OBJECTIVETo investigate the effect of treatment methods of non-operation and surgical operation for scapular fracture.

METHODSA retrospective analysis of 52 patients (male 37, female 15, ranging in age from 20 to 48 years, meanly 31 years)with scapular fractures was done. According to Hardegger classification: the scapular body fracture in 24 cases, the surgical neck fracture in 12 cases, the anatomical neck fracture in 3 cases, the glenoidal lip fracture in 6 cases, the scapular spine fracrure in 7 cases. Of all 52 patients,17 cases were treated conservatively, and 35 were undergone surgical internal fixation. When followed up,the clinical examination was done and the X-ray films were taken to measure glenopolar angle (GPA). Hardegger function evaluation system was adopted. The results were analysed statiscally.

RESULTSFifty-two cases were all followed up for 9 weeks to 48 months. Among 17 patients treated by non-operation, Hardegger function evaluation system showed that the result were excellent in 7 cases, good in 6, fair in 2 and poor in 2; the X-ray film results showed that there were 14 cases of GPA > 20 degrees and 3 cases of GPA < 20 degrees. Of 35 patients treated by surgical operation, Hardegger function evaluation system showed that the result were excellent in 20 cases,good in 12 and fair in 3; the X-ray film results showed that there were 33 cases of GPA > 20 degrees and 2 cases of GPA < 20 degrees. There was no significant difference between the two groups (P = 0.27).

CONCLUSIONBefore treatment of scapular fracture, with CT 3D -recontruction, complete understanding of fragments displacement, and correction indication selection, and perform early exercises, both of the two procedures can provide satisfactory outcome.

Adult ; Female ; Fractures, Bone ; diagnostic imaging ; physiopathology ; surgery ; therapy ; Humans ; Male ; Middle Aged ; Radiography ; Retrospective Studies ; Scapula ; diagnostic imaging ; injuries ; physiopathology ; surgery ; Treatment Outcome ; Young Adult

Objective To investigate the hope level and its influencing factors in chronic obstructive pulmonary disease(COPD)patients.Methods Questionnaires were randomly applied to investigate the hope level and its influencing factors of 76 patients with chronic obstructive pulmonary disease with acute exacerbation (AECOPD).Results The hope level scores were in the range of 21-45 interval,and the mean score was (34.92 ±4.89).97.37％ of AECOPD patients were in mid-high level.Univariate analyses showed that family relationship,monthly salary,activities of daily living(ADL),disease severity were influential factors(P＜0.05).HHI of AECOPD with different respiratory training was different(F =3.76,P ＜ 0.05),and the score of those never exercise was(34.29 ±5.12),(37.08 ± 1.00)in those exercise more often,and(41.50 ±3.54)of those exercise every day.HHI of patients with different oxygen-intake time was different(P ＜ 0.01).Multivariate multiple linear regression analysis showed that monthly salary and ADL were influential factors,and the more salary,and the more hope-level.ADL,oxygenintake time month salary,and disease severity were related to hope-level of patients by multivariate analyses in oxygenintake patients(P ＜ 0.01).Conclusions For nursing care of the COPD patients,attention should be paid on improving the hope level,interfering in the correlated influencing factor as soon as possible so as to continuously improve the quality of life.

Objective To explore the influence of Xihuang Pill on the levels of hormones and receptors in hypothalamus -pituitary-ovary axis and the index of ovary and uterus organs in rats .Methods Wistar female non-pregnant rats were randomly divided into 5 groups ( n =10 in each group):blank group,control group and medium,high and low dose experi-mental groups.Each rat in the control group was given 1.8 mg· kg-1· d-1 tamoxifen;and each rat in the high , middle and low dose experimental groups was given 2.16,1.08 and 0.54 g· kg -1· d-1Xihuang Pill for gastric perfusion,and the blank group was given distilled water with equal volume.The serum levels of gonadotropin -releasing hormone ( GnRH), follicle stimulating hormone (FSH) and luteinzing hormone (LH),estra-diol(E2),progesterone were detected by enzyme linked immunosorbent assay.The expression of follicle stimulating hormone receptor (FSHR) and luteinizing hormone receptor (LHR) in ova-ries were detected by Western blot.Results GnRH in blank group,control group and high,middle and low dose ex-perimental groups were ( 14.99 ±2.33 ), ( 14.63 ±3.39 ), ( 11.90 ±1.11 ), ( 5.55 ±1.05 ), ( 14.82 ±1.47 ) ng· L-1,respectively;comparison between high ,middle dose experimental groups and blank group ,the difference was significant ( all P ＜0.01 ) .E2in the 5 groups were ( 16.84 ±4.20 ), ( 9.10 ±4.76 ), ( 13.38 ±2.12 ), (13.45 ±4.14),(16.32 ±4.23) ng· L-1,respectively;comparison between control group and blank group ,the di-fference was significant ( P ＜0.01 ) .Progesterone in the 5 groups were ( 164.46 ±14.90 ), ( 189.99 ±23.35 ), (187.12 ±17.23),(196.25 ±15.87),(173.26 ±14.07) pmol· L-1,respectively;comparison between control group and high,middle dose experimental groups with blank group ,the difference was significant ( P＜0.05 or P＜0.01 ). Conclusion Xihuang Pill can reduce the contents of GnRH and E 2in serum of rats and increase the content of progesterone,which indicates that Xihuang Pill can have an influence on hypothalamic -pituitary-ovarian axis related hormones.

Adult ; Aged ; Carcinoma, Hepatocellular ; genetics ; pathology ; Female ; Gene Expression ; Humans ; Intercellular Signaling Peptides and Proteins ; genetics ; Liver Neoplasms ; genetics ; pathology ; Male ; Middle Aged ; Neoplasm Metastasis ; RNA, Messenger ; genetics ; Young Adult

OBJECTIVETo investigate the proper time of cryo-preserving tracheal allograft so as to minimize its antigenicity.

METHODSOn a dog model, this study was carried out by allografting a tracheal into a muscular flap formed with sternocephalic muscle and sternohyoid--sternothyroid muscle. The tracheal was treated with cryopreservation in defferent intervals. The viability of the graft was evaluated by the examination of fiberoptic bronchoscopy, histopathology and microangiography. The blood flow of the tracheal mucous was measured with a blood flowmeter and the survival area was decided in the calculation of the percentage.

RESULTSThere are no significant differences in the mucous membrane appearance and the mucosal blood flow one week after the surgery among the non-cryopreservation group and the groups treated with cryopreservation in 1 day, 2 weeks, 4 weeks, 6 weeks and 8 weeks. The graft was found to start necrosis 2 weeks after the transplantation with the infiltration of mononuclear cells examined under light microscope in almost all of the groups, especially in the non-cryopreservation group and the groups treated with cryopreservation in 1 day, 2 weeks. However, there was no significant difference among the autograft group and the allograft groups cryopreservated in 6 weeks and 8 weeks, and the infiltration of the mononuclear cells was not found in these groups either.

CONCLUSIONThe antigenicity of the tracheal allografts could be significantly decreased by the treatment of cryopreservation over 6 weeks.

Animals ; Bronchoscopes ; Cryopreservation ; methods ; Dogs ; Flowmeters ; Models, Animal ; Respiratory Mucosa ; blood supply ; pathology ; Trachea ; immunology ; pathology ; transplantation ; Transplantation, Homologous

OBJECTIVETo evaluate the surgical outcomes for patients with locally recurrent rectal cancer (LRRC) and to analyze the prognostic factors.

METHODSClinical data of 187 patients with LRRC undergoing surgery at the First Hospital of peking University from January 1985 to December 2009 were retrospectively reviewed.

RESULTSProcedures performed included local resection(n=34), abdominoperineal resection (n=35), posterior pelvic exenteration (n=17), total pelvic exenteration(TPE, n=98), TPE with sacrectomy (n=2), and TPE with internal hemipelvectomy (n=1). The operation was R0 in 87 patients, R1 in 60, and R2 in 40. The degree of radical resection was associated with the initial surgery and the degree of pelvic fixation (P<0.05). The pelvic recurrence rate was 44.4%(64/144). The operative morbidity and mortality were 47.5%(89/187) and 2.7%(5/187), respectively. The overall 3- and 5-year survival rates were 42.2% and 30.7%, respectively. The degree of radical resection and lymph node metastasis were independent risk factors associated with prognosis. The 5-year survival rates of R0, R1 and R2 were 42.6%, 17.2% and 0, respectively(P<0.01). The 5-year survival rates of patients with and without lymph node metastasis were 5.6% and 40.5%(P<0.01) respectively.

CONCLUSIONAccurate evaluation of extent of pelvic fixation and achievement of R0 resection are critical to improve the surgical outcomes for LRRC.

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; surgery ; Pelvic Exenteration ; methods ; Prognosis ; Rectal Neoplasms ; mortality ; pathology ; surgery ; Retrospective Studies ; Survival Rate

OBJECTIVETo evaluate the effect of combined resection for the treatment of T(4) gastric cancer and to refine the indication for en bloc dissection.

METHODSClinical data of 69 cases receiving combined resection were analyzed retrospectively, and compared with those of 45 cases undergoing palliative gastrectomy.

RESULTSOf 69 cases, 54 patients underwent curative combined resection, 15 patients underwent palliative combined resection, including 24 with transverse colectomy, 22 with pancreatico-splenectomy, 8 with left lateral lobectomy of liver, 6 with pancreatico-splenectomy and transverse colectomy, 5 with pancreaticoduodenectomy, 2 with cholecystectomy, 1 with splenectomy, 1 with phrenectomy. The total rate of lymph node metastasis was 88.4%; the operative mortality rate was 4.3%; the morbidity rate was 14.5%. The postoperatively 1-, 3-, 5-year survival rates of CR group and NCR group were 66.9%, 39.1%, 26.8% and 33.4%, 7.4%, 0% respectively (P < 0.01). The five year survival rate of curative resection group was 34.1%.

CONCLUSIONSAn en bloc combined resection can cure some T(4) patients, and improve the five-year survival rate.

Adult ; Aged ; Female ; Follow-Up Studies ; Gastrectomy ; methods ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Staging ; Pancreatectomy ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; pathology ; surgery ; Survival Analysis ; Treatment Outcome

Pulsed glow discharge mass spectrometric(Pulsed-GDMS) method for the measurement of 7 kinds of key elements(Mg,Fe,Cu,La,Ce,Pr and Nd) in rare earth alloys was established. The influence factors of measurement repeatability, such as pulse time, sample homogeneity, anode cap, flow tube, corn, and sample tablet density were systematically studied. The results showed that,for elements with mass fraction of more than mg/g, the parts (anode cap, flow tube and corn) had the largest influence on measurement repeatability. When the new graphitic parts were used and no parts were changed during the whole measurement,the relative standard deviation (RSD) was less than 3%. However, the RSD were 2%-11%and 3%-21% when the new graphitic parts and the reusable parts were used and changed,respectively. The second influence factor of measurement repeatability was the tablet density. The results showed that,the lower the density,the worse the measurement repeatability, and for the dense tablet, the RSD was less than 3%. Key elements in 1# rare earth alloy were measured by high resolution inductively coupled plasma-mass spectrometry (HR-ICP-MS), and the analytical results were used as reference values for the calibration of Pulsed-GDMS. The relative sensitivity factors (RSF) were obtained, and the key elements in 2# rare earth alloy were measured by Pulsed-GDMS after calibration. The analytical results of key elements in 2#sample by Pulsed-GDMS and HR-ICP-MS were compared, and the results showed that for the dense sample, the analytical results showed good agreement. Under the optimal conditions, the expanded uncertainty of measurement by Pulsed-GDMS reduced to 3%-10%.

Objective To analyze the community in dental plaque of elder people with root caries.Methods Total DNAs were extracted from the root caries dental plaques of nine elders over 60 years of age.Polymerase chaid reaction-based denaturing gradient gel electrophoresis (PCR-DGGE) was used to analyze the microbial composition,DGGE bands were excised from the gels for sequencing and identification.Results The dominant genus in root caries dental plaque of elder people were:Acinetobacte [0.9％ (1/114) ],Actinobaculum [ 1.8％ ( 2/114 ) ],Actinomyces [ 15.8％ ( 18/114 ) ],Aggregatibacter [0.9％ (1/114) ],Capnocytophaga [ 14.0％ ( 16/114 ) ],Corynebacterium [ 0.9％ ( 1/114 ) ],Haemophilus [0.9％ ( 1/1 14 ) ],Mobiluncus [ 0.9％ ( 1/114 ) ],Naxibacter [ 0.9％ ( 1/1 14 ) ],Neisseriaceae [ 10.5％ (12/114) ],Porphyromonas [ 0.9％ ( 1/114 ) ],Prevotella [ 12.3％ ( 14/114 ) ],Selenomonas [ 6.1％(7/114 ) ],Staphylococcus [ 1.8％ ( 2/114 ) ],Oralis streptococcus [ 6.1％ ( 7/114 ) ],Mutans streptococcu [7.9％ (9/114) ],Tannerella [0.9％ ( 1/114)],Treponema [ 1.8％ (2/114)],Veillonella [ 10.5％(12/114) ] and two uncultured unknown genus [ 1.8％ (2/114 )].Uncultred genotypes accounted for 19.30％ of the total.Gram-positive bacteria genotype accounted for 31.6％ (36/114),and Gram-negative bacteria genotype accounted for 66.7％ (76/114).Conclusions There were many bacteria genotypes in root caries dental plaque in the elderly,which were widely distributed.Gram-negative bacteria accounted for the majority.Genotype-specific pathogenic bacteria were not found.

BACKGROUNDHemocoagulase Agkistrodon for injection is a single component thrombin which has passed phases I and II clinical trials. The purpose of this phase III clinical trial was to evaluate the effect of Hemocoagulase Agkistrodon on hemostasis and coagulation in abdominal skin and subcutaneous incisions and to assess the safety of this agent in surgical patients.

METHODSThis is a phase III, prospective, randomized, double-blind, and controlled multicenter clinical trial including 432 consecutive patients randomized into either a study group (injected with hemocoagulase Agkistrodon at 2 U, n = 324) or a control group (injected with hemocoagulase Atrox, n = 108). The hemostatic time, hemorrhagic volume, hemorrhagic volume per unit area, blood coagulation, and adverse events were measured and compared between the two groups.

RESULTSThe mean hemostatic time in the study group was (36.8 +/- 18.7) seconds; the hemorrhagic volume was (3.77 +/- 3.93) g; and the hemorrhagic volume per unit area was (0.091 +/- 0.125) g/cm(2). In the control group, the corresponding values were (38.1 +/- 19.7) seconds, (4.00 +/- 4.75) g, and (0.095 +/- 0.101) g/cm(2), respectively. No significant difference in values existed between the two groups (P > 0.05). Blood coagulation results and hepatic and renal function were also similar between the two groups. Adverse events were reported in two cases, but were deemed non-drug-related.

CONCLUSIONSHemocoagulase Agkistrodon has good hemostatic and coagulative function and is safe for the use of arresting capillary hemorrhage that occurs while incising the abdomen during surgery.

Abdomen ; surgery ; Adolescent ; Adult ; Aged ; Agkistrodon ; Animals ; Batroxobin ; adverse effects ; pharmacology ; Blood Coagulation ; drug effects ; Double-Blind Method ; Evidence-Based Medicine ; Female ; Hemostasis ; drug effects ; Hemostatics ; pharmacology ; Humans ; Male ; Middle Aged ; Prospective Studies