Objective To explore the combined toxicity of dominant volatile organic compounds(VOCs) and ammonia in indoor air of newly decorated rooms.Methods The gaseous mixture of several main components of VOCs and ammonia was prepared using their pure chemical reagents based on the percentage of mass proportion to each pollutant calculated by the medians of concentrations of formaldehyde,benzene,methylbenzene,dimethylbenzene,ethylbenzene and ammonia obtained from the in situ monitoring data on indoor air of 45 newly decorated apartments.The Kunming mice were exposed to the prepared gaseous mixture at doses of 3.93,8.47,18.24 and 39.35 g/m3 for acute toxicity test,and at doses of 3.935 g/m3(higher dose),1.970 g/m3(middle dose)and 0.393 g/m3(lower dose)for sub-acute toxicity test respectively.Results The LC50 of the prepared gaseous mixture was 26.84 g/m3 for Kunming mice.The sub-acute toxicity test showed that the lower levels of reticulocyte count of female mice in each dose group,the lower level of HCT of female mice dose group,the lower levels of PLT in serum of female and male mice in higher dose group,higher activity of ALT in serum of female mice in higher dose group showed significant differences compared with those of controls (P

[Objective] To explore the effect of B-Twin intervertebral cage for degenerative lumbar instability with posterior mini-incision.[Methods]Thirteen patients(13 disc-spaces)treated with B-Twin intervertebral cage in combination with autogenous morselized bone were enrolled in this study.Among the patients,11 had degenerative instability in L4、5 and 2 in L5S1.Patients were graded postoperatively with JOA scoring system.[Results]The lower back pain and leg pain were relieved significantly in all patients after operation.All were followed-up for an average of 16.2 months,and the JOA scores inproved from 4.2 preoperatively to 14.4 at the final follow-up.The good to excelleat rate was 92.3%.The bony fusions presented in an average of 19.8 weeks postoperatively by CT scan.Neither cage loosening nor neurological injury was found.[Conclusion]B-Twin intervertebral cage combined with autogenous morselized bone insertion for lumbar degenerative instability by posterior mini-incision operation is a good technique,which could achieve satisfactory clinical results with less injury.

Humans are negatively affected by parasitic infection.However, recent researches revealed that to some extent, parasitic infections are advantageous to humans.Parasitic infections are found to benefit patients of inflammatory bowel disease, diabetes mellitus, autoimmune disease and allergic disorder.Furthermore, they promoted studies on pathogenesis of these diseases, and therefore on safe and effective therapeutic strategy.In addition, by taking the Caenorhabditis elegans as model organism, researchers have made a breakthrough in the area of life science, including signal transduction, functional genomics and drug screening.

Objective To compare the difference of function regain level of spinal cord after operative or non-operative treatments of cervical spinal cord injury without fracture dislocation. Methods Twenty-four cases with cervical spinal cord injury without fracture dislocation were retrospectively analyzed and divided into operative treatment group ( n =13) and non-operative treatment group ( n =11). JOA (Japanese Orthopaedic Association) scores at injury and during follow-up were recorded to make a comparison between operative treatment group and non-operative treatment group before and after treatment. Results JOA scores three months after treatment were 1.64?0.58 in the non-operative group and 3.29 ?0.90 in the operative treatment group. JOA scores 12 months after treatment were 2.00? 0.73 in the non-operative group and 4.93?0.96 in the operative treatment group. There was a significant difference statistically between both groups through t test ( P

BACKGROUND:The clinical research have found that the interbervebral disc herniation often occurs in several members or even al the members of a family, and the location, reason and symptom are basical y the same, indicating that genes play an important role in this kind of disease. OBJECTIVE:To analyze the apoptosis Fas gene expression characteristics of lumbar disc in the familial patients with intervertebral disc herniation. METHODS:Semi-quantitative reverse transcription-PCR was used to test Fas gene expression of vertebral pulp and cartilage endplate in the intervertebral disc among 15 familial patients, 21 ordinary patients and five fresh cadavers. RESULTS AND CONCLUSION:Fas gene expression level of endplate of familial and ordinary patients with intervertebral disc herniation was higher than that of fresh cadavers, and there was no significant difference (P<0.05);there was no significant difference in Fas gene expression in endplates between familial patients and ordinary patients with intervertebral disc herniation (P>0.05). Compared with the vertebral pulps of ordinary patients with intervertebral disc herniation and fresh cadavers, there was no significant difference in the Fas expression of vertebral pulps of familial patients with intervertebral disc herniation (P>0.05). The increasing Fas gene expression may be secondary in the endplates of familial patients with intervertebral disc herniation, which can prevent intervertebral disc degeneration through preventing the endplate degeneration.

Objective To discuss the differences between hemiarthroplaty and dynamic hip screws (DHS) by comparing their effect in treatment of osteoporotic femoral intertrochanteric fractures. Methods A retrospective study was done on 86 patients with femoral intertrochanteric fractures treated by hemiarthroplasty and dynamic hip screws respectively. After a follow-up for six months, the operation duration time, loss of ambulatory grades and prosthesis loosing were compared between two groups. Re-suits Operation was lasted for hmgcr time in DHS group, with significant difference between two groups. Loosening rate varied with different degree of osteoporosis in high-, moderate- and low-risk groups but not in hemiarthroplaty group. Internal fixators penetrating cortical bone occurred in DHS group, with inci-dence rate of 51.2%. On the contrary, no evidence proved loosening of prosthesis in hemiarthroplaty group. Conclusion For osteoporosis patients with intertrochanteric fracture, the hemiarthroplaty is a reasonable alternative to DHS device, for it can help obtain earlier and better functional recovery and less postoperative complication.

Objective To observe the individualized insertion choice in treatment of upper cervical injury with posterior atlantoaxial short-segmental pedicle screws or lateral mass screws and the relevant clinical outcome.Methods A total of 23 cases of upper cervical injuries received skull traction preoperatively.Individual surgery plan including internal fixation using pedicle screws or lateral mass screws as well as diameter,length,entry point,direction,and angle of screws was determined according to their atlantoaxial CT scan and three-dimensional reconstruction results.Results Six cases of Frankel grade C and eight of grade D were all recovered to grade E after operation.All cases presented rigid fixation and bony fusion in the follow-up of 6 to 36 months.Besides,screws were removed after bony fusion for three young cases and one case with left atlas pedicle screws emerged laterally out of cortex.Clinical outcome was all satisfactory.Conclusion Individualized posterior atlantoaxial fixation using pedicle screws or lateral mass screws is an effective way to treat upper cervical injury and gains advantages of stable threedimensional structures,short fixation segments,and few postoperative complications.

Objective To investigate the clinical results of free super-thin peroneal artery perforator flap containing neurovascular axis in reconstruction of hand or foot soft tissue defects.Methods A retrospective case series study was made on 23 cases of hand or foot soft tissue defects admitted from January 2006 to March 2013.There were 16 males and 7 females,with a mean age of 33 years (range,17-51 years).Wounds were located in dorsal hand (n =12),dorsal pedis or amputated forefoot (n =8),greater thenar (n =2) and index finger (n =1) respectively.Defects ranged in size from 5.0 cm × 3.5 cm to 11.5 cm × 7.5 cm.Flap elevating was performed underneath the deep fascia and the perforator supplying the flap was dissected thoroughly,ligated and cut at the location arose from the peroneal artery.Most of the deep fascia except stripe shaped areas along the main blood supply chains was moved sharply and the fat underlying thinned primarily to the subdermal vascular network.After transferred to the recipient site,the flaps were revascularized by anastomosis of the perforating artery and its venae comitantes to appropriate recipient vessels.A total of 15 cases received innervated flap reconstruction.Flap vascularity and cosmetic results were recorded.Hand function was evaluated with the standard set up by the hand surgery branch of Chinese Medical Association.For foot reconstruction,shoe wearing status,gait,pressure-sore,flap sensibility,donor site appearance and complications were evaluated.Results All flaps were transplanted successfully with satisfactory cosmetic results,except that one flap used to cover dorsal ring finger defect left slightly bulky appearance.Mean duration of follow-up was 19 months (range,11-26 months).For hand reconstruction,the functional results were excellent in 6 cases and good in 9 cases.Repairing of foot defects with the flaps caused no problem of shoe wearing and no sore occurred.Normal gait was acquired except two cases of partially amputated foot.If innervated,flap sensibility was restored at least to the degree of S3.Protective sensation and touchpressure sensation were restored in eight non-innervated cases,and two of them were recovered to the degree of S3.There was only suture or small grafting scars on the donor leg and partially sensibility loss of lateral foot without functional defects in 13 cases.Conclusion Free super-thin peroneal artery perforator flap containing neurovascular axis is an easy and reliable technique that can attain satisfactory results for accurate coverage of hand or foot soft tissue defects.

Objective To evaluate the safety and effectiveness of three endoscopic methods for re-moval of common bile duct stones (CBDs)accompanied with periampullary diverticula(PAD).Methods A total of 154 patients hospitalized at Taizhou Hospital and Taizhou No.1 People′s Hospital of Zhejiang prov-ince from December 2012 to July 2013 were divided randomly into three groups,i.e.,EST,EPBD and ES-BD group,and received the treatment of EST,EPBD and limited EST plus EPBD (ESBD)to extract CBDs, respectively.After 12 months of follow-up,the rate of full stone clearance,stones clearance rate in one time,the rate of mechanical lithotripsy,the rate of urgent lithotripsy,the average procedures,the average removal time and the complication incidence among three groups were compared.Results The rates of stone clearance in one time in group ESBD was higher than those of group EST and group EPBD (94.12% VS 78.43%,73.08%;P <0.05)with significant difference.The average procedures in group ESBD was lower than that of group EPBD (1.08 VS 1.31,P <0.05),which also showed significant difference.The occur-rence rates of early complication in group ESBD was lower than that of group EPBD (15.69% VS 34.61%, P <0.05).The occurrence rates of post-ERCP hyperamylasemia in group ESBD was lower than that of group EPBD (5.88% VS 21.15%)with significant difference (P <0.05).The incidence of pneumobilia in group EST was higher than those of group EPBD (52.27% VS 26.19%,P =0.013)and group ESBD (52.27%VS 27.66%,P =0.016).Conclusion The stone extraction efficiency of ESBD is better than that of EST and EPBD.Compared with conventional EST,ESBD shows similar safety level,and is safer than EPBD.So ESBD is a safe and effective method to remove CBDs with PAD.

Objective: To report operative techniques and clinical results of free sural cutaneoadipofascial flap containing the neurovascular axis based on a dominant peroneal perforating artery (DPPA, with a caliber≥0.8 mm) and its concomitant veins for reconstruction of dorsal forefoot soft tissue defects. Methods: The flap was applied in 32 cases with middle to large soft tissue defects in the dorsal forefoot from Aug. 2009 to Dec. 2014. DPPAs arising from the posterolateral intermuscular septum was located and assessed preoperatively with color Doppler flow image and computed tomography angiography. According to the location, size, and shape of the defects, one of these DPPAs was chosen for flap planning. The flap was harvested from the posterolateral aspect of the leg. The neighboring neurovascular axis (one or more of that of the sural nerve, the medial cutaneous nerve, the lateral cutaneous nerve of calf and the sural communicating nerve) was included to ensure vascular supply. According to skin laxity of the donor site, the width of the full harvesting part which should be able to cover the region of the recipient site where pressure and friction force were prominent while wearing shores was decided; the rest was harvested as an adipofascial flap (without skin) to get enough size. After transfer to recipient site, the flap was revascularized by anastomosing the perforating artery and its venae comitantes with appropriate recipient vessels, and reinnervated (antegrade or retrograded methods). Skin grafting was performed on the adipofascial surface of the flap primarily or secondarily. The defects in donor site of the leg was closed directly. Results: All flaps (ranged from 7.5 cm×5.0 cm to 23.0 cm×13.0 cm) were transplanted successfully, and no vascular or donor site problems occurred. All primary skin grafts (19 cases) was partially lost, but only 2 of them need a second grafting. Adipose necrosis occurred in 4 of 13 cases receiving secondary grafting but only needed wound care before surgery. Following up for 11-26 months showed both satisfactory functional and cosmetic results without problems of shoe wearing. Flap sensibility restored at least to the degree of S3. Conclusions The cutaneoadipofascial flap combines the advantages of perforator, neurocutaneous axis, free and adipofascial flaps leaving only suture scar in the donor leg, and is a satisfactory method for free-style and acute coverage of dorsal forefoot defects.