Objective To clarify the features and early diagnosis of the traumatic diaphragmatocele associated with pelvic fracture. Methods The clinical materials of 486 multiple injuried patients with pelvic fractures as main trauma were retrospectively analysed. The pathogenesis, clinical manifestation and reasons for misdiagnosis in 9 cases of traumatic diaphragmatocele were analysed. Results In this series, the incidence of the traumatic diaphragmatocele was 1.9%(9 of 486). Because of under recognition of this associated injury, 7 in 9 cases of traumatic diaphagmatocele were misdiagnosed or undiagnosed. The incidence of misdiagnosis was 77.8% in this series. Conclusion The main reason for the occurrence of diaphragmatocele was the rapid increase of the intra abdominal pressure which resulted in rupture of the weak area of the diaphragm. Type B1 pelvic fracture can cause traumatic diaphragmatocele easily. The symptoms of the diaphragm hernia are easily overlooked when the trauma is serious or the patient is in shock. Because the early symptoms are not often evident and typical, the doctor can not notice it thoroughly. The main reason for misdiagnosis of the diaphragm hernia is the poor clinical presentation and sign of the diaphragmtocele which initially is very similar to that of the thoraco abdominal injury. In the case with chest and abdominal symptoms concomitant with pelvic fracture should be observed carefully and the chest and abdominal radiographs should be taken as soon as possible. Closed attention should be paid to diaphragmatocele when treating a pelvic fracture in consideration of 7 out of 9 patients being misdiagnosed in this series.

In order to overcome the shortcomings of traditional X-ray inspection taking passive protection mode, this paper combines the automatic control technology, puts forward a kind of active protection X-ray equipment. The device of automatic detection of patients receiving X-ray irradiation part, intelligent adjustment in patients and shooting device between automatic tracking radiation protection device height. The device has the advantages of automatic adjustment, anti-radiation device, reduce the height of non-irradiated area X-ray radiation and improve the work efficiency. Testing by the professional organization, the device can decrease more than 90% of X-ray dose for patients with non-irradiated area.
Humans ; Radiation Dosage ; Radiation Protection ; instrumentation ; methods ; X-Rays

Objective To analyze the antimicrobial resistance profile of clinical isolates in Shanghai Xinhua Hospital Chongming Branch affiliated to Shanghai Jiaotong University School of Medicine , a member of China Antimicrobial Resistance Surveillance System, during 2015, for the purpose to facilitate rational antimicrobial therapy. Methods Strain identification?and?susceptibility?testing?were?carried?out?for?the?clinical?isolates?using?MicroScan?WalkAway?96?Automated?Systems and Kirby-Bauer method. Results In 2015, a total of 1815 isolates were collected, including gram-negative bacteria (73.2 %) and gram-positive bacteria (26.8 %). The top three frequently isolated species were Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa. ESBL-producing strains were found in 36.3 % of the Escherichia coli isolates, 12.6 % of the Klebsiella (K. pneumoniae and K. oxytoca) isolates, and 28.0 % of the Proteus mirabilis isolates. The prevalence of carbapenem-resistant strains was 0.69 % in Enterobacteriaceae isolates. The prevalence of methicillin-resistant strain was 29.1 % in S. aureus, and 61.4 % in coagulase-negative Staphylococcus isolates. No more than 15 % of the Enterobacteriaceae isolates and no more than 20 % of the P. aeruginosa and Acinetobacter isolates were resistant to carbapenems. No vancomycin-or linezolid-resistant strains were found in Enterococcus or Staphylococcus. Conclusions Antibiotic-resistant clinical isolates are a serious threat for clinical antimicrobial treatment. We should pay more attention to such urgent situation and rational use of antibiotics.

AimTo investigate the protective effect of nerve growth factor (NGF) from the Chinese cobra venom on spinal neurons after sciatic nerve lesion. Methods Fourty Wistar rats were divided into 2 groups each containing 20 animals. After surgical crush lesion on the bilateral sciatic nerve, the rats were injected NGF into the target muscle every day. On the d 5 and d 10 after operation, enzyme histochemistry technique was used to show acetycholinesterase(AchE) activity of the motoneurons in L5～S2 spinal cord anterior hornandfluorideresistantacidphophatase (FRAP) activity of substantia gelatinosa in L5～ S2 spinal cord posterior horn. The activity of enzyme was analysed with computer image analysis system. Results Compared with the control group, the activity of FRAP in NGF group was higher on the d 5 and d 10 after operation and the activity of AchE in NGF group was higher on the d 10 after operation. ConclusionIt is demonstrated that NGF could protect the mononeurons in spinal cord anterior horn and the sensory neurons in dorsal root ganglia after axotomy.

ObjectiveTo evaluate the fourth-generation ultrasonic lithotripsy system for treating the urinary tract stones.Methods243 cases of urinary tract stones who received treatment of fourth-generation EMS ultrasonic lithotripsy system were analyzed retrospectively.ResultsImmediate phase I lithotrotrisy was performed successfully in 227 cases and the successful rate of phase I was 93.3％ (227/243).Delayed phase Ⅱ lithotripsy was performed for 16 patients.Complications happened in 2 cases,one case occurred hydropneumothorax during operation,required indwelling thoracic drainage tube processing,the other had severe bleeding which conservative treatment was ineffective,cured by the intervention of super-selective renal artery embolization.Conclusion Fourth generation of ultrasonic lithotripsy for treating stones on different anatomical locations of urinary system was safe,practical and efficient,worthy of clinical application.

Objective To study the animal toxicity test on skin of the Chinese herbal drugs liquid paste (CHDLP).Methods Acute and multiple times skin stimulation test and skin allergy test were performed on healthy guinea pig by using CHDLP.Results The acute skin stimulation score and intensity score were all zero.Multiple skin stimulation score and pathological examination score were all zero.So were the skin allergy score and the sensiti- zation rate.Conclusion CHDLP is a weak sensitizer and arose no skin stimulation on guinea pig.It's safe when ex- ternal use.

The chitosan scaffolds with different deacetylated degree were prepared in this study. The morphology of scaffolds were observed using SEM, and the porosity, the water absorbing swelling ratio and the degradation were examined both in vitro and in vitro. The results showed that the chitosan scaffolds with different deacetylated degree exhibited three-dimensional structure with high porosity. With increasing of deacetylated degree, their porosities were 93.46%, 90.02% and 86.71%, respectively. The swelling ratios of chitosan scaffolds were 820%, 803% and 772%, respectively. At the fourth week, the degradation rates were 30.44%, 22.08% and 17.10% in vitro, respectively; while the corresponding rates were 57.48%, 40.23%, 29.53% in vivo respectively. The degradation rate of chitosan scaffold was negatively correlated to deacetylated degree. Furthermore, it showed that the speed of degradation in vivo was faster than that in vitro. We concluded that controlling the deacetylated degree of chitosan can provide a well-matched degradable scaffold material for the reparation of cartilage defects.
Absorbable Implants ; Acetylation ; Animals ; Biocompatible Materials ; Chitosan ; analogs & derivatives ; chemical synthesis ; chemistry ; Female ; Male ; Materials Testing ; Rats ; Rats, Sprague-Dawley ; Tissue Engineering ; Tissue Scaffolds ; chemistry

OBJECTIVETo investigate thirdhand smoke (THS) pollution in certain places of Nanjing, as well as to analyze its distribution characteristics.

METHODSFrom March to May, 2014, we selected 3 types of places (residencies, public places and transportation vehicles) that were close to people's living in Jianye,Yuhua,Jiangning,Xuanwu,Gulou and Pukou districts of Nanjing city.For each of the above 3 types of places, 2-3 smoking and non-smoking (smoking ban) locations were investigated, totally 51 locations, 9-10 samples were collected each location, totally 477 samples. The surface wipe sampling method in conjunction with liquid chromatography-tandem mass spectrometry (LC-MS/MS) was utilized to quantify the levels of nicotine that served as the tracer of THS pollution.One-way ANOVA and t-tests were employed to compare the levels of nicotine collected at different places and locations.

RESULTSTotally 477 samples were collected in this study, of which 27.0% was from residencies (129/477), 61.0% (291/477) from public places and 11.9% (57/477) from transportations. The levels of indoor surface nicotine in smoking residences, public places and transportations were (214 ± 55),(1 408 ± 177) and (1 511 ± 785) µg/m(2), respectively, which were all higher than those in the corresponding non-smoking places ((23 ± 9),(62 ± 11), and (46 ± 15) µg/m(2); t values were 13.79, 13.15, 3.45, respectively. P values were <0.001, <0.001 and 0.006, respectively).In the smoking places, the levels of surface nicotine on walls, desks, sofas, cabinets, door backsides and air conditioning openings were (171 ± 62),(232 ± 38),(373 ± 151),(903 ± 239), (978 ± 212), (1 721 ± 517) µg/m(2) (F = 7.06, P = 0.009).In the smoking condition, the levels of surface nicotine collected from public places were higher (F = 9.25, P = 0.024), while under non-smoking (smoking ban) conditions, the levels of surface nicotine collected from residences were lower (F = 7.88, P < 0.001).

CONCLUSIONTHS pollution was widespread in public places, residences and transportations in Nanjing city, which was more serious in the smoking environments than non-smoking (smoking ban) environments; the contamination was less serious in non-smoking (smoking ban) private residences; in the smoking condition, the levels of surface nicotine were relatively high at locations close to air conditioning openings, door backsides and cabinets.

Air Conditioning ; China ; Housing ; Humans ; Nicotine ; Public Facilities ; Smoking ; Tandem Mass Spectrometry ; Tobacco Smoke Pollution ; Transportation

Objective:To determine the effects of pentoxifylline-tocopherol-clodronate combination (PENTOCLO) protocol in the treatment of localized temporal bone osteoradionecrosis (TBORN).Methods:A retrospective analysis was conducted on the clinical data of 21 patients, who suffered localized TBORN (23 ears) and were treated with the PENTOCLO protocol in Sun Yat-sen Memorial Hospital, Sun Yat-sen University from November 2020 to April 2021. The curative effects of the PENTOCLO protocol were evaluated based on the changes in ear symptoms and the extent of exposed bone before and after treatment.Results:The PENTOCLO protocol was applied for (506 ± 48) d on average. As a result, 19 ears (82.6%) became free of earache and purulent ear discharge, and two ears (8.7%) showed alleviation of symptoms. Moreover, nine ears (39.1%) exhibited re-epithelialization in the ear canal, 11 ears (47.6%) showed a decrease in exposed ear canal bone, and the osteonecrosis of three ears (13.0%) was stable.Conclusions:PENTOCLO has encouraging treatment effects on TBORN, and thus can be used as an effective nonsurgical option for localized TBORN.

The formulations of pramipexole hydrochloride sustained-release tablets were screened by single factor test and optimized by Box-Behnken design. The effects of the viscosity and content of hydroxypropyl methyl cellulose, as well as the insoluble sustained-release material combined with HPMC K100M on the in vitro release behavior were investigated. After single factor screening, a three-factor, three-level Box-Behnken design was used for optimization using the contents of HPMC K100, Eudragit RSPO and Eudragit L100 as independent variables, and the cumulative release at different time as responses. The optimal range of the three-factor optimized by Box-Behnken design, one of the optimized formulations was achieved with HPMC K100M of 101. 5 mg, Eudragit RSPO of 98 mg, and Eudragit L100 of 13. 7 mg, and the observed responses of the optimized formulation were very close to the predicted values. The in vitro drug release mechanism of the tablet was studied by drug released model fitted with different equations. The results explained that Eudragit RSPO promoted the release of the pramipexole hydrochloride, while Eudragit L100 blocked the release, and there was an antagonism between them. In conclusion, the drug release behavior of optimized formulations prepared by Eudragit RSPO/L100 was stable, less pH-dependent, which improved the drug bioavailability in vivo.