Objective To observe neurophysiological changes and pulmonary function in obstructive sleep apnea syndrome (OSAS) and analyze their inter-relationship. Methods Sixty OSAS patients were studied. Their lung function and phrenic motor nerve conduction (PNC) were examined. Thirty cases without respiratory disorder served as controls. The lung function tests included percentage of the predicted value of vital capacity ( VC% ), percentage of the predicted value of maximal voluntary ventilation ( MVV% ), percentage of the predicted value of forced expiratory volume in one second ( FEV1% ), inspiratory capacity ( IC), and expiratory reserve volume (ERV). The phrenic nerve was stimulated electrically, and the latent period and the diaphragmatic compound muscle action potential (dCMAP) were recorded. Results The VC%, MVV%, FEV1% , IC and ERV of the patients with OSAS were significantly lower than those of the controls. There was no significant difference between the patients and the controls with regard to their PNC latency. In the OSAS patients the amplitude ratio of their dCMAPs was positively correlated with VC% , MVV% , FEV1% , IC and ERV, and negatively with an apnea hypopnea index (AHI).Conclusions PNC examination can provide valuable information for evaluating diaphragmatic dysfunction in those with abnormal lung function. Decreased dCMAP might be associated with abnormal lung function.

OBJECTIVEUsing geographic information system (GIS) and the remote sensing techniques (RS), we developed a schistosomiasis database and geographic distribution map in Zhongxiang city,Hubei province in order to display and analyze the endemic situation longitudinally after the water conservancy project is completed.

METHODSEpidemiological data of schistosomiasis and the correlated climate and hydrology data for the last 30 years were collected and the relevant GIS databases were established under Artificial Neural Networks(ANN) and network training of Landsat TM images.

RESULTSGIS database of schistosomiasis in Zhongxiang city, Hubei province and its vicinity areas were developed including 1 maps regarding the epidemic situation of schistosomiasis. The areas of snail distributing were 4.4 hm2, 8.2 hm2, 24 hm2, 130.4 hm2, 8.13 hm2 and 7.53 hm2, respectively.

CONCLUSIONThe maps created by GIS database and RS techniques supported the complicated query on space and property, providing a new way in keeping,updating and analyzing available data. The techniques used should be able to provide evidence for the control of schistosomiasis to this water conservancy project.

Animals ; China ; epidemiology ; Climate ; Conservation of Natural Resources ; Databases, Factual ; Humans ; Schistosomiasis ; epidemiology ; prevention & control ; Snails ; Water

China ; epidemiology ; Communicable Diseases ; epidemiology ; mortality ; Female ; Hepatitis, Viral, Human ; epidemiology ; mortality ; Humans ; Incidence ; Male ; Rabies ; epidemiology ; mortality ; Tuberculosis, Pulmonary ; epidemiology ; mortality

OBJECTIVETo compare the impact of traditional and fast bowel preparation on the changes of gut flora in the patients following colorectal resection.

METHODSSixty patients undergoing colorectal resection from March 2010 to March 2011 in the Nanfang Hospital were randomly divided into the control group(n=27, 3 days of bowel preparation) and the experimental group(n=33, 1 day of bowel preparation). Fresh feces were collected before bowel preparation and on the first defecation after surgery. The postoperative changes in gut flora and septic complications were observed.

RESULTSGut flora disturbance was found in both groups. The postoperative population of Bifidobacterium and Lactobacillus decreased significantly(P<0.05), and the decrease was more significant in the experimental group compared to the control group(P<0.05), while E.coli and Staphylococcus were much higher than the preoperative level(P<0.05), which was more significant in the control group. The incidence of postoperative infection was 9.1%(3/33) in the experimental group, which was significantly lower than 29.6%(8/27) in the control group(P<0.05).

CONCLUSIONFast bowel preparation is effective in reducing gut flora disturbance and the incidence of postoperative infection.

Colorectal Neoplasms ; microbiology ; surgery ; Digestive System Surgical Procedures ; Enema ; methods ; Feces ; microbiology ; Female ; Humans ; Male ; Microbiota ; Middle Aged ; Postoperative Period ; Preoperative Care ; Prospective Studies

Objective To explore the clinical effects of Ilizarov technology combined with closed minimally invasive osteotomy and slow tissue distraction in the treatment of complex crus malformations.Methods From June 2006 to February 2016,83 cases suffering complex crus malformations in our department were treated by Ilizarov technique combined with closed minimally invasive osteotomy and slow tissue distraction.Of whom,39 cases were traumatic bone defect,36 cases were bone osteomyelitis,8 cases were congenital pseudarthrosis of tibia.Bone defect ranged from 6 to 11 cm,with an average of 8 cm.All cases were conducted by segmental resection of bone lesions combined with closed minimally invasive osteotomy and Ilizarov technique.The functional evaluation was carried out according to the Paley evaluation criterion.Bone healing time,duration of external fixation,postoperative limb lengthening and limb function recovery were recorded.Results Eighty-three patients were followed up for 8 to 36 months,with an average of 16 months.All patients' crus malformations were completely corrected.The external fixation time was from 6 to 18 months,with an average of 10.3 months;the length of the limb lengthening was from 4.5 to 9 cm,with an average of 6.3 cm;and bone healing time was from 6 to 15 months,with an average of 9.8 months.According to the Paley evaluation criterion,53 cases were excellent,24 cases were good,6 cases were general.Conclusion Ilizarov technology combined with closed minimally invasive osteotomy and slow tissue distraction a reliable method to correct the complex deformity of the tibia and fibula.

BACKGROUNDBleomycin-induced fibrosis is extensively used to model aspects of the pathogenesis of interstitial pulmonary fibrosis. This study aimed to determine the benefic effects and mechanisms of simvastatin on bleomycin-induced pulmonary fibrosis in mice.

METHODSBleomycin-induced pulmonary fibrosis mice were administered with simvastatin in different doses for 28 days. We measured inflammatory response, fibrogenic cytokines and profibrogenic markers in both bleomycin-stimulated and control lungs, and correlated these parameters with pulmonary fibrosis.

RESULTSSimvastatin attenuated the histopathological change of bleomycin-induced pulmonary fibrosis and prevented the increase of lung hydroxyproline content and collagen (I and III) mRNA expression induced by bleomycin. Moreover, simvastatin down-regulated the increased expression of transforming growth factor-beta1 (TGF-beta1) and connective tissue growth factor (CTGF) induced by bleomycin at both gene and protein levels. Simultaneously, the accumulation of neutrophils and lymphocytes and the increased production of tumor necrosis factor-alpha (TNF-alpha) in bronchial alveolar lavage fluid were inhibited by simvastatin in early inflammatory phase after bleomycin infusion. The higher dose of simvastatin was associated with a more significant reduction in these inflammatory and fibrotic parameters. Furthermore, the inactivation of p38, RhoA and Smad2/3 signaling pathways was observed during simvastatin administration.

CONCLUSIONSSimvastatin attenuated bleomycin-induced pulmonary fibrosis, as indicated by decreases in Ashcroft score and lung collagen accumulation. The inhibitory effect of simvastatin on the progression of pulmonary fibrosis may be demonstrated by reducing inflammatory response and production of TGF-beta1 and CTGF. These findings indicate that simvastatin may be used in the treatment of pulmonary fibrosis.

Animals ; Antibiotics, Antineoplastic ; Bleomycin ; Mice ; Mice, Inbred C57BL ; Pulmonary Fibrosis ; chemically induced ; metabolism ; pathology ; Simvastatin ; pharmacology

BACKGROUNDThe surgical management of the absence of the vagina is a complex problem and constitutes a significant technical challenge. As the laparoscopy has been an important tool for the treatment of uterovaginal anomalies, we evaluated the feasibility of laparoscopic vaginoplasty using an ileal segment retrospectively.

METHODSTotally 86 patients who underwent laparoscopic vaginoplasty using an ileal segment in Beijing Anzhen Hospital during February 2004 to July 2007 were enrolled in this study. Of the 86 patients, 70 (81.4%) underwent primary operations and 16 (18.6%) secondary operations. Nineteen (22.1%) patients underwent total laparoscopic vaginoplasty and 67 (77.9%) patients underwent laparoscope-assisted vaginoplasty. The operation time, cost of hospitalization, and hospital duration were compared between the two laparoscopic groups. The Student's t test and the Mann-Whitney test were used to examine the differences.

RESULTSAll the surgeries were successfully completed with no any intraoperative complication. There were three major surgical complications in the postoperative period: one case of intra-abdominal hemorrhage, one case of meatal stenosis, and one case of intestinal obstruction. The mean follow-up period of this series was 18 months. Seventy-eight patients were satisfied with their sexual lives after the surgeries except 5 women complaining of vaginal stenosis and 3 with no sexual partner during the follow-up. Significant differences were obtained between total laparoscopic and laparoscope-assisted vaginoplasty groups, such as the operation time, cost of hospitalization, and hospital duration (P < 0.01). There were no significant differences in sexual function between the two groups.

CONCLUSIONSThe laparoscopic vaginoplasty using an ileal segment is satisfactory for cosmetic, functional, and anatomic results. Vaginoplasty with an ileal segment, performed by either total laparoscopic or laparoscope-assisted techniques, has a high success rate for a functional vagina.

Adult ; Female ; Gynecologic Surgical Procedures ; methods ; Humans ; Ileum ; transplantation ; Laparoscopy ; methods ; Male ; Middle Aged ; Retrospective Studies ; Transsexualism ; surgery ; Treatment Outcome ; Vagina ; abnormalities ; surgery ; Young Adult

OBJECTIVESTo evaluate and analyze the role of posterior ligament complex (PLC) in determining therapeutic principle for traumatic thoracic-lumbar fracture.

METHODSFrom August 2005 to May 2008, 60 patients (38 male, 22 female) who suffered from the traumatic thoracic-lumbar fracture were carried out posterior operations. According to the Magerl traumatic thoracic-lumbar fracture classification system, these cases were classified to subtype A, B and C. The average age was 34 years (21 - 65 years). Magnetic resonance imaging (MRI) scan, which including both T1/T2 weight and fat-stir sequence, as well as the MRI negative film reading technique were used to evaluate the state of PLC. Furthermore, related physical or neurological examinations (such as severe skin bruising and sinking, broadening spinous process gap and tenderness, spinal cord or nerve root injury) and another X-ray or CT reconstruction films were taken to evaluate the the state of PLC synthetically. Above-mentioned results were compared with the final exploration results during operation and some parameters were analyzed.

RESULTSThe sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV), misdiagnosis rate and rate of missed diagnosis of these sixty patients were 85.3%, 80.8%, 83.3%, 85.3%, 80.8%, 19.2%, 14.7% respectively. After 13 cases of thoracic-lumbar fracture-dislocation were eliminated, the sensitivity, specificity, accuracy, PPV, NPV, misdiagnosis rate and rate of missed diagnosis of remaining 47 cases were 81.0%, 80.8%, 80.9%, 77.3%, 84.0%, 19.2%, 19.0% respectively. There were 5 cases with MRI negative results before operation but positive results during operation. Contrarily, 5 cases with MRI positive results before operation but negative results during operation occurred.

CONCLUSIONSMRI is a main means for evaluating the state of PLC. Although the MRI fat-stir sequence as well as the MRI negative film reading technique are adopted, the state of PLC can not be estimated exactly before operation (especially for those unfracture dislocation cases). In order to estimate the state of PLC exactly, the related local physical examination and image technology as well as the location of the abnormal image signal in MRI film and time of injury must be analyzed synthetically.

Adult ; Aged ; Female ; Humans ; Ligaments ; pathology ; Lumbar Vertebrae ; injuries ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Spinal Fractures ; pathology ; surgery ; Thoracic Vertebrae ; injuries ; Young Adult

OBJECTIVETo investigate the significance of CD11b expression in neutrophils and lymphocytes in children with systemic inflammatory response syndrome (SIRS).

METHODSCD11b expression in neutrophils and lymphocytes was measured using flow cytometry in 36 children with SIRS (SIRS group) and 28 children with infectious disease but without SIRS (control group). The sensitivity and specificity of neutrophil CD11b for diagnosis of SIRS were evaluated.

RESULTSDuring the acute phase, an increased CD11b expression in neutrophils (96.7+/-8.1%) was observed in the SIRS group compared with the control group (85.1+/-5.1%) (p<0.05). Using neutrophil CD11b expression >92.2% as a cut-off value for diagnosis of SIRS, the sensitivity and the specificity were 97.2 % and 92.9% respectively. Lymphocytic CD11b expression in the SIRS group (13.4+/-8.6%) was lower than that in the control group (19.2+/-6.4%) in the acute phase (p<0.05). In the SIRS group, lymphocytic CD11b expression was remarkably suppressed in the severe sepsis subgroup (7.27+/-3.04%), showing significantly decreased expression compared with the non-infectious subgroup (19.3+/-2.9%) and the sepsis subgroup (15.9+/-12.5%) (p<0.01). In the convalescence stage lymphocytic CD11b expression in the SIRS group was similar to that in the control group.

CONCLUSIONSCD11b expression in neutrophils may serve as a reliable indicator for diagnosis of SIRS. The down-regulation of lymphocytic CD11b expression might be a signal of the condition aggravation in children with SIRS.

C-Reactive Protein ; analysis ; CD11b Antigen ; blood ; Child ; Child, Preschool ; Female ; Flow Cytometry ; Humans ; Infant ; Lymphocytes ; chemistry ; Male ; Neutrophils ; chemistry ; Sensitivity and Specificity ; Systemic Inflammatory Response Syndrome ; diagnosis ; immunology

OBJECTIVETo investigate the significance of flexible bronchoscopy in children with respiratory diseases.

METHODSA retrospective analysis was performed for the clinical data of 80 children who were hospitalized due to respiratory diseases (including severe pneumonia, Mycoplasma pneumoniae pneumonia with atelectasis/lung consolidation/local emphysema, protracted pneumonia, coughing and wheezing of unknown cause, chronic cough of unknown cause, and laryngeal stridor) and who underwent flexible bronchoscopy/alveolar lavage.

RESULTSBronchoscopy found that all the 80 children had endobronchial inflammation, among whom 28 children had severe airway obstruction by secretion. Twenty-four children had congenital airway dysplasia besides endobronchial inflammation, and three children had bronchial foreign bodies. In the children with coughing and wheezing of unknown cause and laryngeal stridor, some had congenital airway dysplasia or bronchial foreign bodies. Among the 27 children with Mycoplasma pneumoniae pneumonia, 26 had severe airway obstruction/embolization by secretion; 25 children (93%) underwent chest imaging again at 2 weeks after alveolar lavage, and the results showed complete or partial lung recruitment. Among the 80 children who underwent bronchoscopy, 3 had severe hypoxemia during surgery, 1 had epistaxis, 1 had minor bleeding during alveolar lavage, 3 had transient bronchospasm, and 5 had postoperative fever; these children were all improved after symptomatic treatment.

CONCLUSIONSFlexible bronchoscopy is safe and reliable in children with respiratory diseases. Early alveolar lavage under a flexible bronchoscope is recommended for children with severe/refractory Mycoplasma pneumoniae pneumonia to improve prognosis. Flexible bronchoscopy is recommended for children with recurrent coughing and wheezing and persistent laryngeal stridor, in order to directly observe the throat and airway under an endoscope.

Bronchoscopy ; adverse effects ; methods ; Child ; Child, Preschool ; Cough ; diagnosis ; Female ; Humans ; Infant ; Lung Diseases ; diagnosis ; Male ; Pneumonia, Mycoplasma ; diagnosis ; Respiratory Sounds ; diagnosis ; Retrospective Studies