Objective To discuss the reasonable utilization of β-lactam antibiotics in patients with renal failure on hemedialysis. Methods The clinical characteristics of patients with renal failure on hemodylysis,who de-veloped the adverse effect of nervous system and psychiatric symptom while being treated with β-lactam antibiotics,were retrospectively analyzed. Results The adverse effect of nervous system and psychiatric symptom showed dur-ing and after hemodialysis,including: mental confusion,hyperexcitabiliy,incoherent speech,lethargy and amyestasia in two cases. Physical examination did not show signs of cerebral focal injury in all cases. Computed tomography of brain in 7 patients did not show acute lesions. The symptoms completely disappeared after withdrawal of β-lactam antibiotics but bemodialysis or hemodiafiltration continued. Conclusion β-lactam antibiotics used in conventional dose could cause temporary adverse effect of nervous system in patients with renal failure on bemodialysis,which is related to prolongation of drug half life.

Arrhythmogenic Right Ventricular Dysplasia ; Humans

Objective To investigate the effects of different analgesia protocols on immune function in patients undergoing surgery for ovarian neoplasms after neoadjuvant chemotherapy.Methods Forty ovarian neoplasms patients ageing from 31 to 62 years undergoing neoadjuvant chemotherapy were randomly divided into 2groups:epidural analgesia group (group E,n =20) and intravenous analgesia group (group Ⅰ,n =20).All patients underwent surgery under total intravenous general anesthesia.Patients in group E were given 2 mg morphine in epidural space at half an hour before abdomen was closed,then epidural analgesia pump was installed,with ropivacaine composite morphine in the pump.Analgesia time was 48 h.Patients in group Ⅰ were given sufentanil 0.1 μg/kg intravenously at half an hour before abdomen was closed,then analgesia pump was installed,with sufentanil compound flurbiprofen ester in the pump.Analgesia time was 48 h.The cervical venous blood samples were obtained from the patients at 30 min before surgery(T0),immediately(T1),12 h(T2),24 h(T3) and 48 h (T4) after the end of operation for determination of the expression of CD3 +,CD4 +,CD8 + on T cells and natural killer cell.Visual analogue scales (VAS)and adverse reaction at T2-4 were recorded.Results No statistical difference was found between group E and group Ⅰ in VAS and adverse reaction.Compared with T0,CD3 +,CD4 + T-lymphocytes,CD4 +/CD8 +,and NK cell decreased.Compared with group E,CD8 + increased at T1-2in both groups and at T3-4 in group Ⅰ.CD3 +,CD4+ T-lymphocytes,CD4+/CD8 + and NK cell decreased while CD8 + increased at T2-4 in group Ⅰ.Conclusion Epidural analgesia may be better to promote the immunologic function of ovarian neoplasms patients undergoing surgery after neoadjuvant chemotherapy.

OBJECTIVETo investigate the clinical experiment of cortical screw in the treatment of tibiofibular syndesmosis separation together with ankle fractures.

METHODSFrom March 2008 to May 2012,42 patients with tibiofibular syndesmosis separation were treated with cortical screw, including 20 cases in the left and 24 cases in the right. All the patients had closed injury. According to Lauge-Hansen classification, there were 18 cases of supination-external rotation, in which 4 patients with injuries belong to type II, 8 patients with injuries belong to type III, 6 patients with injuries belong to type IV; 14 cases of pronation-external rotation, in which 6 patients with injuries belong to type III, 8 patients with injuries belong to type IV; and 12 cases of pronation-abduction, in which 4 patients with injuries belong to type II, 8 patients with injuries belong to type III. According to injury of ankle, 4 patients had injuries in one ankle, 28 patients had injuries in 2 ankles, and 12 patients had injuries in 3 ankles. All the patients were diagnosised definitely in sight of medical history, checking-up, iconography. The clinical effects were evaluated based on Baird-Jackson score and activity degree of ankle.

RESULTSAll the patient were followed up, and the duration ranged from 11 to 23 months, with an average of 15.7 months. No postoperative wound infection, nonunion, and tibiofibular syndesmosis separation again and other complications occurred. Postoperative Baird-Jackson score exhibited 91.56 ± 6.26 (75 to 99), and 26 patients got an excellent result, 10 good, 6 poor and 2 bad. One patient had nail broken after operation,and got good function after removing broken nail without external fixation. Other 1 patient had osteoarthritis to 1 degree, and got better result with the treatment of physical therapy and intra-articular injection.

CONCLUSIONCortex screw is the effective treatment for tibiofibular syndesmosis separation. Clear diagnosis, delicate operation and postoperative reasonable functional exercise are primary factor of prognosis.

Adult ; Ankle Fractures ; surgery ; Ankle Joint ; surgery ; Bone Screws ; Female ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Treatment Outcome

Adult ; Choanal Atresia ; etiology ; therapy ; Constriction, Pathologic ; etiology ; Humans ; Male ; Nasopharyngeal Diseases ; etiology ; therapy ; Otorhinolaryngologic Surgical Procedures ; adverse effects ; Palate ; surgery ; Postoperative Complications ; therapy ; Uvula ; surgery

Cerebrospinal Fluid Rhinorrhea ; surgery ; Endoscopy ; methods ; Female ; Humans ; Male

Obiective To study the characteristics and the correlation factors of ADR induced by Ginkgo Leaf Extract and Dipyridamole Injection on the purpose of providing reference for clinical rational administration.Methods All ADR cases that induced by Ginkgo Leaf Extract and Dipyridamole Injection reported between January 2006 and August 2009 were retrieved and statistically analyzed.Results Of all 24 ADR patients induced by Ginkgo Leaf Extract and Dipyridamole Injection,the female patients were more than the male,and the senile patients had highest incidence 41.67%.Most ADR events happened within 30min(70.83%).ADR mainly manifested as adverse reactions of skin and appendants(33.33%),followed by central nervous system adverse reaction.Conclusion Great importance should be attached to ADR induced by Ginkgo Leaf Extract and Dipyridamole Injection.Medication monitoring should be enhanced to avoid occurrence of ADR clinically.

Objective To assess the feasibility of heterogeneous acellular dermal matrix(ADM)seeded with adipose derived stem cells(ADSC)for urethroplasty in a rabbit model.Methods ADSC were isolated from a rabbit and expanded in vitro,then identified by flow cytometry.We seeded ADSC onto the ADM and made it into tissue-engineered urethra.12 male rabbits were removed 1 cm urethra and divided into experiment group and control group.There were 6 rabbits in each group.Reconstructed urethra with tissueengineered urethra was used in experiment group,while unseeded ADM were used in control group.Urethrography was performed at 6 months after surgery.The animals were scarified at 3 and 6 months after surgery and the repaired urethra were harvested.H&E staining and immunohistochemical staining were performed with cytokeratin AE1/AE3 and smooth muscle desmin makers.Results The morphology of isolated ADSC was with long spindle cross-links,and had multicentral growth.Flow cytometry showed that the ADSC expressed CD166,CD105,CD90 and CD44,but not expressed CD45 and CD13.The cells could growth well on the ADM and showed good biocompatibility with it.All animals could void normally,urethrography showed there was no significant stenosis.3 months after surgery,the experiment group appeared regenerated smooth muscle but not in the control group,both groups did not regenerate urothelium.At 6 months urothelium and smooth muscle cells could be observed in the experiment group,but only the smooth muscle was evident in the control group.Conclusions By applying tissue engineering methods,we can seed the ADSC onto the heterogeneous ADM and make it into tissue-engineered urethra,which can help improve the reconstructive effect of urethra.

Objective To study the influence of unilateral and bilateral amplification on the effect of hearing aid evaluation .Methods Using the subjective method that International Outcome Inventory for Hearing Aids (IOI-HA) and objective method that medium acoustic intensity (65 dB SPL) word recognition score(WRS) to evaluate the effect of unilateral and bilateral hearing aid fitting of middle -aged severe sensorneural hearing loss .Results Hearing aid were used for severe sensorneural hearing loss and the improvement of monosyllables and sentences in quiet and noise test of unilateral were 35 .73% ,43 .15% ,43 .23% ;the improvement of monosyllables and sentences in quiet and noise test of bilateral were 37 .90% ,51 .33% ,54 .86% .The WRS of bilateral was higher than unilater-al .The score of IOI-HA was 15~37 ,meaning patients with severe sensorneural hearing loss were satisfied with hearing aid ,and there was no statistical significance between unilateral and bilateral fitting .Conclusion The bilat-eral hearing aid fitting was better than unilateral .Binaural hearing loss are recommended to fit bilaleral hearing aids .

Arteriovenous Fistula ; complications ; diagnosis ; diagnostic imaging ; Child ; Contrast Media ; Coronary Angiography ; Coronary Vessels ; pathology ; Female ; Humans ; Superior Vena Cava Syndrome ; diagnosis ; diagnostic imaging ; etiology ; Tomography, X-Ray Computed ; Vena Cava, Superior ; abnormalities ; diagnostic imaging