Objective To investigate the causes on platelet distribution width (PDW)results not shown in the automatic he-matology analyzer and evaluate the accuracy of the platelet results of these samples with the automatic hematology analyzer. Methods The platelet morphology was observed in microscope for the specimen which PDW were not shown in the auto-matic hematology analyzer.And the platelet results counted in microscope were statistically compared with that in the auto-matic hematology analyzer.Results In the 200 specimens which PDW were not shown in automatic hematology analyzer, there were 104 specimens(52%)in which large platelet was found,36 cases(18%)in which platelet aggregation was visible, 28 cases(14%)in which the microcytes or erythrocyte debris could be seen,32 cases(16%)in which the obvious abnormal was not found.The platelet results counted in microscope for the specimens,in which large platelets,platelet aggregation or microcytes were found,were very different with the results counted with the automatic hematology analyzer(P < 0.05).The PDW of the 200 specimens were rechecked in the automatic hematology analyzer.And 64 cases (32%)PDW results were got,of which 55 cases(85.9%)PDW results were beyond the normal range.Conclusion The main causes for the PDW not shown in automatic hematology analyzer includes large platelets,platelets aggregation and microcytes etc.The platelet re-sults in these specimens by automatic hematology analyzer were different with that counted in microscope.Therefore,the platelet of these specimens should be counted in microscope.

Objective To investigate a better method for repair of scalp avulsion with skull exposure.Methods After primary debridement and skin grafting,tissue expanders were placed into subgaleal layer of normal scalp.After enough expansion,expanded scalp flaps were used to repair the skull exposure and the bald deformity.Results All of 6 cases had satisfactory results,wounds were repaired,no bald deformity occurred and no tissue expander infected case was encountered.Conclusion Using this method,we can treat the scalp avulsion with skull exposure without bald deformity.

Objective To investigate the distribution and resistance of clinical isolates obtained from the second affiliated hospi-tal of Chongqing medical university in 2012 .Methods The bacteria strains isolated from clinics were collected .Identification and drug susceptibility test were performed by automatic analysis system and API manual identification system .The date was analyzed according with software WHONET 5 .6 .Results A total of 3 454 bacterial isolates were obtained ,which included 36% gram-posi-tive strains ,64% gram-negative strains and 1% Anaerobic bacteria .The detection rates of methicillin-resistant S .aures was 33% , the detection rate of vancomycin -resistant enterococci was 1 .6% .In enterobacteriaceae ,ESBLs producing strains accounted for 60 .6% and 35 .8% in E .coil and K .pneumonia respectively .The drug resistance of A .baumannii and P .aeruginosa was increased . Conclusion Drug resistance of bacterial isolated from our hospital is universal .Drug monitoring data is important for clinical treat-ment .

Objective To investigate a expander placement technique for fast tissue expansion. Methods Port-free thin wall expanders with long tube were specially made and tested on 45 cases of patients with skin scar. All expanders were placed subcutanuously through intralesional perpendicular short incisions with injection tube laid out. A large amount of saline was injected to expanders intraoperatively. Three sorts of fast expansion were carried out. Results Under the local tumescent anaesthesia, subcutaneous pockets were all dissected successfully. The amount of bleeding was less and no patient received blood infusion. All of forty five cases completed fast expansion satisfactorily without incision infection and dehiscence. Conclusion The technique of intralesional perpendicular short incisions has the advantages of less invasion and better safety, and suitable for fast tissue expansion.

Objective To find an effective method to prevent expanding flap from necrosis when expanders were removed. Methods After the expanders were removed, dexamethasone (5mg/kg) was injected into vein immeadiately when flaps showed blood flow disturbance, then decreased gradually and stopped until 6 days after operation. Results 33 of 35 patients recovered completely, and other 2 flaps survived mostly. Conclusion Dexamethasone given immeadiately could prevent expanding flap from necrosis.

Objective:To evaluate the feasibility and effectiveness of sentinel lymph node (SLN) detection in the ovarian neoplasms.Methods:A search of the literature describing ovarian SLN was performed using China National Knowledge Infrastructure (CNKI), WANFANG DATA, VIP, PubMed, Embase, web of science, Cochrane library from 2000.01.01 to 2020.07.29. The quality evaluation and data extraction of the included literature were conducted, and the development rate, sensitivity and negative predictive value of SLN were calculated.Results:Eight prospective single-arm studies were included, with heterogeneity I2=57.41%>50%, and the P<0.1. A total of 96 patients with ovarian cancer [Stage International Federation of Gynecology and Obstetrics (FIGO)Ⅰ-Ⅱ] were included, of whom 93 completed systematic pelvic and para-aortic lymphadenectomy after SLN detection. The most common tracers were technetium-99m radioactive colloid ( 99Tc m), blue dye or indocyanine green (ICG), and the most common injection sites were the infundibulopelvic ligaments and the proper ovarian ligaments. The SLN detection rate was 88.5%(85/96) and the average number was 2-3. SLN was found in the ipsilateral or contralateral regions of the tumor, 40.8%(31/76) was found only in the para-aortic, 14.5%(11/76) was found only in the pelvic, and 44.7%(34/76) was found only in the para-aortic and pelvic region. The sensitivity was 90.9%(10/11) and the negative predictive value was 98.8%(82/83) of lymph node metastasis. Conclusions:SLN detection for ovarian neoplasms is feasible, and whether it can effectively predict lymph node status of ovarian cancer still needs large sample, multi-center, prospective clinical studies to further verify.

OBJECTIVETo assess the safety and the accuracy of surgical navigation technology in the resection of severe ankylosis of the mandibular condyle with the middle cranial fossa.

METHODSThe CT scan data was transferred to a Windows-based computer workstation, and the patient' s individual anatomy was assessed in multiplanar views at the workstation. In the operation, the patient and the virtual image were matched by individual registration with the reference points which were set on the skull bone surface and the teeth. Then the real time navigation can be performed.

RESULTSThe acquisition of the data sets was uncomplicated, and image quality was sufficient to assess the operative result in three cases. The operations were performed successfully with the guidance of real-time navigation. The application of surgical navigation have enhanced the safety and the accuracy of the surgery for bony ankylosis of temporomandibular joint.

CONCLUSIONSThe application of surgical navigation can improve the accuracy and safety of surgical excision of the ankylosed skull base tissue.

Anatomic Landmarks ; anatomy & histology ; Ankylosis ; surgery ; Humans ; Skull ; diagnostic imaging ; surgery ; Surgery, Computer-Assisted ; methods ; Temporomandibular Joint ; surgery ; Temporomandibular Joint Disorders ; surgery ; Tomography, X-Ray Computed

BACKGROUND:The meningeal defect patients can be treated with artificial dural materials combined neurosurgical techniques which can protect the integrity of brain tissue. OBJECTIVE:To analyze the biocompatibility and application feasibility of various artificial dura mater materials. METHODS:The artificial dura materials were classified according to the different sources, and the biocompatible and application feasibility of various artificial dura mater materials were analyzed, as wel as the advantages and disadvantages of various materials. The anticoagulant and hemolytic properties of the materials were analyzed through recalcification test and hemolysis test. 100 patients receiving col agen membrane repair selected from Department of Neurosurgery, Dongfang Hospital of Beijing University of Chinese Medicine were observed. RESULTS AND CONCLUSION:The dural repair materials mainly include autologous material, al ograft materials, dissimilar materials, synthetic materials and natural materials. Each kind of material has its advantages and disadvantages. Meningeal defect complications include cerebrospinal fluid leakage, pseudo meninges, infection and arachnoiditis. There are many problems of artificial dural materials to be solved, and the novel biological dural materials and absorbable materials are the direction of dural material research.

Chlorides ; metabolism ; Diarrhea ; congenital ; Humans

Objective To study the effect of hyperbaric oxygen (HBO) therapy on changes in the prolifera-tion of endogenous neural stem ceils (NSCs) in neonatal rats after hypoxie ischemic brain damage (HIBD). Meth-ods A total of 150 Sprague-Dawley rats aged 7 d were randomly divided into a normal eontrol group ( CON ), a HIBD group and a HBO treatment group. HBO was administered to the HBO treatment group within 3 h after HIBD at 2 atmospheres, once daily for 7 d. The HIBD model rats were subjected to unilateral carotid artery ligation followed by 2 h of hypoxia (8% O2> ). BrdU/nestin immunofluorescence was used to examine the proliferation of NSCs dynami-cally in the subventricular zone (SVZ) and the dentate gyms (DG) at the 3rd h, 21st h, 3rd d, 7th d and 14th d af-ter HBO therapy. Nestin protein was detected by Western blot analysis at various time points after HIBD. Results In the HIBD rats treated with HBO, proliferation of endogenous NSCs was observed in the SVZ and DG. The prolifer-ating NSCs increased at the 3rd h and 21st h after HBO therapy in the SVZ and DG respectively, peaked at the 7th d after HBO therapy, and decreased by the 14th d after HBO therapy, though their level was still higher than that in the controls. The Western blot analysis showed that nestin protein began to increase at the 21st h after HBO therapy, peaked at the 7th d after HBO therapy, then decreased. Conclusion HBO administered within 3 h after HIBD can promote proliferation of endogenous NSCs in neonatal rats after HIBD.