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 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 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.

OBJECTIVE:To investigate clinical efficacy and safety of recombinant human tissue type plasminogen activator (rt-PA) intravenous thrombolytic in the treatment of elderly patients (over 75 years old) with acute cerebral infarction (ACI). METHODS:78 elderly ACI patients,on the basis of routine treatment,were divided into thrombolysis group (40 cases) and non-thrombolysis group (38 cases) according to the will of patients or family members. Non-thrombolysis group received aspirin 200 mg,qd;thrombolysis group was given rt-PA 0.9 mg/kg(maximum dose of 90 mg)by intravenous push of 10% dose within 1 min,and intravenous dripping of residue dose within 60 min;receiving aspirin 200 mg,qd,24 h after thrombolytic therapy with-out contraindications. Both groups were treated for 14 days. The effective rate,NIHSS score before treatment and 24 h,7 d and 14 d after treatment,prognosis after 90 d were compared between 2 groups,and the occurrence of ADR was observed in 2 groups. RE-SULTS:The total effective rate was 67.50% in thrombolysis group and 52.63% in non-thrombolysis group,with statistical signifi-cance(P<0.05);there was significant difference in NIHSS score between 2 groups 24 h,7 d,14 d after treatment(P<0.05);90 d prognosis of thrombolysis group was superior to that of non-thrombolysis group,there was statistically significance (P<0.05);there was no statistical significance in the incidence of ADR between 2 groups (P>0.05). CONCLUSIONS:4.5 h time window rt-PA intravenous thrombolytic therapy is safe and effective for elderly patients with ACI,and can reduce disability and fatality,im-prove prognosis.

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 explore the role of protein kinase C(PKC) to regulate the activation of nuclear factor-?B(NF-?B)in T lymphocyte in children with acute idiopathic thrombocytopenic purpura(ITP).Methods Sterility peripheral blood was collected from acute ITP children(n=30)and healthy children(n=30).T lymphocytes were isolated and purified,and divided into 3 groups:control group,PMA group stimulated with PMA,PMA plus H-7 group stimulated with PMA and H-7.The expression of NF-?B and inhibitor protein-?B(I-?B)was detected by immunohistochemical staining and Western blot,respectively.Results The percentage of cells with active NF-?B was significantly higher and the expression level of I-?B was significantly lower in acute ITP PMA group than that in acute ITP control group and normal PMA group,respectively(all P

Objective To select more rapid,sensitive and specific method in detection of respiratory syncytial virus(RSV)directly from clinical specimens.Methods RSV was detected by virus isolation in tissue culture,direct smears and detection by indirect immunofluorecence assay(IFA),rapid culture assay,sandwich enzyme linked immunosorbent assay(ELISA)as well as labbed streptavidin biotin method(LSAB)from 45 specimens(nasopharyngeal aspirates,NPAs) collected from infants and young children with acute lower respiratory tract infection.Results Of 45 NPAs,12 cases(26.7%) were positive by virus isolation,14 cases(31.1%) were positive for RSV by direct detection of RSV antigen by IFA,20 cases(44.4%) were positive with rapid culture assay,4 cases(8.9%)were positive by sandwich ELISA,4 cases(8.9%)were positive by LSAB.Conclusion Rapid culture assay and direct detection of RSV in NPAs direct smears by IFA are rapid,sensitive method in the diagnosis of RSV infections.