Objective To compare the clinical outcome of external fixation device with Kirschner wire or fragment fixation pin with mini plate and screw fixation in treatment of metacarpal and phalangeal articular fracture dislocation. Methods From October 2002 to March 2008, 106 patients with metacarpal and phalangeal articular fracture dislocation were randomly divided into A and B group. The 53 patients in A group were treated with external fixation device with Kirschner wire or fragment fixation pin. There were thumb injury in 24 cases, fracture-dislocation of proximal interphalangeal joint(PIP) in 36 cases, fracture-dislocation of metacarpophalangeal joint (MP) in 17 cases. The 53 patients in B group were treated with mini plate and screw fixation. There were thumb injury in 22 cases, fracture-dislocation of PIP in 30 cases, fracture-dislocation of MP in 23 cases. Duncan rating criteria were used to compare finger range of motion. Results The mean follow-up of 16.8 and 17.5 months in A group and B group. According to Duncan rating criteria, there were excellent in 33 cases, good in 16, fair in 3, and poor in 1 case. The excellent and good rate was 92.5% in A group. There were excellent in 30 cases, good in 17, fair in 5, and poor in 1 case. The excellent and good rate was 88.7% in B group. In A group, 1 case of wound infection was found. The average arc of motion of thumb joint was 134°±21° while the average arc of motion of other fingers was 248°±19°. In B group, no wound infection occurred. The average arc of motion of thumb joint was 122°±18° while the average arc of motion of other fingers was 225°±17°. Conclusion External fixation device with Kirschner wire or fragment fixation pin was better than the application of mini plate and screw fixation in treatment of metacarpal and phalangeal articular fracture-dislocation.

Adenocarcinoma ; drug therapy ; secondary ; surgery ; Adult ; Aged ; Aged, 80 and over ; Antineoplastic Agents ; adverse effects ; therapeutic use ; Benzenesulfonates ; adverse effects ; therapeutic use ; Carcinoma, Renal Cell ; drug therapy ; secondary ; surgery ; Diarrhea ; chemically induced ; Female ; Follow-Up Studies ; Humans ; Kidney Neoplasms ; drug therapy ; pathology ; surgery ; Liver Neoplasms ; drug therapy ; secondary ; Lung Neoplasms ; drug therapy ; secondary ; Male ; Middle Aged ; Niacinamide ; analogs & derivatives ; Phenylurea Compounds ; Pyridines ; adverse effects ; therapeutic use ; Remission Induction

Objective To explore the clinical efficacy of modified corneal ulcer debridement combining with anti-fungal agents in the treatment of keratomycosis(fungal corneal ulcer).Design Prospective case series.Participants Criteria for inclusion:1)fungal corneal ulcer was diagnosed under direct 10% KOH wet film microscopic examination;2)corneal ulcer located away from the center with superficial infiltration,or located in the center but in small size;3)depth of corneal infiltration was uncertain.From January,2007 to December,2009,141 cases of fungal corneal ulcer patients in Shandong Eye Institute affiliated to Qingdao Eye Hospital were recruited into this study.Methods All patients received modified corneal ulcer debridement including stripping off ulcer lesion as well as infiltrated tissue,and repairing ulcer fringe.For postoperative treatment,0.25% amphotercin B or 5% natamycin and 0.5% fluconazol eye drops were topically administrated with high frequency to the diseased eye.In the meantime,itraconalzole was orally taken as systematic treatment.Clinical efficacy of the above therapy was evaluated at last.Main Outcome Measurs Corneal ulcer infiltration,corneal epithelium reparation and recovery of vision acuity were closely observed following surgery.Results 10% KOH wet film examination showed that hypha was found in all of the 141 cases.The average time for postoperative follow-up was 29 days(from 14 to 60 days).All 141 cases of fungal corneal ulcer were completely healed,of which 127 cases were healed by taking corneal ulcer debridement surgery and anti-fungal medication,and the other 14 cases had to take penetrating keratoplasty(10 cases) or lameller keratoplasty(4 cases) due to uncontrolled infection.No recurrence was found during follow-up.The average time for healing in the 127 cases was 8.5 days,and among these cases,29 cases had a preoperative visual acuity below 0.05,80 cases between 0.05 and 0.3,and 32 cases between 0.3 and 1.0.Postoperative evaluation showed that 6 cases had a visual acuity below 0.05,42 cases between 0.05 and 0.3,93 cases(65.96%) between 0.3 and 1.0,and among 93 cases,81 cases(57.45%) had a visual acuity between 0.5 and 1.0.Conclusions The modified corneal ulcer debridement combining with anti-fungal agents has proved to be an effective treatment for fungal corneal ulcer.It greatly improves patient's visual acuity and shortens the disease duration.For cases of superficial or uncertain infiltration,corneal ulcer debridement enables better ulcer observation and provides guidance for further treatment.

Objective To evaluate the bone healing effect of vascularized tissue-engineered bone induced by endothelial progenitor cells(EPCs)in repair of large segmental radius defects in rabbits.Methods A total of 68 healthy New Zealand white rabbits were enrolled in the study and randomized into three groups,ie,experimental group(EPCs group):EPCs plus bone marrow mesenchymal stem cells (BMSCs)plus decalcified bone matrix(DBM);control group:BMSCs plus DBM;sham control group:pure DBM.Materials mentioned above were implanted into middle radius defects for 15 mm.At 12 and 16 weeks post-operatively,X-ray test,bone mineral density test,histological light microscopic test,osteocalcin immunohistochemical staining test and biomechanical test were carried out.Results Growth and plasticity of callus,speed of medullary cavity recanalization,bone healing speed and biomechanical intensity in the experimental group were all significantly better than those of control group.Conclusions Vascularized tissue-engineered bone induced by EPCs has strong osteegenic ability,can accelerate bone healing and hence is an effective method for repair of large segmental bone defects.

OBJECTIVETo observe the effectiveness of Bushen Huoxue Decoction in improving the erectile function of male patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI) with stent implantation.

METHODSEighty male CHD patients after PCI with stent implantation were equally assigned to receive conventional Western medicine (control group) and combination of Western medicine with Bushen Huoxue Decoction (treatment group), both for 3 months. Then we compared the pre- and post-medication IIEF-5 scores between the two groups of patients.

RESULTSCompared with pre-medication, the total IIEF-5 score was significantly increased after 3 months both in the treatment group (8.19 ± 2.87 vs 17.83 ± 4.92, P <0.05) and in the control (7.98 ± 2.96 vs 12.18 ± 3.69, P <0.05), even higher in the former than in the latter group (P <0.05), and so were the scores on the 5 specific items (all P <0.05). The total effectiveness rate was 72.5% in the treatment group, significantly higher than 47.5% in the control (P <0.05). No obvious adverse reactions and events were observed during the treatment in either of the groups.

CONCLUSIONBushen Huoxue Decoction can obviously improve the erectile function and the quality of the sexual life of CHD patients after PCI with stent implantation.

Coronary Disease ; surgery ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Male ; Penile Erection ; drug effects ; physiology ; Percutaneous Coronary Intervention ; Phytotherapy ; Stents

3T3-L1 adipocytes were cultured with various concentrations of high-density lipoprotein ( HDL, 0, 10, 50, and 100 μg/ml ) for 16 h and with lipopolysaccharide ( LPS, 100 ng/ml ) for another 6 h. Interleukin-8 in the medium was determined by ELISA, and PPAR-γ mRNA expression by reverse transacription polymerase chain reaction (RT-PCR). Interleukin-8 levels were increased in LPS-treated cells ( P＜0.05 ), but decreased in HDL-treated cells in the dose-dependent manner. PPARγ mRNA expressions were increased in HDL-treated groups than those treated only with LPS. These results suggested HDL may decrease interleukin-8 secretion via up-regulating PPARγ expression in adipocytes.

Objective To investigate the correlation between apparent diffusion coefficient (ADC)of diffusion weighted imaging (DWI)and prognostic factors in rectal cancer.Methods 5 5 patients with rectal cancer were confirmed pathologically.Conventional pelvic MRI and DWI examination were performed,and the mean ADC values of tumor were measured preoperatively.The patients were divided into two groups with or without lymph node metastasis,and were also divided into four groups with negative,weakly positive,positive or strongly positive expression of EGFR in rectal cancer.The ADC values were calculated in each group,and the correlation of ADC values with the lymph node status and EGFR expression classification were analyzed.Results In 5 5 patients with colorectal cancer,there were 13 lesions with lymph node metastasis and the positive expression rate of EGFR was 67.2%.There were no significant difference in mean ADC value between the groups with and without lymph node metastasis (P=0.342).The number of lesions with negative,weakly positive,positive and strongly positive EGFR expression were 18,15,12 and 10.The difference in the mean ADC values among negative,weakly positive,positive and strongly positive expression groups of prognostic factor EGFR was not significantly different (P=0.412).There were also no correlations in the prognostic factors mentioned above (r=0.183 and -0.324,all P>0.05).Conclusion The ADC value can not be used to predict the prognosis and to provide more valu-able information for individualized therapy in patients with rectal carcinoma,which needs further studiy in the future.

Objective To explore if bacillus bifidus relieve CPFX-induced testosterone reduction in mouse testes.Methods Twenty-four male mices were divided into 4 groups, then administered saline for 6 days (Sal6 group), CPFX for 6 days (A6 group), CPFX for 6 days followed by bifidobacteria treatment for the next 6 days (A6+P6 group), CPFX for 6 days and then saline for the next 6 days (A6+Sal6 group).We detected serum levels of testosterone by RIA, as well as levels of steroidogenic enzymes mRNA [cholesterol side-chain cleavage enzyme (P450scc) and steroidogenic acute regulatory protein (StAR)] and NF-E2-related factor2 (Nrf2) mRNA in testes by real-time PCR, Nrf2, heme oxygenase-1 (HO-1), and 4-hydroxy-2-nonenal (4-HNE) by Western blot and4-HNE by Immunohistochemistry.Results The A6 group had significantly lower serum testosterone levels compared with the Sal6 group (P<0.001), the A6+P6 group had significantly higher compared with the A6 (P<0.001) and A6+Sal6 groups (P<0.01).The A6 group had significantly lower StAR mRNA compared with the Sal6 group (P<0.001), the A6+P6 group had significantly higher level compared with the A6 (P<0.01) and A6+Sal6 groups (P<0.01).The A6 group had significantly lower P450scc mRNA as compared with the Sal6 group (P<0.001), the A6+P6 group had significantly higher compared with the A6 (P<0.001) and A6+Sal6 groups (P<0.05).The A6 group had significantly lower Nrf2 compared with the Sal6 group (P<0.001), the A6+P6 group had significantly higher compared with the A6(P<0.01) and A6+Sal6 groups (P<0.05).The A6 group higher 4-HNE expression compared with the Sal6 group, the A6+P6 group had significantly lower compared with the A6 (P<0.01) and A6+Sal6 groups (P<0.05).Conclusions Bifidobacteria the reduction of CPFX-induced testosterone reduction, and these effects may potentially explained by Nrf2 inflammatory signaling pathway.

Objective To investigate the diagnostic value of transbronchial lung biopsy (TBLB) under virtual bronchoscopic navigation (direct path), endobronchial ultrasonography with a guide sheath (GS) and rapid on-site evaluation (ROSE) for solitary pulmonary nodules (SPNs). Methods One hundred and seventy-eight patients who were underwent transbronchial lung biopsy in the Tianjin Medical University General Hospital between January 2015 to December 2016 were retrospectively evaluated. CT images of all patients showed solitary pulmonary nodules surrounded by lung tissue, and ROSE was undergone during the procedure. The patients were divided into conventional (C-TBLB) group, virtual bronchoscopic navigation (VBN) group, endobronchial ultrasonography with a guide sheath (GS) group, and virtual bronchoscopic navigation combined with endobronchial ultrasonography with a guide sheath group (combination) depending on the different devices. The diagnostic yield and the location or the effect of lesion on the diagnostic rate were compared between four groups. The coincidence rate of ROSE and the histopathological findings of TBLB were compared. The value of ROSE for the early diagnosis of disease was further evaluated. Results The diagnostic rates were 32.5％(13/40), 66.7％(24/36), 68.2％(30/44) and 75.8％(44/58) for C-TBLB group, VBN group, GS group and combination group, respectively. There were significant differences in diagnostic rates between C-TBLB group and other tree groups (χ2=8.853, 10.677 and 18.293, P<0.008). But there were no significant differences in diagnostic rates between VBN group, GS group and combination group (P>0.008). The diagnostic rates for peripheral pulmonary nodules were 12.5％ (2/16), 42.9％ (6/14), 40.0％ (4/10) and 75.9％(22/29) in C-TBLB group, VBN group, GS group and combination group. The diagnostic rate was significantly higher in combination group than that of other three groups (χ2=17.434, P<0.05). The result of ROSE was consistent with result of histopathology (Kappa = 0.775, P<0.001). The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of ROSE during transbronchial biopsy for solitary pulmonary nodules were 90.7％, 87.0％, 86.7％, 90.9％ and 88.8％, respectively. No pneumothorax, hemoptysis or other serious complications were found in patients. Conclusion Virtual bronchoscopic navigation, endobronchial ultrasonography with a guide sheath for solitary pulmonary nodules by transbronchial lung biopsy can improve the diagnostic rate of solitary pulmonary nodules.

Objective:To study the causes of misdiagnosis of patients with POEMS syndrome and to discuss the clues for its early diagnosis.Methods:The clinical and laboratory data of 26 inpatients with POEMS syndrome,who were treated in Changhai hospital over the last decade,were retrospectively analyzed.Results:The misdiagnosis rate of our group was 100%. The misdiagnosis was made in(3.31?0.97)hospitals and in(3.31?0.93)clinical departments;the misdiagnosis period was (19.42?10.86)months and it had been misdiagnosed as 18 other diseases.The initial symptoms included polyneuropathy in 21 (80.8%)cases,edema of lower extremity in 22(84.6%)cases,and body weight loss in 8(30.8%)cases.The typical clinical symptoms included polyneuropathy in 26(100%)cases and organomegaly in 24(92.3%).Two cases had newly-identified uterine hypertrophy,one had adrenal gland hypertrophy,and one had gastric wall thickening mimicking advanced gastric cancer.Hypothyroidism,impotence,skin pigmentation and sclerosis occurred in 76.9%(20/26),60%(6/10),92.3%(24/ 26)and 65.4%(17/26)cases,respectively.Monoclonal plasma cell proliferation was documented in 18(81.8%);M proteins were positive in 14(63.6%)cases by serum immunofixation,and only 2(9.1%)cases also positive by serum protein electrophoresis.One patient was positive of M protein by urine immunofixation and one had abnormal infiltration of plasma cells in the gastric wall.Lymph node biopsy were performed in 8 patients and 3 were found to have Castleman disease;the other 5 cases had lymphocyte infiltration,with 3 complicated with plasma cell proliferation.Nerve biopsy in 4 cases all revealed axonal degeneration and one patient complicated with demyelination.Bone marrow biopsy in 5 cases revealed plasmacytosis in 2 cases and myeloma in one.Excessive radioactivity resorption was found in 10 of the 16 cases(62.5%)and abnormal plasma cells were detected in 2 cases by bone aspiration guided by radioisotope bone scan.Conclusion:Misdiagnosis of POEMS syndrome is very common.Polyneuropathy,edema of lower extremity and body weight loss are the common early symptoms of POEMS syndrome. Early diagnosis can be made by having an intimate knowledge of the progression of the disease and by detecting M protein through various approaches.