Adult ; Female ; Hemangioma, Cavernous ; surgery ; Humans ; Nose ; surgery ; Orbit ; surgery ; Orbital Neoplasms ; surgery

OBJECTIVETo investigate methods and short-term effects on tantalum metal block for reconstruction of Paprosky type III severe acetabulum bone defect.

METHODSTwelve patients (12 hips) with Paprosky type III severe acetabulum bone defect,treated with tantalum metal block in revision of total hip arthroplasty, were retrospectively analyzed from March 2009 to December 2012. Among the patients, there were 5 males and 7 females aged from 45 to 78 years old with an average of 64 years old; the courses of disease ranged from 3 to 32 months with an average of 16 months. According to classification of Paprosky, all patients were Paprosky type III acetabulum bone defect. All patients were used tantalum metal block in revision of total hip arthroplasty, and large diameter biological acetabulum cups were used in combination. Operative time,blood loss and postoperative complications were recorded and compared, Harris score were used to evaluate clinical effects.

RESULTSEleven patients ( 11 hips) were followed up from 9 to 36 months with an average of 25 months, 1 case was lost to follow-up for dying in car accident. The incisions were healed at stage I . Operative time ranged from 2 to 6 h with an average of 3 h; blood loss was 300 to 1 600 ml with an average of 900 ml. No deep venous thrombosis, periprosthetic femoral fracture and infection, sciatic nerve injury occurred after operation. Harris score were improved from (46.25 ± 8.99) before operation to (83.75 ± 6.76) after operation. There was significant difference in Harris score before and after operation (t = 3.14, P = 0.00 < 0.05), and 7 cases got excellent results, 2 good and 2 moderate. CONCLUCSION: Tantalum metal block is suitable for revision of Paprosky III acetabulum bone defect, could repair different kinds of acetabulum cup defect, could fill up inclusive defect of inner wall combined with particulate bone graft, induce bone growth pressured between metal block and metal cup, provide a new further choose for the treatment of Paprosky type III severe acetabulum bone defect.

Acetabulum ; surgery ; Aged ; Arthroplasty, Replacement, Hip ; methods ; Female ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Retrospective Studies ; Tantalum

ObjectiveTo verify whether the three different framing effects distinguished by Levin still exist in imitatively medical situation.MethodsEstablished medical decision making problems concerning doctor evaluation,medical compliance and treatment options selection.All these problem were described in the gain and loss frames.300 volunteers were randomly assigned to six groups.Every volunteer completed 2 decision making problems and evaluated their degrees of certainty.ResultsIf doctors were described in valid number,people tended to make more positive evaluations than described in invalid number( x2 =32.09,P ＜ 0.01 ).If treatment options were described in survival rates,people tended to choose adventure option of long-term benefit,otherwise people tended to choose conservative option of short-term benefit( x2 =25.92 P ＜ 0.01 ).If doctors' advices were respectively described in damaging or beneficial frames,the former one has better compliance (x2 =11.07,P ＜0.01 ).Parts of the deferences between the decision making confidence of choosing the adventure or conservative options were significant ( t attribute,positive =3.84,P ＜ 0.01 ; t goal,negative =6.44,P ＜ 0.01 ; t risky,positive =6.57,P ＜0.01 ).People were likely to be more confident with these options conforming to the framing effect.Conclusion-Framing effect exists in imitatively medical situation.

Objective To investigate the clinical characteristics and mutations of guanosine triphosphate eyclohydrolase (GCH) Ⅰ gene in patients with dopa-responsive dystonia (DRD). Methods Five families with 18 affected family members and 17 patients with sporadic DRD were examined. Patients were allocated into 3 groups according to onset time, either in childhood, or in adolescence or adult. Interview, physical examination, psychologic testings and CT/MR scan were performed. Mutation screening was performed on 26 patients and 1 normal family nember. Thirty-five healthy control subjects were matched for age and sex. Statistical analysis were conducted with the use of SPSS 13.0 computer software. Results(1)Most of patients started with dystonia. The main clinical manifestation was dystonia too. There was no difference among 3 groups.(2) There were significant differences in diurnal fluctuation among 3 groups(15/15,6/6,7/14, χ2=13.125,P=0.001). Diurnal fluctuation negatively correlated with age (r=-0.720, P<0.01).(3)The differences in postural tremor were also found among 3 groups (7/15,5/6,1/14, χ2=8.073, P=0.018). Postural tremor positively correlated with age (r=0.399, P=0.018).(4)There were differences in exaggeration of tendon among three groups(11/15,1/6,4/14, χ2=8.309, P=0.016). Exaggeration of tendon reflexes negatively correlated with age (r=-0.429, P=0.010).(5)The scores of Hamilton Depression Scale and Hamilton Anxiety Scale in patients were higher than those in controls.(6)DNA sequencing revealed a heterozygous A224G missense mutation(Tyr75Cys)located within exon 1 in one autosomal dominant inheritance family. Conclusions The manifestations of DRD varies. The clinical course is closely correlated with age. A missense mutation(A224G)in coding region of the GCH 1 gene probablyleads to the occurrence of DRD.

Objective:To observe the clinical efficacy of combined acupuncture and scraping therapy for simple obesity and its effects on phlegm-dampness constitution.Methods:Seventy subjects with phlegm-dampness constitution were divided into treatment group and control group with a randomized digital table.Control group was given health education and dietary instructions,and treatment group was given acupuncture and scraping therapy besides health education and dietary instructions.After four-week treatments,the scores of obesity and phlegm-dampness constitution were recorded to assess the clinical efficacy.Results:There was a striking difierence in the total effective rate in treating obesity between the two groups (P＜0.01);combined acupuncture and scraping therapy can relieve the phlegm-dampness symptoms(P＜0.01);but the phlegm-dampness symptoms were not improved in the control group(P＞0.05).Conclusion:Combined acupuncture and scraping therapy is quite effective for simple obesity and in improving phlegm-dampness constitution of simple obesity people.

Objective To investigate the dynamic changes of glutamic acid(Glu) levels,ATP levels,free calcium ion,mitochondrial membrane potential,apoptosis related to mitochondrial pathways of apoptosis and Na+-K+-ATPase activity,and explore the mechanism of mitochondrial pathways of apoptosis in neuron injury of rats with kainite acid(KA)-induced epilepsy.Methods KA-induced epilepsy model was induced by injection of KA into the hippocampus.Forty SD rats were randomly divided into 2 groups: control group(n=8)and KA group(6 h,1 d,3 d,7 d,n=8).The concentration of Glu in hippocampus CA3 area was detected by high performance liquid chromatography.The apoptosis of hippocampus neurons and the concentration of Ca2+ were assayed by flow cytometry.The mitochondrial membrane potential was detected by JC-1.The Na+-K+-ATPase activity was examined.Results 1.The concentration of Glu in hippocampus increased at 3 d after KA injection and reached the peak after 7 d injection.2.The concentration of Ca2+ level,mitochondrial membrane potential,and the number of apoptosis neurons were significantly increased,wherase the mitochondrial membrane potential decreased after 6 h of KA injection,7 d after KA injection,and the changes were more severe.3.In the hippocampus,the activities of the Na+-K+-ATPase significantly decreased at 1 d after KA injection,and they decreased more over at 7 d after KA injection.4.The levels of ATP,mitochondrial membrane potential,and the activity of the Na+-K+-ATPase were negatively correlated with the neuron apoptosis(Pa

Objective To analyze diagnostic experience of children with anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) and assess its surgical results.Methods Six children with ALCAPA had been diagnosed in our hospital from Mar. 2006 to Oct.2007 aged from 6 months to 10 years old(median 43.5 months).The medical data included common clinical presentations,the findings of electrocardiogram(ECG),the echocardiogram,ECG-gated 64-slice computed tomography,the digital subtraction angiogram (DSA),surgical records and the outcome.Results Diaphoresis,fantod,breathlessness and difficult feeding were commonly presented in 5 cases ALCAPA and the 5 children presented with left ventricular failure in infancy.The predominant ECG findings were Q waves and ST segment changes in the anterolateral chest leads in 4 cases,ST changes in 1 case,and normal ECG in 1 case.Cross-sectional echocardiography showed dilated left ventricles with poor contractility in 4 cases,medium mitral regurgitation in 2 cases and severe mitral regurgitation in 2 cases,aneurysmal dilatation of the right coronary artery(RCA) in 2 cases.CT and DSA examinations showed characteristic changes in these children.The surgical reestablishment of a two-coronary system was performed in 5 cases,direct reimplantation in 2 cases and creation of an autologous extrapulmonary tunnel in 3 cases.Simultaneous mitral annuloplasty was performed in 2 cases.After operation,the symptoms of 5 cases were all improved and none died.Conclusions Understanding the clinical manifestations and lab findings of ALCAPA is helpful to making an early diagnosis of ALCAPA.Early surgical treatment can improve the patients′ outcome.

Adult ; Angioplasty, Balloon, Coronary ; adverse effects ; Balloon Occlusion ; Cardiac Tamponade ; etiology ; Catheter Ablation ; adverse effects ; Catheterization ; adverse effects ; Coronary Disease ; surgery ; therapy ; Female ; Humans ; Male ; Middle Aged ; Mitral Valve Stenosis ; therapy ; Retrospective Studies ; Stents ; adverse effects

Objective To construct the lentivirus carrying human ?-catenin-EGFP(enhanced green fluorescent protein)and observe its expression in human follicle stem cells.Methods The ?-catenin gene sequence was amplified by RT-PCR from extraction of total RNA of human vascular endothelial cells.TA cloning technique was utilized to acquire gene subcloned pUCm-T-?-catenin.After transformation reaction,candidate clone was further analyzed by PCR and gene sequencing.Then the plasmid was transfected into FT293 cells.After identification by Western blotting,the plasmid was transfected into FT293 cells again for packaging.Infection titer was monitored by green EGFP expression.The expression of ?-catenin-lentivirus in human follicle stem cells were observed under inverted fluorescence microscope.Results The ?-catenin gene was cloned into the lentivirus successfully.The high expression of green fluorescence protein in FT293 cell line was found under fluorescent microscope.Viral titer checked by real-time PCR was about 2.0?108 TU/mL.When the multiplicity of infection(MOI)was 10,the infection efficiency of ?-catenin-lentivirus in human follicle stem cells was nearly 80% after infection 48 h around.After 3 weeks of continuous observation,we found the infection efficiency still keeping in the range of 80%-90%.Conclusion The lentivirus expression vector for ?-catenin was successfully constructed.It can steadily infect human follicle stem cells and the infection efficiency is considerable high.

Objective To explore the value of MRI-R2 * and to compare clinical effect of two iron chelators(deferasirox and deferoxamine) in iron-overloaded patients.Methods By completely randomized balanced design,24 iron-overloaded patients were randomly divided into 2 groups,which consisted of 12 patients treated with deferasirox and 12 patients treated with deferoxamine.The planned deferasirox dose was 40 mg· kg-1 · d-1,and the deferoxamine dose was no less than 50 mg · kg-1 · d-1 All patients underwent quantitative MRI at the time points of the primary screening,6 months and 12 months.Pair Wilcoxon rank sum test was used to compare the differences of liver R2 * values of the 2 groups at various time points respectively.Wilcoxon rank sum test was used to compare the differences of change rate of liver R2 * values between the two groups at the time point of 6 months,12 months,respectively.Results Deferasirox group's liver R2 * values of primary screening,6 months and 12 months were 1081,889 and 712 Hz,while deferoxamine group's liver R2 * values were 1042,838 and 488 Hz.There was no statistically significant difference between liver R2 * values of two groups at primary screening (Z =-0.029,P ＞ 0.05).The change rate of liver R2 * of deferasirox group at 12 month was-32％,while it was-58％ for the deferoxamine group,and there was statistically significant difference between the two groups (Z =-3.060,P ＜0.01).The change rate of serum ferritin of deferasirox group at 12 month was-15％,while it was -55％ for the deferoxamine group,and there was statistically significant difference between the two groups (Z =-2.945,P ＜ 0.01).Conclusion By using MRI-R2*,it suggest that both deferasirox and deferoxamine can effectively remove liver iron and deferoxamine is superior to deferasirox.