Objective To compare the clinical effect of vascularized fibular flap transplantation and vancomycin sulfate calcium on chronic osteomyelitis of the tibia and bone defects.Methods A total of 35 cases with chronic tibial osteomyelitis and bone defect were involved and divided into group A with 21 cases receiving anastomosis of vascularized fibular flap transplantation and group B with 14 cases recciving vancomycin sulfate calcium.Infection control rate and Enneking score were compared in both groups.Simultaneous detection of two groups preoperative,postoperative 2 weeks,1 month and 3 months of the levels of CRP and PCT were conducted.Results Postoperative CRP and PCT were under control in both groups.No statistical significance was found in the comparison of CRP and PCT preoperative and postoperative 2 weeks,1 month and 3 months.In terms of infection control rate,two groups had no signiticant difference (P ＞ 0.05) and there was statistical significance of the comparison of postoperative Enneking score (P ＜ 0.05).Conclusions The clinical results of the two methods are satisfied.The infection degree and the length of the bone defect are decisive factors in choosing the treatment method and sometimes the combination of two treatment methods may be a better choice.

Zwittermicin A was purified by ion exchange resin and HPLC from supernatants of Bacillus thuringiensis.subsp.kurstaki strain D1-23 cultivation.2.89mg pure Zwittermicin A was acquired,proved by HPLC-MS.Results show that the optimized wash concentration of NH_ 4 H_ 2 PO_ 4 is 5mmol/L at first step.Next step CH_ 3 COONH_ 4 concentration is 30 mmol/L,the gradient pH is 8.0～9.5.Totally 93% Zwittermicin A can be reserved with ion exchange resin.The temperature and pH stability experiments show the half life of Zwittermicin A is 48.22 minutes in 100℃,and it is more stable in lower pH in pH 2.0～12.0.

The authors explained the process of organizing and implementing of the designed experiments.The designed experi- ments can improve students' creative thinking ability and activate students'initiative and meanwhile,it can improve teachers' level and contribute to making progress in teaching and studying although there are still some problems to solve.

Objective To summarize the technique and managements of complications in endovascular embolization on intracranial aneurysm with Guglielmi detachable coils(GDC),and to evaluate the effect of the treatment.Methods One hundred and thirty six cases with Aneurizym were treated using GDC to embolize the aneurismal sac via femoral artery approach.Results One hundred and thirty six aneurysms were cured.Of them 132 cases recovered clinically,4 patients died.The mortality was 2.9%. The sac of 123 aneurysms were embolizied at 100%,8 cases with 95% embolization,5 with 90% embolization.3 aneurysms reptured during the embolization,cerebral vasospasm happened in 7 eases. microcoil escaped in 2 case.Three recurring cases were cured after second GDC embolization.The technique-related complications occured in 13 cases.No re-bleeding occurred during the 6 to 54-month follow-up.Conclusion Endovascular embolization of intracranial aneurysm with coils is a safe and effective treatment for intracranial aneurysm.Advances in Techniques and treating the complications correctly would decrease the complications and improve future outcomes.

Chaetomium thermophilum CT2 can produce extracellular cellulase with industrial value. We designed two degenerate primers to amplify catalytic domain sequence of cellobiohydrolase II ( CBH II). Full length of cDNA was obtained by rapid amplification of cDNA ends technologies. DNA sequencing revealed that cbh2 has an open reading frame of 1428bp, which encodes a putative polypeptide of 476 amino acids. The deduced amino acid sequence shows that the predicted molecular mass is 53 kD and the cbh2 consists of a fungal-type carbohydrate binding domain (CBD) separated from a catalytic domain by a linker region rich in proline/serine/threonine. PCR product consisting of the entire CBH II coding region without its signal sequences was cloned into the yeast secretive plasmid pPIC9K, which was then transformed into Pichia pastoris GS115. Highly efficient production of the cellobiohydrolase II was achieved in P. pastoris under the control of the AOX1 promoter, and the expressing level was 1.2 mg/mL by small-scale culturing. The recombinant cellobiohydrolase II was purified by using ammonium sulfate fraction, DEAE-Sepharose Fast flow chromatography. A molecular mass of the purified enzyme is 67 kD determined by SDS-PAGE and this is similar to the native cellobiohydrolase II purified from C. thermophilum CT2. The recombinant enzyme exhibited optimum catalytic activity at pH 4.0 and 50 degrees C respectively. It was thermostable at 50 degrees C and retained 50% of its original activity after 30 min at 70 d degrees C . The high level of fully active recombinant cellobiohydrolase II got from P. pastoris makes this expression system attractive for fermentor and industrial applications.
Amino Acid Sequence ; Base Sequence ; Cellulose 1,4-beta-Cellobiosidase ; biosynthesis ; genetics ; Chaetomium ; enzymology ; genetics ; Cloning, Molecular ; DNA, Complementary ; genetics ; Fungal Proteins ; biosynthesis ; genetics ; Molecular Sequence Data ; Open Reading Frames ; genetics ; Pichia ; genetics ; metabolism ; Recombinant Proteins ; biosynthesis ; genetics

OBJECTIVETo investigate the species of Ligularia distributed in the northwestern China and their medicinal uses in the local area.

METHODField investigation, specimen collection, taxonomic study and datum check were adopted.

RESULTThere are 29 species and 1 varieties of Ligularia distributed in the northwestern China, and 18 species of them had been used as folk medicines with the function of resolving phlegm, relieving cough, clearing heat and toxins.

CONCLUSIONThe northwestern China is abundant in medicinal resource of Ligularia.

Anti-Asthmatic Agents ; isolation & purification ; pharmacology ; Antitussive Agents ; isolation & purification ; pharmacology ; Asteraceae ; chemistry ; classification ; China ; Conservation of Natural Resources ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Ecosystem ; Humans ; Hypnotics and Sedatives ; isolation & purification ; pharmacology ; Pharmacognosy ; Plants, Medicinal ; chemistry ; classification

Objective To investigate the clinical,neuroimaging and myopathological features of mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes(MELAS).Methods The clinical manifestations,neuroimaging and myopathological features of 31 patients with MELAS diagnosed in our Neuromuscular Center in the recent 7 years were retrospectively analyzed.A3243G point mutations were analyzed by RFLP method in 10 patients.Results ①Clinical features:There were 18 male patients and 13 female patients.The age of onset ranged from 3 to 43 years,averaging 21.9 years.The averaged duration was 4.9 years.Thirteen patients in this group had family history of maternal inheritance pattern.The main clinical manifestations included short stature(26 patients),recurrent headache and vomiting(24 patients), muscle weakness(22 patients),epileptic seizure(21 patients),cognitive decline(19 patients),visual disturbance(17 patients),sensorineural deafness(16 patients),ataxia(6 patients),psychiatric symptom (8 patients),external ophathalmoplegia(2 patients)and diabetes mellitus(9 patients).The serum CK level was slightly elevated in 6 patients,and the fasting blood lactic acid was increased in 15 of the 18 detected patients.②Neuroimaging features:The stroke-like lesions were mostly confined to cerebral cortex, including temporal lobe(24 patients),occipital lobe(21 patients),parietal lobe(12 patients)and frontal lobe(4 patients).Three patients had deep white matter involvement.Migrating stroke-like lesions were confirmed in 4 patients by repeated cranial CT/MRI examination.In addition,cerebral atrophy(17 patients)and bilateral basilar ganglion calcification(11 patients)were found.③Myopathological features: Scattered ragged red fibers(RRF)in various number were found in all the patients by MGT staining.Other founding included strongly SDH-reactive blood vessel(27 patients),COX enzyme deficiency(19 patients), and mild to moderate lipid storage in RRF(20 patients).④MtDNA analysis showed 9 patients with A3243G point mutation in all the detected 13 patients.Conclusion The clinical and neuroimaging features may offer important clue to the diagnosis of MELAS,but a definite diagnosis of MELAS relies on the myopathology and mtDNA mutation analysis.

OBJECTIVETo review the efficacy of total anomalous pulmonary venous connection (TAPVC) repair and to conclude the factors impacting the peri-operative death rate.

METHODSThe clinical data of 145 infants under 1 year old who underwent the TAPVC repair from January 2001 to July 2008 was analyzed. There were 94 male and 51 female patients. The mean age when the repair was performed was (7 ± 3) months, and the average weight was (6.3 ± 1.6) kg. As to the pulmonary connection type, 77 patients were supracardiac (53.1%), 47 patients were cardiac (32.4%), 9 patients were intracardiac (6.2%), and the remaining 12 patients were mixed (8.3%). Pre-surgery echocardiography showed that 21 patients had pulmonary venous obstruction (12 patients were supracardiac type, 3 patients were cardiac type, 3 patients were intracardiac type, and 3 patients were mixed type).

RESULTSAll patients underwent two-ventricle anatomy correction (the cases of complex malformations had been excluded). Peri-operative mortality was 11.7% (17/145). Because of the significant improvement in the surgical techniques, anesthesiology, cardiopulmonary bypass and the management of ICU in January 2006, the population was divided into two groups: A (before January 2006) and B (after January 2006). Peri-operative mortality decreased from 19.0% in group A to 6.2% in group B(P = 0.020). After analysis, it was determined that the factors impacting mortality were which group the patient belongs to, whether he/she had preoperative pulmonary vein obstruction and how big the atril septel connection was. The operative technique to keep the anastomotic aperture adequate and prophylaxis pulmonary hypertensive episodes contributed to the improvement on the mortality rate. There had been no case of repeating the surgery because of pulmonary venous obstruction during peri-operative care period.

CONCLUSIONSImprovements of the surgical technique as well as the treatment in preoperative and postoperative have led to the reduction of the mortality. Preoperative pulmonary vein obstruction is still an important factor that contributes to early mortality.

Female ; Humans ; Infant ; Male ; Pulmonary Veins ; abnormalities ; surgery ; Retrospective Studies ; Treatment Outcome ; Vascular Diseases ; congenital ; surgery

OBJECTIVETo review the experience in repair of aortic coarctation with intracardiac anomaly in infants and toddlers.

METHODSFrom January 2000 to December 2006, 84 infants and children diagnosed as aortic coarctation with intracardiac anomaly underwent surgical treatment. Mean age of the patients was 13.5 months, with a range from 1 month to 3 years. Mean body weight was 7.3 kg, with a range from 3.3 to 15 kg. Twelve patients complicated with complex intracardiac anomaly. Seventy-two patients complicated with ventricular septal defect and other simple anomaly. Twenty-one patients had hypoplasia of the aortic arch. Sixty-two patients had one-stage repair. Median sternotomy was used to simultaneously repair coarctation and intracardiac defect in 49 patients. Left thoracotomy and median sternotomy were applied to repair aortic coarctation and intracardiac anomaly respectively in 13 patients. Twenty-two patients had staged repair. Operational techniques for aortic coarctation include 42 patients of patch aortoplasty, 30 patients of resection and end-to-end anastomosis, 6 patients of subclavian flap aortoplasty, 3 patients of vascular bypass, and 1 patient of balloon dilation. In all 49 patients of one-stage operation through median sternotomy, selective cerebral perfusion was used in 43 patients, deep hypothermia low flow was applied in 4 patients, deep hypothermia circulatory arrest was performed in 2 patients.

RESULTSThere were 8 hospital deaths. The mortality is 9.5%. Among 8 deaths, 3 patients were misdiagnosed.

CONCLUSIONSSurgeries for aortic coarctation with intracardiac anomaly have satisfactory short-term results in infants and toddlers. One-stage repair through median sternotomy can be applied to most of the patients. Selective cerebral perfusion with deep hypothermia and circulatory arrest in lower body can protect the brain and other vital organs.

Aortic Coarctation ; complications ; surgery ; Child, Preschool ; Female ; Heart Defects, Congenital ; surgery ; Humans ; Infant ; Male ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo retrospectively review the experience in repair of interrupted aortic arch (IAA) and associated cardiac anomaly.

METHODSFrom January 1997 to January 2008, 36 patients with interrupted aortic arch and associated cardiac anomaly underwent surgical treatment. There were 22 male and 14 female. Mean age of the 35 children patients was 2.8 years, with a range from 2 months to 7 years. There was a 31 years old adult patient. Types of interrupted aortic arch include 30 cases of type A and 6 cases of type B. In all 36 patients, 33 cases had patent ductus arteriosus (PDA) and intracardiac abnormality, including 28 cases of simple anomaly as ventricular septal defect and 5 cases of complex anomaly, two cases were single IAA arch without PDA and other cardiac defect, one case had no intracardiac anomaly but PDA. For 33 patients with PDA and intracardiac anomaly, median sternotomy was used to simultaneously repair interrupted aortic arch and intracardiac defect in 31 cases, left thoracotomy and median sternotomy were applied to repair IAA and intracardiac anomaly respectively in one case, one patient had palliative repair. For three patients without intracardiac anomaly, left thoracotomy was applied in two cases, median sternotomy and abdominotomy were used in one adult patient. Techniques of operation for interrupted aortic arch include 16 cases of conduit connection, 9 cases of direct anastomosis, 9 cases of direct anastomosis with patch augmentation, 1 case of subclavian flap aortoplasty. In all 31 cases of one-stage operation through median sternotomy, selective cerebral perfusion was used in 17 patients, deep hypothermia and low flow were applied in 8 cases, deep hypothermia circulatory arrest was performed in 6 patients.

RESULTSThere were 5 hospital deaths. Three cases died of pulmonary infection, 1 case died of of pulmonary hypertension crisis, and another case died of postoperative low cardiac output, which was misdiagnosed before operation. Seven cases had other main postoperative complications. Thirty-one survivors were followed up from 3 months to 5 years, there was no late death and reoperation.

CONCLUSIONOne-stage repair through median sternotomy using selective cerebral perfusion or deep hypothermia and low flow can be applied to most of the cases with associated cardiac anomaly.

Aorta, Thoracic ; abnormalities ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Heart Defects, Congenital ; surgery ; Humans ; Infant ; Male ; Retrospective Studies ; Treatment Outcome