Objective To evaluate the early therapeutic effect of flail chest with pulmonary contusion by using different mode of mechanical ventilation. Methods Twenty-nine patients of flail chest with pulmonary contusion were analysed retrospectively. All the patients were treated with the ventilator Bear1000. Two groups were established: invasion group was treated with SIMV+PEEP(8 cases) and CPAP+PSV (7 cases), noninvasion group was treated with NIPPV(14 cases). Results There was no death in all the patients. CPAP+PSV was more effective than SIMV+PEEP not only in decreasing breath rate and improving hypoxemia but also in decreasing peak inspiratory pressure(P

Acute paraplegia is a rare presentation for a spinal cord ependymoma. Subarachnoid hemorrhage (SAH) due to spinal ependymoma is also very rare. We report a 32-year-old woman who presented with acute paraplegia and typical clinical signs of SAH with normal cerebral angiography, and further diagnostic work-up revealed an spinal cord ependymoma as the source of the hemorrhage. There is evidence that some spinal cord ependymomas have intratumoral hemorrhage, but most of these bleedings occur without symptoms. We discuss the clinical and neuroradiological findings of this rare case and review the literature related to this unusual presentation.431

Objective To evaluate the effects of locking calcaneal plate in the treatment of SandersⅢ～Ⅳcalcaneal fractures.Methods 15 feet of 12 patients of SandersⅢ～Ⅳcalcaneal fractures received the treatment of internal fixation reduction with locking calcaneal plate and hone graft.Results All the patients were followed up for 4 to 21 months(average 11 months) with the results that according to Maryland foot score,4 feet were reported ex- cellent,6 good,1 average and 1 poor,with total excellent and good rate of 83.3 %.Conclusion Using locking cal- caneat plate in the treatment of complicated calcaneal fractures was proved to be a good method and had satisfactory effects.

OBJECTIVE To investigate the positive rate of ?-lactamase,oprD2,aminoglycosides modifying enzyme and qacE△1 gene among clinical isolated strains of multi-resistant Pseudomonas aeruginosa in our hospital.METHODS P.aeruginosa was determined by VITEK,and MIC was determined by agar dilution method.TEM,IMP,VIM,oprD2,aac(3)-Ⅱ,aac(6′)-Ⅰ,aac(6″)-Ⅱ,ant(3″)-Ⅰ,ant(2″)Ⅰ and qacE△1 in strains were detected by polymerase chain reaction(PCR).RESULTS The positive rate of TEM,aac(3)Ⅱ,aac(6′)-Ⅱ,ant(3″)-Ⅰ and ant(2″)-Ⅰ in multi-resistant P.aeruginosa were 51.4%,48.6%,40.0%,54.3%,45.7% and 60.0%,respectively.No IMP and VIM genes were detected.CONCLUSIONS Positive rate of ?-lactamase, aminoglycosides modifying enzyme is high in 35 tested strains,and that should be paid more attention.

Objective To construct an expression plasmid carrying the specific siRNA of survivin gene,and to evaluate its silencing effect on the expression of survivin gene and its inhibition effect on the growth of gastric cancer cells.Methods The specific siRNA of survivin gene was designed and synthesized,and an expression plasmid pAdGFP-siRNA was constructed.Gastric cancer cell line SGC-7901 was cuhured and transferred with pAdGFP-siRNA,then the silencing of survivin gene expression and the growth inhibition of cancer cell mediated by pAdGFP-siRNA were identified.Results The growth of gastric cancer cells was inhibited after transferring the pAdGFP-siRNA,with the inhibition rate of 68.2% compared to the control group.Immunohistochemistry showed that the specific siRNA markedly silenced the expression of survivin gene in cancer cells.Conclusions The overexpression of survivin gene in gastric cancer cells results in the high proliferation and the resistance to the chemo- and radio-therapy of the cancer cells.The specific siRNA can markedly silence the expression of survivin gene and inhibit the growth of cancer cells.

Objective To investigate the effects of heparin coating on intimal hyperplasia in implanted decellularized xenografts.Methods The resected canie carotid arteries were decellularized,and heparin coating was partially performed.Eighteen rabbits were divided into non-heparin-coated group(n=9)and heparin-coated group(n=9).During implantation,only the left carotid between the anastomotic stoma was ligated.Doppler ultrasonography was performed 1,3 and 12 weeks post-implantation to measure the luminal diameter,and the hemodynamic parameters such as PSV,RI and PI were calculated.All animals were sacrificed,histological observations were conducted at 12 weeks post-implantation,and I/(I+ M)was calculated.Results Except for 1 week post-implantation in the ligated side,the luminal diameters in non-heparin -coated group were significantly smaller than that of pre-implantation.Besides,those of the non-ligated side at each time points were significantly smaller than the ligated side(P

Antipsychotic Agents ; poisoning ; Clozapine ; blood ; poisoning ; Exchange Transfusion, Whole Blood ; methods ; Humans ; Infant, Newborn ; Male ; Treatment Outcome

Adenoviridae ; genetics ; Calcium-Binding Proteins ; genetics ; metabolism ; Cells, Cultured ; Female ; Genetic Vectors ; Humans ; Microfilament Proteins ; genetics ; metabolism ; Myocytes, Smooth Muscle ; metabolism ; Myometrium ; cytology ; metabolism ; RNA, Small Interfering ; genetics ; Recombinant Fusion Proteins ; genetics ; metabolism ; Transfection

·AlM: To investigate pathogeny and effects of surgery on paralytic strabismus.
· METHODS: A retrospective study was done in 46 patients with paralytic strabismus who underwent squint correction in our hospital from June 2010 to June 2013. Among 26 horizontal strabismus, the cases of extra rectus palsy was 16, internal rectus palsy was 10.Among all20 vertical strabismus, the cases of superior oblique palsy, superior rectus palsy, inferior rectus palsy, double elevator palsy counted for 7, 8, 2 and 3, respectively. Pathogenesis: trauma was 19 cases, followed by 10 cases that the causes could not be identified.Nine was congen ital paralytic strabismus, 8 o ccurred after nose or brain surgery. The surgery methods included rectus muscle recession, rectus muscle resection, partial rectus muscle transposition, Jensen procedure, inferior oblique myectomy and anterior transposition of inferior oblique. Statistical software SPSS10.0 was used in chi-square test between two groups, while the situation of paralysis eye movements improved by two methods in the horizontal strabismus group was compared with t test.
· RESULTS: Among all horizontal strabismus the rate of cure, improvement and inefficiency was 20 ( 77%) , 5 ( 19%) and 1 ( 4%) , respectively. Among vertical strabismus the ratio of cure, improvement and inefficiency was 15 (75%), 3 (15%) and 2 (10%).There was no significantly difference between the two groups ( P >0.05 ). The movements of paralytic eyes were improved. Two procedures used in horizontal strabismus, can improve paralysis eye movements were 3.76 ±0.91, 3.72 ±0.84mm, with no significant difference (P=0.93) statistically.
· CONCLUSlON: Paralytic strabismus in adults had complicated conditions. Choosing different operation methods in treating paralytic strabismus according to the degree of paralysis can result in satisfactory cosmetically alignment of the eyes and modify head position and diplopia.

Radical retropubic prostatectomy (RRP) has been one of the most effective treatments for prostate cancer.This study is designed to identify the related predictive risk factors for complications in patients following RRP.Between 2000 and 2012 in Department of Urology,Fudan University Shanghai Cancer Center,421 cases undergoing RRP for localized prostate cancer by one surgeon were included in this retrospective analysis.We reviewed various risk factors that were correlated with perioperative complications,including patient characteristics [age,body mass index (BMI),co-morbidities],clinical findings (preoperative PSA level,Gleason score,clinical stage,pathological grade),and surgeon's own clinical practice.Charlson comorbidity index (CCI) was used to explain comorbidities.The total rate of perioperative complications was 23.2％ (98/421).There were 45/421 (10.7％),28/421 (6.6％),24/421 (5.7％) and 1/421 (0.2％) in grade Ⅰ,Ⅱ,Ⅲ,Ⅳ respectively,and 323/421 (76.8％) cases had none of these complications.Statistical analysis of multiple potential risk factors revealed that BMI ＞30 (P=0.014),Charlson score ≥1 (P＜0.001) and surgical experience (P=0.0252) were predictors of perioperative complications.Age,PSA level,Gleason score,TNM stage,operation time,blood loss,and blood transfusion were not correlated with perioperative complications (P＞0.05).It was concluded that patients' own factors and surgeons' technical factors are related with an increased risk of development of perioperative complications following radical prostatectomy.Knowing these predictors can both favor risk stratification of patients undergoing RRP and help surgeons make treatment decisions.