Objective To explore the pathological changes of the middle-small arteries and veins of uremic patients in early stage.Methods Forty patients with chronic kidney disease at Ⅴ stage were randomly subjected in our study.Radial artery and cephalic vein about 0.5 to 1 cm in length were obtained by arteriovenous fistula operations.Cephalic veins from 4 trauma patients were taken as control group.Immunohistochemisty with anti-?-SMA(smooth muscle actin-alpha),BMP-2(bone morphology protein-2) and BMP-7(bone morphology protein-7) antibodies,alizarin Bordeaux staining,HE staining and Masson trichrome staining were carried out to investigate calcification and fibrosis.Results Compared with control group,the expressions of ?-SMA and BMP-2 were up-regulated obviously.Masson trichrome staining indicated fibrosis in the vein from uremic patients.Conclusion Fibrosis may be one of the early pathologic changes in the vein from uremic patients,suggesting the venous alterations may be related to cardiovascular disease of uremic patients.

Epidemiologic Studies ; Humans ; Indium ; toxicity ; Occupational Diseases ; epidemiology ; Occupational Exposure ; adverse effects

Sleep is a common physiological phenomenon of animals.We may have different kinds of sleep disorders in our daily life,such as difficulty falling asleep,insomnia,hypersomnia and changes of sleep patterns,etc.Pain is a subjective response of the body to stimuli of certain degrees.Sleep disorders are closely related to pain:pain can interfere with people's normal physiology and psychology conditions and affect individual's sleep;different kinds of sleep disorders can affect the body' s sensitivity to pain.The relationship between pain and sleep disorders has become one of the most common causality in clinical research.In this paper we summarizes the pathophysiological relation and mutual influence between pain and sleep disorders.

OBJECTIVETo investigate the early clinical efficacy of induced membrane technique for reconstruction of large bone defects after debridement in adults with chronic osteomyelitis of limbs.

METHODSFrom March 2010 to March 2012,a total of 23 adult patients with chronic osteomyelitis of limbs were treated in our department. There were 15 males and 8 females, with a mean age 35.2 years old (ranged from 26 to 49 years old). Sixteen patients had open fracture history. According to the lesion site, there were 12 cases of tibia, 7 cases of femur, 3 cases of humerus, and 1 case of both radius and ulna. Among them, 19 patients had diseases in diaphysis and 4 patients in the metaphysis. The mean interval from infection to operation was 6.9 months (ranged from 4 to 13 months). All the patients were treated by using induced membrane technique. The follow-up evaluation included clinical complications, time of bone healing and limbs function. The Chinese version of SF-36 scores was used in the assessment of quality of life pre- and post-operation.

RESULTSThe average duration of follow-up was (27.6 ± 5.3) months (ranged from 18 to 43 months). Two patients had postoperative flap edge necrosis, 1 patient had superficial iliac incision infection, no obvious complications were recorded. Twenty patients obtained radiological union at a mean time of 4.6 months (ranged from 3 to 7 months). Among them, 16 patients treated with lower limbs surgery achieved full weight-bearing at about 5.2 months (ranged from 4 to 8 months) postoperatively. Four patients suffered from reinfection during follow-up, but 3 of them achieved complete bone healing after the second surgeries with induced membrane technique. At the final follow-up, there was a substantial improvement in each dimension scores and total scores of SF-36 as compared with those before surgery.

CONCLUSIONWhen treating with adult chronic osteomyelitis of limbs, the induced membrane technique can effectively reconstruct large bone defects after debridement, significantly shorten treatment cycle, provide satisfactory results with minimal complications, promote good recovery of limbs function and require relatively simple operation technique.

Adult ; Chronic Disease ; Extremities ; surgery ; Female ; Humans ; Male ; Middle Aged ; Osteomyelitis ; surgery ; Reconstructive Surgical Procedures ; methods

OBJECTIVETo evaluate the early clinical and radiographic outcome of scaphoid non-unions treated with Acutrak headless compression screw.

METHODSFrom January 2008 to July 2011,21 patients with scaphoid non-union were treated in our department. There were 18 males and 3 females with a mean age of (23.6 +/- 4.6) years; 12 cases were on right hand and 9 were on left. According to Herbert-Fisher classification, there were 10 cases with type D1, 7 cases with type D2, 3 cases with type D3, and 1 case with type D4. The mean time from injury to operation was (12.4 +/- 2.7) months. All patients were treated with Acutrak headless compression screw fixation (6 cases received 2 screws fixation, 15 cases received 1 screw fixation, and Matti-Russe bone grafting was applied in 7 cases). The carpal height, the scaphoid index and changes of the scapholunate angle were assessed before and after the operation. Range of motion and grip strength were recorded and the wrist function was assessed according to the Patient-Rated Wrist Evaluation (PRWE).

RESULTSAverage duration of follow-up was (21.3 +/- 3.6) months. All the patients attained radiological union in a mean time of (13.3 +/- 2.4) weeks following the operation. No obvious complications were recorded. The surgical treatment allowed the preoperative mean scaphoid index of 0.61 +/- 0.13 and the preoperative mean scapholunate angle of (59.4 +/- 6.8) degree to be improved to 0.69 +/- 0.10 and (44.3 +/- 8.2)degree postoperatively, respectively. There was a substantial improvement in grip strength and pain amelioration after surgery. The preoperative mean PRWE score of 45.2 +/- 4.7 was improved to 76.1 +/- 5.2 postoperatively. All patients returned back to the original work,the average time from surgery to work was (6.0 +/- 1.1) months.

CONCLUSIONFor scaphoid non-unions, Acutrak headless compression screw fixation can provide anatomical reduction, provide satisfactory results with a high union rate, well return of function and minimal complications in the early stage.

Adolescent ; Adult ; Bone Screws ; Female ; Fracture Fixation, Internal ; Fractures, Ununited ; surgery ; Humans ; Male ; Range of Motion, Articular ; Scaphoid Bone ; injuries ; physiopathology ; surgery ; Treatment Outcome ; Wrist Injuries ; physiopathology ; surgery ; Wrist Joint ; physiopathology ; surgery ; Young Adult

Objective To evaluate the diagnostic yield and safety of transbronchial lung biopsy (TBLB) under virtual bronchoscopic navigation (Direct Path), endobronchial ultrasonography with a guide sheath (GS) and rapid on-site evaluation using an ultrathin bronchoscopy (UNRE) for bacterial infection located in the peripheral third of the lung field. Methods Ninety-seven patients with bacterial infection, which located in the peripheral third of the lung field on CT images, were ran-domly assigned to UNRE (n=49) or non-UNRE (NUNRE, n=48) groups, who were treated in General Hospital of Tianjin Medical University between April 1, 2014 and March 31, 2015. The TBLB guided by UNRE was performed in two groups. The diagnostic yield, safety and complication rate were compared between two groups. Moreover, the differences of autofluo-rescence intensity of alveolar macrophage in alveolar lavage fluid were compared between two groups of patients. Results The diagnostic yield was significantly higher in UNRE group than that of NUNRE group (81.6% vs 56.2%, χ2=7.313, P <0.01). The diagnostic yield was higher in UNRE group with bronchus sign compared to that of NUNRE. All patients had a mild bleeding at the time of biopsy. There were no hemoptysis, pneumothorax or other serious complications. The autofluores-cence intensity of alveolar macrophage was different in different levels of infection in patients. Conclusion The procedure of UNRE has higher diagnostic rate and fewer complications. The careful selection of suitable cases can further improve the diagnostic accuracy. The autofluorescence intensity of alveolar macrophage in alveolar lavage fluid indicates the severity of infection in patients.

Objective To evaluate the effect of small-dose ketamine on the onset time and course of modified electroconvulsive therapy (MECT) in mentally depressed rats.Methods Sixty SPF adult male SpragueDawley rats,aged 2-3 months,weighing 220-250 g,were randomly divided into 6 groups (n =10 each) using a random number table:normal control group (group C),depression group (group D),ECT group,propofol + ECT group (group PE),ketamine + ECT group (group KE) and ketamine + propofol + ECT group (group KPE).The depression model was established by chronic unpredictable mild stress (CUMS).Mter CUMS,C,D and ECT groups received intraperitoneal normal saline 8 ml/kg,group PE received intraperitoneal propofol 100 ml/kg,group KE received intraperitoneal ketamine 10 ml/kg,and group KPE received intraperitoneal ketamine 10 ml/kg + propofol 80 ml/kg.All the groups received ECT once a day for 7 consecutive days starting from the time point when righting reflex was lost except C and D groups.Open-field test was performed before CUMS,at 1 day after CUMS and at the end of each ECT (T0 8).The total distance and the number of standing on the back legs were recorded.Morris water maze test was performed at 2 days after CUMS and 1 day after the end of therapy,and the escape latency and time of staying at the original platform quadrant were recorded.Results Compared with group C,the total distance was shortened and the number of standing on the back legs was reduced,the escape latency was prolonged,and the time of staying at the original platform quadrant was shortened at T1-8 in D,ECT,PE and KE groups and at T1 5 in KPE group,and no significant was found in KPE group in the total distance,number of standing on the back legs,escape latency,and time of staying at the original platform quadrant at T6-8.Compared with group D,the total distance was prolonged and the number of standing on the back legs was increased at T6-8 in ECT and PE groups and at T4-8 in KE and KPE groups,the escape latency was prolonged,and the time of staying at the original platform quadrant was shortened in ECT group,and the escape latency was shortened,and the time of staying at the original platform quadrant was prolonged in KPE group.Compared with ECT and PE groups,the total distance was prolonged and the number of standing on the back legs was increased at T4-7 in group KE and at T4-8 in group KPE,and the escape latency was shortened,and the time of staying at the original platform quadrant was prolonged in KPE group.Compared with group KE,the total distance was prolonged and the number of standing on the back legs was increased at T6.7,the escape latency was shortened,and the time of staying at the original platform quadrant was prolonged in KPE group.Conclusion Small-dose ketamine can shorten the onset time and course of MECT in mentally depressed rats.

Objective: To explore the clinical and anatomical characteristics of coronary slow lfow (CSF) in relevant patients.
Methods: We summarized the patients without coronary angiography (CAG) proved coronary stenosis (stenosis < 40%) while with TIMI indicated CSF in our hospital from 2013-01 to 2015-01. The patients were divided into 2 groups: CSF group, n=56 patients having at least 1 major coronary artery with TIMI frame counts > 27 and Control group,n=55 patients with normal coronary lfow. The related laboratory indexes were examined and relationship between MCV and CSF was studied by multi-logistic regression analysis.
Results: In CSF group, MCV 90.4 (87.48, 92.65) fL and RDW-CV 12.5 (12.30, 13.18) % were lower than those in Control group 92.3 (90.1, 94.3) fL and 13(12.7, 13.4) %,P<0.05; while MCHC 337 (332, 347) g/L and the number of left circumlfex distal braches involved 3 (2, 4) were higher than those in Control group 327.5 (322, 338) g/L and 2 (2, 3),P<0.05. Multi-logistic regression analysis showed that MCV was negatively related to CSF (partial regression coefficient= -0.138, P=0.015), Spearman rank correlation analysis presented that MCV was negatively related to TIMI frame counts (r= -0.201, P=0.009).
Conclusion: Deformability of red blood cells might be involved in pathogenesis of CSF in relevant patients.

Objective To observe the time characteristics of acute aortic dissection (AAD) in Urumqi and its peripheral areas in Xinjiang Uygur autonomous region, and to explore the effect of meteorological conditions on the onset of AAD.Methods Retrospective analysis of the related data of the adult AAD patients diagnosed by imaging examination, and admitted to the First Affiliated Hospital of Xinjiang Medical University from March 2010 to July 2016 was performed. The onset time, the contemporaneous meteorological data, including daily minimum, average, and the highest temperature, daily average air pressure, daily average relative humidity, daily precipitation, daily average wind speed, daily maximum wind speed, and sunshine duration per day were collected. Analysis of concentrated distribution trend of the AAD onset was done by circular distribution statistics. Meteorological conditions were compared between the AAD day and no AAD day. The changes of air temperature 5 days before onset were observed.Results A total of 379 patients were enrolled, with 307 male and 72 female. The ratio of male to female was 4.19:1, the average age was 52.27±12.18; and the underlying diseases was hypertension (about 58.05%); the incidence sites were Urumqi and Changji city. ① The incidence of AAD in Urumqi and its peripheral areas had clear concentrated trend, and the peak period of AAD corresponded to January 1st to 2nd (homogeneity testr = 0.104,r0.05 = 0.009,P < 0.05). ② The minimum, mean and maximal atmospheric temperatures on the AAD day were lower than no AAD day [℃: 4.10 (-9.55, 14.60) vs. 7.75 (-6.70, 16.20), 14.10 (-1.50, 25.00) vs. 17.50 (0.60, 26.78), 8.50 (-6.22, 19.45) vs. 12.10 (-3.60, 20.90), allP < 0.05], sunshine duration was significantly shorter than no AAD day [hours: 8.50 (4.60, 10.70) vs. 8.90 (5.50, 11.50), P< 0.01], and atmospheric pressure were higher than no AAD day [kPa: 91.24 (90.66, 91.75) vs. 91.12 (90.62, 91.61), 19.11 (18.99, 19.22) vs. 19.09 (18.98, 19.19), bothP < 0.05]; there were no significant differences in the incidence of daytime temperature difference, average relative humidity, precipitation, average wind speed, and maximum wind speed between the two groups. ③ the peak period of AAD occurrence was December (38 cases), which was followed by January (36 cases); and there were 26 cases of each month in May, June, July, and September, which were lower than the rest of months. It was shown by the temperature distribution that the minimum average temperature was in January (-12.46 ℃), followed by December (-9.03 ℃); the maximum average temperature was in July [(24.59±3.21)℃], followed by August [(23.14±3.64)℃]. ④ The patients was sorted according to the quartile of daily mean temperature, into < -5.2 ℃, -5.2-10.7 ℃, 10.7-20.4 ℃, and > 20.4 ℃ groups, and each group had 104, 99, 98, 78 cases of AAD, respectively. The number of AAD in lowest temperature group was 1.33 times of the highest temperature group. In the 45-59 and 60-74 years, the number of AAD in lowest temperature group was higher than that in the highest temperature group (50 vs. 36, 26 vs. 13). In patients with hypertension, the number of AAD in lowest temperature group was higher than that in the highest temperature group (60 vs. 44). ⑤ The maximum air temperature, mean air temperature of the day from 5 days before to the onset day of AAD, and the lowest temperature from 3 days before to the onset day of AAD display slowly decrease trends, but there was no significant difference in daily temperature.Conclusions The incidence of AAD in Urumqi and its peripheral areas was concentrated from January 1st to 2nd of each year. When the temperature was lower than -5.2 ℃, AAD were more likely to attack. The 5 days changes of temperature and daily temperature before the attack were relevant with onset of AAD. It was speculated that the weather conditions such as air temperature may affect patient who has a past history of cardiovascular disease to attack AAD.

Objective To observe the efficacy and adverse reaction of ozone therapy combined with gemcitabine and cisplatin (GP) regimen in patients with advanced non-small cell lung cancer.Methods Fifty-five patients with advanced non-small cell lung cancer were enrolled and allocated to treatment group (28 cases) and control group (27 cases).The patients in treatment group received ozone therapy combined with GP regimen,and the patients in control group received GP regimen only.The efficacy,quality of life,adverse reaction and cellular immune function after treatment was compared between two groups.Results There was no significant difference in the efficacy between two groups (P ＞ 0.05).The quality of life after treatment in treatment group was better than that in control group (P ＜ 0.05).The liver function damage in treatment group was lower than that in control group (P ＜ 0.05).The cellular immune function in treatment group was stronger than that in control group (P ＜ 0.05).Conclusion Ozone therapy combined with GP regimen can effectively alleviate adverse induced by GP regimen chemotherapy and significantly improve the quality of life in patients with advanced non-small cell lung cancer.