OBJECTIVETo explore clinical efficacy of double Endobutto reconstituting coracoclavicular ligament combined with repairing acromioclavicular ligament in stage I in treating acromioclavicular dislocation with Rockwood type III - V .

METHODSFrom January 2010 to September 2013, 56 patients with Rockwood type III - V acromioclavicular dislocation were treated by operation, including 20 males and 36 femlaes, aged from 32 to 52 years old with an average of 38.5 years old. Twenty-five patients were on the left side and 31 cases on the right side. The time from injury to operation was from 3 to 14 days, averaged 7 days. All patients were diagnosed as acromioclavicular dislocation with Rockwood type III - V, and double Endobutto were used to reconstituting coracoclavicular ligament, line metal anchors were applied for repairing acromioclavicular ligament. Postoperative complications were observed, Karlsson and Constant-Murley evaluation standard were used to evaluate clinical effects.

RESULTSAll patients were followed up from 8 to 24 months with average of 11 months. According to Karlsson evaluation standard at 6 months after operation,42 cases were grade A, 13 were grade B and 1 was grade C. Constant-Murley score were improved from (42.80±5.43) before operation to (91.75±4.27) at 6 months after operation. All items at 6 months after operation were better than that of preoperative items. Forty-eight patients got excellent results, 7 were moderate and only 1 with bad result. No shoulder joint adhesion, screw loosening or breakage were occurred during following up.

CONCLUSIONDouble Endobutto reconstituting coracoclavicular ligament combined with repairing acromioclavicular ligament in stage I for the treatment of acromioclavicular dislocation with Rockwood type III - V could obtain early staisfied clinical effects, and benefit for early recovery of shoulder joint function.

Acromioclavicular Joint ; injuries ; surgery ; Adult ; Bone Plates ; Bone Screws ; Female ; Humans ; Ligaments, Articular ; injuries ; surgery ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; Shoulder Dislocation ; surgery ; Treatment Outcome

BACKGROUND: Epidemiologic studies have shown an association between higher insulin levels and coronary artery disease, and metabolic studies have associated insulin resistance and compensatory hyperinsulinemia with non-insulin-dependent diabetes mellitus, hypertension, obesity,and lipid disorders.OBJECTIVE: To investigate the relationship between insulin resistance (IR) and erythrocyte insulin receptors (EIRs) in the patients with cerebral infarction (CI).DESIGN: Case-control trial.SETTING: Department of Neurology, China-Japan Union Hospital of Jilin University.PARTICIPANTS: From January 2004 to October 2004, 40 patients with CI, who were in-patients in China-Japan Union Hospital of Jilin University,were selected for the study. Meanwhile, 30 healthy doctors or nurses were recruited as normal controls.METHODS: The levels of blood glucose and serum insulin under fasting and 2-hour after oral glucose tolerance test (OGTT) were detected in the 40 patients with CI and 30 healthy doctors or nurses. Fasting blood glucose multiplied by fasting serum insulin was insulin resistance index (IRI). The number of insulin receptors and their binding affinity on every erythrocyte were determined using modified Gambhir's method. The correlation between the number of EIRs and IRI was analyzed.MAIN OUTCOME MEASURES: Comparison of CI group with controlRESULTS: Data of 40 patients with CI and 30 controls were analyzed, and under fasting and 2-hour after OGTT: The level of serum insulin under fasting and blood glucose, serum insulin at 2-hour after OGTT in CI group were higher than those in normal group [(13.30±5.15), (9.85±4.36) mU/L,(8.27±1.65), (6.32±1.37) mmol/L, (75.21±21.12), (28.26±6.31)mU/L,P ＜ 0.01,EIRs: The number of insulin receptors with high and low affinity and maximum specific binding rate in the patients with CI were significantly less than those in normal group [20.30±4.50, 23.80±4.10; 2 223.80±509.30,2 610.10±435.10; (10.62±3.55)%, (13.21±2.94)%, P ＜ 0.01]. Multiple linear regression analysis and correlation analysis showed the numbers of two types of EIRs in the patients with CI were negatively correlated with IRI (r=-0.458, -0.439, P ＜ 0.01, both).CONCLUSION: Insulin resistance can lead to cerebral infarction. Decrease in insulin receptors may play an importance role in cerebral infarction induced by insulin resistance.

Dideoxynucleosides ; False Positive Reactions ; Fluorine Radioisotopes ; Fluorodeoxyglucose F18 ; Humans ; Inflammation ; diagnosis ; Neoplasm Staging ; Neoplasms ; diagnosis ; metabolism ; pathology ; radiotherapy ; Positron-Emission Tomography ; methods ; Radiotherapy, Intensity-Modulated ; Sensitivity and Specificity ; Tomography, X-Ray Computed ; Treatment Outcome

Adenocarcinoma ; pathology ; radiotherapy ; Carcinoma, Squamous Cell ; pathology ; radiotherapy ; Consensus ; Esophageal Neoplasms ; pathology ; radiotherapy ; Humans ; Lymph Nodes ; pathology ; Lymphatic Vessels ; pathology ; Neoplasm Invasiveness ; Neoplasm Metastasis ; Neoplasms, Multiple Primary ; pathology ; radiotherapy ; Radiotherapy Planning, Computer-Assisted ; methods ; Radiotherapy, Computer-Assisted ; methods ; Radiotherapy, Image-Guided ; methods ; Tumor Burden

Adult ; Breast Neoplasms ; radiotherapy ; surgery ; Cone-Beam Computed Tomography ; instrumentation ; methods ; Female ; Humans ; Mastectomy, Segmental ; Middle Aged ; Particle Accelerators ; Postoperative Period ; Radiotherapy Planning, Computer-Assisted ; instrumentation ; methods ; Respiration

Pregnancy ; Humans ; Female ; Cesarean Section/adverse effects* ; Abdominal Cavity ; Neoplasms

Objective To explore the possibility of hearing protection in acoustic neurinoma (AN) resection and to evaluate the effect of dynamic auditory monitoring and the effect of oto-endoscope for hearing protection. Methods From July 2003 to July 2007, there were a total of 138 cases of AN received surgical treatment. Continuous hearing monitoring was conducted in 18 cases with residual hearing. In these 18 cases, there were 6 males and 12 females, with 12 cases in left side and 6 cases in right. Fifteen cases were solitary AN, 3 cases were diagnosed as neurofibromeatosis Ⅱ. Maximal diameters of the tumor varied between 12 and 33 millimeters with an average of 19. 9 millimeters. All cases were operated on by retrosigmoid approach with routine facial nerve monitoring. Ten cases were assisted by oto- endoscope. Eighteen cases were performed accompanying continuous auditory brainstem response (ABR) and electro-cochleogram (EcochG). The patients were given routine hearing function test 7 to 10 days after operation, and reexamined 6 months to 1 year. The duration of follow-up ranged 6 months to 2. 5 years. Hearing data of the last time was thought as the judging result. Preoperative and postoperative hearing standard refer to (AAO-HNS)classifying. Results In all 18 cases, tumors were rsected completely in 16 cases, but sub-totally removed in 2 cases which were Ⅱ neurofibromeatosis. There was no mortality and no severe complication in this series. All the 18 cases had no facial paralysis before operation, and during operation facial nerves in 18 cases were kept anatomic integrity. According to House-Brackmann grade system, for 18 AN patients 7 days after operation only 50.0% (9/18) were kept at grade Ⅰ to Ⅱ, but 88.9% (16/18) were kept at grade Ⅰ to Ⅱ 6 months after operation. Out of 18 cases, hearing function were preserved in 11 cases (61.1%, 11/18) . After operation, there were 4 cases at hearing grade A, 4 cases at hearing grade B, 2 cases at hearing grade C and 1 cases at heating grade D. In all 18 cases, there were 5 cases with tumor diameter more than 20 millimeters, in which only 2 cases of them preserved hearing function (2/5). However, 9 cases preserved their hearing function in the other 13 cases whose tumors diameter less than 20 millimeters (69. 2% ,9/13). In 10 cases assisted by oto-endoscope, 8 cases obtained hearing protection (80.0% ,8/10)and 2 cases lost hearing. During operative monitoring, when drilling posterior lip of internal auditory canal (IAC), dragging and electric coagulating nearby IAC, especially clamping labyrinthine artery, removing tumor in IAC or electric coagulating arachnoid blood vessel on the top of tumor tissue, the ABR waves were affected greatly. Conclusions For the AN patient with preoperative residual hearing, it was necessary to protect hearing by combining continuous auditory monitoring with oto- endoscope technique. Based on these efforts the patient could preserve applicable hearing after operation. Whether or not arachnoidal on the top of AN remain and the conditions about blood supplying were the main factors that affect postoperative hearing. Moreover trauma of labyrinthine artery was the key to postoperative hearing loss.

Objective To study the effects of Chinese herbs Yiyanheji on intestinal mucosa barrier in rats with SAP.Methods Animal models of SAP were induced by retrograde injection of 5% sodium taurocholate (0.1ml/100g) into the common biliopancreatic duct.90 healthy Wistar rats weighing (250?30)g were randomly divided into 3 groups:sham operation group (SO,n=30),SAP group (SAP,n=30) and Chinese herbs Yiyanheji treated group(SAP+YH,n=30).Treated group was treated with Yiyanheji after operation.The SAP group was treated with physiological saline.Three groups of rats were killed at 72 hours after operation or treatment.Bacterial cultures were performed in all animals.The changes of terminal ileum' tissue were observed by optical electron mi- croscopy.The data of test were analyzed by statistic software.Results The incidence of bacterial translocation was 22.5% in Yiyanheji treated group,and it was lower than that in SAP group which was 90.0 %.The difference was significant(P

Objective To explore the sustainable development strategy.of translational medicine in hospitals, we conducted the in-depth analysis for the current status of translational medicine in the Level 3-A hospitals in Wuxi city.Methods the SWOT analysis was performed to identify the advantages, disadvantages, opportunities and threats in the translational medicine development in for those hospitals.Results Development of translational Medicine in those hospitals in Wuxi city highlights the advantages, opportunities and challenges.Conclusions the leadship of Translational Medicine should change their concepts, provide full play to the advantages of a variety of resources, conducting reform and innovation, establish a long-term system of human resource for talented researchers and reward system in order to accelerate the development of translational medicine.

Objective To evaluate the dose of vancomycin for the treatment of central nervous system (CNS) infection after neurosurgery. Methods The information of hospitalized patients treated by vancomycin after neurosurgery from January 2011 to December 2015 at Beijing Tiantan Hospital, Capital Medical University was collected retrospectively. The patients with CNS infection were retrieved, the relevant data were extracted and systemized. A daily dose of 2 g or 30-60 mg/kg of vancomycin was thought as the standard, and the difference between the actual dose and the guidelines was analyzed. Results There were 5 816 patients used vancomycin for a total of 46 787 days. The number of patients with CNS infection after neurosurgery was 1 198 (20.6%), the total treatment course was 14 083 days (30.1%), the median treatment days was 9, the median daily dose was 26.0 mg/kg; and the percentage of male patient was 50.8%, the median age was 42.0 years, and the median body weight was 68.0 kg. The most commonly used dose and frequency of vancomycin was 1.0 g every 12 hours with 6 957 days (49.4%) and 60.3% daily dose of vancomycin reached the standard. 355 patients were treated to the target and 843 patients were treated empirically, the age of targeted treatment group was older than empirical treatment group [years: 44.0 (32.5, 54.0) vs. 41.0 (31.0, 52.0), P < 0.05]. The mean duration of targeted treatment group was obviously longer than empirical treatment group [days: 11 (6, 17) vs. 9 (6, 12), P < 0.01], but there was no difference in the total daily dose between the two groups [mg/kg: 25.4 (20.0, 30.3) vs. 26.1 (20.9, 31.0), g: 1.80 (1.50, 2.00) vs. 1.85 (1.50, 2.00), both P > 0.05], and daily dose of both groups did not reached the standard goal. 16.3% patients (195/1 198) received multi-courses therapy and there was no difference among the first course of dose. The clinical mortality of all patients was 1.5% (18/1 198). The targeted treatment and multi-courses had a higher proportion in the death group, and the treatment durations were longer than the non-death group [the targeted treatment proportion: 72.2% (13/18) vs. 29.0% (342/1 180), the multi-courses proportion: 83.3% (15/18) vs. 15.3% (180/1 180), the total treatment duration: 29.0 (17.8, 45.0) vs. 9.0 (6.0, 14.0), the days of the first course: 11.5 (7.5, 21.5) vs. 8.0 (6.0, 12.0), all P < 0.05]. Conclusions The dose of vancomycin to treat postoperative CNS infection was inappropriate in a majority of patients. Clinician's education regarding appropriate vancomycin dosing is recommended to achieve compliance with the guidelines.