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

OBJECTIVE To investigate hand hygiene of healthcare workers in burn ward in our hospital and provide scientific basis for the effective prevention and control of hospital infection in burn ward.METHODS Selected randomly 30 healthcare workers in burn ward and sampled from hands for bacterial culture.RESULTS The average colony of hand pathogens of the 30 healthcare workers was 105.42 CFU/cm2,the maximam was 1093 CFU/cm2.Among the hand pathogens,40.91% were Bacillus subtilis,36.36% were micrococcus and 13.64% were Staphylococcus aureus.CONCLUSIONS Hand hygiene of healthcare workers are not optimistic in burn ward.Strengthening the education of hand hygiene and raising the executable rate of hand hygiene are important measures to prevent and control the hospital infection in burn ward.

Objective To evaluate the relationship between recurrence of cryptogenic ischemic cerebrovascular disease (CICVD) and patent foramen ovale (PFO),as well as to access the clinical significance of PFO in ischemic cerebrovascular disease.Methods Consecutive patients with CICVD aged 15 to 70 years who were hospitalized in Department of Neurology,Xuanwu Hospital Capital Medical University from January 2008 to March 2011 were prospectively investigated.Identified by transesophageal echocardiography,patients were divided into two groups with respect to outcome:PFO group and non-PFO group.The recurrence of cerebral ischemic events was compared between the two groups after neurological follow-up.Results A total of 91 patients were recruited,including 57 patients with PFO and 34 patients without PFO.The follow-up period of two groups was 695 (506,1142) d.The recurrence rate at 15 months in patients with PFO (24.5％ (12/49)) was higher than those without PFO (6.9％ (2/29),x2 =4.391,P =0.036).Cum hazard curve indicated that recurrence risk of cerebral ischemic events in patients with CICVD in PFO group was higher than that of patients in non-PFO group during the follow-up period (P =0.044).Cox model used for multivariate survival analysis indicated that PFO was a risk factor for cerebral ischemic event recurrence among patients with CICVD (OR =4.159,95％ CI 1.178-14.689,P =0.027).Conclusions PFO is associated with increased recurrence risk of cerebral ischemia in CICVD patients.In addition,PFO may be a significant factor for ischemic cerebrovascular disease.

Objective To analyze the risk factors for patients with cryptogenic ischemic cerebrovascular disease (CICVD) and patent foramen ovale (PFO), as well as to evaluate the relationship between common risk factors and PFO in cerebral ischemia. Methods Consecutive patients with CICVD aged 15 to 70 years who referred to Department of Neurology, Xuanwu Hospital, Capital Medical University from January 2008 to July 2011 were investigated. Identified by transesophageal echocardiography, they were divided into PFO group and non-PFO group with respect to outcome. The common risk factors of cerebral ischemic between 2 groups were compared. The relationship between these risk factors and PFO was analyzed. Results A total of 102 patients were investigated, including 61 patients (59.80%) with PFO and 41 patients (40.20%) without PFO. Positive family history of ischemic cerebrovascular disease proportion in PFO group (31.1%)was higher than that in non-PFO group (9.8%) (P=0.011). There was no significant difference in other observed indicators (P>0.05). Positive family history of ischemic cerebrovascular disease correlated with PFO among CICVD patients (r=0.251, P=0.011). Conclusion PFO was not only more common in CICVD patients, but also correlated with positive family history of ischemic cerebrovascular disease.

Objective To investigate the morphological changes, apoptosis and brain-derived neurotrophic factor mRNA(BDNF mRNA)expression in rat conus medullaris induced by cauda equine compression, and to discuss the possible mechanisms. Methods Ninety male SD rats were divided into 3 groups: normal control, sham operation,and cauda equine compressed. The animals were sacrificed and took samples in 30 min, 2 hours,4 hours,8 hours,1 day,3 days,1 week,2 weeks,3 weeks after cauda equine compression model were created. The morphological study concerned with cauda equina and conus medullaris was done under light microscope and transmission electron microscope. TUNEL staining and in situ hybridization staining were used to investigate apoptosis and BDNF mRNA expression changes. The positive cells in 1mm2 were calculated,and the data were disposed through one way analysis of variance. Results Histological observation showed notable alteration of cauda equina and neurons in conus medullaris. The positive cells of TUNEL and BDNF mRNA in situ hybridization staining increased in 8 hours and 4 hours after cauda equina compressed,and both reached the climax in 3days after cauda equina compressed. At the time 3weeks after cauda equine compressed, the positive cells were still much higher than that of the control groups. Conclusion The compression of cauda equina will result in neurons morphological changes and apoptosis in medullary cone,and cause central neuron un-reversible injury. It might be one of the reasons why the prognosis is poor in cauda equina syndrome. Neurons and glial cells may produce BDNF by themselves to survival from cauda equina compression.

AIM: To investigate the alterations of tear film after sutureless large incision manual cataract extraction (SLIMCE). METHODS: Sixty-eight SLIMCE operation eyes were studied with slit-limp microscope, break- up time (BUT), SchirmmerⅠtest (SⅠt),and fluorescence(FL) to observe the alterations of tear film at different time points in postoperation. Impression cytology and microphoto-analyses technique were also applied to observe the goblet cells at different time points postoperation(7,14,30,60,90 days). RESULTS: Subjective complaint of dry eye within 90 days after the operations were significantly increased compare with preoperations(5-27,23,19,16,13; 2-16,14,8,6,3). The schirmmer Ⅰ test were greatly increased in 14 days postoperation(10.1±4.5;15.0±4.7,13.8±5.7),the mean scores of fluorescence increased (0-17,9,5;0-8,3,1) and the mean break-up time decreased in 30 days post-operation(10.3±2.2;5.5±2.3,7.0±2.4,7.9±2.2) (P<0.05). CONCLUSION: SLIMCE operation have effect on the stability of tear film.

Objective To observe the variation of enzymatic activity and areas and bulk of focus of heart injuries by using controllable catheter to ablate epicardial tmsue of rabbits and focus underneath atrioventrieular ring narcosis with 20% urethane(4 ml/kg)and divided into three groups.Each group included 7 rabbits.Anterior wallepieardium of left ventricle was ablated thirty seconds in each group(10,20 and 30 W)with self-made ablationspheroid microwave antenna,refilling with high pressure normal saline at same time.Then all of the rabbits were sacrificed respectively and their ventricular myocardium were taken out to undergo immunohistochemistry in order to display suceinate dehydrogenase(SDH).Also amplitude Wag measured in order to calculate areas of heart injuries.(8F)wag delivered to the pre-selected sites around atrioventricular ring of thirty-two healthy dogs,which had beenin intravenous narcosis with pentobarbital sodium(30 mg/kg).The dogs were divided into four groups(40,50,60 and 80 w) and two time points(60 and 120 s),by the combined method of X-ray and endocardial electrocardiograph,the microwave antenna could be confirmed to be located at the accurate position between anterior and posterior wall close to septum of left/right ventricle.After ventricular myocardium had been taken out,amplitude were measuredin order to calculate bulk of heart injuries by 1/6×3.14 x long×wide×deep.In addition.the histological changesand transmural injury were examined by optic microscope.Results In each group,the centre of injuries wagenzyme deficiency locus.The diameter and areag of heart injuries enlarged significantly(3.99.±0.41),(5.20±0.25),(6.31±0.37)mm and(12.53±2.56),(21.19±3.14),(30.96±3.76)mm2 with the increased microwave power level(10、20、30 W).Group comparison had statisficM significance(F＝76.8,58.5;P＜0.01 or ＜0.05).A total of 116points were ablated.The myocardial lesion showed ellipse in shape,and continuous symmetrical coagulationnecrosis under microscopic examination.There was a clear demarcated line around tlle myocardial tissue and fewparietal thmmbus.There were 16 transmura]injuries and five-with lung damage.The bulk of lesion aroundatrioventrieular ring hag been significantly enlarged(46.7±2.5),(51.1±2.7),(133.2±3.4),(141.8±3.9),(248.5±6.2),(260.3±6.5),(313.7±9.5),(327.4±10.5)with the increased microwave power level(40,50,60and 80 W)and/or distance of microwave ablation(60 and 120 s).Groups comparison had statistical significance(F＝31.16,27.85;all P＜0.01).In each time point,the lesion bulks had conspicuous distinction of statistics.In the same microwave power,the time wag longer,the bulk was larger(P＜0.01).Conclusions The more the microwave power level and time,the severe the heart injuries is.It is possible to use the microwave energy to ablate the deep focus under endocardium around atrioventricular ring.

OBJECTIVETo observe the effect of cold or hot properties of traditional Chinese medicines (TCM) on biological effect indexes, and analyze the contribution of variables on cold or hot properties, in order to preliminarily establish the discrimination mode for the biological effects of cold or hot properties.

METHODRats were randomly divided into the blank control group, cold TCM groups (Coptidis Rhizoma, Scutellariae Radix, Phellodendri Cortex, Gardeniae Fructus, Sophorae Flavescentis Radix and Gentianae Radix) and hot TCM groups (Aconiti Lateralis Preparata Radix, Zingiberis Rhizoma, Alpiniae Officinarum Rhizoma, Zanthoxyli Pericarpium, Cinnamomi Cortex and Evodiae Fructus), and orally administered with 10 mL x kg(-1) of corresponding TCM water decoctions for 30 d, twice a day. Altogether 53 biological effect indexes correlated to cold or hot properties of traditional Chinese medicines were founded by searching literatures. The data warehouse were established by using data-mining software Clementine12.0. Data of the blank control group, cold TCM groups (Coptidis Rhizoma, Phellodendri Cortex, Gardeniae Fructus, Sophorae Flavescentis Radix, Gentianae Radix) and hot TCM groups (Aconiti Lateralis Preparata Radix, Zingiberis Rhizoma, Alpiniae Officinarum Rhizoma, Zanthoxyli Pericarpium, Cinnamomi Cortex) were selected into a training set. C5.0 algorithm and C&R classification and regression algorithm were adopted to define the importance of variable, create the decision trees, and test hot or cold properties of Evodiae Fructus and Scutellariae Radix.

RESULTAccording to C&R classification and regression algorithm, SDH activity of livers was the most important hot or cold property, with the significance closed to 30%. It was followed by triglyceride, liver Na' -K' -ATPase enzyme, muscle glycogen and platelet distribution width, with the accuracy up to 97.39% in models. C5.0 algorithm showed that liver SDH activity was the most important hot or cold property, with the significance closed to 40%. It was followed by triglyceride, GOT, muscle glycogen and liver Na(+)-K(+)-ATPase enzyme, with the accuracy up to 98.26% in models. The possibilities that Evodiae Fructus is in hot property and Scutellariae Radix is in cold property were 100. 00% and 77.78% by using both C&R classification and regression algorithm and C5.0 algorithm.

CONCLUSIONThe SDH activity of liver is the most important biological effect index to distinguish cold and hot properties of TCMs. The discrimination pathway or mode of cold and hot properties is closely related to energy metabolism.

Algorithms ; Animals ; Drugs, Chinese Herbal ; classification ; pharmacology ; Fruit ; chemistry ; Liver ; drug effects ; metabolism ; Liver Glycogen ; metabolism ; Male ; Medicine, Chinese Traditional ; methods ; Outcome Assessment (Health Care) ; methods ; Phytotherapy ; classification ; methods ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; classification ; Random Allocation ; Rats, Sprague-Dawley ; Rhizome ; chemistry ; Sodium-Potassium-Exchanging ATPase ; metabolism ; Succinate Dehydrogenase ; metabolism ; Triglycerides ; metabolism

OBJECTIVETo investigate the changes of the cardiac hemodynamics after acute high altitude exposure in healthy young males and the relationship with acute mountain sickness(AMS).

METHODSLeft ventricular function and oxyhemoglobin saturation (SaO2), heart rate (HR), blood pressure (BP) were measured in 218 healthy young males before and after high altitude exposure within 24 h respectively. According to the lake louise score criteria, the subjects were divided into two groups: acute mountain sickness group (AMS group) and non acute mountain sickness group (non-AMS group).

RESULTSHR, diastolic blood pressure (DBP), mean arterial pressure (MAP), left ventricular ejection fraction (LVEF), stroke volume (SV), stroke index (SI) cardiac output (CO), cardiac index (CI) were significantly increased upon acute high altitude exposure (P < 0.05). Whereas SaO2 and end-systolic volume (ESV) were significantly decreased (P < 0.05). In addition, HR, systolic blood pressure (SBP) and MAP in AMS group were significantly higher than those in non-AMS group (P < 0.05). But stroke index (SI) and end-diastolic volume (EDV) in AMS group were significantly lower than those in non-AMS group (P < 0.05).

CONCLUSIONCardiac function in healthy young males upon acute high altitude exposure was enhanced. EDV, HR and SI might become the indexes of predicting the acute mountain sickness in the future.

Acute Disease ; Adult ; Altitude ; Altitude Sickness ; physiopathology ; Humans ; Male ; Ventricular Function, Left ; physiology

Objective To investigate the short?term functional connectivity (FC) changes of default mode network (DMN) after liver transplantation (LT) by using seed?based functional connectivity analysis of resting?state functional MRI (rs?fMRI). Methods Eighteen cirrhotic patients as transplant candidates and 20 healthy controls were included in this study. All the patients underwent rs?fMRI examination before and one month after LT. The data were analyzed using DPARSF and REST software. Seed?based functional connectivity analysis was used to isolate the DMN. The posterior cingulate cortex (PCC) was chosen as seed region for the DMN map. Maps of the DMN were compared among the groups. Values of Z reflecting the functional connectivity of 3 groups were obtained. Two?sample t?test was performed to explore the DMN difference between cirrhotic patients and controls, and we used paired t tests to examine for any differences in functional connectivity before and after LT. Pearson correlation analysis was performed to explore the relationship between the changes of functional connectivity with that of clinical indexes and neuropsychological test scores pre?and post?LT. Results Typically spatial distributions of the DMN were found in all the groups. According to paired t test, post?LT patients showed increased FC in left medial prefrontal cortex (t=3.31, P<0.05), while decreased FC in left precuneus and left lateral temporal cortex (t=-3.37,-4.53,respectively, both P<0.05). Compared to healthy controls, pre?LT patients showed decreased FC in the right precuneus, bilateral medial prefrontal cortex, bilateral inferior parietal cortex, and bilateral lateral temporal cortex(t=-4.32—3.00, all P<0.05), and post?LT patients showed decreased FC in right precuneus, left posterior cingulate cortex, bilateral inferior parietal cortex, and bilateral lateral temporal cortex(t=-4.33—2.99,all P<0.05). Pearson correlation analysis revealed positively correlation between the changes of functional connectivity in left medial prefrontal cortex with that of DST (r=0.543, P=0.02). Conclusions This study found that the DMN FC of post?LT patients still lower than that of healthy controls one month after LT. The left medial prefrontal cortex was the first brain region that showed increased FC, while the FC of some regions continued to decrease, suggesting that brain function reorganization can continue after LT. Rs?fMRI can be used to observe the DMN changes in post?LT patients.