Objective To investigate the clinical features and prognosis of replantation of fingertips distal to the middle nail.Methods Between August 2001 and August 2005,16 fingertips amputated in the Ishikawa zoneⅠwere replanted.We anastomosed only the digital arteries,and adopted postoperative bloodletting.Results Fourteen fingertips survived,and two failed.The survival rate was 87.5%.Of the 14 successfully replanted fin- gertips,12 were followed up from 3 to 12 months.The length and appearance of the fingertips recovered and good joint motion were maintained.Their two-point discriminations ranged from 3 to 6 mm.Conclusion Fingertip replantation is an optimal treatment for fingertip amputation distal to the middle nail to regain satisfactory appearance and function of the digits with a high survival rate,but severe crush injury to the amputated part and high cost should be taken into consideration.

Antifungal Agents ; therapeutic use ; Aspergillus fumigatus ; pathogenicity ; Brain Abscess ; diagnostic imaging ; drug therapy ; microbiology ; Humans ; Infant ; Male ; Neuroaspergillosis ; complications ; pathology ; Occipital Lobe ; pathology ; Pulmonary Aspergillosis ; diagnostic imaging ; drug therapy ; microbiology ; Tomography, X-Ray Computed ; Treatment Outcome

Objective To explore the methods and effects of specialty training for wound care. Methods Fourteen nurses working and studying in the wound care center received specialty training of wound care. Their current knowledge and train-ing needs were assessed through writing test and symposium before the training. Then,the training contents and plan were de-signed. The training duration was identified as 3-6 months. The open teaching method was applied in the training directed by the entrostomal therapists(ET). According to the evaluation index,the nurses were asked to finish a reading report in the first month,a case report in the second month,and group discussion on a case of complicated wound care the third month. In ad-dition,they needed to finish the exam of wound care theory and skills every three months. The correlations between perfor-mance in the examination and the nurses' age,years of working experlence,educational level,professional title,duration and times of training by correlation analysis. Results The times of training was significantly correlated with the performance in the examination(r=-0.49,P<0.05),especially with the performance of case report,reading report,and group discussion on compli-cated wound care(r=0.51,-0.60,P<0.05). There was no correlation between the performance with nurses' age,years of working experience,educational level,professional title and duration of training. Conclusion One time of specialty training at least 3 months can achieve good effect. The times of training is correlated with the training effect,especially in case report,reading report and group discussion on complicated wound care.

AIM: To investigate the effect of rigid contact lens in the treatment after pterygium excision and limbal stem cell transplantation in senile patients.METHODS: Totally 90 elderly patients diagnosed as unilateral pterygium in our hospital from March 2015 to March 2016 were selected and divided into two groups, observation group and control group, 45 case with 45 eyes in each group.Observation group was treated with limbal stem cell transplantation and rigid contact lens.Control group was treated with limbal stem cell transplantation only.The following indicators were observed and compared: corneal healing time, visual analogue score(VAS) at 1, 3, 5 and 7d after surgery and the recurrence rate of pterygium.RESULTS: The score on corneal irritation of observation group was significantly lower than that of control group (P<0.05).Control group took more time on corneal healing than observation group (P<0.05).VAS of control group were higher than that of the observation group at 1 and 2d after treatment with significant difference (P<0.05).The recurrence rates of pterygium were not statistically significant between the two groups (P>0.05).CONCLUSION: Autologous corneal stem cell transplantation combined with rigid contact lens for pterygium in elderly patients is effective with shorter healing time and less pain, and it does not increase the recurrence rate.

Objective To investigate neurogenesis in the dentate gyrus of adult rat following conditioned fear stimulus.Methods 24 adult male rats were randomly divided into conditioned fear stimulus group and control group,and all rats were intraperitoneally injected bromodeoxyuridine(BrdU)3 days before conditioned fear stimuli.Animals in conditioned fear stimulus group were given monotone matching foot shock and made conditioned fear stimulus model,animals in control group only give monotone.Freezing time was detected before stimuli and 7th,14th days after stimuli,then rats were sacrificed 7th or 14th day after fear conditioned stimulus,and immunohistochemistry for Brdu was detected.Results Behavioral assessment showed that the percents of freezing time in conditioned fear stimulus group 7th,14th days after conditioned fear stimulus were significantly high(88.68%,91.33%)than those in control group(11.18%,14.23%,P<0.01)and before stimulus(24.11%,16.11%,P<0.01).Compared to control group(1567±28,580±5),Brdu positive cells in dentate gyrus of rat in conditioned fear stimulus group(1364±21,296±22)were decreased,and it reached to a statistical significance on 14th day (P<0.05).Conclusion The decreased neurogenesis in the dentate gyrus of adult rat following conditioned fear stimuli may have relation to fear and other emotion memory.

Adolescent ; Biopsy ; Cough ; etiology ; Diagnosis, Differential ; Female ; Fever ; etiology ; Humans ; Lung ; diagnostic imaging ; pathology ; Sarcoidosis, Pulmonary ; diagnosis ; diagnostic imaging ; pathology ; Tomography, X-Ray Computed

Age of Onset ; China ; epidemiology ; Dust ; Humans ; Occupational Exposure ; analysis ; Pneumoconiosis ; epidemiology

BACKGROUND:Atlantal lateral mass screw fixation contains lateral mass screw fixation under the posterior arch of the atlas and lateral mass screw fixation via the posterior arch of atlas (also cal ed atlas pedicle screw fixation) according to different insertion points. The two methods have their advantages and disadvantages. There are lacks of the comparative studies on bony anatomy feasibility by two kinds of atlantal lateral mass screw fixation.
OBJECTIVE:To compare the feasibility associated with two kinds of atlantal lateral mass screw fixations taking Chinese data of atlantal bony anatomy as evidence.
METHODS:Data of CT scans in 30 adults with cervical spondylosis (60 sides) were col ected, and data were reconstructed using CT workstation. We measured key bone anatomy structure after atlantal lateral mass screw fixation. The atlantal lateral mass was suitable for lateral mass screw fixation via the posterior arch of atlas if its height and width of vertebral artery groove at the posterior arch ≥ 4 mm. It was suitable for lateral mass screw fixation under the posterior arch of the atlas if the height of posterior arch of atlas lateral mass ≥ 4 mm.
RESULTS AND CONCLUSION:The height of vertebral artery groove at the posterior arch was (4.54±1.17) mm. The width of vertebral artery groove at the posterior arch was (8.69±1.12) mm. The height of posterior arch of atlas lateral mass was (4.98±1.07) mm. There were 41 cases with the height of vertebral artery groove at the posterior arch>4 mm (suitable for lateral mass screw fixation via the posterior arch of atlas, occupying 68%. There were 52 cases with the height of posterior arch of atlas lateral mass>4 mm (suitable for lateral mass screw fixation under the posterior arch of the atlas), occupying 87%. There were significant differences in the differences between the two groups (P<0.05). These results indicated that lateral mass screw fixation under the posterior arch of the atlas was more feasible compared with lateral mass screw fixation via the posterior arch of atlas. Preoperative CT measure for key anatomic structure was significant for making personalized surgical plan.

Objective To discuss the psychological behavior intervention methods on reducing the violence behavior of schizophrenia patients. Methods 120 schizophrenia patients were admitted from January to December, 2007 and randomly assigned into the behavior intervention group (group A), the psy-chological support group (group B), the health education group (group C) and the control group (group D) with 30 cases in each group. Group A received routine nursing plus behavior intervention, group B was giv-en routine nursing plus psychological support, group C adopted routine nursing plus health education, group D only received routine nursing. The intervention effect was evaluated with MOAS and the relapse rate of violence behavior went through statistics. Results After intervention, the scores of MOAS decreased sig-nificantly in group A, B, C and D compared with those before intervention. The reduction of MOAS scores in group A, B and C was significantly higher than that of group D, with the highest reduction score in group A and group B and C followed subsequently. The relapse rates of the violence behavior in group A, B and C were significantly lower than those of group D. Conclusions Routine nursing, health education, psycho-logical support and behavior intervention can all reduce and decrease the violence behavior and the inci-dence of the violence behavior, among which behavior intervention proves to be the most effective, and psy-chological support and health education go subsequently.

Objective To assess isehemic myocardial regional function of different coronary atherosclerosis using velocity vector imaging(VVI).Methods Two-dimensional images of apical four-，two-chamber and long-axis view were obtained in 50 patients with coronary artery disease.All segments of the left ventricle were divided into 5 groups：group 0 with no coronary artery stenosis，group 1 with stenosis＜50%，group 2 with stenosis 50%to 74%，group 3 with stenosis 75%to 99%and group 4 with a completely occluded coronary artery.The segmental myocardial systolic peak strain(ε)，systolic strain rate(SRs)，early diastolic strain rate(SRe)，late diastolic strain rate(SRa)and their ratio(SRe/SRa)were analyzed with VVI offline software.Results①Compared with group 0，SRe and SRe/SRa of group 1，SRs，SRe，SRe/SRa of group 2～4，εof group 2 and group 4 decreased significantly(P＜0.05).②In the comparison of four ischemic groups，ε，SRe，SRa of group 3 were markedly higher than those of group 2，while ε，SRs，SRa of group 2 were lower than those of group 1(P＜0.05)；for group 4，ε，SRs，SRe were lower than those of group 1，SRe was lower than that of group 2，and ε，SRs，SRe were lower than those of group 3(P＜0.05).ConclusionsIn the process of coronary atherosclerosis，myocardial diastolic and systolic dysfunction occurred early and orderly，and has a bidirectional change：decreased firstly，then increased and decreased at last.