Adult ; Bone Transplantation ; Fibula ; transplantation ; Humans ; Male ; Maxilla ; surgery ; Osteogenesis, Distraction ; methods ; Surgical Flaps ; Zygoma ; transplantation

Objective To investigate the clinical characteristics of acute inhalational metallic nickel poisoning and its treatment effect.Methods Data including epidemiology,clinical features,laboratory tests,imaging examinations,therapy protocol as well as prognosis were collected and analyzed.Results Thoracic CT scan of all patients demonstrated as bilateral diffuse infiltration.Nickel concentration in both blood and urine were high in all patients and the concentration was positively associated with poisoning severity.All 4 patients received glucocorticoid treatment,2 of whom with acute respiratory distress syndrome were admitted to ICU to initiate mechanical ventilation and were given sodium dimercaptopropanesulfonate.All patients survived to hospital discharge.Conclusions Acute inhalational metallic nickel poisoning is uncommon and early symptoms are inconclusive.The blood and urine nickel concentration is helpful to judge the severity of the disease.Pulmonary diffuse infiltration is the main clinical feature.Glucocorticoid,chelation therapy as well as symptomatic treatment are effective therapies to relief disease severity.

OBJECTIVETo detect the concentration of monocyte chemoattractant protein-1 (MCP-1) in the serum of patients with incomplete spinal cord injury and evaluate its relation with the pathologic classification of the spinal cord injury.

METHODSMCP-1 concentration in the serum of patients with incomplete spinal cord injury (iSCI), single spine compression and healthy subjects were detected by ELISA, respectively in the present study and the magnetic resonance imaging data of these patients were studied at the same time on a blind base.

RESULTSSerum level of MCP-1 in iSCI patients was 428 pg/ml +/- 11 pg/ml by ELISA, which was higher than both that of the patients with single spine compression and of controls, with the concentration of 184 pg/ml +/- 21 pg/ml and 124 pg/ml +/- 15 pg/ml, respectively. There was significant difference between any two groups (P < 0.01). iSCI patients with normal MRI showed a lower serum level of MCP-1 as 312 pg/ml+/- 30 pg/ml. Pathological classification of spinal cord edema and hematoma corresponded to 390 pg/ml +/- 16 pg/ml and 508 pg/ml+/- 24 pg/ml in the concentration of MCP-1.

CONCLUSIONSMCP-1 may induce secondary inflammatory response by recruiting inflammatory cells to the injury site and thus affect the prognosis of spinal cord injury.

Acute Disease ; Adult ; Aged ; Chemokine CCL2 ; blood ; Enzyme-Linked Immunosorbent Assay ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Spinal Cord Injuries ; blood ; pathology

OBJECTIVETo study changes in the radiographic appearance during weight-bearing and non-weigh-bearing in hallux valgus, and to analyse the correlation between the elasticity of plantar soft tissue of hallux valgus and the pain under the metatarsal head.

METHODSFrom May 2012 to October 2012, 240 feet of 120 patients with hallux valgus were enrolled in the study. The degrees of the pian under the metatarsal head of all the patients were observed. AP and lateral X-ray films of feet were taken on the condition of weight-bearing and non-weight-bearing. So the hallux valgus angle (HVA), the inter-metatarsal angle between the first and second metatarsals (IM1-2), the inter-metatarsal angle between the first and fifth metatarsals (IM1-5), top angle of the medial longitudinal arch (TAOTMLA),and anterior angle of the medial longitudinal arch (AAOTMLA) were measured on the X-ray films. The differences of HVA, IM1-2, IM1-5, TAOTMLA and AAOTMLA between two groups were compared, and the correlation between the changes of IM1-2, IM 1-5, TAOTMLA, AAOTMLA and the degree of the pain under the metatarsal head were analysed.

RESULTSOne hundred and forty-eight feet had the pain under the metatarsal head. The IM1-2, IM1-5 and TAOTMLA increased on weight-bearing position compared with those on non-weight-bearing position, but the HVA and AAOTMLA decreased on weight-bearing position compared with those on non-weight-bearing position. There was a moderate relationship between the changes of IM 1-2,IM1-5 and the degree of the hallux valgus deformity, as well as the relationship between the different of IM1-5 and the degree of the pian under the metatarsal head.

CONCLUSIONThe degree of the collapse of the arch of foot with hallux valgus becomes serious with its deformity increasing. The pain under the metatarsal head of hallux valgus increases with the increased changes of IM 1-2,IM 1-5 and TAOTMLA. Analysis of the X-ray observation indexes of hallux valgus on weight-bearing position and non-weight-bearing position has important significance in evaluating the degree of the collapse of the arch of foot with hallux valgus,preventing and curing the the pain under the metatarsal head.

Adult ; Aged ; Female ; Hallux ; anatomy & histology ; diagnostic imaging ; physiopathology ; Hallux Valgus ; complications ; diagnostic imaging ; physiopathology ; Humans ; Metatarsalgia ; complications ; diagnostic imaging ; physiopathology ; Middle Aged ; Radiography ; Weight-Bearing ; Young Adult

OBJECTIVETo evaluate and summarize the possibility and experience of reconstructive vascular operation for kinking of internal carotid artery.

METHODSReconstructive vascular operation was performed on 5 patients with symptomatic kinking of internal carotid artery between July 2008 and June 2009. There were 2 male and 3 female patients, age ranged from 53 to 68 years (mean 62 years). Cutting the internal carotid artery at the bifurcation, mobilizing and stretching the internal carotid artery, then anastomosing the internal and common carotid artery. Two of them underwent endarterectomy simultaneously.

RESULTSFor the 5 patients, postoperative recovery went smoothly and symptoms were well improved. Except that mild high perfusion syndrome happened in 1 patient, no other obvious complications. Kinking of internal carotid artery had been stretched in the postoperative CT angiography. In the 5-16-month follow-up, no transient ischemic attack or cerebral infarction happened, and no restenosis appeared.

CONCLUSIONSReconstructive vascular operation is an effective surgical approach to kinking and coiling of the internal carotid artery. For some risk exists, all-round evaluation should be performed before operation, and operative indication should be strictly controlled.

Aged ; Carotid Artery, Internal ; Carotid Stenosis ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Vascular Surgical Procedures ; adverse effects ; methods

AIMTo investigate the hypersensitization of alpha-adrenoreceptor of artery smooth muscle in hypertensive patients and rats and the mechanisms concerned.

METHODSIsometric tension of artery ring segments was recorded by a sensitive myograph system in vitro and the relative amount of alpha-adrenoreceptor mRNA was quantified by a real-time PCR.

RESULTSNoradrenaline (NA)-induced concentration-contraction curve of mesenteric artery segments in spontaneously hypertensive rats (SHR) was more potent than that in Wistar-Kyoto (WKY) rats. The E(max) of NA in SHR was 1.82 times of that of WKY. The concentration-contractile curve induced by NA in great omental arteries of hypertensives significantly shifted toward left and the pD2 value of NA was larger than that of normotensives. After organ culture, the concentration-contractile curves of SD rat mesenteric artery induced by NA shifted toward left with significantly increased E(max). The relative amounts of mRNA for alpha1-adrenoreceptor was increased, but mRNA level for alpha2-adrenoreceptor did not change.

CONCLUSIONThe sensitivity of alpha1-adrenoreceptor of artery smooth muscle in hypertensive man and rat is enhanced, suggesting alpha1-adrenoreceptor is upregulated.

Adrenergic alpha-Agonists ; pharmacology ; Animals ; Dose-Response Relationship, Drug ; Humans ; Hypertension ; physiopathology ; In Vitro Techniques ; Mesenteric Arteries ; drug effects ; metabolism ; physiopathology ; Muscle Contraction ; drug effects ; Muscle, Smooth, Vascular ; drug effects ; metabolism ; physiopathology ; Norepinephrine ; pharmacology ; Omentum ; blood supply ; RNA, Messenger ; biosynthesis ; genetics ; metabolism ; Rats ; Rats, Inbred SHR ; Rats, Inbred WKY ; Rats, Sprague-Dawley ; Receptors, Adrenergic, alpha ; genetics ; Reverse Transcriptase Polymerase Chain Reaction ; Species Specificity ; Vasoconstriction ; drug effects

OBJECTIVETo summarize experience of using screws and cement to rebuild tibial bone defect in primary total knee arthroplasty (TKA) and to discuss the relationship between the number of required screws and the severity of tibial bone defects.

METHODSFrom July 2009 to May 2015, 34 patients (40 knees) with varus knees underwent TKA, and the screw and cement technique was used to rebuild medial tibia plateau during operation. There were 8 males (8 knees) and 26 females (32 knees), and the average age was (65.00 +/- 7.25) years old (ranged,55 to 82 years old). One to 6 screws were used in each case. Extension stems were used in 2 cases (4 and 5 screws was used respectively). The area percentages of the bone defects measured as defect area/tibia plateau area, depth of each defect, the number of screws needed in each case, were all used to determine the relationship between the number of screws and the area percentage in certain depth of bone defect by statistic methods, as well as the relationship between screw number and defect depth.

RESULTSAll the patients were followed up and the average duration was 24 months (ranged, 1 to 72 months). The average preoperative HSS score was 43.33 +/- 6.11 (ranged, 32 to 51 scores). Whereas the average postoperative HSS score was 92.15 +/- 4.64 (ranged,83 to 96 scores). The preoperative individual scores including pain, function, activity, nuscle strength, flexion deformity and stability were all improved compared with preoperation,and the differences were statistically significant. All the patients received normal alignment postoperatively, femoraltibial angle was improved from (167.00 +/- 6.39) degrees preoperatively to (175.00 +/- 2.69) degrees postoperatively, the tibial angle was improved from (78.09 +/- 4.51) degrees preoperatively to (88.75 +/- 1.24) degrees postoperatively. Both area percentage and depth of bone defect in a fitting Ologistic model had a significant statistical relationship with the screw number, and a rectangular coordinate system could be formed according to the relationship.

CONCLUSIONScrews and cement technique is a simple, safe and convenient method to rebuild tibial bone defects in primary TKA and its short-term and midterm effect are both reliable. During opera- tion, according to the rectangular coordinate system, the screw number needed in the operation can be inferred form th area and depth of tibia defect, which could have a guiding function in surgery.

Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Knee ; instrumentation ; methods ; Bone Screws ; utilization ; Female ; Fracture Fixation, Internal ; Humans ; Knee Injuries ; surgery ; Knee Joint ; surgery ; Male ; Middle Aged ; Tibia ; surgery

Adolescent ; Child ; Hemangioma, Capillary ; diagnostic imaging ; Humans ; Male ; Testicular Neoplasms ; diagnostic imaging ; Ultrasonography

OBJECTIVETo evaluate variations of pulmonary venous drainage and venous ostium index (VOI) in patients with atrial fibrillation (AF) prior to radio-frequency catheter ablation (RFCA) by MDCT pulmonary venography.

METHODS16-detector row CT pulmonary venography was performed in 64 AF patients referred to RFCA from June, 2005 to May, 2006. Variations in pulmonary venous drainage were observed in volume render imagines. Anterior-posterior and superior-inferior diameters of pulmonary venous ostium were measured on maximum intensity projection images. VOI derived from left superior, left inferior, right superior, right inferior pulmonary veins and variations in pulmonary venous drainage were calculated.

RESULTSClassic pulmonary veins anatomy was found in 11 patients (17.18%), early branching veins in 45 patients (70.31%), left common ostium in 5 patients (7.81%), right common ostia in 1 patient, right accessory (middle) pulmonary vein in 5 patients (7.81%) and left accessory (middle) pulmonary vein in 1 patient (1.56%). VOI of homolateral pulmonary veins and bilateral superior pulmonary veins were similar (P > 0.05) while there was a significant difference on VOIs derived from left superior and right inferior; two inferior, left inferior versus right superior veins (P < 0.05). Right inferior pulmonary venous ostium was most rounded and had the highest index (0.88) and left inferior pulmonary venous ostium was most oval and had the lowest index (0.72).

CONCLUSIONMultidetector row CT pulmonary venography (MDCT-PV) could provide valuable informations on pulmonary venous anatomy in AF patients referred to RFCA and should be used as a routine examination prior to the operation.

Adolescent ; Adult ; Aged ; Atrial Fibrillation ; diagnostic imaging ; therapy ; Catheter Ablation ; methods ; Female ; Humans ; Male ; Middle Aged ; Pulmonary Veins ; abnormalities ; diagnostic imaging ; Tomography, Spiral Computed ; methods ; Young Adult