OBJECTIVETo observe the efficacy of the treatment of refractory wound by VSD combined with platelet-rich plasma.

METHODSFrom April 2010 to June 2012,15 patients with refractory wound were treated including 11 males and 4 females with an average age of 35.2 years old ranging from 18 to 45 years old. The formation time of wound was from 6 to 24 months, which was unhealed after long-term medication or repeated treatment. The VSD combined with autologous platelet-rich plasma was applied to treat the wound. The wound healing was an indicator and treatment and clinical features were summarized.

RESULTSAll the patients were followed up for 3 to 8 months (means 5 months). The wound of all patients were healed without recurrence.

CONCLUSIONThe curative effect of VSD combined with platelet rich plasma for treatment of refractory wounds is obvious. It could reduce the treatment course and the treatment cost.

Adolescent ; Adult ; Drainage ; methods ; Female ; Humans ; Male ; Middle Aged ; Negative-Pressure Wound Therapy ; methods ; Platelet-Rich Plasma ; metabolism ; Wound Healing ; Wounds and Injuries ; metabolism ; physiopathology ; therapy ; Young Adult

Objective To evaluate radical resection for thyroid carcinoma in patients without lateral neck lymph node metastasis.Methods Clinical data of 132 thyroid carcinoma patients without lateral neck lymph node metastasis undergoing radical thyroidectomy were retrospectively analyzed.Results There were 35 male and 97 female patients.Age ranged from 18 to 62 years,median age was 34.2 years.All patients underwent ipsilateral lobectomy plus isthmectomy and Ⅵ level dissection.The rate of recurrent laryngeal nerve injury was 4.5% (6/132).Taking into account of tumor invaded nerve,the rate of dissection procedure caused injury was 1.6% (2/128).Conclusion Combination of ipsilateral lobectomy plus isthmectomy and Ⅵ level dissection constitutes radical thyroidectomy in papillocarcinoma of the thyroid gland without lateral neck lymph node metastasis,recurrent laryngeal nerve exposure is the key for this en bloc resection.

Objective To investigate the influence of low frequency micromovement induced by an external fixator with controlled micromovement device on callus formation and fracture healing. Methods 39 sheep were involved in the study. After transverse osteotomy with a gap of 2 mm was done at the mid-shaft of both tibias, the hind limbs were fixed with unilateral external fixators with controlled micromovement device. 10 days after osteotomy, one hind limb of the sheep was randomly selected to have micromovement. According to different micromovement frequencies, the sheep were randomly divided into 3 groups: Group A, 0.5 Hertz; Group B, 1 Hertz; Group C, 5 Hertz. The micromovement had an amplitude of 0.25mm and stopped by the end of the fourth postoperative week (30 min/d). The other hind limb of each sheep did not have micromovement and served as the control. Macrostructural and histological observations, radiographic examinations, and biomechanical tests were done respectively at 4, 6, 9 weeks after osteotomy. Results Macrostructural observations and X-ray examinations revealed a large amount of callus formation with a peak at the end of the fourth postoperative week in the 3 experimental groups. Histological analysis showed faster endochondral ossification and osteoid formation in the experimental groups than in the control by the sixth postoperative week, with the highest rate in Group B (1Hz). Biomechanical tests proved that the bending stiffness in the experimental groups was superior to that in the control, with the strongest in Group B (1 Hz). Conclusions Low frequency-micromovement at the fracture sites can promote callus formation and accelerate mineralization at the early stage of fracture healing. A frequency of 1 Hz can produce the best results.

Objective To investigate the effect of iodine-131(131Ⅰ) therapy on patients with differentiated thyroid carcinoma concurrent metastases.Methods 50 cases with differentiated thyroid carcinoma after operation ac-cording to metastaticsites were given one of fractionated treatment,a total removal of dose(370～740)×107Bq,inter-val of 4 months.Results 35 of 50 patients(70.O%) had successful ablation of residual thyroid tissue after the first administration of radioiodine.Metastatic carcinoma in 18 cases,6 cases(33.3%) were cured,effective treatment was shown in 8 cases(44.4%)and treatment failure in 4 cases(22.2%);Thyroid metastasis before treatment were signifi-cantly higher than non-HTG thyroid metastasis(t=2.715,P<0.01),decreased significantly after treatment(t=2.844,all P<0.01);The contents of CD4+、CD8+、CD4+/CD8++ in treatment group after treatment[(26.5±4.7)%、(39.4±5.7)%、(0.6±0.4)%] were lower than before treatment[(38.3±5.6)%、(29.8±6.9)%、(1.4±0.5)%](t=2.345,t=2.244,t=2.451,all P<0.05).Conclusion Treatment with multiple hlsh doses of 131Ⅰ was safe and effective with little adverse side-effect.

The paper proposes and realizes a programmable wireless neural stimulation system which can be used as a solution of functional electrical stimulation to treat neural diseases. The system is composed of two parts: controller and neural stimulator. The controller can transmit pulse parameters to the stimulator wirelessly, and the stimulator can generate bidirectional pulses with charge balance. The simulator takes use of ADCs to sample on the bidirectional pulse output, which compared with preset amplitude to the DAC output voltage to realize the voltage calibration. Through the test, the whole system works stably and the output of the biphasic charge balanced circuit is definite. The stimulator output ranges from 0 to 5 V ajustably, and the frequency ranges from 1 Hz to 200 Hz ajustably, while the pulse width ranges from 500 μs to 1500 μs ajustably. The duration of the stimulation can be set from 10 s to 10 min.
Electric Stimulation ; instrumentation ; Equipment Design ; Wireless Technology

Objective To investigate the distribution and drug resistance of pathogenic bacteria in children with urinary tract infection.Methods All data were analyzed retrospectively.Middle segment urine samples from 573 outpatients and inpatients in children were collec-ted,cultured and identified for pathogenic bacteria by the way of ATB apparatus during Jan.2005-Dec.2007,and the drug resistance of positively cultured bacteria was tested with disc agar diffusion method.Extended spectrum ?-lactamases(ESBLs) were determined by phenotypic comfirmatory test according to the criteria of National Committee for Clinical Laboratory(NCCLS),and the identifications of methicillin-resistant staphylococcus aureus(MRS) and high level aminoglycoside resistance(HLAR) were carried out by the methods recommended from NCCLS too.Results Four hundred and eighty-two pathogenic strains were isolated from urine culture of children during 3 years,in which 385 strains(79.9%) were gram-negative(G-) and 97 strains(20.1%) were gram-positve(G+).The primary G-bacterium was Escherichia coli which accounted for 41.1%(198 strains),and the primary G+ bacterium was Enterococcus which accounted for 14.7%(71 strains).All the strains of Escherichia coli and klebsiella pneumoniae were sensitive to imipenem.Their resistance rates to sulperazone,amikacin and nitrofurantoin were less than 9.7%,while the rates to piperacillin,ceftazidime,ciprofloxacin and trimethoprim-sulfamethoxazole were more than 50%.ESBLs-producing strains accounted for 59.2% in Escherichia coli and 52.7% in klebsiella pneumoniae.Pseudomonas aeruginosa showed high multi-drug resistance.All the Enterococcus strains were sensitive to vancomycin.The resistance rate to nitrofurantoin was less than 8.1%.The detection rate of HLAR was 26.1%.All the Staphylococcus strains were sensitive to vancomycin.The resistance rate to nitrofurantoin and rifampicin were less than 22.4%.The detection rate of MRS was 52.7%.Conclusions The primary pathogenic bacterium in children with urinary tract infection is G-bacteria.The Escherichia coli is the first,the Enterococcus is the second and the klebsiella pneu-moniae is the third.All the pathogenic strains show high drug resistance to antibiotics in common use,therefore,clinicians should attach importance to the results from bacteria culture and susceptibility test,in order to obtian reference for accurate clinical diagnosis and rational use of antibiotics.

BACKGROUND: Severe acute respiratory syndrome (SARS) is caused by a genetically novel coronavirus that is caused by acute infectious disease. It is not yet clear for the immunology function of SARS patients in their convalescent stage.OBJECTIVE: To study the effects on T lymphocyte, and the titer profiling of 24 T cell receptor (TCR) V β subfamilies expressions in SARS convalescent patients.DESIGN: A self-control observation.SETTING: Central Laboratory, Guangdong Provincial Hospital of Traditional Chinese Medicine.PARTICIPANTS: Seventy-six cured SARS patients who received treatment in the Second Hospital Affiliated to Guangzhou University of Traditional Chinese Medicine between January and April 2003. All the patients corresponded to "clinical diagnostic criteria of atypical pneumonia", " diagnostic criteria of severe atypical pneumonia and discharge criteria" and "clinical diagnostic criteria and discharge criteria of severe acute respiratory syndrome". The involved patients, 30 male and 46 female, averaged (32±11 (years old. Another 10 subjects who simultaneously received health examination in the same hospital, 5 male and 5 female, aged (32±7(years, were involved in the study. Informed consents of detected items were obtained from all the subjects.METHODS：①Detecting the expression of 24 T cell receptor(TCR)V β subfamilies in SARS convalescent patients：Peripheral blood(2 mL) was collected from the healthy convalescent subjects,and EDTA-K2 was used as anticoagulant．In the flow cytometry delection tubes．10 μL various fluorescein-labeled mAb，such as anti-CD3,anti-CD4，anti-CD8,anti-CD25，anti-CD28，anti-HLA-DR，anti-CD3mAb conjugated with PC5，TCR Vβ1(PE+FITC)．Vβ2(PE+FITC)。Vβ3 (FITC)，Vβ4(PE+FITC)，Vβ5．1(PE+FITC),Vβ5．2(PE),Vβ5．3(PE)，Vβ7．1(PE+FITC)，Vβ7．2(FITC),Vβ8(FITC),Vβ9 (PE)，Vβ11(PE)，Vβ12(FITC)，Vβ13．1(PE),Vβ13．2(PE),Vβ13．6(PE+FITC)，Vβ14(FITC),Vβ16(FITC),Vβ17 (PE+FITC)，Vβ18(PE)，Vβ20(FITC)，Vβ21．3(FITC),Vβ22(PE+FITC)and Vβ23(PE)，was added in special flow tubes,and then 50 μL whole blood was added．The mixed solution was incubated away from light for 15 minutes．After erythrocytolysin being added，mixed solution was washed．Finally．cell deposit was dissolved in 300 μl phosphate buffer solution (PBS)．Coulter ESP flow cytometer was used for detection．For the analysis of TCR expression,an electronic gate was set on these cells and at least 5000 events per sample were collected．Three-color cytofluodmetric analysis was performed using a Coulter ESP flow cytometer．②Detecting the T cell subset,activated T and B cells,and the percentage of Ts and Tc cells：5000 cells were collected and used to calculate the expression of T cells (CD3,CD4 and CD8),the activated T and B cells(CD3+／CD25+,CD3+/HLA-DR+ and CD3-／HLA-DR+),as well as the percentage of Ts and Tc cells by Coulter ESP flow cytometer and its software．MAIN OUTCOME MEASURES：①The change of T cell subset(CD3，CD4，and CD8)from SARS convalescent patients．②The change of activated T and B cells(CD3+／CD25+，CD3+／HLA-DR+ and CD3-／HLA-DR+)．③The percentage of Ts and Tc cells(CD8+／CD28+，CD8+/CD28-)in convalescent patients．④Analysis of the 24 TCR V β subfamilies from SARS patients in convalescence．RESULTS：All data were explored to analyze the expression profiling of 24 TCR Vβ subfamilies,the data from 74 SARSpatients and 10 healthy controls were explored to other result analysis．①The detecting results of T celI subset：The percentage of CD4+T cell mean value was lower than the reference value[(33．33±6．64)％ vs．(43±9)％，P＜0．01]．The percentage of CD8+T cell mean value was higher than the refefence value[(34．07±6．40)％ vs．(30±9)％,P＜0．01]．② The expression of activated T and B cells：Percentage of HLA-DR+ T and B cell was Increased while the percentage of CD25+ T-cell was decreased compared with reference values．In 53 out of 74 patients,the percentage of CD25+ T cells was lower than the reference value,and 64 patients had a lower percentage in CD3+/CD25+ T cells．The percentages of CD3+/HLA-DR+ and CD3-／HLA-DR+ cells were higher than the normal reference value．T cells expressing higher CD3+／HLA-DR+ were found in 36 patients，and T cells expressing higher CD3-/HLA-DR+ were found in 30 patients．③The ratios of Ts and Tc cells：The percentage of Ts cells which expressed CD8+／CD28- was increased compared with reference value [(28．75±7．31)％ vs．(15．99±5．1)％，P＜0．01],while the percentage of Tc cells which expressed CD8+／CD28+ was decreased [(5．99±3．60)％ vs．(13．2±4．1)％，P＜0．01]．Thirty-nine patients were found to possess the lower Tc cells and forty-eight patients were found to possess the higher Ts cells．The ratios of both CD4+ and CD8+ T cells were in the normal reference value．④24 TCR Vβ subfamilies expressions in T cells：It was noteworthy that Vβ14 had a highest percentage in all 24 Subfamilies,and followed by Vβ 5．3,and Vβ 23 in the convalescent patients．The percentage of Vβ 14 was the highest in the normal controls,which was consistent with the results of SARS patients．But the other subfamilies expression patterns were different．There were significant differences between Vβ1,Vβ5．2,Vβ5．3,Vβ7．2，Vβ9，Vβ11,Vβ13．1,Vv13．2，Vβ17,Vβ18，Vβ22 and Vβ23．In the convalescent period，each TCR Vβ expression of SARS patients was higher than that of controls(P＜0．05-0．01)．CONCLUSION:In SARS convalescent patients,the increased CD8+CD28- T cell may elevate CD8+ T cell number;Meanwhile.the reduced CD3+ and CD4+ T cell number may be corresponding to the increased Ts cell number．For some inhibiting factor secreted by Ts cell was also increased．The usage pattern of 24 TCR Vβ subfamilies in SARS patients is different from that of control group．The increase of percentage of CD3+／HLA-DR+ and CD3-／HLA-DR+ T cell may be related to the late response of activated T and B cells.

Objective To verify the safety of non-thoracoscopic Nuss procedure,and review our experience in correction of pectus excavatum by Nuss procedure with post-implantation thoracoscopic assistance.Methods 191 patients with pectus excavatum were surgically corrected by Nuss procedure with post-implantation thoracoscopic assistance.There were 146 boys and 45 girls,The age ranged from 2.8 to 20 years with mean age was ( 6.46 ± 3.36) years.Hailer' s index was 4.68 ± 1.84.The operation was performed under Non-thoracoscopic assistance first and then with thoracoscopic observation.Results The operation in all patients had been performed successfully.The time of the operation ranged from 27 to 50 minutes with mean time was ( 32.49 ± 2.79) minutes.The average bleeding volume during procedure was ( 2.19 ± 0.87 ) ml.The durstion of follow-up was 10 to 23 months.All patients have been satisfied with their surgical correction.The postoperative complication was 13 cases( 6.81％ ).The bar outsides the pleura in both sides was 18 cases( 9.42％ ).The bar outsides the right pleura was 23cases( 12.0％ ).The bar outsides the left pleura was 17 cases( 8.90％ ).Conclusion Nuss procedure with non-thoracoscopic assistance for correction of poctus excavatum is safety if the surgeon experienced and have certain methods.Post-implantation thoracoscopic Nuss procedure is safer,and can deal with the damage caused by non-thoracoscopic assistance.

Objective To summarize the experience of diagnosis and treatment of pectus excavatum associated with congenital pulmonary disease in children.Methods The data of 91 patients with pectus excavatum associated with congenital pulmonary disease was collected from July 2002 to August 2010 in Beijing Children's Hospital.There were 64 males and 27 females.30 patients with pectus excavatum associated with congenital pulmonary cyst,congenital cystic adenomatoid malformation,pulmonary sequestration,and some severe cases of congenital lobar emphysema received the Nuss surgery and lobectomy simultaneously.Results 30 cases with pectus excavatum asseeiated with congenital pulmonary disease received simultaneous Nuss procedure and lobectomy.All cases were confirmed by pathology and recovered uneventfully.Conclusion Chest CT scan is an effective way to evaluate pectus excavatum associated with pulmonary diseases.Whether surgery is needed for the pulmonary disease depend on the specific types of disease,age and other various factors.Simultaneous surgery for pectus excavatum and pulmonary disease can lower the risk of the multiple operations,and reduce the financial burden of famihes.

Objective To understand the level of resilience and quality of life of burn patients during convalescence,to provide theoretical guidance for burn patients' psychological crisis prevention and intervention.Methods 255 cases of burn patients during convalescence were interviewed with general status questionnaire,CD-RISC,and burn specific health scale(BSHS).Results The resilience score of burn patients was at the middle level,the level of quality of life was at the lower-middle-level,significant positive correlation was found between the level of resilience and quality of life.Resilience level had a greater impact on the level of mental health in burn patients.The factors of physical strength and tenacity of resilience scale were positively correlated with mental health.Conclusions Intervention should be given to help people improve resilience,in order to reach the effect of potential development and prevention of behavior dysfunction,so that help them engender positive psychological adjustment.