0.05). Furthermore, the severity of painful feeling occurred during packing and withdrawing of packing material was also much less severe in the group of cases packed with Merocel than in those with vaseline gauze. It is concluded that the using of Merocel highly expansive sponge is an effective material and usable for nasal packing in epistaxis.

Auricle reconstruction involves auricular framework construction and selection of skin soft tissues that coats the auricular support. To date, there has no ideal biomaterial for the auricular framework. The materials of auricular framework include autologous costal cartilage, medical grade silicon rubber, and porous polyethylene. The autologous costal cartilage avoids rejection, and has advantages such as good flexibility, easy combination with surrounding coated tissues, and low surgical cost. However, the acquisition causes injury, increases pain of patients, alters thoracic cage structure, and the cartilage graft is absorbable and deformable. The medical grade silicon rubber exhibits good exposure rate and high inflammation, which limit its clinical application. Medpor implant has been used recently as novel medical chemical synthesis materials. It makes of high density polyethylene, with strong plasticity, time-efficacy, stable fusion with local tissue and good biocompatibility. However, the exposure of Medpor implant is the complication. In this study, the Medpor implant in combination with total auricle reconstruction was used to treat 12 cases of congenital microtia, trauma-induced auricular defect, auricular defect complicated by atresia of external auditory canal and hearing disturbance. Postauricular fascial flap was expanded to form reconstructed auricle, followed by wound skingrafting. The expanded fascial flap improves blood supply, with close coating, decreases complications. Moreover, all reconstructed auricle survived, with no ulcerate or exposure, and the appearance is similar to normal auricle.

To investigate the curative effect of Medtronic merocel packing after endoscopic sinus surgery,76 patients underwent endoscopic sinus surgery in the Department of Otolaryngology,Xiangfan Hospital,Tongji Medical College,Huazhong University of Science and Technology from June to December in 2004,were adopted in this study and randomly divided into two groups:36 cases in observation group were packed with Medtronic merocel sponge,40 cases in control group with Vaseline gauze,the nasal pain and haemostasis effect after the package removal were observed.The result showed that,the incidence rate of nasal pain and haemostasis in the observation group was significantly lower than that in the control group(P

Objective To study the protective effects of the intracord transplantation of microgene pSVPoMcat－ genetically－ modified Schwann cells (MSCs)on spinal cord injury (SCI).Method Rats with semi－ division(SD) of the spinal cord was divided into 4 groups.Group S consisted of the rats with SD treated with the transplantation of MSCs, Group B of the rats with SD treated with the transplantation of SCs without genetic modification,Group C of the rats with SD without treatment and Group D was the normal control. 8 hours after operation,the half of the rats of each group were killed and the injured segment of the spinal cord was resected to be examined with atomic absorption spectrophotometry . Another half of the rats of all the groups were examined with neurological function tests to have a combined behavioral score (CBS).Result There was a significant increase of water content and Na＋ and Ca2＋ ions and a decrease of K＋ and Mg 2＋ ions in the injured cord segment of Group C and a statistically significant recovery was observed in Group A. The intracord transplantation of pSVPoMcat genetically modidied SCs improved the neurological outcome of spinal cord injury.Conclusion Our findings indicate that intracord transplantation of pSVPoMcat－ genetically－ modified－ Schwanncells exerts protective effects on the injured segment of the spinal cord through the improvement of the internal ion environment of the spinal cord.

Objective To understand the clinical features of Behcet′s Disease( BD) with pulmonary hypertension( PH) .Methods The etiology, clinical features, treatment and prognosis of 25 patients with Bahcet′s disease ( BD) complicated with pulmonary hypertension ( PH) admitted in Peking Union Medical College Hospital from January 2000 to August 2015 were retrospectively reviewed.Results Total 912 BD patients were hospitalized during the same period, among whom 25 cases were complicated with PH accounting for 3%.There were 15 males (60%) and 10 females (40%), with the mean age of (33 ±12) years (range 19 to 66 years).The median interval from the diagnosis of BD to the onset of PH was 1 year (range 0 to 40 years).The most common cause of PH was heart valve disease (n=10, 40%), followed by pulmonary arterial stenosis or occlusion (n=6, 24%), pulmonary arterial aneurysm with thrombus (n=1, 4%), pulmonary thrombosis (n=1, 4%), cardiomyopathy (n=1, 4%);there were no causes identified in 6 cases (24%).Pulmonary arterial pressures estimated by echocardiography were 40 to 117 mmHg (1 mmHg=0.133 kPa) with a mean pressure of (60 ±22) mmHg.When the PH developed, elevated erythrocyte sedimentation rate ( ESR ) and increased hypersensitive C-reactive protein ( hs-CRP ) were founded in 48% ( 11/23 ) and 82% ( 14/17 ) of patients, respectively.After treated with glucocorticoid (96%,24/25), immunosuppressive agents(92%, 23/25), anticoagulation or thrombolysis(36%,9/25) and specific targeted vasodilator(32%,8/25), the levels of ESR and hs-CRP declined in 91% (10/11) and 71%(10/14) of patients, respectively; and pulmonary arterial systolic pressure declined in 50% of cases (8/16).Among 9 patients followed for 2 to 96 months, 4 died, 1 aggravated, 2 kept stable and 1 improved.Conclusion PH is an uncommon complication in disease.Heart valve disease, pulmonary artery involvement are the major causes of PH.The therapeutic effect and prognosis are poor.

Objective:　To evaluate the effect and safety of early moderate hypothermia therapy (MHT) on patients with head injury by using parallel-control test. 　　Methods:　Thirty patients with severe head injury within 6 hours after accidents were treated by MHT generally for 4-10 days. The other 30 patients with similar head injury treated routinely were enrolled for a parallel-control test. The mortality, morbidity and changes of some neuro-functional indexes as Glasgow Coma Scores, and Glasgow Outcome Scale, levels of endothelin and some other factors of neurobiochemistry in blood plasma were observed. Meanwhile, the dynamic monitoring by transcranial Doppler ultrasonography was conducted in these patients. 　　Results:　The mortality in MHT group was significantly lower than that in control group. MHT not only reduced endothelin but also increased the brain biochemical factors, which were helpful to the protection of neurons in the early brain ischemia after head injury. 　　Conclusions:　Early MHT can help reduce mortality and morbidity in patients with acute head injury.

OBJECTIVETo observe the repair effect of Schwann cells (SCs) modified by microgene pSVPoMcat on injured spinal cord in rats.

METHODSSemi-transection injury at the level of T(8) of spinal cord was made with cutting method on 120 Sprague Dawley (SD) rats. Then 40 rats implanted with SCs modified by microgene pSVPoMcat were taken as Group A, 40 rats implanted with simple SCs as Group B and the other 40 rats were taken as the control group (Group C). The functional recovery of the rats was observed through combined behavioral score (CBS) and cortical somatosensory evoked potential (CSEP), and the expression of the glial fibrillary acidic protein (GFAP) was measured with in situ hybridization and immunocytochemistry. At 3 months after operation, the rats were examined with magnetic resonance image (MRI), and the neurofilaments (NF) of the axons were stained with immunohistochemical method.

RESULTSGFAP expression in Group A was significantly lower than that of the other 2 groups. MRI showed that the spinal signals in the injured area recovered fundamentally in Group A, didn't recover in Group B and malacia focus was found in Group C, which was same as the results of NF staining. Wave amplitudes in incubation periods in Group A and Group B tended to recover. It recovered to the normal level in Group A, which was similar to the results of CBS.

CONCLUSIONSSCs modified by microgene pSVPoMcat can inhibit GFAP expression, improve the growth of the axons and the functional recovery of neurons after spinal cord injury.

Analysis of Variance ; Animals ; Evoked Potentials, Somatosensory ; Gene Transfer Techniques ; Genetic Therapy ; Glial Fibrillary Acidic Protein ; metabolism ; Immunohistochemistry ; In Situ Hybridization ; Magnetic Resonance Imaging ; Nerve Regeneration ; Rats ; Rats, Sprague-Dawley ; Schwann Cells ; metabolism ; transplantation ; Spinal Cord ; physiopathology ; Spinal Cord Injuries ; pathology ; physiopathology ; therapy

OBJECTIVETo study the curative effect of wilsonii injecta on severe head injury (SHI).

METHODSA total of 120 patients with SHI were divided randomly into 2 groups, the patients treated with conventional methods as Group A (n=60) and the patients treated with wilsonii injecta as Group B (n=60). The changes of neural function indexes were evaluated with Glasgow Coma Scale (GCS) before treatment and with Glasgow Outcome Scale (GOS) after treatment, simultaneously, the parameters of hemorrheological indexes (HI), brain electrical activity map (BEAM) and transcranial Doppler sonography (TCD) were observed before and after treatment.

RESULTSIn Group B, the clinical GCS, the HI, the BEAM and the prognosis GOS were improved much more than those in Group A. And the TCD parameters in Group B decreased, which had significant difference compared with that in Group A (P<0.01).

CONCLUSIONSWilsonii injecta can rapidly improve the injured p ersons' conscious states, the abnormal BEAM and the surviving quality. It suggests that the improvement of the HI is related to the relief of the vasospasm of the arterial blood vessels in the brain, which may be one of the important mechanisms of wilsonii injecta in improving the prognosis.

Adult ; Brain Injuries ; diagnostic imaging ; drug therapy ; Brain Mapping ; Female ; Follow-Up Studies ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Humans ; Injury Severity Score ; Male ; Plant Extracts ; administration & dosage ; Probability ; Reference Values ; Treatment Outcome ; Ultrasonography, Doppler

Objective To explore the clinical implications of left ventricular hypertrophy (LVH) in patients with pheochromocytoma and paraganglioma(PH/PGL).Methods Seventy-eight PH/PGL patients receiving medical attention at Peking Union Medical College Hospital from October 2010 to April 2013 were included in the study.Forty-six healthy people who had no hypertension,pathoglycemia,dyslipidemia history,and with normal chest X-ray,electrocardiogram and echocardiography results served as control group.Clinical symptoms and signs,levels of 24-hour urinary catecholamine,electrocardiogram and echocardiography of participants were recorded and analyzed.Results (1) Left ventricular ejection fraction,cardiac output index,left ventricular mass index (LVMI),left atrial volume index (LAVI) and mitral E/E' were all significantly higher while mitral annulus lateral E' velocity was significantly lower in PH/PGL group than in control group(all P ＜ 0.05).(2) LVH was associated with more prevalent acute left-sided heart failure episodes (12％ (3/25)vs.0,P =0.030),sustained LVEF depression (12％ (3/25) vs.0,P =0.030) and ECG ST-T segment alterations (60％ (15/25) vs.21％ (11/53),P =0.001) in PH/PGL patients.LAVI ((30.2 ± 8.8) ml/m2 vs.(23.8 ± 4.7) ml/m2,P =0.007) and mitral E/E' (11.2 ± 6.0 vs.7.2 ± 1.4,P =0.003) were significantly higher in patients with LVH than in patients without LVH.Mitral annulus septal ((7.8 ± 2.6) cm/s vs.(10.4 ± 3.2) cm/s,P =0.001) and lateral ((9.3±3.3) cm/s vs.(12.9±2.9)cm/s,P＜0.001) E' velocity,averaged S' velocity((7.9 ± 1.6) cm/s vs.(8.8 ± 1.7) cm/s,P =0.036) were significantly lower in LVH patients comparing to patients without LVH.(3) According to multiple linear regression analysis,age (t =3.491,P =0.001),gender (t =2.899,P =0.005),heart rate (t =2.255,P =0.027),and 24-hour urinary norepinephrine level (t =3.369,P =0.001) were independent factors affecting LVMI of PH/PGL patients.Conclusion Left ventricular hypertrophy is associated with acute left-sided heart failure,left ventricular diastolic dysfunction and elevated left ventricular filling pressure in PH/PGL patients.

OBJECTIVE: To investigate the changes of leukotriene D4 (LTD4) in nasal discharge and plasma of patients with persistent allergic rhinitis (AR) and the effects of antihistamine. METHOD: The investigation was a prospective, randomized controlled trial. Forty AR patients (group C) were divided randomly into two subgroup. One group received oral antihistamine 10 mg everyday for one week (group CA) and another group received no loratadine tablets 10 mg everyday for one week (group CB). Fifteen age matched healthy (group D) people were enrolled as control. The level of LTD4 and interleukin-5 (IL-5) in both nasal discharge and plasma by using enzyme linked immunosorbent assay (ELISA) and enzyme immunoassay (EIA), cell counts and cell differentials in nasal discharge, were measured before and after three month. The clinical symptom and life quality scores of group C were also investigated. RESULT: The concentrations of LTD4 in nasal discharge [(794 +/- 305) pg] and plasma [(5219 +/- those in group D [(347 +/- 169) pg, (2283 +/- 489) ng/L, all P 1185) ng/L] in group C were significantly higher than those in group D [(347 +/- 169) pg, (2283 +/- 489) ng/L, all P < 0.05]. The level of LTD4 in nasal discharge was positively correlated with the percentage of neutrophil (r = 0.453, P < 0.05) and IL-5 (r = 0.364, P < 0.05). The pre- and post-therapy concentrations of nasal discharge and plasma in group CA were (812 +/- 1592) pg, (657 +/- 495) pg and (5422 +/- 935) ng/L, (4589 +/- 1057) ng/L respectively; While in group CB the concentrations were (776 +/- 227) pg, (860 +/- 194) pg and (5074 +/- 1850) ng/L, (6063 +/- 450) ng/L, respectively. There were no significant difference either in the level of LTD4 in nasal discharge or in plasma in both groups (all P > 0.05). CONCLUSION The results suggested that LTD4 was involved in airway inflammation in AR. Antihistamine was not effective enough in decreasing the levels of LTD4 in both nasal discharge and plasma of AR patients.
Adult ; Anti-Allergic Agents ; pharmacology ; Bodily Secretions ; chemistry ; Female ; Histamine H1 Antagonists ; pharmacology ; Humans ; Leukotriene Antagonists ; therapeutic use ; Leukotriene D4 ; analysis ; blood ; metabolism ; Male ; Middle Aged ; Plasma ; chemistry ; Prospective Studies ; Rhinitis, Allergic, Perennial ; blood ; drug therapy ; metabolism