Objective To evaluate the clinical effect of mandibular osteomuscular flap pedicled with temporalis and radial forearm free flap to repair palatomaxillary defects. Methods From March 2008 to March 2011,nine patients with palatomaxillary defects following malignant tumor ablation,were repaired with mandibular osteomuscular flap pedicled with temporalis and radial forearm free flap. According to Brown's classification for the maxillectomy defect,eight cases were type Ⅱ B and 1 case was type Ⅱ C. There were 6 males and 3 females with an average age of 57 years(range,34-68 years). Results All the 9 osteomuscular flaps and forearm flaps survived.The patients were followed up for 12 to 24 months with an average of 14 months. The patients acquired satisfactory appearance and complete functional restoration except 1 case of chondrosarcoma of recurrence was encountered 6 months after operation. Conclusions Palatomaxillary defects were reconstructed by mandibular osteomuscular flap pedicled with temporalis and radial forearm free flap immediately.It is easy to elevate,safe,and there were no donor site problems.This is an ideal method of repairing the palato maxillary defects.

Objective To assess alternations in left ventricular volume and systolic synchrony in patients with frequent premature ventricular complexes(PVCs) from the right ventricular outflow tract(RVOT).Methods Twenty-nine patients with frequent isolated PVCs from RVOT were included and 30 healthy subjects as control.Instantaneous full-volume imaging(IFI) was performed to evaluate left ventricle volumetric parameters,including end-systolic volume (ESV),end-diastolic volume (EDV),stroke volume (SV),ejection fraction (EF),and systolic synchrony parameters,including systolic dyssynchrony index (SDI),dispersion end-systole (DISPES),mean end-systolic time (MES),pre-contraction time volume (PreContr) and post-contraction time volume (PostContr).Contraction front mapping was performed to visualize volumetric contraction sequence.All values of patients with PVCs were recorded during sinus beats (PVC-S) and premature ventricular beats (PVC-V) respectively.Results Significant differences were observed in left ventricular systolic volumetric and synchrony parameters between PVC-V and control subjects (P＜0.01),as well as in MES and PreContr between PVC-S and control subjects (P＜0.01).Conclusions Left ventricular systolic dysynchrony was demonstrated in patients with PVCs from RVOT.IFI was a novel tool to analyze left ventricular global and regional volumetric alternations.

The modern statistical and data mining technology is used to analyze the law of the acupoint selection in the treatment of insomnia with acupuncture and moxibustion. The clinical literature on the treatment of insomnia with acupuncture and moxibustion in recent 10 years is collected from China National Knowledge Infrastructure (CNKI). Excel software is applied to establish the database of acupuncture prescriptions for insomnia so as to conduct the descriptive analysis, association rule analysis and clustering analysis on the data. In the treatment of insomnia with acupuncture and moxibustion, Shenmen (HT 7) is of the highest frequency and most acupoints were selected from the Governor Vessel. The commonly used acupoints are located on the head, face, neck and nape region. The combination of the local acupoints with the distal ones is predominated. The crossing points among the specific points present the advantage in the treatment. The association: rule analysis indicates the highest, correlation among Taixi (KI 3), Sishencong (EX-HN 1) and Shenmen (HT 7). The clustering analysis results in 6 effective clusters and 10 pairs of key points and summarizes the common law of the acupoint combination for insomnia. All of these provide the reference to the treatment of insomnia with acupuncture and moxibustion.
Acupuncture Points ; Acupuncture Therapy ; China ; Data Mining ; Databases, Factual ; Humans ; Moxibustion ; Sleep Initiation and Maintenance Disorders ; therapy ; Software

OBJECTIVE:To compare the clinical efficacy and safety of Kangshuling gel,mupirocin and lactate ethacridine in the treatment of diabetic foot. METHODS:90 patients with diabetic foot were randomly divided into Kangshuling group,mupiro-cin group and lactate ethacridine group. All the patients were treated by lowing blood glucose,nutritional support,improving micro-circulation and anti-infection,etc. On this basis,3 groups were given Kangshuling gel,Mupirocin ointment and Lactate ethacridine solution for wet compress by gauze. The course was 180 d. The clinic data was observed,including clinical efficacy,and wound ar-ea,healed patients’granulation,epithelial tissue,healing time and incidence of adverse reactions before and after treatment. RE-SULTS:The total effective rate in Kangshuling group was significantly higher than mupirocin group and lactate ethacridine group;healed patients’granulation,epithelial tissue and healing time were significantly shorter than mupirocin group and lactate ethacri-dine group,with significant differences(P<0.05). After treatment,wound area in each group were significantly smaller than be-fore,and Kangshuling group was smaller than mupirocin group and lactate ethacridine group,with significant differences(P<0.05);there were no significant differences between mupirocin group and lactate ethacridine group(P>0.05). There were no obvi-ous adverse reactions during treatment. CONCLUSIONS:Based on the conventional treatment,Kangshuling gel has better efficacy than mupirocin and lactate ethacridine in the treatment of diabetic foot,with good safety.

OBJECTIVE:To explore the clinical features and regularity of drug-induced liver injury (DILI),and to provide reference for clinical rational drug use. METHODS:104 DILI cases in our hospital from 2005 to 2014 were selected and analyzed retrospectively in respects of patient’s gender,age,allergic history,medication history,drug type and clinical manifestations. RE-SULTS:DILI hospitalized cases increased year by year. There were 47 males and 57 females,and average age was(8.71±13.90). The clinical symptoms appeared within 12 weeks after using the drug. The symptoms were no specific,including weak,anorexia, jaundice,yellow urine,etc. and 10.57% of patients were asymptomatic. Most of the DILI cases were hepatocyte type(80.77%), followed by cholestasis type(12.50%)and hybrid type(6.73%). The most common cause of drug-induced liver injury were TCM, antimicrobial drugs and the nervous system drugs. CONCLUSIONS:The incidence of DILI in females is slightly higher than males. DILI often occurs after 40 years old. The clinical symptoms have no specificity and are similar to viral hepatitis. The hepatic lesions can be caused by most of drugs. DILI by TCM should concerned. Clinical physicians should pay more attention to DILI.

Adolescent ; Adult ; Fistula ; congenital ; Humans ; Male ; Pyriform Sinus

Objective To know the medication compliance in elderly patients with hypertension,to analyze the influence factors of medication compliance,and to propose forward intervention countermeasures.Methods The treatment of hypertension in elderly patients was investigated by questionnaire survey.Medication compliance and influence factors were analyzed.Results 166 cases with poor medication compliance,and the rate was 45.0％; 203 cases with good medication compliance,and the rate was 55.0％.It's showed significantly difference on degree of education between the observation group and control group (x2 =12.071,P=0.002).The proportion of peasant and worker was higher in the observation group than control group (78.9％ vs.62.1％,x2 =12.817,P=0.002).The smoker (48.8％) and drinker (59.0％) in observation group more than smoker (27.1％) and drinker (31.0％) in control group(x2=18.481,P＜0.001; x2=29.115,P＜ 0.001).The ratio of payout of-pocket for healthcare was higher in the observation group (21.1％) than control group (9.9％) (x2=9.084,P=0.003).The duration of hypertension was longer in the observation group (8.8±4.6) than control group (6.0±4.1) (t=1.806,P=0.036).The income per month was less in the observation group (1850±150) than control group (2150±200) (t=5.799,P＜ 0.001).There were regression relationship between medication compliance and degree of education,medical security and duration of hypertension.Conclusions According to the influence factors of medication compliance in elderly hypertensive patients,it's useful to improve medication compliance by enhancing health education and designing a personal treatment.

This study was aimed to analyze acupoint selection principle for acute gouty arthritis treatment. Literatures on acupuncture treatment of acute gouty arthritis were collected from CNKI in recent 20 years. Excel software was used in the establishment of database on main acupoints for acute gouty arthritis treatment. On Windows 8 platform, SPSS 17.0 and Clementine 12.0 software were used in the descriptive analysis, association rules analysis and cluster analysis. The results showed that the top three acupionts with the highest frequency of application were Sanyinjiao (SP 6), Zusanli (ST 36), and Y inlingquan (SP 9). The meridian used with the highest frequency was the spleen meridian of foot Taiyin. The result of association rules analysis showed that Sanyinjiao (SP 6)-Xuehai (SP 10)-Quchi (LI 11) was the most relational one. The cluster analysis indicated the top four core cluster groups including Xiangu (ST 43)-Neiting (ST 44)-Xingjian (LR 2), Xuehai (SP 10)-Hegu (LI 4)-Quchi (LI 11), Taibai (SP 3)-Y inbai (SP 1)-Dadu (SP 2)-Fenglong (ST 40), and Zhubin (KI 9)-Zhigou (TE 6)-Gongsun (SP 4)-Bafeng (EX-LE 10). It was con-cluded that the clinical acupoint selection and combination principle in acute gouty arthritis treatment were analyzed through large amount of data. It can provide evidences and references for acupuncture clinical practice.

Objective To explore the clinical significance of rheumatoid factor (RF) in primary SjSgren's syndrome (pSS).Methods The clinical and laboratory data of 141 cases of hospitalized pSS patients from Wannan Medical College Affiliated Yijishan Hospital from 2006 to 2012 were analyzed retrospectively,and the clinical significance of RF was also analyzed.The data were analyzed using t-test and ~ test respectively.Results The positive rate of RF in pSS was 49％ (63/128),the rate of low-titer positive RF was 32％ (20/63),and the high-titer positive RF was 68％ (43/63).Patients with high-titer positive RF were more prone to suffer from parotidomegaly,arthritis and hematological system involvement.In terms of the results of laboratory examination,the following were more frequent,including positive anti-SSA antibody,the elevated IgG level,the decrease of platelet,the increase of erythrocyte sedimentation rate (ESR) and the increase of total globulin level.For the respect of clinical performance and laboratory examination between patients with low-titer positive RF and negative RF,no difference was found statistically.Conclusion pSS patients with high-titer positive RF are prone to have extraglandular organ involvement,and acute-phase reactants and antibody levels are relatively high.

Objective To explore the incidence and possible risk factors of restless legs syndrome (RLS) in the maintenance hemodialysis patients.Methods A total of 375 maintenance hemodialysis patients were enrolled in this study from September 1 to 30 in 2012.The diagnosis and assessment of severity were based on the International Restless Leg Syndrome Study Group (IRLSSG) standard.The relevant laboratory parameters and dialysis indicators were collected,such as hemoglobin,serum ferritin,parathyroid hormone,blood flow and dialysis mode.The clinical data were analyzed by multivariate logistic regression method.Results The incidence of RLS was 13.3％ with the severity score of 18.69 ± 0.95.The logistic regression analysis showed that anuria (OR 0.292,95％ CI 0.114-0.750) and β2 microglobulin(OR 1.023,95％C1 1.003-1.044) were the risk factors for RLS in the maintenance hemodialysis patients,while hemoglobin,serum iron and parathyroid hormone were not correlated with RLS.Conclusions The incidence of RLS is high in the maintenance hemodialysis patients.The risk factors of RLS are anuria and β2 microglobulin.Therefore,the preservation of residual renal function and the improvement of dialysis adequacy,especially the removal of the middle molecular weight toxins,may reduce the occurrence of RLS and improve the quality of life in the hemodialysis patients.