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.

Objective To understand the clinical features of candidemia.Methods A retrospective analysis was performed based on the data of 88 candidemia cases treated in Huashan Hospital during the period from 2007 to 2012.The clinical data were re-viewed in terms of species distribution,underlying diseases,clinical manifestations,treatment and outcomes.The prognostic factors were analyzed by chi-square test or Fisher exact probability test.Multivariate analysis was conducted by multiple Logis-tic regression.Results Candida albicans (40/88,45.5%)was the most common pathogen isolated from these candidemia ca-ses,followed by Candida tropicalis (20/88,22.7%),Candida parapsilosis (17/88,19.3%),Candida glabrata (10/88, 11 .4%),and Candida krusei (1/88,1 .1 %).Solid malignancy,diabetes,and surgical procedure were the most frequently identified underlying diseases.Fatal or deteriorative outcome was reported in 28 cases.The attributable mortality was 18.2%. Multivariate prognostic analysis indicated that presence of central venous catheter (OR:6.322,95% CI :1 .055-37.891 ,P =0.044)was independently correlated to increased mortality.Appropriate antifungal therapy was an independent predictor of de-creased overall mortality (OR:0.137,95% CI :0.039-0.480,P =0.002).Conclusions The pathogen distribution of candi-demia has changed slightly.Appropriate antifungal therapy plays a key role in the treatment of candidemia.

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 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.

Gas Chromatography-Mass Spectrometry ; Solvents ; analysis ; chemistry ; Volatile Organic Compounds ; analysis ; chemistry

OBJECTIVE:To study the ex vivo adsorption of montmorillonite powder to ofloxacin.METHODS:Different dosages of ofloxacin and montmorillonite powder were mixed with artificial gastric juice and artificial intestinal juice,respec?tively,which were filtrated after warmed at(37?0.5)℃in water bath for1hour,the content changes of ofloxacin were de?termined by ultraviolet spectrometry.RESULTS:The adsorption rates of montmorillonite powder to ofloxacin in artificial gastric juice and in artificial intestinal juice were(99.76?0.01)%and(99.55?0.02)%,respectively.CONCLUSIONS:Montmorillonite powder has strong adsorption to ofloxacin in both artificial gastric juice and artificial intestinal juice,there?fore,which should not be administered simultaneously in the clinic.

Objective To investigate the correlation between red cell distribution width RDW) and prognosis in patients with severe traumatic brain injury.Methods A total of 264 consecutive patients with severe traumatic brain injury admitted from May 2012 to November 2014 were enrolled.The patients were divided into low-RDW group (RDW ＜ 15％,n =198) and high-RDW group (RDW ≥ 15％,n =66) based on their RDW levels.Between-group differences were evaluated on general conditions,acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ),inflammatory markers [high sensitivity C-reactive proteins(hs-CRP) and arterial lactate],liver/renal dysfunction,and 28-day mortality.Spearman correlation analysis of RDW with mortality was conducted.Independent factors of 28-day mortality were identified using multivariate Logistic regression.Kaplan-Meier 28-day survival curve was analyzed and survival probability of the two groups was compared using Log-Rank test.Results The 28-day mortality was significantly enhanced in high-RDW group compared to that in lowRDW group (43.9％ vs 26.8％,P ＜ 0.01).RDW ≥ 15％ related positively to APACHE Ⅱ and mortality(r =0.172 and 0.253 respectively,P ＜ 0.01),but negatively to Glagow coma score (GCS) (r =-0.169,P ＜0.01).RDW≥ 15％ was the independent risk factor for predicting the 28-day mortality (OR =2.144,95％ CI 1.202-3.826,P ＜0.01).After adjusted gender,age,and other relative factors,RDW≥15％ was still strongly correlated with the 28-day mortality(OR =2.244,95％ CI 1.076-4.678,P ＜ 0.05).Significantly lower 28-day survival rate was found in high-RDW group than in low-RDW group (P ＜ 0.01).Conclusions RDW level rises beyond the normal range on admission in patients with severe traumatic brain injury,which is closely correlated with the 28-day poor outcome.RDW≥ 15％ has significant predictive value in the prognosis.