Objective:To learn the effect of personality in the course of cognitive decline.Methods:106 aged people from two districts were selected randomly.Arithmetic,digit span,picture filling,block patterns,digit symbol,visual attention span,spatial reasoning were used to learn the cognitive ability,“Kartaier's 16 personality factors test”were used to explore the personality of aged people.Results:16 personality factors test shows that old people are more deferential and self-assured.The relation between reasoning and arithmetic,rule-consciousness and arithmetic,abstractedness and digit span,reasoning and block design,dominance and digit symbol,sensitivity and special reasoning,apprehension and visual attention span,openness to change and visual attention span reach the statistical significance.Conclusion:Age is the most important reason to the cognitive impairment in aged people, education can prevent the cognitive impairment in a large degree.Personality can affect the cognitive ability although different personality factor affect different cognitive fields.

Liver transplantation is the only way to treat end-stage liver disease. In order to overcome the shortage of donor, marginal donors have been used widely, which bring about a series of problems. Machine perfusion can stimulate the circulation in vivo and is beneficial for the protection of liver. It could also improve the graft function and reduce postoperative complications, which makes it a hot spot in recent years. The aim of this study is to summarize the current status and prospects of application of machine perfusion on clinical liver transplantation.
Humans ; Liver ; Liver Transplantation ; Perfusion ; instrumentation ; methods ; Tissue Donors

A 57-year-old man was admitted to the hospital for a 7-year progressively spreading plaques involving the entire body surface, and multiple irregularly sized red nodules and infiltrated patches on the face, trunk and limbs. Histopathological examination showed pleomorphic tumor cells diffusely dis-persed throughout the dennis, giving an appearance of low proliferation. Some cells with cytoplasmic pro-cesses appeared multiangular in shape, lmmunohistochemically, tumor cells were negative for CDla or S-100, but positive for CD45, FXIIIa, CDl4, MHC- Ⅱ, CD68 and lysozyme with extracellular interstitial expression. Ultrastructurally, the cells exhibited cytoplasmic processes and irregularly sized nuclei; no Birbeck granules were observed. Vesicules of low electron-density were seen diffusely in cytoplasm and extracellular matrix. The case is herein diagnosed as cutaneous non-Langerhans cell histiocytosis, which presents with a chronically invasive clinical course. These cells may develop from immature dermal dendritic cells.

Objective To set up a new diagnostic platform based on microarray exon-capture and next-generation sequencing for detecting small mutations in dystrophin gene.The sensitivity and specificity of the method were assessed in clinical settings and the distribution of small mutations in Chinese Duchenne muscular dystrophy/Becker muscular dystrophy (DMD/BMD) patients were also analyzed.Methods Forty-one DMD/BMD patients diagnosed by the clinical criteria without large deletion or duplication (≥ 1exon) were recruited from Peking Union Medical College Hospital consecutively.Genomic DNA was extracted from blood samples.The libraries were prepared.Then exon and intron-exon flanking sequences of DMD gene were captured by custom microarray.Targeted next-generation sequencing and Sanger Sequencing were conducted.The patients who were not detected any disease-causing mutation were performed muscle biopsy.Results Thirty-eight subjects were detected small mutations in DMD gene.All single nucleotide variants (SNVs) and insertion & deletions (INDELs) were validated by Sanger sequencing.Twenty-one novel mutations were reported.The distribution of SNVs and INDELs was similar to other international DMD databases.Upon immunohistochemistry staining of dystrophin protein,1 of 3 mutation-undetected patients was diagnosed as DMD,2 of them were excluded.The specificity of the method was 100％,while the sensitivity was 97.4％.Conclusions Our microarray-captured next-generation sequencing assay could detect SNVs and INDELs with high sensitivity and specificity.Its advantages are economic,time-saving and stable.The platform is suitable for clinical gene diagnosis.

Objective To investigate the clinical effect of the free fibula composite tissue flap transplantation to repair the first metatarsal bone with soft tissue defect on foot.Methods From August, 2008 to August, 2013, 6 patients with the first metatarsal bone and soft tissue defect on foot were treated with transplantation of free fibula composite tissue flap.The causes: 2 cases in traffic accident injury, 4 cases in machine injury;3 cases with traumatic defect, and septic defect in 3 patients.Of the 6 cases, the fibular length with transplantation was 6 cm to 12 cm, and the flap area was 8 cm × 5 cm-18 cm × 16 cm;All the cases were followed-up in 3, 6, 12 months postoperatively to observe the fracture healing, and to assess injured limb function in 1 year postoperatively.Results All cases were followed up 12-24 months, and average of 14 months;All the flaps survived, and the metatarsal bone and fibula healing was good visibly in half a year, The surgery function were assessed according to Maryland's scale, and the excellent were 2 and the good were 4.Conclusion The transplantation of free fibula composite tissue flap to repair the first metatarsal bone with soft tissue defect on foot is a safe and effective strategy, and it has the advantages such as covering the wound at foot approvingly, one-time rebuild repair foot weight bearing area and the surrounding soft tissue defect, shorten the treatment cycle, for small area damage in donor area, and the function postoperative is good, etc.

Objective To investigate the diagnostic value of MRI in the infantile developmental dislocation of the hip.Methods Forty-five cases of preoperative hip MRI data of DDH (patient group)and 40 cases of normal hip (control group)MRI data were retrospectively analyzed.Three types were classified according to the standard of Dunn.Then the bony acetabular index (BAI),cartilaginous acetabular index (CAI)were measured on coronal MRI and all the intra-articular structures (articular cartilage,labrum, teres ligament and iliopsoas)in the acetabulum that impeded the reduction of the femoral head were observed.Results There were normal hips (80 hips)and dislocated hips (73 hips).In dislocated hips typeⅠ (30 hips),typeⅡ (20 hips),and typeⅢ (23 hips) were found.The values of BAI were (26.13±2.19)°and (35.87±4.42)°,CAI (13.84±1.07)°and (21.92±4.70)°for patient group and control group.The values of BAI were (31.80±1.74)°,(37.80±3.40)°and (39.17±4.11)°,CAI (17.20±2.68)°,(20.91±2.02)°and (27.50±2.78)°for the typesⅠ,Ⅱ,Ⅲ respectively.Differences of BAI and CAI between patient group and control group were showed (t=-11.048 and -9.188,P =0.000).Statistically significants were found among the typeⅠ,Ⅱ,Ⅲ(F=22.159 and 47.241,P =0.000).There were linear correlations for patient group ,control group,and the typeⅠ,Ⅱ,Ⅲ (r= 0.964,0.844,0.953,0.931 and 0.870,P =0.000).Some pathological changes such as varus labrum,thick teres ligament,iliopsoas spasm,articular cartilage hyperplasia,fat hyperplasia,joint effusion were observed in the type Ⅱand Ⅲ.Conclusion MRI is not only used for measuring the values of BAI and CAI,and a linear correlation among all kinds of DDH,but also some factors hindering the reduction of the femoral head can be found clearly.It can provide an important reference basis for the diagnosis and treatment of DDH.

Objective:To evaluate of the feasibility of low-dose CT(LDCT)in the reconstruction of three-dimensional(3D)model of maxillofacial hard and soft tissues.Methods:Lightspeed 16-slice spiral CT scanner was used to scan one adult cadaveric head specimens with conventional parameters(280 mA)and low dose parameters(200,150,100,50,35,25,15 and 5 mA)respectively;the 3D model of the hard and soft tissues were reconstructed with Mimics 10.01 software,and 3D comparison were carried on with Geomagic 11.0 software.A comparison of the surface morphology of the hard and soft tissues of the 3D models with different scanning parameters was made.Results:With the reduction of the tube current,the model surface became rough gradually.Compared with the 280 mA scan results,the model surface produced by 35 mA scanning was still fairing,when the dose fell to less than 25 mA,the model surface became rough and the exact shape of the model could not be recognized.The same results of model surface were pro-duced after registration.Conclusion:The low-dose (35 mA)CT can be used to reconstruct 3D model of the maxillofacial hard and soft tissues.

Objective To investigate the clinical effect of harvesting the free anterolateral thigh flap irregularly for the repair of the multiple and complex skin and soft tissue defect at lower limb.Methods From January,2009 to January, 2014, 7 patients with multiple and complex skin and soft tissue defect at lower limb were treated with transplantation of the free anterolateral thigh flap with harvesting irregularly.The parts of wound defect: 2 cases of medial leg andlateral leg, 3 cases of foot back andankle, and 2 cases of medial malleolus and lateral malleolus.All the cases were operated in fracture fixation and wound without obvious infection.The vascular pedicle of free flaps were descending branch of lateral circumflex femoral artery.The types of the harvesting the free anterolateral thigh flap irregularly: 3 cases of the anterolateral thigh flap and terminal branch of lateral femoral circumflex artery muscle flap, 2 cases of the anterolateral thigh flap and transverse branch of lateral circumflex femoral artery muscle flap, and 2 cases of reconstructed lobar femoral anterolateral thigh perforator flap (vascular anastomosis of pedicle of lobulated anterolateral thigh perforator flap with the main stem branch artery of the lateral femoral circumflex vessels).The area of harvesting the free anterolateral thigh flap irregularly were 6 cm × 4 cm to 16 cm × 12 cm;The donor site were closed directly.All the patientsbegined to early rehabilitative exercise under the protection of orthosis after 4 weeks of the operation.Results All cases were followed up for 6 to 14 months, and the average of 8.2 months.All the flaps survived, besides 2 cases with necrosis of small area in distal, and which were healed by dressing, debridement,skin grafting and so on;The healing time were 12 to 34 days, and the average of 17.1 days.The area of flaps without obvious retraction, color were the same as the region, no obvious scar contracture.Conclusion The anterolateral thigh flap feed by the same source vessels for the repair of the multiple and complex skin and soft tissue defect at lower limb is a safe and effective strategy.The flap can be combinated differently to repair multiple and irregular wound one-time, the donor site is small invasive, shorten the treatment cycle, and relieve the suffering.

Objective To report treatment of infectious bone and soft tissue defects caused by tibial shaft fracture of Gustilo type Ⅲ B using free flap and Ilizarov bone transport.Methods Nineteen patients who had suffered from infectious bone and soft tissue defects following tibial shaft fracture of Gustilo type Ⅲ11 B were treated from May 2010 to February 2015.They were 15 men and 4 women,aged from 21 to 58 years (average,45.3 years).Their course of disease ranged from 16 to 21 months,averaging 17.9 months.The area of their infectious defects ranged from 10 cm × 6 cm to 21 cm × 12 cm,and the length of their bone defects from 5 to 11 cm (average,7.4 cm).They were treated with debridement,simple external fixation to reconstruct bony support,coverage of wounds with free flap,and stuffing the dead space with antibiotic concrete beads,followed by Ilizarov bone transport and bone graft after control of infection to reconstruct the defective tibia and function of the affected limb.Results All the flaps survived.Necrosis occurred at the distal margin of one flap but responded to dressing.Pin tract infection occurred in 4 cases but also responded to dressing and antibiotic therapy.Autografts of iliac cancellous bone were implanted into the gliding and traction ends of the bone fragments one month after bone transport had come to rest.All the patients achieved direct bony union.The patients were followed up for an average of 25 months(range,from 19 to 36 months).No secondary fractures or angular deformity was observed.The total treatment time averaged 17.9 months,with no recurrence of infection.According to the Puno score system for functional evaluation at the last follow-up,7 cases were rated as excellent,6 as good and 6 as fair.Conclusion The infectious bone and soft tissue defects caused by tibial shaft fracture of Gustilo type Ⅲ B can be treated by free flap and Ilizarov bone transport,resulting in definitely positive outcomes.

Objective To study the effect of cleaning intestinal tract on treatment jaundice in premature infants.Methods We randomly assigned 48 premature infants from January to December in 2004.In the treatment group the intestinal tract was cleaned with 30～40 mL NS once daily and 3～4 days.The through cutis bilirubin(TCB),the times of blue light,me conium exhustion and feeding toleration were recorded.Results 1.The TCB was obviously descented about 34.2 ?mol/L and the time of blue light was shortened by 20 h in treated group(P