followed up,the clinical examination was done and the X-ray films were taken to measure glenopolar angle (GPA). Hardegger function evaluation system was adopted. The results were analysed statiscally.

RESULTSFifty-two cases were all followed up for 9 weeks to 48 months. Among 17 patients treated by non-operation, Hardegger function evaluation system showed that the result were excellent in 7 cases, good in 6, fair in 2 and poor in 2; the X-ray film results showed that there were 14 cases of GPA > 20 degrees and 3 cases of GPA < 20 degrees. Of 35 patients treated by surgical operation, Hardegger function evaluation system showed that the result were excellent in 20 cases,good in 12 and fair in 3; the X-ray film results showed that there were 33 cases of GPA > 20 degrees and 2 cases of GPA < 20 degrees. There was no significant difference between the two groups (P = 0.27).

CONCLUSIONBefore treatment of scapular fracture, with CT 3D -recontruction, complete understanding of fragments displacement, and correction indication selection, and perform early exercises, both of the two procedures can provide satisfactory outcome.

Adult ; Female ; Fractures, Bone ; diagnostic imaging ; physiopathology ; surgery ; therapy ; Humans ; Male ; Middle Aged ; Radiography ; Retrospective Studies ; Scapula ; diagnostic imaging ; injuries ; physiopathology ; surgery ; Treatment Outcome ; Young Adult

Femur ; diagnostic imaging ; injuries ; physiopathology ; Fractures, Malunited ; diagnostic imaging ; physiopathology ; surgery ; therapy ; Humans ; Male ; Manipulation, Orthopedic ; methods ; Postoperative Complications ; diagnostic imaging ; physiopathology ; therapy ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVEThe aim of this study was to evaluate the efficacy and toxicity of the CCCG-97 and BFM-90 protocols in the treatment of pediatric patients with B-cell non-Hodgkin's lymphoma (B-NHL) retrospectively, and to explore the optimal therapeutic strategy.

METHODSForty-five consecutive untreated patients (age of 18 years or less) with newly diagnosed B-NHL (including Burkitt Lymphoma and diffuse large B-cell lymphoma), treated in our hospital between July 1999 and December 2008 were enrolled in this study. The patients were classified into 2 groups by different protocols. From July 1999 to December 2004, twenty-one 3- to 13.8-year-old children were enrolled in the CCCG-97 group, with 1 in stage I/II, and 20 in stage III/IV(St Jude staging). From January 2005 to December 2008, twenty-four 2.8- to 14.1-year-old cases were enrolled in the BFM-90 group, with 3 in stage I/II, and 21 in stage III/IV (St Jude staging). The survival rates were evaluated by Kaplan-Meier analysis.

RESULTSForty of the 45 patients (88.9%) reached complete response (CR) after 2 courses of chemotherapy. In the CCCG-97 group, the CR rate was 95.2% (20/21 pts), while that in the BFM-90 group was 83.3% (20/24 pts). At a median follow-up time of 62 (17 to 131) months, the 5-year event-free survival (EFS) was 71.8% for all patients, and 69.1% for Stage III/IV, respectively. In the CCCG-97 group, the 3-year EFS was 76.2%. In the BFM-90 group, it was 75.0%. There was no significant difference in survival rates between the CCCG-97 and BFM-90 groups (P=0.975). Unfavorable events recorded were as follows: Death of progression before achieving CR during induction therapy in 4 cases, and relapse after achieving CR in 6 cases. The relapse rates were 19.0% (4/21 pts) in the CCCG-97 group and 8.3% (2/24 pts) in the BFM-90 group, with a non-significant statistical difference (P=0.292). Major toxicities were myelosuppression and mucositis, especially in the BFM-90 group, but were tolerable and manageable. five patients in the BFM-90 group received rituximab, 2 patients (Stage III) achieved CR, while the other 3 patients (Stage IV) had progressive disease or relapse.

CONCLUSIONSShort-pulse and intensive chemotherapy, stratified according to stage of disease, can improve the survival rate of pediatric mature B-NHL. The efficacy of the CCCG-97 protocol and BFM-90 protocol is comparable and the toxicity is tolerable.

Adolescent ; Antibodies, Monoclonal, Murine-Derived ; therapeutic use ; Antineoplastic Agents ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Burkitt Lymphoma ; drug therapy ; pathology ; Child ; Child, Preschool ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Lymphoma, Large B-Cell, Diffuse ; drug therapy ; pathology ; Male ; Mucositis ; chemically induced ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Remission Induction ; Retrospective Studies ; Rituximab ; Survival Rate

OBJECTIVEThis meta-analysis evaluated the accuracy of diagnosing coronary artery disease using 64-section spiral computed tomography, and compared the difference between Chinese studies and abroad studies.

METHODSRelevant English and Chinese articles published from 1998 to 2009 were searched in Cochrane library, Medline, Embase database, OVID database and CNKI. Heterogeneity was tested, pooled weighted sensitivity and specificity and the corresponding 95%CI were calculated. Summary receiver operating characteristic (SROC) curve was drawn and the area under the curve was calculated, differences between studies from China and abroad were compared.

RESULTSA total of 433 articles were searched and 108 articles were included (46 English articles and 62 Chinese articles) after excluding articles of research purposes or design does not match. Because of no gold standard, no blind, can not be calculated literature data, 7 and 20 (P > 0.05), 44 and 6 (P < 0.05), 3 and 1 (P < 0.05) Chinese studies and English articles respectively were excluded. Twenty-seven articles fulfilled all inclusion criteria (8 Chinese and 19 foreign studies) In 8 Chinese studies the pooled weighted sensitivity and specificity and area under SROC curve was 0.892 (95%CI: 0.868 - 0.913), 0.972 (95%CI: 0.966 - 0.977) and 0.983 (95%CI: 0.966 - 1.000) at segment-based analysis. In 19 foreign studies, the pooled weighted sensitivity and specificity and area under SROC curve was 0.971(95%CI: 0.957 - 0.982), 0.878 (95%CI: 0.852 - 0.902) and 0.973 (95%CI: 0.958 - 0.989) at patient-based analysis, 0.917 (95%CI: 0.895 - 0.936), 0.919 (95%CI: 0.909 - 0.928) and 0.974 (95%CI: 0.964 - 0.984) at vessel-based analysis, 0.882 (95%CI: 0.868 - 0.895), 0.959 (95%CI: 0.956 - 0.962) and 0.985 (95%CI: 0.978 - 0.992) at segment-based analysis. Pooled weighted pecificity of 64-section spiral CT angiography at segment-based analysis has significant different between home and abroad (P < 0.05).

CONCLUSIONSMeta-analysis showed that noninvasive 64-section spiral computed tomography could correctly diagnose coronary artery disease with high sensitivity and specificity. Quality of related studies performed in abroad is significantly higher than those performed in China.

China ; Coronary Artery Disease ; diagnostic imaging ; Humans ; Sensitivity and Specificity ; Tomography, Spiral Computed ; United States