OBJECTIVETo investigate the best choice of operation opportunity and operation plan for limb fractures combined with severe craniocerebral trauma in children.

METHODSFrom January 2005 to July 2012,36 patients with limb fractures and severe craniocerebral trauma were received,including 24 males and 12 females aged from 1 to 13 years old (mean, 6.1 +/- 3.0). The time from injury to hospital was (18.0 +/- 15.0) h. Glasgow coma score were less than 8 with an average of 6.4 +/- 1.3. AIS-ISS score were 25.9 +/- 8.1. Thirteen patients were open fracture, 23 were closed fracture. Patients were divided into immediate operation group (21 patients) received fracture fixation with 24 h, the average time was (15.0 +/- 7.4) h, and delayed operation group (15 patients) received fracture fixation after 24 h, the average time was (165.4 +/- 114.6) h. All patients were treated by open reduction, and 33 cases by internal fixation, 3 cases were external fixation. Operative time, blood loss, fracture healing time and brain trauma,physical trauma, postoperative rehabilitation situation were observed and evaluated.

RESULTSAll patients were healed at stage I ,and no dead, aggravating of coma, disorders of breathing and circulation occurred during operation. Operative time,blood loss,healing time in immediate operation group was (44.5 +/- 25.3) min, (47.1 +/- 36.5) ml, (2.7 +/- 0.5) months, respectively; while in delayed operation group was (87.0 +/- 40.0) min, (112.7 +/- 67.5) ml, (3.8 +/- 1.2) months,respectively; and there were obvious differences between two groups. There was no siginificant meaning in Glasgow coma score and Fugl-Meyer motor function between immediate operation group (4.7 +/- 0.6, 97.9 +/- 2.7) and delayed operation group (4.7 +/- 0.5, 97.7 +/- 3.9) (t = 0.23, P > 0.05; t = 0.11, P > 0.05).

CONCLUSIONThe condition of limb fractures combined with severe craniocerebral trauma in children is seriously, comfortable surgical opportunity should according to particular case, and immediate operation can performed on the condition of stabled vital signs.

Adolescent ; Child ; Child, Preschool ; Craniocerebral Trauma ; surgery ; Extremities ; injuries ; surgery ; Female ; Follow-Up Studies ; Fracture Fixation ; Fracture Fixation, Internal ; Fractures, Open ; surgery ; Humans ; Infant ; Male

OBJECTIVETo investigate the correction of secondary nasal deformity of cleft lip with autogenous costal cartilage framework.

METHODS237 cases with secondary nasal deformity of unilateral cleft lip were treated. The rib cartilage was harvested through a mini-invasive incision, and was fabricated as a C-shaped framework, as well as some cartilage fragments. Through transcolumella incision, the C-shaped framework was implanted to support the depressed alar and the cartilage fragments were used to augment the nasal base.

RESULTSSatisfactory cosmetic and functional results were achieved in all the patients with primary healing. 93 patients were followed up one year after operation with good cosmetic results.

CONCLUSIONSAutogenous costal cartilage framework can be used for the correction of secondary nasal deformity of cleft lip with satisfactory results.

Cleft Lip ; surgery ; Costal Cartilage ; transplantation ; Humans ; Nose Deformities, Acquired ; surgery ; Rhinoplasty ; methods

Objective Understanding the risk factors of female infertility among child-bearing aged women, in Nanchang area. Methods A hospital-based matched case-control study was carried out in Nanchang. Matched by age ( ±2 years old) , 383 pairs of cases and controls were recruited and studied. Database was established with EpiData 3.0 software. Both cases and controls were interviewed face to face, with a uniformed questionnaire. Conditional logistic regression model was used for univariate and multivariate analysis on SPSS 11.5 to estimate odds ratios (OR) and 95% confidence intervals (CI). Results Data from multiple conditional logistic regression analysis showed that the risk factors of infertility would include pelvic inflammatory diseases (0R=7.078, 95% Ch 3.462-14.467),post-abortion complications' history(0R=3.674, 95% CI: 1.690-7.986), drug treatment history (0R=23.576, 95% Ch 12.324-45.102), dysmenorrhea (0R=1.622, 95% CI: 1.161-2.266), pain from sexual intercourse (0R=2.447, 95% CI: 1.201-4.986), monthly frequency of sexual intercourse (0R=1.416,95% CI: 1.048-1.913)and mental stress (0R=2.146, 95% CI: 1.662-2.771). The protective factor of infertility, however, was level ofeducation(0R=0.522,95%Cl:0.391-0.696). Conclusion Prevention and treatment of pelvic infection, application of strictly controlled drugs, popularization of awareness on sexual and reproductive health and relief of mental stress would be important measures in decreasing the incidence of infertility.

Objective To develop a human Tim-3 specific monoclonal antibody and evaluate its biological activity and possible use in clinical diseases associated with dysregulated Tim-3 expression .Methods The BALB/c mice were immu-nized by conventional method, and positive clones were used to develop anti-human Tim-3 antibody, the binding and neutralization activities of which in vitro and in vivo were investigated.Results ①A monoclonal antibody (clone L3D) which could specifically bind to human Tim-3 protein in ELISA assay was obtained and the subtype of the monoclonal antibody was IgG2a .②Flow cytometry indicated that the monoclonal antibody could bind to Tim-3 expressed in human U937 cells.This antibody also showed a cross activity to mice′Tim-3.③The monoclonal antibody inhibited the apoptosis of THP1 cells induced by Gal-9, the ligand of Tim-3.④Injection of Tim-3 antibody exacerbated sepsis in mice as marked by the decreased survival rate and increased expression of pro-inflammatory cytokines .Conclusion An anti-human Tim-3 monoclonal antibody is successfully obtained.The excellent binding and neutralization activities of this antibody enable it to be widely used in clinical diseases associated with deregulated Tim-3 expression .

Objective To evaluate the therapeutic effects of adult neural stem cells derived from the brain, adipose tissue and bone marrow on spinal cord injuries in adult rats. Methods The brain subventricular zone (SVZ), adipose tissue and bone marrow from the same rat were obtained to induce the neural stem cells (NSCs). In 72 SD rats with spinal contusive injury, the NSCs from the 3 origins were grafted into the injured spinal cord one week after the injury, with 24 rats as the saline control group and another 24 as the sham-operated group. The locomotor recovery of the rats was evaluated according to the BBB scores, and the cell survival, distribution, migration and differentiation in the injured spinal cord were evaluated by immunohistochemistry. Results Compared with the rats in sham-operated and saline groups, the rats receiving transplantation of NSCs of different origins all showed significantly increased BBB scores. At 9 weeks after the transplantation, the rats receiving brain SVZ-derived NSCs (SVZ-NSs) exhibited significantly improved locomotor function compared with those grafted with the other two NSCs (P<0.05). The SVZ-NSs showed significantly higher Brdu/nestin+cell percentage than bone marrow-derived NSCs(BM-NSs) and adipose-derived NSCs(AD-NSs) at 4 weeks after grafting, but till 8 week after the grafting, only a few positive cells were found in the injured spinal cord in the 3 groups, without significant difference between them (P>0.05). Conclusion Grafting of the NSCs derived form the brain SVZ, adipose tissue and bone marrow all help improve the locomotor recovery of the rats following spinal cord injury, and the SVZ-NSs has the most obvious effect. But AD-NSs may seem a better option than those of other origins for repairing the injured spinal cord due to their abundant sources and strong proliferation ability.s

Objective To establish an easy culture method of successively getting high purity and yield of microglia. Methods Cortices of neonatal Wistar rats (1-3 days old) were employed in this experiment. The first-generation microglial cells were isolated from the mixed glial culture by mechanical means (gently shaking and blowing with pipette). After the mixed glial cells being passaged at a density third generations ofmicroglial cells were harvested. CD1 lb/c, CD45, CD80, CD86 and GFAP were employed as the identification markers in detecting the phenotypes and purity of different generation of microglial cells by scanning electron microscope and flow cytometry. Immunofluorescence staining and CCk8 vitality measurement were used to judge the expression of CD11b/c and detect the proliferation of microglia cells. Microglial phagocytotic function was evaluated by phagocytosis of fluorescent microspheres. Results High yield and purity of microglial cells were stably obtained in this experiment. CD11b/c, CD45, CD80 and CD86 positive expressions were noted in the first and third generations of microglial cells by flow cytometry; CD1 1b/c positive expression was noted in the first,second and third generations of microglial cells by immunofluorescence staining. No obvious differences in the 3 different generations of microglia cells were found on proliferation ability by CCk8 vitality measurement, and on morphology and phenotypes by scanning electron microscope; no obvious differences in the first and third generations of microglia cells were found on phagocytic ability (P＞0.05).Conclusion High yield and purity of microglial cells can successively obtain through the above method;no significant differences are noted among different generations of microglia cells on purity, morphology,phenotypes, proliferation activity and phagocytic ability.

OBJECTIVETo introduce the experience in coronary artery bypass grafting (CABG) combined with concomitant valve operation.

METHODSFrom 1998 to 2002, forty-five patients (38 men and 7 women) with coronary artery lesion and valve diseases underwent myocardial revascularization combined with concomitant valve operation. The mean age of the patients was 59 years (42 to 75 years). Heart function was Class II (NYHA) in 7 patients, Class III in 30, Class IV in 8. The value of ejection fraction was 0.32 to 0.50. Thirty patients had mitral valve lesion, 7 aortic lesion, and 8 both lesions. Seventeen patients had single-vessel diseases, 20 double-vessel diseases, 8 triple -vessel diseases, and 8 left main artery lesion. After cardiac arrest by cold blood cardioplegia under moderate cardiopulmonary bypass (CPB), distal anastomosis of the saphenous vein (SV) to the target vessels were firstly performed and followed by valve replacement (32 patients) or plasty (2). The left internal mammary artery (LIMA) was grafted to the left anterior descending artery (LAD) before aortic unclamping. Proximal anastomosis of the SV to the aorta was finally finished on beating heart. The mean bypass time was 173.5 min and the mean duration of aortic cross-clamping time was 112.6 min.

RESULTSNo mortality occurred during hospitalization and all patients were discharged 9.2 days after operation. Cardiac function of all patients was improved to Class I-II and no patient died during follow-up.

CONCLUSIONSCABG combined with valve surgery can be safely performed with good results.

Adult ; Aged ; Coronary Artery Bypass ; Coronary Artery Disease ; complications ; surgery ; Female ; Follow-Up Studies ; Heart Valve Diseases ; complications ; surgery ; Heart Valve Prosthesis Implantation ; methods ; Humans ; Male ; Middle Aged ; Postoperative Complications ; prevention & control ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo investigate changes in serum complement, immunoglobulins and lymphocyte subsets in children with common and severe bronchial pneumonia, and the role of immune function testing in bronchial pneumonia.

METHODSTwenty children with common bronchial pneumonia, 20 with severe bronchial pneumonia and 20 healthy children (as controls) were enrolled in this study. Immunization rate scattering turbidimetry and six-color flow cytometry were used to detect changes in serum levels of IgA, IgG and IgM, complement C3 and C4 and CD3(+), CD4(+), CD8(+), CD16(+), CD56(+) and CD19(+) cells.

RESULTSThe IgA levels of children with common and severe pneumonia were significantly lower than in the control group (P<0.05). The IgG level of children with severe pneumonia was significantly lower than in the control group (P<0.05). There were no significant differences in the levels of IgM and complement C3 and C4 between the two pneumonia groups and the control group (P>0.05). Compared with the controls, the children with severe pneumonia showed significantly lower CD4(+) and CD3(+) counts (P<0.05) and a significantly higher CD19(+) count (P<0.05), and the CD16(+) and CD56(+) counts of children with severe pneumonia were significantly lower than in the controls and in children with common pneumonia (P<0.05). There were no differences in CD8(+) count and CD4(+)/CD8(+) ratio between the two pneumonia groups and the control group (P>0.05).

CONCLUSIONSImmune dysfunction exists in children with bronchial pneumonia, especially those with severe pneumonia. Changes in immune function are correlated with the severity of pneumonia. Immune function testing in children with pneumonia has important clinical significance.

Bronchopneumonia ; immunology ; Child, Preschool ; Female ; Humans ; Immunoglobulin A ; blood ; Immunoglobulin G ; blood ; Infant ; Killer Cells, Natural ; immunology ; Male ; T-Lymphocyte Subsets ; immunology

OBJECTIVETo investigate the clinical effect of subcutaneous undermining dissection with continuous negative pressure drainage for the closure of cystic cavity-type bedsore.

METHODS12 patients with cystic cavity-type bedsore underwent surgical debridement and the wounds were closed after subcutaneous undermining dissection. The negative pressure drainage was put in the deep space. The healing process was observed.

RESULTSCompleted healing was achieved in all the 12 cases. The skin wounds healed after 17-20 days and the deep spaces closed after 36-43 days. 12 cases were followed up for 1 year with no occurrence.

CONCLUSIONSIt is an easy and effective method to treat cystic cavity -type bedsore by subcutaneous undermining dissection with continuous negative pressure drainage.

Debridement ; methods ; Drainage ; methods ; Humans ; Negative-Pressure Wound Therapy ; Pressure Ulcer ; surgery ; Wound Healing

OBJECTIVETo investigate a new technique for nasal reconstruction with total rib cartilage framework.

METHODSThe expanded frontal flap was fabricated by skin expansion and flap delay to cover the reconstructed nose. The dorsal flap was reversed as the lining of reconstructed nose. The whole framework was made by rib cartilage. Secondary revision operation was also performed to make the reconstructed nose more natural.

RESULTSTotal nasal reconstruction was performed successfully in 37 cases. Each patient underwent 4-7 operation during a period of 6-8 months. 32 patients were followed up for 12-24 months. The reconstructed nose had a natural skin color and symmetric appearance with good ventilation and less scar. Both doctors and patients were satisfied with the results.

CONCLUSIONSatisfactory cosmetic result and ventilation function can be achieved by nasal reconstruction with total rib cartilage framework.

Adult ; Braces ; Female ; Humans ; Male ; Nose ; surgery ; Rhinoplasty ; methods ; Ribs ; transplantation ; Treatment Outcome