[Objective]To look for rehabilitation means for swollen and painful hands,and feet.[Method]A Herbal bath was used to bathe swollen hands and feet after wrist and ankle fractures.The design of the clinical trial was randomized,single-blinded with placebo.Parameters measured included hand or foot volume,joint motions and self-evaluation.[Result]Results showed that positive outcome was observed in swelling control and joint motions as well as self-evaluation.[Conclusion]Herbal bath produced good results in the control of hand and foot swellings.

OBJECTIVETo explore clinical characteristics and treatment of posterior Pilon fracture.

METHODSFrom January 2011 to January 2013,18 patients with posterior Pilon fracures were treated. Among them, 13 were male and 5 were female, aged from 22 to 63 years old, with an average age of 46. All the patients were closed fractures. Open reduction and internal fixation were performed after swelling subsided, lateral malleolous and posterior Pilon fracture were exposured through lateral approach on healthy side, plates were used to fixed,screws or small plates were used to fix the posterior prominence of medial malleolus after changed to supine position. AOFAS scoring were applied to evaulate clinical effects.

RESULTSAll patients were followed up with an average of 22(ranged, 12 to 48)months. All patients obtained satisfactory reset except one patient. All factures were recovered well with an average healing of 11 weeks. According to AOFAS score at the final following up, 7 cases were excellent,2 cases were moderate, and the total score was 86.8±9.2.

CONCLUSIONPosterior Pilon fracture is not rare in clinical, its mechanism of injury, traumatic anatomy, surgical procedure and prognosis are different from that of classical ankle fracture and Pilon fracture.

Adult ; Ankle Injuries ; surgery ; Female ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Tibial Fractures ; surgery ; Treatment Outcome ; Young Adult

OBJECTIVETo study the effects of skin wound induction gel on the glans scabbing rate, class-A wound healing rate, and wound healing time of circumcision for phimosis in pediatric patients.

METHODSWe randomly assigned 48 six to thirteen years old children with phimosis to an experimental group (n = 25) and a control group (n = 23) to be treated by circumcision. After surgery, the patients in the experimental group received application of skin wound induction gel while those in the control group received that of povidone iodine only to the glans and incision. We recorded and compared the glans scabbing rate, class-A wound healing rate, and wound healing time between the two groups of patients.

RESULTSGlans scabbing was observed in 3 cases in the experimental group and 17 cases in the control group (12.0% vs 73.9%, P < 0.01). No statistically significant differences were found in the rate of class-A wound healing between the two groups (100% vs 91.3%, P > 0.05). The wound healing time was significantly shorter in the experimental than in the control group ([10.7 ± 1.7] d vs [11.9 ± 2.1] d, P < 0.05).

CONCLUSIONPost-circumcision application of skin wound induction gel to the glans and incision can effectively reduce glans secreta, alleviate inflammatory reaction, and shorten the healing time in the treatment of phimosis in children.

Adolescent ; Child ; Circumcision, Male ; Gels ; administration & dosage ; Humans ; Induction Chemotherapy ; methods ; Inflammation ; prevention & control ; Male ; Phimosis ; drug therapy ; Postoperative Complications ; prevention & control ; Wound Healing ; drug effects

OBJECTIVETo explore clinical effects of Ilizarov technique at stage I for repairing tibial post-traumatic osteomyelitis with bone and skin defect.

METHODSFrom June 2010 to December 2013,44 patients with tibial post-traumatic osteomyelitis with bone and skin defect were treated with Ilizarov technique at stage I . Among them, there were 35 males and 9 females aged from 18 to 70 years old with an average of 42.5 years old. Bone defect ranged from 4 to 16 cm, skin defect ranged from 3 cm x 4 cm to 5 cm x 16 cm. The operation was performed debridement thoroughly, removed inflammatory bone section, osteotomy invasively, install circular external fixator by Ilizarow technique; screw nut were rotated at 1 week after operation, and prolonged 0.5 to 1.0 mm everyday. Wound surface, new born callus and bone healing were observed to evaluate clinical effects.

RESULTSAll patients were followed up from 11 to 36 months with an average of 18.5 months. Bone defect after osteotomy was from 6 to 22 cm with an average of 11.5 cm; the time of wound healing time ranged from 21 to 79 d with an average of 38 d; bone defect healing time was from 8 to 15 months with an average of 12.5 months. All patients were cured, no recurrent infection, refracture and shorten of calf deformity were occurred.

CONCLUSIONRepairing tibial post-traumatic osteomyelitis with bone and skin defect by llizarov technique at stage I has advantages of less trauma, low inflammatory recurrence rate, could avoid multiple complex operation, and receive definite curative effect.

Adolescent ; Adult ; Aged ; Female ; Humans ; Ilizarov Technique ; Male ; Middle Aged ; Osteomyelitis ; surgery ; Osteotomy ; Tibia ; surgery

OBJECTIVETo compare the criteria of sperm morphology evaluation in the fifth edition of WHO Laboratory Manual for the Examination and Processing of Human Semen and those in the fourth edition, and to know the changes in the criteria of sperm morphology evaluation in the new edition.

METHODSNine technicians from Zhejiang Human Sperm Bank evaluated the morphology of 1 000 spermatozoa in 96 sperm morphological pictures according to the criteria in the fourth and fifth editions of WHO Laboratory Manual, respectively.

RESULTSThe percentage of morphologically normal sperm by the criteria of the fifth edition was (26.50 +/- 5.06)%, significantly higher than (11.39 +/- 3.17)% by the fourth edition (P < 0.05), while the rates of sperm head and tail defects based on the former were (64.26 +/- 7.66)% and (10.92 +/- 2.03)%, significantly lower than (76.11 +/- 8.18)% and (39.89 +/- 3.85)% according to the latter (P < 0.05). There were no significant differences in the rates of sperm midpiece defects and excessive residual cytoplasm by the fifth and fourth editions ([16.46 +/- 3.08]% vs [15.22 +/- 3.51 ]% and [4.24 +/- 1.66]% vs [3.87 +/- 1.68]%, P > 0.05).

CONCLUSIONThe criteria of sperm morphology evaluation in the fifth edition of WHO Laboratory Manual are less strict than those in the fourth, and the percentage of morphologically normal sperm is higher according to the fifth edition.

Humans ; Male ; Semen Analysis ; standards ; Sperm Head ; ultrastructure ; Sperm Midpiece ; ultrastructure ; Sperm Motility ; Spermatozoa ; ultrastructure ; World Health Organization

OBJECTIVETo search for a method for the precise measurement of human semen volume so as to provide reliable evidence for clinical semen analysis.

METHODSThe volumes of 492 semen samples collected from 137 donors by Zhejiang Human Sperm Bank were measured respectively by three different methods including electronic balance weighing, volumetric cylinder measuring, and combination of the two methods above. With the combined measuring method, the semen weight was first obtained by electronic balance weighing, then the semen density determined by volumetric cylinder measuring, and lastly the semen volume figured out by a formula. Paired sample t-test was used to compared the combined method with electronic balance weighing and volumetric cylinder measuring.

RESULTSThe mean volume of the 492 semen samples obtained by the combined measuring method was (3.46 +/- 1.17) ml, significantly lower than (3.75 +/- 1.21) ml from electronic balance weighing (P < 0.05) and markedly higher than (3.22 +/- 1.16) ml from volumetric cylinder measuring (P < 0.05). The mean semen density of the 492 samples was (1.0928 +/- 0.0761) g/ml, and the mean weight of the residual semen in the container used in volumetric cylinder measuring was (0.269 +/- 0.122) g.

CONCLUSIONSemen volume measured by electronic balance weighing is higher while that obtained from volumetric cylinder measuring is lower than the actual value. An accurate semen volume can be achieved by the combined measuring method, which, therefore, deserves to be widely used both clinically and in researches.

Adult ; Body Weights and Measures ; Humans ; Male ; Semen ; Semen Analysis ; methods ; Young Adult

Objective To observe the dynamic changes of plasma matrix metalloproteinases (MMPs) and investigate the effect of early or delayed percutaneous coronary intervention (PCI) in the presence or absence cilostazol on left ventricle (LV) remodeling in patients with non-ST elevation myocardial infarction (NSTEMI). Methods One hundred and sixty-four patients undergoing PCI with NSTEMI were randomized to early PCI (PCI within 24 h) group or delayed PCI group (PCI after 36 h), and patients in both group were further assigned to cilostazol or no cilostazol group. Plasma MMP-2 and MMP-9concentrations were measured at 2, 4 days and 2 and 4 weeks after PCI. Left ventricular end-diastolic volume ( LVEDV ), left ventricle ejection fraction ( LVEF), left ventricle posterior wall ( LVPW ) and interventricular septum (IVS) were measured by echocardiography at baseline and 1 year after PCI. Results MMP-2 concentration at 2 weeks after PCI is higher than that at 2, 4 days and 4 weeks after PCI. MMP-9concentration at 4 days is higher than that at 2 days, 2 weeks and 4 weeks after PCI. MMP-2 and MMP-9were significantly lower in cilostazol group compared with that in non-cilostazol group at 4 days, 2 weeks and 4 weeks after NSTEMI ( all P ＜ 0. 05 ). Changes of LVEDV and LVEF were significantly less in cilostazol group and early PCI group than that in no cilostazol group and delay PCI group (P＜0.05 or P＜0. 01) at 1year after NSTEMI. Conclusions Early PCI and Cilostazol use are associated with less LV remodeling in patients with NSTEMI. Cilostazol attenuated LV remodeling possibly by reducing concentration of MMP-2and MMP-9 after PCI.

OBJECTIVETo improve the diagnosis and treatment of primitive neuroectodermal tumors (PNET) of the pancreas.

METHODSOne patient with PNET of the pancreas was reported in this article. The corresponding literatures on the diagnosis and treatment was reviewed.

RESULTSThe patient was diagnosed as pancreatic PNET by her clinical, microscopic, and immunohistochemical features as well as cytogenetic analysis after the resection of the tumor located in the uncinate process in PUMC Hospital. Radiochemotherapy was given after the operation for 8 months and no recurrence was observed. Since PNET of pancreas have no specific clinical symptoms and most patients have jaundice and/or abdominal pain, the diagnosis depended on the immunohistochemical features of positive P30/32(MIC2) and at least two of the neural markers. The cytogenetic analysis showed translocation mainly harbored the characteristic t (11; 22) (q24; q12). Since pancreatic PNET were highly aggressive, early chemotherapy, close follow-up, and immediate surgical interventions were required as early as possible.

CONCLUSIONPNET can occur in pancreas, and diagnosis and treatment should be made as early as possible to improve the outcome.

Child ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Humans ; Neuroectodermal Tumors, Primitive ; diagnosis ; therapy ; Pancreatic Neoplasms ; diagnosis ; therapy

AIMTo assess the possible role of genetic polymorphisms in DNA repair gene XRCC1 (X-ray repair cross-complementing group 1) during spermatogenesis by investigating the associations of one promoter polymorphism (T-77C) and two exonic polymorphisms (Arg194Trp and Arg399Gln) in XRCC1 gene with risk of idiopathic azoospermia in a Chinese population.

METHODSThe genotype and allele frequencies of three observed polymorphisms were examined by polymerase chain reaction-restriction fragment length polymorphism based on a Chinese population consisting of 171 idiopathic azoospermia subjects and 247 normal-spermatogenesis controls.

RESULTSIn our study, all the observed genotype frequencies were in agreement with Hardy-Weinberg equilibrium. The 399A (GA+AA) allele frequency for idiopathic azoospermia subjects and controls was 0.216 and 0.269, respectively. Compared with GG genotype, the AA genotype of Arg399Gln showed a significant association with a decreased risk of idiopathic azoospermia (odds ratio = 0.315; 95% confidence interval = 0.12-0.86). However, no significant differences were found between the cases and controls for T-77C and Arg194Trp polymorphisms. The major haplotypes of XRCC1 gene were TCG, TTG and TCA, whereas no haplotypes appeared to be significantly associated with idiopathic azoospermia based on the cutoff of P < 0.05.

CONCLUSIONIn a selected Chinese population, AA genotype of Arg399Gln appears to contribute to a decreased risk of idiopathic azoospermia, while we have not any evidence of involvement of XRCC1 T-77C and Arg194Trp polymorphisms in idiopathic azoospermia.

Adult ; Asian Continental Ancestry Group ; ethnology ; genetics ; Azoospermia ; ethnology ; genetics ; Case-Control Studies ; China ; DNA-Binding Proteins ; genetics ; Gene Frequency ; Genetic Predisposition to Disease ; Genotype ; Humans ; Infertility, Male ; genetics ; Male ; Polymorphism, Restriction Fragment Length ; genetics ; Risk Factors ; Spermatogenesis ; genetics ; X-ray Repair Cross Complementing Protein 1

OBJECTIVETo report the first case of non-composite combined liver and intestinal allotransplantation in China. The technical aspects of the case and pros and cons of such an approach versus composite technique were discussed.

METHODSThe patient suffered from short bowel syndrome and TPN-related liver damage. A non-composite technique was used in this case. During operation, the whole 380 cm intestine was transplanted with systemic drainage and aortic inflow, while the liver graft was placed in a piggyback fashion. Warm ischemic time of donor graft was 2 min and 30 seconds, and cold ischemic duration for intestinal and liver graft was 6 hours and 40 and 8 hours and 7 utes respectively. Postoperative immunosuppression management includes tacrolimus, methylprednisolone, MMF and Zenapax.

RESULTSThe recipient recovered smoothly with no evidence of rejection on days' follow up. Now he is maintained well on enteral nutrition.

CONCLUSIONNon-composite technique should be considered in adult recipients, especially those with a history of abdominal infections or multiple laparotomies.

Adult ; Humans ; Intestines ; transplantation ; Liver Transplantation ; Male ; Short Bowel Syndrome ; therapy ; Transplantation, Homologous ; methods ; Treatment Outcome