Objective To explore the treatment approach to severe l ower extremity trauma. Methods A retrospective study was ca rried out in 42 cases with severe lower extremity trauma from 1989 to 1999. Mang led extremity severity score (MESS) was 6.24?1.45 in all the cases, among which were 34 cases with MESS

The conditions of the mosquito-borne HBsAg were investigated with the RPHA method in Henan Province. The number of capture of Anopheles hyrcanus sinensis was small, and no HBsAg was detected from them. HBsAg was detected in both Culex pipiens pallens and Armigeres subalbatus and their positive rates of HBsAg were 10.3 and 4.6% respectively. The positive rates varied with different physiological conditions of mosquitoes, being 15.0, 7.2 and 7.5% respectively for fed, unfed and gravid females.With the digestion of the blood in the mosquito's stomach, most of the HBsAg was excreted in the feces gradually. This new finding of the transmission of HBsAg inside the mosquito's body has not been reported. The fact that HBsAg was not detected in eggs and larvae showed that it is not transmitted by eggs.

BACKGROUND: The effect of the treatment of long tubular bone defect by free vascularized fibular graft, especially when combined with monitoring island skin flap is definitely reliable. However, there is still the possibility of broken fibular graft with single fibular graft for repairing the long loading tubular bone.OBJECTIVE: To investigate the clinical effect on the treatment of long femoral bone defect by combinatorial fibular graft with monitoring island skin flap.DESIGN: Before and after self-controlled observation.SETTING: Department of Orthopaedic Spine Surgery, Guangzhou People's HospitalPARTICIPANTS: Totally 14 patients who wer treated for long femoral bone defect in the Department of Orthopaedic Spine Surgery were recruited between July 1995 and November 2003. Locus: distal part of the femur,5cases; middle part of the femur, 9cases.The length of bone defect was 6 to 28 cm.INTERVENTIONS: There were 7 cases of free vascularized bi-fibular graft transplantation with monitoring island skin flap. There were 7 cases of free vascularized fibular graft centralized with large segmental allograft.Monitoring island skin flap was 3 cm×5 cm, sectioned fibular was 16 to 32cm. Dry frozen bone of allograft was 12 to 28 cm. The wound and island skin were detected postoperatively.MAIN OUTCOME MEASURES: The living condition of bi-fibular graft or binding composite allograft with skin flap, morphology change of transplanted bone and loaded walking ability in patients with bone defect after operation.RESULTS: Totally 14 patients entered the result analysis. Seven cases in bi- fibular group were followed up for 3 years and 7 patients in the centralized graft group were followed up for 1 year. Fourteen cases detected by monitoring island skin flap all survived. One case in the centralized graft group presented yellow exudates 3 months after operation, and then the graft bone was taken out. Follow-up of the rest 6 patients showed that transplanted fibular bone was closely connected with allograft. The thickness of the transplanted bone was increased, shaped and similar with the diameter of the femur at the receptor. Patients in the two groups could walk with loading without walking stick. Transplanted bone has no fracture.CONCLUSION: Transplantation of free vascularized bi-fibular graft transplant or free vascularized fibular graft monitoring island skin flap binding to large segmental allograft can increase its structural strength through hypertrophy, decrease or avoid fracture of the transplanted graft fibula.

Objective To evaluate the effectiveness of Moss Miami pedicle sc re w system in the treatment of thoracolumbar burst fractures. Methods A total of 2 7 cases of thoracolumbar burst fractures were operated on with Moss Miami pedicl e screw system through posterior approach to provide spreading, reduction and fi xation. The bilateral posterolateral bone-graft spinal fusion was also done at the same time. Results The 27 patie nts were followed up for 6 to 30 months. The heights of compressed vertebral bod y and the cross spinal canal were significantly increased after treatment (P

Objectives To compare the differences in intestinal phylum firmicutes between elderly patients with type 2 diabetes (T2DM)and the healthy elder people.Methods 37 elderly patients with T2DM and 69 healthy controls in Shaoxin city were recruited.DNA of phylum firmicutes from fecal samples was extracted.The real-time quantitative PCR was used with special primers for bacterial genus including Faecalibacterium prausnitzii,Eubacterium rectale,Clostridium leptum,and Peptostrepyococc.The differences in content of different bacteria between two groups were analyzed and compared.Results In healthy elderly group versus the elder patient with T2DM,the contents of intestinal phylum firmicutes were[(6.22±1.41) × 107 versus(5.41± 1.40) × 107,t=2.83,P=0.006] in Eubacterium rectale,[(7.46 ± 0.98) × 107 versus (6.96 ± 1.40) × 107),t =2.13,P =0.036] in Faecali bacterium prausnitzii,[(7.89±0.89) × 107 versus(7.46±1.11) × 107,t=2.15,P=0.034]in Clostridium leptum,and[(4.86 ± 1.33) × 107 versus (4.21 ± 1.24) × 107,t=2.45,P =0.016] in Peptostrepyococc,which showed that the contents of intestinal phylum firmicutes were less in T2DM group than in healthy elderly group.Conclusions There are some differences in intestinal flora between the elderly patients with T2DM and healthy people.These intestinal flora may play an important role in the development of T2DM.This study may provide new evidences for probiotic treatment of T2DM.

In the present study, platelet GSH_(px), SOD activities and cAMP contents, as well as whole blood, erythrocyte, plasma and hair selenium levels were comparatively measured in children from Keshan disease endemic and non-endemic areas. The results showed that blood and hair selenium contents were significantly lower in children of the endemic area than in those of the non-endemic area; children in the endemic area had a signifi cantly lower platelet GSH_(px) activities as compared to those in the non-endemic area, but no remarkable difference of platelet SOD activities and cAMP contents between children in the two areas was observed. The results indicate that the reduced GSH_(px) activity of low-selenium children in the endemic area may result in alterations in platelet functions and arachidonic acid metabolism.

In total, 106 patients with maintenance hemodialysis (MHD) were divided into two groups based on their valsartan administration, and 53 healthy controls were recruited in the study. Plasma concentrations of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), resistin and high sensitivity C-reactive protein (hs-CRP) were measured by enzyme-linked immunosorbent assay (ELISA) before and after valsartan treatment. Plasma levels of resistin, IL-6, TNF-α and hs-CRP were all significantly increased in patients with MHD as compared to those in healthy controls (P＜0. 05). Among patients with MHD the plasma levels of resistin, IL-6 and hs-CRP in valsartan group were lower than those in non-valsartan group (P＜0. 05).

Objective To investigate the indications and results of long channel technique with pedicle inner preputial flap urethroplasty for middle hypospadias repair. Methods During September 2007 to April 2010,28 cases of middle hypospadias were include in this study.The average age was 2.0 years (1.5 -6.0 years).The orifice of urethra was opened in the shaft of penis,and the distance between the urethral meatus and the center of glans was 25 mm ( 16 - 37 mm).A pars-meatus skin incision was made,which was dissected deep to the urethral plate.The urethral plate was transected,and a long channel between the urethral plate and the corpora cavernosa was created.The neourethra was made from the inner prepuce,and transposed to the ventral tunnel through a tunnel between buck's fascia and albuginea of ventrolateral corpora cavernosa.The neourethra was anastomosed with the proximal urethra.The buck's and dartos fascia along the skin incision were brought together and sutured individually,covering the proximal neo-urethra and the anastomosis.Induced penile erection confirmed that 13 cases were with mild penile curvature,and the other 15 case were without penile curvature.The average length of the defected urethra and tunnel was 38 mm (30 -42 mm) and 33 mm (26 -38 mm). ResultsSuccess was achieved in all cases without fistula or urethral stricture formation with the average follow-up of 20 months (6 -31 months),and penile curvature was completely corrected.The urethra was opened in the apex of the glans with normal-looking circumcised penis. ConclusionsLong channel technique with pedicle inner preputial flap urethroplasty can provide another option for repairing middle hypospadias without penile curvature or with mild penile curvature,especially for young children and those with small penis.This technique is simple,and the result is satisfied.

Objective To investigate whether perfusion-weighted imaging (PWI) can be used to evaluate blood perfusion of patients with leukoaraiosis (LA), its relationship to clinical features, and the therapy effect of LA. Methods The 44 patients with LA were recruited in the study. All the subjects were examined with both conventional and dynamic susceptibility contrast-enhanced perfusion MR imaging, 13 of them repeated the examinations after the treatment. The shapes and sizes of the biggest lesions in each patient were confirmed by conventional MR imaging, then the values of relative cerebral blood volume (rCBV), relative cerebral blood flow (rCBF) and relative mean transit time (rMTT) in each lesion were calculated respectively. Furtherly, a Pearson's correlation analysis was performed to show whether these values were correlated with mini-mental state examination (MMSE)scores or activities of daily living (ADL) scores. Results The 44 lesions of all the subjects showed significant decreases in rCBV (0. 797 ± 0. 160) and rCBF (0. 779± 0. 164) but increase in rMTT (1. 029±0. 073). There were positive correlations between rCBV and MMSE (r = 0. 524, P =0. 000), between rCBV and ADL (r=0. 621, P=0. 000), between rCBF and MMSE (r=0. 555, P=0. 000), and between rCBF and ADL (r= 0. 690, P= 0. 000), and negative correlations between rMTTand MMSE (r=-0.307, P=0.043), and between rMTT and ADL (r=-0.434, P=0. 003). The blood perfusion was enhanced in 10 out of 13 patients who received the repeated examinations after the treatment, most of whom showed the improvement of clinical symptoms.Conclusions Perfusion MR imaging can assess hemodynamic alterations in LA, which could reflect the clinical symptoms. Moreover, the changes of blood perfusions can be used to evaluate and monitor the therapy effect of LA.

Objective To investigate the effects of ω-3 polyunsaturated fatty acids (ω-3 PUFA) on systemic inflammatory response and intestinal mucosa barrier in rats with traumatic brain injury and hemorrhagic shock (TBIS).Methods A total of 36 male Wistar rats were equally randomized into 3 groups:sham operation group,TBIS model group,and ω-3 PUFA pretreatment group.The serum levels of tumor necrosis factor-α (TNF-α),8-iso-prostaglandin F2 a (8-iso-PGF2 a),interleukin (IL)-1 β,and IL-10 were measured by enzyme linked immunosorbent assay (ELISA).HE staining was performed for morphological assessment of the intestinal tissue and evaluation of the intestinal mucosa damage index (IMDI).The marked bacilli of the mesenteric lymph nodes,lung,liver,spleen,and kidney tissue were counted under a fluorescent microscope.Results Compared with those in the sham group [ (38.15 ± 6.37) ng/ml,(84.91 ± 17.22) pg/ml,(2.52 ± 0.83 ) μg/L,(2.86 ± 0.82) μg/L,0.36 ±0.14,and 8.33％ ],the serum levels of TNF-α [ (328.11 ±20.09) and (244.37 ±21.82) ng/rrl],8-iso-PGF2a [ (263.47±55.19) and (176.35±41.63) pg/ml],IL-1β [ (27.06±2.61) and (18.91 ±1.78) μg/L],IL-10 [ (7.63 ± 1.29) and (9.52 ± 4.66) μg/L],the IMDI (4.18 ±0.39 and 3.31 ±0.40),and the positive rates of bacterial translocation (56.67％ and 35.00％ ) were significantly higher in both the TBIS model group and ω-3 PUFA group ( all P ＜ 0.01 ).Compared with TBIS model group,the levels of TNF-α,8-iso-PGF2 a,and IL-1 β,the IMDI,and the positive rate of bacterial translocation were significantly lower ( all P ＜ 0.05 ) and the levels of IL-10 were significantly higher in the ω-3 PUFA group (P ＜0.01 ).Conclusion The supplementation of ω-3 PUFA can remarkably inhibit the systemic inflammatory response and protect the integrity of intestinal mucosa in rat with TBIS.