OBJECTIVE: To observe the efficacy of rhinoplasty with autogenous nasal septal cartilage for saddle nose caused by nasal bone and nasal septum fracture after trauma. METHOD: During the treatment process of 30 cases of nasal trauma, simple nasal bone fracture reposition and nasal septum correction was done, and rhinoplasty was done using the nasal septal cartilage. All the patients were followed up to evaluate subsequent effect. RESULT: All the patients were satisfied with the result of one stage repairment. After following-up for 3-42 months, 28 cases (93.3%) were of long-term satisfaction. CONCLUSION Rhinoplasty with autogenous nasal septal cartilage for saddle nose was an effective method to repair the nasal trauma.
Adolescent ; Adult ; Female ; Humans ; Male ; Middle Aged ; Nasal Cartilages ; transplantation ; Nasal Septum ; surgery ; Nose Deformities, Acquired ; surgery ; Rhinoplasty ; methods ; Transplantation, Autologous ; Treatment Outcome ; Young Adult

With the population ageing,increasing health needs and demands,changing family structure and the transformation of general hospital service model,home care as an important part of primary care,has been brought more and more attention.Home healthcare would relieve the pressure caused by increasing needs of elderly care and transformation of hospital functions,so it should have greater development in the future.This article reviews the present situation and the future development direction of home healthcare in China.

Objective To study the image features and clinical significance of 3-dimensional (3-D)and multiplanar reconstruction with spiral CT(SCT) in cervical spinal fractures.MethodPlain film radiography and spiral CT scanning were taken for 26 cases of cervical spinal fractures.The type of fractures, diagnositic successful rate, parameter of scanning and late stage managing methods were investigated retrospectively to find out the effective difference between the diagnosis of plain X-ray and SCT. The imagin location of fractures,sequence of cenrum, heighth of centrum, fracture line, auxillary structure and rotation/dislocation of the fractures were emphasized to evaluate the advantages of 3-D imaging.ResultIn the 26 cases, there were 4 Jefferson fractures, (in which 1 combined with articular dislocations), 17 C2 spinous process fractures, (in which 1 had failure of plain X-ray diagnostic), 1 Hangman fracture, 2 C1～2 imbalance, (in which 1 had failure of plain X-ray diagnostic).There were 2 cases of axoid longitudinal fractures without obvious dislocation. The diagnositic successful rate were 100% in SCT group, while 65% in X-ray group in which 6 cases had diagnostic failure and 3 cases had fracture mis-diagnozing as dislocation.The anatomical structure of upper cervical spine was complicated and was significantly different from other cervical spine constructions. Spiral CT could reveal high resolution images of the upper cervical spine, morphosis of vertibral canal, dislocation information of fracture mass and its relation with neighbouring tissues. Especially in C1 burst fracture,C2 dens fracture and C1～2 dislocation, SCT could provide clear 3-D information of the size of collateral mass and the dislocation degree, furthermore, images could be rotated freely to observe the fracture in any proper section. That provides important information for the decision of operation, selection of operation types and evaluation of operation dager.ConclusionThe spiral CT scan and 3D reconstruction can reveal fracture better.The advantages of SCT are suggested that this diagnostic modality may be the standard method for the initial evaluation of the upper cervical spine injury.

Objective To evaluate the X-ray signs of the ascending venography of the lower limbs.Methods The imaging findings of ascending venogaphy in 80 sides lower limb were reviewed retrospectively.Results According to the imaging findings,all patients were divided into normal groups and abnormal groups;unusual groups including simple venous valvular inadequacy 4 sides,traffic venous valvulor inadequacy 6 sides,primary deep venous valvular inadequacy 32 sides and secondary 5 sides,thrombosis 3 sides,congenital dysplasia 2 sides,phlebangioma 5 sides.Conclusion The ascending venoraphy of the lower limbs is a simple and effective method,it is valuable in diagnosis of venous disease.

Objective To investigate the clinical significance of antiendothelial cell antibodies (AECA) in systemic vasculitis. Method With Human umbilical vein endothelial cell (HUVEC) as substrate cell, sera from 129 systemic vasculitis patients [including 59 Behcet′s disease(BD), 28 Takayasu arteritis (TA), 20 Wegener′s granulomatosis (WG), 8 polyarteritis nodosa (PAN), 9 microscopic polyangiitis (MPA), 5 Churg-Strauss syndrome (CSS)] were screened for the presence of AECA by ELISA. Sera from SLE, RA and healthy donors were examined as controls. The association of AECA to clinical disease activity was analyzed. Result The prevalence of AECA by HUVEC cell-ELISA was 59% in systemic vasculitis [48% in BD,79% in TA, 65% in WG, 63% in PAN, 44% in MPA, 80% in CSS], 46% in SLE, 4% in RA, and 2.4% in control group. Compared with patients with RA and control group, AECA were more frequently found in patients with systemic vasculitis and SLE (P

Objective To evaluate the effect of stent implantation using Multimodal CT in patients with MCA and ICA stenosis. Methods Twenty-six patients with ischemic cerebrovascular disease who received MCA or ICA stent implantation in ChongQing xinqiao Hospital were recruited. Multimodal Stroke Assessment Using CT Score (MOSAIC) was used to evaluate the Neuroimaging data before stent implantation and Alberta Stroke Program Early CT Score (ASPECTS) to evaluate the time to peak (TTP) of CTP before and after stent implantation. Results Patients were divided into 4 groups based on scores: 4 scores, 5 scores, 6 scores, and 7 scores groups. the improvement degree was increase by 31.7%±14.17%、38.6%±15.73%、43.3%±10.3%、358.6%±13.45% in 4 scores, 5 scores, 6 scores, and 7 scores groups, respectively. The paired t test demonstrated that there were a statistically significant difference among four groups(H=10.673, P <0.05). Preoperative MOSAIC score was positively correlated with the improvement of ASPECT score for TTP, with a correlation coefficient of 0.579 ( P <0.002). Conclusions Multimodal CT is a sensitive assessment for the evaluation of ischemic cerebrovascular disease and patients with a higher MOSAIC score may benefit more from stent implantation.

Objective To analyze the clinical features of patients with hemophagocytic syndrome (HPS) in autoimmune diseases (AID). Methods We collected the data of 11 patients with AID complicated with HPS in Peking Union Medical College Hospital from 2004 to 2009. The underlying diseases, clinical features, laboratory findings and treatment outcomes were retrospectively analyzed. Results Of the 11 patients,3 were male,8 were female. Mean age was (30. 7 ± 18. 3) years. The underlying diseases included Still disease ( n = 4 ), systemic lupus erythematosus ( n = 3 ), and rheumatoid arthritis, primary Sj(o)gren's syndrome, Wegener granulomatosis and Crohn disease in each one case. HPS was associated with the onset of AID ( n = 4), active infection alone ( n = 1 ) and both factors ( n = 6 ). HPS was clinically characterized by high fever ( 100% ), hepatosplenomegaly ( 72. 7% ) , lymphadenopathy ( 63.3% ) and central nervous system involvement (36. 3% ). 4 patients presented with disseminated intravascular coagulation(DIC) (36. 3% ). Laboratory data mainly manifested with cytopenia ( 100% ), liver dysfunction ( 100% ), hypofibrinogenemia ( 62. 5% ), hypertriglyceridemia ( 81.8% ), serum ferritin ＞ 500 μg/L (100%), low NK-cell activity(80% ) and hemophagocytosis in bone marrow( 100% ). Based on treating underlying infections and use of corticosteroids and immunosuppressive agents in combination with intravenous immunoglobulins(IVIG) therapy, 5 patients recovered , 6 patients died. The mortality rate was 54. 5%. DIC were associated with mortality ( r = 0. 69, P = 0. 019 ). Conclusion The episode of HPS always occurs simultaneously with multiple system involvement that was often difficult to distinguish from active AID. The present of DIC on HPS related with poor prognosis and high mortality. Corticosteroids and immunodepressant and IVIG may improve the prognosis of HPS, while anti-infection therapy is very important and necessary for the patients accompany with active infection.

This study was aimed to establish an Ultra Fast Liquid Chromatography-Photo Diode Array (UFLC-PDA) method for the simultaneous determination of five chemical components, which included chlorogenic acid, loganin, sweroside, evodia rutaecarpa glycosides and triplostoside A, in Pterocephalus hookeri h eck. Agilent Poroshell 120 SB-C18 (100 mm í 4.6 mm, 2.7 μm) was adopted, with acetonitrile-0.2% phosphoric acid solution in gradient elution as the mobile phase at the flow rate of 1.0 mL·min-1. And the injection volume was 0.4 μL. The detection wavelength was set up at 237 nm and 325 nm. And the column temperature was 30℃. The results showed that the calibration curve was linear within the range of 8.72~218.0, 1.52~38.0, 2.44~61.0, 29.36~734.0, 3.00~75.0μg·mL-1 (r > 0.999 6, n=9) for chlorogenic acid, loganin, sweroside, evodia rutaecarpa glycosides and triplostoside A, respectively. The average recovery rates were 99.46%, 99.41%, 100.14%, 98.89%, and 99.42%, respectively. The RSD was 0.69%, 0.66%, 0.60%, 1.21%, and 0.64%, respectively (n = 9). It was concluded that this method was simple, accurate and reproducible, which can be used for the simultaneous determination of the content of five chemical components in P. hookeri.

Objective To analyze the clinical features and factors associated with knee osteonecrosis in patients with systemic lnpus erythematosus (SLE).Methods Medical charts of Peking Union Medical College Hospital from 2000 to 2013 were reviewed to identify patients who were diagnosed as SLE with kuee osteonecrosis.Controls were selected and matched to the cases by age and sex.The clinical and laboratory variables were compared between SLE patients who were with and without knee osteonecrosis.Numerical data and categorical data comparisons were analyzed using t-test,x2-test,respectively.Results Sixteen patients developed knee osteonecrosis that constituted 0.37％ of all the 4 301 hospitalized SLE patients during the same period.Fifteen patients were female,who developed knee osteonecrosis with an average age of 36 years (range:17-67 years).The mean duratiou of SLE before the diagnosis of knee osteonecrosis was 64±40 months (range:16-120 months).The interval from onset of symptoms to diagnosis was 0.5 to 24 months.The distal end of femur was involved in all 16 patients,while the proximal tibia necrosis also occurred in 8 patients.The detection rate of knee osteonecrosis by MRI was 100％,while it was only 19％ by plain radiography.The incidence of skin vasculitis,myositis,osteoporosis,hyperlipidemia,hypoalbuminemia and elevated serum immunoglobin G levels were significantly higher in SLE patients with knee osteonecrosis than in controls (P＜0.05).In addition,the use of anti-malarials was significantly lower in SLE patients with knee osteonecrosis than in controls (P＜0.05).Conclusion The knee osteonecrosis in SLE patients is affected by multifactors.The risk factors include skin vasculitis,myositis osteoporosis,hyperlipidemia,hypoalbuminemia and the elevated immunoglobin G level.The use of antimalarial drugs in SLE patients may protect against knee osteonecrosis development.Knee osteonecrosis coull be diagnosed early by MRI.

This study aims to observe different factors which affected the bionic enzymatic hydrolysis of icariin into baohuoside I and to optimize the reaction conditions in order to provide research foundation for building a novel bionic enzymolysis drug delivery system. To simulate the environment in vivo, 37 degrees C was set as the temperature and artificial intestinal juice and gastric juice were selected as the buffer solutions. Taking the conversion of baohuoside I as index, the effects of the kinds of enzyme, enzyme activity, substrate concentration, reaction time, pancreatin in artificial intestinal juice and surfactant on the conversion of baohuoside I were investigated. The results showed that cellulase, beta-glucosidase and snailase were all inactive in artificial gastric juice and no baohuoside I generated. Pancreatin in artificial intestinal juice couldn't significantly influence the activity of beta-glucosidase or snailase (P > 0.05), but noticeably decrease the activity of cellulase (P < 0.05). In artificial intestinal juice, the conversion of baohuoside I was highest by using beta-glucosidase, and the optimum reaction conditions were determined as follows: enzyme activity 10 U x mL(-1), substrate concentration 1 mg x mL(-1), 3 g x L(-1) rhamnolipid and reaction time 3 h. Under this condition, the conversion of baohuoside I was 99.8%.