Adolescent ; Adult ; Aged ; Calcaneus ; injuries ; surgery ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; adverse effects ; Fractures, Bone ; physiopathology ; surgery ; Humans ; Male ; Middle Aged ; Postoperative Complications ; pathology ; physiopathology ; Recovery of Function ; Retrospective Studies ; Young Adult

Objective To investigate the clinical features,treatment and prognosis of Vibrio vulnificus infection in patients with characteristic skin lesions.Methods Clinical data on 23 cases of Vibrio vulnificus infection with characteristic skin lesions collected from 1996 to 2008 in Second Affiliated Hospital Affiliated to Wenzhou Medical College,were analyzed retrospectively.Results There were 23 patients including 15 males and 8 females.Of them,15 had a history of chronic type B viral hepatitis or alcoholic liver disease;17 ate raw oysters before the onset.A rapid onset Was observed in all of these patients,and initial symptoms were dominated by swelling and pain of,as well as bullae and hemorrhagic bulla in lower extremities.Vibrio vulnificus was isolated by culture from blister fluid of 13 patients,from both blood and blister fluid of 9 patients,and from necrotic tissue of 2 patients.Histopathologic examination revealed vacuolar degeneration and necrosis of cells,interstitial neutrophilic infiltrates,and vasculitis.Bacteria were seen in infiltrated neutrophiles.Electromicroscopy showed numerous round or arcuated microorganisms and bacterial flagella in hypodermal cells.Seven patients diagnosed from May 1996 to May 2000 died from this infection,and survival WaS observed after treatment only in 2 out of 6 patients collected from July 2000 to October 2003 and 6 out of 10 patients from May 2004 to October 2008.Conclusions Early recognition of skin eruptions and timely management are essential for the control of Vibrio vulnificus infection and for the improvement in survival among pafients infected with this bacterium.

Abrin is isolated from abrin seeds (Aburs precatoriusL.), which is a kind of cytotoxic protein. This article reviewed the anticancer effect and mechanisms of Abrin from five aspects in several years, which were the molecular structure and toxicity of Abrin, the characteristics of Abrin in anticancer effect, the role of Abrin in inhibiting cancer cell proliferation, the mechanisms of Abrin induced apoptosis of cancer cells, the anticancer mechanisms of Abrin in enhancing immune function. And the application prospect of Abrin immunotoxin targeted therapy and nano preparation will be expounded in this article. It will be helpful to further research about application on Abrin. It will provide the scientific basis for discovering new drug targets of cancer.

Coronary Angiography ; adverse effects ; Heart Atria ; Humans ; Male ; Middle Aged

Objective To study the 18F-FDG PET/CT features of tuberculous and malignant diffuse peritoneal lesions and to discuss the diagnostic value of 18F-FDG PET/CT in diagnosing and differentiating the lesions. Methods The 18F-FDG PET/CT features of 72 patients with tuberculous peritonitis,28 primary serous papillary carcinoma of the peritoneum and 135 peritoneal metastases confirmed by clinic and/or histopathology, were retrospectively reviewed. The peritoneal thickening features of tuberculous and malignant peritoneal lesions were observed. The maximal standardized uptake value (SUVmax) of peritoneal lesions and ascites, ascites SUVmax/liver SUVmax (T/NT) were compared between tuberculous peritonitis and cancerous peritonitis. The ROC curve was used to analyze the diagnostic efficiency of T/NT, SUVmax of peritoneal lesions and ascites. Results The typical 18F-FDG PET/CT features of tuberculous peritonitis were uniformity thickening of parietal peritoneum, mesenteric and omental stain like changes, widely and even distribution of the peritoneal 18F-FDG, while the cancerous peritonitis was obvious uneven thickening of parietal peritoneum, mesenteric and omental nodules and pie-shape changes, uneven distribution of the peritoneal 18F-FDG. The degree of 18F-FDG uptake was increased in all peritoneal lesions, and there was no significant difference between the tuberculous group (SUVmax=10.53±5.44) and the cancerous group (SUVmax=11.45±6.78, t=1.017, P>0.05). The 18F-FDG concentration in malignant ascites (SUVmax=1.88±0.65,T/NT=0.73± 0.18) was obvious higher than that of tuberculous ascites (SUVmax=1.67±0.69,T/NT=0.57±0.27, t=2.243 and 5.045,both P<0.05). The area under the ROC curve of T/NT, SUVmax of ascites, SUVmax of peritoneal lesions were 0.707, 0.593, 0.536, respectively. Conclusion The 18F-FDG PET/CT imaging can reflect the morphology and metabolic changes of peritoneal lesions. It is important to combine the SUVmax of ascites in order to improve the efficiency of diagnosing the diffuse peritoneal diseases.

Patients in intensive care unit were more critically ill, and often accompanied by dottiness and restless. In order to avoid the adverse events and self-injury, body constraints were often used on the patients. Therefore, this paper would discuss the ethics of body constraints and give the suggestions. According to the literature review and the analysis of the clinical nursing experience of relevant ethical principles, data was collected. The principle of informed consent, respect, and harmless was hard to decide on the issue of body constraints for patients in ICU. Nurses might pay attention to the application of ethical principles, and strengthen the humanistic care. On the issue of body constraints for ICU patients, nurses might pay special attention to the application of possible ethics principles in nursing process and reduce the application of the body constraints, and promote the physical and mental comfort of patients. It reflected the progress of the humanistic solicitude in the current clinical nursing and important value.

Objective To investigate the distribution of T follicular helper(Tfh)cell subsets in hepa-titis B patients at different immune stages and to clarify the relationships between the level of CXCL13 and the distribution of Tfh cell subsets. Methods Flow cytometry analysis was performed to detect the distribution of Tfh cells. Enzyme-linked immunosorbent assay(ELISA)was performed to measure the levels of CXCL13 in ser-um samples collected from hepatitis B patients. RT-PCR and Western blot assay were used to analyze the expres-sion of CXCL13 in HepG2 and HepG2. 2. 1. 5 cells. Results The percentages of Tfh1 cells were significantly up-regulated at the immune activation(IA)stage,while those of Tfh2 cells were significantly raised at the im-mune tolerance(IT)stage. The percentages of Tfh17 cells in patients at the stage of IT were similar to those in patients at the stage of IA,but were higher than those in responders with HBsAg seroconversion(RP)or healthy controls(HC). The expression of CXCL13 was positively correlated with the percentage of Tfh2 cells. More over,hepatitis B virus(HBV)enhanced the expression of CXCL13 at both transcriptional and translational lev-els. Conclusion HBV might up-regulate the percentage of Tfh2 cells through promoting the expression of CXCL13,which resulted in the induction of immune tolerance. Elucidating the functions of Tfh1,Tfh2 and Tfh17 cells and understanding the type conversion mechanism among the three subsets are important for further researches on HBV-induced immunosuppression.

Objective Ultrasonongraphy and mammography were employed to estimate the pathological response of patients with breast cancer ,who had been accepted neoadjuvant chemotherapy .According to the pres-ent study ,we can provide additional evidence on therapeutic effect on evaluation of neoadjuvant chemotherapy and better selection of regime for breast cancer .Methods One hundred Thirty-six patients who were previously dia-gosed diagnosed with primary breast cancer were included in this study .All subjects were female with clearly pathological detection and accepted neoadjuvant chemotherapy about 4 to 6 cycles regardless of regime .The resid-ual tumor size was evaluated by mammography and /or ultrasonography before operation .Tumor size measured by image were compared with pathological size to predicting the accuracy of two types of imaging .Results Forty one of 116 records were undetectable imaging by mammogram and 19 of 106 records were undetectable by ultrasound which were considered a pathologic complete response .Sixty one(62.24%)of 98 patients who were accepted de-tection of mammogram and ultrasound would be predicted the tumor size by mammogram .Eighty three(84.69%) of 98 patients would be predicted the residual tumor by ultrasound .31 and 59 were accurately evaluated by mam-mogram and ultrasound , respectively .The result indicated that ultrasound was more accurate than mammogram (60.20%vs.31.63%,χ2 =16.11,P<0.001).The correctly rate was 92.85%(91/98)for ultrasound and 68. 37%(67/98) for mammogram.The diagnosis efficiency of ultrasound was more higher than mammogram ,even though there was no different significance between the two methods (χ2 =2.028,P=0.164).Conclusion Ultra-sonongraphy in estimating the residual tumor size after neoadjuvant chemotherapy of patients with breast cancer displays more accurately than mammography .

Aim To observe the effects of liver cirrho-sis on the expression of transforming growth factor-β1 ( TGF-β1 ) and ColⅠin rat myocardium and interven-tion of erythropoietin ( EPO ) . Methods Thirty-six male Sprague-Dasley rats were randomly divided into three groups:control group, liver cirrhosis group and EPO group, then the cardic hemodynamic parameters in vivo and levels of serum lactate dehydrogenase ( LDH ) as well as creatine kinase isoenzyme ( CK-MB) were measured. With Masson′s trichrome stain, changes of collagen formation of myocardial tissue in different groups were observed. Also the mRNA ex-pressions of TGF-β1 and ColⅠin myocardium were de-tected by RT-PCR. Results In contrast to control group, rats in liver cirrhosis group showed a decline in systolic and diastolic function of left ventricule, rising myocardial enzyme, a distinct increase of cardiac colla-gen deposition, as well as an elevation of TGF-β1 and ColⅠmRNA expressions. In contrast to liver cirrhosis group, rats in EPO group demonstrated an improve-ment in systolic and diastolic function of left ventricule as well as in cardiac collagen deposition, and a de-crease in both myocardial enzyme and TGF-β1 and ColⅠmRNA expressions. Conclusion Liver cirrhosis can lead to the changes of myocardial structure and function in rats,and it can accelerate myocardial inter-stitial fibrosis; EPO can protect the myocardial injury in liver cirrhosis rats.

Objective To evaluate the diagnostic value of shear wave elastography on deep venous thrombosis in different stage.Methods Models of rabbits'deep venous thrombosis have been established to noninvasively measure Young's moduli of thrombosis in day 1 ,4,7,10 and 14 respectively by shear wave elastography.Results The elastic modulus of thrombosis increased with increment of the stages of thrombosis.Specifically,the mean Young's moduli of thrombosis increased from (4.0±1 .42)kPa (day 1)to (25.71 ±6.09)kPa (day 14),with statistical differences between each two observation time points (P <0.05).Conclusions Shear wave elastography can effectively reflect the elasticity of thrombosis in different stages,and the stage of thrombosis can be estimated judging by quantitative ultrasound elasticity preliminarily.