Female ; Heart Defects, Congenital ; surgery ; Heart Septal Defects, Ventricular ; surgery ; Humans ; Male ; Pulmonary Artery ; abnormalities ; Pulmonary Atresia ; surgery

AlM: To study the trabeculectomy clinical effect of use tunnel knife to make double - deck scleral flap and to cut off the layer scleral flap of glaucoma.METHODS: Using the random grouping method to divide 46 cases (60 eyes) of glaucoma into the treatment group of 24 cases (32 eyes) and control group of 22 cases (28 eyes). The treatment group, tunnel knife was used to make double- deck sclera flap and superficial scleral flap about the size of 5mm×5. 5mm, 1/3 scleral thickness, under the sclera flap made another one about the size of 3. 5mm× 4mm, 1/3 scleral thickness, resected the middle layer of the sclera flap, removed 2mm×2mm trabecular tissue, underwent routine peripheral iridectomy, could adjust suture the superficial scleral flap, sutured Ball fascia and bulbar conjunctiva. ln control group, routine glaucoma trabeculectomy was undergone.RESULTS:Patients were followed up for 1a, the vision in treatment group was obviously better than that in the control group, with a statistically significant difference (P< 0. 05). The postoperative intraocular pressure of the two groups of patients were significantly lower than that of the preoperative one. Postoperative 1 and 3mo, no statistical significant difference of intraocular pressure in two group(P>0. 05). But after 6 and 12mo, the intraocular pressure of the treatment group were significantly lower than that of the control group, with statistically significant difference (P<0. 05). Postopeartive 1a, the cumulative complete success rate and conditions for successful rate were 90. 63% and 96. 88% in the treatment group, and those were 75% and 89. 29% in control group. There was significant difference between two groups(P<0. 05).CONCLUSlON:The trabeculectomy have a good effect to lower the intraocular pressure by use tunnel knife to make double-deck scleral flap and to cut off the layer scleral flap. The scleral flap have uniform thickness, smooth surface, and the function of the filtering bleb maintained for a long time, less postoperative complications, suitable for various types of glaucoma, so it is worthy of clinical promotion.

Objective To explore the impact of nutritional risk on short-term clinical outcomes after laparoscope-assisted radical gastrectomy for gastric cancer.Methods The retrospective case-control study was conducted.The clinical data of 150 patients who underwent laparoscopic gastrectomy at the First Affiliated Hospital of Wenzhou Medical University between June 2014 and April 2016 were collected.According to nutritional risk screening 2002 (NRS 2002),42 and 108 patients were respectively divided into the nutritional risk group (NRS 2002 score ≥3) and non-nutritional risk group (NRS 2002 score ＜3).Laparoscope-assisted radical subtotal gastrectomy or total gastrectomy was performed based on tumor location.Observation indicators:(1) postoperative short-term clinical outcomes:postoperative complications,duration of postoperative hospital stay,hospital expenses,unplanned readmission within 30 days after discharging.Postoperative complications meant total complications within 30 days postoperatively,grade Ⅰ-Ⅴ of Clavien-Dindo grade was complication classification.Grade Ⅱ and above of Clavien-Dindo grade were analyzed in this research.(2) Risk factors analysis affecting occurrence of postoperative complications of patients.Measurement data with normal distribution were represented as x±s and analyzed using the independent-sample t test.Measurement data with skewed distribution were described as M (Qn) and analyzed using the Mann-Whitney U test.Categorical variables were described as number and percentage and analyzed by the chisquare test.Ranked data were analyzed by the Mann-Whitney U test.Univariate analysis was done by the chi-square test.P＜0.1 of univariate analysis was used to multivariate analysis.COX regression model in multivariate analysis was built using progressive condition method.Results (1) Postoperative short-term clinical outcomes:number of patients with total complications,number of patients with severe complications,duration of postoperative hospital stay,hospital expenses and number of patients with unplanned readmission within 30 days after discharging were 9,2,11 days (9 days,16 days),57 825 yuan (51 894 yuan,66 908 yuan),2 in the nutritional risk group and 16,3,11 days (9 days,13 days),55 067 yuan (49 395 yuan,62 423 yuan),8 in the non-nutritional risk group,respectively,with no statistically significant difference between the 2 groups (X2=0.952,0.010,Z=-1.133,-1.691,X2 =0.048,P＞0.05).Results of univariate analysis showed that age was a risk factor affecting incidence of complications after laparoscope-assisted radical gastrectomy for gastric cancer (X2 =4.468,P＜ 0.05).Results of multivariate analysis showed that preoperative hypoproteinemia was an independent risk factor affecting incidence of complications after laparoscope-assisted radical gastrectomy for gastric cancer (OR =2.797,95％ confidence interval:1.053-7.435,P＜0.05).Conclusion There is little poor impact of nutritional risk on short-term outcomes after laparoscope-assisted radical gastrectomy for gastric cancer,preoperative hypoproteinemia is an independent risk factor affecting occurrence of grade Ⅱ and above of postoperative complications.

Objective To investigate the expression of c-FLIPL in leukemia and explore its clinical significance. Methods The expression level of c-FLIPL mRNA in bone marrow mononuclear cells was determined by real-time polymerase chain reaction(PCR)in 103 leukemia patients with different types of leukemia,including 54 cases of acute lymphocytic leukemia(ALL)with 37 newly diagnosed,5 relapsed,and 12 complete remis-sion,38 cases of acute myeloid leukemia(AML)with 24 newly diagnosed,6 relapsed,and 8 complete remission,newly diagnosed 2 cases of acute undifferentiated leukemia(AUL),6 cases of chronic myelocytic leukemia(CML),and 3 cases of chronic myelomonocytic leukemia(CM-ML). The immunophenotype of patients were detected by flow cytometry. Results Expression level of c-FLIPL mRNA was higher in newly diag-nosed and relapsed leukemia patients. There was no significant difference between newly diagnosed and relapsed leukemia patients(P>0.05). Ex-pression level of c-FLIPL mRNA of AUL and CML was higher than that in other patients ,but there was no significant difference(P>0.05). Ex-pression level of c-FLIPL mRNA of all newly diagnosed and relapsed leukemia patients was significantly higher than that in control group and com-plete remission group(P<0.05). The expression level of c-FLIPL mRNA was correlated with risk stratification ,white blood cell(WBC),lactate dehydrogenase(LDH),hydroxybutyrate dehydrogenase(HBDH),CD45 and TEL-AML1,but was not associated with age,sex,fibrinogen and chromosome abnormality. Conclusion c-FLIPL mRNA is highly expressed in leukemia patients ,and is closely related with risk stratification , WBC,LDH,HBDH and prognosis.

OBJECTIVETo assess whether HTR1A and HTR1B polymorphisms are associated with the predisposition, gender, PUMC Classification and/or severity of adolescent idiopathic scoliosis (AIS).

METHODSRs6294 (HTR1A) and rs6296 (HTR1B) were genotyped in 103 AIS patients treated from January 2006 to March 2007, and 108 controls with matched gender and age. The data were analyzed by the allelic and genotypic association analysis, and the genotype-phenotype (gender, PUMC Classification, and Cobb angle) association analysis.

RESULTSThe distributions of the alleles of all the 2 SNPs met Hardy-Weinberg equilibrium in the controls (goodness-of-fit chi(2) test, P > 0.05). The allele A of rs6294 was related with the occurrence of AIS (P = 0.041), but differences of the allele frequencies of rs6296 and the genotype frequencies of both SNPs between 2 groups had no statistical significance (P > 0.05). The genotype A/A + A/G of rs6294 was associated with AIS PUMC type III, and there was no other positive results in genotype-phenotype association analysis.

CONCLUSIONThese results suggest that HTR1A may be a predisposition gene of AIS PUMC type III, and PUMC Classification may has its genetic basis.

Adolescent ; Gene Frequency ; Genetic Association Studies ; Genotype ; Humans ; Polymorphism, Genetic ; Polymorphism, Single Nucleotide ; Receptor, Serotonin, 5-HT1A ; genetics ; Receptor, Serotonin, 5-HT1B ; genetics ; Scoliosis ; genetics

OBJECTIVETo investigate the effect of sea cucumber cerebroside(SCC) and its long-chain base(LCB) on lipid and glucose metabolism in obese mice.

METHODSThe mouse obese model was established by feeding high fat diet. The mice were randomly assigned to 4 groups: control group, model group, SCC group and LCB group. After 4 weeks, the glucose tolerance test was undertaken. After 5 weeks, the body fat content, organic indexes, serum lipid level, glycemic index and liver lipid level were determined.

RESULTSCompared with the model group, the glucose tolerance in the SCC group and LCB group was ameliorated significantly (P<0.01, P<0.05); glycemic index (P<0.01, P<0.01), the weight of adipose tissue (P<0.05, P<0.01) and the hepatic TG were reduced significantly (P<0.05, P<0.05).

CONCLUSIONSea cucumber cerebroside and its long-chain base can improve the glucose and lipid metabolism in obese mice.

Animals ; Blood Glucose ; metabolism ; Cerebrosides ; pharmacology ; Lipid Metabolism ; Lipids ; blood ; Male ; Mice ; Mice, Inbred C57BL ; Mice, Obese ; Obesity ; blood ; drug therapy ; Sea Cucumbers ; chemistry

OBJECTIVETo study the prevalent characteristics in children with hand-foot-mouth disease (HFMD) in the Kunming area in 2010.

METHODSThe clinical data of 13286 outpatient and inpatient children with HFMD in Kunming Children's Hospital between January and December, 2010, including 8 death cases, 715 serious cases and 12563 non-serious cases, were retrospectively studied.

RESULTSHuman enterovirus was detected in 8200 children (61.72%). Children infected with EV71 and CoxA16 accounted for 29.49% (2418/8200) and 53.21% (4363/8200), respectively. Seventy-five children (0.91%) were found to have a mixed infection of the two viruses. Other types of human enterovirus were detected in 1344 children (16.39%). There were significant differences in the total positive rate of human enterovirus in the four quarters of the year (P<0.01). The total positive rate in the second quarter represented the highest proportion (71.56%), and the number of patients was also highest, accounting for 52.94% of the total number of patients in the whole year. EV71 infection was common in the serious case group while CoxA16 was found to be the main pathogen in the non-serious case group. Serious cases were common in children under three years old. In the positive EV71 cases, the viral load of EV71 was not statistically different between the death cases, serious and non-serious cases.

CONCLUSIONSIn 2010, children with HFMD in the Kunming area were mainly infected with CoxA16. Serious cases of HFMD were more common in those who were infected with EV71, and the majority of serious infections were suffered by children who were less than three years old. The viral load was not associated with disease severity. The highest morbidity rate was in the second quarter of the year.

Adolescent ; Child ; Child, Preschool ; China ; epidemiology ; Enterovirus A, Human ; isolation & purification ; Female ; Hand, Foot and Mouth Disease ; epidemiology ; virology ; Humans ; Infant ; Male ; Prevalence ; Retrospective Studies ; Seasons ; Time Factors

Objective To analyze the choice of implant materials,key points of operative proce- dures,prevention and management of postoperative complications in patients treated with cranioplasty. Methods Two hundred and twenty six patients with craniocerebral trauma underwent cranioplasty with different implant materials.Attention should be paid for the purpose of not tearing or injuring the dura ma- ter during operation.To take the dura mater up to the implant material and the edge of the bone flap,and put drainage under the scalp flap before closure of the incision.Results The clinical symptoms and neural function were improved in 146(64.6%)patients postoperatively.Postoperative complications mainly were infection,fluid collection and hematoma in the operative region.Follow-up showed the occur- rence of displacement or collapse of the implant materials in some patients.Conclusion Timely cra- nioplasty can not only resolve cosmetic problems but also improve clinical symptoms and neural function. The causes of postoperative complications are mainly related with the operative procedures and the materi- als used.

BACKGROUNDMany potential causative factors are related to the initiation and progression of osteonecrosis of the femoral head. The aim of this research was to investigate the etiology and clinical features of osteonecrosis of the femoral head in Chinese patients.

METHODSFrom January 1990 to July 2011, 643 cases of osteonecrosis of the femoral head were investigated retrospectively to analyze the potential causative factors, age, gender, latency period, time from the onset of pain to diagnosis, and Association Research Circulation Osseous stage.

RESULTSOf 643 cases, 315 cases were bilateral and 328 cases were unilateral, with an average age of (47.55 ± 15.27) years. In the steroid-induced group, the average age at symptom onset was (41.80 ± 15.47) years, and the median duration from taking steroid to the onset of pain was 36 months. The underlying diseases in the steroid-induced osteonecrosis of the femoral head group consisted of autoimmune and other diseases, of which systemic lupus erythematosus was the most common. In the alcohol-induced group, the average age at onset of symptoms was (48.06 ± 11.90) years and the median time of habitual alcohol use was 240 months. In the traumatic group, the average age was (51.43 ± 14.23) years and the median time from trauma to the onset of pain was 20 months. In the idiopathic group, the average age was (50.33 ± 15.88) years. Of the total of 958 hips, 647 were at stage III or IV. The stage at diagnosis was earlier in the steroid-induced group than in the alcohol-induced, traumatic, or idiopathic groups.

CONCLUSIONSSteroid use is the most common cause for osteonecrosis of the femoral head in this study. The age at diagnosis, time from the onset of pain to diagnosis, and stage were significantly earlier in the steroid-induced group.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Femur Head Necrosis ; etiology ; Humans ; Male ; Middle Aged ; Risk Factors

Objective To describe the characteristics of radiation induced mucositis in patients withhead and neck cancer ( HNC) during radiotherapy, and analyze the effect of radiation induced mucositis on diet patterns and weight change and the influencing factors for radiation induced mucositis. Methods Patients with HNC treated with radiotherapy in one cancer hospital were recruited. Data were collected before, during and at the end of the radiotherapy, which included radiation induced oral and pharyngeal mucositis, pain during eat-ing, diet patterns and weight. Results Two hundred and two patients were completely investigated and 43.5％and 34. 2％ of the patients suffered from moderate to severe (≥grade 2) oral mucositis and pharyngeal mucosi-tis, respectively during the radiotherapy. At the end of radiotherapy, 53. 5％ and 51. 5％ of the patients suffered from moderate to severe oral mucositis and pharyngeal mucositis (≥grade 2 ) , respectively. Oral and pharyngeal mucositis were significantly correlated with pain during eating, diet patterns and weight ( P<0. 05) . Tumor site was the main reason that affected the severity of mucositis ( Wald χ2 =26. 033, 14. 216;P<0.001). Conclusion Radiation induced mucositis was gradually aggravated with radiotherapy progress, which is closely related to pain during eating, change of diet patterns and weight loss. The severity of mucositis is re-lated to the tumor site. Measures should be taken to strengthen the management of adverse reactions and nutri-tional status of patients.