OBJECTIVETo explore the clinical effect of the method by using an expanded post-auricular skin flap combined with autologous rib cartilage framework for correction of concha-type microtia.

METHODSThe operation were performed in three stages. The expander was implanted under post-auricular skin at the first stage and expanded skin flap was formed. At the second stage, the expander was taken out and the expanded skin flap was transferred with autologous rib cartilage framework and skin graft for correction of microtia. At the third stage, the reconstructed ear was revised and new concha was formed.

RESULTSFrom August 2008 to August 2011, 108 cases with 113 concha-type microtia were corrected by this method. All patients healed primarily and were followed up for 6 months to 3 years. The reconstructed ears had a good appearance and position, and were symmetric to ear on the healthy sides.

CONCLUSIONSUsing expanded post-auricular skin flap combined with autologous rib cartilage framework is a reliable method for concha-type microtia.

Adolescent ; Adult ; Cartilage ; transplantation ; Child ; Child, Preschool ; Ear, External ; abnormalities ; Female ; Humans ; Male ; Reconstructive Surgical Procedures ; methods ; Ribs ; Skin Transplantation ; methods ; Surgical Flaps ; Tissue Expansion ; methods ; Transplantation, Autologous ; Treatment Outcome ; Young Adult

Objective To investigate the clinical value of the combination of routine magnetic resonance imaging (MRI),magnetic resonance cholangiopancreatography (MRCP),diffusion weighted imaging (DWI)and enhanced magnetic resonance imaging in the diagnosis of recurrent pyogenic cholangitis (RPC).Methods The clinical and MRI data of 2 1 cases of RPC confirmed by surgery or puncture were retrospectivly analyized.Results All of 2 1 patients were performded with routine MRI (FSE T2 WI,FSPGR T1 WI and FIASTA),MRCP and DWI.1 2 cases were underwent three-dimensional dynamic contrast-enhanced MRI with a liver volume accelerated acquisition sequence (LAVA).The raw data was uploaded to GE ADW4.4 station and the three dimensional MRCP and DWI were analyzed.(1)All of 21 cases were hepatolithiasis complicated with irregular expansion.11 cases were involved left intra-hepatic bile duct,7 cases were right intrahepatic duct,and 3 cases were involved left and right intrahepatic bile duct.Wall thickening was in 19 cases,normal biliary duct wall was in 2 cases.(2)Common bile duct disease:calculus of intrahepatic and extrahepatic bile duct complicated with bile duct dilatation were in 8 cases.Calculus of intrahepatic bile duct were individually in 13 cases.(3)Gall-bladder disease:there were 5 cases of gallstone,9 cases of chronic cholecystitis,3 cases of acute cholecystitis and 4 cases of chole-cystectomy.(4)Liver parenchyma disease:there were 6 cases of liver atrophy in all the cases (left lobe atrophy of 4 cases,right lobe atrophy of 4 cases).The inflammatory changes around dilated bile ducts were found in 1 2 cases.The MRI findings of those were slight patchy hyperintensity signal on conventional T2 WI,the area of hyperintensity signal on T2 WI was extended on DWI.On dynamic contrast-enhanced MRI,the inflammatory areas were uniformity minor enhancement on arterial phase,and hardening in-creases on portal and delayed phase.Conclusion Multi-sequences MRI can be more fully reflected the pathologic changes of RPC, which is important for imaging diagnosis of the disease.

Objective To understand the overall development of TCM technique patent in Guangdong Province through the analysis on the patent application and authorization status of TCM technique patent in Guangdong Province from 2006 to 2015. Methods CNIPR and State Intellectual Property Office platform was searched, and 2006-2015 TCM technique patent application literature in Guangdong Province were obtained, the patent application and authorization status were analyzed. Results The number of application for TCM technique patent in Guangdong Province was 1434 during 2006-2015, and the number of application and authorization rates were increasing. The number of application in the Pearl River Delta (PRD) region of Guangdong Province was greater than that of the non-PRD regions, with individual application of 65.9% and enterprise application of 25.9%; A61K36 accounted for 98.7% in TCM technique patent classification statistics. Conclusion The quantity of patent application of TCM technique in Guangdong Province is large, but the number of application of non-individuals, the rate of authorization, technology statistical classification and innovation ability of TCM technique are low.

Objective To investigate the risk factors for leukoaraiosis (LA). Methods The clinical and imaging data in patients with stroke were collected retrospectively. LA was divided into periventricular LA and subcortical LA according to the findings of MRI, and they were scored and classified. Results A total of 113 patients with stroke were included. There were 39 women and 74 men (mean age 61.33 ± 1.32 years). The age (65.52 ± 12. 56 vs.47. 96 ±9. 23 years, t =5. 634, P =0. 000), hypertension (68. 60% vs. 29. 63% ,x2 = 12. 932,P =0. 000), diabetes (30. 23% vs. 3.70%, x2 = 7. 953, P = 0. 005), systolic blood pressure (SBP) (147. 42 ± 2. 78 mm Hg vs. 134. 00 ± 22. 45 mm Hg,t = 2. 862, P = 0. 004), glucose (6. 54 ± 3. 48 mmol/L vs. 5. 35 ± 1.37 mmol/L, t = 2. 808, P = 0. 005), and total cholesterol (TC) level (5. 17±0.89 mmol/L vs. 4.59±0.61 mmol/L, t=3. 152, P=0. 002) in patients with periventricular LA (n = 86) were significantly higher than those without periventricular LA (n =27). The age (66. 44 ± 11.33 vs. 47. 96 ±9. 23 years, t =4. 768, P =0. 000), hypertension (74. 29% vs. 34. 88%, x2 = 17. 134, P = 0. 000), SBP (85.46 ± 9. 80 mm Hg vs. 69. 81 ±8. 74 mm Hg, t =2. 999, P=0. 003), diastolic blood pressure (DBP) (85.46 ±9. 80 mm Hg vs.69. 81 ±8.74 mm Hg, t =2. 999, P =0. 003), and TC level (5.22±0.99 mmol/L vs. 4.91 ±0. 75 mmol/L, t =3. 330, P =0. 001) in patients with subcortical LA (n =70) were significantly higher than those without subcortical LA (n =43). Spearman correlation analysis showed that the periventricular LA classification was significantly correlated with the age (rs = 0. 606, P =0. 000), drinking (rs = -0. 257, P = 0. 006), hypertension (rs = 0. 428, P = 0. 000), diabetes (rs =0. 236, P =0. 012), SBP (rs =0. 382, P =0. 000), and DBP (rs =0. 258, P =0. 006). The subcortical LA classification was significantly correlated with the age (rs = 0.488, P = 0. 000),hypertension (rs = 0. 416, P = 0. 000), SBP (rs = 0. 386, P = 0. 000), DBP (rs = 0. 326, P =0. 006), and TC level (rs =0. 231, P =0. 014). Multivariate logistic regression analysis showed that the age (odds ratio[OR] = 1.071, 95% confidence interval [CI] 1.009-1. 137; P=O. 024), hypertension (OR =4. 106, 95% CI 1. 657-10. 174; P =0. 002), and SBP (OR =1. 049,95% CI 1. 162-7. 013; P = 0. 022) were independently correlated with LA. Conclusions The age, hypertension, and SBP are the independent risk factors for LA, in which the age is an uncontrollable factor, and the aggressive prevention and treatment of hypertension may reduce the occurrence of LA.

Objective To find out the weakness in the emergency nursing for burst group accidents, and then building a normative nursing program which have included framework and 4 stages. Methods Using the method of Fish-Bone Drawing to analyzed the nursing courses in 22 burst accidents within the past 4 years retrospectively. Results After using the normative nursing program, nurses have known their own working targets and responsibility, which can apply the nursing care effectively and orderly. Conclusion The application of emergency nursing program is a kind of quick and proper nursing method, which can improve the patients' prognosis effectively.

OBJECTIVE: To observe the efficacy of modified acupotome combined with blocking therapy in patients with carpal tunnel syndrome (CTS). METHODS: Fifty-five patients with CTS were divided into three groups, which were modified acupotome group including 26 CTS patients with 28 lesions treated by modified acupotome combined with blocking therapy, traditional acupotome group including 14 CTS patients with 16 lesions treated by traditional acupotome combined with blocking therapy, and blocking therapy group including 15 CTS patients with 15 lesions only treated by local blocking. The treatment outcome and one-year recurrence rate were observed. RESULTS: The response rate and one-year recurrence rate after operation in the modified acupotome group were 85.7% (24/28) and 20.8% (5/24) respectively, which had no significant differences as compared with 81.3% (13/16) and 38.5% (5/13) in the traditional acupotome group. The response rate and one-year recurrence rate after operation in the above two groups were both improved significantly as compared with those in the blocking therapy group which were 46.7% (7/15) and 85.7% (6/7) respectively. There were no acupotome-related adverse effects and injuries observed in the modified acupotome group. CONCLUSION: The modified acupotome is a considerable treatment method for CTS with respect to its simple manipulation and high effectiveness.

Objective: To study the attenuating effect of angiotensin I type 1 receptor antagonist losartan and an-giotensin converting enzyme inhibitor captopril on aortic atherosclerosis in rabbits. Methods: Thirty-one male New Zealand rabbits were randomly divided into 5 groups:control group,high cholesterol diet group,losartan group, captopril group and combined drug administration groupdosartan+captopril). The animals were killed after 16 weeks and the serum total cholesterol ,triglyceride, high and low density cholesterol .atherosclertic ratio,endothelin,NO,plaque area percentage,aortic cholesterol content and vascular smooth muscle cell (VSMC) apoptosis were determined. Results:The plaque area percentage,aortic cholesterol contents and endothelin levels of 3 drug treatment groups were significantly lower than that of high cholesterol group,NO contents and VSMC apoptosis were significantly higher. Conclusion:Losartan and captopril can attenuate aortic atherosclerosis induced by high cholesterol diet .combined administration of the 2 drugs at low doses are more effective. The mechanism may be related to the protection of endothelial function and the effect on apoptosis of VSMC.

Objective To evaluate the value of stress perfusion cardiovascular magnetic resonance in the diagnosis of coronary ar-tery disease.Methods Relevant literatures about stress perfusion cardiovascular magnetic resonance in the diagnosis of coronary ar-tery disease were searched.According to the recommended contents of the Cochrane Collaboration,we set inclusion criteria and screen literatures.Using software STATA 12.0 and Meta-disc 1.4,we analyzed the data ,including the heterogeneity,publication bias,subgroup analysis,Meta-regression,clinical application,pooled sensitivity(SEN),specificity(SPE),positive likelihood ratio (PLR),negative likelihood ratio(NLR),diagnostic odds ratio(DOR)and 95%confidence interval(95%CI),we drew the summary receiver operating characteristic curve(SROC)and calculated the area under the curve(AUC).Results Twenty-nine literatures were included,the pooled SEN,SPE,PLR,NLR,DOR and 95%CI were 0.90(0.89~0.92)、0.78(0.75~0.80)、4.03(3.32~4.91)、0.14 (0.11~0.18)、32.54(22.25~47.60)respectively.The AUC of SROC was 0.907 8.Conclusion The current evidence indicates that stress perfusion cardiovascular magnetic resonance has a high diagnostic accuracy for detection coronary artery disease.However, the relatively high false positive rate was found due to the medium specificity.

Objective To investigate correlations between nursing students’discrimination on psychopaths and exposure to them.Method One hundred and twenty-one nursing students were involved in the investigation by a general information questionnaire,a discrimination against mental patients scale(DAMPS)and an exposure to mental patients scale(FLS).Results The total mean score on discrimination,scores on isolation dimension and scores on capability were all significantly lower than the norms(all P<0.01).Negative correlation was observed between nursing students’discrimination against patients and exposure to patients(r=-0.31,P<0.05). Conclusion Measures should be taken to encourage nurses to understand patients so as to alleviate their discrimination.

OBJECTIVETo investigate the characteristics and incidence of the thoracic deformities in patients with microtia.

METHODSIn Plastic Surgery Hospital, we conducted a retrospective study of the clinical and radiographical data of 300 patients with microtia from March 2013 to October 2014. Pearson χ2 test was used to analyze the relationship among deformities of ribs and spine, as well as microtia.

RESULTSA total of 78 (26.0%) patients were documented with rib deformities, 26 patients (8.7%) had spinal deformities, and 17 patients (5.7% )had both. The incidence of rib deformities in microtia I, II, and III was 7.1% (2/28), 26.7% (62/232) and 35.0% (14/40) respectively. The incidence of spinal deformities in microtia I, II, and III was 3.6% (1/28), 6.5% (15/232) and 25.0% (10/40 respectively. The patients with microtia III were found to have a higher incidence of ribs and spinal deformities than those with microtia II, patients with microtia II were found to have a higher incidence of ribs and spinal deformities than those with microtia I (P < 0.05).

CONCLUSIONSThe incidence of ribs and spinal deformities is high in patients with microtia. The poorer one auricle developed, the higher the incidence of thoracic deformities.

Biomedical Research ; Congenital Microtia ; epidemiology ; Humans ; Incidence ; Retrospective Studies ; Ribs ; abnormalities ; Spine ; abnormalities