Objective To compare the effects of different moist environment for treating severely burned patients.Methods From November 2009 to December 2014 in the Burn Unit of Hainan General Hospital, 170 hospitalized patients with severe burns were randomly equally divided into observation group and control group.The patients of control group were treated with the traditional wet therapy treatment, while of the observation group were given the closed moist therapy treatment.The wound healing, pain relief and adverse reactions were observed.Results All patients completed the treatment,and the cure rates at the 7th and 14th day of treatment in the treatment group were 80.0％ (68/85) and 97.6％ (83/85), significantly higher than those of the control group (52.9％ (45/85), 89.4％ (76/85), x2 =8.344,4.111, P ＜ 0.05).The number of dressing changes((7.44±2.39) times), cumulative dressing time ((45.98 ± 13.29) min) and wound healing time ((14.98±4.33)d) in the observation group were significantly less than those in the control group((11.76 ±3.14) times, (87.03 ± 14.99) min), (18.87 ± 5.13) d)), the differences were statistically significant (t =6.349,6.540,3.111, P＜0.05).After treatment, the pain scores were showed clear downward trend, with had significant difference compared before treatment (P＜0.05), while the pain scores at the 7th day((3.10± 1.34) scores) and 14th day((1.76±0.67) scores) of treatment in the treatment group were significantly lower than the control group((4.09±0.89) scores, (3.11±0.56) scores, P＜0.05).The incidence of adverse events during treatment in both groups were 5.9％, obviously improved after symptomatic treatment.Conclusion The moist environment conducive to the treatment of severely burned patients, and safety.Conclusion to traditional wet therapy, closed moist therapy has better cure rate of severe burns, can promote wound healing, relieve pain and shorten the dressing cycle time.

Objective To investigate the correlation between the degree of pathogenetic condition and cogni-tive impairment in young OSAHS patients. Methods Sixty-three patients (18～44 years old) were divided into 3 groups according to the assessment criteria regarding the degrees of pathogenetic conditions of hypoxemia and its persistence time: mild group(the lowest SaO2 ≥ 85 %, n = 20 ), moderate group (the lowest SaO2 : 65 ～ 84 %, n =24), and severe group (the lowest SAO2<65%, n= 19). Twenty-five healthy young adults were selected as the control group. All the subjects were tested with event-related potential, namely P300, the polysomnogram and the mini-mental state examination scale(MMSE). Results P300 latency in patients of three OSAHS groups was sig-nificantly prolonged as 326.1±12.7, 346.9±19.1, and 34.9±18.3 ms, as compared with those of control group: 311.9±18.3 ms (P< 0.05, respectively). In severe group, P300 latency was markedly increased compared with mild and moderate groups(P<0.01, P<0.05, respectively). No obvious differences were observed between mild and moderate groups(P=0. 095). The difference of hypoxemia lasting time could influence the P300 latency, such as when the hypoxemia lasting time was 4～60 seconds, the latency was 338. 12±13.7 ms, and when the hypoxemia lasting time increased to 60 ～ 140 s, the latency was prolonged to 354.74±16.7 ms(P = 0. 031 ). There was no difference among all groups in the P300 amplitudes. The MMSE scores for all patients were within normal limits andthere were differences between serve and control group(RA -RB=9. 91, P= 0. 003). Conclusion Among patients with OS-AHS, the impairment of cognitive function is con'anon. The degrees of pathogenetic conditions of hypoxemia and its lasting time may be used to evaluate the impairment degree of cognitive function in patients with OSAHS.

Objective To analyze the misdiagnosis in extraovarian peritoneal carcinoma(EOPC). Methods The clinical manifestation, blood tumor marker, imaging examination, laparotomy, pathology, treatment and prognosis of 19 EOPC patients were retrospectively analyzed. Results The clinical symptoms were abdominal distention, abdominal pain and swelling. 17 cases were tested for blood CA-125 with 15 at abnormaly high level, and in 4 cases ascites was CA-125 positive ( ＞ 10 KU/L). Tumor cells were detected in the ascites in 12 cases. Three cases were misdiagnosed as of uterine origin, 13 cases misdiagnosed as adnexal tumor, 1 case was misdiagnosed as bladder and intestinal tumor. Only 2 cases were correctly diagnosed before the operation. All of the cases were pathologically proved as peritoneal carcinoma. The five-year survival rate was only 20 percent. Conclusions Abdominal distention and pain with unknown causes were the primary manifestations of EOPC, elaborate physical examination sometimes may provide with important information. The significant elevation of serum CA-125 and the ascites cytology may be helpul for the differential diagnosis of PPC. CT scan is valuable for the diagnosis of EOPC.

Objective To compare the short-term efficacies of laparoscopic adjustable gastric banding (LAGB) and laparoscopic sleeve gastrectomy (LSG) in the treatment of obesity and type 2 diabetes mellitus,and to investigate the relationship between the body weight loss and the decrease of glucose of the 2 treatment methods.Methods The clinical data of 40 patients with obesity combined with type 2 diabetes mellitus who were admitted to the Changhai Hospital of the Second Military Medical University from January 2010 to December 2011 were retrospectively analyzed.There were 14 patients treated by LAGB (LAGB group) and 26 by LSG (LSG group).The body weight loss and the decrease of glucose at postoperative year 1 of the 2 groups were compared.The differences in the body weight and glucose before and after operation within groups were compared using the paired t test,and the differences in the body weight and glucose between the 2 groups were compared using the multiple analysis of variance.The correlation between the body weight loss and the decrease of glucose was analyzed using the linear regression analysis.Results Laparoscopic surgery was successfully done without conversion to open surgery or intraoperative complications.The operation time and volume of blood loss were (69 ± 16)minutes and (31 ± 14)mL in the LAGB group,(120 ± 15) minutes and (148 ± 48) mL in the LSG group.Complications including postoperative malnutrition,electrolyte disturbance,delayed gastric emptying,bleeding,anastomotic leakage did not occurr in the 2 groups.Two patients were complicated with abdominal incision fat liquefaction,and were cured by symptomatic treatment.(1) The body weight,body mass index (BMI) and waistline had a decrease trend.The body weight,BMI and waistline in the LAGB group were decreased from (117 ± 28)kg,(40 ± 8)kg/m2 and (118 ± 15) cm before operation to (94 ± 28) kg,(33 ± 8) kg/m2 and (92 ± 15) cm at postoperative week 48.The body weight,BMI and waistline in the LSG group were decreased from (119 ± 25)kg,(42 ± 6)kg/m2 and (123 ± 14)cm before operation to (74± 16)kg,(26± 4)kg/m2 and (86 ± 13)cm at postoperative week 48.The EWL had an increase trend in the 2 groups.The EWL in the LAGB group was increased from 7％ ± 2％ at postoperative week 1 to 53％± 24％ at postoperative week 48,and the EWL in the LSG group was increased from 11％ ± 4％ at postoperative week 1 to 90％ ± 20％ at postoperative week 48.There were significant differences in the changes of body weight,BMI,waistline and EWL between the 2 groups (F =60.660,74.490,57.650,90.020,P ＜ 0.05).(2) The levels of glycosylated hemoglobin,fasting glucose,fasting insulin,HOMA-IR,triglyceride,total cholesterol,low-density lipoprotein and high density lipoprotein in the LAGB group were decreased from 8.1％± 0.8％,(8.4±0.6)mmol/L,(21±8)μmol/L,7.9 ±2.9,(1.68±0.50)mmol/L,(6.0±1.1)mmol/L (4.1 ± 0.8) mmol/L,(1.09 ±0.15)mmol/L to 6.4％ ±0.8％,(6.3 ±0.3) mmol/L,(10 ± 3) μmol/L,2.7 ±0.9,(1.04 ± 0.09) mmol/L,(4.3 ± 0.8) mmol/L,(2.3 ± 0.4) mmol/L,(1.22 ± 0.09) mmol/L at postoperative week 48 ; the levels of glycosylated hemoglobin,fasting glucose,fasting insulin,HOMA-IR,triglyceride,total cholesterol,low-density lipoprotein and high density lipoprotein in the LSG group were changed from 7.9％ ± 1.0％,(9.0±1.0)mmol/L,(21 ±9) μ mol/L,8.5 ±3.5,(2.09 ± 0.70) mmol/L,(6.0 ± 1.2)mmol/L,(3.9 ± 1.1) mmol/L,(1.06 ± 0.21) mmol/L before operation to 5.1％ ± 0.8％,(5.2 ± 0.4) mmol/L,(4 ± 1)μmol/L,0.9±0.2,(1.22±0.17)mmol/L,(4.2±0.8)mmol/L,(2.3 ±0.6)mmol/L,(1.30±0.13)mmol/L at postoperative week 48.There was a decrease trend of the glycosylated hemoglobin,fasting glucose,fasting insulin,HOMA-IR,trigluceride,total cholesterol and low density lipoprotein and a increase trend of the high density lipoprotein in the 2 groups.There were significant differences in the levels of glycosylated hemoglobin,fasting glucose,fasting insulin,HOMA-IR,triglyceride,total cholesterol,low-density lipoprotein and high density lipoprotein between the 2 groups (F =57.650,74.270,36.750,42.960,10.870,30.650,32.560,11.490,P ＜0.05).The levels of glucose of the LAGB group at postoperative month 1 and 3 were influenced by BMI (b =0.543,0.753,P ＜ 0.05),while the levels of glucose of the LAGB group did not be influenced by BMI at postoperative month 6 and year 1 (b =0.130,0.222,P ＞0.05).The levels of glucose of the LSG group did not be influenced by BMI at postoperative month 1,3,6 and year 1 (b =0.185,0.035,0.212,0.126,P ＞0.05).Conclusions The efficacy of LSG is superior to LAGB for the treatment of obesity combined with type 2 diabetes mellitus.The efficacy of LAGB is correlated with the change of body weight,while the efficacy of LSG does not correlated with the change of body weight.

Objective To determine the clinical characteristics and its effect on the clinical efficacy of residual bony impingement lesion after hip arthroscopic osteoplasty for pincer-type femoroacetabular impingement.Methods There were 30 patients who underwent hip arthroscopic osteoplasty for isolated pincer-type femoroacetabular impingement from December 2010 to January 2012 and had a minimum follow-up period of 2 years,including 21 males and 9 females.The average age at surgery was 34.5 years (range from 28-42 years).All of the patients had no advanced hip arthritis and the T(o)nnis grade was 0-2.Radiological evaluation was performed by 3-dimensional CT.According to residual rate,these patients were divided into 3 groups:residual rate ＜10％ group,residual rate of 10％-20％ groups and residual rate ＞20％ group.Results The average follow-up period was 26.3 months (range,22-34 months) and nineteen cases had residual bony impingement lesion after surgery.Among them,84.2％ of the residual bony impingement lesion was posterior to the acetabular actual resection zone.The preoperative and postoperative bony impingement angle were 77.47°±21.31° and 12.94°±18.04°,respectively.The residual rate was 16.7％± 8.83％.The modified Harris hip score got significantly improved from 55.18±7.96 preoperatively to 94.71±4.39 postoperatively.The overall satisfactory rate was 76.7％,and the postoperative modified Harris hip score for these three groups was 95.86±1.71,95.23±1.99 and 85.52±6.41,respectively.The postoperative modified Harris hip score in residual rate ＞20％ group was significantly worse than those in other two groups.The satisfactory rate was 92.9％,80.0％ and 33.3％,respectively.The satisfactory rate in residual rate ＞20％ group was significantly worse than those in other two groups.There was a significant negative linear relationship between the residual rate and postoperative modified Harris hip score (R2=0.516,P=0.001).Conclusion The incidence of residual bony impingement lesion after hip arthroscopic osteoplasty for pincer-type femoroacetabular impingement was 63.3％.The residual rate was 16.7％.The residual impingement lesion was mainly at the posterior part of the acetabulum.The patients with residual rate ＞20％ got significantly worse clinical score and satisfactory rate.

Objective:To compare therapeutic effects and safety of intracoronary (IC ) abciximab and intravenous (IV) abciximab on ST‐elevation myocardial infarction (STEMI) . Methods:The databases of PubMed ,Cochrane Central Register of Controlled Trials ,Chinese Biomedical Literature Database (CBM) and CNKI were retrieved on computers for collecting randomized controlled trials (RCTs) about comparison of therapeutic effects between IC abciximab and IV abciximab published from Jan 1993 to Jun 2014. At the same time ,the data included literature , conference abstracts and related websites were retrieved manually .The data of eligible RCTs were extracted and re‐ceived meta‐analysis using RevMan5.0 software .Results:A total of seven RCTs were enrolled .Meta‐analysis indi‐cated that incidence rate of recurrent myocardial infarction in IC abciximab group was significantly lower than that of IV abciximab group (OR= 0.61 ,95% CI:0.40~0.92 , P=0.02 );there were no significant difference in all‐cause mortality (OR=0.85 ,95% CI :0.59~1.23 ,P=0.39) ,target vessel revascularization rate (OR=0.66 ,95%CI :0.40~1.09 , P=0.10) and incidence rate of major bleeding (OR=1.00 ,95% CI :0.68~1.47 , P=0.99) be‐tween IC abciximab group and IV abciximab group . Conclusion:The IC abciximab can more significantly reduce in‐cidence rate of recurrent myocardial infarction in STEMI patients .

Objective To observe the efficacy of imatinib on the treatment of bcr-abl positive essential thrombocythemia (ET). Methods A case of bcr-abl positive ET resistant to hydroxyurea (HU) treating with imatinib (200～400 mg/d) was reported and related literatures were reviewed. Results A case of bcr-abl positive ET was initially treated with 1.5～2.0 g/d HU, the platelet count decreased to 562x109/L after 4 weeks; however, the platelet count increased to (1020～1330)×109/L treating with same dose of HU 16 months later. With the elevation of HU to 3.0 g/d, platelet count was still high(1290～1780)x109/L companied with the very low white blood cell count(0.3～0.9)×109/L. While treating with imatinib (400 mg/d) for 1 month,the platelet count decreased to 390×109/L and white blood cell count was 0.5×109/L; Furthermore, treating with 200×300 mg/d of imatinib, the platelet and white blood cell count recovered in normal after 1 month,and bcr-abl fusion gene negative 2 months later. Conclusion Imatinib may be the effective targeting drug for the bcr-abl positive ET, and the bcr-abl positive ET is sensitive to low dose imatinib.

Humans ; Fractures, Bone/etiology* ; Bone and Bones/diagnostic imaging* ; Disability Evaluation

Objective To study the clinical effect and complications of modified autogenous fat grafting for breast augmentation.Methods The datas of 29 patients with improved autogenous fat grafting for breast augmentation and 32 patients with traditional autogenous fat grafting for breast augmentation were summarised.The adipocyte survival rate,complications and patient satisfaction survey after 3 and 6 months of transplantation were evaluated.PAAG breast augmentation and normal breast tissue specimens were detected by HE staining and immunofluorescence staining to analyze the safety of autogenous fat grafting for breast augmentation.Results Both of adipocyte survival rates and satisfaction of patients who recieved improved autogenous fat grafting were significantly higher than those of patients with traditional autogenous fat grafting(P ＜ 0.05),both two methods with less complications,the difference was not significant (P ＞ 0.05).The immunofluorescence tests showed that there was no inflammatory reaction and immune dysfunction of autogenous fat grafting,which had no difference with the results of the normal tissues (P ＞ 0.05).Conclusion Autogenous fat grafting for breast augmentation is safe and reliable,and modified autogenous fat grafting for breast augmentation can obviously increase the adipocyte survival rate after transplantation.

Objective To identify differently expressed genes and pathways between Kashin-Beck disease (KBD) cartilage and healthy cartilage,and to explore the mechanism of articular cartilage lesions of KBD.Methods Cartilage specimens were collected from 9 patients with KBD and 9 healthy controls.Total RNA was extracted from cartilage specimens,and transcribed into cDNA.KBD and control groups were labeled by Cy3 and Cy5,respectively.Agilent genome-wide microarray was applied to compare the expression profile of KBD cartilage and healthy cartilage.The microarray data was analyzed by single gene and pathway expression analysis to identify differently expressed genes and pathways between KBD and healthy controls.Results ①Tweenty nine genes were significantly up-regulated in KBD group (averaged ratio =6.68 + 1.98,P ＜ 0.05),mainly involved in apoptosis,metabolism,extracellular matrix,cytoskeleton and cell movement.Additionally,extracellular matrix-related FBLN1 gene was down-regulated in KBD group(ratio =0.14 + 0.06,P ＜ 0.05).②Five apoptosis and 6 hypoxia-related pathways presented higher expression levels in KBD compared to healthy controls(all P＜ 0.05).Conclusions We find significant expression differences of apoptosis and hypoxia-related genes and pathways between KBD cartilages and healthy cartilages,suggesting that hypoxia might contribute to chondrocytes apoptosis of KBD.Further studies may be needed to investigate the relationship between hypoxia and articular cartilage lesions of KBD.