Objective To evaluate the effectiveness of arthroscopically assisted percutaneous reduction and internal fixation with eannulated screws.Methods The fracture was reduced by closed manipulation or percutaneous leverage force by using the Kirschner wire.Then the patella was temporarily fixed by using a large size towel clamp or Kirschner wires.Under the guidance of knee arthroscopy,a micro-incision was made at the size of cannulated screw placement,the pilot holes were drilled at a proper depth,and the thread was configured.Two titanium screws were inserted parallelly.Results Following-up chekups for 4～24 months in 18 cases showed a satisfactory recovery of knee functions.According to the Bostman' standard,excellent effects were obtained in 16 cases and good effects in 2 cases.Conclusion Treatment of patellar fractures by percutaneous cannulated screw fixation under arrhroscope of- fered advantages of minimal invasion,accurate reduction,reliable fixation,and excellent recovery of joint functions.

Objective To understand the general self-efficacy level of patients with tuberculosis(TB patients) and its influencing factors, provide evidence for improving the general self-efficacy of TB patients.Methods All TB inpatients in a comprehensive pulmonary hospital were conducted face-to-face survey through a general questionnaire and general self-efficacy scale, self-efficacy level of TB patients and its influencing factors were analyzed.Results Mean scale of general self-efficacy of 402 TB patients was (20.4±4.2), of which only 14 cases(3.5%)showed a high level self-efficacy.163(40.5%), 225(56.0%), and 14(3.5%)patients were with low(10~),medium(20~), and high(30~) self-efficacy scale.The general self-efficacy level of TB patients was influenced by the course of disease(P<0.001), residence(P=0.012), whether or not attended the lecture on tuberculosis education(P=0.034), whether or not conducted physical exercise(P=0.053,stepwise multiple linear regression analysis: P=0.017), working status(P=0.027), No.of hospitalization due to TB(P=0.002), family economic situation(P=0.027), and education level(P=0.020).Conclusion TB patients' self-efficacy level is low, and the general self-efficacy level and its influencing factors should be assessed by health care workers during the follow-up for patients, individualized nursing intervention for improving the TB patients' self-efficacy level should be developed.

Objective To examine the variation of protein expression in nasopharyngeal carcinoma cell lines with different biological characteristics and to identify the radiobiological associated proteins. Methods Biological characteristics of 5-8F and 6-10B were compared by flow cytometry assay after irradia- tion. The total proteins of 5-8F and 6-10B were separated by immobilized pH gradient(IPG) IEF-SDS two- dimensional gel electrophoresis technique. The differentially expressed proteins were cut from the gel and di- gested into peptides for MALDI-TOF MS and the Q-TOF mass spectrometric analysis. Identification of pro- tein was made through searching in protein sequence database. Protein expressions were examined by western blot and immunohistochemistry method. Results Nine most differentially expressed proteins between 5-8F cell and 6-10B cell were identified, p73 and CK19 expression examined by western blot were conformal with that by proteomic method, p73 expression in 5-8F cell was higher than in 6-10B cell. CK19 expression in 6- 10B cell was higher than in 5-8F cell. Conclusion Differentially expression of proteins exist in nasopha- ryngeal carcinoma cell lines with different biological characteristics. These proteins may be associated with cell radiobiological characteristic with the p73 as a potential biomarker.

Hernia, Inguinal ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Peritoneal Dialysis, Continuous Ambulatory ; Peritoneum ; diagnostic imaging ; Tomography, X-Ray Computed ; methods

Objective To observe the clinical efficacy of modified Huanglian Qingxin Decoction for the treatment of recurrent oral ulcer. Methods Eighty recurrent oral ulcer patients were randomly divided into treatment group and control group by random number table method,40 cases in each group. The treatment group was given oral use of modified Huanglian Qingxin Decoction, and the control group was treated with Zinc Sulfate Tablets and Compound Vitamin B Tablets. Four weeks constituted one course of treatment. The scores of oral symptoms and signs of the two groups were observed before and after treatment,and the short-term effect and long-term effect of the two groups were evaluated after treatment. Results (1)After treatment for 5 days,ulcer area,ulcer pain, congestion area,exudation area,and sleep of the treatment group were much relieved (P < 0.01), and ulcer area,congestion area,and exudation area of the control group were improved (P < 0.05). The treatment group had better effect on improving ulcer area, ulcer pain, congestion area, exudation area, and sleep than the control group (P < 0.01). (2)After treatment for 5 days, the total short-term effective rate of the treatment group was 95.0%,and that of the control group was 72.5%,the difference being significant (P < 0.05).(3) Within one year after the suspension of treatment, total intermission period for ulcer attack in the two groups was prolonged (P < 0.05), and the amount of ulcer foci were much reduced (P < 0.05), the effect of the treatment group being superior to that of the control group(P < 0.05).(4)Within one year after the suspension of treatment,the total long-term effective rate of the treatment group was 70.0%,and that of the control group was 45.0%,the difference being significant (P<0.05). (5)During the treatment,the results of blood and urine routine examination,hepatic and renal function,and electrocardiography showed no abnormal changes. Conclusion Modified Huanglian Qingxin Decoction has better clinical efficacy for the treatment of recurrent oral ulcer than western medicine by relieving clinical symptoms and signs, prolonging the intermission period for ulcer attack, and reducing the total amount of ulcer foci.

OBJECTIVETo investigate the feasibility of splenopancreatic-preserving dissection of No.10 and No.11 lymph nodes in radical resection for proximal gastric carcinoma.

METHODSThe data of 62 patients with proximal gastric carcinoma undergoing splenopancreatic-preserving dissection of No.10 and No.11 lymph nodes were analyzed retrospectively.

RESULTSThis splenopancreatic-preserving dissection was effective significantly. The incidences of lymphatic metastasis in No.10 and No.11 were 19.4% and 22.6% respectively, and the incidence of complications was 16.1%, significantly lower than that (40 %) of non-splenopancreatic-preserving dissection.

CONCLUSIONSThe splenopancreatic-preserving dissection of No.10 and No.11 lymph nodes is a safe and feasible method in radical gastrectomy for proximal gastric carcinoma. The surgical procedure is not difficult. With careful operation,the complete clearance of the lymph nodes can be obtained.

Adult ; Aged ; Feasibility Studies ; Female ; Humans ; Lymph Node Excision ; methods ; Lymph Nodes ; pathology ; Male ; Middle Aged ; Neoplasm Staging ; Pancreas ; Retrospective Studies ; Spleen ; Stomach Neoplasms ; pathology ; surgery

OBJECTIVEThe study was undertaken to analyze retrospectively the results of radiofrequency catheter ablation (RFCA) on septum originated tachycardia in children with arrhythmia. The 98 children were all treated with RFCA on septum originated tachycardia in which the ablation sites were located near the bundle of His.

METHODSFifty female and forty-eight male cases were included in this analysis. They were at the age of 8.1 +/- 2.3 years and their body weight was (28 +/- 9) kg. The arrhythmia they suffered from consisted of atrioventricular nodal reentry tachycardia (AVNRT) (n = 62), atrioventricular reentry tachycardia (AVRT) on septum (n = 25), atria Itachycardia on Koch areas (n = 3) and left ventricular tachycardia (ILVT) on the septum (n = 8). Swartz SRO long sheath was used on the right site ablation. Titration of capacity and degreed time of increase were used in the ablation.

RESULTSRadiofrequency ablation was successful in all cases. Eleven cases had relapse after the procedure. They accepted RFCA again and then the treatment succeeded. One case of AVRT at the posterior septum experienced complete atrioventricular block (AVB) during ablation. Two weeks later this case was implanted with permanent pacemaker.

CONCLUSIONSThe septal site is narrow and small in children. Atrioventricular node is tender. If the above facts were neglected, it was very likely to cause AVB, especially in children accepting the procedures of electrophysiologic study an RFCA on the septal site. Attention should be paid to the followings during such procedures: ablation in the sinus rhythm; ablation following the principle, titration of capacity and degreed time of increase; ablation at the right site long sheath; thermo-ablation catheter application and ablation on the two sides of septum in the posterior septum ablation procedure. The end-point of ablation in children should be the elimination of tachycardia and the delta wave, disassociation of VA or passing through bundle of His at pacing in the ventricle, disappearance of jumping conduction or no echo or one echo but without AVNRT after infusion of isoprenaline and stimulation procedure. Avoiding bundle of His injury is important during the procedure of ablation in children.

Adolescent ; Bundle of His ; physiopathology ; Catheter Ablation ; methods ; Child ; Child, Preschool ; Echocardiography, Doppler ; Electrocardiography ; Female ; Humans ; Male ; Retrospective Studies ; Tachycardia ; physiopathology ; therapy ; Treatment Outcome

OBJECTIVETo research the diagnosis and effective treatment of penetrating anorectal wounds.

METHODSRetrospective analysis was done in 16 cases of penetrating anorectal wounds from 1985 to 2004. Debridement and suture of anorectal and vesical wounds, effective diversion of fecal and urinary stream and sufficient presacral drainage were performed in all cases.

RESULTSAll the 16 cases were cured. Among them, 2 cases with infection in presacral space were cured by sufficient drainage after operation, one case was cured by secondary repair after anal sphincter was repaired unsuccessfully and one case with rectovesical fistula was cured with conservative treatment. None of them suffered from complications such as anal stenosis, dysuria or impotence etc.

CONCLUSIONSFor penetrating anorectal wound, to master early recognition of concomitant injures, to select appropriate surgical intervention and to strengthen perioperative treatment are the keys to improve the curative effects.

Adolescent ; Adult ; Anal Canal ; injuries ; Humans ; Male ; Middle Aged ; Rectum ; injuries ; Treatment Outcome ; Wounds, Penetrating ; diagnosis ; surgery

OBJECTIVEIn children with congenital heart diseases who have undergone surgical interventions, postoperative arrhythmias frequently complicate the clinical course. "Incisional" atrial tachycardia or flutter is one of the most common forms of postoperative arrhythmias in these patients and can lead to significant morbidity and even mortality. The aim of this study was to investigate how to use antiarrhythmic drugs and the CARTO system to treat these cases.

METHODSThere were 12 patients with "incisional" atrial tachycardia or flutter complicating surgery for congenital heart diseases in this study (3 patients with correction of tetrology of Fallot, 3 with atrial septal defect repair, 2 with ventricular septal defect repair, 1 with switch, 1 with repair of Ebstein's anomaly, 1 with total anomalous pulmonary venous drainage, and 1 with atrial septal closure with the Amplatzer septal occlusion). Patients whose body weight was less than 10 kg or those who did not wish to accept ablation were treated with antiarrhythmic drugs, including digitoxin, propranolol, metoprolol and cordarone. CARTO system was used to map 6 patients whose body weight was more than 10 kg and who agreed with accepting ablation for atrial tachycardia and flutter. Radio-frequency ablation was performed in these 6 cases including two cases of "incisional" atrial tachycardia and 4 of atrial flutter.

RESULTS(1) The antiarrhythmic drug was successful in 6 patients with "incisional" atrial tachycardia. (2) Six patients including 2 children with "incisional" atrial tachycardia and 4 children with atrial flutter were successfully ablated. But one case of "incisional" atrial tachycardia relapsed after 3 months of ablation. This case, however, was successfully ablated again later. No further relapse was observed during the 2 - 24 months of follow-up.

CONCLUSIONAblation of "incisional" atrial tachycardia and flutter is the first choice to treat the patients whose body weight is more than 10 kg and those who agree with accepting ablation by CARTO system. Drug therapy of "incisional" atrial tachycardia and flutter is palliative and it is the only selection to treat the patients whose body weight is less than 10 kg or those who do not wish to accept ablation procedure.

Anti-Arrhythmia Agents ; therapeutic use ; Atrial Flutter ; etiology ; therapy ; Catheter Ablation ; methods ; Heart Defects, Congenital ; complications ; surgery ; Humans ; Infant ; Infant, Newborn ; Postoperative Care ; Tachycardia, Ectopic Atrial ; etiology ; therapy ; Treatment Outcome

OBJECTIVETo investigate the role of psoriasin in mycosis fungoides.

METHODSPsoriasin protein expressions in normal skin tissues and mycosis fungoides tissues were detected by immunohistochemistry.

RESULTSPsoriasin protein was not expressed in normal skin tissues. In 21 mycosis fungoides tissue specimens, psoriasin was expressed in the stratum corneum and stratum spinosum but not in the stratum basale, with a positivity rate of 90.5% in these specimens. Psoriasin expression was significantly higher in mycosis fungoidesa tissues than in normal tissues (P<0.001).

CONCLUSIONPsoriasin may play a role in the pathogenesis of mycosis fungoides by chemotaxis of CD4+ T lymphocytes.

Adult ; Aged ; CD4-Positive T-Lymphocytes ; physiology ; Chemotaxis ; physiology ; Female ; Humans ; Male ; Middle Aged ; Mycosis Fungoides ; etiology ; metabolism ; S100 Calcium Binding Protein A7 ; S100 Proteins ; metabolism ; Skin ; metabolism ; Young Adult