Objective To investigate the imaging diagnosis and surgical treatment of intestinal malrotation in adult patients. Methods The clinical data of 11 adult patients with intestinal malrotation who had been admitted to General Hospital of PLA from January 2003 to December 2007 were retrospectively analyzed. Multiple imaging modalities, including barium enema, gastrointestinal radiography, B sonography, computed tomography (CT) scan and mesenteric angiography were applied for diagnosis. All patients received Ladd procedure. Results Two patients were diagnosed by gastrointestinal radiography +B sonography, 4 by gastrointestinal radiography +CT scan, 1 by angiography, 1 by B sonography + CT scan, 1 by iodine radiography + CT scan and 2 by intraopera-tive examination. After the operation, 2 had renal insufficiency, 1 had intestinal fistula and 1 had short bowel syndrome and died at the third month after operation. Conclusion Combined application of multiple imaging modalities can improve the diagnostic rate, and Ladd procedure is effective and safe for adult patients with intes-tinal malrotation.

OBJECTIVETo compare clinical efficacy of anatomic locking plate and Gamma nail in treating unstable femoral intertrochanteric fractures with external wall fractures.

METHODSFrom June 2010 to June 2014,clinical data of 44 patients with intertroehanteric fractures associated with lateral wall fractures (type 31A2.2-3.3) followed more than 12 months,which treated with Gamma nail or anatomic locking plate,were retrospective analyzed. Sixteen patients were treated with anatomic locking plate, including 6 males and 10 females aged from 32 to 83 years old with an average of 56.5 years old. Twenty-eight patients were treated with Gamma nail including 17 males and 11 females aged from 26 to 87 years old with an average of 60.4 years old. Operative time, intraoperative fluoroscopy times, blood loss (intraoperative and hidden blood loss), hospital stays were observed and compared. PPMS and HHS scoring were used to evaluate postoperative clinical effect.

RESULTSAll patients were followed up from 12 to 24 months with an average of 16.2 months. Operative time in Gamma nail was shorter than anatomic locking plate; while blood loss( intraoperative and hidden blood loss) and intraoperative fluoroscopy times in anatomic locking plate were less than that of in Gamma nail. There was no significant meaning in hospital stays between two groups. Postoperative full weight-bearing time in anatomic locking plate was prolonged than Gamma nail. At the final following-up, PPMS in Gamma nail was 7.50 ± 1.78 and 6.82 ± 1.38 in anatomic locking plate, and there was no obvious meaning between two groups (t = 2.341, P = 0.132); there was no significant differences in HHS score between Gamma nail (83.25 ± 11.18) and anatomic locking plate (86.14 ± 12.36) (t = 1.923, P = 0.243). The incidence of complications in Gamma nail was less than anatomic lock-ing plate (P = 0.005).

CONCLUSIONAnatomic locking plate for intertrochanteric fractures with external wall fractures could avoid re-injury of external wall, especially for severe comminuted fractures, difficult for intramedullary nailing, and there was no significant meaning in hip joint function compared with Gamma nail, while postoperative incidence of complications was higher than Gamma nail, so early weight-bearing was not stress.

Adult ; Aged ; Bone Nails ; Bone Plates ; Female ; Fracture Fixation, Intramedullary ; instrumentation ; methods ; Hip Fractures ; surgery ; Hip Joint ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

Abstract? AIM: To analysis the relation of severity of rhegmatogenous retinal detachment with the levels of amino acids and vascular endothelial growth factor ( VEGF) in the serum and in subretinal fluid.? METHODS: Forty -eight patients ( 52 eyes ) with rhegmatogenous retinal detachment treated in our hospital were selected.According to the degree of retinal detachment, patients were divided into <1/2 quadrant group, 1/2-3/4 quadrant group and>3/4 quadrant group. Fifty-five healthy objects for physical examination in our hospital were selected as the control group, to compare the differences of amino acids and VEGF levels in the serum.Correlation analysis on VEGF levels and amino acids in the serum and in subretinal fluid among patients with different grades of rhegmatogenous retinal detachment was conducted.? RESULTS: In patients with rhegmatogenous retinal detachment, the tryptophan in serum was 28.59±4.46mg/L, phenylalanine 8.95 ±2.55mg/L, methionine 8.15 ±2.17mg/L, valine 28.62 ±5.29mg/L, histidine 18.96 ±1.85mg/L and VEGF 589.92 ±185.34μg/L, which were higher than those in the control group, and the difference was statistically significant(P<0.05).The levels of phenylalanine was 9.85 ±1.21mg/L, histidine 20.63 ±2.07mg/L and VEGF 718.69 ± 283.34μg/L in the subretinal fluid of>3/4 quadrant group, which were significantly higher than those in the <1/2 quadrant group and 1/2-3/4 quadrant group ( P<0.05). VEGF in the subretinal fluid of VEGF in the rhegmatogenous retinal detachment group were positively correlated with phenylalanine (r=0.542, P<0.001), and histidine (r=0.782, P<0.001).?CONCLUSION: The levels of amino acids and VEGF in the subretinal fluid of patients with rhegmatogenous retinal detachment was higher than those in normals and increased with the severity of retinal detachment.

Objective To evaluate the clinical effectiveness of perioperative fast-track surgery(FTS)program and nutrition support in the elderly patients with gastric cancer.Methods Totally 42 patients were equally randomized into FTS group(receiving perioperative FTS program)and control group(receiving a conventional therapy).The postoperative first defecation time,postoperative hospital stay,hospitahzation expenditure,and postoperative complications were compared between these two groups.Results The postoperative first defecation time and postoperative hospital stay were(75.4±24.3)hours and(11.2±3.2)days in FIS group and(98.0±22.6)hours and(14.4±4.6)days in control group(P=0.0165,P=0.0004;respectively).The hospitalization expenditure was significantly lower in FTS group than in control group[(3.66±0.48)×104 vs.(4.56±0.78)×104 RMB yuan;P=0.0001].The incidence of postoperative complications in FTS group was also significantly lower than that in control group(9.5% vs.28.6%,P=0.0422).Conclusion Perioperative FTS program can accelerate postoperative rehabilitation,shorten hospital stay,lower hospitalization expenditure,and reduce the incidence of postoperative complications.

Objective To summarize the treatment experiences in gastrointestinal leaJcage atter gastrectomy for gastric cancer. Mehods From January 1997 to December 2006 the clinical data of 37 cases of gastrointestinal leakage including anastomotic leakage in 19 cases and duodenal stump leakage in 18 after gastrectomy for gastric cancer in People's Liberation Army General Hospital were analyzed retrospectively. Results All of the Cases were treated with abdominal drainage,continuous gastrointinal decomnression and parenteral nutrition combined with enteral nutrition.There were 32 cases receiving glutamine enrichment nutrition support,31 ases used somatostatin,13 cases received supplemented recombinarlt human growth hormone.Fistula healed in 21～30 d in 9 cases after gastrectomy,in the other 24 cases fistula healed in 30-60 d,while it healed in 60～81 d in the remaining 2 cases.Two died of leakage associated complications after gastrectomy for gastric cancer including anastomotlc leakage follwing esophagojejunostomy complicated by severe thoracic and lung infection in one and duodenal stump leakage complicated by severe abdominal cavity sepsis and hemorrhage in the other. Conclusion Patent and effective abdominal cavity drainage,continuous gastrointestinal decompression,parenteral nutrition combined with enteral nutrition,glutarnine,somatostafin and recombinant human growth hormone are the'mportant factors for the healing of gastrointestinal leakage after gastrectomy tor gastric cancer.

AIM:To study the visual acuity and refractive status of students pupils and middle school students in Shenzhen, and to provide a scientific basis for the prevention and control of myopia.
METHODS:A cluster sampling method was used to select five primary school students(6 737) and three junior middle school students(1 925) from Shenzhen. The visual acuity, anterior segment, fundus, eye position, and refractive status were measured. Information on associated factors for poor vision were also obtained using a questionaire. The risk factors of poor vision and the rate of myopia between grade or gender were analysed by Chi-square test.
RESULTS:The rate of poor vision was 67. 0%. Female, family history of high myopia, long time of continuous look near, short time of outdoor activities were the main risk factors. The rate of emmetropia, hyperopia, astigmatism and myopia were 15. 1%, 11. 3%, 11. 0% and 62. 6% respectively. Emmetropia, hyperopia and astigmatism incidenece rate decreased with age growing, but myopia incidence rate was increased. There were significant differences between adjacent two grades in myopia(χ2=7. 338-45. 018, P<0. 05 ) except the primary grade six and the junior grade one. There were significant differences between boys ( 61. 0%) and girls ( 65. 5%) in myopia(χ2=17. 180, P<0. 05).
CONCLUSION:The rate of poor vison is pretty high in students of Shenzhen aged between 5 to 16 years old, and myopia is the main reason. The development rate of myopia is increased with age. Early management of myopia may play an important role in controlling poor vision in students.

Background Oxidative damage may cause the functional dysfunction and death of retinal vascular endothelial cells(RVECs),and further leads to the development of retinal vascular diseases.Fufang xueshuantong has a therapeutic effect on retinal vascular diseases,but little is known about its molecular mechanism.Objective The goal of this study was to investigate the protective effects and mechanism of fufang xueshuantong on injury of human RVECs induced by tert-butyl hydroperoxide(t-BHP).Methods Human RVECs were isolated from healthy donor eyes and primarily cultured and then identified by flow cytometry.The third to fifth generations of cells were used in this experiments.The fufang xueshuantong solution of 0.0625,0.1250,0.2500,0.5000 and 1.0000 g/L were added in the cuhure plate with 5 × 104/L cells respectively in the experimental groups,and t-BHP of 75,100,200 and 300 μ.mol/L were added in the model control groups.MTT was used to detect the A490and survival rate of RVECs.The apoptotic rate and death rate of the cells were evaluated by double staining of Annexin V-FITC/PI.Morphology of human RVECs were examined using invert microscopy and Hoechst33258 staining.The expressions of nitro tyrosine (a marker of oxidative damage of protein)and 8-OHdG(a marker of oxidative damage of DNA)in human RVECs were assessed by the immunofluorescence staining.Western blot was used to detect the expressions of nuclear factorkappa B(NF-KB),p53,bcl-2 and bax after 6,12,24 hours t-BHP action.This study was approved by the Ethic Committee of Zhongshan Ophthalmic Center.Results No significant difference was found in A490value among the normal control group,0.0625,0.1250,0.2500,0.5000 and 1.0000 g/L fufang xueshuantong groups(F =1.989,P＞0.05).The survival rates of the cells were lower in 75,100,200 and 300 μmol/L t-BHP groups compared with corresponding fufang xueshuantong groups(t =14.57,13.82,21.51,32.64,P＜ 0.01).The percentages of normal cells were evidently lower in 75,100,200 and 300 μmol/L t-BHP compared with corresponding fufang xueshuantong groups(t=14.908,5.495,17.165,26.330,P＜0.01).The numbers of deformation and death of the human RVECs increased as the elevated concentration of t-BHP,but those in fufang xueshuantong groups were less than the t-BHP groups under the invert microscopy.Compared with t-BHP groups,the expressions of nitro tyrosine,8-OHdG,NF-KB,p53 and bax were lower but the expression of bcl-2 was higher in human RVECs with the statistically significant differences(P＜0.05).Fufang xueshuantong at the concentration of 0.2500 g/L showed maximally protective effect on human RVECs.Conclusions Fufang xueshuantong protects human RVECs against the t-BHP-induced injury through downregulating the expression of NF-kB,p53,bax and up-regulating the express of the bcl-2 protein.

Adult ; Air Pollutants, Occupational ; adverse effects ; Chemical Industry ; Female ; Humans ; Insecticides ; adverse effects ; Male ; Maximum Allowable Concentration ; Middle Aged ; Occupational Diseases ; chemically induced ; diagnosis ; Organothiophosphorus Compounds ; adverse effects ; Phosphorus Compounds ; adverse effects ; Sulfides ; adverse effects

OBJECTIVETo explore rest, cold compress and elevate (RICE) with rest, compress and elevate (RCE) without cold for the treatment of acute ankle sprain, in order to clear mid-term clinical effects.

METHODSEighty-nine patients with acute ankle sprains were collected from January 2013 to March 2014,including 30 males and 59 females aged from 18 to 60 years old with an average of 36 years old; the time from injury to hospital ranged from 3 to 24 h with an average of 9 h. All patients were divided into two groups according to visiting sequence. There were 45 patients in RICE group, and 45 patients in RCE groups. The main therapeutic effect index was evaluated by Karlsson scoring, and secondary therapeutic effect index was pain and satisfactory VAS scores. Safety index evaluated by adverse event.

RESULTSOn the 2nd weeks after injury, Karlsson score in RICE group was 44.66 ± 11.58, and 46.67 ± 8.52 in RCE group, while there was no statistical significance between two groups in Karlsson scores (P > 0.05). Karlsson score of two groups after treatment were higher than before treatment. There was no significantly meaning in pain and satisfactory VAS scores between two groups (P > 0.05). No adverse reaction were occurred between two groups.

CONCLUSIONCold compress did not receive much more final gains, and no evidence showed cold compress could affect recovery of joint function.

Acute Disease ; Adolescent ; Adult ; Ankle Injuries ; physiopathology ; therapy ; Case-Control Studies ; Cold Temperature ; Female ; Humans ; Male ; Middle Aged ; Sprains and Strains ; physiopathology ; therapy

Objective To discuss the clinical characteristic and diagnosis of children with moyamoya disease(MMD).Method The clinical features of 4 children with MMD were analyzed.Results The early clinical spectrum in children with MMD was transiently ischemic attack,and presented with injured neuron manifestations after some seizures,such as paralysis,extremity sensory disturbance, seizure of epilepsy,language disorder,involuntary movement and psychotic symptoms.Magnetic resonance angiography(MRA) and DSA demonstrated multiple cerebral vessels occlusion or stenosis and moyamoya vessels,so MRA became the first choice for detec- ting MMD.Conclusions The clinical symptom and neuron symptom of children MMD may not be typical,and it is easily misdiagnosed.Its correct diagnosis depends on thorough physical examination,appropriate laboratory tests,and the general knowledge of this disease.