Objective To repair and reconstruct severe burn wounds on face,hands and joints with the principles and techniques of plastic and aesthetic surgery.Methods Twenty three burn victims in a single batch were transferred from a remote area to our Burns Institute on post burn day 2,June 28,2006.All the patients were males aged from 17 to 46 years,with a mean of 24.4?6.3 years,the mean total burn area was 15.7%?13.9% TBSA(ranged from 6% to 75%),with moderate to severe inhalation injury,and fourteen of them had received tracheostomy.The burn areas on face ranged from 0.5% to 3% TBSA,and all of them were deep second or third degree burn.The burn areas on hands ranged from 1% to 4% TBSA of deep second or third degree.On post burn day 3,the patients received escharectomy or tangential excision of eschar on hands followed by split thickness skin grafting with the principles and techniques of plastic and aesthetic surgery.During post burn week 2 to 3,the eschar on the faces were peeled off,followed by split-thickness skin grafting according to the principles and techniques of plastic and aesthetic surgery.Results All the wounds on the face and joints were repaired successfully,the configuration and functions were satisfactory.Conclusion It is feasible to repair the burn wounds on face and joints with the principles and techniques of plastic and aesthetic surgery for the burn patients of mass fire catastrophe.

Objective To investigate the effects of acupuncture rehabilitation techniques combined with Xingnaojing injection on functional recovery and the plasam level of glial fibrillary acidic protein (GFAP) in patients with severe traumatic brain injury (STBI).Methods Eighty-four patients with STBI admitted to Department of Neurosurgery in Jiuquan People's Hospital from October 2013 to December 2015 were enrolled,they were divided into observation group (44 cases) and control group (40 cases) by random number table,all patients received the routine basic treatment,such as decreasing intracranial pressure,anti-infection,neural nutrition therapy,etc.In addition,the observation group was treated with acupuncture rehabilitation training (each training 50 minutes,1-2 times a day,10 times as a course of treatment,a total of 5 courses) and Xingnaojing injection (in 0.9％ normal saline or 5％ glucose injection 250 mL intravenous infusion,one time a day,10 days as a course of treatment,a total of 3 courses).The evaluation score of Montreal cognitive assessment (MoCA),Modified Barthel index (MBI),Fugl-Meyer assessment (FMA) of motor function score and the plasma levels of GFAP and myelin basic protein (MBP) were measured before and after treatment in the two groups.Results After treatment,the MoCA,MBI and FMA scores were significantly higher in two groups than those before treatment (all P ＜ 0.05),the contents of MBP and GFAP were significantly lower than those before treatment,and the changes in observation group were more significant than those in control group [visual space and execution capability (score):4.99 ± 0.67 vs.3.42 ± 0.73,denomination capability (score):2.98 ± 0.77 vs.2.84 ± 0.47,delayed memory (score):5.76± 0.33 vs.3.87± 2.08,attention (score):6.17± 0.65 vs.4.75 ± 0.81,speech capability (score):3.51 ± 0.46 vs.2.04 ± 0.13,abstract thinking capability (score):2.94 ± 0.27 vs.1.58 ± 0.96,orientation force (score):6.02±0.65 vs.4.88±0.62,FMA score:68.71 ±34.17 vs.41.13 ± 14.82,MBI score:69.12± 10.45vs.37.63±6.11,MBP (μg/L):1.32±0.23 vs.5.31±0.79,GFAP (μg/L):0.19±0.08 vs.0.39±0.04,all P ＜0.05].Conclusions Acupuncture rehabilitation training combined with Xingnaojing injection may obviously improve the cognitive and motor functions in patients suffered from STBI,and clinically the combined treatment is worthwhile to be used extensively.

Objective To explore a method of large cranial bone defect reconstructed by titanium implant with computer aided design(CAD)/computer aided manufacture(CAM)technique.Methods From April 2006 to June 2008,7 cases of cranial bone defect due to tumor and trauma were admitted.The data of skull bone defects were obtained by CT.The resin model was designed and manufactured with rapid prototyping technique.Results The CT data could be used by image software directly.The resin model was manufactured accurately by RP technique.The titanium implant design could be completed by CAD/CAM.7 patients achieved one stage healing.After a follow-up of 6 months to 1 year,cranial bone defect was reconstructed satisfactorily.Conclusion Individual design and repair of large cranial bone defect with CAD/CAM technique is worth extending application clinically.It is a quite ideal and very simple method for the surgical treatment of the cranial bone defect.

0.05).CART vaccine at 10?g significantly depressed the analgesic effect of morphine analgesia (P

OBJECTIVETo investigate the quality of life ( QOL) of inpatients with coal workers' pneumoconiosis( CWP) and analyse its influential factors, and to provide a theoretical basis for effective control measures.

METHODSEighty-eight CWP patients in a hospital were included in the study. A questionnaire survey was conducted in them using a self-designed QOL scale. A database was established by software EpiData3.1, and the obtained data were statistically analyzed by software SPSS 16.0.

RESULTSOf the 88 patients, 73( 82.9%) had middle-level QOL, with a mean QOL loss rate of 36.2%; the loss rates of physical function and somatic sensation were the highest ( 44.2% and 41.5%). The patients with stage II CWP had significantly lower physical function than those with stage I and III CWP; the physical function and social function of patients significantly decreased with age; the personal income, household income, and housing condition of the patients had a marked impact on their physical and psychological functions, and the housing condition and education level had a marked impact on their social function. The multivariate analysis showed that old age, low income,and poor housing condition were the main adverse factors for the QOL of inpatients with CWP.

CONCLUSIONThe QOL of inpatients with CWP declines significantly, and their QOL is related to the age, income, and satisfaction with housing condition.

Aged ; Aged, 80 and over ; Anthracosis ; Humans ; Male ; Middle Aged ; Quality of Life

Objective To investigate the recurrence and risk factors of gastric high-grade intraepithelial neoplasia(HGIN)and early gastric cancer(EGC)after endoscopic submucosal dissection (ESD). Methods The clinical and follow-up data on 444 patients(451 lesion)with HGIN and EGC undergoing ESD in Digestive Endoscopy Center of Chinese PLA General Hospital from November 2006 to January 2016 were summarized, and the risk factors of recurrence were analyzed. Results A total of 410 patients were followed-up, and the recurrence rate was 3.2%(13 patients, 13 lesions), with mean recurrence time of 17.6±9.6 months(6-38 months). Univariate and multivariate analysis revealed that the size of the lesion>4.0 cm was the only risk factor of recurrence(P=0.012,OR=10.855,95%CI:1.673~70.442). Conclusion The rate of recurrence is increasing with the EGC extending, therefore, postoperative monitoring should be strengthened to patients with larger lesion.

OBJECTIVETo observe the effect of different concentration of Tamoxifen ointment on the fibroblasts and transforming growth factor (TGF-beta2) of hypertrophic scar at rabbit ears, so as to explore the possibility of treatment of hypertrophic scar with Tamoxifen.

METHODSThe hypertrophic scar model was established in 96 New Zealand rabbits' ears. The wounds were divided into four groups (A, B, C and D), with 144 wounds in each group. Different concentration of tamoxifen ointment (0.5%, 1%, 2%) was topically administered in groups A, B and C respectively, and blank ointment in group D. On postoperative day 30, 60 and 90, the scar samples were harvested. The scar thickness, scar histological change and the content of TGF-beta2 were detected.

RESULTS(1) On the 30th day after operation, the difference of scar tissue thickness among groups A, D and B, C reached statistical significance (group A, D < group B < group C). However, there was a contrary tendency in fibroblasts density and TGF-beta2 content of the scar tissue simultaneously. (2) On 60th, 90th day after injury, there was statistical difference in scar thickness, fibroblasts density and the content of TGF-beta2 in scar of four groups (P < 0.05). The content of TGF-beta2 in group A, B, C, D was (43.97 +/- 3.63) microg/L, (41.92 +/- 3.91) microg/L, (36.69 +/- 4.15) microg/L, (54.90 +/- 4.71) microg/L, respectively, on 60th day; and (45.69 +/- 2.63) microg/L, (40.43 +/- 3.87) microg/L, (38.76 +/- 3.24) microg/L, (52.59 +/- 4.92) microg/L, respectively, on 90th day. The fibroblasts density of scar in groups A, B, C, D was (4392.07 +/- 327.84) point/mm2, (4208.57 +/- 329.76) point/mm2 (4 033.44 +/- 427.91) point/mm2, (4863.03 +/- 387.98) point/mm2, respectively, on 60th day; and (4418.41 +/- 432.52) point/mm2, (4077.65 +/- 386.70) point/mm2, (3844.53 +/- 354.29) point/mm2, (4838.64 +/- 390.52) point/mm2, respectively, on 90th day. The content of TGF-beta2 and fibroblasts density of scar were lined up as group D > group A > group B > group C (P < 0.05).

CONCLUSIONSTopical Tamoxifen can reduce the content of TGF-beta2 and fibroblast, decrease fibroblasts density and the formation of hypertrophic scar at rabbit ears. It offers a new way for the treatment of the hypertrophic scar.

Animals ; Cicatrix, Hypertrophic ; drug therapy ; metabolism ; pathology ; Disease Models, Animal ; Ear Diseases ; drug therapy ; metabolism ; pathology ; Fibroblasts ; drug effects ; pathology ; Ointments ; Rabbits ; Tamoxifen ; pharmacology ; Transforming Growth Factor beta2 ; metabolism

OBJECTIVETo explore an appropriate measure to repair tissue defects and deformities in mandibulo-cervical region.

METHODSEighteen cases with severe tissue defects and deformity in jaw and neck were repaired with thoracic skin flap with multiple blood supply system in our unit from Jan. 2006 to Nov. 2008. Anterior cutaneous branch of transverse cervical artery, intercostal branch of internal thoracic artery and lateral thoracic artery were included in the pedicles.

RESULTSAll skin flaps survived, except in one patient in whom a small belb appeared at the distal end of the island flap with anterior cutaneous branch of transverse cervical artery, and it was healed after a few dressing changes. The functions and appearances were satisfactory after 6-month to 2-year follow-up, without showing secondary deformity.

CONCLUSIONSThe blood supply of thoracic skin flap is abundant and constant, which is an ideal method for repair of tissue defects and deformities in jaw and neck after taking into account some factors, such as the demand of the patient, general physical condition, and the size of the defect.

Adolescent ; Adult ; Child ; Female ; Humans ; Male ; Middle Aged ; Neck ; abnormalities ; surgery ; Reconstructive Surgical Procedures ; methods ; Skin ; blood supply ; Skin Transplantation ; methods ; Surgical Flaps ; blood supply ; Thoracic Wall ; surgery ; Wound Healing ; Young Adult

OBJECTIVETo explore the mechanism of acupuncture on the treatment of glaucoma so as to find out a kind of simple and effect approach to control and stabilize intraocular pressure (IOP) of patients with glaucoma.

METHODSThirty-nine cases (75 eyes) of glaucoma (unstable control of IOP) were treated with acupuncture at Sibai (ST 2), Cuanzhu (BL 2), Jingming (BL 1), Qiuhou (EX-HN 7), etc. IOP before and after acupuncture, at 10 a.m, 2 p.m, 6 p.m, 10 p.m., at 5 a.m. and 7 a.m. on the second day as well as diurnal IOP variation in 24 h were observed separately.

RESULTSAfter acupuncture, IOP at each time point reduced as compared with that before acupuncture. IOP at 5 a.m., 7 a.m., 10 a.m., 6 p.m. and 10 p.m. after acupuncture was different significantly in statistics as compared with that before acupuncture correspondingly (all P<0.05). After acupuncture, 24 h diurnal IOP variation was (5.31 +/- 2.84) mmHg, which was lower significantly than (7.06 +/- 3.86) mmHg before acupuncture (P<0.05).

CONCLUSIONFor the patients with unstable control of IOP, acupuncture can not only reduce IOP, but also stabilize 24 h diurnal IOP variation and benefit the visual function of patients with glaucoma.

Acupuncture Therapy ; Adult ; Aged ; Female ; Glaucoma ; physiopathology ; therapy ; Humans ; Intraocular Pressure ; Male ; Middle Aged

OBJECTIVETo investigate the prognostic impact of heart block during the transcatheter closure of ventricular septal defect (VSD).

METHODSForty three patients developed complete left or right bundle branch block (CLBBB, CRBBB), incomplete left or right bundle branch block (ILBBB, IRBBB), and atrioventricular block (AVB) during and within 1 week post procedure were followuped at 1, 6, 12, 24, 36, 48 and 60 months post procedure. Electrocardiogram, dynamic electrocardiogram and transthoracic echocardiography were made.

RESULTSBundle branch block and atrioventricular block were detected in 26 patients (CLBBB n = 4, CRBBB n = 5, ILBBB n = 2, IRBBB n = 10 and third-degree AVB n = 5) during the transcatheter closure of VSD, and in 17 patients (CLBBB n = 5, CRBBB n = 2, first-degree AVB n = 3, second-degree I-type AVB n = 1 and third-degree AVB n = 6) within 1 week post procedure. Heart block disappeared in 33 patients (76.7%) before discharge, in 37 patients (86.1%) at 1 month and in 41 patients (95.4%) at 6 months post procedure. CLBBB or CRBBB was seen in two cases at 24 months after closure. There was no heart failure and serious cardiac dilatation during follow up.

CONCLUSIONThe heart block occurred during the periprocedure period of transcatheter closure of VSD was a benign phenomenon without prognostic importance.

Cardiac Catheterization ; adverse effects ; Echocardiography ; Follow-Up Studies ; Heart Block ; etiology ; Heart Septal Defects, Ventricular ; therapy ; Humans ; Prognosis ; Treatment Outcome