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Humans ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; Thumb ; abnormalities ; surgery

Guangxi Medical University had taken a lot of measures to construct systematic general medicine education system consisting of medical college education, post graduation education and continuing medical education. These measures included constructing the organization, modifying the personnel training program, training rural-order directional medical students, standardizing resi-dent training, providing on-the-job training and postgraduate degree education for general practitioners.

ObjectiveTo detect the changes of gastroesophageal reflux disease (GERD) with high resolution endoscopy,and to explore its diagnostic value for nonerosive reflux disease (NERD). Methods From April 2007 to January 2008, consecutive out-patients visiting the Department of Gastroenterology due to continuous or recurrent symptoms of acid reflux, heartburn, cardiac-like chest pain for at least three months and volunteer healthy controls were recruited to the study. The subjects were classified into the normal group ( n =48 ), the NERD group ( n =70), the erosive esophagitis (EE) group ( n =70), and the Barrett esophagus (BE) group ( n =48). All subjects underwent endoscopy, and the shape of Z-lines, the shape of mucosal pits, mucosa roughness above Z-line and the shape of mucosal blood vessels were observed. The NERD changes were analyzed with optimal scale. ResultsZ-line shape of NERD group showed a significant difference from that of EE and BE groups ( P ＜ 0. 01 ), which was not different from that of normal controls ( P ＞0. 01 ). The shape of mucosal pits of NERD group was different from that of EE and BE (P ＜0. 01 ), which also was not different from that of control (P＞0. 01 ). Roughness of the mucosa above Z-line of NERD group was different from other 3 groups (P ＜0. 05). And the shape of mucosal blood vessels of NERD was different from the control (P＜0. 05), but was not from two others. Features of NERD relative images were thin,straight and spiral blood vessels, bar-like pits, plat mucosa, round, smooth and wide tooth-like Z-line and mucosa of white particle hypertrophy. ConclusionHigh resolution endoscopic features of most NERD patients are cloudy, white and rough mucosal surface, with white particular hypertrophy, spiral vascular dilation, extending to Z-line. These features can be indicators of NERD.

Objective To review the effects of preventive management during the operation for post-operative chylothorax in patients with lung cancer of state Ⅲ. Methods Total 425 patients underwent pulmonary resection (at least lobectomy) and systematic mediastinal lymph node dissection for lung cancer of state Ⅲ from January 1998 to June 2005. Took some especial management during the operation to prevent post-operative chylothorax in 132 patients after March 2004. According to the surgical procedure,all patients were divided into preventive group and non-preventive group. Results There were 14 patients (4.8%) with post-operative chylothorax in the group of inchoate 293 patients before March 2004. Only 1 patient (0.07%) among 132 patients who underwent treatment for chylothorax during the operation after March 2004 had post-operative chylothorax (P

Objective To investigate the correlation of plasma N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) level with echocardiographic indicators and P wave terminal force of lead V 1 (PtfV1) in the patients with hypertension and paroxysmal atrial fibrillation(PAF) .Methods Fifty‐six outpatients and inpatients with hypertension were divided into the PAF group (n=26) and the sinusrhythm group (n=30) .Thirty age‐matched and gender‐matched healthy volunteers were taken as the control group . The plasma NT‐proBNP level was determined .Left ventricular enddiastolic diameter (LVEDD) ,left atrial diameter(LAD) and left ventricular ejection fraction(LVEF) were examined by echocardiography .the 12‐lead electrocardiogram was routinely performed Pt‐fV1 was calculated .Results The plasma NT‐proBNP level in the PAF group was higher than that in the sinusrhythm group and the control group ,the difference was statistically significant (P<0 .05) .The plasma NT‐proBNP level in the PAF group was de‐creased significantly after successful cardioversion .The plasma NT‐proBNP level in the PAF group was positively correlated with LVEDD(r=0 .543 ,P<0 .05) and LAD (r=0 .606 ,P<0 .01) .The plasma NT‐proBNP level was negatively correlated with LVEF (r= -0 .750 ,P<0 .01) and positively correlated with the PtfV 1 absolute value (r= 0 .513 ,P< 0 .01) .Conclusion The plasma NT‐proBNP level can better reflect the heart structure and function in the patients with atrial fibrillation .Detecting the plasma NT‐proBNP level combined with echocardiographic indicators and PtfV 1 is conducive to comprehensively assess the heart function in the patients with hypertension and PAF .

The amino group PEGylation of rhIFNomega with monomethoxy polyethylene glycol succinimidyl succinate (mPEG-SS, 20 000) was investigated, and the modified mixture was separated and purified by ion exchange chromatography and gel filtration chromatography. Under the optimized purification conditions, the average content ofmono PEG-rhIFNomega in the collect liquid reached 182 microg x mL(-1). The average purified yield of mono PEG-rhIFNomega exceed to 22%, and the purity of mono PEG-rhIFNomega was greater than 98% by SDS-PAGE and RP-HPLC. Relative molecular mass of mono PEG-rhIFNomega was 43 790 detected by MALDI-TOF MS. The apparent molecular mass measured by SDS-PAGE was about 60 810. The purified PEG-rhIFNomega has the characteristics of typical PEGylated protein. Activity reservation rate of mono PEG-rhIFNomega was 15.0%, while the antigenicity decreased by at least 64 folds. In addition, the acid stability, thermal stability and stability in serum and trypsin solution of mono PEG-rhIFNomega were markedly better than those of the rhIFNomega. The pharmacological properties of mono PEG-rhIFNomega were significantly improved. The prepared PEG-rhIFNomega might be developed to a novel safe and long-acting interferon.

ObjectiveTo test the the association between PRODH gene variant rs385440 and the susceptibility to schizophrenia and the severity of schizophrenia in Guangxi Zhuang and Han population,further exploring the genetic mechanisms of schizophrenia in Guangxi Zhuang and Han population.MethodsThe schizophrenia patients were diagnosed according to ICD-10 criteria in this study.The subjects in the association analysis were 282 unrelated schizophrenia patients(94 Zhuang and 188 Han) and 282 healthy controls (94 Zhuang and 188 Han).A quantitative real-time PCR TaqMan MGB experimental method was carried out to analysis rs385440.The clinical psychotic symptoms of 246 schizophrenia patients (83 Zhuang and 163 Han) were assessed by PANSS.Statistical analyses were carried out with SPSS13.0 for windows.ResultsThere was no statistically significant difference in different allele and genotype frequencies of rs385440 between schizophrenia cases and controls in Zhuang samples,Han samples and combined samples respectively (P＞ 0.05 ).In Zhuang schizophrenia patients the score of N4 (passive/apathetic social withdrawal) item in A allele carriers (3.28 ± 1.34) was higher than that of G allele carriers ( 2.40 ± 1.36 ) significantly (P ＜ 0.05 ),and the score of G12 ( lack of judgment and insight) item in A allele carriers(4.92 ± 1.55 ) was higher than that of G allele carriers ( 4.12 ± 1.85 ) significantly (P ＜ 0.05 ).Conclusion There is no association between PRODH gene variant rs385440 and the susceptibility to schizophrenia in Guangxi Zhuang and Han population.Rs385440 associated the severity of passive/apathetic social withdrawal symptom and poor attention symptom of schizophrenia in Zhuang.

OBJECTIVETo explore effective approaches of treating elderly patients with distal tibiofibular fractures.

METHODSFrom August 2008 to October 2012,175 elderly patients with distal tibiofibular fractures were treated with locking compression plate (LCP) through anterior tibial. There were 112 males and 63 females with an average of 71.3 (ranged 60 to 83) years old. Of them,89 cases were treated by anterior tibial tension reduced incision with LCP,including 62 males and 27 females with a mean age of (71.8 +/- 6.4) years old. Eighty-six patients were treated by distal tibial incision with LCP,including 58 males and 28 females with a mean age of (70.3 +/- 6.7) years old. Swelling time, operation time, intraoperative blood loss, hospital stay, healing time, complications and AOFAS scores were compared between two groups after operation.

RESULTSSwelling time in anterior tension reduced incision with LCP and distal tibial incision with LCP was (5.6 +/- 1.3) and (9.7 +/- 2.1) days, healing time was (4.2 +/- 1.4) and (5.4 +/- 1.9) months,and complications were found 3 in tension reduced incision and 10 in distak tibial incision respectively;and all data shown statistically significant differences between two groups (P < 0.05). At 12 months after operation,AOFAS score was 89.0 +/- 9.7, 87.9 +/- 9.4; and there was no statistically significant difference between two groups (P > 0.05).

CONCLUSIONTension reduced incision through anterior tibial combined with locking compression plate fixation in treating elderly patients with distal tibiofibular fractures can provide good clinical effects with quick fracture healing and low complications.

Adult ; Aged ; Aged, 80 and over ; Bone Plates ; Female ; Fibula ; injuries ; surgery ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Tibia ; injuries ; surgery ; Tibial Fractures ; surgery ; Treatment Outcome

Objective To evaluate the feasibility of plasma NT-pro brain natriuretic peptide guided therapy of β1-blocker to patients with moderate and severe heart failure.Methods A total of 1 95 patients with moderate and severe heart failure were ran-domized to the clinical group and the BNP group.The use of β1-blocker was guided by monitoring clinical representation and the changes of BNP values respectively.The duration of initiative use ofβ1-blocker,the recurrence of heart failure,the mortality due to heart failure and the mean dosage ofβ1-blocker were observed and analysed.Results Compared with the clinical group,the time of initiative use ofβ1-blocker was significantly shorter in NT-proBNP group[(5.89±1.76)d vs .(7.03±2.08)d,P <0.01].The mean dosage ofβ1-blocker is significantly higher in BNP group than that in clinical group[(47.65 ± 13.09 )mg/d vs .(35.08 ± 1 1.08) mg/d,P <0.01].The recurrence and mortality of heart failure were similar in two groups(P >0.05).Conclusion NT-proBNP-guided therapy ofβ1-blocker might contribute to early use and tolerance of higher dosage ofβ1-blocker in patients with NYHA Ⅲ-Ⅳ class heart function,with no extra adverse event.