Amphotericin B ; administration & dosage ; Antifungal Agents ; administration & dosage ; Child ; Cryptococcus neoformans ; drug effects ; pathogenicity ; Diagnosis, Differential ; Drug Delivery Systems ; instrumentation ; methods ; Humans ; Injections, Intraventricular ; Injections, Spinal ; Intracranial Hypertension ; complications ; drug therapy ; etiology ; Male ; Meningitis, Cryptococcal ; diagnosis ; drug therapy ; physiopathology ; Treatment Outcome

Adolescent ; Adult ; Air Pollutants, Occupational ; adverse effects ; analysis ; Cadmium Compounds ; adverse effects ; analysis ; Eye ; drug effects ; Humans ; Oxides ; adverse effects ; analysis ; Young Adult

Objective To discuss the early clinical management of the pa tients with traumatic hemipelvectomy. Methods A case was reported and literature reviewed. Results The patient was a 4-year-old boy who incurred a left groin and proximal thigh crush with nearly complete transection of this extremity and arrived at our hospital 7 hours after injury. After the vital signs were stabili zed with reasonable wound care and 2 hours of fluid resuscitation, the patient r eceived a thorough debridement and the hip disarticulation and fixation of pubic symphysis. The postoperative course was relatively smooth. While the successful treatments of this patient corresponded to the experiences in the literature, s pecial considerations regarding this severe injury were discussed. Conclusion Im mediate prehospital hemostasis by local pressure, rapid transport, aggressive in itial resuscitation, early recognition of the severity and prompt decision to co mplete the amputation, and attention to details in the rehabilitation phase are necessary for successful management of these patients.

Animals ; Cells, Cultured ; Interleukin-1 ; pharmacology ; Matrix Metalloproteinase 1 ; secretion ; Muscle, Smooth, Vascular ; cytology ; Myocytes, Smooth Muscle ; cytology ; drug effects ; metabolism ; Platelet-Derived Growth Factor ; pharmacology ; Rabbits

Chromosomes, Human, Pair 14 ; Chromosomes, Human, Pair 18 ; Dendritic Cells, Follicular ; metabolism ; pathology ; Humans ; Lymphoma, Follicular ; genetics ; metabolism ; pathology ; Lymphoma, Large B-Cell, Diffuse ; genetics ; metabolism ; pathology ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Translocation, Genetic

Modern Chinese Orthopaedic traumatology has stemmed from the orthopaed ics of Traditional Chinese Medicine(TMC)and western orthopaedics.On the one hand,with a long history and its unique system of theory and treatment,TMC orthopaedics h as made a great con-tribution to the development of modern Chinese orthopaedic traumatology.On the other hand,the introduction and development of western medicine have dramatically pro moted the development of modern Chinese orthopaedic traumatology.Modern Chinese surgeons of orthopaedic trauma have accomplished numerous successful f irst cases in the world since 1950s an d have thus expanded their professional influence.At pr esent,the Chinese orthopaedic trau ma community has grown much stronger and established its ow n academic associations and journals.More and more de-partments of orthopaedic traumatology have been successively establis hed as an independent en-tity in large and middle-sized hospi tals in China.So far,the Chinese orthopaedic trauma com-munity,on the whole,has reached the international level,but there are q uite a lot to be improved in the aspect of treatment.To end the backwardness,in the future Chinese orthopaedic trauma community should make great efforts in education of orthopedists on comp rehensive knowledge,establishment of formal profession al training system,national standardization of orthopaedic procedures in clinical diagnosis an d treatment,active membership of re lative international aca-demic associations and increasing p rofessional exchanges with international counterparts,as well as in research and development of operative techniques and fixators.All these will be the main strategies and developmental trends in the future for Chinese orthopaed ic traumatology. [

Objective To summarize the clinical features,diagnosis and treatment principles of abdomen postsurgical gastroparesis syndrome(PGS).Methods The clinical data of 28 patients with abdomen postsurgical gastroparesis syndrome,collected from our hospital in the past ten years,were analyzed retrospectively.Results All 28 patients were cured by conservation therapy.The average gastric dynamics response time was 20.2 days(12.0～34.0 days),which included 2 cases recovered within 1-2 weeks,17 cases recovered within 2-3 weeks,7 cases recovered within 3-4 weeks,2 cases recovered over 4 weeks.Conclusion PGS is a functional reaction rather than mechanical obstruction disease.The diagnosis mainly depends on the symptoms and sighs combined with gastrointestinal angiography or endoscopy.Most of the patients can be cured by conservative treatment.

Objective To evaluated the diagnostic value of malignant biliary obstrutive disease magnetic resonance cholangiopancreatography(MRCP).Methods 21 cases with malignant biliary obstructive disease diagnosed by clinic and CT were examined by MRCP,the results of MRCP and operation-pathology were analysed.Results The accuracy of MRCP for evaluating the cause of obstructive were 90.5%(19/21),dilated biliary duct appeared "soft canes-like"and "sausage-like",obstructive ends of biliary duct exhibited "cut-off form","down cup mouth-form"and "mouse tail-form".Conclusion Malignant biliary obstruction can accurately diagnosed by MRCP,it may provide an efficient method for the patients who can not accept ERCP provide an efficient alternative to direct cholangiopancreatography.

Objective To investigate the association of prognosis with clinical features,tumor imaging,and pathological grading and staging in small renal cell carcinoma(SRCC). Methods The clinical data of 76 cases of SRCC (no more than 3 cm in diameter) were analyzed retrospectively.According to the clinical symptoms,they were divided into two groups,symptomatic (hematuria and lumbago) group (n=17,accounting for 22.4%) and asymptomatic group (n=59,77.6%).All the 76 cases underwent CT scan,with the diagnosis rate of 94.7%;69 cases underwent B-ultrasound examination with the diagnosis rate of 84.1%. Results All the 76 cases underwent radical nephrectomy through oblique incision in the lumbus.The excised tumors were pathologically confirmed to be clear cell carcinoma.The patients were followed up for 32 to 87 months(mean,62.7 months).The 1-,3-,and 5-year cancer-free survival rates of the symptomatic and asymptomatic groups were 100% and 53.3%,33.3% and 100%,90.6% and 77.4%,respectively.There were statistically significant differences between the two groups in the 3- and 5-year cancer-free survival rates (P

While the basic concept of saving life and decreasing disability h as not changed in the management of polytrauma, the timing and strategies of tre atment have been gradually modified. Damage control is one of the new strategies , and its application in orthopedic traumatology is known as damage control orth opedics. Damage control orthopedics involves formalized three stages in the mana gement of fractures of long bones and pelvis. Stage 1 consists of temporary fixa tion of the unstable fractures and hemostasis. Stage 2 comprises resuscitation, warming, oxygen delivery and administration of coagulation factors to the patien t in the intensive care unit. In Stage 3 definitive fixation is done for the fra cture. Indications of damage control orthopedics: for patients with polytrauma w hose conditions are unstable or in extremis the damage control strategy is recom mended. For the borderline patients early total care may be applied, but the sur gery should be performed with great caution. It has to be converted to the damag e control strategy if conditions of the patient deteriorate during the operation . Since damage control orthopedics is an evolving practice, further work is need ed to enhance its effectiveness and to reduce the incidence of ARDS and MOF.