Objective To investigate the short-term outcome of vacuum sealing drainage (VSD) in the treatment of infection early after tibiofibular fracture surgery.Methods A retrospective analysis was performed on 19 patients sustaining early infection after tibiofibular fracture surgery from December 2012 to December 2014.The patients consisted of 13 males and 6 females,aged from 26 to 57 years [(37.0 ± 5.3) years].There were 4 cases of isolate tibial fracture,2 isolate fibular fracture,and 13 tibial and fibular fracture.Open fractures were noted in 13 cases and close fractures in 6 cases.Infection occurred 14-21 days [(18.0 ± 3.3) days] after open reduction and internal fixation and was treated with gentamicin and VSD.Parameters were monitored dynamically after operation,including white blood cell count (WBC),C-reactive protein (CRP),erythrocyte sedimentation rate (ESR) and limb perimeter.Results The wound was basically debrided 7-10 days after VSD.Eighteen cases had one-stage wound closure with instrumentation preservance,and one case with progressed infection from soft tissue to bone marrow had instrumentation removal and wound suture.VSD decreased markers of inflammation including WBC,CRP,and ESR as well as limb perimeter.A follow-up of 6-24 month [(11.0 ± 2.3)months] showed fracture healing,without complications of detectable deformity growth,dysfunction,or chronic osteomyelitis.Conclusion VSD results in sufficient wound drain,reduction of swelling,decreased levels in CRP and ESR and controlled wound infection,which facilitates wound closure.

Using a H₂O₂-induced BRL cell senescence model, we investigated the anti-aging effects of drug-containing serums of Erzhi Wan (EZW) and various polar extracts (petroleum ether, ethyl acetate, n-butanol, water, and iridoid glycoside-enriched fractions). Cell viability was detected by MTT assay. Cell senescence was evaluated with β-galactosidase staining assay. Intracellular reactive oxygen species (ROS) were measured by flow cytometry. UFLC-Q-TOF-MS/MS was used to identify chemical components in EZW and the extracts, and molecular docking technology was used to predict the anti-aging components of EZW. Results showed that treatment of cells with 600 μmol·L^-1 H₂O₂ for 72 h markedly induced cell senescence, inhibited cell proliferation and increased intracellular β-galactosidase activity and ROS levels. If cells were pretreated with drug-containing serum of EZW this induction of senescence was decreased. A total of 49 chemical compounds were identified in EZW by liquid chromatography-mass spectrometry, 14 of these were identified by molecular docking as potential active ingredients. Based on these analyses, and the in vitro experiments with polar extracts, we conclude that the anti-aging components of EZW are triterpenes, flavonoids and phenyl alcohols, providing a basis for further elucidation of the active agents and mechanism of the anti-aging effect of EZW.

OBJECTIVE Inflammatory myofibroblastic tumor(IMT) is a rare lesion of unknown etiology which was first described in the lung. The clinical and pathologic characteristics,treatment, prognosis of IMT in head and neck were discussed. METHODS The clinical data of 4 cases of IMT were analyzed retrospectively. The specimens of the 4 cases were prepared for immunohistochemical staining and light microscopy. RESULTS The patients included 3 males and 1 female. Their age ranged from 32 to 58 years. The tumors located at the true vocal cord in 2 cases, at the nasal cavity and maxillary sinus in 1 case, at the maxillary sinus in 1 case. Histological examination was found that the tumors consisted of spindle cells,chronic inflammatory cells and myxoid background with delicate vasculature. Immunohistochemical staining demonstrated that the SMActin and Vimentin were expressed positively in the tumor. The patients were followed up for 9 to 21 months after operation. Three patients were alive with no evidence of diseases, one patients recurred at 4 months after operation and were alive with IMT. CONCLUSION IMT is a true neoplasm with a potential of local recurrence. The main treatment of IMT is to resect the lesions thoroughly.

Objective To demonstrate the spectrum of multi-detector spiral CT (MSCT) findings of drug-induced liver injury (DILI). Methods From May 2008 to January 2010, DILI was identified in 10 cases based on their clinical and pathological results. The spectrum of CT findings was analyzed retrospectively. Results According to the CT features, DILI were divided into three types. ( 1 ) Two cases presented diffuse hepatic injury, which appeared as homogeneous hypo-attenuation in precontrast CT scan and mild enhancement after contrast injection. The histopathological findings of the involved 1ivers include hepatocellular steatosis, neutrophil and eosinophil infiltration, punctiform necrosis and canalicular cholestasis. (2) Six cases presented focal hepatic injury, including massive wedge-shaped necrosis in 4,multiple small necroses in 1 and multiple regenerated nodules in 1. In precontrast CT scan, hepatic necroses were seen as inhomogeneous hypo-attenuation areas, which turned to hyper-attenuation after contrast injection and presented "flip-flop" sign between precontrast CT scan and portal venous phase scan. In the case with regenerated nodules, slight hyper-attenuation lesions were detected with diffuse distribution in liver in precontrast CT scan, which showed enhancement in hepatic arterial phase and turned to iso-attenuation in portal venous phase and equilibrium phase. The histopathological changes included massive necrosis or bridging necrosis with abundant neutrophil and eosinophil infiltration in 5 cases, nodular regeneration with cholestasis and feathery degeneratin in 1 case. (3) Two cases presented liver cirrhosis. CT displayed obvious nodularity of liver, which complicated with splenomegaly, ascites and collateral veins. The histopathological changes of these two cases included punctiform necrosis, canalicular cholestasis and pseudolobular formation. Conclusion CT signs of DILl have certain characteristics, which may help in detecting and determining the severity of liver damage.

The source impedance of the power circuit in the x-ray machine is analyzed in the paper and based on the voltage drop generated by the impedance, the cross-sectional area of the cable is calculated. In the end, the cross-sectional areas of the cables, corresponding to their respective distances between the transformers and the switchboards are given.
Electric Power Supplies ; Radiography ; instrumentation

This study investigated the mental health status of medical students in China, and analyzed the influencing factors in order to provide evidence for mental health education for medical students. A stratified cluster sampling method was used to recruit medical students from Huazhong University of Science and Technology, China. The questionnaire survey on general information and Symptom Checklist 90 (SCL-90) were used for investigation and analysis. The results showed among the 1137 valid questionnaires, 278 (24.45%) participants had SCL-90 score ≥ 160. The top three mental problems of medical students were obsessive-compulsive disorder, interpersonal sensitivity and depression in terms of the factor score ≥ 2.5 and the number of participants who reflected on the diseases. The third-year medical students had the worst mental health status, and fifth-year medical students had the best mental health status. Students from rural area had more psychological problems than those from urban area; furthermore, students with high professional satisfaction, those who were the single child of the family, non-poor students, and those whose parents had high education level had better mental health status. It was concluded that the mental health of medical students is not optimistic in China. Medical students have some mental health problems of different degrees. Factors that influence the mental health of medical students include academic pressure, professional satisfaction level and family environment.

Objective:Clinicopathological features, treatment and prognosis of urinary and male reproductive system soft tissue sarcoma (STS) and sarcomatoid carcinoma in adults were compared.Methods:A retrospective analysis was performed on the clinical data of 73 patients with STS and 15 patients with sarcomatoid carcinoma in adult urinary and male reproductive system in the First Affiliated Hospital of Zhengzhou University. There were 59 males and 14 females in STS group, with a median age of 41 (18-78)years old. The maximum tumor diameter ranged from 0.5 to 19.0 cm. The primary tumors were located in testis and peritesticular (23 cases), kidney (23 cases), prostate (15 cases), bladder (8 cases), ureter(3 cases), other parts(1 case). There were 18 cases of lymph node metastasis and 8 cases of distant metastasis. Among 73 patients with STS, 66 patients underwent surgical resection, of which 31 patients underwent radical resection. Among the 66 patients who underwent surgery, 3 patients received neoadjuvant chemotherapy; 22 patients received adjuvant chemotherapy; 5 patients were treated with adjuvant radiotherapy. Among 7 patients with STS did not receive surgical treatment, 2 patients received radiotherapy combined with chemotherapy, 2 patients received chemotherapy alone, and 3 patients received symptomatic support treatment.There were 11 males and 4 females in sarcomatoid carcinoma group, with a median age of 65 (23 - 84)years old. The measurable tumor diameter ranged from 0.4 to 16.9 cm. The primary tumors were located in kidney (6 cases), bladder (5 cases), ureter(2 cases) and prostate(2 cases). There were 2 patients of lymph node metastasis and 4 patients of distant metastasis. Of the 15 patients with sarcomatoid carcinoma, 12 patients underwent surgical resection, of which 5 patients underwent radical resection. 2 patients were treated with adjuvant therapy after operation. Among the 12 patients who received surgical treatment, 2 patients had distant metastasis before operation, all of which originated from the kidney. Among the 3 patients without surgical treatment, 1 patients received systemic chemotherapy and 2 patients received symptomatic supportive treatment. There was no significant difference in gender, tumor maximum diameter, distant metastasis and operation, chemotherapy, radiotherapy and operation combined with chemotherapy ( P>0.05) and there were significant differences in age, tumor primary location and lymph node metastasis ( P<0.05) between STS and sarcomatoid carcinoma patients.The categorical variables of the two groups were compared by χ2.With Kaplan-Meier method for univariate survival analysis, the Cox was used for multivariate analysis. Results:The median follow-up time was 18.3(0.3-90.4) months.In STS group, there were 14 patients of synovial sarcoma, 11 patients of liposarcoma, 15 patients of rhabdomyosarcoma, 16 patients of leiomyosarcoma, 10 patients of other types, and 7 patients of spindle cell sarcoma without specific classification. Among 66 patients with STS, 8 patients recurred, 14 patients metastasized after operation, 4 patients recurred and metastasized after operation. The 7 patients without surgical treatment all progressed. Among the 10 patients of sarcomatoid carcinoma without distant metastasis before operation, 3 patients recurred and 3 patients metastasized after operation. Two patients of renal sarcomatoid carcinoma with distant metastasis were treated with nephrectomy and chemotherapy. One of them had overall survival (OS) up to 2 years, and one recurred 2 months after operation. The 3 patients without surgical treatment all progressed without remission. The median OS of STS patients were 59.3 (95% CI 24.1-94.5) months and that of sarcomatoid carcinoma patients were 8.7 (95% CI 6.1-11.2) months. The OS of STS patients were better than those of sarcomatoid carcinoma patients ( HR=2.874, 95% CI 1.118-7.386, P=0.022). Conclusions:The onset age of STS in adult urinary and male reproductive system was lower than that in sarcomatoid carcinoma. The primary lesions of STS were mainly in testis, peritesticular and kidney. The primary lesions of sarcomatoid carcinoma were mainly in kidney. Among STS, leiomyosarcoma was the most common type.STS and sarcomatoid carcinoma should be diagnosed and treated with surgery quickly, and systemic therapy should be performed for patients who cannot be treated with surgery.

Objective To study the clinical presentations,radiologic features,prognosis,and possible causes of liver injury associated umbilical venous catheter (UVC ).Methods We reviewed database of our NICU from December 2012 to November 2015 and identified preterm infants with liver injury while UVC in place.The gestational age,birth weight,gender,days of UVC in place prior to liver injury, the depth of UVC (cm),UVC tip position,ultrasound findings of liver injury,laboratory tests,treatment and outcomes were collected.Results During study period,322 infants received UVC insertion.Ten cases (3.1 %)of liver injury associated with UVC were diagnosed.Of the ten infants,nine were diagnosed as extravasation of fluid to liver parenchyma,and one was diagnosed as liver hematoma.The mean birth weight was (1184 ±207)g,mean gestational age was (28.5 ±1.7)weeks.The UVC tip was at thoracic (T) vertebrae T 9 to T 11 level,nine UVC tips were below the right diaphragm level.All UVCs were used for total parenteral nutrition before liver injury was diagnosed.Six infants had clinical manifestations,and four infants were free of clinical manifestations.The most prominent clinical signs were abdominal distension (n =5),weak bowel sounds (n =5)and hepatomegaly (n =4).One infant who was diagnosed with liver hematoma also had progressive hemoglobin decline (minimum 34 g/L)and shock.Abdominal ultrasound showed well-limited,irregular,hyperechoic rimmed lesions with heterogeneously hypoechoic centers or anechoic liquid dark space.Extravasation of fluid to liver parenchyma will restorate within one week after the UVC was remove.One baby who was diagnosed as liver hematoma passed away at 9 days of life.Liver ultrasound of eight returned to normal in 52 days to 3.5 months,and one had calcified lesions at 9 months of age.Conclusions Liver injury is an unusual complication of UVC insertion and usage.Proper positioning of the UVC tip may help to avoid this complication.Early recognition,prompt diagnosis with liver ultrasound examination and timely treatment can lead to better outcome in newborns with extravasation of fluid to liver parenchyma.

To investigate the structure disruption of BSA (1mg/ml, dissolved in PBS) induced by ultrasonication and the French press. The BSA solution was passed through the French press and received ultrasound irradiation, and then detected by HPLC(High-performance liquid chromatography),DLS(Dynamic Light Scattering),CD(Circular Dichroism)and nondenaturing SDS-PAGE. Detection results showed that BSA was polymerized after ultrasound irradiation and the polymerization can be reduced by adding mannitol (free radical scavenger). This means that the free radical play an important role in this process. However, the BSA passing through the French press for several times wasn’t polymerized, and the secondary structure was somewhat destroyed. These results suggested that ultrasound irradiation and French press destroy the molecular structure in different manners, so that the suitable cell lyses methods should be selected according to the characteristics of the protein.

During the dilute acid pretreatment of lignocellulosic materials such as corn stover, hemicellulose is hydrolyzed into monosaccharides, and meanwhile, toxic by-products are simultaneously generated, which may influence ethanol fermentation thereafter. Studies on the inhibitory effects of the by-products on ethanol fermentation are of practical use for further improvement of ethanol yield from lignocellulosic materials. Five by-products, including acetic acid, formic acid, vanillin, furfural and 5-hydroxymethylfurfural, were identified to be the main components in the hydrolysate of dilute acid pretreatment of local corn stover, which were added into the medium at different concentrations to study their impacts on the growth and ethanol fermentation of a recombinant xylose-utilizing yeast strain, S. cerevisiae 6508-127. The ethanol production was inhibited by formic acid and acetic acid to a lesser extent than that to the growth, and formic acid was shown to be much more toxic than acetic acid, showing severe inhibitory effects at the concentration of 1g/L, half of the concentration for acetic acid which showed remarkably negative effects on ethanol fermentation. Vanillin caused a much longer lag-phase in growth when the concentration was 2g/L, and the lag-phase was not obvious at lower concentrations. At the concentration of 6g/L, vanillin completely inhibited the fermentation as well as the cell growth. 5-Hydroxymethylfurfural was showed to remarkably inhibit ethanol production, but the biomass yield was higher by exogenous addition of 5-Hydroxymethylfurfural than control. Furfural at 0.5~1.5g/L inhibited the cell growth, but the ethanol yield was higher than that of the control experiment. It was also found that vanillin, furfural and 5-hydroxymethylfurfural could be assimilated and metabolized by S. cerevisiae 6508-127 under the experimental conditions.