Objective To improve the corrected results of the nasal deformities of the hare lip nose. Methods Based on the reposition of the lower lateral cartilages and the caudal septum, the authors corrected the secondary hare lip nose with the L shaped silicon rubber graft to reinforce and model the nasal tip.Results From 1996～2000, the procedure was performed for 20 cases (15 male, 5 female ), aged from 16～21 years. Follow up was from 3 months to 4 years. All cases obtained satisfactory results. Conclusions The results of utilizing L shaped silicon rubber graft combined with reposition of the mislocated nasal cartilages are better than the latter method only, especialy for the nasal tip. The procedure is easy to learn .The material silicon rubber graft is cheap and can be trimmed very conveniently. And it can also correct the saddle nose at the same time.

OBJECTIVETo explore the risk factors of breast cancer for better control and prevention of the malignancy.

METHODSThe clinical data of 232 patients with pathologically established breast cancer were investigated in this 1:1 case-control study to identify the risk factors of breast cancer.

RESULTSThe history of benign breast diseases, family history of carcinoma and multiple abortions were the statistically significant risk factors of breast cancer, while breast feeding was the protective factor.

CONCLUSIONA history of benign breast diseases, family history of carcinoma and multiple abortions are all risk factors of breast cancer.

Abortion, Habitual ; Adult ; Aged ; Breast Diseases ; complications ; Breast Feeding ; Breast Neoplasms ; epidemiology ; etiology ; Carcinoma ; complications ; Case-Control Studies ; China ; epidemiology ; Female ; Humans ; Middle Aged ; Risk Factors ; Young Adult

Objective To investigate the effects of exendin-4 (exenatide) on insulin sensitivity and adipocytokine in high-fat-fed rats. Methods Rats were divided randomly into normal-chow group (NC), high-fat group (HF) and high-fat+exendin treated group (HE). HE rats were given exenatide (2 μg/kg) twice daily for 6 wk. The insulin sensitivity was evaluated by intravenous insulin tolerance test (IVITT). Insulin-stimulated changes in insulin signal transduction, visfatin and adiponectin mRNA expressions as well as their plasma levels were also observed in these rats. Results Plasma free fatty acids (FFA), triglyceride (TG), total cholesterol (TC) levels were significantly reduced after exenatide treatment (in HE rats all P<0.01). And IVITT parameters were also improved in these rats. Insulin-stimulated IRS-1 tyrosine phosphorylation was slightly increased in exenatide-treated rats as compared with HF rats (P<0.05). In addition,plasma visfatin level was significantly reduced in HF and HE groups as compared with controls (P<0.05 and P<0.01). The adiponectin mRNA expression in adipose tissues and circulating adiponectin level were significantly elevated in exenatide-treated rats as compared with untreated rats and controls (P<0.01). Conclusions Chronic exenatide treatment improves insulin resistance in high-fat-fed rats, and the changes of IRS-1 tyrosine phosphorylation and adiponectin may be related to the role of exenatide in elevating insulin sensitivity

Objective To discuss the methods of selecting different shapes occluder and to evaluate the feasibility,safety and efficacy of them in transcatheter closures of congenital ventricular septal defect (VSD) in children.Methods Transcatheter closures were performed in 226 children with congenital VSD,age ranging from 2 to 14 years(mean 5.62 years) under the guidance of transthoracic echocardiography(TTE) and fluoroscopy.There were 14 patients with intracristal VSD,209 patients with perimembranous VSD and 3 patients with muscular VSD.Left ventriculography and transthoracic echocardiography were performed repeatedly after the procedure to assess the effect of occlusion.The echocardiography and electrocardiography were scheduled before discharge,1,6 and 12 months for the follow-up.Results The occluders were deployed successfully in 211 patients.The successful rate was 93.4%.Thin waist shape occluders,were deployed in 7 patients;equal side shape occluders,were deployed in 191 patients;eccentric shape occluders were deployed in 12 patients,and muscular defect occluders were deployed in 1 patient.There were no complications encountered during or after closure.Conclusions It is very important in transcatheter closure of congenital in children to select different shape occluder according to pathologic characteristics.In general,equal side shape occluder is suita-ble for a large number of defect and it is easy for deployment.In some conditions,the other shape occluder may be necessary.

OBJECTIVETo analyze 3D digitized image of the adult penis, providing morphological data for plastic plerosis of the adult penis diagnosis and the surgery planning.

METHODS200 adult penis were measured at the length and perimeter of the resting state and erection, and the relation among the erectile angle and length, perimeter were analyzed by the Angel Digital Image Studio software.

RESULTSPenis increase with the age and stature growing. But the length increases in not the same ratio with the stature . With the erectile angle increasing, penile hardness is becoming strong, but penile volume do not marked change.

CONCLUSIONSThe digitized model of the penis and adjacent structure offer unique insights into the complex penis anatomy, providing morphological data for preoperative design and postoperative effective evaluation of the penile plastic plerosis.

Adolescent ; Adult ; Humans ; Imaging, Three-Dimensional ; Male ; Middle Aged ; Penis ; anatomy & histology ; Young Adult

OBJECTIVEThe history of clinical application of extracorporeal membrane oxygenation (ECMO) has been more than 30 years. But in China, there were only a few ECMO centers with limited successful cases reported by the end of twentieth century. The high morbidities and mortalities in current pediatric ECMO practice are noted in China. Therefore, it is necessary to review the experience on rescue use of ECMO in critically ill pediatric patients.

METHODA retrospective analysis was done for patients who had been receiving ECMO treatment to rescue refractory cardiorespiratory failure from different causes in a hospital between July 2007 and May 2011.

RESULTA total of 12 patients were treated with ECMO; 7 of them were male and 5 female, they aged 6 days to 11 years, weighed 2.8 - 35 (17.21 ± 11.64) kg. The underlying causes of cardiorespiratory failure were as follows: two cases with acute respiratory distress syndrome (ARDS) leading to respiratory failure, 4 with failure of weaning from cardiopulmonary bypass, 3 with fulminant myocarditis, 1 with right ventricular cardiomyopathy leading to repeated cardiac arrest, 1 with preoperative severe hypoxemia, and 1 with anaphylactic shock complicated with massive pulmonary hemorrhage and severe hypoxemia. Of the 12 cases, 3 were established ECMO (E-CPR) while underwent chest compression cardiopulmonary resuscitation (CPR). The mean ECMO support time was 151.75 (15 - 572) h. Seven patients (58.33%) were weaned from ECMO, 6 patients (50.00%) were successfully discharged. Six cases had bleeding from sutures, 2 cases with severe bleeding underwent thoracotomy hemostasis, 2 presented with acute renal failure. Infection was documented in 3 cases, hyperbilirubinemia in 2 cases, lower limb ischemia in 1 case, hyperglycemia in 3 cases, disseminated intravascular coagulation in 1 case, membrane lung leakage in 2 cases, systemic hemolysis in 3 cases, oxygenator failure in 2 cases and oxygenator thrombosis in one case. During the follow-up between 6 months and 4.5 years, 5 patients survived with good quality of life, without any documented central nervous system disorders. One case survived with the right lower extremity disorder from ischemic damage. His motor function has been improved following orthopedic operation at one year after discharge.

CONCLUSIONECMO is a justifiable alternative treatment for reversible severe cardiopulmonary failure in critically ill children.

Cardiac Output, Low ; etiology ; therapy ; Cause of Death ; Child ; Child, Preschool ; Critical Illness ; mortality ; therapy ; Extracorporeal Membrane Oxygenation ; adverse effects ; Female ; Heart Failure ; etiology ; mortality ; therapy ; Hemorrhage ; epidemiology ; etiology ; Humans ; Infant ; Infant, Newborn ; Male ; Postoperative Complications ; mortality ; therapy ; Respiratory Insufficiency ; etiology ; mortality ; therapy ; Retrospective Studies ; Survival Analysis ; Thrombosis ; epidemiology ; etiology ; Treatment Outcome

OBJECTIVETo study the clinical efficacy of the treatment of comminuted patellar fractures with internal NiTi-Patellar concentrator and tension bind wire fixation.

METHODSFrom March 2004 to June 2007, 38 cases of fresh comminuted patellar fractures were treated with internal NiTi-Patellar concentrator and tension bind wire fixation. There were 25 males and 13 females,ranging from 21 to 64 years (mean 42.5 years). All were comminuted fractures with displacement, 16 cases were 3 fragments, 14 cases were 4 fragments, 8 cases were 5 fragments. There were other fractures in 8 cases. During followed-up, knee function and complications were evaluated.

RESULTSAll patients were followed up for 8 to 24 months (mean 15 months) and obtained complete bone union. No case of implant was loosening and fragment displacement, traumatic arthritis occured in 2 cases. Under Lysholm & Gillquist score, the results were excellent in 17 cases, good in 19, fair in 2.

CONCLUSIONInternal Ni-Ti-Patellar concentrator and tension bind wire fixation is one of the ideal methods for the treatment of comminuted patellar fracture, which could provide satisfied reduction, reliable fixation and good functional recovery.

Adult ; Bone Wires ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; surgery ; Fractures, Comminuted ; surgery ; Humans ; Internal Fixators ; Male ; Middle Aged ; Nickel ; Patella ; injuries ; surgery ; Titanium ; Young Adult

OBJECTIVETo compare the accuracy of 64-slice computed tomography and coronary angiography in the diagnosis of coronary atherosclerosis.

METHODSThe imaging data of both 64-slice computed tomography and coronary angiography in 65 patients were analyzed retrospectively.

RESULTSAmong the 455 coronary arteries evaluated, the sensitivity, specificity and accuracy of 64-slice computed tomography were 54.6%, 95.1%, and 85.5%, respectively.

CONCLUSION64-slice computed tomography has a good potential in the diagnosis of coronary atherosclerosis with excellent sensitivity and specificity.

Adult ; Aged ; Coronary Angiography ; Coronary Artery Disease ; diagnosis ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, Spiral Computed ; methods

OBJECTIVESTo evaluate the diagnostic value of arterial spin labeling (ASL) technology in newborns with hypoxic ischemic encephalopathy (HIE).

METHODSeven full-term newborn infants without any history of asphyxia and other nervous system diseases were selected as the control and 33 full-term newborn infants were assigned into HIE group. The patients in HIE group were further divided into three subgroups (19 cases of mild, 6 cases of moderate and 8 cases of severe HIE) based on their clinical diagnosis. The control group and HIE group were examined with GE Signa EXCITE HD 3.0T superconducting MRI scanner with a head phase array coil. Both groups were scanned with conventional axial MRI (T1FLAIR, T2WI and T2FLAIR), 1HMRS (PRESS sequence) and ASL (FAIR). Original images of 1HMRS and ASL were processed by Functool software of ADW 4.3 workstation. ASL perfusion images were observed and the signal intensity values of the region of interest (bilateral gray, white matter and basal ganglia) of the two groups were quantitatively measured, and mean value were calculated and compared between groups. Statistical analysis was performed with SPSS 13.0 software, and statistically significant difference was set at P < 0.05.

RESULTThe perfusion images of two groups were obtained perfectly. The signal intensity values of bilateral gray, white matter and basal ganglia of control group were 125.34 ± 11.76, 73.42 ± 11.67 and 173.65 ± 15.49, respectively and there was a statistically significant difference between the different areas. The signal intensity values of bilateral gray, white matter and basal ganglia of HIE group were 153.47 ± 11.72, 71.35 ± 10.37 and 217.13 ± 12.51, respectively. There was a statistically significant difference (P < 0.05) in the average signal intensity value of gray matter and basal ganglia, but there were no statistically significant difference (P > 0.05) in white matter between the two groups.

CONCLUSIONASL Perfusion technique can assess HIE comprehensively and accurately. Furthermore, it can evaluate the brain damage of hypoxic ischemia. The results provide a strong basis for clinical treatment.

Case-Control Studies ; Electron Spin Resonance Spectroscopy ; Female ; Humans ; Hypoxia-Ischemia, Brain ; diagnosis ; Infant, Newborn ; Male ; Spin Labels

Objective To explore the dosage and injection method of concanavalin A(Con A) for inducing Wistar rats into the acute hepatic injury model. Methods (1)According to the dosage of Con A, 42 Wistar rats were randomly divided into groups A, B, C, D, E, N, 7 rats in each group. Group N was given tail intravenous injection of normal saline as normal control group. Groups A, B, C, D, E were given intravenous injection of 4, 8, 16, 30, 40 mg/kg of Con A respectively. At the 8th hour after modeling, the levels of alanine transaminase(ALT), aspartate aminotransferase(AST), albumin(ALB), interleukin(IL)-2 , IL-10, interferon (IFN)-γ, and tumor necrosis factor(TNF)-αwere detected. And HE staining was used to observe the pathological feature of hepatic tissue. (2)According to the injection method of Con A, 21 Wistar rats were randomly divided into normal control group, intraperitoneal injection group and tail intravenous injection group, 7 rats in each group. The dosage of Con A for the rats in intraperitoneal injection group and tail intravenous injection group was 16 mg/kg. At the 8th hour after modeling, the levels of serum ALT, AST, and ALB were determined. Results The number of abnormal deaths in various dose Con A groups at the end of each experiment was 0 in groups A, B, C, and 2 in group D, and 7 in group E. A small amount of spotty necrosis, inflammatory cell infiltration, and hepatic lobule with almost integrity of structure were found in groups A, B, while obvious bridging-like necrosis was seen in groups C, D. Serum ALT, AST, and ALB levels in intraperitoneal injection group had no statistically significant difference as compared with the normal control group. Conclusion Tail intravenous injection of 16 mg/kg of Con A can be used to induce an acute immunological liver injury rat model successfully.