Objective To observe the curative effect of the treatment of serious femoral neck fractures with vascularized great trochanter bone flap transposition in young adults.Methods Twenty-nine cases were investigated.In which Garden type Ⅲ were 10 and type IV 19.There were 12 ca$,e8 of fresh fractures and 17 old fractures.According to the X-ray films of old fractures,caput femoris necrosis occurred in 7 patients.Tibial tubercle traction was carried out as preoperative preparation as soon as the patients were sent to hospital.The operation was performed by combining hollow-lag-svcrews fixing with vascularized great trochanter bone flap transposition.Results The foUow-up lasted 39 to 84 months,with an average of 54 months.The patients suffering from fresh femoral neck fractures all recovered and no necrosis WaS found.The healing time was between 4 to 6 months,with an average of 4.5 months or so.And old fractures were all healed up almost within the same time.The recovery time of patients who suffered from fractures and necrosis was with an average of 12.5 months.Of 10 cases of old fractures without caput femoris necrosis prior to operation,necrosis occurred in 3 c88es.The functions of hip joints of 15 cases completely recoveTed,and 12 patients were partially restricted.Another 2 patients could not squat because the flexion function was seriously restricted.The crispation of limbs was well corrected.According to Harris standard.the postoperative mean SCOre is 89.2.Concision It is good for treatment of serious femoral neck fractures with vascularized great trochanter bone flap transposition in young adults.

Objective To investigate the choice of methods and time on the treatment of Gustilo type Ⅲ B and type ⅢC open tibia fractures by bone fixation and tissue flap repairing.Methods The clinic data of 136 cases of Gustilo Ⅲ B and Ⅲ C open tibia fractures were retrospectively studied.There were 102 males and 34 females,with average age of 34 years(range 14 to 68 years).Ninety-eight cases were classified as Gustilo type Ⅲ B and 38 cases were type Ⅲ C in degree.In all cases,one hundred and thirteen were treated with onestage external fixation,ninteen cases were treated with secondary bone fixation.Sixty-seven cases of all wounds were repaired by one-stage vascular pedicle skin flap.Seven wounds were repaired by one-stage free flaps with vascular anastomosis.Sixty-two cases were secondary repaired by different flaps after defect tissue under VSD (vacuum-sealing-drainage) treatment by 1 to several weeks,which contains 9 free skin graft,eleven muscle flaps based on posterior tibial artery perforator,thirteen flaps based on fibial artery perforator,fourteen gastrocnemius falps and 15 cross-leg flaps.Results Wound of all cases were healed wholly.Primary union occurred in 121 cases,twelve,cases healed after bone grafting for segmental bone defect.Three cases with delayed union healed after reoperation for infection that caused osteomyelitis and sinus tract.The period of bone healing was form 5 to 12 months.Conclusion The treatment of Gustilo Ⅲ B and Ⅲ C open tibia fractures by onestage or secondary bone fixation and tissue flap repairing get their advantages and disadvantages,but one-stage bone fixation and tissue flap repairing was better where appropriate.

The derivatization towards the hydroxyl groups of steroid environmental endocrine disrupting chemicals,such as estrone(E1),17β-estradiol(E2),estriol(E3) and 17α-ethynylestradoil( EE2),with A,O-bis (trimethylsilyl) trifluoroacetamide ( BSTFA ) as derivatization reagent followed by gas chromatography-mass spectrometry(GC-MS) was studied. The effects of the amount of BSTFA,derivatization temperature and time on the derivatization of target compounds,as well as the stability of steroid derivatives,calibration curves,instrumental quantification limits were investigated. The cleavage mechanism of steroid derivatives characteristic fragment ions was also interpreted. The results showed that better derivatization results were obtained when the amount of BSTFA was 25 μL for 100 μL steroids standard mix solution at 0.01 g/L;it is unnecessary to heating in the derivatization,better results were obtained when the steroids were derivatized with BSTFA at room temperature (20℃) for 10 min. The derivatives of target compounds were stable because their relative response factors(RRFs) had no observable change when deposited at -20℃ for 48 h. Under the optimal conditions,good linear correlation was obtained and the instrumental quantification limit was 0. 3μg/L for E1 and E2,while it was 5μg/L for EE2 and E3.

To evaluate the effect of dexmedetomidine on prognosis after cardiac surgery with cardiopulmonary bypass (CPB) in the patients.For this retrospective study,753 patients of both sexes,aged 18-84 yr,who underwent cardiac surgery with CPB from September 2013 to May 2015,were divided into 2 groups depending on whether or not dexmedetomidine was used during surgical procedures:control group (group C,n=548) and dexmedetomidine group (group D,n =205).Propensity score matching analysis with preset caliper width was used.A total of 197 matched pairs were selected from the patients.The development of postoperative arrhythmia,in-hospital mortality,pulmonary infection after operation,and acute renal injury,length of intensive care unit stay,length of hospital stay and 30-day readmission to the hospital were collected.Compared with group C,the incidence of postoperative tachyarrhythmia and inhospital mortality rate were significantly decreased (P＜0.05),and no significant changes were found in the incidence of postoperative bradyarrhythmia,pulmonary infection after operation and postoperative acute renal injury,length of intensive care unit stay,length of hospital stay and rate of 30-day readmission to the hospital in group D (P＞0.05).Dexmedetomidine can effectively improve prognosis after cardiac surgery with CPB in the patients.

Objective To investigate the instant clinical efficacy of intra-arterial infusion of fasudil combined with routine anti-vasospasm for symptomatic cerebral vasospasm (SCVS). Methods The clinical data of 21 patients with subarachnoid hemorrhage (SAH) due to ruptured aneurysm, who were admitted to authors' hospital during the period from May 2010 and February 2014, were retrospectively analyzed. The lesions included Fisher gradeⅡ(n=2), gradeⅢ (n=16) and gradeⅣ (n=3). Endovascular embolization of the aneurysm was carried out within 48 hours after the confirmation of the diagnosis with total cerebral DSA;no bleeding occurred during the operation and routine anti-vasospasm therapy was given. Within 4-9 days after the onset of the disease, all 21 patients presented SCVS. Half dose systemic heparinization, superselective intra-arterial infusion of fasudil (30 mg fasudil+250 ml saline, lasting for 30 min) were adopted. Reexamination of angiography performed at 15 min after fasudil infusion was employed, and the results were evaluated with NIHSS score by comparing the preoperative findings. Results Imaging examination performed after the treatment showed that significant improvement was obtained in 15 patients and no obvious changes in 6 patients. Clinical symptoms were remarkably improved in 11 patients, partially improved in 4 patients and remained unchanged in 6 patients. The mean NIHSS score was improved from preoperative 28.6 to postoperative 21.2. Conclusion For the treatment of symptomatic cerebral vasospasm, superselective intra-arterial infusion of fasudil is effective and safe, and it has good clinical application value.

Objective:To illuminate the influence of InsB15-23 H-2Kd dtSCT to the morbidity of type 1 diabetes mellitus in NOD mice.Methods:An eukaryotic plasmid encoded membrane-expressed InsB15-23 H-2Kd dtSCT was inoculated into 3 weeks old female NOD mice subcutaneously and the blood sugar and morbidity of type 1 diabetes mellitus were monitored once a week.To illuminate the cellular mechanism of immunologic intervention of membrane-expressed InsB15-23 H-2Kd dtSCT to the course of type 1 diabetes mellitus in NOD mice,the mononuclear cell infiltration of islets was detected by tissue slice and the frequency of IGRP206 2-14 specific CTLs in PBMC was analyzed by FACs.Results: As compared with pcDNA3.1 (-) control ( 60%) and untreated NOD mice ( 80%) , mice immunized with InsB15-23 H-2Kd dtSCT exhibited low level of islet infiltration and low morbidity in 30 weeks old ( 9%) .But the frequency of IGRP206-214 specific CTLs in PBMC of 16 and 40 weeks old mice showed no difference.Conclusion:Membrane-expressed InsB15-23 H-2Kd dtSCT can protect NOD mice from type 1 diabetes mellitus in IGRP206-214 independent pattern.

Adolescent ; Humans ; Hyperthyroidism ; etiology ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; complications

Cytokines ; physiology ; Humans ; Nephritis ; etiology ; Purpura, Schoenlein-Henoch ; etiology

Monitoring engraftment of donor cells after allogeneic hematopoietic stem cell transplantation (allo-HSCT) is supposed to be important for the early diagnosis of graft failure or relapse of malignancy. Several techniques have been reported for this purpose. PCR-based assays analyzing polymorphic short tandem repeats (STR) as markers are attractive because they are sensitive and can be performed rapidly. The intent of this study was to test a novel approach for assessment of donor engraftment using denaturing high-performance liquid chromatography (DHPLC) combined with STR-PCR. The feasibility of this assay and the accuracy of semi-quantitative results were tested in-vitro by using serial DNA mixtures from unrelated individuals. The results showed that dilution experiments of the mock chimerism sample revealed a clear correlation between the percentage of donor or recipient DNA and the proportion of allele peak areas, with the limit of detection for a minor DNA percentage being 5%. Discrimination between donor and recipient was possible in all patients analyzed (n = 51) except for 5 patients whose pre-transplant samples were not available and identical twins in one case. STR results were the same as values obtained by capillary electrophoresis combined with fluorescence labeling multiply PCR. Results were also compared with data obtained with FISH analysis in a subgroup of patients receiving grafts from sex-mismatched donors or with PCR-detectable disease-specific gene products analysis. The results of the microsatellite analysis correlated well with the corresponding clinical findings. Full donor chimerism (FDC) were detected in all patients; decreasing values of donor chimerism were detected concomitantly with the appearance of relapse of disease in 3 patients. Samples from eight patients receiving HLA mismatched-haploidentical transplants from related donors together with cord blood transplants from unrelated donors were analyzed by this method. The results showed all 8 patients achieved FDC derived from related donors. It is concluded that this novel approach allows a rapid, sensitive, economical, auto-mated and non-isotopic STR-PCR testing, thus provides a reliable alternative for assessment of the status of engraftment after allo-HSCT.
Adolescent ; Adult ; Child ; Child, Preschool ; Chromatography, High Pressure Liquid ; methods ; Female ; Graft Survival ; Hematopoietic Stem Cell Transplantation ; methods ; Humans ; Leukemia ; genetics ; surgery ; Male ; Microsatellite Repeats ; genetics ; Middle Aged ; Polymerase Chain Reaction ; methods ; Reproducibility of Results ; Transplantation, Homologous

Objective To investigate the characteristics of attention networks impairment in Parkinson' s disease patients.Methods Attention network test was performed in 28 PD patients and 28 normal controls on the efficiency of three anatomically defined attentional networks:alerting,orienting,and executive control.Results The correct rate of attention network test was significantly lower(P0.05).The relative analysis showed that the Hoehn Yahr stage was positively correlated with the value of executive netwok(r=0.794,P