Anemia, Refractory, with Excess of Blasts ; complications ; drug therapy ; Azacitidine ; analogs & derivatives ; therapeutic use ; Humans ; Male ; Middle Aged ; Myelodysplastic Syndromes ; complications ; drug therapy ; Treatment Outcome

OBJECTIVETo investigate the clinical application of pedicled superficial circumflex iliac artery (SCIA) flaps in Burns and Plastic Surgery.

METHODS19 cases with skin and soft tissue defects were repaired with the Superficial circumflex iliac artery flaps. The defects located in the hand and forearm, the lower abdomen and perineal area, the radicle area of thigh, etc. Before the SCIA flaps were transfered to the recipient areas, 15 cases with different kinds of wounds were debrided thoroughly, 3 cases with scar were removed directly. The size of the flaps ranged from 3.0 cm x 4.5 cm to 26.0 cm x 22.0 cm, and the pedical was 5 cm to 7 cm in length.

RESULTSThe flaps in the 18 cases survived completely. Skin necrosis in the distal end of the flap appeared in 1 case, and the wound healed after the second repair. The follow-up period rang from 3 to 18 months. The apperance and function of the hand or foot was satisfactory.

CONCLUSIONSBecause the pedicled SCIA flaps can be obtain conveniently and contain sufficient blood-supply, so the flap is easy to survive and the flap can be designed in a large size. We believe it is an ideal method to use this flap to repair skin and soft tissue defects located in hands, forearms, the lower abdomen and perineal areas, the radicle area of thigh and so on.

Burns ; surgery ; Forearm ; Graft Survival ; Hand ; Humans ; Iliac Artery ; Necrosis ; Reconstructive Surgical Procedures ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; blood supply ; pathology ; transplantation ; Thigh ; Wound Healing

Objective To explore the diagnostic value of endoscopic retrograde cholangio-pancreatiography (ERCP),ultrasonography (US) and CT scanning on cholagio-pancreatic diseases caused by clonorchis sinensis infection.Methods The results of US,CF and ERCP examination in 65 cases of obstructive jaundice caused by clonorchiasis and confirmed by presence of imagoes or eggs in feces or bile juice were analyzed and compared retrospectively.Results US examination was the simplest and most convenient which was characterized by diffuse even dilatation,thickening of walls,strengthened echo with the shape of“equal sign”intrahepatic bile ducts.The characteristic findings of CT included saccular dilatation of bile ducts of the periphery of the liver,thickening of the walls of bile ducts.Under duodenoscopy,32.3% (21/65) of cases presented as abnormal papilla such as small opening,mucosa outward turned,trapping or stiffness.Alterations in ERCP were characterized by shm or oval filling defect,diffuse saccular dilatation of terminal intrahepatic bile ducts.The most common complications included cholangiolithiasis (40%,26/65),carcinoma of bile duct on papilla (9.8%,6/65),and pancreatitis (1.5%,1/ 65).Conclusions Three methods were all useful for diagnosis of cholangio-pancreatic diseases caused by clonorchis sinensis infection,which were identically characterized by diffuse saccular dilatation of terminal intrahepatic bile ducts.The gold standard of diagnosis was the presence of imagoes or eggs in bile juice aspirated by the route of ERCP.Endoscopic sphincterectomy with postoperative vermifugal was the first choice of the treatment.

Spinal biomechanics, especially the range of spine motion,has close connection with spinal surgery. The change of the range of motion (ROM) is an important indicator of diseases and injuries of spine, and the essential evaluating standards of effect of surgeries and therapies to spine. The analysis of ROM can be dated to the time of the invention of X-ray and even that before it. With the development of science and technology as well as the optimization of various types of calculation methods, diverse measuring methods have emerged, from imaging methods to non-imaging methods, from two-dimensional to three-dimensional, from measuring directly on the X-ray films to calculating automatically by computer. Analysis of ROM has made great progress, but there are some older methods cannot meet the needs of the times and disappear, some classical methods such as X-ray still have vitality. Combining different methods, three dimensions and more vivo spine research are the trend of analysis of ROM. And more and more researchers began to focus on vivo spine research. In this paper, the advantages and disadvantages of the methods utilized recently are presented through viewing recent literatures, providing reference and help for the movement analysis of spine.
Animals ; Humans ; Imaging, Three-Dimensional ; instrumentation ; methods ; trends ; Radiography ; Spine ; diagnostic imaging

Background:Colonoscopy is considered as a standard method for detecting various kinds of colorectal polyps. However,conventional colonoscopy( CC)still has the chance to miss some lesions. Literatures have already reported that transparent hood assisted colonoscopy( THAC)can improve the detection of colorectal polyps. However,the effect of black hood assisted colonoscopy( BHAC)on detection of colorectal polyps is still unclear. Aims:To evaluate the effect of BHAC on detection of colorectal polyps. Methods:A total of 1 076 patients underwent CC and BHAC from Sept. 2014 to April 2015 at Huadong Hospital Affiliated to Fudan University were enrolled in this prospective randomized controlled study. Baseline characteristics,cecal intubation time,withdrawal time,number of polyps,detection rate of polyps,location, size,morphology and pathological diagnosis of polyps between two groups were compared. Results:Compared with CC group,cecal intubation time was significantly shorter in BHAC group than in CC group[(6. 31 ± 3. 51)min vs.(7. 05 ± 4. 15)min,P=0. 002]. No significant differences in withdrawal time and rate of cecal intubation were found between two groups(P>0. 05). Detection rate of polyps was significantly higher in BHAC group than in CC group(65. 4% vs. 48. 7%,P=0. 004). No significant differences in size,morphology of polyps were found between two groups(P>0. 05). Conclusions:Compared with CC,BHAC could significantly improve the detection of colorectal polyps,and shorten cecal intubation time.

Objective To establish a novel TRFIA for the measurement of heparanase (HPA) in serum samples,and investigate its clinical application.Methods The micro-pore plate wells were first coated with partially recombinant murine anti-human HPA monoclonal antibody.Biotin-labeled recombinant HPA protein was then used to compete with HPA in serum samples,and the prepared europium (III)-labeled streptavidin (Eu3+-SA) was used as signal readout for establishing the BSA-TRFIA assay.Using this assay,the serum HPA levels in healthy subjects (n=32) and tumor patients (n=54) were measured.The results of BSA-TRFIA were compared with those of ELISA.Two-sample t test (or t' test),and linear correlation analysis were used to analyze the data.Results The sensitivity of BSA-TRFIA for measuring HPA was 0.33 ug/L.The CV values for intra-batch and inter-batch were 5.29% and 7.54%,respectively.The average recovery rate was 105.5%.The standard curve range was 0-1 000 ug/L.The serum HPA level measured by the BSA-TRFIA method in healthy subjects was (2.03_+ 1.47) Iug/L.In tumor patients,the HPA level was significantly higher:(22.13_+7.38) ug/L (t'=19.388,P

Objective To study the clinical effect of pedicle screw fixation in treatment of unstable upper and middle thoracic vertebrae fractures. Methods A retrospective study was performed on 17 cases of unstable upper and middle thoracic vertebrae fractures treated with vertebral pedicle screw system (GSS 全称in 11 cases and USS 全称in six) fixation, posterolateral bone grafting and fusion from March 2001 on. There were one case of T_3, two T_4, two T_5, four T_6, six T_7 and two T_8. Of all, nine cases were with compression fractures, five with fracture-dislocation and three with burst fractures. Results All cases were followed up for 10-38 months (average 21.1 months). During the follow up, the anterior vertebral body height was restored from preoperative 40% to postoperative 91%. Except for four screw malpositions, there was no postoperative neurologic deterioration, screw loose or breakage of the internal fixation, or loss of the normal spine curve and the spinal height of the injured vertebra. Conclusions Pedicle screw fixation is an effective way for treating unstable upper and middle thoracic vertebrae fractures. Correct placement depend on a comprehensive familiarity of pedicle anatomy, appropriate pedicle diameter and entry point and depth can avoid potential risks in placing pedicle screws into the upper and middle thorax.

Objective To investigate the protective effect and its mechanism of DL-3-n-Butylphthalide on the brain damage in rats following whole brain irradiation.Methods A total of 120 male Sprague Dawley rats were randomly divided into sham-irradiation group,irradiatien group and DL-3-n-Butylphthalide group.The model of whole-brain irradiatien was established by exposuring rat brain to 4 MeV X-rays with a single-dose of 10 Gy.The rats were intraperitoneally injected with DL-3-n-Butylphthalide at the dosages of 0.3,1.0,and 3.0 mg/kg once a day.The contents of malondialdchyde and super oxide dismutase activity were measured,while the expressions of apoptosis-associated genes and the ultrastructural changes in hippocampus were examined by immunohistnchemisty staining and electron microscope,respectively.Results After irradiation,the content of malondialdehyde and the expression of apoptosis gene bax in rat brain tissue increased while the activity of super oxide dismutase(SOD) and the expression of anti-apoptosis gene bcl-2 decreased.Apoptosis was also observed in the neurons of hippocampus CA1.Compared with irradiation group,the content of malondialdehyde and the expression of bax gene in the DL-3-n-Butylphthalide group wen significantly reduced ( t =-3.89--1.96,2.72-3.48,P ＜ 0.05 ),while the activity of SOD and bcl-2 gene were significantly elevated ( t =2.94-3.76,-3.18--2.08,P ＜ 0.05),and the injury degree of neuron structure in the DL-3-n-Butylphthalide group was slighter than that in the irradiation group.Conclusions DL-3-n-Butylphthalide executes protective effects in a dose-dependent manner againest the radiation injury in rats brain by reducing the induction of malondialdehyde,raising the activity of SOD and inhibiting the generation of apoptosis.

Objective To investigate the diagnostic accuracy of 13C urea breath test (13C-UBT)in the diagnosis of Helicobacter pylori (Hp) infection in patients with gastric remnant.Methods A total of 94 gastric remnant patients (gastric remnant group) and 100 non-gastric remnant patients (control group) received 13C-UBT.According to the course of the disease,the gastric remnant group were divided into group 1 (29 cases,≤5 years),group 2 (33 cases,6 to 10 years) and group 3 (32cases,＞10 years).Before surgery,the diagnosis of Hp infection was according to 13C-UBT and gastric mucosa tissue staining.After surgery,the diagnosis was according to gastric mucosa tissue staining.The applying value of 13C-UBT in gastric remnant patients was evaluated.The consistency of results between 13C-UBT and gastric mucosa tissue staining were evaluated by the Kappa test.Results In gastric remnant group,the Hp infection rate after surgery (37.2％) was obviously lower than that before operation (79.8％;x2 =35.058,P＜0.01) and that of control group (77.0％).After surgery,the Hp infection rate of patients with Billroth Ⅱ gastrectomy (24.4％) was lower than that of patients with Billroth Ⅰ gastrectomy (47.2％ ; x2 =5.133,P=0.023).Before surgery,the Hp infection rate of gastric remnant subgroups were similar (P＞0.05).With the extension of the postoperative course,the Hp infection rate gradually decreased in gastric remnant subgroups (group 1:58.6％,group 2:36.4％,group 3:18.8％; x2=7.839,P=0.021).Setting the cut-off point at 2.0‰ in the gastric remnant group and 3.5‰ in the control group,the accuracy rate of diagnosis was the highest (92.6％ and 96.0％).There was good consistency between the results of 13C-UBT and gastric mucosa tissue staining (Kappa =0.84,P＜0.01).Conclusion With suitable operation and standard,13C-UBT may be a easy,safe and effective assay applied in the gastric remnant patients.

To evaluate the dynamic changes of erythropoietin (EPO) and its significance following ABO-incompatible allogeneic hematopoietic stem cell transplantation (allo-HSCT), sequential changes in serum EPO levels were measured by enzyme linked immunosorbent assay (ELISA) in 11 patients receiving allo-HSCT from ABO-incompatible donors. The results showed that the mean EPO level was markedly elevated and reached to its highest level at 0 day-2 week after allo-HSCT (233.73 +/- 81.95 mU/ml and 226.07 +/- 113.87 mU/ml respectively, P >0.05). Although the EPO levels were significantly lower at 1 month (128.49 +/- 108.92 mU/ml, P <0.05) and after the reversion of blood type (73.07 +/- 68.85 mU/ml, P <0.05), they were still elevated up to 2 months after allo-HSCT. The EPO levels always had significant positive correlation with the RBC transfusions. At 0 day and 4 week after allo-HSCT, the EPO levels had significant negative correlation with the Hb levels; at 6 and 8 week after allo-HSCT, the EPO levels had no relation with the Hb levels, they had significant positive correlation with the time of erythrocyte recovery and anti-A isoagglutinin titers at the same time. It is concluded that serum erythropoietin levels continuously increasing following ABO-incompatible allogeneic allo-HSCT suggest that exogenous recombinant human erythropoietin treatment for anemia may not be beneficial.
ABO Blood-Group System ; immunology ; Adolescent ; Adult ; Blood Group Incompatibility ; blood ; Erythropoietin ; blood ; Female ; Hematopoietic Stem Cell Transplantation ; Humans ; Male ; Transplantation, Homologous