Humans ; Mediastinal Emphysema ; complications ; Paraquat ; poisoning ; Poisoning ; complications ; Pulmonary Fibrosis ; complications ; Subcutaneous Emphysema ; complications

Objective To observe clinical curative effect of pregabalin combined with oxycodone hydrochloride controlled-release tablets on patients with postherpetic neuralgia(PHN).Methods 84 patients with PHN were randomly divided into observation group (n=42 cases) and control group ( n=42 cases); control group was given oxycodone hydrochloride controlled-release tablets, observation group received pregabalin combined with oxycodone hydrochloride controlled-release tablets treatment; NRS, dermatology life quality index (DLQI), Pittsburgh sleep quality score (PSQI) and SAS score were recoded before and after 1,2,4 weeks treatment; 24 h duration of pain, 24 h total sleep time , pain-relief effectiveness and adverse reactions of two group were compared.Results NRS, DLQI, PSQI and SAS score of two groups after 1,2,4 weeks treatment was lower than before treatment (P<0.05), all the scores of observation group were lower than control group (P <0.05); 24 h duration of pain of observation group was obviously less than control group ( P <0.05 ) , 24 h total sleep time was longer than control group ( P <0.05 ); dose of oxycodone hydrochloride controlled-release tablets in observation group was lower than control group ( P <0.05 ); pain relief effectiveness of observation group was obviously higher than that of control group (P<0.05); adverse reactions of observation group such as dry mouth, dizziness was higher than control group (P<0.05), the rest of the adverse reactions in two groups had no significant statistical difference.Conclusions Treatment of pregabalin combined with oxycodone hydrochloride controlled-release tablets are both effective and safe significantly, and can obviously improve the patient’ s pain symptoms, improve quality of life, preferable satisfactory comprehensive curative effect.

BACKGROUND: Adipose-derived mesenchymal stem cells (ADMSCs) can improve the liver function of rats with liver failure, which illustrates the important research value in the field of tissue engineering and cell transplantation.OBJECTIVE: To evaluate the therapeutic potential of human ADMSCs in heart failure rats and to discuss the possible biological mechanisms involved.METHODS: Heart failure rats were randomized into model and ADMSCs groups, which were given normal saline or DAPI-labeled human ADMSCs (3.0×106) via the tail vein. At 1, 3, 7 days after transplantation, we detected the biochemical indexes for liver function in rats. At 3 days after transplantation, the serum levels of cytokines, such as tumor necrosis factor α and interleukin-10, were detected, the histomorphological changes in the liver were observed by hematoxylin-eosin staining, and the protein expression of proliferating cell nuclear antigen was detected by western blot. RESULTS AND CONCLUSION: We found that human ADMSCs could migrate to the liver and lung tissues in rats after the transplantation via the tail vein. At 1 and 3 days after transplantation, the levels of serum alanine aminotransferase and aspartate aminotransferase were significantly reduced in the ADMSCs group as compared with the model group (P< 0.05); furthermore, the secretion of tumor necrosis factor α and interleukin-10 was significantly suppressed at 3 days after cell transplantation (P < 0.05). The results of hematoxylin-eosin staining indicated a significant improvement in liver degeneration and necrosis. The expression of proliferating cell nuclear antigen protein in the ADMSCs group was significantly up-regulated compared with the model group. To conclude, human ADMSCs can inhibit the inflammatory reaction and up-regulate the expression of proliferating cell nuclear antigen, to promote the regeneration of liver cells and he recovery of liver function.

Objective To investigate clinical results of the treatment of posterior shoulder instability in a combined way of bone block procedure and posterior capsulorrhaphy. Methods The double contrast CT arthrography was performed for 5 patients suffering from posterior shoulder instability so as to detect the pathology. The treatments combining bone block procedure and posterior capsulorrhaphy were carried out according to the pathological conditions of bone and soft tissue. Results The double contrast CT arthrography showed posterior bone defects, posterior glenoid labrum tear and enlargement of posterior capsular cavity. After the bone block procedure and posterior capsulorrhaphy, no patients complained shoulder instability in the follow-up of 5 to 38 months. Conclusions Many pathological factors may induce posterior shoulder instability, which should be corrected by an appropriate operation rather than a “standard”method of operation. For patients involving several pathological factors, a combined operation may be needed in order to correct various pathological changes.

Objective:To evaluate the efficacy and safety of oral prednisone acetate and oral prednisone acetate combined with local injection of triamcinolone acetonide for the prevention of esophageal stricture after endoscopic submucosal dissection (ESD) for early esophageal cancer and precancerous lesions.Methods:Data of 52 patients with early esophageal cancer or precancerous lesions hospitalized from December 2014 to February 2019 in Zhongda Hospital of Southeast University were analyzed retrospectively. They were divided into the control group (group A, n=20), oral hormone group (group B, n=17) and oral medication combined with local injection group (group C, n=15). The rates of stenosis and refractory stenosis, endoscopic dilatation times after ESD, time interval of first dilation after ESD and adverse events related to the operation and administration of glucocorticoids were compared among the three groups. Results:The differences in stenosis rates [85.0% (17/20) VS 47.1% (8/17) VS 46.7% (7/15), P<0.01], rates of refractory stenosis [75.0% (15/20) VS 23.5% (4/17) VS 20.0% (3/15), P<0.01], and endoscopic dilatation times [3.50 (2.25, 6.00) VS 0.00 (0.00, 2.50) VS 0.00 (0.00, 2.00), P<0.01] were statistically significant among the three groups. In pairwise comparison, the above indicators in group B and group C were significantly lower or less than those in group A ( P<0.05), but there were no statistical differences between group B and group C ( P>0.05). The time intervals of the first dilation after ESD were significantly different among the three groups (27.7±9.4 d VS 110.1±46.0 d VS 147.4±9.4 d, P<0.01). In pairwise comparison, the first dilation intervals in group B and group C were longer than that in group A ( P<0.01), and this indicator in group C was longer than that in group B ( P<0.01). Two patients in the control group developed perforation after ESD but they were treated actively and recovered finally. No severe ESD, steroid, or perforation related adverse events occurred in any other patient of the three groups. Conclusion:Both oral prednisone and oral prednisone combined with local injection of triamcinolone acetonide after ESD can effectively and safely prevent esophageal stricture after ESD. Oral administration combined with local injection of corticosteroids can prolong the time interval of the first dilation after ESD, which is beneficial to the psychological recovery and the improvement of patients’ life quality after the operation.

Objective To investigate the anatomic structure of the Chinese people,develop the procedure of minimally invasive total hip arthroplasty through the anterolateral intermuscular approach and investigate its clinical outcome.Methods Three fresh adult cadavers(6 hips)were used for study of the anatomic construction of the anterolateral intermuscular approach in Chinese people.Sixteen patients were treated with minimally invasive total hip arthroplasty through anterolateral intermuscular approach.The clinical results and operation technique were recorded.Results The anterolateral intermuscular approach was a triangle muscular interval slightly parallel to the femur.The medial-superior angle of the triangle muscular interval consists of the anterior border of gluteus medius and tensor fascia lata muscle with juncture of muscles,where the inferior branch of superior gluteal nerve entered into tensor fascia lata muscle.The average incision length was 8.8 cm(7-10 cm),with mean blood loss of 350 ml(250-550 ml).The patients took out-of-bed activity 3-5 days after operations.During operations,anterior border injury in deep portion of the gluteus medius muscle was observed in seven patients and the injured muscles were trimed or repaired.All patients were followed up for 18-39 months(averaged 27.7 months).Most of the patients had excellent location of the phantoms,except that one acetabulum had a little pitch angle and two acetabulums had a little abduction angle.No complication was observed.The mean Harris scores of hip for all patients was increased from preoperative(39.1±6.7)points to(80.6±11.3)points on six month,(88.7±9.6)points on 12 month and(91.4±13.5)points on 24 months(11 patients).No patient suffered from gluteus medius muscle weakness during the follow-up.ConclusionAnterolateral intermuscular approach has the advantages of simple anatomic construction,small incision,little operative injury,muscle sparing and fast recovery without separate muscle or tendon and is suitable for the Chinese patients.Exact incision and special operative instruments should be emphasized to avoid the increase of acetabular pitch angle and abduction angle.

BACKGROUND: At present, common therapies of obstructive sleep apnea syndrome (OSAS) are uvulo-palato-pharyngoplasty and nasal continuous positive airway pressure (N-CPAP). The effective rate of surgical treatment was 50% and the prostecdtive efficacy is decreased gradually. As to treatment with breathing machine, some of the patients can not adapt to it.OBJECTIVE: To investigate the effects of auricular acupoint pressing therapy on clinical indexes of patients with OSAS and its clinical effect,and analyze the possible mechanism.DESIGN: Randomized control observation.SETTING: Department of Acupuncture and Department of Respiration,Second Hospital of Hebei Medical University.PARTICIPANTS: Forty-five outpatients with OSAS between April 2001 and April 2004, who were diagnosed as OSAS in the room of sleep-monitoring of Department of Respiration, were selected from the Clinic of Respiration, Second Hospital of Hebei Medical University, including 44 males and one female. All subjects were randomly divided into treatment group (n=30) and control group (n=15).METHODS: ①Patients in the treatment group were treated by auricular acupoint pressing therapy, acupoint-locating: shenmen, sympathesis, subcortex, heart, lung, spleen, kidney, anterior ear lobe. Each acupoint was pressed about 10-20 times with 3-5 times every day and 10 days as onecourse. Patients in the control group were treated with placebo and orally took 100 mg of Vitamin C three times a day. Patients in both groups were detected by 7hour nocturnal polysomnography before treatment and 10 days after the treatment, and the curative effects were evaluated.②Criteria of the curative effects on clinical symptoms: Effective: clinical symptoms such as dizzy,somnolence, oppressed chest and obstructing etc. were significantly ameliorated with nocturnal times decreased from 4-5 times to once or none and awake times decreased from 4-5 to once or none. Valid: clinical symptoms were improved. Invalid: no amelioration was found in clinicalsymptoms.MAIN OUTCOME MEASURES: Changes of clinical symptoms before and after the treatment and hypopnea index (HI), apnea index (AI), apnea hypopnea index (AHI), minimum blood oxygen saturation as well as the longest apnea time detected by polysomnography were observed.RESULTS: A total of 45 patients with OSAS were involved in the analysis of results, and no one withdrew from the study.①The clinical symptoms in auricular acupoint treatment group were significantly ameliorated than control group. In the treatment group, 17 patients were effective (56.7%), 12 patients were valid and one patient was invalid. The clinical symptoms in the control group were not improved before and after the treatment, and there were significant differences between the treatment group and control group (P ＜ 0.05). ②Comparison in each inspecting indexes by polysomnogram: those in the auricular pressing therapy group were remarkably different from those in the control group after treatment (P ＜ 0.001). There was no significant difference in all indexes of the control group between and after the treatment (P ＞ 0.05).③The differences in AI, HI, AHI, minimum blood oxygen saturation as well as the longest apnea time of the auricular pressing treatment group after the treatment were markedly different from those before treatment [(65.25±7.44), (53.69±10.80) times/hour; (72.40±7.92), (59.22±10.55) times/hour; (9.46±2.6), (6.5±2.9) times/hour; (73.3±4.8)%,(77.67±3.78)%; (90.16±33), (45.33±24.69) s,P ＜ 0.001]. Among them, the maximum decrease of AI was 19.3 times/hour, the maximum decrease of AHI was 17.8 times/hour, the maximum decrease of HI was 12.9 times/hour and the maximum increase of blood oxygen saturation was 7% CONCLUSION: Auricular acupoint pressing therapy, in the treatment of OSAS, can significantly ameliorate the AI, HI; AHI, minimum blood oxygen saturation as well as the longest apnea time with better curative effects.

Objective To compare surgical gastrojejunostomy and endoscopic stenting in palliation of malignant gastric outlet obstruction.Methods This retrospective study investigated patients treated for malignant gastric outlet obstruction from January 2007 to January 2014 in the first affiliated hospital of Nanjing Medical University.Endoscopic stenting was placed in 29 patients and surgical gastrojejunostomy was performed in 42 patients.The outcomes assessed included diet scores,time to diet,length of hospital stay,treatments fees and complications.Results Both endoscopic stenting and surgical gastrojejunostomy can relieve patients' syndrome with significant higher GOOSS score compared with that before treatment (P ＜0.05),but score improves faster in stenting group.Clinical success for endoscopic stenting and surgical gastrojejunostomy was 96.6％ and 92.9％ respectively,and technical success was 100％ for both of them.Endoscopic stenting group was found to have lower early complication rate(3.4％ VS 23.8％,P ＜0.05),higher late complication rate(24.1％ VS 6.9％,P ＜0.05),less time to diet,hospital stay and treatment fees(all P value ＜ 0.05)than surgical gastrojejunostomy group.The major complication after endoscopic stenting is re-obstruction while it is infection and leak of anastomotic site for surgical group.There were no significant differences in complication between two groups (27.6％ VS 11.9％,P ＞ 0.05).Conclusion Both endoscopic stenting and surgical gastrojejunostomy can relieve patients' syndrome effectively and safely,but endoscopic stenting improves GOOSS scores more rapid with less time to diet,less early complication rate and easy-dealing late complications,also it needs less hospital stay and fees.It's a better choice for patients with less survival expectation.

Objective: To investigate the clinical effect of plasma exchange (PE) versus double plasma molecular adsorption system combined with PE (DPMAS+PE) in the treatment of toxic hepatic failure. Methods: A total of 67 patients with toxic hepatic failure who were admitted during the same period of time were divided into PE group, DPMAS+ PE group, and control group. The 22 patients in the PE group were treated with PE alone, and the 24 patients in the DPMAS+PE group were given DPMAS combined with PE. The clinical out-come was compared between the three groups. Results: Both treatment groups had significantly higher clinical response rate and 24-week survival rate than the control group. After treatment, both treatment groups had significant reductions in the serum levels of total bilirubin (TBil) , direct bilirubin (DBil) , alanine aminotransfer-ase (ALT) , and aspartate aminotransferase (AST) , and the PE group had significant reductions in the albumin (Alb) level and activated partial thromboplastin time (APTT) (P<0.05) ; the DPMAS+PE group showed no sig-nificant changes in the Alb level and APTT (P>0.05). There were no significant differences in TBil, DBil, ALT, and AST between the two treatment groups after treatment (P>0.05). After treatment, the PE group had significantly higher Alb level and APTT than the DPMAS + PE group (P<0.05). Compared with the control group, both treatment groups had significant reductions in TBil, DBil, ALT and AST after treatment (P<0.05). Conclusion The two artificial liver support techniques can significantly improve patients' liver function and in-crease their survival rate, and the combined artificial liver support technique can reduce the amount of plasma used.

In the present work, NiTi alloy substrates were activated by three different pretreatment processes. 5 X SBF1 and 5 X SBF2 concentrated simulated body fluids were prepared with citric acid buffer reagent, and then calcium phosphate coatings were formed quickly on NiTi alloy surface by accelerated biomimetic synthesis after pretreatment. The microstructure, composition and surface morphology of calcium phosphate coatings were studied. The results indicate that calcium phosphate coatings possess porous and net structure, which are composed of precipitated spherical particles with diameter less than 3 microm. The analysis of XRD shows that the main component of calcium phosphate coatings is hydroxyapatite, whereas the concentrated 5 x SBF simulated body fluid, which is in the absence of Mg2+ and HCO3- crystal growth inhibitors, apparently accelerates the growth rate of hydroxyapatite coatings.
Biomimetic Materials ; Body Fluids ; Calcium Phosphates ; chemistry ; Coated Materials, Biocompatible ; chemical synthesis ; Computer Simulation ; Durapatite ; chemical synthesis ; Humans ; Nickel ; Titanium