OBJECTIVETo explore the technique and clinical results of close reduction by manipulation and minimally invasive percutaneous osteosynthesis with intramedullary nail for the treatment of femur shaft fractures. methods: A retrospective study was conducted to analyze 96 patients with the femur shaft fractures who had been treated with close reduction by manipulation and minimally invasive percutaneous osteosynthesis with intramedullary nail. There were 67 males and 29 females. The average age of patients was 39 years old (ranging from 16 to 88). According to AO fracture classification for the femur shaft fractures,there were 29 cases of type A,46 type B,21 type C.

RESULTSAll the patients were followed up and the duration ranged from 12 to 24 months (averaged, 15 months). All the fractures showed union. The time required for the bony union ranged from 3 to 10 months (averaged,4 months). The clinical results were evaluated by Thorsen classification system. At the latest follow-up, 87 patients obtained excellent results, 7 good, 2 fair.

CONCLUSIONThis treatment method combines advantages of intramedullary nail with close manipulative reduction, so can get satisfactory clinical results for the treatment of femoral shaft fracture with minimal trauma.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bone Nails ; Female ; Femoral Fractures ; diagnostic imaging ; surgery ; therapy ; Follow-Up Studies ; Fracture Fixation, Internal ; instrumentation ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; instrumentation ; Musculoskeletal Manipulations ; methods ; Retrospective Studies ; Tomography, X-Ray Computed ; Wound Closure Techniques ; Young Adult

UNLABELLEDOBJECTIVE To observe the clinical efficacy by Qingying Huoxue Decoction (QHD) combined ursodeoxycholic acid (UDCA) in treating patients with early and mid-term primary biliary cirrhosis (PBC). METHODS Totally 78 patients were randomly assigned to the treatment group and the control group, 39 in each group. All patients received basic treatment and took UDCA (at the daily dose of 13-15 mg/kg). Patients in the treatment group took QHD, one dose per day. The treatment course for all was 6 weeks. Clinical efficacy, gamma-glutamyl transferase (γ-GGT), alkaline phospatase (ALP), TBIL, alanine aminotransferase (ALT), and aspartate transaminase (AST) were observed before and after treatment. RESULTS Totally 21 (53. 8%) patients obtained complete response in the treatment group, with statistical difference when compared with that of the control group (11 cases, 30. 8%). Levels of GGT, ALP, ALT, AST, and TBIL decreased in the two groups after treatment (P < 0.01). Levels of ALP, GGT, and TBIL were obviously lower in the treatment group than in the control group (P < 0.05).

CONCLUSIONSQHD combined UDCA in treating early and mid-term PBC patients was superior to the effect of using UDCA alone. It also could improve patients' liver function.

Alanine Transaminase ; metabolism ; Aspartate Aminotransferases ; metabolism ; Drug Combinations ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Liver Cirrhosis, Biliary ; drug therapy ; Ursodeoxycholic Acid ; therapeutic use ; gamma-Glutamyltransferase ; metabolism

It is now clear that continued stimulation o f the neurohormonal system in heart failure (HF) has serious deleterious effects on the heart. The increase of circulating catecholamines exerts direct toxic ef fect on cardiac myocytes, increases membrane permeability and myocardial fibrosi s; lead to aggravation of HF. β-blockers are commonly used in the treatment of HF including propranolol, metoprolol, bisoprolol, bucindolol and carvedilol. These drugs are used in combination with ACEIs, digitalis and diuretics. Genera lly, the benefits of β-blockade therapy in HF include improving symptoms, decr easing morbidity, mortality, elevating need for hospitalization and quality of l ife. β- blockade therapy arrests and reverts LV remodeling and improves the ri sk of life threatening arrhythmias and sudden cardiac death. A few serious adver se effects include hypotension, heart blocks, bradycardia and fluid retention.

Electrocardiography ; Humans ; Lung Abscess ; complications ; Male ; Middle Aged ; Pulmonary Veins ; diagnostic imaging ; Radiography ; Tachycardia, Paroxysmal ; etiology ; surgery

OBJECTIVETo evaluate a retro-grade auricular flap for repairing large alar defects.

METHODSTwenty-nine adult cadavers were anatomically used for vascular investigation of the frontal, nasal and temporal regions by injecting a dye into the main vessels. Based on the anatomical study in these regions, a retro-grade auricular flap was designed for repairing alar defects in 16 patients.

RESULTSThe blood supply of the auricle could be nourished by the inner carotid artery system from the supratrachlear artery and supraorbital artery through the frontal arterial anastomotical network into the frontal branch of the superficial temporal artery. It is then passing the main trunk of the superficial temporal artery into the ear area through the auricular branches of the superficial temporal artery. The retro-grade auricular island flap could be formed by basing the supratrachlear artery and the supraorbital artery through the vascular network between the superficial temporal artery and the supratrachlear artery or the supraorbital artery. Sixteen patients with large alar defects and half-sized nasal defects were successfully repaired by this technique.

CONCLUSIONSThe retro-grade auricular island flap, based on the inner carotid artery system, could be a good and safe flap for repairing a large alar defect or half-sized nasal reconstruction.

Adult ; Arteries ; Cadaver ; Carotid Artery, Internal ; Ear Auricle ; blood supply ; Humans ; Nose Deformities, Acquired ; surgery ; Ophthalmic Artery ; Reconstructive Surgical Procedures ; Surgical Flaps ; blood supply ; transplantation ; Temporal Arteries

For obtaining new structural compounds with unique resistance profiles or novel mechanisms of action on HIV-1 from natural products, anti-HIV-1 drug screening models were used in vitro. Norcantharidin (NCTD), a derivative from cantharidin, was found to have inhibitory activities on HIV-1(IIIB) p24 antigen in lymphocyte lines MT-4, CEM and H9. It inhibited HIV-1 strain 018a (sensitive to zidovudine) from replicating with EC50 (50% effective concentration) of 14.9 micromol L(-1) and also inhibited HIV-1 strain 018c (resistant to zidovudine) from replicating with EC50 of 20.2 micromol L(-1) in primary lymphocytes peripheral blood mononuclear cells (PBMC). Norcantharidin showed synergistic activity with zidovudine on HIV-1(IIIB) in MT-4 cells, the combination index was less than 0.3. But, it was not active on HIV-1 integrase, reverse transcriptase or protease in vitro. As the structure of norcantharidin is unique and different from that of all clinic drugs approved, it would be possible to obtain new and effective compounds against HIV-1 with low toxicities after modification of norcantharidin.
Anti-HIV Agents ; pharmacology ; Bridged Bicyclo Compounds, Heterocyclic ; pharmacology ; Cell Line ; Drug Resistance, Viral ; Drug Synergism ; HIV Core Protein p24 ; metabolism ; HIV Integrase ; metabolism ; HIV-1 ; metabolism ; Humans ; Leukocytes, Mononuclear ; cytology ; virology ; Peptide Hydrolases ; metabolism ; RNA-Directed DNA Polymerase ; metabolism ; T-Lymphocytes ; cytology ; virology ; Virus Replication ; Zidovudine ; pharmacology

OBJECTIVE: To investigate and analyze the occurrence of 64,101 perinatal birth defects from 2000 to 2004, to determine the tendency of the incidence rate of birth defects and perinatal mortality, and to explore feasible and effective intervention strategy. METHODS: We investigated 64,101 perinatal infants who were born in 13 hospitals in Changsha from January 2000 to December 2004. The incidence rate of all birth defects, mortality of perinatal infants, the incidence rate of various kinds of birth defects, and the component rate of birth defects were analyzed. RESULTS: Altogether 1,050 neonate birth defects were found, with the incidence rate of 1.638%. The incidence rate of birth defects was increasing year-by-year in 2000 compared with that in 2002, 2003 and 2004, with significant differences (all P values<0.05): the incidence rate of birth defects in 2001 compared with that in 2002, 2003 and 2004, also with significant differences (P<0.05). Eight hundred seventy nine perinatal infants died, and the mortality was 1.371%. The mortality perinatal of infants increased in 2001 compared with that in 2002 and in 2003, with significant differences (P<0.05). The top 5 birth defects with the highest incidence were congenital heart disease, polydactly, auricle malformation, cheiloschisis, and palatoschisis, congenital hydrocephal in turn. The incidences of congenital heart disease and hydrocephal increased significantly. One hundred seventy seven fetuses were performed induced labor because of fetal defects from 2003. CONCLUSION We must pay attention to the increasing tendency of birth defect incidence and perinatal mortality. Strengthening environmental protection and antenatal care can decrease the birth defect incidence. Performing antenatal examination and neonatal screening regularly can discover the birth defects in time. When severe birth defects occur, the induced labor should be performed.
China ; epidemiology ; Congenital Abnormalities ; mortality ; Female ; Humans ; Incidence ; Infant Mortality ; trends ; Infant, Newborn ; Perinatal Mortality ; trends ; Pregnancy

OBJECTIVETo explore the pattern of lymph node metastasis and its influence on the prognosis of early gastric cancer(EGC).

METHODSThe pattern of lymph node metastasis and the 3-,5-year survival rates in 157 EGC patients undergone surgery from October 1995 to October 2005 were analyzed retrospectively. The SPSS 11.5 statistics software was used to perform univariate and multivariate analysis.

RESULTSTwenty-two cases had lymph node metastasis among 157 EGC patients(14%). Two mucous cancers(2.4%) and 20 submucosal tumors(27.0%) had lymph node metastases (P<0.01). Lymph node metastasis was not seen in minute gastric cancer(diameter < or =0.5 cm). Lymph node metastasis rates were 6.4% in the cancers with diameter 1.1-2.0 cm and 21.5% in the cancers with the diameter >2.0 cm(P<0.01). Besides, lymph node metastasis rate of well-differentiated EGC was 0, of moderate differentiated EGC 11.1%, and poor-differentiated EGC 0.9%(P<0.01). Of 9 cases with vascular cancer embolus, 4 had lymph node metastases. Logistic regression analysis showed that tumor size, vascular cancer embolus, histopathological type and depth of invasion were independent factors of lymph node metastasis in EGC. The 3- and 5-year survival rates of EGC patients with lymph node metastasis were 81.6 % and 79.5% respectively, which were much lower than those without lymph node metastasis(95.7% and 93.2%, P<0.01).

CONCLUSIONSLymph node metastasis in EGC is mainly correlated with depth of infiltration, tumor size, vascular cancer embolus and differentiation. For EGC treatment, choice should be made reasonably based on the risk of lymph node metastasis.

Adult ; Aged ; Female ; Humans ; Logistic Models ; Lymphatic Metastasis ; diagnosis ; pathology ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; diagnosis ; pathology ; Survival Rate

OBJECTIVETo examine the utility of the Ligasure vessel-sealing system in D(2) lymphadenectomy of gastric cancer, and compare with conventional hand tie method.

METHODSOne hundred and twenty-four consecutive patients undergone D(2) lymphadenectomy of gastric cancer from Jan. to Oct. 2005 were enrolled in this study. Operations of 62 patients were performed with Ligasure, whereas the other 62 patients with hand tie method. Operative duration, volume of intraoperative hemorrhage and postoperative course were analyzed.

RESULTSThere was significant difference in operative duration (187.3 min vs 210.5 min, P< 0.05) and no significant differences in volume of intraoperative hemorrhage, postoperative course, or duration of postoperative drainage between Ligasure group and conventional method group. No significant difference was observed in the frequency of postoperative complications between the two groups.

CONCLUSIOND(2) lymphadenectomy of gastric cancer using Ligasure instead of conventional hand tie method appears to be technically feasible and easy.

Female ; Hemostasis, Surgical ; methods ; Humans ; Ligation ; Lymph Node Excision ; Male ; Middle Aged ; Neoplasm Staging ; Stomach Neoplasms ; pathology ; surgery

OBJECTIVETo compare enzyme-linked immunospot assay (ELISPOT) and tuberculin skin test (TST) and explore their roles in the auxiliary diagnosis of initial pulmonary tuberculosis.

METHODSTotally 123 patients with initial pulmonary tuberculosis (tuberculosis group) and 102 patients with non-tuberculosis pulmonary disease (control group) were enrolled. The peripheral blood mononuclear cells of all participants were co-cultured with early secretiny antigen target-6/culture filtrate protein-10 fusion protein (ESAT-6/CFP-10), and spot forming cells (SFCs) were enumerated by ELISPOT (ESAT-6/CFP-10-ELISPOT). TST was also performed simultaneously.

RESULTSESAT-6/CFP-10-ELISPOT showed significantly higher numbers of SFCs after stimulation in tuberculosis group than in control group (P = 0.000). The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, positive predictive value, and negative predictive value of ESAT-6/CFP-10-ELISPOT were 91.1% (111/123), 81.4% (82/102), 4.60, 0.12, 0.85, and 0.87 respectively, while the above values of TST were 65.6% (59/90), 45.1% (46/102), 1.31, 0.76, 0.51, and 0.60, respectively. The sensitivity and specificity of ESAT-6/CFP-10-ELISPOT were significantly higher than those of TST (all P = 0.000). The number of SFCs were not significantly different between smear-positive tuberculosis subgroup and smear-negative tuberculosis subgroup (P = 0.166). The sensitivities were 91.8% (67/73) and 88.0% (44/50) in these two subgroups, respectively, (P = 0.448).

CONCLUSIONSESAT-6/CFP-10-ELISPOT may be a more accurate approach for the auxiliary diagnosis of initial pulmonary tuberculosis; meanwhile, it offers certain diagnostic evidences for smear-negative tuberculosis. However, its specificity may be affected by latent tuberculosis infection. On the contrary, TST has poor value in the auxiliary diagnosis of initial pulmonary tuberculosis.

Enzyme-Linked Immunospot Assay ; Humans ; Leukocytes, Mononuclear ; Sensitivity and Specificity ; Tuberculin Test ; Tuberculosis, Pulmonary ; diagnosis