ObjectiveTo investigate the distribution of high-intensity zone (HIZ) of lumbar intervertebral disc in patients with low back and/or leg pain,and analyze its related factors.MethodsSix hundred and twenty-eight patients with low back and/or leg pain were examined by MRI scan from June 2009 to August 2010.According to the diagnostic criteria of HIZ,the features of distribution of HIZ on age,segment and degree of intervertebral disc degeneration were analyzed retrospectively.ResultsAmong 3140 intervertebral discs of the 628 patients,172 cases (27.39％,172/628) and 206 discs (6.56％,206/3140)were involved with HIZ.There was no significant difference between men and women [26.38％(86/326)vs.28.48％(86/302)] (P=0.556).HIZ occurred more often [40.22％(72/179)] in those patients between 40 and 49 years of age.The incidence of HIZ at the segments from L1-2,L2-3,L3-4,L4-5,L5-S1 was 0.80％(5/628),2.07％(13/628),2.07％(13/628),14.01％(88/628) and 13.85％(87/628) respectively.In cases with and without HIZ,the incidence of intervertebral disc degeneration up to grade V was 49.03％(101/206) and 23.76％(697/2934) respectively (P ＜ 0.01 ).HIZ was correlated with age,degree of intervertebral disc degeneration and disc segment (r =-0.040,P=0.025 ;r =0.217,P＜ 0.01 ;r =0.179,P＜ 0.01 ).Conclusions HIZ is correlated with age,degree of intervertebral disc degeneration and disc segment.Intervertebral disc degeneration plays the most important role in the occurence of HIZ.HIZ_mainly occur in L4-5 and L5-S1 segment and in those between 40 and 49 years of age.

Effects of Cr 6+ concentration and culture time on four heavy metal removing strains,stability of these four strains removing Cr 6+,configuration changes inside or outside their cells,effects of Cr 6+ on soluble reductive sugar inside their cells,and effect of several factors on these strains had been studied,and the Cr 6+ resistance mechanisms of these strains have been discussed elementarily. The results showed that the Lethality of these strains caused by Cr 6+ was similar with one another, namely, increasing at first, then decreasing, and finally increasing again as culture time passed. Acclimatization of Candida sp. was better than Sporobolomycetaceae sp.,and the Cr 6+ resistance of Sporobolomycetaceae sp. 7-3 was the best of the four. The research also demonstrated that the metabolic activity of these strains had been influenced by Cr 6+ in a certain extent. Scanning electron microscopy,transmission electron microscopy,and atomic force microscopy observations approved that removal of Cr 6+ by Candida sp. was depended on both surface adsorption and intracellular accumulation. Effects of Cr 6+ concentration, pH, culture time, nitrogen source, carbon source and adsorption time on these strains are not the same.

Objective To analyze our clinical results of head and neck reconstruction using microsur- gical free flap transfer techniques.Methods The free flap donor sites with long vascular pedicle and large diameter of vessel were routinely chosed,and chose receipt vessels with large diameter and proper position, and perform vessel ananstomosis under surgical loups instead of microscope.The un-buried free flap with a mo- nitoring window were harvest,and do double venous anastomoses in some flaps to ensure adequate venous out- flow.Results From May 1999 to March 2005,1066 consecutive free flap transfers were used to reconstruct head and neck defects.The overall success rate of free flap was 98.3%.The vessel thrombosis rate was 3.1%,and the flap salvage rate was 45.5%.Conclusion Head and neck reconstruetion using microsurgi- cal free flap transfer technique is safe and reliable,and good clinical results can be obtained.

BackgroundWhether the peeling of the inner limiting membrane (ILMP) increase the closure rate of idiopathic macular hole is still in controversy.Some ophthalmologist recommend vitrectomy combined with inner limiting membrane peeling for the treatment of idiopathic macular hole.However,the removal of ILMP is difficult because of its similar appearance to adjacent tissues.Objective This study was to investigate the efficacy of triamcinolone acetonide(TA) and indocyanine green(ICG) double staining-assisted vitrectomy combined with ILM peeling during the surgery.Methods A consecutive case- observational study was designed.The standardized vitrectomy was performed in 25 eye of 23 cases with IMH.During the vitrectomy,TA and ICG were injected into posterior pole vitreous to visualize and assist the ILM peeling.The dying effectiveness was observed,and the closure rate of macular hole,visual acuity,intraocular pressure and complications were evaluated after surgery.Written informed consent was obtained from each patient prior to operation.Results Posterior vitreous cortex and ILM were visible and the residual vitreous and cortex were removed clearly after dying of TA and ICG in all the 25 eyes.During the following-up duration of 3-8 months,the completely anatomical reattachment of the macular area was in 22 eyes ( 88.0％ ) and partially reattachment in 3 eyes( 12.0％ ).The best corrected vision was 0.07-0.60 in all of the operated eyes 2 months after surgery.Conclusions TA and ICG- assisted vitrectomy combined with ILM peeling appears to be a safe and effective method for IMH repair.

OBJECTIVETo investigate therapeutic effects of vacuum sealing drainage (VSD) in the treatment of soft tissue defect combined with tendon and bone exposure.

METHODSFrom October 2007 to February 2011, 397 patients (412 feet) with open ankle fracture and dislocation combined with soft tissue defected were treated by VSD. There were 301 males and 96 females with an average age of 36 years (ranging age from 20 to 73 years). According to AO classification, 74 feet were type I, 211 feet were type II, 108 feet were type III and 19 feet were type IV. The mean time from injury to operation was 5.6 h ( 2 to 12 h). The mean treatment time of was 10 months (4 to 19 months).

RESULTSOne hundred and forty-one patients were primarily healed, 97 patients were sutured at stage II. Split-thick skin grafting was performed at stage II was performed in 103 patients; free flap transplantation was performed in 25 patients. Three of the 34 patients with infection were removed steel plate; Eviscerate flap coverage wound was performed in 14 patients caused by the first metatarsal bone exposure; Toe amputation were performed in 22 cases caused by toes necrosis. Tarsometatarasl joints perforators' surgery was performed in 10 patients with forefeet necrosis. Thirty hundred and six patients were followed up from 3 to 20 months (averaged 10 months). The wounds healed well.

CONCLUSIONVSD for soft tissue defects caused by ankle injury is a simple and effective method, but can not replace debridement and transfer flap.

Adult ; Aged ; Ankle Fractures ; Debridement ; Drainage ; methods ; Female ; Humans ; Joint Dislocations ; surgery ; Male ; Middle Aged ; Skin Transplantation ; Treatment Outcome ; Vacuum ; Young Adult

Humans ; Moxibustion ; Depression ; Acupuncture Therapy ; Gastroesophageal Reflux ; Esophagitis, Peptic

Objective To investigate the relationship between insulin resistance and erythrocyte in- sulin receptors in patients with gout associated with macroalbruminuria(MAU).Methods FBG,PBG,FINS, P2hINS,CH,TG,HDL,LDL-c,UA and erythrocyte insulin receptors were determined in 44 patients with MAU,62 patients with normal MAU(NMAU).Results In MAU,the levels of FINS,TG,LDL-c and HOMA-IR were(16?4)mU/L,(2.5?0.6)retool/L,(3.2?0.5)mmol/L and 3.6~1.2 respectively.While they were(13?3) mU/L,(2.3?0.8)mmol/L,(3.0?0.5)mmol/L and 3.0~0.4 in NMAU group.The levels of FINS,TG,LDL-c and HOMA-IR were significantly higher in the MAU patients than those in NMAU patients(P

Crystallography, X-Ray ; DNA Repair ; Exodeoxyribonucleases ; chemistry ; Humans ; Protein Conformation

Objective To explore the treatment of cervical tracheoesophageal fistula (TEF) with complicated or remnant iaryngotracheal stenosis (LTS) and anterior neck defect (AND). Methods From 1980 to 2007,14 patients were diagnosed as TEF. Among them, 9 patients had complicated or remnant LTS, 3 patients had complicated AND, and 2 patients had TEF which were induced by Niekel-Titaium alloy mesh stent for treating benign esophageal stricture. All these patients were retrospectively studied in Tangdu Hospital. Treatment consisted of conservative therapy of TEF, staged surgical repair of TEF and laryngotracheal reconstruction according to the dimension (small or large) of TEF and complications. Results Four patients with small TEE (2-3 mm length) complicated LTS underwent laryngotracheal reconstruction stented with silicone T tube and TEF was adopted conservative treatment. The TEF and LTS were healed. Six patients with larger TEF (10-25 mm length) were repaired by staged surgical repair of TEF and laryngotracheal reconstruction. Among them, 3 eases had complicated LTS and AND, 2 cases had rement LTS and 1 ease had TEF without complication. Two patients had TEF and LTS, whose TEF healed before laryngntracheal reconstruction, the remnant LTS were reconstructed and healed. During the follow-up ranged from one to ten years, 12 patients were successfully treated without complications. One patient with TEF and LTS was treated only LTS because of a segment of esophagus was closed and treated with esophugngastrostomy in the department of thoracic surgery after LTS was successfully reconstructed and cured. One patient died of bleeding and asphyxia induced by the Nickel-Titanium alloy stentt because of the stent had not been taken out. Conclusion The small cervical TEF complicated or remnant LTS can be treated by laryngotracheal reconstruction and conservative treatment of TEF at the same time. A larger TEF complicated LTS should be treated by staged repair of TEF and LTS.

Objective To investigate the influence of anti-depression therapy on cardiac function and short-term prognosis in elderly patients with congestive heart failure (CHF) and the safety and effectiveness of fluoxetine in these patients.Methods Ninety six elderly hospitalized patients with CHF accompanied with depressive disorder were randomly divided into two groups:fluoxetine (20mg once daily)and placebo treated groups based on the routine cardiac drug therapy for 3 months. Results The prevalence rate of depressive disorder in elderly patients with CHF was 31.1%.The length of stay of fluoxetine group was shorter than that of placebo group.The post-treatment depressive exponents of self-rating depression scale(SDS)in fluoxetine group (51.39%?8.63)was lower than those in pretreatment and in placebo group.The improvement of cardiac function in fluoxetine group(53.4%?4.5%) was much better than that of placebo group (P