OBJECTIVETo evaluate the clinical effect of a new surgical approaches for repairing the acute Achilles tendon rupture.

METHODSFrom January 2009 to January 2014, 21 patients with Achilles tendon rupture were treated by 2 minimally invasive incisions and remaining skin bridge of achilles tendon end including 16 males and 5 females with an average age of 44.3 years old ranging from 21 to 57 years old. Postoperative complications, the range of movement of affected ankle joint, the circumference calf and ankle on both side, time of reture to work and sports activity were observed and recorded. The American Orthopaedic Foot and Ankle Society (AOFAS) score was used to evaluate the functional recovery.

RESULTSAll patients were followed up for 6 to 36 months with an average of 13.5 months. No skin necrosis, wound infection, deep vein thrombosis,re-rupture and sensory disturbance with the ankle or foot in the sural nerve distribution were found. At 1 year after operation, there was no significant difference in the range of movement between affected foot (55.4 ± 6.5)° and unaffected foot (56.3 ± 3.7)° (t = 0.872, P = 0.325). There was significant difference in AOFAS between preoperative (65.1 ± 6.9) and postoperative (94.3 ± 5.5) (t = 7.672, P = 0.013). All patients returned to work and study at an average of 10 weeks (ranged from 6 to 15 weeks) and 15 patients returned to normal sports activities at 21 weeks (ranged from 18 to 24 weeks). Calf and ankle circumferences decreased by 0.45 cm (0.3 to 0.8 cm) and increased by 0.4 cm (0.2 to 0.7 cm), respectively in the injured leg as compared with the contralateral leg.

CONCLUSIONThe simplicity of the technique of minimally invasive incision and skin bridge for acute closed Achilles tendon reconstruction is an effective and reliable method with low complication.

Achilles Tendon ; surgery ; Acute Disease ; Adult ; Female ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Rupture

Humans ; Infant, Newborn ; Intermittent Positive-Pressure Ventilation

Blood Cell Count ; Child ; Fever ; Histiocytosis, Non-Langerhans-Cell ; diagnosis ; Humans ; Male ; Prognosis

Neonatal mortality has been significantly decreased because of the development of neo-natal respiratory support techniques. Nevertheless,constant and high frequency ventilators have some limita-tions to solve all problems in neonatal respiratory failure. Special mechanical ventilation,mainly including he-liox and partial liquid ventilation,provides new respiratory support for newborn infants. The clinical signifi-cance of heliox and partial liquid ventilation need further investigation.

Objective To investigate the clinical efficacy of open radical mastoidectomy (ORM) combined with ear cavity angioplasty and mastoid cavity obliteration in treatment of cholesteatoma otitis media (COM). Methods Eighty-two patients with COM were divided into 2 groups according to surgical approach: control group (41 patients undergoing simple ORM) and observation group (41 patients undergoing ORM combined with ear cavity angioplasty and mastoid cavity obliteration). The clinical efficacy and recurrence rate between the 2 groups were compared. Results The total effective rate, dry ear rate and eardrum healing survival rate in observation group were significantly higher than those in control group: 95.12% (39/41) vs. 78.05% (32/41), 97.56% (40/41) vs. 75.61% (31/41) and 90.24%(37/41) vs. 73.17% (30/41), and there were statistical differences (P<0.01). The dry ear time and epithelialization time in observation group were significantly shorter than those in control group:(31.23 ±5.69) d vs. (48.12 ± 8.97) d and (24.41±3.23) d vs. (36.24 ± 5.69) d, the postoperative pure tone audiometry (PTA) and air bone gap (ABG) in observation group were significantly lower than those in control group:(25.61 ± 5.67) dB vs. (35.41 ± 8.23) dB and (13.24 ± 3.98) dB vs. (19.02 ± 5.52) dB, and there were statistical differences (P<0.01). There was no statistical difference in the incidence of complications between 2 groups (P>0.05). The recurrence rate in observation group was significantly lower than that in control group:2.44%(1/41) vs. 14.63%(6/41), and there was statistical difference (P<0.05). Conclusions The application of ORM combined with ear cavity angioplasty and mastoid cavity obliteration in the treatment of COM has significant effect, with rapid postoperative dry ear and epithelialization, fewer complications and lower recurrence rate. It should be widely applied.

Children′s unique physiological, developmental and psychological attributes make them one of the most vulnerable groups in large-scale flood disasters.Formulating a reasonable and feasible emergency preparedness plan for flood disasters can improve their ability to cope with flood disasters and optimize the outcomes of children suffering from flood disasters.The emergency preparedness plan for children′s flood disaster should cover the allocation and utilization of various resources during disasters, regional cooperative rescue and evacuation of children, ethical problems in treatment under special circumstances, psychological counseling of children, family members and medical personnel.Relevant staff of pediatric emergency rescue need to consider all aspects and make reasonable plans so that the rescue work of children affected by disasters can be carried out in an orderly manner.

Adenoma, Liver Cell ; metabolism ; pathology ; Adolescent ; Adult ; Child ; Diagnosis, Differential ; Female ; Focal Nodular Hyperplasia ; metabolism ; pathology ; Humans ; Immunohistochemistry ; Liver ; chemistry ; pathology ; Liver Neoplasms ; metabolism ; pathology ; Male ; Middle Aged ; Peptidyl-Dipeptidase A ; biosynthesis ; Young Adult

OBJECTIVE:To systematically evaluate the effectiveness of probiotics in adjunctive prevention and treatment of chemotherapy-induced diarrhea(CID),and to provide evidence-based reference in the clinic. METHODS:All relevant randomized controlled trials (RCTs) of probiotics in adjunctive prevention and treatment of CID were collected by searching EMBase,Co-chrane library,PubMed,CJFD,VIP,Wanfang databases and CBM. Meta-analysis were performed with Rev Man 5.2 software af-ter data extraction and quality evaluation by Cochrane Hand book 5.0risk-bias assessment tool. RESULTS:10 RCTs were includ-ed,involving 871 patients. The results of Meta-analysis showed that addition of probiotics on the basis of conventional symptomatic therapy significantly reduced the total rate of diarrhea in cancer patients [OR=0.31,95%CI(0.20,0.49),P<0.001] and Ⅲ-Ⅳ diar-rhea rate[OR=0.09,95%CI(0.03,0.24),P<0.001],improved overall response rate [OR=4.16,95%CI(2.40,7.23),P<0.001] and complete remission rate [OR=2.55,95%CI(1.66,3.90),P<0.001],with statistical significance. The probiotics had little effect onⅠ-Ⅱlevel diarrhea rate[OR=0.86,95%CI(0.48,1.56),P=0.62] and partial remission rate[OR=1.00,95%CI(0.67,1.50),P=1.00],with statistical significance. CONCLUSIONS:The use of probiotics before chemotherapy can effectively prevent the occur-rence of severe CID in cancer patients;in the treatment of CID,the combination of probiotics can also improve therapeutic effica-cy of conventional symptomatic treatment.

Objective:To investigate the expression and correlation of cyclooxygenase-2(COX-2) and c-erbB-2 in human breast cancer.Methods: The expressions of COX-2 and c-erbB-2 in 48 breast cancer patients with breast cancer were detected with immunohistochemistry examination and was analyzed.The relationship between their expression and the clinicopathologic characters of breast cancer was also analyzed.Results: The positive rate of COX-2 was 60.4%(29/48) in these patients;the expression was higher in patients with tumor size larger than 2 cm,lymph node metastasis,and negative expression of ER or PR,but was not related with the ages,the pathologic types and the TNM stages.Expression of c-erbB-2 was identified in(39.6%)(19/48) of these patients;the expression was significantly higher in patients with lymph node metastasis or negative expression of ER and PR,but was not related with the ages,the sizes and the pathologic types.COX-2 was positive in 84.2%(16/19) of patients positive of c-erbB-2 and in 44.8%(13/29) of patients negative of c-erbB-2,with significant difference found between the 2 figures(P=0.006).Conclusion: The high expression of COX-2 in breast cancer is related to the expression of c-erbB-2,suggesting that they may regulate each other and jointly contribute to the tumorigenesis and progression of breast cancer.