Objective To analyze the mechanism of nasal deformity by reviewing the possible pathogenesis and nasal anatomy and to find the effective and reliable operative methods to correct nasal deformities in unilateral cleft lip.Methods 57 patients (37 males,20 females,and range in age from 12 to 25 years,with mean of 18.6 years) with nasal deformities in unilateral cleft lip were available for this study.The nasal deformities were treated with the following surgical procedures according to the different locations and degree Of nasal deformities.The eompositive techniques included:alveolar bone grafting was taken to correct the collapse the nasaI base;a cortical plate was inserted between the two medial crura of the alar cartilage.According to the nasal contours of non-cleft side,the alar cartilage was resected and suspended to its normal and symmetrical position.The alar cartilaginous ring was reconstruction,which maintained the nostril shape 3 month postoperatively.Results A total of 57 cases were treated by the method above,and were ranged with score by operators and patients.93% of cases were evaluated as satisfaction after operation.The follow-up for 3 to 24 months showed that 52 cases had achieved satisfactory effects,5 cases showed the trend to relapse.Conclusion The cause of nasal deformities in unilateral cleft lip is complex.The study has achieved a significant improvement by synthetical correction of deformities of maxilla,cartilage and soft tissues, and the restoration of nasal-labial muscles.The rigid suspending is more important to maintain the nostril contour and avoid relapse.

Humans ; Meniere Disease

Objective To investigate the feasibility and application scope of the looping technique by using a gooseneck snare and a loach guide wire in retrieving tubular foreign bodies within the vascular or ureteral duct. Methods During the period from July 2009 to Dec. 2013, six patients with ruptured catheter were admitted to authors’ hospital. All six patients were females. Three patients had internal ruptured peripherally inserted central venous catheter (PICC), one patient had ruptured implantable venous access port catheter and two patients had replacement of double “J” ureteral catheter stent. By using looping technique, i.e. a loach guide wire and a gooseneck snare were separately placed at the two ends of the tubular foreign body, then the gooseneck snare entangled the soft leading end of the loach guide wire to form a annular structure to seize the ruptured tubular catheter and then to pull it out of the body. Results With the help of the looping technique, the internal ruptured catheter or the double “J” ureteral catheter was successfully removed in all the six patients. Conclusion For the retrieval of the tubular foreign bodies within the vascular or ureteral duct, the looping technique by using a gooseneck snare and a loach guide wire is an effective and fast treatment. Therefore, this technique should be recommended in the clinical practice.

ObjectiveTo evaluate the diagnostic performance of CTCA in predicting myocardial perfusion defects through comparative analysis between MPI defects and severity of coronary stenosis on CTCA.MethodsFour hundred and seventy-eight patients who underwent CTCA and 99Tcm-MIBI MPI in the same period were analyzed retrospectively.According to the severity of coronary stenosis judged by visual evaluation of the vessel diameter,the patients were divided into five groups:no stenosis,mild stenosis,moderate stenosis,severe stenosis and total occlusion.MPI results were classified as negative or positive for perfusion defects,and the prevalence of perfusion defects in every group was calculated per-patient and per-vessel basis.The cut-off of stenotic severity for predicting myocardial perfusion defects was designated as 50％ or 75％,with MPI as standard reference.True positive,true negative,false positive and false negative statistics were thus determined separately on patient and vessel basis.The diagnostic performance for CTCA were calculated and compared.Pearson Chi-square and its partition tests or Fisher exact test were used to compare ordinal variables.ResultsFifty-eight patients showed myocardial perfusion defects.Either by patientbased or vessel-based analysis,the prevalence of myocardial perfusion defects showed an increasing trend with greater coronary artery stenosis in each group,and there were statistical differences among them (x2 =116.62 and 483.83,both P ＜ 0.05).On patient-based analysis,sensitivity ( SN),specificity ( SP),positive predictive value( PPV),negative predictive value(NPV) and accuracy (AC) for CTCA predicting myocardial perfusion defects were 62.1 ％ ( 36/58 ) and 34.5％ ( 20/58 ) (x2 =8.84,P ＜ 0.05 ),84.5％(355/420) and 97.1％ (408/420) (x2 =40.16,P ＜0.05),35.6％ (30/101) and 62.5％ (20/32) (x2 =7.19,P＜0.05),94.2％ (355/377) and 91.5％ (408/446) (x2 =2.18,P ＞0.05),81.8％ (391/478)and 89.5 ％ (428/478) (x2 =11.66,P ＜ 0.05 ) when the cutoff was set to 50％ and 75％,respectively.On vessel-based analysis,the SN,SP,PPV,NPV and AC for CTCA predicting myocardial perfusion defects were 58.8％ (40/68) and 30.9％ (21/68) (x2 =10.73,P ＜ 0.05),95.9％ (1768/1844) and 99.0％ (1826/1844) (x2 =36.72,P ＜ 0.05 ),34.5％ (40/116) and 53.8％ (21/39) (x2 =4.59,P ＜0.05 ),98.4％ (1768/1796) and 97.5％ ( 1826/1873 ) (x2 =4.14,P ＜ 0.05 ),94.6％ ( 1808/1912 ) and 96.6％ ( 1847/1912 ) (x2 =10.31,P ＜ 0.05 ),respectively.ConclusionsThe prevalence of myocardial perfusion defects correlates positively with the severity of coronary stenosis seen on CTCA.CTCA may predict perfusion defects with high SP and NPV.However,the PPV of CTCA in predicting myocardial perfusion defects is poor when the stenosis cut-off is set at 50％.It is significantly improved when the cutoff value is set at 75 ％.

OBJECTIVETo investigate the effects of external fixation combined with minimally invasive internal fixation for the treatment of distal radial fracture and dislocation of type IV based on Fernandez classification.

METHODSFrom January 2007 to October 2012,19 patients with the distal radius fracture and dislocation of type IV according to Fernandez classification were reviewed. There were 14 males and 5 females,ranging in age from 22 to 42 years old,with an average of 36.5 years old. All the patients were treated with minimally invasive reduction, and external fixation with finite internal fixation. The K-wire was used to fix radiolunate articular surface for correcting the instability of dorsal and volar intercalated segment. The radiolunate angle, scapholunate angle, and the length of the radial shorting were measured by the standard X-ray. Gartland and Werley evaluation system was used to evaluate recovery of function.

RESULTSNo complications such as injury of blood vessels and radial nerves and pin track infections occurred. After operation, the radiolunate angle, scapholunate angle and the length of the radial shorting time were (9.5 +/- 3.3) degrees, (51.3 +/- 11.2) degrees and (11.2 +/- 1.8) mm by the standard X-ray. On the 3rd month after operation, GW score was 3.02 +/- 3.05. There was no re-displacement and subluxation occurred during the follow-up period. Good functional recovery were improved wrist function significantly.

CONCLUSIONExternal fixation combined with minimally invasive internal fixation can treat distal radial fracture and dislocation of type IV based on Fernandez classification. Wrist joint stability depends on the structure of the bone and ligament around wrist joint. Emphasis on the diagnosis and treatment of carpal instability, and postoperative functional rehabilitation can improve wrist function.

Adult ; Bone Nails ; Female ; Fracture Fixation, Internal ; Humans ; Joint Dislocations ; surgery ; Male ; Minimally Invasive Surgical Procedures ; Radius Fractures ; physiopathology ; surgery ; Range of Motion, Articular ; Treatment Outcome ; Wrist Injuries ; physiopathology ; surgery ; Wrist Joint ; physiopathology ; surgery ; Young Adult

Objective To study the feasibility of using gooseneck snare combined with 0.035 inch loach guidewire for subintimal angioplasty in iliac artery occlusion , and to discuss its clinical indications. Methods During the period from October 2011 to May 2013, 3 cases with unilateral complete iliac artery occlusion were admitted to authors’ hospital. As the guidewire inserted from the healthy side could not returned into the true lumen once it entered into the subintimal space of the iliac artery , the puncture at the diseased side was carried out and the guidewire was pushed into the artery , but the catheter and the guidewire could not converge or anastomose in the subintimal site , gooseneck snare had to be used to grab the guidewire in subintimal site as to establish a path and completed the angioplasty. Results Successful and safe balloon dilatation and stent implantation were accomplished in all the 3 patients , and the patients complained of no special discomfort. Conclusion In performing the subintimal angioplasty for patients with iliac artery occlusion, the use of gooseneck snare combined with retrograde insertion of guidewire should be considered when it occurs that the guidewire can not return into the true lumen after it enters into the subintimal space. Nevertheless, gentle manipulation is first important in order to avoid the possible rupture of vessels.

Objective To investigate the role and intracellular signal transduction mechanism in the injury of renal tubular cells induced by postasphyxial-serum in neonate.Methods Human renal proximal tubular cell(HK-2 cell) was used as target cell. The experiment was designed as:control group, asphyxia group ,and pyrrolidine dithiocarbamate (PDTC)blocking group. The attacking concentration of serum was 20%, and the apoptosis rate of HK-2 cells was detected by flow cytometer.Results Compared with controls[(13.3?1.70)%],after being stimulated with postasphyxial-serum, the apoptosis rate of HK-2 cells of asphyxia group [(46.73?3.68)%] and PDTC blocking group [(31.19?2.79)%]were significantly increased(P

Objective To investigate the role of postasphyxial-serum of neonate in inducing injury of human renal proximal tubular cells(HK-2 cells).Methods HK-2 cells were used as target cell.The neonatal different concentration postasphyxial-serum of 1,3,7 days after asphyxia were used as attacking means.The experimental groups were divided into 15 groups:the 2.5%,5.0%,10.0%,(20.0%) attacking concertration groups of 1,3,7 day after asphyxia and control group of each concertration.The culture medium and concertration of the control group and the experimental groups were the same.The changes of morphology were observed under inverted microscope,the cell viability was measured by 3-(4,5-dimethyl-2-thiazoly1)-2,5-diphenyl-2H-tetrazolium bromide(MTT) method and the leakage rate of lactate dehydrogenase(LDH) was determined by biochemical methods.Results Compared with control group,the changes in morphology of HK-2 were most serious and obvious,the cell viability were obviously decreased(all P

BACKGROUND:Pelvic and acetabular fractures in elderly are frequently observed in the clinic, and the incidence gradual y increased. Moreover, it is difficult to conduct reduction and fixation due to their physical status and osteoporosis to different degrees. Locking plate is ideal fixation material in surgical treatment of acetabular fractures in elderly due to the special functions and good molding of screw and locking plate.
OBJECTIVE:To analyze the advantages and disadvantages of locking reconstruction plate used in the acetabular fracture for the aged patients and to improve the clinical effect of acetabular fractures in elderly.
METHODS:From January 2010 to February 2013, 21 aged patients with acetabular fracture were treated by open reduction and internal fixation with locking reconstruction plates made of titanium and 00Cr 18 Ni 14 Mo 3 stainless steel in the Department of Orthopedics Affiliated Hospital of Jining Medical University.
RESULTS AND CONCLUSION:Of 21 patients, 20 cases were fol owed up for 12-18 months (mean 14 months), but one dropped out. Al the fractures were healed within 4-6 months and no failure cases. According to Matta evaluation criteria, the satisfactory rate was 90%. According to the D’Aubigne scoring system, the excellent and good rate was 95%. These data indicated that locking reconstruction titanium plate is reliable, has low failure rate and satisfactory clinical effects for acetabular fracture in aged patients, and is ideal fixation material in treatment of acetabular fractures in elderly.

BACKGROUND:Bone marrow mesenchymal stem cels transplantationvia the trachea can relieve the lung injury of rats exposed to silica dust, but their distribution and migrationin vivois stil unclear. OBJECTIVE:To investigate the distribution and homing of bone marrow mesenchymal stem cels transplanted via the trachea into rats exposed to silica dust. METHODS: Bone marrow mesenchymal stem cels from Sprague-Dawley rats were isolated through bone marrow adherent method and transfected with lentivirus carrying enhanced green fluorescent protein gene (Lv-eGFP). Trypan blue staining and cel counting kit-8 were applied to assay the viability and proliferation of the transfected and untransfected cels. Sprague-Dawley rats, SPF level, were randomized into control group and silica dust exposure group. Rats in the two groups were respectively injectedvia the trachea with 1 mL of sterile silica dust suspensions (40 g/L) and 1 mL of normal saline. At 2 days after modeling, 2.2×106 transfected bone marrow mesenchymal stem cels were injected via the trachea into the rats of control group and silica dust exposure group. Rats were kiled at weeks 1, 2, 3, 4 after transplantation, and the distribution and intensity of green fluorescence in the lung, heart, liver, spleen, kidney, and brain tissue were observed under the fluorescence microscopy by frozen sections and analyzed using imaging analysis software. RESULTS AND CONCLUSION: When the multiplicity of infection was 50, there were no significant differences between the viability and proliferation activity of the transfected and untransfected cels (P > 0.05). After transplantation of transfected bone marrow mesenchymal stem cels, strong green fluorescence was observed widely in the lung, especialy around the bronchus and blood vessels, and stil obvious at the 4th week. The fluorescence of other organs also could be observed at the 1st week. It was strong and wide in the liver, spleen and heart, while faint and less in the kidney and brain, and al reduced with time. It shows bone marrow mesenchymal stem cels transplantedvia the trachea into rats exposed to silica dust can be homing to the injured lung of rats.