Objective To explore the ideal postoperative nursing methods of repair the lacerateon of lacrimal canaliculus. Methods Using pigtail probe to repair the lacerateon of lacrimal canaliculus in 49 patients, observed the postoperative nursing points in different clinical phases. Results There were 2 patients had the anstomotic stoma split, 1 patient had the canaliculitis. There were 46 patients had successful extubation. Conclusion The Worst lacrimal probe is an satisfactory and reliable method to repair the lacerateon of lacrimal canaliculus. The detailed interpretation and the skillful nursing care are the guarantee for successful operation.

ObjectiveTo investigate the influence of r egional wall motion abnormality(RWMA) on cardiac anatomic structure with coronary artery disease (CAD) and to recognize serious degree of the disease by echocardiography. MethodsA total of 125 cases was observed. There were 63 patients in CAD group (41 cases with general CAD,7 cases with acute myocardial infarction and 15 cases with old myocardial infarction). All the patients had undergone respectively CABG,PTCA and stent,coronary angiography or radionuclide scan for confirmation. There were 62 cases in normal control group. Using 2D echocardiography,stand short and long axis images of left ventricle(LV) were chosen. Displayed RWMA to compose the centripetal disharmonized motion with whole-wall of LV,and the discentripetal contradiction motion. M mode for continuous scan was to detect the typical characterisitic of RWMA. ResultsSingle-occurring RWMA from 43 cases ( 68.2 %) in 63 cases with CAD was displayed, while multiple-occurring RWMA from another 20 cases ( 31.8 %) was displayed(P

On the basis of the development of a new CE method for the analysis of α-lactalbumin (α-Lac), β-lactoglobulin A(β-LgA) and β-lactoglobulin B(β-LgB), different concentrations of acetic acid (HAc) and trichloroacetic acid (TCA) for the removal of proteins in raw milk, infant formula A and B, and yogurt were investigated.It was shown that TCA is better than HAc for eliminating of proteins in the above four samples.The proteins in 2 g of raw milk could be eliminated by 3 mL of 100 g/L TCA.0.5 g of infant formula A and B needs 5 mL of 10 g/L and 20 g/L TCA to remove the proteins, respectively.For 2 g of yogurt, 3 mL of 20 g/L TCA is enough.The present research may provide valuable information for protein-containing sample (such as raw milk, infant formula and yogurt) pretreatment.

Objective To investigate the effects of three different motor training regimens on motor function improvement after spinal cord injury (SCI) in rats.Methods Forty-five healthy,adult Sprague-Dawley rats (female),weight 260-300 g,were included.Six rats were selected as the normal group.A model of incomplete SCI at the T9 level was induced in the others using a modification of Allen's method.Nine rats died after the injury and were excluded.The other 30 rats were randomly divided into 5 groups:a 7 d control group,a 35 d control group,a bodyweight-supported-treadmill-training (BWSTT) group,a swimming training group and a wheel running group,with 6 rats in each group.The three training groups began exercising at the 8th day post surgery,30 min per day,5 days a week for 4 weeks.Locomotor function was evaluated by inclined plane tests,modified Tarlov scores,and the BassoBeattie-Bresnahan (BBB) scale before the operation and on the 1st,7th,14th,21st,28th,and 35th day post surgery.Histomorphological changes of the T9 level spinal cord and the gastrocnemius muscle were observed with light microscopy and electron microscopy,and the cross sectional areas and diameters of the gastrocnemius muscle fibers were calculated.Results ①In the BWSTT group and the swimming training group,locomotor function scores increased significantly at all time points compared with the two control groups.There was no significant difference in rehabilitative effect between the BWSTT group and the swimming training group.But compared with both control groups,improvement in the wheel running group was not significant.②After 4 weeks of training,histomorphological observation of the injured T9 spinal cord tissue and gastrocnemius muscle fibers showed that the improvement in the BWSTT group was the most significant.The edema of the injured T9 level spinal cord tissue had decreased,cell vascular degeneration had lessened,the morphology of the neurons and glial cells trended to perfect recovery and nerve fibers had proliferated significantly.③Comparing the cross sectional areas and diameters of gastrocnemius muscle fibers showed that the improved amyotrophy in the BWSTT group was the most significant.The average cross sectional area (55.34 + 14.46 μm2) and diameter (8.32 + 0.99 μm) were close to the normal group (55.49±13.84 μm2 and 8.37 +1.13 μm).The swimming training group also had great improvement (46.05±8.50 μm2 and 7.68 + 0.76 μm) compared with the 35 d control group,while improvement in the wheel running group was not significant.Conclusions All three motor training regimens can improve locomotor and neurologic function,but the effects of BWSTT and swimming are better than that of wheel running.

The noninvasive measurement of liver stiffness (LS) was evaluated by transient elastography (FibroScan) and the possible influencing factors from the patients' clinical situations including age, gender, liver inflammation represented by alanine transaminase (ALT) and total billirubin (TBIL) level, HBV replication (HBV DNA loads), portal vein pressure (portal vessel diameter, PVD), splenic thickness (SPT) and body mass index (BMI) were analyzed in patients with chronic hepatitis B (CHB). A total of 466 patients including 31 patients with acute-on-chronic liver failure (ACLF), and 435 patients with chronic hepatitis B (CHB) among which 82 patients were diagnosed with liver cirrhosis (LC) by clinical manifestations and liver B-type ultrasonic inspection were enrolled at Tongji Hospital from April to December 2009. LS was measured by a FibroScan device (EchoSens, France). Simultaneously, ALT and TBIL levels, HBV DNA loads, PVD, SPT and BMI in all patients were also tested. Forty-one healthy volunteers served as controls. The values of LS were correlated positively with ages of CHB patients and significantly higher in males than in females. In patients with BMI>28 kg/m(2) (obesity) and abnormal levels of ALT and TBIL, LS values were significantly increased as compared with those having normal levels of ALT and TBIL. The patients with ACLF had the highest LS value. Furthermore, LS values in the patients with LC were significantly higher than those in patients without LC. It is concluded that noninvasive measurement of liver fibrosis by FibroScan provides an alternative method to evaluate liver fibrosis of patients with CHB. In order to properly illustrate the stiffness value taken by transient elastography, patients' gender should be taken into consideration and it is also suggested to avoid possible influencing factors including liver inflammation (high levels of ALT and TBIL) and obesity (high BMI).

Objective To analyze the change of cysteinyl leukotriene ( Cys-LTs) levels and 8-Isopros-tane (8-iso-PG) levels in the exhaled breath condensate (EBC) of asthmatic children from acute exacerbation to clinical remission, and investigate the role of the detection of Cys-LTs and 8-iso-PG in EBC in its severity and pathogenesis , and explore the relationship between the Cys-LTs and 8-iso-PG through measuring Cys-LTs levels and 8-iso-PG levels in the EBC of asthmatic children. Methods The outpatient or inpatient asthmatic children of the pediatrics and a group of healthy children were studied. All subjects′ EBC were collected by the R-Tube produced by American Respiratory Research. The concentration of Cys-LTs and 8-iso-PG in EBC were measured by enzyme-linked immunosorbent assay (ELISA), and compared among children in asthmatic exacerbation, asthmatic remission, and healthy condition. The relevance of their change would be explored at the same time. Results (1) Cys-LTs levels in EBC were higher in asthma exacerbation, compared to healthy controls (P<0. 05), while no significant difference were found between asthmatic remission and asthmatic exacerbation or healthy controls ( P>0. 05 ) . ( 2 ) 8-iso-PG levels was higher in asthmatic exacerbation compared to asth-matic remission ( P<0. 05 ) . Moreover, the 8-iso-PG levels were significantly higher in asthmatic remission than in healthy controls (P<0. 05). (3) Through the relevance analysis of the Cys-LTs and 8-iso-PG levels in EBC among the three groups, Cys-LTs levels in EBC of asthmatic exacerbation significantly were correlated with 8-iso-PG levels (n1 =35, r1 =0. 61, P<0. 05), while there was no significant correlation between 8-iso-PG levels and Cys-LTs levels in asthmatic remission. Conclusion The increase of 8-iso-PG levels in EBC of bronchial asthmatic patients correlates with the disease and its control. Therefore, 8-iso-PG can be an objective indicator for asthmatic diagnosis and healing efficacy. Cy-LTs levels increase in the EBC of bronchial asthmatic according to disease severity. The two levels correlate during asthmatic exacerbation, indicating that a link be-tween airway oxidative stress and inflammation among asthmatics.

OBJECTIVETo explore the anatomic basis and clinical application of the horn shaped perforator flap pedicled with the angular artery for the reconstruction of midface defect.

METHODS(1) 10 fresh cadavers were perfused with a modified guiding oxide gelatin mixture for three-dimensional visualization reconstruction using a 16-slice spiral computed tomography scanner and specialized software (Materiaise' s interactive medical image control system, MIMICS). The origin and distribution of the angular artery perforator were observed. (2) Between July 2012 and July 2014, twenty-one patients underwent operations for the reconstruction of midface defect. Ten patients had squamous cell carcinoma, nine patients had basal cell carcinoma and two patients had nevus. The flaps' size ranged from 1.5 cm x 3.5 cm to 2.5 cm x 5.0 cm.

RESULTSThe facial artery branches the lateral nasal artery 1 cm from the outside corner of the mouth, subsequently strenches to inner canthus continuing as the angular artery. The angular artery anastomoses extensively with the dorsal nasal artery and the infraorbital artery. All the flaps survived. The patients were satisfied with the final aesthetic and functional results.

CONCLUSIONSThe flap can be designed flexibly and simply with reliable blood supply. The donor sites could be closed directly without skin graft, it is a simple and fast method for the reconstruction of midface defect.

Anastomosis, Surgical ; methods ; Arteries ; anatomy & histology ; Cadaver ; Carcinoma, Basal Cell ; surgery ; Carcinoma, Squamous Cell ; surgery ; Face ; blood supply ; Facial Neoplasms ; surgery ; Humans ; Nevus ; surgery ; Nose ; blood supply ; Perforator Flap ; blood supply ; transplantation ; Skin Neoplasms ; surgery ; Skin Transplantation ; Software ; Tomography, Spiral Computed

BACKGROUND: The graft versus host disease (GVHD) is the main reason for allogeneic hematopeic stem cell transplantation (allo-HSCT) failure, and oral tolerization is a newly developed treating method.OBJECTIVE: To evaluate the inhibition effect of acute GVHD induced by feeding donors with recipient splenocytes orally before allo-HSCT in a murine model and to compare the immune tolerance with immunosupression agents currently used in clinical treatment.DESIGN, TIME AND SETTING: A randomized grouping design of contrast observation was performed at the Center Laboratory of School of Medicine, Southeast University in December 2008.MATERIALS: The male C57BL/6J(H-2~b) mice were served as donors, and the female (BALB/C) mice (H-2~d) were served as recipients.METHODS: The mice were prepared allo-HSCT/GVHD models, and divided into 5 groups, which received prevent scheme. ①Oral tolerization group: C57BL/6J mice were fed with BALB/C (H-2~d) splenocytes before the transplantation, with dose of 10 μg per time, 1 day interval, for 3 times. ②Rapamycin group: mice were intragastric administrated rapamycin from the 1st after transplantation with dose of 1.5 mg/(kg·d). ③Ciclosporin A+ methotrexate group: mice were intragastric administrated ciclosporin A with 1.5 mg/(kg·d), increased to 5 mg/(kg·d) when mice were recovered the gastrointestinal function, and received intragastric administrated 0.4 mg/(kg·d) methotrexate at days 1, 3, 6 and 11 after transplantation. ④Blank control group: no medication after transplantation. ⑤Irradiation group: mice were received no transplantation.MAIN OUTCOME MEASURES: The presence of GVHD after allo-HSCT, and the difference of immune tolerance index.RESULTS: Typical GVHD symptoms occurred in all mice after transplantation. In the blank control group, most mice dead at days 14-18 and the mortality was nearly 100%. Compared to the blank control group, the symptoms were significantly ameliorated and the median survival times were extended in the other 3 transplantation groups (P < 0.05). The pathological structures in liver, intestine and skin tissue in the oral tolerization group were significantly decreased. Flow cytometry assay showed that oral tolerization significantly increased the CD4~+/CD8~+ lymphocyte ratio and the percentage of the CD4~+CD25~+ cells.Oral tolerization also induced the decrease of GVHD-related cytokine level. The MTT results also showed that the immunologic tolerance in the oral tolerization group was significantly enhanced and the proliferation of lymphocyte was suppressed.CONCLUSION: Oral tolerization has obviously inhibitory effect towards GVHD after allo-HSCT, its exact mechanism may be due to the suppressing the proliferation of lymphocyte and increase the immunologic tolerance in recipients. Compared to the widely used immunosuppressive drugs, oral tolerization exhibits strong ability in ameliorating GVHD.

Objective To propose a practical method for moderate-to-server cup-ear correction.Methods Auricular reconstruction was performed in a manner of two-stage approach with mastoid flap and costal cartilage support.In the first stage,the autogenous costal cartilage framework was inserted under the retroauricular mastoid skin flap.The corrected ear was raised in the second operation and wound was closed with grafting skin.Results Satisfaction of appearance was achieved for totally 18 cases except one case of partly necrosis of cartilage.They were followed-up for 3-26 months.Conclusions This integrative two-stage approach of mastoid flap combining three dimensional costal cartilage is safe and effctive for moderate to severe cup-ear correction,which brings about good appearances and symmetry.The complications are in control.

Objective To investigate the effects of carboxymethytl pachymaram ( CMP ) on the methylation of SOCS-1 (suppressor of cytokine signaling-1) gene and the in vitro maturation of human mono-cyte-derived dendritic cells (DCs).Methods Human DCs were induced from the peripheral blood mono-cytes in vitro with the treatment of recombined human GM-CSF and interleukin-4 ( IL-4 ) and cultured with different concentrations of CMP (10, 50, and 100 mg/L).The methylation and expression of SOCS-1 gene were analyzed by methylation-specific polymerase chain reaction (MSP) and real-time PCR, respectively. The phenotypic markers of DCs were detected by flow cytometry .Mixed lymphocyte reaction ( MLR) and ELISA were performed to measure the lymphocyte proliferation induced by DCs and IL-12 secretion by DCs . Results CMP promoted the methylation of SOCS-1 gene, but inhibited the expression of SOCS-1 gene in dendritic cells at the concentrations of 50 mg/L and 100 mg/L.The expression of phenotypic markers (CD80, CD83, CD86 and HLA-DR), IL-12 secretion and lymphocyte proliferation induced by DCs were significantly enhanced in a dose dependent manner with the treatment of CMP .Compared with control group , the levels of methylated SOCS-1 gene and IL-12 and the lymphocyte proliferation index were increased upon the stimulation with 50 mg/L and 100 mg/L of CMP (P<0.01), but the expression of SOCS-1 gene was de-creased.The expression of CD80, CD83 and HLA-DR on DCs in the presence of 100 mg/L of CMP were higher than those of control group (P<0.05).Conclusion CMP could induce the methylation of SOCS-1 gene and the maturation of DCs derived from peripheral blood monocytes .