Objective To evaluate the effect of Dermlin,an inorganic activity induced skin wound dressing,in combination with a nano-silver dressing,on chronic diabetic foot ulcer.Methods A total of 93 elderly diabetic patients with chronic foot ulcer were recruited and randomly assigned into the treatment group and the control group.In additional to routine systemic and topical treatment for both groups,the treatment group was given a combination of Dermlin and nano silver dressngs,while for the control group,iodophor gause was used to cover the ulcer.The two groups were compared on ulcer grading,wound healing time and positive rate of bacterial culture.Results The wound healing time in the treatment group was significantly shorter than that in the control group [(41.6±2.7) d vs.(61.9±2.9) d,t=-35.09,P=0.000].Positive rates of bacterial culture for the treatment group at admission,14 d after admission and 28 d after admission were 88.46％,23.07％ and 15.38％,respectively,in contrast to 88.89％,59.26％ and 40.74,respectively,for the control group at the same time points (x2 =0.01,6.88,7.34,P=0.065,0.008,0.006).The rate of effectiveness for the control group was 63.83％ (30/47),clearly lower than the 82.61％ for the treatment group (38/46) (x2=4.17,P=0.035).The patients' foot ulcers were graded using the Wagner system.In the treatment group,27 patients with grade 2 ulcers showed an 88.89％effectiveness rate (24/27),considerably higher than the rate of 67.86％ in the control group (18/28)(x2=4.60,P=0.032).For grade 3 ulcers,the effectiveness rate was 73.86％ (14/19) for the treatment group and 63.15％ for the control group (12/19),with no statistical difference between the two groups (x2=0.49,P=0.364).Conclusions The combination of Dermlin and Nanosilver can promote healing for grade 2 chronic diabetic foot ulcers,but has no obvious effect on grade 3 ulcers.

10.3969/j.issn.2095-4344.2013.26.012

Objective To present a method for breast reconstruction with the superficial inferior epigastric artery (S1EA) flap and to summarize the operative experiences. Methods The diameter and distribution were evaluated with multipledetector-row computed tomography (MDCT) angiography and doppler perfusion flowmeter. Bipedicle superficial inferior epigastric artery flap was designed below umbilicus. Superficial inferior epigastric artery and vein were anastomosed to the internal mammary artery and vein. Results Since 2007, we have used the superficial inferior epigastric artery flap in 4 cases of breast reconstruction. Four flaps survived completely. With the follow-up of 6-12 months, the reconstructed breasts were well-shaped and there were no complications such as abdominal hernia, bulge and weakness in donor sites. Conclusions Breast reconstruction using the superficial inferior epigastric artery flaps can not only preserve the advantages of the traditional method using the deep inferior epigastric perforator flaps, but also retain the maximal function of the fascia and the rectus abdominal muscle and prevent the occurrence of abdominal weakness and hernia. It is an ideal alternative method of breast reconstruction on condition that definitive preoperative assessment of vessels and skilled surgical technique are provided.

OBJECTIVE:To evaluate the effect of L-carnitine on serum total level of homocysteine (tHcy) in patients undergoing maintenance hemodialysis. METHODS: 60 patients undergoing maintenance hemodialysis were randomly divided into two groups (treatment group and control group): the patients in the treatment group were injected i.v. with 1.0 g of L-carnitine for 12 weeks,and those in the control group were injected i.v. with 5 mL normal saline for 12 weeks. Meanwhile,the healthy people were involved as normal control group(n=20). tHcy was detected by ELISA method;the fasting insulin was detected by radio-immunity method. Fasting blood glucose,total cholesterol,triglyeride,HDL and LDL were detected by routine method. The reciprocal of the multiplication product between fasting blood glucose and insulin concentration were computed as insulin sensitivity index(ISI). RESULTS: After treatment for 12 weeks,the treatment group showed increased ISI but significantly reduced tHcy(P

Gastric bronchogenic cysts （GBCs） is uncommon with atypical clinical features. It is difficult to diagnose by preoperative imaging examinations. Therefore , postoperative histopatho-logical examination is regarded as the golden bacteria in ultimate diagnosis. The treatment of GBCs：ultrasound-guided fine needle aspiration and endoscopic mucosal resection is only used for small GBCs with intra-cavity growth pattern. However , GBCs with extra-cavity growth pattern is featured with deeply anatomical position , large size , and prone on attaching to vital blood vessels and organs , which makes laparoscopic resection is the first choice in treatment. The authors introduce the diagnosis and treatment of a case of GBCs attaching to lesser curvature , in order to provide references for clinical diagnosis of GBCs.

Objective To investigate the effect of all-trans retinoic acid (ATRA) on expression of gap junction genes 26, 32 and 43 in two human hepatocellular carcinoma cell lines. Method Human hepatocellular carcinoma cell lines SMMC-7721 and BEL-7404 were cultured and inoculated in culture plate. Cells were divided into 2 groups and cultured respectively with normal medium and medium contains ATRA at a concentration of 10-mol/L. After 24, 48 and 72 hours, cells were collected and total mRNA were extracted. RT-PCR was used to detect the transcription of gap junction genes 26, 32 and 43. Result SMMC-7721 and BEL-7404 cultured under condition of normal medium do not express CX26 mRNA and CX32 mRNA. With the effect of ATRA for 48 and 72 hours, SMMC-7721 cell expressed CX26 mRNA and CX32 mRNA. BEL-7404 expressed CX26 mRNA and CX32 mRNA while cultured with ATRA for 72 hours. CX43 mRNA expression of the two cell lines was not altered by ATRA. Conclusion ATRA affects the expression of CX26 and CX32 in HCC cell lines SMMC-7721 and BEL-7404 at the transcription level.

OBJECTIVETo find out the optimal concentration, infusion rate and dosage of saline for resuscitation.

METHODSForty-five dogs were used to establish hypovolemic shock models. The dogs were resuscitated with saline of different concentrations and different dosages under different infusion rates, and the resuscitation results were compared.

RESULTSThe best concentration was 7.5%, the best rate of infusion 20 ml/min (a volume equivalent to 15% of the shed blood) and the best dosage 5.71 ml/kg. The method was effective for resuscitation, the mean arterial pressure (MAP) could be elevated to 89% of the baseline, and this MAP could be kept for more than one hour.

CONCLUSIONSUsing 7.5% sodium chloride solution equivalent to 15% of the shed blood at an infusion rate of 20 ml/min can achieve a best resuscitation result.

Animals ; Blood Pressure ; Blood Volume ; Body Weight ; Dogs ; Electrolytes ; blood ; Female ; Male ; Resuscitation ; Saline Solution, Hypertonic ; administration & dosage ; Shock, Hemorrhagic ; physiopathology ; therapy

Performance appraisal of public hospitals have given a guidance for the development of public hospitals at all levels.A Class A tertiary hospital reviewed the problems in the development of the hospital at the present stage and focused on the following four aspects:①insufficient fine management;②No clear orientation of discipline development;③The bottleneck of the improvement of medical operation efficiency;④New challenges in the reform of payment mode.The tertiary hospital launched a fine management practice in May 2022,in order to solve the problems by taking the Department of Surgery as a pilot area,laying the foundation for fine management through information system construction,improving the efficiency of medical operation through management process optimization,improving the overall competitiveness of disciplines through the construction of sub-specialty and Discipline Alliance and adjusting the performance appraisal index system to play the role of performance incentives.The measures effectively improve the overall capacity and efficiency of hospital medical services and help the hospital to achieve high-quality development.

OBJECTIVETo detect pathogenic mutation of the SLC39A4 gene in a male patient with acrodermatitis enteropathica (AE).

METHODSPeripheral venous blood sample and clinical data from the patient and his parents were collected. One hundred unrelated healthy individuals were recruited as controls. All coding exons and flanking exon-intron sequences of the SLC39A4 gene were analyzed by PCR and direct sequencing.

RESULTSThe results revealed that the patient and his mother have both carried a novel frame-shift mutation c.1110InsG (p.Gly370GlyfsX47 to TGA) in exon 6. A novel nonsense mutation c.958C to T (p.Q320X) in exon 5 was also detected in the patient and his father and grandmother. This novel mutation was not detected in the unaffected family members and 100 unrelated healthy controls.

CONCLUSIONThe novel frame-shift mutation c.1110InsG (p.Gly370GlyfsX47 to TGA) derived from the mother and nonsense mutation c.958C to T (p.Q320X) of the SLC39A4 gene derived from the father may underlie the disease in the patient.

Acrodermatitis ; genetics ; Adolescent ; Base Sequence ; Cation Transport Proteins ; genetics ; Exons ; Homozygote ; Humans ; Male ; Molecular Sequence Data ; Mutation ; Pedigree ; Zinc ; deficiency

OBJECTIVETo identify pathogenic mutations of TSC1 and TSC2 genes in two familial and one sporadic cases with tuberous sclerosis complex (TSC).

METHODSFor five patients and their family members, potential mutations of the TSC1 and TSC2 genes were detected by direct sequencing.

RESULTSFor one family, a novel missense mutation c.1964C>T (p.S655F) was detected in the exon 19 of the TSC2 gene. For the sporadic patient, a repeat substitution with deletion mutation c.5238-5255delCATCAAGCGGCTCCGCCA (p.His1746GlnfsX56) was detected in the exon 40 of the TSC2 gene, which led to a stop codon TGA after the 56th amino acids. No mutation was found in another family.

CONCLUSIONThe missense mutation c.1964C>T(P.S655F) and the substitution with deletion mutation 5238-5255delCATCAAGCGGCTCCGCCA(p.His1746GlnfsX56) of the TSC2 gene probably underlie the disease in the first family and the sporadic case.

Adolescent ; Adult ; Base Sequence ; Child, Preschool ; DNA Mutational Analysis ; Female ; Humans ; Male ; Mutation, Missense ; Pedigree ; Phenotype ; Tuberous Sclerosis ; genetics ; Tumor Suppressor Proteins ; genetics