Objective To evaluate the clinical application and effect of plastic surgery in emergency treatment of facial soft tissue injuries,and to explore the better plastic surgery method for facial soft tissue injuries in order to regain the patient facial morphology and function maximally.Methods The clinical data of 798 patients with facial soft tissue injuries from June 2009 to June 2011 were analyzed retrospectively.And plastic surgical techniques were applied to the early treatment of facial soft tissue injuries in this group cases,according to the size of defect and the degree of deformity of the patient,different plastic surgery treatment was chosen,such as skin flap or skin graft to repair wound surfaces.In this process,one must follow sterile noninvasive principle strictly with emphasis on the technique of plastic surgery such as entire debridement,wound healing application of skin flap and so on.Results 790 cases of facial soft tissue injuries were healed by first intention without significant complications,while 8 cases of them had mild scars.During 6 to 12 months of follow-up,neither scar,nor infections and necrosis of the wound region occurred,and the morphology and function of patients' face recovered well without the second operation.Conclusions Using plastic surgery techniques in the emergency treatment of facial soft tissue injuries as soon as possible can avoid the disfigurement and the function disturbance,and promote the facial morphology and function regeneration rapidly and effectively.

Objective To explore the clinical value of diffusion weighted imaging (DWI) in the diagnosis of breast disease ,and compared with ultrasound and mammography .Methods The clinical data of 28 patients who were pathologically confirmed with breast cancer were retrospectively reviewed .The diagnostic accuracy of DWI ,mammogra-phy and ultrasound , the surface diffusion coefficients ( ADC value ) were statistically analyzed .Results ( 1 ) DWI scan:the diagnostic accuracy of malignant tumor was 90.9%(20/22),the ADC value of malignant tumor was (0.955 ±0.199) ×10 -3mm2/s;the diagnostic accuracy of benign lesions was 83.3%(5/6),the average ADC value of benign lesions was (1.660 ±0.339) ×10 -3 mm2/s,there were statistically significant differences ( t=2.371,P<0.05).(2)Mammography:the diagnostic accuracy of malignant tumor was 81.8%(18/22),the diagnostic accuracy of benign lesions was 33.3%(2/6).(3) Ultrasound:the diagnostic accuracy of malignant tumor was 86.4%(19/22),the diagnostic accuracy of benign lesions was 50.0%(3/6).The diagnostic accuracy of malignant tumor had no significant difference among three techniques (χ2 =0.752,P>0.05),but for the diagnostic accuracy of benign lesions,DWI was better than ultrasound and mammography ,the difference was statistically significant (χ2 =6.146, P<0.05).Conclusion For the diagnosis of malignant breast tumors and benign lesions ,DWI is better than ultra-sound and mammography ,which has high clinical application value .

OBJECTIVE:To discuss the ways to improve the drug control outcome in China and to facilitate the related system reform.METHODS:The causes and countermeasures for the failure of drug control policy in China were analyzed comparatively using economic theory.RESULTS & CONCLUSIONS:Information dissymmetry in the medicine area,monopoly of medical institution and their evasion of control etc all resulted in the failure of price control policy.To avoid this failure,it is necessary to take reform measures in many aspects,enhance the scientificity of price control,and improve the conduction mechanism of price control policy.

The fasting blood sugar (FBS), blood insulin (INS), insulin sensitivity index (ISI) and resistant hormone of INS in 46 patients with NIDDM were observed before and after the treatment. It was showed that the good effect was achieved in the cases by acupuncture and moxibustion, while the contents of FBS and INS in plasma were all decreased and ISI was increased in the cases treated by acupuncture and moxibustion, the degree of decrease of FBS and INS, and increase of ISI being closely related to therapeutic effect. The level of resistant hormone of INS and lipid in patients tend to normal level. Acupuncture and moxibustion had a good regulatory effect on the function of endocrine,sugar and lipid metabolism. It suggests that IR can be corrected by acupuncture and moxibustion,which is a key to therapeutic effect.

Objective To study the effect of S1P on HLF cell fibrosis and its mechanism. Methods (1) The expression of ECM in HLF cells was analyzed by using Western Blot after treatment by S1P(1 μmol/L), FTY720-P(5μmol/L),ponesimod(5μmol/L)and SEW2871(5μmol/L)24 h;(2)The HLF cells were pre-treated using selective S1PR antagonist W146(1 μmol/L),JTE-013(0.2 μmol/L),and TY-52156(1.25 μmol/L)1 h before incubation by S1P and S1PR agonists 24 h and then the expression of ECM was analyzed;(3)The HLF cells were pre-incubated using JTE-013(0.2μmol/L)and TY-52156(1.25μmol/L)for 1 h and then the expression of ECM was analyzedafter being treated by S1P and S1PR agonists 24 h. Results (1)S1P and selective S1P receptor agonist increased the expression of ECM to various extents;(2)The S1P1R antagonist W146 did not affectthe expression of ECM induced by S1P and S1PR agonists and S1P2R antagonist JTE-013 and S1P3R antagonist TY-52156 both decreased the expression of ECM induced by S1P and S1PR agonists;(3)The expression of ECM induced by S1P and S1PR agonists further decreased using both JTE-013 and TY-52156 but not using ponesimod. Conclusion S1P2R and S1P3R are activated under the influence of S1P so as to increase the synthesis of ECM and promote fibrosis gene expression in HLF cells.

Objective To explore the application of serum SELDI proteomic patterns to screen breast cancer biomarkers.Methods Serum protein profiles of 110 breast cancer patients and 100 healthy controls were analyzed with surface-enhanced laser desorption/ionization time-of-flight mass spectrometry (SELDI-TOFMS).The spectra were generated on weak cation exchange (WCX2) chips and protein peaks clustering and classification analyses were made using Biomaker Wizard software.Differences in protein intensity between breast cancer cases and controls were measured with the Mann-Whitney U test and adjusted for confounding in a multivariate logistic regression model.Results Forty-nine of these proteins were found to have statistically differential expression levels between breast cancer and normal control sera (P ＜ 0.05).Based on literatures reported,six protein biomarkers,with mass-to-charge ratio (M/Z) (4376,8126,8924,3264,3968,and 9180) were selected.Proteins with M/Z 4376,4126,and 8924 were statistically significantly decreased in breast cancer cases compared to those in healthy controls (P ＜ 0.05).Proteins with M/Z 3264,3968,and 9180 were significantly increased in breast cancer cases compared to those in healthy controls,Protein with M/Z 9180 was associated with TNM stage and Her-2 expression in breast cancer (P ＜ 0.05).Protein with M/Z 8926 was related with lymph node metastasis (P ＜0.05).Conclusion These results suggest that serum SELDI protein profiling can distinguish breast cancer patients from normal subjects with relatively high sensitivity and specificity.SELDI-TOF-MS plays a valuable role in the diagnosis of breast cancer and the discovery of new tumor-specific protein biomarkers.

Objective To explore the changes of elasticity in the large arteries and its clinical significance of sublingual administration of nitroglycerin in patients with elevated PWV,and mild and moderate essential hypertension.Methods Totally,779 patients with mild and moderate hypertension and PWV more than 1400 cm/s were selected and divided into four groups,one with simple hypertension,the second one with only one risk factor for it,the third one with two risk factors,and the fourth one with three risk factors or damage in their target organs.Sublingual administration of 0.5 mg nitroglycerin was administered and blood pressure and PWV were measured for all of them.and data were statistically compared and analyzed by groups and before and after nitroglycerin administration.Results Systolic blood pressure decreased to(135±20)mm Hg from(149±15)mm Hg,pulse pressure decreased to(50±11)mm Hg from(59±12)mm Hg,PwV decreased to(1329±288)cm/s from(1688±378)cm/s,respectively,after nitroglycerin treatment for hypertensive patients(t=3.036,2.473,3.885,all P＜0.05).Improvement of elasticity of the large arteries in them after nitroglycerin treatment inversely correlated with the number of risk factors for hypertension they had,with 89.1 percent,74.3 percent,72.6percent and 44.0 percent of improvement in PWV,respectively for those with simple hypertension,only one risk factor.two risk factors and three risk factors or with damage in target organs.Conclusions Systolic blood pressure and pulse pressure significantly correlated with elasticity of the large arteries in hypertensive patients,and their stifiness improved after sublingual administration of nitroglycerin due to decrease in systolic blood pressure and pulse pressure.The more risk factors the hypertensive patients had,the poorer elasticity of their large arteries and less sensitive to nitroglycerin treatment were.

Objective To investigate the dementia caregivers' awareness of dementia diagnosis for patients aged≥80 years in veterans community in Beijing.Methods Patients aged 80 years and over who were diagnosed as dementia were selected from Dec.2009 to Jul.2011 in the veterans community in Beijing.A face-to-face interview and questionnaire survey were conducted in dementia caregivers individually,including basic social demographic data (gender,age,educational background),awareness rate of dementia,treatment and drug use situation and their attitude to dementia patients.Results A total of 118 caregivers were investigated individually.The caregivers in this study were mainly the spouse of the patients,and most of them were elderly people.46.6％ (55/118) of caregivers were the spouse of the patients,and 52.5％ (62/118) of caregivers were 65 years old and over.The caregivers' awareness rate of dementia was 32.3％ (38/118) when patients were diagnosed as dementia.There was no correlations of gender,age and educational background with the awareness rate of dementia diagnosis (all P＞0.05).50％ of dementia patients received the dementia treatment,and only 17.8％ (21/118) of patients got the first line drug treatment for dementia (acetylcholinesterase inhibitors and / or memantine).98.3 ％ (116 / 118) of caregivers agreed that the dementia patients should be treated kindly.Conclusions The dementia caregivers are mainly patients' spouse in veterans community and most of them are the elderly.The awareness rate of dementia diagnosis is low among the caregivers.Most patients do not take the formal treatment.The social support for the dementia caregivers should be strengthened.

Aim To study the effects of telmisartan upon serum calcineurin.Methods 92 male SD rats with the same age were randomly divided into control group (N), sham operation group (S), 2K1C+distilled water group (K) and 2K1C+telmisartan group (T).S rats were performed the open-abdomen surgery without being restricted any renal artery, but the K and the T rats were restricted their left renal artery. Beginning from the third week after the surgery, the K rats started to be treated with the intragastric infusion of distilled water 10 ml·(kg·d)~(-1) , while the T rats with telmisartan 10 mg·(kg·d)~(-1) .And after being treated for 2, 4 and 8 weeks, rats were respectively measured the systolic blood pressure (SBP), the diastolic blood pressure (DBP) of the abdominal aorta. Before and after the operation, ultrasonography with probe of 7.5 MHz was used to obtain the structure and functional indexes, such as IVSd, IVSs, LVPWd, and serum calcineurin were evaluated by ELISA and colorimetric assay kit.Result Compared with the S group and the N group, ① the results of blood pressure (SBP, DBP) were significantly higher in K group (all P <0.01), after use of telmisartan, blood pressure was significantly reduced(P <0.01);② the thickness of interventricular septal and left ventricular posterior wall at the end of diastolic and systolic were significantly higher in K group (all P <0.01), after use of telmisartan, the thickness of those declined(all P <0.01);③ the level and activity of serum calcineurin were significantly higher in K group (all P <0.01), after use of telmisartan, the level and activity of calcineurin significantly fell(P <0.01).Conclusion The serum calcineurin of artery was also raised in the left ventricular remodeling. Telmisartan ameliorates ventricular remodeling effectively, which may be associated with decreasing the expression of artery serum calcineurin.

A 21-year-old male was hospitalized for recurrent swelling of lower limbs (lymphedema) for 1 year and worsening of it for 1 week.Physical examination revealed several smooth,firm enlarged lymph nodes of the neck,groin without apparent tenderness measuring about 1 cm in diameter.Cardiac and pulmonary auscultation showed no obvious abnormality.The abdomen was soft on palpation without tenderness or rebound tenderness.Skin examination revealed swelling of both lower limbs,especially the left lower limb,as well as scattered irregularly sized,dark erythematous patches with a wood-like consistency on the swollen lower limbs,with high temperature but no tenderness.Elevated peripheral eosinophil count was observed before and after admission,with the eosinophil percentage higher than 70％.Vascular ultrasonography showed thrombosis in the right anterior tibial artery,left dorsal artery of foot and lower portion of the left great saphenous vein.Multiple enlarged lymph nodes were found by computed tomography in the mediastinal,bilateral axillary,retroperitoneal regions and around the abdominal aorta.Lymph node and bone marrow biopsies showed eosinophilia.Histopathology of lesions on the extensor aspect of the left medial thigh and left lateral malleolus showed massive eosinophilic infiltration and lymphatic dilation in the dermis,as well as eosinophil emboli in some lumens.The FIP1L1-PDGFRA fusion gene was undetected.A diagnosis of idiopathic hypereosinophilic syndrome was finally made.The symptoms rapidly regressed after glucocorticoid treatment.