Objective To study the availability of escharectomy in shock phase and its role in preventing complications.Methods To make an analysis between the escharectomies and skin grafting of 79 cases in or beyond shock phase in the incidence of sepsis,visceral complications,MODS,mortality,healing time and the expenditure.Result The cases of the early operations revealed much better consequences than those performed beyond shock phase.Conclusion The escharectomy in shock phase proves to be available and significant in reducing post burn complications.

Objective To study the effect of renal ischemic reperfusion injury on intracellular ionized calcium level and apoptosis. Methods The model of rat's acute renal ischemic reperfusion injury was established.A total of 30 Wistar rats were divided into 5 groups:control, 1 h ischemia and 1 h,2 h,24 h reperfusion groups (n=6 for each group).Renal intracellular [Ca 2+]i level was determined by Fura-2/AM fluorescence assay,and renal cell apoptosis rates were measured by flow cytometry. Results The renal intracellular [Ca 2+]i levels at 1h,2h and 24h timepoint of reperfusion were 156.2 nmol/L,181.6 nmol/L and 260.6 nmol/L,respectively,which were significantly higher (P

Bone Neoplasms ; Chondrosarcoma ; Female ; Humans ; Middle Aged ; Nasal Septum

Objective To study the etiological agent of hand, foot and mouth disease ( HFMD) and the genetic characteristics of coxsackievirus A16 ( CVA16 ) strains isolated from clinical specimens of patients with HFMD in Liaocheng city in 2013.Methods Throat swab and stool specimens were collected from patients with HFMD in the disease surveillance hospitals in Liaocheng city from January to December 2013.Samples pos-itive for CVA16 strains were screened out for the isolation of virus strains with rhabdomyosarcoma ( RD) cells and Vero cells.The entire VP1 coding regions of 9 randomly selected CVA16 isolates were amplified and se-quenced.BioEdit and MEGA4 softwares were used for homology analysis.A phylogenetic tree among the 9 CVA16 isolates and 56 CVA16 representative strains of known genotypes and subgenotypes was constructed.Re-sults The results of PCR analysis showed that 747(77.73%) out of 961 specimens were positive for HFMD and among them, 74 samples (9.91%) were positive for EV71 strains, 130(17.40%) were CVA16 strains and 543(72.69%) were other enterovirus strains.The 9 CVA16 strains clustered into the B2b evolution branch of B genotype with the representative strains, sharing 97.7%to 100%homologies in nucleotide sequences and 99.3%to 100%in amino acid sequences.Conclusion Although EV71 and CVA16 strains were identified, other enteric viruses were the predominant pathogens causing HFMD in Liaocheng city in 2013.The CVA16 iso-lates belonged to B2b subgenotype.The pathogen spectrum of HFMD had already changed.It is necessary to strengthen the surveillance for EV71, CVA16 and other enteric viruses and understand their genetic characteriza-tions, which would be of great significance for the prevention and control of HFMD.

Objective To investigate the relationship between the appearance of donor cells in urine and acute rejection and the clinical implication. Methods Eighty renal transplantation patients were observed, in which the donors were male and the recipients were female, or HLA DR antigen were mismatched (30 cases were at perioperative period, 20 cases were subjected to acute rejection, 30 cases had stable renal function). Urine samples were collected regularly. PCR and PCR SSP were applied to detect DYZ 1 (special gene fragment of Y chromosome) and DRB 1of HLA DR antigen respectively after DNA were obtained.Results Perioperative period group: donor cells in urine were detected in all the patients 24?h after operation. With the development of disease, the intensity of donor DNA expression in urine was decreased generally. 30 days later, donor cells in urine disappeared only in 3 cases of 30 cases, and acute rejection happened in 8 cases of the rest 27 cases. Acute rejection group: donor cells in urine were detected in 18 cases (90%); 2 weeks following anti rejection therapy, donor cells in urine were negative only in 3 cases, still positive in the other 15 cases, and the intensity of donor DNA expression in urine was decreased generally during the treatment. Donor cells in urine were negative in 16 cases ( 88.9% ) after treatment for 3 months. Stable renal function group: DYZ 1 or HLA DRB1 was positive in 2 cases ( 6.7% ), negative in 28 cases ( 93.3% ). Conclusion PCR and PCR SSP were used to detect DNA of donor cells in urine, which would be a new method to diagnose acute rejection of renal transplantation, but would not exactly fit for those happened in early stage. The intensity change of donor DNA expression in urine represented the recovery of renal transplantation, which provided the possibility to evaluate renal allograft rejection quantitatively at the same time.

Objective To investigate the relationship between microchimerism and immunologic tolerance in kidney transplantation recipients. Methods In samples of peripheral blood and urinary sediment from 176 females who received male donor's kidney,DNA and mRNA expression of specific fragment in Y chromosome were determined by PCR and RT PCR. Results The test results were positive for chimerism in 137 out of 176 recipients(77.84%),and negative in 39 cases (22.16%).The mean survival period in chimerism positive group was 8.9?3.7 years,and 5.2?3.9 years in chimerism negative group.The difference was statistically significant between the 2 groups ( P

Objective To explore the risk factors for infantile hemangiomas with the emphasis on perinatal factors and socioeconomic and environmental status.Methods A questionnaire survey was carried out targeting mothers and their babies who admitted to the Department of Prevention and Health Care of China-Japan Friendship Hospital for registration from Jan.1st,2009 to Dec.31st,2011.Information gathered included maternal basic information,perinatal factors before and during pregnancy,and socioeconomic and environmental status.Photos and record of the position and size of the pathological change were taken once infantile hemangiomas were diagnosed.Univariate analysis and multivariate Logistic regression analysis were carried out to investigate the risk factors.Results One thousand nine hundred and ninety-eight questionnaires with detail information were collected,among which 94 infants were diagnosed with infantile hemangiomas (4.7 ％).It showed that maternal age≥ 30 (OR =2.687,95％ CI:1.615-4.472,P =0.000),multiple pregnancies (OR =1.730,95 ％CI:1.032-2.901,P=0.038),female infants (OR =1.855,95 ％ CI:1.187-2.899,P =0.007 ),threatened abortion ( OR =3.135,95％ CI:1.487-6.609,P =0.003),amniocentesis (OR =2.754,95 ％CI:1.278-5.938,P =0.010),family history of hemangiomas (OR =2.978,95 ％ CI:1.127-4.049,P=0.032) and video display terminals exposure ＞45 h/week (OR=3.166,95％CI:2.027-4.944,P=0.000) were closely associated with infantile hemangiomas development.Conclusions The elderly maternal age,multiple pregnancies,female infants,threatened abortion,amniocentesis and family history of infantile hemangiomas and long-time exposure of video display terminals might be the risk factors for infantile hemangiomas.

Objective To study the effect of three dimensional conformal intensity modulated radiotherapy and prognostic factors for postoperative local recurrent esophageal squamous cell carcinomas.Methods A total of 468 patieuts with postoperative local recurrent esophageal squamous cell carcinomas were retrospectively analyzed.The median interval between surgery and recurrence was 14.95 months (2-252 months).There were 45 patients with supraclavicular lympy node relapse,291 with mediastinal lymph node relapse,4 with abdominal lymph node relapse,15 with anastomosis relapse,89 with supraclavicular and mediastinal lymph node relapse,11 with anastomosis and mediastinal lymph node relapse,7 with mediastinal and abdominal lymph node relapse,1 with supraclavicular and anastomosis relapse,2 with supraclavicular and abdominal lymph node relapse,3 with anastomosis,mediastinal and supraclavicular lymph node relapse.There were 224 patients who received three-dimensional conformal radiation therapy,and the other 244 patients of intensity-modulated radiation therapy,with a median dose of 59.4 Gy (40-70 Gy).A total of 166 patients received adjuvant chemotherapy.Kaplan-Meier method was used to calculate the survival rate;Log-rank test was used for univariate prognostic analysis;Cox regression test was used for multivariate prognostic analysis.Results The follow-up rate was 95.3％.The recent curative effect in the effective rate was 81.6％,with 41.2％ CR rate.The overall 1,2,3,4 years of survival rates after radiotherapy were 61％,32％,21％,14％ respectively and the median survival time was 17.6 months.Univariate analysis showed that age,.pathologic stage,the number of positive lymph node cleaning,the recurrence area,single or multiple lesions,the size of the lesion,overall response rate,radiation dose,and chemotherapy (x2 =4.814-247.322,P ＜ 0.05) were associated with prognosis.Multivariate analysis showed that age,pathologic stage,the recurrence area,single or multiple lesions,the size of the lesion,overall response rate,radiation dose,and chemotherapy (P ＜0.05) were independent prognostic factors.A total of 370 patients had progressive diseases after radiotherapy,176 had local failure 47.57％ (176/370),148 had distant metastasis 40.00％ (148/370) and 16 had both local and distant failures 4.32％ (16/370).One case died of pneumonia;2 cases died of acute myocardial infarction;1 case died of cerebral hemorrhage;26 cases died of unknown cause (including lost to follow-up).Lung was the most common distant metastatic site.Conclusions Radiotherapy may improve the survival of esophageal squamous cell carcinoma patients with postoperative recurrence.Patients with less than 70 years old,early postoperative stage,single recurrent lesion,initial small lesions,response to radiotherapy,radiation dose of higher than 59.4 Gy,chemoradiation might have better prognosis.

Objective To identify the outcome of pregnancy and the alteration of renal function in women with nephrotic syndrome. Methods From 2003 to 2007, 59 pregnant women with nephrotic syndrome in our hospital were enrolled in the study. Their clinical data were retrospectively analyzed, including the time of kidney disease onset, 24-hour proteinuria, serum albumin, serum creatinine, blood uric acid, blood pressure, fetal survival, fetal mortality, rate of premature delivery, birth weight of the newborn, and proteinuria, renal function, blood pressure of the patients during their postpartum follow-up. Logistic regression analysis was used to identify the risk factors influencing the outcome of the patients and the newborns. Results The average gestational week was (20.35±9.40) weeks when proteinuria was detected in these pregnant women. The 24-hour proteinuria ranged from 3.5 to 15 g/24 h (median 5.1 g/24 h). The serum albumin was between 10 and 28 g/L (median 22.5 g/L). The serum creatinine was between 32 and 825 μmol/L (median 84 μmol/L) and the serum uric acid ranged from 196 to 793 μmol/L (median 385.5 μmol/L). Pregnancy-induced hypertension syndrome occurred in 75% of the patients, among whom 55.5% suffered from preeclampsia. Forty-three (72.9%) newborns survived , among whom 76.7% (33/43) were premature births and 62.8% (27/43) were low birth weight infants. 50% of the pregnant women still had nephrotic syndrome after delivery. 75% of 24 patients with pre-existing chronic glomerulonephritis had increased proteinuria during pregnancy. Among the 38 patients with renal insufficiency, 36.8% had poorer renal function after delivery. 23.7% of the patients progressed into end stage renal failure after delivery, 80% of whom had serum creatinine ≥ 265 μmol/L. 89% of the patients had persistent hypertension after childbirth. The Logistic regression analysis indicated hyperuricemia during pregnancy (P=0.018, OR=1.012) and the increase of serum creatinine (P=0.039, OR=1.005) were risk factors of renal failure in pregnant women after delivery. Hyperuricemia (P=0.012, OR=1.006)was the risk factor of fetal death. Conclusions Pregnancy with nephrotic syndrome leads to a low fetal survival. Hyperuricemia is the most important risk factor of the poor outcome of pregnant women and newborn.

OBJECTIVETo investigate the effect of delayed skin grafting combined traction in severe joint cicatricial contracture.

METHODSAt the first stage, the joint cicatricial contracture was released completely with protection of vessels, nerves and tendons. The wound was covered with allogenetic skin or biomaterials. After skin traction for 7-14 days, the joint could reach the extension position. Then the skin graft was performed on the wound. 25 cases were treated from Mar. 2000 to May. 2013.

RESULTSPrimary healing was achieved at the second stage in all the cases. The skin graft had a satisfactory color and elasticity. Joint function was normal. All the patients were followed up for 3 months to 11 years with no hypertrophic scar and contraction relapse, except for one case who didn' t have enough active exercise on shoulder joint.

CONCLUSIONDelayed skin grafting combined traction can effectively increase the skin graft survival rate and improve the joint function recovery.

Biocompatible Materials ; therapeutic use ; Cicatrix, Hypertrophic ; Combined Modality Therapy ; methods ; Contracture ; surgery ; Female ; Humans ; Male ; Recovery of Function ; Recurrence ; Skin Transplantation ; methods ; Tendons ; Traction ; methods ; Wound Healing