OBJECTIVETo discuss the effect of surgical staging and using craft bone with vancomycin for the treatment of calcaneal fractures.

METHODSFrom January 2006 to December 2012,13 patients with open calcaneal fractures were treated including 9 males and 4 females with an average of 35.2 years old ranging from 23 to 66. All cases were emergency cases. According to Sanders classification of calcaneal fractures, 2 cases were type II, 7 cases were type III, 4 cases were type IV. According to Gustilo-Anderson soft tissue injury classification, 8 cases were type II, 2 cases were type III A, 2 cases were type III B, 1 case were type III C. Firstly a thorough debridement or VSD procedures were applied,secondly calcaneal fracture were treated with open reduction, plate fixation and bone graft complex with antibiotics. Based on clinical examination, radiographic evaluation, and American Foot and Ankle Surgery Society (AOFAS), ankle function were evaluated after operation.

RESULTSOpen wounds were headed after dressing and repairing,, lateral calcaneal wound were healed during the first period. All patients were followed up for 6 to 36 months (means 14.5 months). Fracture healing time was 14 to 20 weeks (means 16.2 weeks). Last follow-up AOFAS ankle-hindfoot score was (80.0 +/- 7.4) ranging from 55 to 95.

CONCLUSIONFor patients with open fractures, through reasonable clinical evaluation, staging operation, using bone graft with antibiotics can reduce the incidence of postoperative wound infection and promote fracture healing.

Adult ; Aged ; Anti-Bacterial Agents ; administration & dosage ; Bone Transplantation ; methods ; Calcaneus ; injuries ; surgery ; Female ; Fracture Fixation, Internal ; Fracture Healing ; Fractures, Open ; surgery ; Humans ; Male ; Middle Aged

Objective To investigate the effects of fluvastatin (Flu) on the levels of estradiol(E2 ) ,tumor necrosis factor-α(TNF-α) ,insulin-like growth factor-1(IGF-1) and bone glaprotein(BGP) in experimental osteoporosis rats .Methods The model of osteo-porosis was established ,all rats were ovariectomized .The rats were given Flu(20 ,10 ,5 mg/kg) through intragastric administration (ig) .After treating for 12 weeks ,weighed all rats ,then sacrificed all rats ,removed the uterus and weighed its wet weight ,and calcu-lated uterus index ;the levels of E2 ,TNF-α,IGF-1 and BGP in serum were detected .Results Flu did not affect the uterus weight in experimental osteoporosis rats ;20 mg/kg Flu could increased the osteoporosis rat′s serum levels of E2 and IGF-1(P<0 .05) ,de-creased the levels of TNF-αand BGP(P<0 .01);10 mg/kg Flu could decreased the osteoporosis rat′s serum levels of BGP .Conclu-sion Flu could increased the levels of E2 ,IGF-1 ,and decreased the levels of TNF-α,BGP in experimental osteoporosis rats .

The objective of this work was to develop a valuable adsorbent for recovery of platinum by studying the properties of Pt4+ -adsorption with immobilized Citrobacter freudii XP05 biomass. Five methods for immobilization of Citrobacter freudii XP05 biomass were compared. The method with gelatin-alginate sodium as entrapment matrix was considered to be the optimal. Spherical and uniform beads were produced and the SEM micrograph indicated that the cell of strain XP08 were uniformly dispersed within the matrix. The adsorption of Pt4+ by immobilized XP05 biomass was affected with adsorptive time, pH value of the solution, immobilized biomass concentration, Pt4+ initial concentration The adsorption was a rapid process. The optimal pH value for Pt4+ adsorption was 1.5, and its adsorptive capacity increased linearly with increasing Pt4+ initial concentrations in the range of 50 - 250 mg/L. The experimental data could be fitted to Langmuir and Freundlich models of adsorption isotherm. The adsorptive capacity reached 35.2 mg/g under the conditions of 250 Pt4+ mg/L, 2.0 g/L immobilized biomass, pH 1.5 and 30 degrees C for 60 min. 98.7% of Pt4+ adsorbed on immobilized biomass could be desorbed with 0.5 mol HC1/L. The characteristics of dynamic adsorption and desorption of immobilized XP05 biomass in packed-bed reactor were investigated. The saturation uptake was 24.66 mg Pt4+ /g under the conditions of flow rate 1.2 mL/min, pH 1.5, 50 mg Pt4+/L and 1.85 g biomass(dry weight) . Adsorptive efficiency of Pt4 + by the immobilized XP05 biomass was above 78% for 4 cycles of adsorption and desorption. The recovery of platinum from waste platinum catalyst was studied. The adsorptive capacity was 20.94 mg Pt4+/g immobilized biomass under the conditions of 4.0 g/L immobilized XP05 biomass, 117.76 mg Pt4+/L and pH 1.5 for 60 min. The immobilized XP05 biomass is potentially applicable to the recovery of platinum from waste and wastewater containing platinum.
Biomass ; Bioreactors ; microbiology ; Citrobacter ; metabolism ; Microscopy, Electron, Scanning ; Microspheres ; Platinum ; isolation & purification ; metabolism ; Waste Disposal, Fluid ; methods ; Water Pollutants, Chemical ; isolation & purification ; metabolism

BACKGROUNDA wealth of evidence has indicated that labor epidural analgesia is associated with an increased risk of hyperthermia and overt clinical fever. Recently, evidence is emerging that the epidural analgesia-induced fever is associated with the types of the epidural analgesia and the variations in the epidural analgesia will affect the incidence of fever. The aim of the present study was to investigate the effects of epidural analgesia with 0.075% or 0.1% ropivacaine on the maternal temperature during labor.

METHODSTwo hundred healthy term nulliparas were randomly assigned to receive epidural analgesia with either 0.1% ropivacaine or 0.075% ropivacaine. Epidural analgesia was initiated with 10 ml increment of the randomized solution and 0.5 µg/ml sufentanyl after a negative test dose of 5 ml of 1.5% lidocaine, and maintained with 7 ml bolus doses of the above mentioned mixed analgesics every 30 minutes by the patient-controlled epidural analgesia. The measurements included the maternal oral temperature, visual analog scale pain scores, labor events and neonatal outcomes.

RESULTSEpidural analgesia with 0.075% ropivacaine could significantly lower the mean maternal temperature at 4 hours after the initiation of analgesia and the oxytocin administration during labor compared with the one with 0.1% ropivacaine. Moreover, 0.075% ropivacaine treatment could provide satisfactory pain relief during labor and had no significant adverse effects on the labor events and neonatal outcomes.

CONCLUSIONEpidural analgesia with 0.075% ropivacaine may be a good choice for the epidural analgesia during labor.

Adult ; Amides ; administration & dosage ; therapeutic use ; Analgesia, Epidural ; adverse effects ; Analgesia, Obstetrical ; adverse effects ; Body Temperature ; drug effects ; Female ; Fever ; chemically induced ; Humans ; Labor, Obstetric ; Pregnancy ; Young Adult

OBJECTIVETo observe the effects of combined treatment with sansanmycin and macrolides on Pseudomonas aeruginosa and formation of biofilm.

METHODSMicro-dilution method was used to determine the minimal inhibitory concentrations (MICs) of sansanmycin, gentamycin, carbenicillin, polymyxin B, roxithromycin, piperacillin, and tazobactam. PA1 and PA27853 biofilms were observed under optical microscope after staining and under SEM after treatment with sansanmycin at different dosages and combined treatment with sansanmycin and roxithromycin. Viable bacteria in PA1 and PA27853 biofilms were counted after treatment with sansanmycin at different dosages or combined treatment with sansanmycin and roxithromycin.

RESULTSThe MIC of sansanmycin was lower than that of gentamycin and polymyxin B, but was higher than that of carbenicillin. Roxithromycin enhanced the penetration of sansanmycin to PA1 and PA27853 strains through biofilms. PA1 and PA27853 biofilms were gradually cleared with the increased dosages of sansanmycin or with the combined sansanmycin and roxithromycin.

CONCLUSIONSub-MIC levels of roxithromycin and sansanmycin substantially inhibit the generation of biofilms and proliferation of bacteria. Therefore, combined antibiotics can be used in treatment of intractable bacterial infection.

Animals ; Anti-Bacterial Agents ; administration & dosage ; pharmacology ; Bacterial Adhesion ; drug effects ; Biofilms ; growth & development ; Cercopithecus aethiops ; Drug Therapy, Combination ; Macrolides ; administration & dosage ; pharmacology ; Microbial Sensitivity Tests ; Oligopeptides ; administration & dosage ; pharmacology ; Pseudomonas aeruginosa ; drug effects ; physiology ; ultrastructure ; Uridine ; administration & dosage ; analogs & derivatives ; pharmacology ; Vero Cells

Objective To investigate the ICU nurses' mastering degree about the related knowledge of "severe infection and guidelines for the treatment of septic shock", and to evaluate the effect of centralized training in sepcial knowledge. Methods A centralized training was given to the ICU nurses of our hospital based on the contents of guidelines. The nursing staff's mastering degrees about the related knowledge of resuscitation therapy of septic shock were surveyed using a questionnaire before and after the training. Results The rate of awareness about the contents of guidelines in ICU nurses of this group after the training increased by 28.5% compared to that after the training. The total scores before and after the training and the scores of four aspects were compared. The total scores were (14.50±3.53) and (16.08±4.29) before and after the traning, respectively. The difference had a statistical meaning (P < 0. 05). Conclusions The ICU nurses' mastering degrees about the related knowledge of severe infection and treatment of septic shock are not adequate. The training of related knowledge can improve the nursing staff's mastering degrees of knowledge.

OBJECTIVEMethylmalonic aciduria (MMA) is a common one of the congenital disorders of organic acids metabolism. Some of the patients with the disorder are complicated with homocysteinemia. Recently, gas chromatography-mass spectrometry (GCMS) has been used to diagnose MMA in China. However, the diagnosis of the patients with combined MMA and homocysteinemia is often delayed. In this study, the natural history, clinical features and outcome of 57 Chinese patients with combined MMA and homocysteinemia were investigated.

METHODSFrom 1996 to 2006, 96 MMA patients from 16 provinces or cities were diagnosed in our hospital by urine organic acids analysis using GCMS. Homocysteinemia was found by serum and urine total homocysteine determination using a fluorescence polarization immunoassay.

RESULTSFifty-seven of the 96 MMA patients (59.4%, 32 males and 25 females) were found to have combined MMA and homocysteinemia. They had markedly increased urine methylmalonic acid, total serum homocysteine (81.5 to 226.5 micromol/L vs. normal range 4.5 to 12.4 micromol/L) and urine homocysteine (79.1 to 414.5 micromol/L vs. normal range 1.0 to 25.0 micromol/L). Thirteen (22.8%) of them presented with symptoms resembled hypoxic-ischemic encephalopathy in the neonatal period. Fourteen (24.6%) patients had the onset at the age of one month to 1 year with mental retardation, vomiting and epilepsy. Nine (15.8%) showed developmental delay, seizures, poor appetite or anemia from the age of 1 to 3 years. Eighteen (31.6%) had psycho-motor degeneration at the age of 6 to 15 years. Among them, 7 patients experienced multiple organ dysfunctions with liver dysfunction, hematuria, renal failure and peripheral neuropathy. Three (5.3%) patients developed progressive mental degeneration, motor disorders and anorexia at the ages of 16, 24 and 34 years. Eleven (19.3%) patients ultimately died; 5 (8.8%) of them were diagnosed postmortem. Forty-six (80.7%) patients were treated with vitamin B12, folic acid, L-carnitine and betaine supplementation and 11 (19.3%) of them recovered completely.

CONCLUSIONSCombined MMA with homocysteinemia is a common form of MMA in China. The clinical spectrum of the patients varies from severe neonatal-onset forms with high mortality to milder forms with adult-onset. Serum or urine total homocysteine analysis is important for the deferential diagnosis of the patients with MMA.

Adolescent ; Adult ; Amino Acid Metabolism, Inborn Errors ; complications ; Anemia ; complications ; metabolism ; Carnitine ; metabolism ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Gas Chromatography-Mass Spectrometry ; Homocysteine ; blood ; Humans ; Male ; Metabolic Diseases ; blood ; complications ; metabolism ; Methylmalonic Acid ; urine ; Urologic Diseases ; complications ; metabolism ; Vitamin B 12 ; pharmacology ; Vitamin B Complex ; pharmacology ; Young Adult

OBJECTIVETo investigate the clinical utility of multiplex ligation-dependent probe amplification (MLPA) for detecting 22q11 deletion and duplication in congenital heart disease (CHD) cases and to study the incidence of 22q11 deletion and duplicaton in different kinds of CHD.

METHODSForty eight probes of which 25 located in 22q11 low copy number region (LCR 22s A-H), 7 in 22q11 surrounding region (CES, 22q13) and 16 in chromosomes 4, 8, 10 and 17 were selected to detect 22q11 deletion and duplication in 181 preoperative children with CHD and 14 fetuses with serious CHD or CHD with multiple malformations. In these cases, karyotype analysis was also performed.

RESULTSMLPA demonstrated that 7 cases had 22q11 deletion [6 cases from CLTCL1 to LZTR1(LCR A-D) and 1 case from CLTCL1 to PCQAP (LCR A-C)] and that 1 case had 22q11 duplication,spanning from ZNF74 to LZTR1(LCR B-D). The phenotypes of heart defect included ventricular septal defect, atrioventricular septal defect, pulmonary stenosis and tetralogy of Fallot. Karyotype analysis showed that 1 case had 21q deletion [46, XY, 21q], 1 case had mosaic trisomy 8 [47,XY, +8/46, XY(1:2)] and 4 cases had trisomy 21. One of the 4 cases with trisomy 21 had concurrent 22q11 duplication.

CONCLUSIONSMLPA is a rapid, sensitive, site specific and relatively inexpensive method for diagnosis of 22q11 deletion and duplication in CHD. 22q11 deletion and duplication may cause various kinds of CHD, suggesting that genetic detection should be performed routinely in CHD patients.

Adolescent ; Chromosome Deletion ; Chromosomes, Human, Pair 22 ; Female ; Gene Duplication ; Heart Defects, Congenital ; genetics ; Humans ; Infant, Newborn ; Male ; Nucleic Acid Amplification Techniques ; methods

BACKGROUNDSevere bilateral carotid stenosis caused by atherosclerosis has not been unusual in the elderly. Such patients have high stroke risk. Many studies show that carotid artery stenting (CAS) is an alternative to treat unilateral carotid stenosis. However, the optimal procedural strategy of bilateral carotid stenosis remains unclear. The purpose of our study was to evaluate the safety of simultaneous bilateral carotid artery stenting (SBCAS) compared with unilateral carotid artery stenting (UCAS).

METHODSIn this single-center retrospective study, we analyzed 234 consecutive patients who underwent carotid stenting from January 2005 to December 2009. Thirty-nine patients (16.7%) of them underwent SBCAS, and the others (n = 195) underwent UCAS. Indication for CAS was defined as carotid artery diameter reduction > 60% (symptomatic) or > 80% (asymptomatic). Six-month and 30-day hemodynamic depression (HD), hyperperfusion syndrome (HPS), stroke, death and myocardial infarction (MI) after carotid stenting were assessed.

RESULTSSBCAS group had no more HD and HPS compared with UCAS group at 30 days (HD: 28.2% vs. 20.0%, P = 0.396; HPS: 2.6% vs. 2.1%, P = 0.262). Moreover, there was no statistically significant difference between SBCAS group and UCAS group in major stroke, death, MI and their combinations within 30 days (major stroke: 0 vs. 3.6%, P = 0.604; death: 2.6% vs. 1.5%, P = 0.520; MI: 2.6% vs. 0.5%, P = 0.306; and their combinations: 5.1% vs. 4.6%, P = 1.000) and 6 months (major stroke: 0 vs. 3.6%, P = 0.604; death: 5.1% vs. 2.1%, P = 0.262; MI: 5.1% vs.1.0%, P = 0.130 and their combinations: 7.7% vs. 5.1%, P = 0.459).

CONCLUSIONSThe patients undergoing SBCAS had no more events than those undergoing UCAS in 30-day and 6-month follow-up. Our finding suggests that SBCAS appears to be as safe as UCAS.

Aged ; Angioplasty, Balloon ; adverse effects ; Carotid Stenosis ; physiopathology ; therapy ; Female ; Hemodynamics ; Humans ; Male ; Middle Aged ; Postoperative Complications ; etiology ; Retrospective Studies ; Stents ; adverse effects ; Time Factors

OBJECTIVETo evaluate the selection of different procedures and the feasibility for the treatment of long segment urethral stricture.

METHODSSeventy-six patients with complex urethral stricture greater than 8 cm long underwent different procedures of urethroplasty. Of them various mucosa grafts urethral reconstruction were adopted in 42 cases (colonic mucosal graft, n = 26; buccal mucosal graft, n = 10; bladder mucosal graft, n = 6); One-stage pedicle flaps urethroplasty in 20; two-stage urethroplasty of Johanson procedure in 12; and penile urethra-prostatic urethra anastomosis, three-stage urethroplasty in 2.

RESULTSIn early followed up (within 6 months postoperatively), 67 patients (88%) voided well and complications developed in 10. Among the 70 patients who lasted more than 1 year after operation, 51 cases were followed up. Forty-four patients voided well, and complications developed in 8. Of the 8 cases urethral restructure developed in 2 (18%) for pedicle flaps urethroplasty, 2 for colonic mucosal urethroplasty (9%), 1 for buccal mucosal graft (1/7), 1 for bladder mucosal graft (1/3); penile chordee in 2 (2/5), and one of them was accompanied by hair bearing neourethra for two-stage urethroplasty of Johanson procedure.

CONCLUSIONSColonic mucosal and buccal mucosal grafts urethroplasty are feasible procedures for the treatment of long segment urethral stricture, and Colonic mucosal graft urethroplasty may be considered when more conventional procedures fail or complicated urethral strictures greater than 10 cm long.

Adolescent ; Adult ; Aged ; Follow-Up Studies ; Humans ; Intestinal Mucosa ; surgery ; Male ; Middle Aged ; Mouth Mucosa ; surgery ; Surgically-Created Structures ; Treatment Outcome ; Urethral Stricture ; pathology ; surgery ; Urologic Surgical Procedures, Male ; methods