OBJECTIVE:To investigate the effects of simvastatin on neurologic function and prognosis of patients with cere-bral infraction. METHODS:A total of 82 patients with cerebral infarction selected from our hospital during Jan. 2015 to Jul. 2016 were divided into observation group and control group according to random number table,with 41 cases in each group. Control group received routine thrombolytic therapy and Aspirin enteric-coated tablets 100 mg orally,qd. Observation group was additional-ly given Simvastatin tablets 10 mg,qd,on the basis of control group. After 1 month of treatment,prognosis,ADE as well as NI-HSS scores before and after treatment were compared between 2 groups. Multiple factor Logistic regression analysis was conducted for clinical information of patients. RESULTS:The excellent rate of prognosis in observation group was 80.49％,which was signifi-cantly higher than 68.29％,with statistical significance(P<0.05). The incidence of intracranial and extracranial vascular stenosis, brain-heart syndrome and death in observation group were 36.59％,19.51％,0,which were significantly lower than 46.34％, 36.59％,7.32％ of control group,with statistical significance(P<0.05). At admission,there was no statistical significance in NI-HSS scores between 2 groups(P>0.05). After 1 month of treatment,NIHSS scores of 2 groups were decreased significantly,and the observation group was significantly lower than the control group,with statistical significance(P<0.05). Age >65 years,NI-HSS score <4 points at admission,combined diabetes,non-use of statins were independent risk factors which affected the survival of patients with cerebral infarction(P<0.05). CONCLUSIONS:Simvastatin can significantly improve the neurologic function and prognosis of patients with cerebral infarction,and reduce the incidence of ADE. Non-use of statins is an independent risk factor which affects the survival of patients.

Objective To investigate the expression of nuclear factor kappa B (NF-κB),tumor necrosis factor α (TNF-α) and interleukin6 (IL-6) in human colorectal carcinoma tissues,and to explore their clinical significances in the genesis and development of colorectal cancer.Methods Sixty cases of colorectal cancer tissues and 36 cases of colorectal adenoma tissues were collected,60 cases of paracancerous normal colorectal tissues were the controls.Immunohistochemistry SABC method was used to detect the expression of NF-κB,TNF-α and IL-6 in each group respectively.The correlation of NF-κB,TNF-α and IL-6 with clinical pathologic features of colorectal cancer was analyzed.Results In colorectal carcinoma,adjacent normal colorectal tissues and colorectal adenoma tissues the positive expression rates of NF-κB were 76.7 ％ (46/60),46.7 ％ (28/60),83.3 ％ (30/36),the positive rates of TNF-α were 70.0 ％ (42/60),36.7 ％ (22/60),66.7 ％(24/36),the positive rates of IL-6 were 80.0 ％ (48/60),43.3 ％ (26/60),61.1％ (22/36).The differences were significant in each group (all P ＜ 0.05).The expression of NF-κB was closely associated with the expression of TNF-α and IL-6 respectively.In addition,the expression of NF-κB and TNF-α were correlated with vascular invaded,lymphnode metastasis and different stages.The expression of IL-6 was correlated with lymphnode metastasis and different stages.Conclusion The over expression of NF-κB and the downriver inflammation factors have close relationship with biological behaviors of colorectal cancer.It may be considered that the pathway of NF-κB play an important role in the genesis and development of colorectal cancer.

Objective To explore the ways of repairing the large long-bone and skin defects as single stage procedures. Methods Five clinic cases were studied, firstly, the arteriae fibularis were restructuered into one or two vaso-nasa which nourished the related fibula segments and the overlying skin, then, binding all of the fibula segments and turn it into a bulky bone with a periosteal vaso-nasa wraparound. The graft was rich in blood supply so osteogenesis activity was vigorous under the periostum, the interspace in the graft soon disappear and the graft increased in diameter gradually. Results All of the harvested skin flaps survived and the wound healed on schedule, besides, the involved fractures were union 1 year later and the grafts were strong enough for weight-bearing and walking 2 year later, Neither fracture occur nor morbidity was created at the donor site, No problem was caused at the ankle. Conclusions It's appropriate way to repair large long-bone and skin defects with a vascularized fibula segments complex transfer incorporationg the overlying skin that was supplied via the same peroneal vessel pedicle.

OBJECTIVETo analyze the effects of metacarpus and phalanx traction on correction of scar contracture of hand after burn on the palm side retrospectively.

METHODSA total of 32 patients with 39 affected hands with scar contracture on the palm side after burn were hospitalized from May 2010 to December 2014. Method of treatment: scar contracture was conservatively released followed by skin grafting, which was referred to as method A; Kirschner wire was inserted into the middle or distal phalanx of finger with contracture and the corresponding metacarpus in the shape of U for 2 to 7 weeks' traction, which was referred to as method B; traction frame was built based on the traction pile and anchor formed by Kirschner wire inserted through the second to the fifth metacarpus and distal phalanx of finger with contracture, and then the affected fingers were pulled into a straight position with rubber bands for 2 to 6 months, which was referred to as method C. Method A was used in patients who would be treated with thorough release of scar followed by skin grafting routinely. Method B was used in patients who would be treated with intramedullary Kirschner wire fixation after release of scar contracture and skin transplantation routinely. Method C was further used in patients when methods A and B failed to accomplish the expected result. Method C was used in the first place followed by method A in whom there might be vascular decompensation or exposure of tendon and bone after scar release, and those who failed to meet the expectation were treated with method C in addition. Patients who were unwilling to undergo surgery were treated with method C exclusively. During the course of treatment, the presence or absence of infection and slipping of Kirschner wire or its slitting through soft tissue were observed. The presence or absence of tendency of recurrence of scar contracture within 1 to 2 weeks after treatment was observed. The length of palmar skin measuring from the root of finger with contracture to wrist crease was measured before treatment, at the termination of treatment, and 1 month after the termination of treatment. Scar condition was assessed with the Vancouver Scar Scale (VSS) before treatment and 1, 3, and 6 month(s) after the termination of treatment. Before treatment and 1 month after the termination of treatment, the range of motion was measured with the Total Active Movement (TAM) method; band function was evaluated by the Jebsen Test of Hand Function (JTHF), and the completion time was recorded. Data were processed with analysis of variance, LSD-t test, and t test.

RESULTSTwenty-four patients with 27 affected hands were treated with scheme A + B; 5 patients with 7 affected hands were treated with method C exclusively; 2 patients with 3 affected hands were treated with scheme A + B + C; 1 patient with 2 affected hands were treated with scheme C + A + C. During the course of treatment, no complication such as infection or slicing of tissue was observed, but there was a slight shifting of U-shaped Kirschner wire in 14 affected hands of 13 patients. Tendency of recurrence of scar contracture was observed in 11 affected hands of 10 patients, but the scar contracture did not reoccur after treatment with orthosis. The skin length of palmar side was respectively (131.8 ± 9.8) and (127.6 ± 7.5) mm at the termination of treatment and 1 month after, and they were both significantly longer than that before treatment [(114.5 ± 2.4) mm, with values respectively 10.71 and 10.39, P values below 0.001]. The score of VSS was respectively (9.8 ± 2.4), (9.7 ± 1.7), (9.3 ± 0.8), and (7.7 ± 0.5) points before treatment and 1, 3, and 6 month(s) after the termination of treatment. Only the score at 6 months after the termination of treatment was significantly lower than that before treatment (t = 3.28, P < 0.01). The ratio of excellent and good results according to method TAM was respectively 2.6% (1/39) and 94.9% (37/39) before treatment and 1 month after the termination of treatment. The time for JTHF measurement was (13.9 ± 4.1) min before treatment, and it was shortened to (11.0 ± 2.8) min 1 month after the termination of treatment (t = 3.65, P < 0.001).

CONCLUSIONSSingle application of metacarpus and phalanx traction or its combination with skin transplantation after scar release in correcting scar contracture of the palm of hand after burn can lengthen the contracted tissue, and it is beneficial for the restoration of function and appearance of affected hand.

Burns ; rehabilitation ; therapy ; Cicatrix ; therapy ; Contracture ; surgery ; Hand Injuries ; rehabilitation ; therapy ; Humans ; Metacarpus ; Orthotic Devices ; Range of Motion, Articular ; Reconstructive Surgical Procedures ; methods ; Retrospective Studies ; Skin ; Skin Transplantation ; Tendons ; Time ; Traction ; Treatment Outcome

Objective To study the expressions and significance of MRP and LRP in HCC. Methods The expressions of two genes were examined in three tissues (54 cases of HCC, 24 para cancer and 12 posthepatitis cirrhosis tissues) by SP immunohistochemical and PCR techniques. Results MRP and LRP were expressed in three tissues, with significantly higher rates in HCC than others (P

Objective To investigate the relationship among the spinous process open degree,the relative displacement of the lumbar facet joints(LFJ),and the morphologic change of the intervertebral foramina.Methods From Nov 2010 to Jun 2012,a total of 6 human fresh cadaveric spines was used in this study.All the ligaments were kept.The relative displacement of the corresponding segments LFJ,and the change of height and width of intervertebral foramen were measured through the corresponding open L3-4 and L4-5 spinous process,respectively.Results Lumbar degeneration was described with the following indices including the proliferation and displacement of LFJ,deformation of the intervertebral foramen morphogenesis,nerve root oppression,and lumbar intervertebral stenosis.When the interspinous process spacer was opened up to 2 mm,lumbar intervertebral foramen heights at the L3-4 and L4-5 [(15.62 ± 0.73) mm,(14.67 ± 0.75) mm] were significantly increased (t =26.00,16.02,P ＜ 0.01) compared to the original state [(13.89 ± 0.77) mm,(12.48 ± 0.80)mm].When the interspinous process spacer was opened up to 4mm,lumbar intervertebral foramen heights at the L3-4 and L4-5 [(17.13 ± 0.78) mm,(16.74 ± 0.76) mm] were significantly increased (t =36.15,30.69,P ＜ 0.01) compared to the original state.The foraminal height with a 4 mm distraction was significantly greater than the 2 mm distraction (t =20.82,21.72,P ＜0.01).When the interspinous distraction was 2 mm,L FJ displacement at the L3-4and L4-5 [(0.31 ±0.04) mm,(0.34 ± 0.07) mm] was significantly better than the original state [(0.63 ± 0.03) mm,(0.56±0.05)mm] (t =61.97,58.91,P ＜0.01).When the interspinous distraction was 4 mm,LFJ displacement at the L3-4 and L4-5 [(0.10 ±0.04) mm,(0.12 ±0.06) mm] was significantly better than the original state (t =18.69,18.88,P ＜0.01).No significant difference was found in the change of the intervertebral foramen width [(8.65 ± 0.38) mm,(7.78 ± 0.37) mm] at the 2 mm interspinous distraction compared to the original state(P ＞ 0.05),but a statistically significant difference was found at the 4 mm interspinous distraction compared to the original state [(9.03 ± 0.41) mm,(8.05 ± 0.32) mm] (t =7.78,7.97,P ＜ 0.01).Conclusions Spinous process shove off can effectively improve LFJ displacement,and increase the intervertebral foramen height,but the increase of its width needs to shove off enough distance.

Objective To evaluate the effect of differ surgey of thyroid gland to the diversification post-hypocalcemia. Methods Retrospectively analyzed 84 cases with thyroid gland treated from October 2010 to January 2013, the 31 cases were bilater most excision,the 17 cases were single complete excision and opposite side, isthmus,the 26 cases were single complete excision,the 10 cases were bilater complete excision. The diversification post-hypocalcemia were com-pared. Results The level of 1 d, 2 d, 3 d hypocalcemia were significant lower in the bilater most excision and bilater complete excision(P<0.05). The level of 1 d, 2 d, 4 d hypocalcemia were significant lower in the single complete exci-sion and opposite side, isthmus (P<0.05). The level of 1 d, 2 d hypocalcemia were significant lower in the single complete excision(P<0.05). There were 52 cases of hypocalcemia in all cases. The most rate were 80.6% and 80.0% in the bi later most excision and bilater complete excision. The rate were 41.2% and 46.2% in the single complete excision and single complete excision and opposite side,isthmus. The symptom of patients were 18 cases (34.6%)and no symp tom were 34 cases (65.4%). Conclusion The occurrence of hypocalcemia has been related to the pathology and surgical method.

Objective: To explore the clinical effect of negative pressure wound therapy (NPWT) in emergency limb-salvage operation of destructive injury of limb. Methods: From July 2014 to December 2017, 43 patients with destructive injury of limb in one side conformed to the inclusion criteria were admitted to our hospital. The patients were divided to NPWT group of 24 patients [ 21 males and 3 females, aged (38±10) years] and routine dressing change group of 19 patients [ 17 males and 2 females, aged (37±10) years] according to their treatment methods. After the emergency debridement, fracture external fixation, neurovascular exploration, and microsurgical repair were performed, NPWT were applied on wounds of patients in NPWT group and routine dressing change treatment on wounds of patients in routine dressing change group. On 7 to 10 days after the emergency operation, incidence of arterial embolism of patients in the two groups were calculated, and condition of wound infection of patients in the two groups were observed. Complete wound healing time and survival condition of limb were recorded. Data were processed with independent sample t test or chi-square test. Results: Incidence of arterial embolism of patients in NPWT group on 7 to 10 days after the emergency operation was 6.67% (3/45), which was close to 5.56% (2/36) of patients in routine dressing change group (χ²=0.043, P>0.05). There was 1 patient with wound infection in NPWT group on 7 to 10 days after the emergency operation, obviously less than 6 patients in routine dressing change group (χ²=5.847, P<0.05). Complete wound healing time of patients in NPWT group was (30±4) d, significantly shorter than (36±8) d of patients in routine dressing change group (t=2.813, P<0.01). Limbs of 24 patients in NPWT group survived, which was close to 18 patients in routine dressing change group (χ²=1.293, P>0.05). Conclusions NPWT can significantly reduce tthe wound infection rate and shorten the time of wound healing of limb with destructive injury after emergency operation, which is worthy of popularization in clinic.

Objective: To study the clinical effect of relaying peroneal artery perforator flap on anterior middle and lower tibia and donor-site defects repair. Methods: From July 2014 to June 2017, 12 patients were included. The anterior middle-lower tibia soft tissue defects and the primary donor-sites were repaired by relaying peroneal artery perforator flaps, and the second donor-sites were directly closed. The size of anterior middle-lower tibia defects ranged from 5 cm × 3 cm to 13 cm × 9 cm. The flaps repairing the wounds ranged from 6 cm × 4 cm to 14 cm × 10 cm in size. The flaps restoring the first donor-site ranged from 5 cm×4 cm to 10 cm×6 cm in size. The clinical effect was evaluated by observing the appearance of the recipient sites and the donor sites. Results: All the flaps survived uneventfully. All patients were followed up for 8-36 months (average 20 months). The flaps remained with good texture and color. The second donor-sites only left linear scar, which do not affect the overall appearance of limb. Conclusions The blood supply of relaying peroneal artery perforator is reliable without any disturbing of the main artery. The flap located on the lateral of the calf. The relaying peroneal artery perforator flap can repair the soft tissue defect at the anterior middle-lower tibia and improve the appearance of the first donor-site.

Objective: To investigate the effect of polycyclic aromatic hydrocarbons (PAHs) exposure on the level of histone H3Ser10 phosphorylation (p-H3S10) and DNA damage degree in peripheral blood lymphocyte (PBLCs). Method: 75 coke oven workers from Benxi steel plant in Liaoning Province of China (PAHs-exposed group) and local 50 hot rolling workers (control group) were recruited in this study with age, working years, labor intensity and high temperature for matching factors using cluster sampling method in 2014. HPLC-fluorescence was performed to determine the level of urinary 1-hydroxypyrene (1-OHP), DNA damage and specific histone modification were measured in PBLCs of the subjects through comet assay and ELISA assay, respectively. Linear regression model analysis was used to analyze the differences among PAHs exposure, DNA damage and p-H3S10 level in two groups. The Mediation analysis was used to analyze the regulated relationships between urinary 1-OHP, DNA damage and histone modification through the bootstrap method. Results: Age of the control and the exposed group were (45.32±8.32) and (43.87±5.67) years old (P=0.284). The concentration of urinary 1-OHP, OTM value, Tail DNA% and p-H3S10 level in exposure group were higher than that in control group, while the M (P₅-P₉₅) of p-H3S10 levels in control and exposed group were 2.21 (0.68-4.71), 4.54 (1.85-23.91) (P<0.001). The degree p-H3S10 level was increased after the subgroups which were (2.59±1.19)%, (3.24±2.81)%, (5.55±3.25)%, (8.77±7.84)%, respectively, divided by quantitated 1-OHP concentration as P₀-P₂₅, P₂₆-P₅₀, P₅₁-P₇₅ and P₇₆-P₁₀₀ (P<0.001). We also found the correlations between urinary 1-OHP and p-H3S10 level or OTM value or Tail DNA%, β (95%CI) were 0.264 (0.167-0.360), 0.500 (0.299-0.702), and 0.510 (0.384-0.671), respectively (P<0.001). Similar result was also observed between p-H3S10 level and OTM value or Tail DNA%, β (95%CI) were 0.149 (0.073-0.226) and 0.220 (0.132-0.308) (P<0.001). Moreover, the mediation effect value of DNA damage on PAHs induced p-H3S10 alteration was 0.054(P=0.040). Conclusion The results suggested that PAHs exposure could induce DNA damage and an increase in histone H3Ser10 phosphorylation in PBLCs. Particularly, the alteration of H3S10 phosphorylation may play an important role in regulating cell DNA damage repair.