Humans ; Spinal Cord Diseases ; therapy ; Spinal Diseases ; therapy

Objective To summarize the clinical experience of repairing facial scar with tubed pattern skin flap from the cervical cutaneous branch of transverse cervical artery.Methods Firstly,a skin flap in the cervical cutaneous branch of transverse cervical artery was designed at chest according to the size of facial scar.The chest skin would be expanded if it was not large enough.Secondly,a skin flap was cut,and the proximal end was rolled and sutured as a tube,whereas the remote end was formed an interface.Thirdly,the scar was removed from the facial scar area and the wound was covered with the tubed pattern skin flap interface.After a blood circulation was established between the face skin and the flap,the flap was trained so that it had plentiful blood supply.Lastly,the tubed pattern skin flap was cut off and open,the remaining facial scar was removed,and the wound was covered and sewed up with the sectioned tubed pattern skin flap.Results The facial scar 35 patients were repaired with tubed pattern skin flap from the cervical cutaneous branch of transverse cervical artery.The survival rate of flap was 100％.Twenty patients received thinning and shaping on flaps in 0.5 to 1 year after surgery.All patients were satisfied with this repair within 1 ～ 5 year follow-up.Conclusions The tubed pattern skin flap in the cervical cutaneous branch of transverse cervical artery is of highly similar to the facial skin.In addition,the supply of the skin is enough.Therefore,it is an ideal flap to repair large facial skin defects.

Adult ; Computer Terminals ; Humans ; Male ; Paper ; Reading ; Students, Medical ; Workload

High-resolution magnetic resonance imaging (HRMRI) is a safe, non-invasive, inexpensive, accurate and reproducible clini-cal imaging modality, and the results can acutely reflect the extent of atherosclerotic disease and have high predictive values for future clini-cal events. It uses black blood imaging techniques and can obtain sufficient sensitivity for submillimetre imaging. HRMRI has been used widely to visualize the vessel wall and differentiate the components of atherosclerotic plaques. It is of important clinical meaning to evaluate plaque vulnerability with HRMRI, which is related to the remodeling pattern, plaque burden, intraplaque hemorrhage and contrast enhance-ment, and plaque distribution, etc.

BACKGROUND:Tissue-engineered bone in the treatment of large bone defects has obvious advantages especial y when the autologous ilium transplantation is limited, which can effectively fil bone defects.
OBJECTIVE:To investigate the rationality of intramedul ary nailing support and tissue-engineered bone fil ing in the treatment of fibrous dysplasia of the proximal femur and the biocompatibility of the tissue-engineered bone.
METHODS:Seven patients with fibrous dysplasia of the proximal femur were subjected to intramedul ary nailing support and tissue-engineered bone fil ing.
RESULTS AND CONCLUSION:Al of the seven patients underwent more than 8 months of fol ow-up, no rejection reaction and other complications occurred. After 4-6 weeks of fixation, al the seven patients removed hip spica braces, with a good hip mobility. After 10-12 weeks, X-ray review showed no pathological fracture, internal fixation loosening and narrow neck stem angle. Using the Harris hip score evaluation of the hip function, the affected side of the seven patients was optimized. After 16-18 weeks, X-ray films reviewed good creeping substitution in the affected area treated with the intramedul ary nailing support and bone graft. After 24-26 weeks, new bone appeared within the scope of lesions. After 1.0-1.5 years, bone creeping substitution was basical y completed in the intertrochanteric region, and original lesions were invisible on X-ray films. These findings confirmed that intramedul ary nailing support and tissue-engineered bone fil ing for treating fibrous dysplasia of the proximal femur has good effectiveness, exhibiting stable internal fixation and avoiding resection of autogenous iliac bone. Tissue-engineered bone has a good biocompatibility in the medium-term fol ow-up, with good hip function activities.

Objective To analyze the clinical features,epidemiologic information and outcome in confirmed cases of human infection with a highly pathogenic influenza A(H5N1).Methods The clinical features and epidemiologic findings in 2 confirmed cases of avian influenza A(H5N1)in Anhui province,in November 2005.Clinical data on vital signs,physical findings,laboratory tests and roentgenology were obtained by means of retrospective review of the hospital records.Epidemiologic data were collected through interviews of the patients and their relatives.Results In both cases,the diagnosis of influenza A(H5N1)was confirmed by means of viral culture and real-time polymerase chain reaction with specific primers for H5 and N1 in samples obtained from tracheal aspiration.All patients were previously healthy young women and resided in village.They had a clear history of di- rect contact with sick/dead poultry and prepared dead chickens at home for eating(removed feathers, washed,cut)hut no report of confirmed HSN1 animals in the village.The time between exposure and onset of illness were 5 days,no one else in family sick.The time between the onset of illness and hos- pitalization were 5 days and 6 days,respectively.Two patients have initial symptoms of high fever (typically a temperature more than 38℃).The prominent clinical features were those of influenza syndrome,including fever,cough,and shortness of breath.Upper respiratory tract symptoms were absent.The platelet counts were decreased.In both patients,there were marked abnormalities on chest radiography,radiographic changes include bilateral and unilateral lobular consolidations with air bronchograms,and had dramatic worsening of findings.Two patients developed acute respiratory dis- tress syndrome(ARDS)complicated multiple organ dysfunction syndrome(MODS)and died of pro- gressive respiratory failure.Conclusions Exposure to dead poultry within a week before the onset of illness was associated with Influenza A(H5N1)infection in humans,but no definitive evidence of hu man-to-human transmission has been found yet.Influenza A(HSNI)infection,characterized by fe- ver,an influenza-like illness with lower respiratory tract symptoms,carries a high risk of death.

Objective To investigate esophageal response to intraesophageal balloon-distention and acid perfusion stimuli and to evaluate the visceral hypersensitivity in non erosive reflux disease (NERD) patients.Methods Thirty-one NERD patients diagnosed by reflux disease questionnaire (RDQ) and endoscopy and 10 control subjects were enrolled in this study.Esophageal mechanical sensitivity was measured by esophageal barostat and recorded as initial perception threshold and maximal tolerated pain threshold by volume.The chemical sensitivity was measured by acid perfusion test,and quantified by two parameters (trigger time and acid related symptom score).Results Initial perception threshold and maximally tolerated pain threshold of NERD patients was (9.6?4.8) ml and (12.3?3.2) ml, significantly lower than those of controls,(13.2?7.5) ml and (21.6?5.7) ml,respectively (P

Objective To investigate prognostic factors for bloodstream infection in adult patients. Methods Clinical data of 131 adult patients with positive blood cultures during January 2002 to December 2003 in the Hospital were collected and 91 cases of them were retrospectively analyzed to understand their pathogen species and prognostic factors for it.Results Blood samples from 91 patients were cultured positive,53 cases(58.2%)with gram-negative bacteria mainly including Escherichia coli,Salmonella spp. and Klebsiella pneumoniae,28(30.8%)with gram-positive bacteria,mainly including Staphylococcus aureus and coagnlase-negative Staphylococci,eight(8.8%)with fungi and two(2.2%)with multiple infections.Case fatality ratio in this group of patients with septicemia was 30.8% during their hospitalization,and that in those with Pseudomonas aeruginosa,Staphylococcus aureus,Stenotrophomonas maltophilia and E.coli with extended-spectrum beta-lactamase was over 50%.Case fatality ratio was associated with severity of sepsis(OR=1.15)and inappropriately initial empirical treatment with antibiotics (OR=6.77).Conclusions Pathogen causing bloodstream infection in adults were mainly gram-negative bacteria and severity of infection and inappropriate initial antibiotics treatment could increase their fatality.

Objective To explore the mechanism underlying the induction of systemic lupus erythematosus (SLE) by estrogen, hydralazine and ultraviolet irradiation. Methods Peripheral blood mononuclear cells (PBMCs) were harvested from 10 patients with SLE and 9 normal human controls, and cultured with or without the intervention with estrogen, hydralazine or ultraviolet irradiation. The DNA methyltransferase-1 (DNMT1) activity of PBMCs was quantified by using DNMT activity/inhibition assay kit. Results No statistical difference was observed in DNMT1 activity between patients with SLE and normal controls (0.36 ± 0.24 vs 0.46 ± 0.17, P ＞ 0.05). A significant decrease was noted in DNMT1 activity in PBMCs from patients with SLE after intervention with estrogen (0.32 ± 0.18 vs 0.46 ± 0.17, t = 1.725, P ＜ 0.05), hydralazine (0.33 ±0.13 vs 0.46 ± 0.17, t = 1.739, P ＜ 0.05) and ultraviolet irradiation (0.30 ± 0.14 vs 0.46 ± 0.17, t = 1.739,P ＜ 0.05 ) compared with that from normal human controls. The treatment with hydralazine also induced an attenuation of DNMT1 activity in PBMCs from normal human controls (0.38 ± 0.12 vs 0.46 ± 0.17, P＜ 0.05).Conclusion Estrogen, hydralazine and ultraviolet irradiation can inhibit the DNMT1 activity of SLE patients,indicating that they may induce the initiation of SLE by altering the activity of DNMT1.

Objective To explore the impact of preoperative neoadjuvant chemotherapy on the expressions of multi-drug resistance genes in patients with cervical cancer and its relationship with the effect of chemotherapy. Methods Ninety-eight cervical cancer patients with TP regimen selected to perform preoperative chemotherapy were enrolled in the Affiliated Hospital of Guiyang Medical College between January 2010 and June 2014. Immunohistochemisty (En vision method) was used to determine the expressions of P-gP, GST-π and TopoII of the same patients before and after neoadjuvant chemotherapy and explore the relationship with the effect of chemotherapy. Results The positive expression rates of P-gp and GST-π were 71.43% and 64.29% before chemotherapy and 80.61%and 74.49%after chemotherapy, respectively. The former two had significant differences (P<0.01). The positive expression rates of TopoII was 48.98%before chemotherapy and 28.57%after chemotherapy , respectively, showing significant differences (P < 0.01). The expressions of P-gp, GST-π and TopoⅡ gene were not affected by the clinical and pathological features of cervical cancer (P > 0.05). Before neoadjuvant chemotherapy, the positive expression of GST-π in the ineffective group was statistically higher than that in the effective group (P<0.05). The positive expressions of P-gp and Topo II showed no statistical significance between the effective group and the ineffective group (P > 0.05). There was significant correlation in the expressions of P-gp, GST-π and TopoⅡ(P < 0.05) before and after neoadjuvant chemotherapy. Conclusions The expression of P-gp, GST-πand TopoⅡgene may not be affected by the clinical and pathological features of cervical cancer, but may change expressions of multi-drug resistance genes in cervical cancer by neoadjuvant chemotherapy. Monitoring their expression has a guiding significance for drug selection, prognostic judgment, and the following treatment regimen decision. The GST-π, expression level can be used as a biological parameter to predict the effect of TP regimen neoadjuvant chemotherapy.