For the current situation of the time background and the cultivation of innovation ability of undergraduates, the problems of fracture classification, function evaluation and postoperative rehabilitation were realized by a software research team which mainly consisted of medical undergrad-uates. We put the project into practice in forms of software production and software promotion trial separately in the field of teaching and clinical practice to encourage students to be involved in learn-ing in the process of software production of professional knowledge. The implementation of the project worked well, and developed the well-designed relevant mobile software which was convenient in clini-cal practice and acquired computer software copyright, indicating that it can effectively motivate the undergraduates' innovation interest and consciousness through participating in the various links and the software production process, and it can also contribute to the cultivation of the comprehensive practical and innovation ability of medical undergraduates.

Objective To evaluate the surgical approaches, surgical timing and materials for cranial defect repair in children. Methods From the year 2002 to 2006, 4 children with cranial defect received cranial reconstruction using absorbable poly-L-lactic acid (PLA) material and hydroxyapatite. Results The 3-year follow-up showed that the cranial defect was successfully repaired using the absorbable material in 3 patients and failure of repair occurred in 1 patient. Conclusion Cranial defect in children can be effectively repaired using absorbable materials and hydroxyapatite without obviously affecting the skull development. This approach provides an important option for cranial defect repair in children.

OBJECTIVETo investigate the impact of timing of nasojejunal feeding tube placement and enteral nutrition on clinical outcomes in children with acute pancreatitis.

METHODSA retrospective analysis was performed on the clinical data of 31 children with acute pancreatitis, who received nasojejunal feeding between January 2008 and July 2013, to investigate the relationship of abdominal symptoms/signs and serum amylase level with the tolerability of catheterization and success rate of enteral nutrition. The treatment outcome and incidence of adverse reactions and complications were compared between the early enteral nutrition group ( ≤7 days from the onset of the disease) and late enteral nutrition group (>7 days from the onset of the disease).

RESULTSAbdominal symptoms/signs and serum amylase level were independent of the tolerable rate of catheterization and success rate of enteral nutrition. Compared with the late enteral nutrition group, the early enteral nutrition group had a shortened time to normal serum amylase level, significantly reduced incidence of systemic complications, length of hospital stay, and hospitalization expenses, and less weight gain. The tolerable rate of catheterization and success rate of enteral nutrition showed no significant difference between the two groups. Similarly, no significant differences were found in the increase in albumin level after enteral nutrition, duration of enteral nutrition, incidence of adverse reactions, and incidence of local complications.

CONCLUSIONSAbdominal symptoms/signs and serum amylase level cannot be used as a measure of whether nasojejunal feeding tube placement and enteral nutrition can be performed. Early enteral nutrition can better improve clinical outcomes in children with acute pancreatitis, and it is feasible.

Acute Disease ; Adolescent ; Child ; Child, Preschool ; Enteral Nutrition ; Female ; Humans ; Intubation, Gastrointestinal ; Male ; Pancreatitis ; therapy ; Retrospective Studies ; Time Factors

OBJECTIVETo observe the promoting consciousness effect of electroacupuncture combined with routine western medicine therapy on the patient with coma caused by craniocerebral trauma.

METHODSThirty-two cases were randomly divided into an acupuncture-medication group treated with electroacupuncture at Neiguan (PC 6) and Quze (PC 3) and routine western medicine, and a control group treated with routine western medicine, 16 cases in each group. Glasgow (GCS) scores were assessed after treatment for 7 sessions and 30 sessions respectively and the promoting consciousness rate was observed.

RESULTSAfter treatment of 7 sessions, GCS score was 6.88 +/- 1.63 in the acupuncture-medication group and 5.25-1.65 in the control group with a significant difference between the two groups (P < 0.05); after treatment of 7 sessions, the promoting consciousness rate was 25.0% in the acupuncture-medication group and 0 in the western medicine group, and after treatment for 30 sessions, the promoting conscious ness rate was 81. 3% in the acupuncture-medication group and 43.8% in the western medicine group with a signifi cant difference between the two groups (P < 0.05).

CONCLUSIONElectroacupuncture at Neiguan (PC 6) and Quze (PC 3) combined with western medicine has a good promoting consciousness effect in the patient with coma caused by craniocerebral trauma, which is better than that of simple western medicine.

Adolescent ; Adult ; Aged ; Coma ; drug therapy ; etiology ; therapy ; Combined Modality Therapy ; Craniocerebral Trauma ; complications ; Electroacupuncture ; Female ; Humans ; Male ; Middle Aged ; Young Adult

OBJECTIVETo evaluate the possible side-effects after injecting hydrophilic polyacrylamide gel for augmentation of the soft-tissue.

METHODSFifteen patients with some side-effects after injecting the hydrophilic polyacrylamide gel had been undergoing for the treatment in our unit from 2000 to 2001. Their symptoms were analyzed and the specimen of the tissue was also removed for pathologic examination.

RESULTSThe major complaints of the patients after injecting hydrophilic polyacrylamide gel were feeling pain(60.00%), uncomfortable (13.33%), no cosmetic improvement results (33.33%), secondary deformity (20.00%), long-lasting swelling (6.67%), and nodules (80.00%). The pathologic examination was showing the capsule formation (53.33%), macrophagocyte infiltration (60.00%) and granuloma producing (20.00%).

CONCLUSIONClinical application of the hydrophilic polyacrylamide gel may result in some serious side-effects. It should be cautious to the physicians who may apply the product for clinic use.

Acrylic Resins ; adverse effects ; Adult ; Breast ; drug effects ; pathology ; Female ; Humans ; Injections ; Male ; Middle Aged ; Surgery, Plastic ; adverse effects

OBJECTIVETo explore the influence of inhibition of hypoxia-inducible factor-1 alpha (HIF-1 alpha) by RNA interference (RNAi) on tumorigenesis of human myeloma cell line (HMCL) RPMI8226 cells in nude mice.

METHODRNAi vector of HIF-1 alpha was constructed with commercial shRNA expression vector pSilencer 2. 1-U6 hygro. RT-PCR and western blot were used to detect HIF-1 alpha mRNA and protein expression respectively. Vascular endothelial growth factor (VEGF) secretion and cell cycle changes were detected by ELISA and flow cytometry respectively. Expression of target gene of HIF-1 alpha, VEGF and Glut-1 were tested under hypoxia condition. Tumorigenesis was observed after transfected cells were injected subcutaneously in nude mice.

RESULTSAfter interference, expression of HIF-1 alpha decreased significantly at both mRNA and protein level. Under normoxia condition, VEGF concentrations in HIF-la inhibited cells (RPMI8226-il and RPMI8226-i2) and non-inhibited cells (RPMI8226-c and RPMI8226) showed no differences. While under hypoxia condition, VEGF concentration in the above four cells was (506.0 +/- 53.2), (494.7 +/- 63.1), (984.4 +/- 61.9) and (938.2 +/- 62.2) pg/ml, respectively, being significantly lower in RPMI8226-il and RPMI8226-i2 cells than in RPMI8226-c and RPMI8226 cells (P <0.05). HIF-1 alpha interference was found to suppress the cells shift from S-phase to G1 induced by hypoxia. VEGF and Glut-1 expressions were markedly attenuated (P <0.05). The growth rate of HIF-1 alpha inhibition tumors in subcutaneous xenograft model decreased drastically.

CONCLUSIONSRNAi inhibits HIF-1 alpha expression. Reduced tumor growth by HIF-1 alpha inhibition may partly through inhibiton of angiogenesis and glycolysis metabolism.

Animals ; Cell Cycle ; Cell Line, Tumor ; Genetic Vectors ; Glucose Transporter Type 1 ; metabolism ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit ; genetics ; metabolism ; Mice ; Mice, Nude ; Multiple Myeloma ; metabolism ; pathology ; RNA Interference ; Vascular Endothelial Growth Factor A ; metabolism ; Xenograft Model Antitumor Assays

OBJECTIVETo apply single nucleotide polymorphism array (SNP-array) for the diagnosis of Williams-Beuren syndrome (WBS) in a patient.

METHODSChromosome G-banding and SNP-array were used to analyze a girl featuring mental retardation.

RESULTSThe karyotypes of the child and her parents were all normal, but SNP-array showed a 1.9 Mb deletion at 7q11.23 in the patient. The same deletion was not found in her parents.

CONCLUSIONThe mental retardation and special facies of the girl were probably due to the 7q11.23 microdeletion. SNP-array has an important value for the diagnosis of mental retardation.

Child ; Chromosome Deletion ; Chromosomes, Human, Pair 7 ; Female ; Humans ; Oligonucleotide Array Sequence Analysis ; Polymorphism, Single Nucleotide ; Williams Syndrome ; genetics

OBJECTIVETo study the risk factors associated with lymphatic metastasis of T2 rectal carcinoma.

METHODSA consecutive series of 122 patients with T2 rectal cancer who underwent radical surgery in the First Affiliated Hospital of Fujian Medical University from 2006 to 2011 were included for retrospective analysis. Risk factors associated with lymphatic metastasis were investigated.

RESULTSThe rate of lymph node metastasis was 21.3% (26/122). Distance to anal verge(P<0.05), morphological type(P<0.05), histological type(P<0.05), tumor differentiation(P<0.05), and depth of invasion(P<0.05) were risk factors for lymph node metastasis in T2 rectal cancer by univariate analysis. The depth of invasion remained statistically significant by multivariate analysis. The rate of lymph node metastasis was 13%(7/54) in patients with shallow muscularis propria involvement, and 28%(19/68) in those with deep muscularis involvement.

CONCLUSIONFor T2 rectal cancer with shallow muscularis involvement, the risk of lymph node metastasis is low and transanal excision should be considered.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; pathology ; Male ; Middle Aged ; Rectal Neoplasms ; pathology ; surgery ; Retrospective Studies ; Risk Factors

OBJECTIVESTo evaluate preliminary clinical experience for combining awake craniotomy and intraoperative language brain mapping within the integrated 3.0 T intraoperative magnetic resonance imaging (iMRI) suite.

METHODSFrom December 2010 to April 2011, 11 right hand-dominant patients with left glioma were involved in, or adjacent to, eloquent cortex was carried out awake craniotomies with cortical stimulation within an integrated 3.0 T iMRI suite. Aphasia battery of Chinese was used to test the language function before the operation. During the procedure, after the occipital, temporal, and supraorbital nerves were blocked by the anesthesiologists, the head was fixed with a custom high-field MRI-compatible head holder. The skull and dura was opened as usual and language brain mapping was then performed. Language testing followed a set protocol: counting numbers from 1 to 50, naming objects, reading single words. Resection of the tumor was guided by neuronavigation system and continued until eloquent areas were encountered or the margin of assessment was reached. An interdissection MRI was acquired to evaluate the glioma removal in a movable MRI scanner after minimal draping. Meanwhile, adverse effects caused by electrical stimulation and iMRI were recorded. The follow-up speech tests were assessed on 7th day and 1 month at least after the operation.

RESULTSThe combined use of 3.0 T iMRI and awake craniotomy was performed safely in all patients. No adverse effects were reported. The duration of surgery was prolonged by 2 to 4 h. The patients' perception of iMRI during surgery was favorable. First-look MRI studies led to further resection attempts in 6/11 cases as well as a 3/11 increase in the number of gross-total resections. One week after surgery, baseline language function worsened in 4 cases. However, no patients had a persistent language deficit one month after surgery.

CONCLUSIONSAwake craniotomy and direct cortical electrical stimulation can be performed safely and effectively within a 3.0 T iMRI suite. The combination of high-field iMRI and awake craniotomy may facilitate safe removal of eloquent glioma.

Adult ; Aged ; Anesthesia ; methods ; Brain Neoplasms ; surgery ; Cerebral Cortex ; surgery ; Craniotomy ; methods ; Female ; Glioma ; surgery ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Monitoring, Intraoperative ; Neuronavigation ; methods ; Wakefulness

OBJECTIVETo report the preliminary experience in clinical application of 3.0 T intraoperative magnetic resonance imaging (iMRI) neuronavigation system in China.

METHODSFrom September 2010 to March 2011, a consecutive series of 122 patients with intracranial lesions underwent operations in guidance with 3.0 T iMRI. A retrospective analysis was conducted regarding clinical efficiency.

RESULTSAmong 122 procedures, the numbers of intraoperative scanning were 2 - 4 times with an average of 2.6. The qualities of images were excellent. Due to the discovery and further possibility of resection of residual tumors, the ratio of gross total resection was increased from 71.7% to 90.0% in cerebral gliomas (n = 60), while from 75.9% to 93.1% in macroadenomas (n = 29). There were 6.7% of all patients occurred postoperative paralysis, but only 3.3% of patients had persistent paralysis at 1 - 2 months follow-up. There was no iMRI-related adverse event occurred. During the same period, more than 2500 patients underwent diagnostic MRI scanning.

CONCLUSIONS3.0 T iMRI neuronavigation system provides high-quality intraoperative structural, functional and metabolic images for real time tumor resection control and accurate functional preservation, resulting in an improvement in maximal safe brain surgery. The system is cost-effective.

Adolescent ; Adult ; Aged ; Brain Neoplasms ; surgery ; Child ; Female ; Glioma ; surgery ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neuronavigation ; methods ; Pituitary Neoplasms ; surgery ; Retrospective Studies ; Young Adult