OBJECTIVETo explore a new technique for repair of alveolar cleft by sutural distraction osteogenesis.

METHODSNine 8-weeks mongrel dogs were used in this study, three being in the control group, six in the experimental group. Alveolar cleft model was created surgically in all animals. Two weeks later, a U-shaped distractor made of Ni-Ti memory alloy wire was insterted into the premaxilla to distract the mid-premaxillary suture. When the premaxilla of the cleft side approached the ipsilateral maxilla, periosteoplasty of the alveolar cleft was performed. The distractor was removed at two weeks after periosteoplasty. The results were evaluated clinically, radiographically, morphologically and histologically.

RESULTSThe cleft model in dogs was stable and similar to the human alveolar cleft. In experimental dogs, the premaxilla was moved gradually toward the maxilla so that the cleft was closed. The distracted mid-premaxillary suture showed a gradually widened traingle, with its tip being posterior. The density of the distracted traingle suture was increased gradually. Bony repair was achieved completely at the cleft three months post-periosteoplasy. The morphology of the mid-premaxillary suture was restored.

CONCLUSIONThe alveolar cleft could be repaired by the technique of mid-premaxilla suture distraction.

Alveoloplasty ; methods ; Animals ; Dogs ; Maxilla ; surgery ; Models, Animal ; Osteogenesis, Distraction ; methods

OBJECTIVETo probe the feasibility of a new technique of sutural distraction osteogenesis for midface hypoplasia repair.

METHODSA protraction system was developed, which consisted of three parts: a rigid external framework, a bone hook, and the elastic band. Four 12-week mongreal dogs were randomly assigned into two groups: the control (n = 1) and the experimental groups (n = 3). Four pairs of titanium bone markers were fixed on either side of the bone sutures of all animals. The experimental group was fitted with a distraction device, through which a forward elastic force was exerted for 1 month. Clinical observations and X-ray examinations were performed at the beginning and the end of distraction. New bone specimens were examined histologically.

RESULTSAll the animals in the experimental group showed progressively forward movement of the maxilla and manifested class II occlusion at the end of the experiment. The distance increase between each pair of bone markers showed that premaxilla advancement was more than that of the maxilla. The next was zygoma. There was no obvious difference between the control and the experimental group in terms of the basilar-maxillary angle and counterclockwise rotation. Theer was active osteogenesis in the sutures, especially in premaxilla-maxillary sutures. The number of osteoblasts and fibroblasts increased dramatically and new bone formation was found at the edge of the suture.

CONCLUSIONThis technique can create effective advancement of the maxilla. The direct force can avoid counterclockwise rotation of the maxilla during distraction.

Animals ; Dogs ; Maxilla ; abnormalities ; diagnostic imaging ; surgery ; Osteogenesis, Distraction ; methods ; Radiography ; Random Allocation ; Suture Techniques

OBJECTIVETo summarize the experience of diagnosis and treatment of esophageal leiomyoma.

METHODSClinical data of 52 patients with esophageal leiomyoma were analyzed from 1993 to 2002.

RESULTSAbout 54% patients in this group had difficulty of food intake. The diagnostic accuracy of gastrointestinal barium meal series, computed tomography, gastric endoscope and endoscopic ultrasonography (EUS) for esophageal leiomyoma was 64% 44% 27% and 90% respectively. All patients received operation, resection of esophageal leiomyoma by videothoracoscopy (VAS) and endoscope were performed in 6, 9 patients respectively. The remaining 37 patients received regular open operation,in whom 32 cases received enucleation of esophageal leiomyoma, 5 cases received partial esophageal resection and esophageal-gastric anastomosis. No serious complications occurred except only one case needed operation again because of bleeding.

CONCLUSIONEUS is an effective method for diagnosing esophageal leiomyoma. VAS and endoscopic treatment should be considered for suitable cases in order to reduce the trauma.

Esophageal Neoplasms ; diagnostic imaging ; surgery ; Female ; Follow-Up Studies ; Humans ; Leiomyoma ; diagnostic imaging ; surgery ; Male ; Middle Aged ; Thoracoscopy ; Ultrasonography

OBJECTIVETo probe the possibility of a new technique of primary cleft palate repair by sutural distraction osteogenesis.

METHODSThe distractor was made of TiNi-shape memory alloy with 2 secure and 2 active arms. Under general anesthesia, 1 hole was drilled on each maxillary process and horizontal plate of palatine. The four arms of the distractor were inserted into holes. The palatine bones would then be distracted and moved medially and posteriorly. After 4 to 5 months' distraction, the two cleft edges approached gradually. The residual cleft, according to its width, was repaired by direct stitch of muco-periosteum incised at cleft edges, or with an additional relaxing incision on one side of the palate. Direct measurement of width of maxillary arch and the cleft, and the length of the hard palate was performed before and after distraction to evaluate the effects of distraction.

RESULTSEight cleft children at their 2 to 4 years of age were treated by the new technique. Two of them terminated the procedure due to premature dislocation of the distractor. Six children underwent 37 to 126 days' distraction. Dramatic narrowing of the cleft and lengthening of hard palate were seen in these children, with the average narrowing of the cleft being 6.5 mm and average lengthening of the hard palate being 4.8 mm.

CONCLUSIONIt is clinically demonstrated that palatal tissue regeneration and cleft closure or narrowing and hard palate lengthening could be achieved by the technique of sutural distraction osteogenesis.

Child, Preschool ; Cleft Palate ; surgery ; Humans ; Maxilla ; Osteogenesis, Distraction ; instrumentation ; methods ; Palate, Hard ; surgery ; Suture Techniques ; Time Factors

Objective To investigate the prognostic value of acute beart block (AHB) after percutaneous transluminal septal myocardial ablation (PTSMA) in patients with hypertrophic obstructive cardiomyopathy (HOCM). Methods Ninety-four HOCM patients underwent PTSMA were included in this study. Twelve-lead electrocardiograms were obtained during and post PTSMA. Association between clinic events and incidence of post-PTSMA AHB was analyzed. Results AHB was induced in 26 patients by PTSMA and disappeared in 11 patients shortly post PTSMA, subacute intraventricular conduction disturbances was seen in 11 (42.3%), subacute I°AVB in 2(7.7% ) and subacute Ⅲ°AVB in another 2 (7.7%) patients. Among 68 patients without AHB during PTSMA, intraventricular conduction disturbances was evidenced in 14 patients (20.6% ), I°AVB in 2 (2.9% ) and Ⅲ°AVB in 1 patient (1.5%) after PTSMA. AHB patients with subacute heart block were associated with poor prognosis (conduction block duration was 42.00 h) while patients without AHB was associated with benign prognosis even with new onset of subacute heart block (conduction block duration was 7.33 h, P <0.01). Conclusion Patients with AHB during PTSMA are at higher risk for subacute heart block, especially intraventricolar conduction disturbances. AHB patients with subacute heart block were associated with poor prognosis and longer recovery time conducting system.

Objective To explore the application nursing warning mark in psychiatric.Methods Photos of psychiatric patients when they admitted to hospital were collected,and their nursing warning logo were made which including their photos,basic information and colored wax light strips.And patients identification and nursing care providing by nurses were accorded to patients' warning logo.The errors due to adverse event occurded on in-hospital patients and mistaken identification during nursing checkup were compared between before and after the application of warning logo.Results After the application of nursing warming logo,the accident rate of hospitalized patients was significantly dropped from 15.7％ to 6.7％ (x2 =64.39,P ＜ 0.01),the incidence of medication error for identification error was decreased to 0.2％,and no infusion error happened.Conclusions Warning sign can be used as a fast,safe,effective clinical nursing identification tool.

Objective To collect the laboratory parameters and clinical parameters of blood culture positive samples,and analyze the composition and laboratory characteristics of real pathogens by combining with clinical follow-up and anti-infectious treatment outcomes.Methods We conducted a prospective study to isolate the 483 strains of pathogens from 4313 cases of blood samples for clinical examination between March 2013 and March 2015.The results of laboratory and clinical infections were collected for each positive culture and were followed up for clinical follow-up to understand the responsible doctors' experience-based judgment and targeted clinical treatment of antibiotics.After comprehensive analysis we determined the real pathogens and contaminants.Results Of the 483 positive cultures,331 were finally determined as pathogenic ones,accounting for 68.5% of the number of positive isolates; 97 were contaminated bacteria (20.1%); and 55 strains with uncertain pathogenic nature (11.4%).Escherichia coli accounted for the highest proportion (41.2%)of pathogenic bacteria.Coagulase-negative staphylococci took up the highest proportion (75.3%)of the contaminated bacteria.As many as 253 strains (52.4%)were detected from the aerobic or anaerobic bottles.The detection rate of Escherichia coli in anaerobic bottles (23.9%)was higher than that in aerobic bottles (13.8%)(P <0.05).Of 97 strains of positive isolates,only one bottle was reported positive for 90 strains,accounting for (92.8%),and more than two bottles of 7 positive strains,accounting for (7.2%)(P <0.05).34 positive in 24 h (35.1%),77 positive in 48 h (79.4%),the positivebacteria ratio within 48 h (79.4%)was higher than that of bacteria contamination ratio within 24 h (χ2 =38.935, P =0.000),with a significant difference.Conclusion Establishment of contaminated bacteria in blood culture cannot rely solely on laboratory or clinical parameters.It should be combined with the experience of clinicians to determine the clinical response to comprehensive judgments.For the laboratory to determine the presence of contamination,the number of positive bottles and the amount of sun are still two factors of important value.Paying attention to inspection of anaerobic bottles is more conducive to the detection of Escherichia coli.

Objective To study the effects of selenium(Se) and protein on cardiac morphology and expression of cellular glutathione peroxidase(GPX1 ) and mitochondrial thioredoxin reductase(TR2) in rat myocardial tissue.MethodsSixty healthy weaning male Wistar rats were randomly divided into four groups by two factors two levels factorial design(n =15).Drinking water was divided into two levels of Se-deficient(0 mg/L) and Se-adequate (0.25 mg/L); diet was divided into two levels of protein-deficeient (10％ protein and 0.008 mg/kg Se) and protein-adequate(20％ protein and 0.015 - 0.026 mg/kg Se).The rats were killed after feeding for one year.Pathological changes in myocardial tissues were observed under light microscope.The expression of GPX1 and TR2 in rat myocardial tissue was detected by immunohistochemistry and Western blotting.Results Compared between groups,the difference of the rate of myocardial necrosis in rats was statistically significant(x2 =11.04,P ＜ 0.05),in which Se-deficient protein-deficient group [66.7％ (8/12) ] was significantly higher than Se-adequate proteinadequate group [ 7.1％ ( 1 / 14),x2 - 11.06,P ＜ 0.05 ].GPX 1 positive rates in Se-deficient protein-deficient group,Se-adequate protein-deficient group,Se-deficient protein-adequate group and Se-adequate protein-adequate group were 0(0/12),81.8％(9/11 ),10.0％(1/10) and 100.0％(14/14),respectively,in rat myocardial tissue determined by immunohistochemistry.Of which,Se-adequate protein-deficient group and Se-adequate protein-adequate group were significantly higher than Se-deficient protein-deficient group and Se-deficient protein-adequate group(x2 =12.88,8.14 and 35.89,32.60,all P ＜ 0.05).The positive expression rates of TR2 in rats myocardial tissue of the four groups were 0(0/12),81.8％(9/11),0(0/10) and 100.0％(14/14),respectively.Of which,Se-adequate proteindeficient group and Se-adequate protein-adequate group were significantly higher than Se-deficient protein-deficient group and Se-deficient protein-adequate group (x2 =28.67,18.25 and 35.89,32.60,all P ＜ 0.05).The four groups'results of the overall mean of the relatively value of protein expression of GPX1 in cardiac tissue by Western blotting were 0.87 ± 0.13,1.18 ± 0.13,0.95 ± 0.13 and 1.74 ± 0.23,respectively.Through analysis of variance of factorial design,the effects of Se and protein on protein expression of GPX1 in the heart were statistically significant(F=124.93,43.16,all P＜ 0.05).And there was interaction between them(F=24.10,P＜ 0.05).The four groups'results of the overall mean of the relatively value of protein expression of TR2 in cardiac tissue by Western blotting were 0.63 ± 0.19,0.97 ± 0.24,0.55 ± 0.08 and 1.03 ± 0.31,respectively.Through analysis of variance of factorial design,the effect of Se on expression of TR2 in the heart was statistically significant(F =36.97,P ＜ 0.05).Conclusions Adequate Se and protein diet can increase the levels of GPX1 and TR2 in the heart compared to deficient Se and protein diet,can enhance anti-oxidizing ability,protect the myocardial endothelial cells,reduce degree of myocardial injury,and the combined effects of both are better.

Objective To investigate the clinical manifestations of patients with pulmonary artery hypertension (PAH) associated with hereditary hemorrhagic telangiectasia (HHT). Methods This retrospective analysis summarized the clinical features of 6 patients with PAH associated with HHT hospitalized at department of cardiology in Cardiovascular Institute and Fuwai Hospital between January 2006 and May 2009. Results The mean age of the 6 patients (3 male) was 34 years (8 -67years). Recurrent epistaxis were present in all patients, there were 4 patients with severe PAH and 2 patients with moderate PAH. All of the six patients with PAH associated with HHT were misdiagnosed at the first hospital visit.Clinical symptoms were significantly improved in 4 patients and remained unchanged in 2 patients combined hepatic venous malformation post medical therapy. Conclusions Misdiagnosis for patients with PAH associated with HHT is a common phenomenon in daily clinical practice. Patients could benefit from the corresponding medical therapy after the establishment of the correct diagnosis.

Objective To probe into the clinical application effect of the transitional care model on alcohol-induced mental disorders.Methods One hundred and two patients with alcohol-induced mental disorders were divided into the intervention group (n =50) and the control group (n =52) patients in group according to block randomization method.The control group received routine care interventions; the patients in the intervention group discharged to home in open wards,received transtional care model intervention and established services file on the basis of routine care.The patients were followed up for 6 months,and were surveyed by medical coping modes questionnaire (MCMQ),social dysfunction screening scale (SDSS) and social support rating scale (SSRS).The complex drink rate and satisfaction were analyzed in patients.Results The differences in the social support,social functioning,coping style and complex drink rate were not statistically significant between two groups in the discharge.The scores of the social support,social functioning,coping style and complex drink rate were respectively (12.68 ± 3.45),(24.68 ± 5.02),(9.88 ± 2.41) in the intervention group six months after discharge,and were better than (10.98 ± 3.47),(20.77 ± 5.90),(6.78 ±2.13) in the control group,and the differences were statistically significant (t =5.63,5.55,14.07,respectively; P ＜0.01).The scores of face,avoid and yielding were respectively (19.86 ±3.68),(10.84 ±1.89),(8.58 ± 2.46) in the intervention group six months after discharge,and were better than (15.84 ±3.65),(16.54 ± 2.88),(13.78 ± 2.47) in the control group,and the differences were statistically significant (t =7.89,9.12,15.75,respectively; P＜0.05).The score of SDSS was (8.21 ±1.91) in the intervention group six months after discharge,and was better than (10.84 ± 2.14) in the control group,and the difference was statistically significant (t =3.87,P ＜ 0.05).The total abstinence rate,the limited drinking rate,the satisfaction of patients were respectively 52.00％,18.00％,98.00％ in the intervention group six months after discharge,and were better than 19.23％,15.38％,84.61％ in the control group,and the differences were statistically significant (x2 =14.504,5.676,respectively; P ＜0.05).Conclusions Transtional care model intervention can improve the patients' social support,social function,coping styles and abstinence rate,and improve the satisfaction of patients and their families.