BACKGROUND:Similarly with C-reactive protein, red blood cel distribution width can reflect the inflammatory process. Red blood cels involved in inflammatory process leads to the increase in red blood cel distribution width due to various inflammation factor receptors existingon the surface of red blood cel s. OBJECTIVE:To analyze the relationship between the neutrophils lymphocyte ratio, red blood cel distribution width and the pathogenesis andseverity of idiopathic facial paralysis. METHODS:The severity of idiopathic facial paralysis was assessed using the House and Brackmann Facial Nerve Grading System (HB) and Sunnybrook System (SB) in 30 included patients with idiopathic facial paralysis (disease group). The patients were graded as general (score 30-100) and severe paralysis (score 0-29) according to SB scores, or as mild (grade II/III), moderate (grade IV), severe paralysis (grade V/VI) according to HB grades. In addition, 30 healthy volunteers were selected as control group. Neutrophils lymphocyte ratio (NLR) and red blood cel distribution width (RDW) were compared between groups. The correlation of SB and HB scores with neutrophils lymphocyte ratio (NLR) and red blood cel distribution width was analyzed. RESULTS AND CONCLUSION:Neutrophils lymphocyte ratio was higher in the disease group than the control group (P< 0.01). A significant difference in red blood cel distribution width was found between different stages of disease severityin patients. Red blood cel distribution width was negatively correlated with SB scores (P< 0.01), while was positively correlated with HB grades (P< 0.01). Our results suggest that (1) neutrophils lymphocyte ratio is increased when idiopathic facial paralysis occurs; (2) red blood cel distribution widthis positively correlated with the severity of idiopathic facial paralysis, which indicates that inflammation is involved in the pathogenesis of idiopathic facial paralysis, and red blood cel distribution may be a marker for assessing the severity of idiopathic facial paralysis.

Antineoplastic Agents ; therapeutic use ; Arsenicals ; therapeutic use ; Humans ; Myelodysplastic Syndromes ; drug therapy ; Oxides ; therapeutic use

Facial nerve grading system (FNG) plays a crucial role in the diagnosis and treatment of idiopathic facial paralysis, and also serves as a primary tool for prognosis. Subjective grading systems are currently the most widely used methods due to their easy accessibility, popularization and low costs. Objective grading systems, which have obvious advantages in terms of index quantization, repeatability and consistency between evaluators, will become the mainstream in future application and possess development prospect despite their limitation of technology and cost. This article reviewd the clinical application of different types of FNGs in facial nerve grading among different periods, and made a summarization of currently-existing facial nerve grading methods. It may provide a scientific and reasonable reference to the constitution, filter and application of facial nerve grading systems in treating idiopathic facial paralysis.

Abstract: Objective　 This article aims to present a rare case of severe fever with thrombocytopenia syndrome (SFTS) complicated by with bacteraemia caused by Campylobacter jejuni, and to discuss the pathogenic characteristics, culture methods, clinical features and treatment points of Campylobacter jejuni and the patient's outcome, with a view to raising clinical awareness of blood culture and providing experience for the treatment of this disease. Methods　The clinical data of a case with SFTS complicated by bacteremia caused by Campylobacter jejuni admitted to Weihai Municipal Hospital were collected and the diagnostic process of the pathogenic bacteria as well as the treatment plan were retrospectively analysed. Results　The patient was a female who had been bitten by a tick bite half a month ago and presented to the hospital on 30th August with a fever, vague pain in the peribulbar abdomen and diarrhea for 5 days. Laboratory tests showed leukopenia and thrombocytopenia, and nucleic acid detection for SFTS was positive, resulting in a diagnosis of SFTS. After a week of antiviral treatment with ribavirin and symptomatic treatment, the patient suddenly experienced high fever at night, with a temperature reaching 39.5 °C. Blood cultures were immediately taken from both sides of the double bottle. Bilateral anaerobic bottles were tested for positive after 53.06 hours, and Gram-negative Campylobacter was cultured anaerobically in a transfer blood plate and further identified as Campylobacter jejuni using mass spectrometry MALDI-TOF MS. Vancomycin was stopped clinically on the basis of bacterial pathogenesis and meropenem was used for anti-infection and symptomatic treatment. During the treatment, blood culture and nucleic acid detection for SFTS turned negative, and the patient's symptoms improved. After normal results were achieved in the follow-up testing, the patient was discharged. Conclusions　This case serves as a reminder that Campylobacter jejuni not only causes intestinal infections, but can also lead to extra-intestinal infections in immunocompromised individuals. Clinical and laboratory personnel should increase their recognition of Campylobacter jejuni, prioritize blood culture methods, and utilize a multidisciplinary approach in diagnosis and treatment.

Objective To describe the method of treating so ft tissue defects of the lower 1/3of l egs with the reversed saphenous neurocu taneous island flaps.Methods From June 1998to December 2000,eight cases of soft tissue defects or unstable scars of the lower one third of the legs,or around the ankle and th e heels were treated with reversed sap henous neurocutaneous island flaps.The size of the flaps were from 6cm ?5cm to 15cm ?9cm,averaging 9cm ?6.3c m.In 3cases in order to avoid the inju ry of the blood vessels of the flap pedicle when it passed thr ough the subcutaneous tunnel,a skin fascial bridge was designed in width of 1.5cm as the pedicle of the island f lap and to form the roof of an open tunnel.Results Seven cases had the flaps survived,one case had partially necrosis of the flap.After 6mo nths to 2years follow-up,all of the8cases were evaluated as satisfacto ry.Conclusion The blood supply of the reversed saph enous neurocuta-neous island flap is reliable,even i n patients with insufficienct arterial supply of the distal one third of t he lower limb.The flap does not sacrifice the major arteries and is easy to be perfomed.[

Objective To evaluate the protective effects of oral administration of D-methionine tablets on noise-induced hearing loss.Methods A total of 203 volunteers were recruited and randomly divided into two groups:experimental group (n=113)and control group (n=90).The subjects in the experimental group received oral administration of D-methionine tablets(1 500 mg/day)and those in the control group received placebo for 3 days before impulse noise exposure.The routine audiometric evaluation and ABR testing were performed and recor-ded 1 day and 7 days post- noise exposure.The statistical analysis was carried out with SPSS 11.0.ResuIts The changes of hearing in all participators were observed after noise exposure.The results were as follow:The hearing thresh-olds at three time points were 40.5±9.3,51.7±12.3,44.1±11.4 dB nHL in experimental group and 41.5±8.9,62.4± 13.7,47.6±12.5 dB nHL in control group,respectlvely;the ABR I-V IPLs at three time points were 3.72±0.21 ms, 3.99±0.36 ms,3.82±0.25 ms in experimental group,while 3.71±0.22 ms,4.45±0.37 ms,3.85±0.34 ms in control group,respectively.There were statistically significant differences between the two groups.ConcIusion The oral adminis-tration of D-methionine tablets pre noise exposure can protect against noise-induced hearing loss.

Objective To investigate the characteristics of the reversed sural neurocutaneou s island flap in clinical application.Methods From June 1997to March 2002,13cases of soft tissue defect in the lower leg,or around the ankle and the heel were repaired with the reversed sural neurocutaneous island flaps.The largest flap size was 15cm ?9cm,while the smallest was 5cm ?6cm.Results11of the flaps survived well and had primary healing,while 2flaps had distal partial necrosis and healed after dressing change.The follow-u p from3months to 4years showed that all fla ps were satisfactory.Conclusion Since the blood supply of the reverse d sural neurocutaneous island flap is reliable,even in patients with insufficient blood supply,and the flap is easy and quick to get without sacrificing the major arteries,it is an ideal method to use this flap to repair the soft tis sue defect in the lower leg and around the malleolus,the heel and the Achilles tendon.[

AIM: To evaluate the effect of microfiltrating the extract of Sophora japonica L. by inorganic ceramic membrane. METHODS: The extract of Sophora japonica L. was processed by inorganic ceramic membrane, and the whole solid, effective ingredinent and flux of mebrane were examined. RESULTS: The extract of Sophora japonica L. became clear after microfiltration. The decreasing rate of the whole solid was 27.88%, the metastasis rate of the effective ingredient was 78.26, and the increasing rate of the effective ingredient was 8.48%. CONCLUSION: The microfiltration of inorganic ceramic membrane can improve the qualitry of extract of Sophora japonica L. refinery effect.

Objective To research the operative methods and their comments on the lower leg, ankle and the foot soft tissue defects. Methods From June 1997 to December 2005, 43 cases of the lower leg, ankle and the foot soft tissue defects were treated with nine different kinds of pedicle flaps transplant. The patients included 38 males and 5 females, with an average age of 35 years (range from 7 to 63 years). The areas of flaps were from 4 cm?3 cm to 25 cm?15 cm. 9 kinds of flaps were underwent in all patients, which includes medial or lateral gastrocnemis myocutaneous pedical flaps in 2 cases; anteromedial cross leg flaps in 2 cases; medial cross leg flap with saphenous nerve in 1 case; medial reverse flow island leg flap with posterior tibial artery in 1 case; medial distal leg fascia flaps in 2 cases; reversed sural neurocutaneous island flaps in 17 cases; reversed saphenous neurocutaneous island flaps in 14 cases; supra extramalleolus reversed island flaps in 2 cases; and medial pedes distal island flaps in 2 cases. Results 37 flaps of 43 cases were completely survived, 1 case with superficial necrosis and 5 cases with distal edge partially necrosis and these 6 cases all healed after short time dressing change. All the cases were followed up 3 months to 7 years, with an average of 16 months, and none recurred. The flaps completely survived even in some special cases such as diabetes mellitus, dorsal artery of foot defect combined venous varicose, sural nerve injury, Gustilo ⅢC open fracture and serious degloving injury of lower leg and foot. Conclusion In order to achieve the desired results, it is important to grasp the surgical indications of various kinds of flaps and keys for the operation. The sural and saphenous neurocutaneous island flaps could be a satisfactory method to treat the soft tissue defects in lower leg, ankle and foot.

[Objective]To observe the clinical effects and the comments of the circular external fixator on the treatment of spiral and oblique fractures of distal one-third of tibia-fibular.[Method]Fifteen patients(11 males,4 females),with a mean age of 38.5 years(range 21 to 57)with spiral and oblique fractures of distal 1/3 of tibia-fibular were treated with circular external fixator from August 2005 to October 2008.The aetiologies of the fractures were as follows:8 cases,motor vehicle accident;5 cases,falls;2 cases,crush.All the fractures were closed.Nine cases had skin and soft tissue contusion on the distal leg and ankle.[Result]All patients were followed up and acquired the bony union.The mean follow-up time was 10.5 months(range 6～30 months).The mean framing time was 4.5 months(range 2.5～9 months).None of the patients had soft tissues infection and osteomyelitis.None of the patients suffered from the complications such as shortness,angulation,rotation deformity.None of the patients suffered from refracture after removal of the frame.Three patients had pin tract infection and were treated by oral antibiotics.Four patients had loss of range of motion in the ankle after the removal of the frame.These 4 patients had loss of mean 5-degree dorsiflexion and mean 10-degree plantar-flexion.All the patients had full knee function.[Conclusion]The circular external fixator may be used as an alternative method in the treatment of spiral and oblique fractures of distal 1/3 of tibia-fibular and the patients can avoid suffering from the removal of internal fixators.