Adult ; Aged ; Female ; Fistula ; surgery ; Humans ; Male ; Middle Aged ; Pectoralis Muscles ; transplantation ; Pharyngeal Diseases ; surgery ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps

Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Myelodysplastic Syndromes ; diagnosis ; epidemiology ; Prognosis ; Young Adult

ATP-binding cassette transporter Al (ABCAl) is a kind of membrane intergrate protein and may have multiple and diverse functions. It mediates the cellular efflux of phospholipids and cholesterol to lipid-poor apolipoproteinA- Ⅰ (apoA- Ⅰ ) and plays a significant role in high density lipoprotein (HDL) metabolism. Mutations in human ABCAl cause severe HDL deficiencies characterized by the virtual absence of apoA- Ⅰ and HDL and prevalent atherosclerosis. ABCAl expression is highly regulated and implies a variety of molecular actors. All of the nuclear receptors which involve in regulation of ABCAl expression act via the DR4 element in the ABCAl promoter. cAMP up-regulates ABCAl expression by acting both at the transcriptional and translational level. Cytokines have been shown to exert pleiotropic and antinomic effects on ABCAl transcription, In addition to these, some of enzymes and proteins such as protein kinase A, protein kinase CK2, cathepsin D are involved in the regulation of ABCAl expression. The recent progress in the structure, function and regulation of ABCAl transporter is reviewed.

97 cases of jaw bone fractures were treated with rigid internal fixation.16 cases had malocclusion postoperation.The etiology was analyzed and the prevention methods were proposed.Intermaxillary elastic traction or fixation and craniomaxillofacial fixation or craniomentum elastic traction were performed to treat the malocclusion.By this way,14 cases were cured.1 case was operated again to resume the normal occlusion,1 case received occlusal adjustment.Incomplete reduction,incorrect operative performance,deficiency of postoperative intermaxillary fixation and incorrect intermaxillary fixation were the main causes to malocclusion.So anatomic in time reduction,correct operative performance,intermaxillary fixation,application of craniomaxillofacial fixation or craniomentum elastic traction instead of intermaxillary fixation for some special cases are effective methods to correct postoperative malocclusion.

Objective:To observe the clinical efficacy of acupuncture plus umbilicus application with Chinese medicine for detrusor underactivity.Methods:A total of 46 male patients with detrusor underactivity who were admitted to our hospital between January and December 2017 were randomized into a control group and an observation group,with 23 cases in each group.The control group received intermittent catheterization and routine nursing,and the observation group was treated with acupuncture plus umbilicus application with Chinese medicine on the basis of the treatment of the control group.The comprehensive efficacy,the improvement of bladder urine residue and maximum flow rate of the two groups were observed.Results:No cases dropped out in the two groups.After the intervention,the total effective rate of the observation group was 78.3％,which was significantly higher than 52.2％ of the control group (P＜0.05).After intervention,the improvements of bladder urine residue and maximum flow rate in the observation group were statistically different from those in the control group (both P＜0.05).Conclusion:The combination of acupuncture and umbilicus application with Chinese medicine added on the basis of intermittent catheterization and routine nursing has a certain effect in treating male patients with detrusor underactivity,and is worth further clinical study.

Asthma ; drug therapy ; immunology ; Diagnosis, Differential ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Major Histocompatibility Complex ; genetics ; immunology ; Medicine, Chinese Traditional ; Phytotherapy

Objective To determine if the cardiac index (CI) measured by transesophageal echocardiography (TEE) through the mitral valve (MV) agrees with that measured by transesophageal echocardiography through the ascending aorta (AA).Methods Sixteen ASA Ⅱ or Ⅲ patients (NYHA Ⅱ or Ⅲ),aged 18-70 kg,weighing 46-72 kg,undergoing mitral valve replacement under cardiopulmonary bypass (CPB),were studied.Total intravenous anesthesia was used for induction and maintenance of anesthesia.After tracheal intubation,the TEE probe was placed in the esophagus.CI was measured by transesophageal echocardiography through the MV (CIMV)and AA (CIAA) at 15,30 and 60 min after termination of CPB and recorded.All the data were compared by Bland-Altman analysis.Results CIMV values were significantly lower at each time point than CIAA values (P ＜0.01).The results of Bland-Altman comparison:CIMV 1.29-5.52 L· min-1 · m-2,mean was (2.6 ± 0.9)L·min-1·m-2,and CIAA 2.7-8.8 L·min-1·m-2,mean was (4.9± 1.7) L·min-1 ·m-2,bias was-2.3 L·min-1 ·m-2,and limit of agreement was-5.62-1.03 L· min-1 · m-2 resulting in r =-0.577,P ＜ 0.01.Conclusion CI values obtained through the MV agrees well with that measured through the AA using TEE in patients undergoing mitral valve replacement,but CIAA values are significantly higher than CIMV values,there is a large difference between them for clinical use,and both methods for CI measurement cannot replace each other.

We enrolled 60 patients with American Association of Anesthesiologists grade Ⅰ - Ⅱ undergoing unilateral total knee arthroplasty. All patients received combined epidural and spinal anesthesia,and a nerve stimulator was used to guide placement of a femoral nerve catheter. Patients were divided into three groups according to the catheter location on X-ray : psoas muscle group ( n = 18 ), iliacus muscle group (n = 19) and local group (n =23). Visual analog scale (VAS) pain scores were recorded at rest and with movement at 4, 24 and 48 h postoperatively and sensory blockade of the femoral, obturator and lateral femoral cutaneous nerves was recorded at 24 h.There were no significant differences in femoral nerve blockade among the three groups. Obturator nerve blockade was significantly better in the psoas muscle group than in the iliacus muscle and local groups, and was also better in the local group than in the iliacus muscle group. There was no significant difference in lateral femoral cutaneous nerve blockade between the psoas muscle and iliacus muscle groups, but there was better blockade in both these groups than in the local group. At 4 h postoperatively, VAS pain scores at rest were significantly lower in the psoas muscle group than in the iliacus muscle and local groups, but there were no significant differences in VAS pain scores with movement among the three groups. At 24 and 48 h postoperatively, VAS scores at rest and with movement were significantly lower in the psoas muscle group than in the iliacus muscle and local groups.

BACKGROUND:There is controversy on the treatment of old femoral neck fracture with hemiarthroplasty.
OBJECTIVE:To observe the clinical effect of cementless hemiarthroplasty in the treatment of old femoral neck fracture, and to compare with total hip arthroplasty.
METHODS:A retrospective analysis was performed on the clinical data of 23 old femoral neck fracture patients treated by artificial joint replacement from January 2009 to June 2010. Among the 23 patients, 11 cases were treated with cementless hemiarthroplasty, and 12 cases were treated with total hip arthroplasty. The time for off-bed activity, Harris score and the incidence of perioperative complications were compared between cementless total hip arthroplasty and hemiarthroplasty.
RESULTS AND CONCLUSION:Al the patients were fol owed-up for 12-18 months. The active straight leg raising angle, time for off-bed activity, incidence of early postoperative complications and Harris score at 1 week after treatment of the cementless hemiarthroplasty group were better than those of the total hip arthroplasty group;there were no significant differences in Harris score at 6 weeks, 3 and 6 months between two groups;the incidence of forward hip pain of the cementless hemiarthroplasty group was higher than that of the total hip arthroplasty group. So, we general y think that cementless hemiarthroplasty has better short-term effect in the treatment of old femoral neck fracture, but the long-term integrated efficacy needs to be further identified.

Objective To summarize the nursing experience of allogeneic hematopoietic stem cell transplantation patients with circumferential mixed hemorrhoid intercurrent infection, explore the nursing methods of severe circumferential mixed hemorrhoid before allogeneic hematopoietic stem cell transplantation. Methods The detailed nurse plan and carefully observation and assess of lesion were performed daily. Iodophor water at the concentration of 0.5‰ was used for anal bath and 2% iodine ointment was used to smear perianal to prevent of infection. And gauzes soaked iodophor were used to cover the lesions, and Chinese traditional herb for anal bath and ultraviolet exposure to control infection. Additionally, the necessary psychological support was given to overcome the fear. Results After the careful nursing, the patient passed through the agranulocytosis period and achieved the success of transplantation. Conclusions This case suggests that the methods in prophylaxis of patients with circumferential mixed hemorrhoids is effectious.