ObjectiveTo study memory impairment of closed head injured(CHI) patients during later recovering period. MethodsMemory function was examined in 20 CHI patients and 20 matched healthy controls by Clinical Memory Scale(CMS). ResultsThe scores of 5 sub tests and MQ of CHI group were significant lower than that of control group, the rate of MQ ≤ 79 in CHI patients was significant higher than in controls. Conclusion There are severe memory impairment in CHI patients during later period, the impairment of recall is more serious than that of recognition.

Acute Disease ; Child ; Gene Expression Profiling ; Humans ; Leukemia ; diagnosis ; genetics ; therapy

Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; chemistry ; pathology ; Female ; Head and Neck Neoplasms ; chemistry ; pathology ; Humans ; Immunohistochemistry

BACKGROUND:With the development of industry and agriculture, organotin compounds have been widely used in China. Organotin compounds cause a common occupational poisoning. The toxicity of organotin was reported in animal studies; however the reports about human organotin intoxication are very rare. In this study we retrospectively analyzed the clinical manifestations of 15 organotin-poisoned patients who had been treated at our hospital from 2002 through 2007. METHODS:Fifteen patients with organotin poisoning were admitted to Sir Run Run Shaw Hospital Affiliated to Zhejiang University School of Medicine from 2002 to 2007. They were 9 males and 6 females, aged from 25 to 52 years. Clinical manifestations and Glasgow Coma Scales showed that the poisoning was mild in 4 patients, moderate in 6 and severe in 5. The severe patients were given glucocorticoid after hospitalization by intravenous guttae of 500 mg methylprednisolone for the first day, followed by 160 mg methylprednisolone per day for three days, and then 80 mg methylprednisolone per day for another three days. Potassium glutamate and sodium glutamate were intravenously dripped to reduce blood ammonia; intravenous guttae plus oral administration of potassium 9 g/day was used to correct intractable hypokalemia; sodium bicarbonate was used to correct metabolic acidosis, and sedatives were used to control spasm and twitch; mechanical ventilators were used in 4 patients with dyspnea. RESULTS:Most of the patients showed elevated level of blood ammonia, decreased level of blood potassium and metabolic acidosis, but some had demyelination changes shown by CT and MRI. Treatments included correction of metabolic acids, blood potassium and ammonia, and mechanical ventilation when necessary. For patients with injuries of the nervous system, glucocorticoids were given immediately after hospitalization. These patients showed intractable hypokalemia and metabolic acidosis during the treatment. Forteen patients recovered completely without long-term side-effect. One patient in the aphasiac stage restored the linguistic capacity during a 6-month follow-up. CONCLUSIONS:Elevated level of blood ammonia, decresed level of blood potassium, and metabolic acidosis are common in patients with organotin poisoning. Demyelination can be observed in patients with severe poisoning. The abnormalities of the patients are reversible after suitable treatments.

ObjectiveTo study possible differences in cognitive dysfunction between left hemisphere injury(LHI) patients and right hemisphere injury(RHI) ones.MethodsCognitive function of 55 LHI patients and 43 RHI patients were examined by aphasia screening test and the Loewenstein Occupational Therapy Cognitive Assessment Battery(LOTCA).ResultsThe scores of RHI group were significant higher than that of LHI group in orientation in place,overlapping figures,spacial perception,praxis(P<0.001-0.005),but significant lower than that of LHI group in visual identification of shapes and visuomotor organization(P<0.001-0.02).The possibilities of RHI group were significant more than that of LHI group in disorientation in time,shape agnosia,disorder in figure-ground identification,unilateral neglect,disordered attention(P<0.005-0.025),but significant fewer than that of LHI group in aphasia,ideomotor apraxia(P<0.005-0.01).The possibilities were no significant differences in disorientation in place,objects agnosia,colour agnosia,spacial agnosia,motor apraxia,constructional apraxia,thinking disorder between RHI group and LHI group(P>0.05).Conclusions There is characteristic cognitive dysfunction after right or left hemisphere injury.

Objective To determine the effect of bacille Calmette-Guerin-polysaccharide nucleic acid (BCG/PSN)on 2,4-dinitrochlorobenzene(DNCB)-induced atopic dermatitis-like skin lesions in Nc/Nga mice.Methods Fifteen mice were randomly and equally classified into 3 groups,i.e.,control group receiving topical acetone on foot pad and abdomen and intraperitoneal injection of physiological saline,model group receiving topical 5% DNCB solution and intraperitoneal injection of physiological saline,treatment group receiving 5% DNCB solution and intraperitoneal iniection of BCG/PSN,and all drugs were used every other day for 7 weeks.Further more,0.1% DNCB was topically applied on the ear and neck of Nc/Nga mice once a week from week 2 to week 7.The effects of BCG/PSN were evaluated by ear thickness,skin histopathology and immunological parameters.Results Repeated application of DNCB caused the development of eczematous dermatitis in mice.Mice in model group chnieally manifested skin dryness,erythema,edema and erosion with histopathological changes including dermal and epidermal thickening,hyperkeratosis,and inflammatory infiltration.The serum levels of IL-4 and IrE in model group were significantly higher than those in control group[(174.72±12.64)μg/L vs (17.32±3.56)μg/L,(91.49±6.32)ng/L vs (83.95±6.63)ng/L,both P<0.05].Increased serum IL-12 and IFN-γ and decreased serum IgE were observed in treatment group compared with the model group[(122.10±4.64)ng/L vs (20.14±6.15)ng/L(73.89±2.39)ng/L vs (51.53±3.45)ng/L, (84.27±9.35)μg/L vs (174.72±12.64)μg/L, all P<0.05].Conclusion BCG/PSN might be beneficial for the treatment of atopie dermatitis-like skin lesions in Nc/Nga mice by enhancing the secretion of IL-12 and IFN-γ and suppressing the synthesis of IgE.

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

In the reform of medical microbiology education on medical students of 8-year-education pro-gram, we compared the traditional teaching methods with Problem Based Learning (PBL) method. Through our practice, we have found that the combination of traditional lecture-based learning and PBL seems to better match the students’ way of learning. The lack of basic knowledge of the students hindered their learn-ing effect during the bilateral discussion in the PBL education. We also found that the application of PBL in medical microbiology education is an iterative process and should be promoted step by step. The theoretical level and the innovative ideas of the teachers play a crucial role in the dynamic process of education reform.

There are many progresses in the therapy of MM with ASCT. ASCT improves the ratio of CR,EFS and OS,compared with conventional chemotherapy.Myeloma patients with renal failure or old age also can be candidate for ASCT.Tandem autologous transplantation improves the ratio of CR. Its impact to long-term EFS and OS still need to be judged.To improve conditional project,to choose suitable time,and- toselect consolidation schedule can boost therapeutic effect.

AIM: To study the changes in anterior chamber angle after phacoemulsification and foldable IOL implantation with ultrasound biomicroscopy.METHODS: Small-incision phacoemulsification and foldable IOL implantation were performed in 50 eyes of 46 senior patients, and the changes of anterior chamber angle were determined quantitatively by using ultrasound biomicroscopy before and one month after the surgery.RESULTS: In all patients, the angle was widened significantly one month after the surgery (P＜0.01). The measurements of TIA500 ( trabecular-iris angle at 500μm from the scleral spur) , AOD250 (angle-opening distance at 250μm from the scleral spur) and AOD500 (angle-opening distance at 500μm from the scleral spur) increased significantly after the operation ( P＜ 0.01). The mean post/pre-operative TIA500ratio, AOD250 ratio and AOD500 ratio were 1.65 (1.12-4.91),1.81 (1.06-2.67) and 1.65 (1.01-2.76), respectively. A significant negative correlation existed between preoperative and postoperative data.CONCLUSION: Small-incision cataract surgery deepens the anterior chamber and widens anterior chamber angle significantly in senior patients. The narrower the preoperative angle, the higher ratio of post/preoperative ratio found.