Objective To compare the efficacy of internal fixation with non-operative treatment of traumatic flail chest combined with sternal fracture.Methods A retrospective review was made on 102 patients with traumatic flail chest combined with sternal fracture treated from January 2007 to January 2014.There were 71 patients in operation group and 31 patients in non-operation group.Operation group was allocated to pure titanium rib plating (Group Ⅰ,22 cases),porous titanium screw fixation (Group Ⅱ,20 cases),and nickel-titanium memory alloy sternal rib plating (Group Ⅲ,29 cases).Rib traction was performed in non-operation group.Clinical results and incidence of complications were compared between the two groups.Results At 24 and 72 hours,operation group was superior over non-operation group with regard to HR [(100.4 ± 9.5) times/min vs (105.2 ± 10.1) times/min,(92.1 ± 9.9) times/min vs (102.1 ± 9.2) times/min],MAP [(97.7 ± 14.5) mmHg vs (91.0 ± 13.3) mmHg,(112.5 ± 15.2) mmHg vs (93.1 ± 13.8)mmHg] and CVP [(7.8 ±3.7)cmH2O vs (9.4 ±3.8)cmH2O,(6.2 ±2.9)cmH2O vs (9.1 ±3.2) cmH2 O] (P ＜ 0.05).Duration in ICU [(5.1 ± 0.8) days vs (9.3 ± 1.1) days],ventilation time [(4.5 ±1.0)days vs (8.2 ± 1.4)days],hospitalization time [(14.6 ±3.5)days vs (23.3 ±4.4)days] and incidence of complications were significantly lower in operation group than in non-operation group (P ＜ 0.05).Two months after discharge,tidal volume (VT) [(0.52 ±0.04)L vs (0.40 ±0.03)L],inspiratory capacity (IC)[(1.99 ±0.45)L vs (1.22 ±±0.33)L],forced vital capacity (FVC) [(3.52 ±0.51)L vs (2.44 ±0.42)L],total lung capacity (TLC) [(5.41 ±0.82)L vs (3.72 ±0.56)L] and forced expiratory volume in one second (FEV1) [(2.80 ± 0.43) L vs (1.95 ± 0.50) L] showed significantly better results in operation group than in non-operation group (P ＜ 0.05).Operation time,intraoperative bleeding and daily drainage volume were (38.8 ±9.2)min,(43.5 ±7.6)ml and (10.9 ± 1.1)ml in Group Ⅱ versus (62.5 ± 10.1)min,(100.0 ± 10.5) ml and (26.8 ±3.1)ml in Group Ⅰ and (49.3 ±9.6)min,(61.4 ±8.3)min and (19.8 ±1.6)ml in Group Ⅲ (P ＜ 0.01).Conclusion For traumatic flail chest combined with sternal fracture,the internal fixation should be done as early as possible so as to reduce incidence of complications.Relatively,porous titanium screw fixation has better clinical outcome.

microRNAs function as effective molecules in regulation of many biological functions of organisms; in most case they regulate gene expression moderately. Emerging evidence suggests that microRNAs play a key role in the regulation of immunological functions including innate and adaptive immune responses. The research on microRNAs would be helpful in elucidation of the mechanisms of human immune system and in development of potential therapies based on microRNAs.
Gene Expression Regulation ; Humans ; Immune System ; physiology ; MicroRNAs ; genetics ; physiology

Management Information Systems ; Occupational Exposure ; Software Design

Objective To investigate the polarization of Th1/Th2/Th3cell function of dermatomyositis/polymyositis(DM/PM).Methods The culture supernatant levels of IL-4,IFN-?,TGF-?1that were produced by the peripheral blood mononuclear cells(PBMC)were detected by Sandwich ELISA in23DM/PM patients(DM18,PM5)and17healthy subjects.Results The level of IFN-?(168.17?218.35ng/mL)produced by PBMC from the patients of DM/PM was significantly lower than that from normal controls(380.61?299.13ng/mL)(P0.05),and normal controls(231.64?83.92)(P

0.05)].Maternal serum concentrations of TG and LDL-C were significantly increased in DM group [(3.6?0.9)and(4.8?0.6)mmol/L] compared with GIGT group [(2.7?0.7)and(3.8?0.9)mmol/L] and GDM group [(2.9?0.7)and(3.7?0.8) mmol/L](P0.05).The incidence of fetal distress in the GIGT group(9.8%)was lower than that in DM group(20.2%)and GDM group(21.4%,P

Calcinosis ; complications ; Decalcification Technique ; Humans ; Meningeal Neoplasms ; complications ; Meningioma ; complications ; Specimen Handling ; methods ; Ultrasonics

Objective To provide reference for anti-infection drugs in Zunyi area by analyzing the etiological characteristics of children with severe pneumonia.Methods The sputum, throat swabs and serum of children with severe pneumonia in pediatric intensive care unit of our hospital from January 2014 to December 2015 were collected in this study.The pathogen species which caused severe pneumonia were detected and identified by the method of pathogen culture,and typical pathogens were detected by RT-PCR and indirect immunofluorescence.Results A total of 337 children with severe pneumonia were included,the pathogen positive rate was 86.65%(292/337).The rate of viral infection(37.32%)was the highest,followed by bacterial infection accounting for 28.42%,then the mixed infection accounting for 27.74%,and the mycoplasma pneumoniae infection accounting for 6.50%.The respiratory syncytial virus type B accounting for 28.44% was the most common in viral infection,and there were significant differences in age distribution(P<0.05),the children under 3-years-old,especially the infants under 1-year-old had the highest susceptibility.Viral infection had certain seasonality,compared with spring and winter,autumn and winter(November to April) had higher viral detection rate and the difference was statistically significant(x2=29.28,P=0.001).The escherichia coli was the most common in bacterial infection,accounting for 21.69%.Klebsiella pneumoniae,Escherichia coli were more common in neonates and infants under 1-year-old,Haemophilus influenzae occured in 1~3 years old children,Streptococcus pneumoniae infection could occur in any age.Conclusion Viral infection is the most common pathogen in children with severe pneumonia in Zunyi area followed by bacterial infection,which is more common in children under 1-year-old,and with the high incidence in autumn and winter.Bacterial infection is more common in children over 3 years of age.Bacterial and viral mixed infection is common in children under 3 years of age,especially in children under 1-year-old.

Adult ; Foot Diseases ; diagnostic imaging ; Humans ; Male ; Melorheostosis ; diagnostic imaging ; Radiography ; X-Rays

Objective:To evaluate the endothelial functions and autoregulation capacity of cerebral blood flow in patients with Fabry disease .Methods:Brachial artery vasodilation was assessed in 8 pa-tients with Fabry disease and 14 healthy controls by means of flow-mediated dilation ( FMD) and Nitro-glycerin-mediated dilation ( NMD) .Cerebrovascular reactivity was calculated in terms of breath-holding index ( BHI) and vascular motor reactivity ( VMR) by TCD-CO2 test in 4 patients and 14 healthy con-trols.Results:Compared with the controls , brachial artery vasodilation experiment showed no difference (the patients:FMD 15.94%±5.03% and NMD 23.92%±7.23%, the controls: FMD 14.57%± 5 .84% and NMD 22 .64%±6 .96%) , there was no relationship between FMD or NMD and the age , course of disease , MSSI or enzyme activity .In respect of cerebrovascular autoregulation capacity , there was no difference in anterior circulation , while cerebrovascular reactivity tended to be impaired in posteri-or circulation .Conclusion:Endothelial function showed no decline in patients with Fabry disease , but cerebrovascular autoregulation capacity tended to be impaired in posterior circulation .

Objective:To perform the preoperative design and operative simulation for periprosthetic femoral fractures (PFF)in one patient with complex tumor knee replacement under assistance of three-dimensional (3D) printing technology,and to explore a more accurate and feasible way to restore the normal anatomy and function of this kind of patients.Methods:The female patient aged 32 years old diagnosed with PFF after an complex tumor knee replacement was selected.The CT images of the patient’s bilateral legs were collected and reconstructed.The bilateral femurs were virtually sliced and the important parameters at each location of both sides were recorded respectively.Novel femoral stem and nail paths were specially designed on the basis of original prosthesis according to these parameters. Then vitual assemble was made with the residual femur. The prosthetic femoral stem components and navigator were customized based on the 3D simulation results when no more errors were found.The residual femoral resin model,customized components and navigator were printed with an SLA 3D printer.The bone cement was taken out and newly designed femoral stem was implanted successfully according to the steps designed preoperatively.The preconcerted allograft bone plates were applied for patch of the bone defect.The pathological results,X-ray and functional scores were included in the observation indexes. Results: With the help of successfully preoperative computer matching,successfully printed bone model-prosthesis assemble and re-customized navigator,the operation was successfully performed.The postoperative alignment shown in the X-ray image was good.The patient was able to normally walk and squat one month after operation with a crutch.MSTS93 score was improved from 0 before operation to 14 only one month after operation.Conclusion:As for PFF of complex tumor knee joint,preoperative design and simulation with 3D printing technology may provide a more accurately and effectively operative outcome than traditional methods.