Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications ; epidemiology ; Tracheostomy ; adverse effects ; Young Adult

OBJECTIVETo investigate therapeutic effects of vacuum sealing drainage (VSD) in the treatment of soft tissue defect combined with tendon and bone exposure.

METHODSFrom October 2007 to February 2011, 397 patients (412 feet) with open ankle fracture and dislocation combined with soft tissue defected were treated by VSD. There were 301 males and 96 females with an average age of 36 years (ranging age from 20 to 73 years). According to AO classification, 74 feet were type I, 211 feet were type II, 108 feet were type III and 19 feet were type IV. The mean time from injury to operation was 5.6 h ( 2 to 12 h). The mean treatment time of was 10 months (4 to 19 months).

RESULTSOne hundred and forty-one patients were primarily healed, 97 patients were sutured at stage II. Split-thick skin grafting was performed at stage II was performed in 103 patients; free flap transplantation was performed in 25 patients. Three of the 34 patients with infection were removed steel plate; Eviscerate flap coverage wound was performed in 14 patients caused by the first metatarsal bone exposure; Toe amputation were performed in 22 cases caused by toes necrosis. Tarsometatarasl joints perforators' surgery was performed in 10 patients with forefeet necrosis. Thirty hundred and six patients were followed up from 3 to 20 months (averaged 10 months). The wounds healed well.

CONCLUSIONVSD for soft tissue defects caused by ankle injury is a simple and effective method, but can not replace debridement and transfer flap.

Adult ; Aged ; Ankle Fractures ; Debridement ; Drainage ; methods ; Female ; Humans ; Joint Dislocations ; surgery ; Male ; Middle Aged ; Skin Transplantation ; Treatment Outcome ; Vacuum ; Young Adult

Objective To analyze the substitutions at amino acid residues of neuraminidases ( NAs) in influenza B virus strains isolated in Jiangsu province from 2010 to 2012 and to further understand the genetic evolution of NAs in those influenza B virus strains .Methods Forty strains of influenza B virus isolated in Jiangsu province from 2010 to 2012 were screened out for this study .A two-step reverse transcrip-tion PCR ( RT-PCR) was performed to amply the gene fragments encoding the neuraminidases of influenza B virus strains.The PCR products were purified and then sequenced in an ABI 3730XL Genetic Analyzer.The evolutionary characteristics of NA gene were analyzed by using DNAStar , Bioedit, MEGA 5.0 and BEAST 1.8.0 softwares.Results The phylogenetic tree analysis of the NA genes showed that the NAs of 28 Vic-toria strains were derived from the Yamagata lineage .There were reassortments between the Victoria lineage-HA and theYamagata lineage-NA.Some of the strains added a glycosylation site at position 462.No substitu-tion was found in important enzyme active sites and neuraminidase inhibitor resistant sites .The Bayesian MCMC analysis showed that the estimated mean evolutionary rate for NA gene was 1.74×10-3(95%HPD:1.46×10-3-2.06×10-3) substitutions/site/year.The dN/dS ratio (ω), an indicator of selective pressure, was 0.24.Conclusion The important amino acid sites of NA were relatively conservative and the evolution -ary rate for NA gene was low .The dN/dS ratio was less than one , indicating that the NA gene was under pu-rifying selection .

Background and purpose: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a new minimally invasive method in the dignosis for mediastinal lymph nodes. This study was to evaluate the diagnostic yield of EBUS-TBNA for mediastinal lymph nodes. Methods: Twenty patients with mediastinal lymph nodes found by CT underwent the dignosis by EBUS-TBNA form April 1st 2009 to July 16th 2009. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of EBUS-TBNA were evaluated. Results: Twenty patients with 37 lymph node groups were studied. Overall sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of EBUS-TBNA for diagnostic were 84.62%, 100%, 100%, 77.78% and 90.00%, respectively. The diagnostic accuracy for cancer was 100%. The operation time was 11.9min per group in average with no serious complication. The median length of hospital stay was 1 (range from 1 to 17 days) day after operation. There were significant differences in the average operation time between the first three patients and the others (36.25 min vs. 7.76 min; z=3.247, P=0.001). Conclusion: Endobronchial ultrasound-guided transbronchial needle aspiration proved to be a safe procedure with a high yield for the diagnosis of mediastinal lymph nodes.

Objective To set up a rat model with acute traumatic coma and identify the variation of microRNA in mesencephalon. Methods After rats were injured moderately by central fluid percussion system, tissues of the mesencephalon were removed one hour after injury. RNA of brain tissue of the mesencephalon was isolated for microRNA array by using the exiqon microarray system. The data were analyzed statistically by Genepix Pro 6.0 after hybridization results were scanned and fluorescence intensity standardized. Resets Hybridization results showed 33 microRNAs with up-regulated expressions but 38 microRNAs with down-regulated activity. Conclusion Expression of microRNA array shows marked changes in the tissues of the mesencephalon in rats with traumatic coma, as may be injury mechanism of traumatic coma and also a way of neurobiological protection of coma.

Two effective flavobacterium strains FCN1 and FCN2 were isolated from the sludge which had been contaminated by coke-plant waste water for a long time.Before isolation,the naphthalene was used to cultivate such sludge for seven weeks as the sole carbon source and its concentration adding to the cultivating system was increased up to 50mg/L gradually.The polycyclic aromatic hydrocarbon degrading characteristics of our isolates themselves and with inorganic ions was studied respectively.The testing results show that our two isolates can transform and degrade anthracene,phenanthrene and pyrene.After 10 hours reaction,the removing rates of anthracene,phenanthrene and pyrene by FCN1 were 84%,69%,80% and by FCN2 were 76%,40%,71% respectively.After 106 hours,the removing rates of TOC caused by anthracene,phenanthrene and pyrene were 70%,54%,69% by FCN1 and 63%,50%,46% by FCN2.The Fe 3+ and Mg 2+ can accelerate the degrading reaction of FCN1.

OBJECTIVETo observe the clinical effects of needle-pricking therapy, a newly medical and minimally invasive technique, for functional retrograde ejaculation and to explore its mechanism. Methods Thirty-six patients with functional retrograde ejaculation were randomly divided into an observation group(19 cases) and a control group(17 cases) In the observation group,needle-pricking therapy was used at Guanyuan(CV 4) and bilateral sacral plexus nerve,lumbar 1 nerve and greater occipital nerve stimulating points,once a week. In the control group, midodrine tablets were prescribed orally,three times a day. All the treatment was given for 9 weeks. The clinical effects of the two groups were observed, and the levels of luteinizing hormone(LH), testosterone(Tes) and estra4 diol(E2) were compared between the two groups.

RESULTSThe total effective rate of the observation group was, 89. 47%(17/19), which was better than 47.06% (8/17) of the control group(P<0. 05). The LH and Tes were obviously increased and E2 was decreased compared with those before treatment in the observation group(all P< 0. 01). Tes was raised(P<0. 05) and E2 was apparently declined in the control group(P<0. 01). After treatment, the differences of serum LH and Tes were statistically significant between the two groups(both P<0. 01).

CONCLUSIONNeedle-pricking therapy has advantages for functional retrograde ejaculation probably in that stimulating lumbosacral nerves can strengthen the function of pelvic floor muscles and urethral expansion muscle and regulate sexual gland axis.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Ejaculation ; Humans ; Male ; Middle Aged ; Needles ; Sexual Dysfunction, Physiological ; physiopathology ; therapy ; Treatment Outcome

Background Researches showed that transforming growth factor-β2 (TGF-β2) promotes the activity of human Tenon capsular fibroblasts (TFs),which plays a role in the scarring of filtering blebs after antiglaucoma surgery.However,its mechanism is not fully clear.Lysyl oxidases (LOXs) are important extracellular matrix proteases which can catalyze the cross-linking of collagen and elastin.Investigating the impact of TGF-β2 on the expression of LOXs has a great significance for the understanding of the pathogenesis of filtering bleb scarring and its prevention.Objective This study was to investigate the effect of TGF-β2 on the expression of LOXs in cultured human TFs.Methods The TFs at 4-8 generations were divided into normal control group and different concentrations of TGF-β2 treated-groups,and 100,200,400,800 μ1 of TGF-β2 with the final concentration of 2,4,8 and 16 ng/ml was added into the medium to treat human TFs respectively for 24 hours.The LOXs in the cells were detected by Western blot to determine the optimal dose of TGF-β2.The 4 ng/ml TGF-β2(200 μ1) was used to treat human TFs for 6,12,24 and 48 hours respectively,and the change of LOXs expression in the cells over time was assayed by Western blot.The expression and distribution of LOX protein in the normal cells and TGF-β2-treated cells was detected by using immunofluorescence technique.This study was approved by Daping Hospital of Third Military Medical University Ethic Commission.The guardians of the patients who offered the specimen knew the purpose of the study and signed informed consent.Results Western blot assay showed that the expressions of LOX,LOXL1,LOXL2,LOXL3 and LOXL4 in the cells were gradually elevated from the normal control group and 2,4,8,16 ng/ml TGF-β2-treated groups,showing significant differences among the groups (F =37.338,13.438,31.067,11.767,15.167,all at P＜0.01).The expression of LOXL2 protein in the cells was 0.68±0.07,1.09±0.10,1.32±0.07,1.50± 0.06 and 1.89±0.12 in the normal control group and 6-,12-,24-and 48-hour groups respectively after 4 ng/ml TGF-β2 treatment,with a significant increase over time (F =82.832,P=0.000).The expression of LOX was weak in the normal cultured TFs,while the fluorescence intensity of LOX expression was evidently enhanced in the cytoplasm of the cells in the TGF-β2-treated group.Conclusions TGF-β2 upregulates the expressions of LOXs in human TFs in a dose-and time-dependent manner,which probably offers a basis for the further study on the prevention of filtering bleb scarring after glaucoma surgery.

Meckel diverticulum (MD), a congenital gastrointestinal anomaly, is often involved in pediatrics, but less in the adult population. The patient in this report was a 69-year-old female presented with massive gastrointestinal bleeding causing hemorrhagic shock due to MD containing ectopic pancreatic tissue. A review of the literature revealed that gastrointestinal bleeding from MD containing ectopic pancreatic tissue is rare in adults and difficult to be identified preoperation. MD should be considered as one of the differential diagnosis for lower gastrointestinal bleeding, although scarce in adults, especially when the patient has massive painless bleeding.
Aged ; Choristoma ; diagnosis ; physiopathology ; Female ; Gastrointestinal Hemorrhage ; diagnosis ; etiology ; Humans ; Meckel Diverticulum ; diagnosis ; physiopathology ; Pancreas ; pathology