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.

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 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.

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.

Carcinoma, Renal Cell ; genetics ; metabolism ; pathology ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit ; genetics ; metabolism ; Kidney Neoplasms ; genetics ; metabolism ; pathology ; Loss of Heterozygosity ; Mutation ; Von Hippel-Lindau Tumor Suppressor Protein ; genetics ; metabolism ; von Hippel-Lindau Disease ; genetics ; metabolism ; pathology

Objective To evaluate the performance of Mindray TSH chemiluminescence immunoassay ,including imprecision , limit of detection ,functional sensitivity ,interference ,cross-reaction ,and calibration consistency .The purpose was to confirm Mind-ray TSH assay meets the criteria of IFCC standardization and harmonization of thyroid functional tests .Methods The CLSI guide-lines defined in EP documents have been followed to measure the limit of detection ,functional sensitivity ,specificity ,imprecision and calibration consistency of Mindray TSH immunoassay on CL2000i system .Results Limit of detection was 0 .001 5 μIU/mL ,func-tional sensitivity was 0 .013 μIU/mL ,the correlation coefficient of linearity was 0 .999 in the range of 0-98 .95 μIU/mL .Mindray TSH calibrator C0 spiked with luteinizing hormone (LH) up to 500 mIU/mL ,follicle stimulating hormone (FSH) up to 500 mIU/mL ,or human chorionic gonadotropin (HCG) up to 200 000 mIU/mL detected no cross reactivity (detected TSH was less than 0 .2μIU/mL) .Hemoglobin up to 500 mg/dL ,bilirubin up to 10 mg/dL ,triglycerides up to 1 800 mg/dL ,and protein up to 10 g/dL showed -6 .91% ~8 .60% bias in TSH measurement .The total imprecision of two controls (high and low levels) and three serum specimens were in the range of 3 .24% and 5 .34% .Calibration consistency which had been demonstrated with high and low controls were measured between -6 .58% and 5 .26% .Conclusion The performance of Mindray thyroid-stimulating hormone assay meets the criteria for IFCC standardization and harmonization of thyroid function tests .

Objective To build a core competence evaluation index system for new nurses which was scientific and comprehensive. Methods 23 nursing experts was consulted by a two-round Delphi method, and finally determined the index system and the weight of each index. Results The core competence evaluation index system for new nurses consisted of 6 first-level indicator, 20 second-level indicator, 66 third-level indicator. The coefficient and authoritative coefficient were 0.370, 0.84. Conclusions The formation of the core competence evaluation index system for new nurses is scientific and reliable, which can provide objected and quantitative standards for assessment, training and evaluation of new nurses.

Heparin and low molecular weight heparin have been widely used in clinical therapy as anticoagulants in cardiovascular disease and in hemodialysis. Crude heparin is usually prepared from porcine intestinal mucosa. Purified heparin is a mixture of polysaccharides consisting mainly of repeating GlcNS(6S)-IdoA2S disaccharides and other disaccharides with different GlcNAc/GlcNS±3S±6S-GlcA/IdoA±2S residues. Heparin injections are drugs prepared from heparin active pharmaceutical ingredient ( API ) that is prepared from crude heparin. Low molecular weight heparins are dominant heparin-based drugs used clinically, which are prepared by degrading heparin into smaller sizes. As a result, low molecular weight heparins are sharing the same major disaccharides but have different reducing and non-reducing ends. In current study, we focused on the disaccharide compositional analysis of clinically used heparin and heparin-based drugs. HeparinaseⅠ,II, and Ⅲ were used to degrade all heparin and heparin-based drugs including heparin sodium injection, Enoxaparin sodium injection, Nadroparin calcium injection, Dalteparin sodium injection, Fondaparinux sodium into disaccharides. All the degraded products were analyzed by strong anion high perforance liquid chromatography ( SAX-HPLC) coupled with an UV-detector. Commercially available unsaturated disaccharide standards were then used for structral identification. Furthermore, unusual disaccharides present in Nadroparin, Dalteparin, and Fondaparinux were confirmed by reversed-phase ion pair HPLC coupled with mass spectrometry. The developed method produced detailed structural information, which should be useful for quality control of heparin and heparin-based drugs.