Adult ; Aged ; Female ; Foot Injuries ; microbiology ; Hand Injuries ; microbiology ; Humans ; Male ; Middle Aged ; Surgical Wound Infection ; epidemiology ; etiology ; microbiology ; Suture Techniques ; adverse effects ; Wound Healing ; physiology

OBJECTIVETo observe the curative effect of integrative medicine for treatment of systematic lupu erythematosus (SLE).

METHODSTotally 110 cases of SLE were randomized into two groups, 50 in the control group and 60 in the treated group, both were treated with prednisone, but to the treated group, integrative medica treatment was given additionally according to syndrome differentiation. The course for both groups was 6 months. Clinical symptoms, immunological indexes, peripheral blood figure, erythrocyte sedimentation rate (ESR), levels of C-reactive protein (CRP) and creatinine (Cr) in blood, and 24 h urinary total protein (u-TP/24 h) were observed before and after treatment.

RESULTSOf the 60 patients in the treated group, the treatment on 29 was evaluated as clinical remission, 18 as remarkably effective, 9 as effective, and 4 as ineffective, the total effective rate being 93.33% (56/60), while that in the control group was clinical remission in 11, remarkably effective in 10, effective in 19, ineffective in 10 respectively, and the total effective rate 80% (40/50), the difference on total ef fective rate between the two groups was significant (chi2 = 4.36, P <0.05). Besides, the improvement in the treated group was superior to that in the control group in terms of clinical symptoms such as fever, arthralgia and baldness (P <0.05, P <0.01); the negative reversion rate of anti-nuclear antibody (ANA, 51.3% vs 28.1%), antidouble-stranded DNA (ds-DNA, 53.6% vs 26.1%), anti- ribonucleoprotein (RNP, 63.2% vs 29.4%) and circulating immnue complexes (CIC, 63.2% vs 29.4%, all P <0.05); lowering of immunoglobulin (for IgG, P < 0.05; IgA, P <0.01; IgM, P <0.01); as well as bettering in peripheral blood figure, ESR, CRP, Cr and u-TP/24 h (P <0.05 or P <0.01).

CONCLUSIONIntegrative medical treatment is obviously effective for SLE patients.

Adolescent ; Adult ; Autoantibodies ; blood ; Blood Sedimentation ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Integrative Medicine ; Lupus Erythematosus, Systemic ; blood ; drug therapy ; immunology ; Male ; Middle Aged ; Prednisone ; therapeutic use ; Young Adult

0.05). After dividing the patients into early-onset and late-onset subgroups, there were significant differences of DRD4 genotype and allele frequency between early-onset patients and controls (P0.05). Conclusion The results suggested that the polymorphism of DRD4 receptor gene may be associated with early-onset OCD. The 3/4 genetype may be the risk factor of early-onset OCD. Early-onset and late-onset OCD may have different etiology.

0.05). If the patients were divided into two subgroups according to SCID-II, there were significant differences of 5-HT2A genotype between patients without obsessive compulsive personality disorder(OCPD) and controls (P0.05). Conclusion The polymorphism of 5-HT2A receptor gene maybe associated with OCD patients who do not have OCPD in the Han nationality. Patients with or without OCPD may have different etiology.

Objective To examine the possibility that a candidate causal species of the skin and lung tumor promotion induced by exposure to dimethylarsinic acid(DMAv)and dimethylarsinous acid(DMAⅢ),caused by the induction of oxidative stress in mice.Methods Two stages lung tumotigensis animal model induced by lung tumor initiator(4-nitroquinoline 1-oxide,4NQO)and promoter(DMAv)in ddY mice,was used to examine the effect of(-)epigallocatechin gallate(EGCG)on DMAv promoting lung tumorigenesis.Two stages skin tumorigenesis animal model induced by skin tumor initiator[dimethylbenz(α)anthracene,DMBA]and promoter(DMAⅢ)in hairless mice.was used to examine the effects of DMAⅢ in skin tumorigenesis and histopathology.The goxo-2'-deoxyguanosine (8-oxodG)in lung and epidermis were analyzed by HPLC.Results The incidence of lung tumors and 8-oxodG level of lung tissue decreased significantly in 4NQO+DMAv+EGCG group.compared with 4NQO+DMAv group (0.89±0.30 vs 4.00±0.82,1.21±0.09 vs 1.53±0.32,P＜0.01).The incidence of severe keratosis in DMBA+ DMIⅢ group was more than that in DMBA group(25 vs 10,P＜0.05).An significant elevation of 8-oxodG in epidermis was observed in 0.5 h[(1.67±0.17)/105 dG],1.0 h[(1.62±012)/105 dG],2.0 h[(1.66±023)/105dG], 3.0 h[(1.60±0.15)/105 dG],compared with 0 h[(1.25±0.11)/105 dG],being significant(P＜0.05).Conclusion tumor promotion due to DMAv administration is mediated by DMAⅢ through the induction of oxidative stress.

OBJECTIVETo analyze the related factors of the infection after operation of open tibiofibula fractures.

METHODSThe clinical data of 141 patients with open tibiofibula fractures underwent surgical treatment from June 2009 to December 2012 were retrospectively analyzed. All the patients were male and aged from 18 to 61 years old with an average of 39.2 years; all the fractures were unilateral. According to Gustilo typing of fracure, 5 cases were type I, 44 cases were type II, 27 cases were type III a, 56 cases were type III b and 9 cases were type III c. These clinical data included patients' age, gender, body mass index (BMI), underlying diseases, time of operation, fracture site, fracture type, fixation method, postoperative drainage, debridement condition and so on. The postoperative infection conditions were recorded, and the correlation between above factors and infections were analyzed. Finally, the significant related variables were introduced into a Logistic regression model to evaluated their risk.

RESULTSAmong the 141 patients, 22 cases developed with infection (15.6%). The significant relative factors with infection contained fixation method, debridement condition, underlying diseases and postoperative drainage (P < 0.05). The correlativities were stepped up in order, their odds ratios value was 2.451, 3.164, 3.414, 5.117, respectively.

CONCLUSIONActive treatment for underlying diseases before operation, thorough debridement for open wound, suitable fixation method for fracture and thorough draining are effective measures in preventing postoperative infection.

Adolescent ; Adult ; Debridement ; Fibula ; injuries ; Fractures, Open ; surgery ; Humans ; Logistic Models ; Male ; Middle Aged ; Postoperative Complications ; etiology ; Retrospective Studies ; Risk Factors ; Surgical Wound Infection ; etiology ; Tibial Fractures ; surgery

BACKGROUNDAt least five mismatch repair (MMR) genes, including hMSH2, hMLH1, hPMS, hPMS2, and hMSH6/GTBP, are associated with hereditary nonpolyposis colorectal cancer (HNPCC). More than 90% of families with HNPCC harbor the hMSH2 and hMLH1 gene mutations. We have analyzed the clinical features of HNPCC among Chinese patients and report the results of screening for mutations in the hMSH2 and hMLH1 genes.

METHODSThe data concerning gender, site of colorectal cancer (CRC), age at diagnosis, history of synchronous and/or metachronous colorectal cancer, instance of extracolonic cancers, and histopathology of tumors for 126 patients from 28 independent families with HNPCC were collected. Fifteen of the families met the Amsterdam I criteria, and 13 met the Japanese clinical criteria for diagnosis. Genomic DNA was extracted from the peripheral lymphocytes. Polymerase chain reaction (PCR) and denaturing high-performance liquid chromatography (DHPLC) were used to screen the coding region of the hMSH2 and hMLH1 genes. Samples showing abnormal DHPLC profiles were sequenced.

RESULTSOne hundred and seventy malignant neoplasms were found in the 126 patients, of whom 23 had multiple cancers. Ninety-eight of the patients (77.8%) had colorectal cancers, with an average age at onset of 45.9 years and a right-sided predominance. Eight hMSH2 or hMLH1 gene sequence variations were found in 12 families, and a germ-line G204X nonsense mutation in the third exon of hMSH2 was found, representing the first mutation in an MMR gene ever found in people of Chinese Mongolian ethnicity.

CONCLUSIONSHNPCC is a typical autosomally dominant hereditary disease, characterized by early onset, a predominance of proximal colorectal cancer, and multiple synchronous and metachronous colorectal cancers. DHPLC is a powerful tool for detecting mutations in the hMSH2 and hMLH1 genes. Mutations in the first nine exons of the hMLH1 gene were more common in Chinese patients.

Adaptor Proteins, Signal Transducing ; genetics ; Adult ; Aged ; Asian Continental Ancestry Group ; genetics ; China ; Colorectal Neoplasms, Hereditary Nonpolyposis ; ethnology ; genetics ; DNA Mutational Analysis ; Female ; Germ-Line Mutation ; Humans ; Male ; Middle Aged ; Models, Genetic ; MutL Protein Homolog 1 ; MutS Homolog 2 Protein ; genetics ; Nuclear Proteins ; genetics ; Pedigree ; Polymerase Chain Reaction

Objective To report the surgical method and treatment outecome of transfer of free upper limb lateral bone-skin flap for repair of bone defects and nonunion in hand and forearm.Methods 17 cases of hand composite trauma,5 cases of forearm composite trauma and 2 cases of nonunion in forearm were treated with free bone-skin flaps in distal humerus,whose pedicle was the posterior branch of radical collateral artery. Area of the flap was 2cm?3cm to 8cm?10cm,length of exseeted bone was 3～6 cm.Results All the bone-skin flaps completely survived,the donor area all achieved primary healing,On postoperative 1～4 years follow-up,the texture of the flap was excellent,and bone union was obtained in all transplants,the donor area of distal lateral humerus became thicker and thicker with new cortical bones formed.According to the upper arm function assessment criterion issued by hand surgery association of Chinese medical association.The hand function had excellent results in 17 cases and good results in 2 cases.Conclusion The bone-skin flap has following advantages:easy dissection,reliable blood supply,and no major vessel needed to be sacrificed,so it is an effective method for repair of skin and soft tissue with bone defects in hand and forearm,It.also can be used to repair refractory nonunion in ulna and radius.

Objective To investigate the relationship between arsenic in drinking water and skin lesions in endemic arsenism area in Shanyin County of Shanxi Province,in order to provide epidemiologic data for further arsenism research.Methods One hundred and eighty-nine endemic arsenism patients and 59 controls were randomly selected in 17 endemic amenism countries in Shanyin County of Shanxi Province.The content of arsenic in drinking water which wa8 collected indoom was half-quantitatively screened by a kit made by Chinese Center for Disease Control and Prevention,then quantitatively determined by HPLC-ICP-MS.Patients of endemic arsenism were diagnosed by "The Standard of Diagnosis for Endemic Amenism"(WS/T 211-2001).Results There were 64.9% (87/134)samples above the arsenic level(50μg/L)of drinking water and the median value of arsenic in drinking water was 91.43 μg/L in 134 water samples.The OR(95%CI)value between arsenic in drinking water and hyperkeratosis,hyperpigmentation,depigmentation was 2.46(1.22-4.94),3.34(1.50～7.44)and 2.86(1.50-5.46),respectively.The prevalence of hyperkeratosis,hyperpigmentation and depigmentation increased,as the arsenic in drinking water increased(≤10,≤50,≤200,＞200μg/L),especially in＞200μg/L group(OR=6.15,13.96,11.41,P＜0.05).The arsenic level in drinking water of Ⅲ degree of depigmentation patients(318.300μg/L)was higher(P＜0.05)than that of 0,Ⅰ and Ⅱ degree groups(86.670,131.800,1 10.590μg/L,P＜0.05).Conclusions Shanyin County is a medial arsenic pollution area. Arsenic in drinking water is considered as a risk factor of skin lesion. The degree of skin lesions increased,as the arsenic in drinking water increased.

Objective To learn the present status of defluoridation water improvement project in Shanxi province in order to provide scientific basis for speeding up the prevention and control of endemic fluorosis.Methods According to "The National Technical Scheme for Endemic Disease Control" from 2005 to 2009, the investigation points were selected in the counties that implemented the measures of water improvement and defluoridation,the status of drinking water defluoridation Project was investigated, and the water fluoride levels were determined by fluoride selective ion electrode. Results The primary status was surveyed in 1658 water improvement and defluoridation projects in 51 counties. The resource of drinking water for water improvement and defluoridation projects was mostly ground water[accounting for 93.12% (1544/1658)]. Among 1658 water improvement and defluoridation projects 1405 projects worked well(accounting for 84.74%) and 190 projects intermittently worked (accounting for 11.46%). Sixty three projects abandoned (accounting for 3.80%), in Datong basin the abandoned projects accounted for 36.36% (12/33). Water fluoride content of 1595 water improvement and defluoridation projects had been determined, among them water fluoride content of 874 projects were above 1.0 mg/L (accounting for 54.80%). The situations of exceeded national standard in the five basins was different(H = 33.22,P ＜ 0.01). The rate of over national standard of fluoride levels in drinking water was 88.37%(38/43) in Datong basin. Therefore, in Datong basin water improvement should be strengthened. Conclusions In Shanxi province the water improvement and defluoridation projects are basically running normally. However, the qualified rate is lower for the water improvement and defluoridation projects. The water improvement status varies dramatically among areas.The situation is still grim in Shanxi province. Water improvement and defluoridation needs to be strengthened to improve the effect of prevention and control of the disease.