Adult ; Bone Marrow ; pathology ; Female ; Humans ; Leg ; Neoplasm Invasiveness ; Rhabdomyosarcoma, Embryonal ; pathology ; therapy

The cerebral blood flow of infant is effected by physiological and pathological factors.As the cerebrovascular autoregulation of neonates is poor,in pathological cases,especially when hypoxemia and hypercapnia impaired regulation of its own,lead to changes in cerebral blood flow,then resulting in severe brain injury.It has made enormous progress in the research on the changes of cerebral blood flow in newborns in recent years.In normal infants,cerebral blood flow velocities is positively correlated to gestational age and body weight,and increase gradually with day-age in the first week after birth.The cerebral blood flow of newborn with brain injury can present as insufficiency,over-perfusion or low speed high-resistance earlier and high speed low-resistance later.Different results may be related to the duration and severity of asphyxia,but all of those are signs of damage of self-regulatory function of cerebral blood flow.Cerebral hemodynamic change is the important pathogenesis mechanism of brain injury.

Objective To evaluate the methods and consequences of surgical technique in the treatment of Stanford A aortic dissection.Methods 108 patients with type Standford A aortic dissection underwent surgery in our study,including urgent surgery in 53 and selective surgery in 55.The operation was performed under deep hypothennic circulatory arrest (DHCA) in 85 cases.Surgical procedures included ascending and semi arch replacement or total arch replacement (some cases combined with stented graft implanted into the descending aorta),"elephant trunk" procedure.Concomitant procedures included repair of intimal tear in arch or descending aorta,Bentall procedure,aortic valve replacement,Cabrol or modified Cabrol procedure,aortic valvuloplasty,mitral valvuloplasty or mitral valve replacement,tricuspid valvuloplasty and CABG.Results In-hospital mortality was 6.5% (7 of 108 patients).The mor- tality was 7.5% (4 of 53 patients) in urgent surgery group and in elective surgery group was 5.4% (3 of 55 patients).Ninety six percent survived patients were followed up for 1 month to 13.3 years [mean (3.2?1.3) years] and 2 deaths occurred during the fel- low-up period.3 patients underwent re-operatian.Conclusion The choice of surgical procedures depend on the location of intimal tear for Stanford A aortic dissection.The better operative effects can be expected with proper surgical indication,perfecting surgical technique,and enhancing postoperative treatment.

The average life expectancy in Macau is ranking the second in the world, the consumption of fresh medicinal plants is a profound culture in Macau. The paper focus on the distribution of the antioxidant herbs, a comprehensive investigation and analysis the amount of the plant resources was carried out. The antioxidant activity of alcohol extracts was determined by using the DPPH method, and six kinds fresh herbs with high antioxidant free radical activity were screened out. Reference to adult daily dose of vitamin C, it is calculated that the daily dose amount of fresh herbs is less than 200 g. For the expected shortage of resources and the ecological status of Macau, we give some suggestions of herbal introduction in population ecology reconstruction.
Antioxidants ; pharmacology ; Ecosystem ; Free Radical Scavengers ; pharmacology ; Macau ; Plant Extracts ; pharmacology

Child ; Endoscopy ; Humans ; Male ; Paraganglioma ; surgery ; Urinary Bladder Neoplasms ; surgery

OBJECTIVETo investigate clinical effects of minimally invasive fixation and bone grafting througn medial side for the treatment of Schatzker III tibial plateau fracture.

METHODSFrom April 2009 to August 2011, 18 patients with Schatzker III tibial plateau fracture were treated with minimally invasive fixation and bone grafting through medial side. There were 15 males and 3 females ranging in age from 64 to 73 years, with an average of (69.75 ± 1.22) years. Sixteen patients were caused by falling down, 2 cases were caused by traffic accident. Operative time and length of incision were be recorded. Clinical and radiological follow-up was performed after operation. Hospital for Special Surgery (HSS) score and Kellgren-Lawrence score were used to evaluate clinical effects.

RESULTSThe mean operative time was (45.32 ± 1.58) min, and the mean length of incision was (5.21 ± 0.65) cm. Postoperative X-ray showed excellent reduction. Eighteen patients were followed up for 10 to 13 months with an average of (11.5 ± 1.35) months. The mean HSS score was 86.51 ± 2.71, 12 cases got excellent results,4 good and 2 fair. Three patients were developed mild osteoarthritis according to the Kellgren-Lawrence system.

CONCLUSIONMinimally invasive fixation and bone grafting through medial side, not only could reduce surgical invasive, but also guarantee early function activities. It has advantages of keeping well after reduction. So it has the favorable future in clinic.

Aged ; Bone Transplantation ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Retrospective Studies ; Tibial Fractures ; surgery

BACKGROUND:Many studies have demonstrated that restoration of femoral offset in revision total hip arthroplasty would contribute to the recovery of joint function.OBJECTIVE:To investigate the importance of restoration of femoral offset in revision total hip arthreplasty on the recovery of joint function.METHODS:An observational study was performed at the Department of Orthopedics,Third Affiliated Hospital of Guangzhou Medical University between February 2004 and May 2007.A total of 15 patients with the revision total hip arthroplasty,including 12 males and 3 females,aging 62 75 years,averaging 67 years old,were recruited into this study.Harris evaluation system was used to evaluate joint function.The femoral neck anteversion and the femoral offset were measured by the method of Sakai.The vertical distance from the teardrop line to the most prominent point of the lesser trochanter was measured from each radiograph.References were combined to investigate the effect of restoration of femoral offset in revision total hip arthroplasty on joint function.RESULTS AND CONCLUSION:All the 15 patients were recruited into this study.The duration of follow-up ranged from 24 months to 5 years.We measured the femoral offset on pre- and post-operative radiographs,and the results indicated that the femoral offset of 4 patients were above 4 mm.The femoral offset of 11 patients was restored.The femoral offset were 22-48 (32.21±0.64) mm pre- and 22-57 (36.13±0.82) mm post-operative radiographs,respectively.The mean difference in femoral offset post-operatively was significant (t=0.424,P=0.01 ).Harris scores were good in 4 cases,passable in 2 cases,and poor in 9 cases pre-operatively,and the scores were excellent in 8 cases,good in 4 cases,passable in 2 cases,and poor in 1 case post-operatively.The score of Harris evaluation system in the patient of restoration group and failed restoration group were 88.72±5.3 (80%) and 72.32±6.5 (27%) post-operative at 1 month respectively.The mean difference of the score was significant (χ~2=1.245,P<0.05).The 3 patients had complication,one was the dislocation of hip,and two had the pain of hip.All the patients with complication were in failed restoration of femoral offset,which was above 4 mm.The restoration of femoral offset contributes to the recovery of joint function and reduce complication occurrence after total hip arthroplasty revision.

BackgroundPterygia is a clinical common disease.A lot of surgical methods are developed to decrease the recurrence rate.Resent years,the application of fibrin glue is receiving more and more attention.Objective This study was to explore the effects of fibrin glue in decreasing inflammatory irritation and its mechanism. Methods Pterygia models were created in 12 clean rabbits by exsection of limbal tissue and topical administration of 1.25％ diluted hydrochloric acid,and then the conjunctival autograft surgery was performed in the experimental rabbits.The conjunctival flap was sutured in the left eyes,and the conjunctival wound was closed using fibrin glue in the right eyes.The operation duration for each group was documented and compared.The irritation sign was examined under the slit lamp in all the rabbits 1 week and 4 weeks respectively.The expressions of vascular endothelial growth factor (VFGF) and basic fibroblast growth factor (bFGF) proteins in the conjunctiva tissue were detected by immunochemistry,and the expressions of VFGF mRNA and bFGF mRNA in the conjunctival tissue were determined by reverse transcription polymerase chain reaction (RT-PCR).Results The operative duration was (21.3±0.2) minutes in suture group and( 10.1 ±0.1 )minutes in the fibrin glue group with a significant difference between two groups( t =102.242,P＜0.05 ).From 1 week through 4 weeks,the hyperemiain degree was obviously slight in fibrin glue group compared with suture group.Immunochemistry showed that VEGF and bFGF proteins were expressed mainly in the cytoplasm of conjunctival epithelium layer.The positive response intensity was weaker in the fibrin glue group than in suture group 1 week and 4 weeks after operation.RT-PCR revealed that the expression level of VEGF mRNA was significantly lower in fibrin glue group than in suture group,and the VEGF mRNA was gradually decreased with the time lapse ( Fgroup =174.443,P =0.000 ; Ftime =231.459,P =0.000 ).The similar outcomes were found in the expression of bFGF mRNA(Fgroup=41.727,P=0.000;Ftime=55.417,P=0.000). ConclusionsThe use of fibringluecanshortentheoperationdurationandreducepostoperationinflammatoryreaction.The downregulation of VEGF and bFGF in tissue is the possible mechanism of remitting irritation sign,which allows a reduce of the recurrence rate of pterygia.

Objective To explore the gene expression of interleukin-13 receptor (IL-13R)?2 and its relationship to proliferation activity of human gliomas.Methods The gene expression of IL-13R?in 50 hu- man gliomas,2 malignant human glioma cell lines and 6 normal brain tissues were studied by RT-PCR.Ki-67 labeling index (Ki267 LI) of all sample were detecteded by immunohistochemical staining.Results Only one normal brain tissues expressed very low IL-13R?2 mRNA,whereas 35 (70%) of 50 human brain tumors expressed 1L-13R?2 mRNA.The positive rate and expression level of IL-13R?2 mRNA were increased with the ascending of WHO tumor grade.(former:rs=0.87;letter:rs=0.69,P＜0.01).The difference of posi- tive rate and expression level of IL-13R 2?mRNA between the low grade and high grade tumors was statistical- ly significant,the proliferation activity of gliomas evaluated by Ki-67LI (Ki-67 Labeling Index,Ki-67LI) was positively correlated with IL-13R?2 gene expression and the tumor grade.Conclusion In human cerebral gliomas,IL-13R?2 genes may play an role in the malignant progression.The expression level of malignancy in molecular level and selecting the target of gene therapy.

OBJECTIVEHelicobacter pylori (H. pylori) eradication remains a challenge with increasing antibiotic resistance. Hybrid therapy has attracted widespread attention because of initial report with good efficacy and safety. However, many issues on hybrid therapy are still unclear such as the eradication efficacy, safety, compliance, influencing factors, correlation with antibiotic resistance, and comparison with other regimens. Therefore, a comprehensive review on the evidence of hybrid therapy for H. pylori infection was conducted.

DATA SOURCESThe data used in this review were mainly from PubMed articles published in English up to September 30, 2015, searching by the terms of "Helicobacter pylori" or "H. pylori", and "hybrid".

STUDY SELECTIONClinical research articles were selected mainly according to their level of relevance to this topic.

RESULTSTotally, 1871 patients of 12 studies received hybrid therapy. The eradication rates were 77.6-97.4% in intention-to-treat and 82.6-99.1% in per-protocol analyses. Compliance was 93.3-100.0%, overall adverse effects rate was 14.5-67.5%, and discontinued medication rate due to adverse effects was 0-6.7%. H. pylori culture and sensitivity test were performed only in 13.3% patients. Pooled analysis showed that the eradication rates with dual clarithromycin and metronidazole susceptible, isolated metronidazole or clarithromycin resistance, and dual clarithromycin and metronidazole resistance were 98.5%, 97.6%, 92.9%, and 80.0%, respectively. Overall, the efficacy, compliance, and safety of hybrid therapy were similar with sequential or concomitant therapy. However, hybrid therapy might be superior to sequential therapy in Asians.

CONCLUSIONSHybrid therapy showed wide differences in the efficacy but consistently good compliance and safety across different regions. Dual clarithromycin and metronidazole resistance were the key factor to efficacy. Hybrid therapy was similar to sequential or concomitant therapy in the efficacy, safety, and compliance.

Clarithromycin ; administration & dosage ; adverse effects ; Drug Resistance, Bacterial ; Drug Therapy, Combination ; Helicobacter pylori ; drug effects ; Humans ; Medication Adherence ; Metronidazole ; administration & dosage ; adverse effects ; Proton Pump Inhibitors ; administration & dosage