Objective To evaluate the efficacy of inferior vena cava filter placement guided by digital subtraction angiography(DSA) for the prevention of pulmonary embolism(PE) after deep vein thrombosis(DVT) of the lower extremities.Methods Under the guidance of DSA,inferior vena cava filter placement was performed in 14 cases of deep vein thrombosis of the lower extremities from October 2003 to December 2004.Of the 14 cases,12 cases were given a simultaneous thrombectomy and 2 cases were treated conservatively.Results Filters were successfully placed in all the cases.The operation time was 85~115 min(mean,95 min).No complications were found during a follow-up of 1~14 months(mean,6 months).No recurrence of pulmonary embolism was seen included 5 patients who had survived previous pulmonary embolism attacks before the placement.Conclusions Inferior vena cava filter placement is a simple,safe,and effective method in the prevention of pulmonary embolism after deep vein thrombosis of the lower extremities.

OBJECTIVETo investigate the feasibility and advantages of total auricular reconstruction with single big expander at dual plane through incision at remnant ear.

METHODS52 patients with microtia were treated. Through incision at remnant ear, one big expander (150 ml) was implanted in the post-auricular area beneath the superficial facial in the hairless area, and above the superficial fascia in the area with hair. In the second stage, total auricular was reconstructed with autologous cartilage framework and expanded skin. Skin graft was not necessary. Another 32 paitents with single big expander above the superficial fascia were used as control. The downward shift distance of expanders, the appearance of auriculocephalic sulcus and complication were recorded in order to assess the effect of these two methods.

RESULTSThe downward shift distance of expanders in the dual plane group (0.7 ± 0.3) cm were lower than that in the control group (1.3 ± 0.4) cm, showing significant difference (P < 0.05). After a follow-up period of 6-12 months, shallow auriculocephalic sulcus was presented in 5 patients of the dual plane group and 12 patient of the control group. The shallow auriculocephalic sulcus was cut to make it deeper and covered with full skin graft.

CONCLUSIONSDual plane skin expansion could reduce the downward shift distance of expander. Adequate skin on the upper part of expander could make satisfactory auriculocephalic sulcus.

Cartilage ; transplantation ; Congenital Microtia ; surgery ; Feasibility Studies ; Hair ; Humans ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; methods ; Subcutaneous Tissue ; Surgical Flaps ; trends ; Tissue Expansion ; methods ; Tissue Expansion Devices

Objective To construct the vector pcDNA3.1 containing VEGF165 gene and examine of pcDNA3.1-VEGF165 vector to the angiopoiesis, composition of collagen in rabbit bone defect model. Methods Extract total RNA from the rabbit tissue. Prepare cDNA by inverse transcription and clone the gene by PCR. Clone plasmid pMD18-T/VEGF165 combined with pcDNA3.1 to reconstruct pcDNA3.1- VEGF165. 28 New Zealand white rabbits weighted (2.0?0.130) kg were made bone defect model for 10 mm length in the bilateral radii. Cut down the skin, resect the bone of 10 mm in length in the middle of radius. The pcDNA3.1-VEGF165 0.2 ml (200 ng) plasmid was injected at one defect side randomly. The defect in the other side was served as control group, and injected with absorbable gelatin sponge and sodium chloride 0.2 ml. After the examination by X-ray the local specimens were obtained at 1,2,4,6,8,and 12 weeks respectively. The expression of collagen type Ⅰ and Ⅲ was examined at 4, 12 weeks by immunohistochemical staining techniques. Results The pcDNA3.1-VEGF165 vector was constructed successfully. The roentgenography: there was no difference between the two sides after 1 week operation; 2 weeks after the operation, there were some callus in the experimental group; there was nothing in the control group. After 4 weeks, there were much callus, synostosis and others in the experimental group, all of these were late in the control group. Two groups were healed after 12 weeks, the bone density was lower in the control group. Inflammatory cell infiltrate, cellular interstitialis, fibroblast, collagen and osteoblast were no difference between the two groups only at the first week, but the density of angiogenesis was much more in the experimental group at the following times. Expression of collagen type Ⅰ, Ⅲ were more intensity in the experimental group than the control one at 4,12 weeks. Conclusion Transcription to local bone cells at defect position with pcDNA3.1-VEGF165 plasmid can enhance quantity of the angiopoiesis, extra cellular matrix and the healing of bone defect.

Medical endoscope capsule is described from its construction principle and drive system.The scheme and function of the drive system,especially the driving velocity and the direction control for that based on FPGA,are introduced in detail.Experiments indicate that the micro-drive system,with a linear speed ranging from 0 to 10 mm/s,can move forward and backward,and turn left and right discretionarily.The availability of programmable logic device makes the system reliable and flexible.

Objective To compare the efficacy of laparoscopic appendectomy(LA) and open appendectomy(OA) for perforated appendicitis.Methods From January 2002 to December 2005,40 patients with perforated appendicitis were treated at Xuanwu Hospital,20 of them received LA,and the others underwent OA.The clinical data of the patients were retrospectively analyzed.Results The operative time in the LA group was significantly longer than that in the OA group [(75.8?11.6) min vs(54.8?9.5) min,t=6.264,P=0.000)].And the patients in the LA group returned to oral intake earlier than those in the OA group [(1.8?0.5) d vs(2.6?0.5) d,t=-5.060,P=0.000].Moreover,the periods of antibiotic use and hospital stay in the LA group were significantly shorter than those in the OA group [(3.8?0.7) d vs(6.3?1.2) d,t=-8.048,P=0.000;and(5.8?1.1) d vs(11.6?1.6) d,t=-13.359,P=0.000].Although 3 patients had incision infection in the OA group,while none of the LA group had such a complication,no significant difference was detected in the complication rate between the two groups(Fisher's exact test,P=0.115).Conclusions Laparoscopic appendectomy is superior to open surgery for perforated appendicitis because of its advantages of quick recovery,short hospitalization,less antibiotic use,and minimal invasion.LA is a safe,effective,and feasible procedure for perforated appendicitis.

Energy-based surgical instrumentation (ESI) are surgical devices ablating or cutting tissues via the application of electrical,luminous,acoustic or other energy.High frequency electrotomes are widely used due to the low price,but they produce smoke in the process of surgery and incisions heal slowly.Ultrasonically activated scalpels' cutting performance is satisfying with easily healing incisions while its coagulating capability is poor.Laser scalpels are qualified for both cutting and coagulating in spite of the need of novel technology to overcome the characteristic that tissues absorb laser wavelength selectively.

Objective: To compare the selective splenic artery embolization (SSAE) with non-operative therapy of traumatic splenic rupture (TSR). Methods: The clinical data of 23 patients with TSR receiving SSAE and 32 undergoing non-operative therapy between 1992 and 2006 in our hospital were retrospectively analyzed. Results: There was no blood transfusion in SSAE group, and one patient was received it in the non-operative therapy group. Two patients in SSAE group had complications with left pleural effusion, and one had left pulmonary infection. One patient with non-operative therapy complicated with spleen abscess (P=0.298). The ratio of successful management in SSAE and non-operative group were 100% (23/23) and 81.3% (26/32) respectively(P=0.035). All the patients in both groups were survival. The mean hospital days in non-operative group(11.9?4.6) were significantly longer than that in SSAE group(7.9?2.1, P=0.045). Conclusions: Splenic injuries with grade Ⅰor Ⅱ are suitable for preserving spleen management. SSAE may be more safe and effective than non-operative therapy.

Objective To analysis effect of compound amino acid 15 peptide 2 on levels of tumor markers in serum of postoperative patients with liver cancer.Methods 42 postoperative patients who were diagnosed with liver cancer were collected.All patients were randomly divided into experimental group and control group, 21 cases in each group.The two groups of patients were given the corresponding parenteral nutrition therapy, after treatment, the serum tumor markers, T lymphocytes, liver function and nitrogen balance related indicators in all patients were detected.Results After treatment, compared with control group, the serum alpha fetal protein(AFP),carbohydrate antigen 19-9(CA19-9) and carcino embryonie antigen(CEA) levels were lower in the experimental group (P<0.05); the serum CD3 +T cells, CD4 +T cells and CD4 +/CD8 + ratio levels were lower in the experimental group (P<0.05); the serum alanine amino transferase (ALT), aspartate aminotransferase (AST) and total bilirubin(TBIL) levels were lower in the experimental group (P<0.05); the patients in the experimental group changed to positive nitrogen balance(P<0.05).Conclusion The diluted compound amino acid 15-2 injection for intravenous injection,can significantly reduce the level of serum tumor markers in patients with liver cancer, improve the immune function of patients, correct negative nitrogen balance, protect liver function.

OBJECTIVETo investigate the application of intense pulsed light (IPL) depilation in the auricular reconstruction with totally expanded skin and its suitable parameter.

METHODSFrom February 2009 to September 2013, one tissue expander(100 or 150 milliliters) were implanted under the skin of mastoid in 126 patients who suffered from microtia. During the skin expanding, the hair on the expanded skin was depilated by JPL technique. The parameter, operation, interval, the depilation result and the complication were recorded. The autologous rib cartilage frameworks were implanted in the second phase of auricular reconstruction.

RESULTSThe energy of IPL was 20 - 35 J/cm2 (mean 25. 3 J/cm2), the width of pulse was 26 - 30 ms ( mean 27. 9 ms), the interval between two operations was 4 weeks. Ninety-six patients were cured(76. 2%, 96/126). The total depilation efficient is 96. 8% (122/126). A fine banding blisters was found in one patient whose depilation areas was marked by black pen. Skin erythema was found in five patients and skin pigmentation was found in 7 patients. There were no skin necrosis and expander exposure in all patients. During 6 - 12 months of follow-up period, ninety-two patients were cured (73.0%, 92/126) and the total depilation efficient is 92. 9% (117/126).

CONCLUSIONSIPL depilation during the skin expanding is feasible and safe with careful procedure. The hairless expanded skin is enough to cover the framework, as well as the post-auricular area. The appearance of reconstructed ear is better without hair.

Congenital Microtia ; surgery ; Costal Cartilage ; transplantation ; Ear, External ; Erythema ; etiology ; Hair Removal ; methods ; Humans ; Mastoid ; Phototherapy ; adverse effects ; methods ; Reconstructive Surgical Procedures ; Skin Pigmentation ; Surgical Flaps ; Tissue Expansion ; Tissue Expansion Devices

Objective To investigate the clinical efficacy ofβ-lactam combined with macrolides antibiotics in treatment of severe community-acquired pneumonia (CAP) in children. Methods Children with severe CAP on admission between 2012 February and 2012 April were divided into treatment group and control group. With the same symptom specific supportive treat-ment, the patients in the treatment group were treated with both cefmetazole and azithromycin, while the patients in the control group were treated with cefmetazole alone. The total effective rate, number of days of symptoms and signs disappeared and num-ber of days of hospitalization were observed. Results The total effective rate was 87.8%in the trearment group and 61.3%in the control group with significant difference (P<0.05). Compared with control group, the recovery time of temperature, time of pulmonary rale disappearing and cough retraction were reduced (P<0.05). As well as the number of days of hospitalization was decreased (P<0.05). Conclusions The treatment of severe CAP in children with combination of azithromycin and cefmetazole results in better curative effect. A combined medication ofβ-lactam and macrolides antibiotics may be rational and effective.