Biomedical Research ; Cicatrix ; pathology ; Humans

Objective To investigate the role of hepatocyte growth factor(HGF),keratinocyte growth factor(KGF) and interleukin-1β(IL-1β) in tracheal aspirates (TA) in the genesis and development of acute respiratory distress syndrome (ARDS).Methods The levels of HGF,KGF and IL-1β in TA of 25 children with ARDS (ARDS group) and 23 children with non-ARDS (control group) were assayed by ELISA.Lung injury score was applied to all patients.Results The levels of HGF,KGF and IL-1β in TA were significantly higher in ARDS group than in control group(P<0.0 1).As compared with survivors,the levels of HGF,KGF and IL-1β in TA were markedly higher in dead patients(P<0.01).LIS had a positive correlation with the levels of HGF,KGF and IL-1β(P<0.01).Conclusion HGF,KGF and IL-1β participate in the development of ARDS.The degree of lung injury and prognosis of ARDS may be early estimated by the levels of HGF,KGF and IL-1β in TA.

Objective To investigate the reconstructive method with better sensory and erectile function for partial penile defect. Methods The procedure was as follows: dissecting the suspensory ligaments and separating part of crus,the local fat flap was transferred to fill the front space of symphysis ossium pubica.Various pedicle skin flaps were designed as covering materials.Penis residual stump was advanced to anterior portion of the newly reconstructed penile body as “glans”.The post-operative follow-up included taking full layer skin of penis from the patients to observe neurofibril regeneration by light microscope, electron microscope and scanning electron microscope;determining sensation recovery by physical examination;and checking erectile function with NEVA system. Results 42 patients underwent the above mentioned procedures.In these cases,the length of the penis varied from 0.5～4.0 cm in flaccid,1.5～5.0 cm in erect state before operation to 5.0～8.0 cm in flaccid,7.0～12.5 cm in erect state after operation.28 patients were followed up for more than 1 year.Of them 23 men got married with acceptable sexual activity;in them 18 had their children.The microscopic examination showed that the tenuous wavy peripheral nerves were well differentiated and no denaturation and necrosis were observed in the dermis,near subcutaneous adipose and around eccrine glands.The positive granules could be seen in the cytoplasm of regenerative neurofibrils by immunohistochemistry technique.The regenerative neurofibrils and related tissues could be seen under scanning and transmission electron microscope.The penis presented normal pain,touch feeling and 2-point identification ability in more than 12 months after surgery.Over 12 months after surgery,the patient had gained 4～9 events during 8～12 hours of sleep, and the durations were 4 to 37 min;the volume changes were from 114% to 505% over baseline. Conclusions With this method,the reconstructed penis tends to have better appearance and functions.For penile partial defect it is superior to the conventional operation.

Objective To investigate the incidence and relative factors of post-stroke depression (PSD). Methods 520 patients with stroke were assessed by 17-item Hamilton Depression Rating Scales (HAMD). A self-designed register form was analysed in 520 stroke survivorsA multiple factor analysis with the logistic regression method was carried out on the basis of these data. Results Among them, 178 cases (34.2%) were identified as depression. The minor, moderate and major incedenses were 20.2%, 10.4% and 3.7% respectively. In addition, stepwise regression analysis shows that important risk factors involved in PSD contained depression history, sex, family harmony, accompanying disease, neurological deficit and stoke course. Conclusion The factors above were the major predictive factors and useful for PSD prevention

Objective The aim of this study was to investigate the distribution of body weight related index and to explore the relationship between weight related index and cardiovascular diseases in rural residents in Yunnan Province. Methods By random cluster sampling method,rural residents were selected in Yunnan Province. The data were collected by face-to-face questionnaire and medical examination. Results 4070 rural residents in Yunnan participated in this study. The survey results showed that gender,age,education level and ethnicity affected both the distribution of body weight related index and low body weight,overweight,obesity,and central obesity(P < 0.05). Compared with low body weight,non overweight,non obesity and non central obesity group,non low body weight,overweight,obesity and central obesity group had higher prevalence rate of hypertension(P < 0.01). Among central obesity group,the prevalence rate of coronary heart disease was higher than non central obesity group(P < 0.01). Conclusion The distribution of body weight related index in rural residents of Yunnan province showed some special characteristic. The overweight,obesity,and central obesity were related to cardiovascular diseases. Change unhealthy living habits or behavior as well as improving their cultural quality have effects on controlling body weight related index and help to reduce the prevalence rates of overweight,obesity and central obesity which can further reduce the prevalence rates of cardiovascular diseases.

To measure carotid intima media thickness(IMT) and to investigate the relationship between carotid atherosclerosis and some major risk factors in elder uremic patients, a cross sectional study was carried out in 30unselected elder uremic patients (16on hemodialysis). Fasting blood sampling for serum lipids, BUN, creatinine, hemoglobin, and echo colour Doppler evaluation of common carotid arteries and heart were performed , BP was measured in all patients (before dialysis day in hemodialysis patients). Relationship between the results and miltifactoral regression analysis were also carried out. 17 patients(56 6%)had carotid IMTwhile 12 dialysis patients(75%) had it. 6patients (20%) had at least one plaque. A significant correlation was found in internal diameter of carotid arteries, IMT and blood vessel resistance between left and right carotid arteries. Carotid IMT had a close relationship with serum BUN, creatinine, cholesterol, systolic BP and heart ejection fraction. In multiple regression models, serum creatinine and cholesterol was significant and an independent predictor of the degree of carotid IMT. In elder uremic patients, carotid IMT is quite common. Elder age, hypertension, degree of renal insufficiency and dyslipidemia are associated with carotid atherosclerosis. Serum creatinine and cholesterol appears to serve as an independent predictor of carotid atherosclerosis, which contributes to the cardiovascular complications and high mortality in elder uremic patients.

Objective To study the feasibility of fluoroscopically guided percutaneous internal fixation with the Universal Spine System(USS) in the treatment of thoracolumbar fractures.Methods A total of 8 patients with thoracolumbar fractures without the need of decompression of the spinal canal underwent posterior percutaneous pedicle screw fixation by using the USS from October 2002 to May 2004.A fixation rod was placed under the vertebrae muscle to complete the reduction and fixation.Results The operation time was 120~240 min(mean,140 min),and the intraoperative blood loss was 20~90 ml(mean,40 ml).The Cobb's angle decreased from 21.5??4.3? preoperatively to 2.7??1.5? postoperatively(t=17.541,P=0.001).The collapse of vertebra was 18.5%?4.1% preoperatively and 2.4%?1.0% postoperatively(t=16.504,P=0.001).All the patients got out of bed 3 weeks after operation with the assistance of girdle brace.Effects of treatment were evaluated according to the Frankel grade at the third postoperative week: 2 patients recovered from grade C to D,1 patient from D to E,1 patient remained in D, and 4 kept in E. Conclusions Percutaneous internal fixation by using the USS in the treatment of thoracolumbar fractures without the need of decompression of the spinal canal offers advantages of minimal invasion and quick recovery,though it has some technical difficulties and disadvantages of long-time exposure under X-ray.

OBJECTIVETo evaluate clinical results of plate on the metatarsal side to reconstruction of tarsometatarsal joint dislocations secondary to diabetic charcot foot.

METHODSSeven patients (9 feet) patients with tarsometatarsal joint dislocations secondary to diabetic charcot foot were treated with plating from April 2012 to December 2014. All patients were male, and 5 cases were on the unilateral side and 2 cases were on the bilateral sides. The age of patients ranged from 45 to 52 with an average of 48 years old. The history of diabetics was from 6 to 15 years. X-ray and CT were used to evaluate fractures healing,and AOFAS was applied to estimate recovery of joint function.

RESULTSAll patients were followed up from 12 to 24 months with an average of 19 months. All incisions were healed at stage I . No infection, loosening and breakage of internal fixation, bone nonunion were found after operation. According to postoperative X-ray and CT results, the time of fracture healing ranged from 10 to 20 weeks with an average of 16 weeks. Six feet got excellent results, 2 good and 1 moderate based on AOFAS scoring.

CONCLUSIONTarsometatarsal joint dislocations secondary to diabetic charcot foot treated with plate on the metatarsal side could obtain stable fixation and got satisfied early clinical results.

Adult ; Bone Plates ; Diabetes Complications ; surgery ; Diabetes Mellitus, Type 2 ; complications ; Female ; Foot Diseases ; etiology ; surgery ; Fracture Fixation, Internal ; Humans ; Joint Dislocations ; surgery ; Male ; Metatarsal Bones ; surgery ; Middle Aged ; Tarsal Joints ; surgery

OBJECTIVETo evaluate the clinical results of dorsal approach and Weil osteotomy in treating the injury of the plantar plate in second metatarsophalangeal joint.

METHODSEight feet with plantar plate tear in five cases were treated by plantar plate repairment through dorsal approach and Weil osteotomy from June 2012 to December 2013. The mean age of the patients was 52 years old. All the patients were followed up for 6 to 12 months. American Orthopaedic Foot and Ankle Society (AOFAS) and visual analogue scale (VAS) were used to evaluate the clinical effect.

RESULTSThe second metatarsophalangeal joint stability recovered and the pain released in all patients. Postoperative VAS was lower and AOFAS was higher than preoperative.

CONCLUSIONCombined dorsal approach and Weil osteotomy can effectively release the pian of plantar plate, stabilize the metatarsophalangeal joint, decrease the incidence rate of postoperative subluxation and anchylosis in treating plantar plate tears in the second metatarsophalangeal joint.

Female ; Humans ; Joint Instability ; surgery ; Metatarsophalangeal Joint ; injuries ; surgery ; Middle Aged ; Osteotomy ; methods ; Plantar Plate ; injuries

Objective To investigate the role of Stathmin in pancreatic cancer invasion and metastasis and its relationship with DNA methylation. Methods Immunohistochemical detection of MBDI and Stathmin protein expression in 40 cases of pancreatic cancer and 15 cases ot normal pancreatic tissue were performed,followed by analysis of their clinical and pathological relationship with pancreatic cancer; Human pancreatic cancer cell line BxPC-3 was treated with 5-Aza-2-dC (AZA).Both qRT-PCR and Western blot analysis of Stathmin expression were used before and after AZA treatment; Stathmin-siRNA transfected BxPC-3 cells were divided into the Stathmi-siRNA group and the empty vector control group.Transwell chamber invasion assay and animal experiment were performed to measure the changes in cell invasion and metastatic capability. Results lmmunohistochemistry showed positive MBDI and Stathmin expressions in 28 (70％) and 24 (60％) out of 40 cases of pancreatic cancer,respectively,which were significantly higher than that in the normal pancreatic tissue (P＜ 0.05); MBDI and Stathmin protein expressions were positively correlated (r =0.356,P =0.037),so were MBDI expression and lymph node metastasis (P=0.023).Stathmin expression was significantly correlated with clinical staging and lymph node metastasis (P =0.002,and P =0.001,respectively).After AZA treatment,both Stathmin mRNA and protein expression in BxPC-3 were significantly decreased.Transwell chamber invasion assay showed that compared with the control group,the cell invasion capability of the Stathmin-siRNA group was significantly decreased (P＜0.05).Animal experiment showed that the incidence of liver metastasis was significantly lower in the Stathmin-siRNA transfected group than the empty vector control group (P＜0.05).Conclusion Demethylation may contribute to the reduction of Stathmin expression in pancreatic cancer and further improve the prognosis of pancreatic cancer patients.