BACKGROUND:Mechanical factors play an important role in wound healing and scar formation. Finite element model is established to stimulate, analyze and optimize different sutures, which has become a hotspot to guide surgies accurately. OBJECTIVE:To analyze the stress distribution of different simple interrupted suturing directions on the skin wound by establishing the skin finite element model, and to provide basic data for the study of scar formation. METHODS:Porcine back skin uniaxial tensile test was performed to provide reference for the mechanical properties of human skin. Orthotropic skin wound model was established using ABAQUS to calculate the stress distribution on the wound in different suturing directions. RESULTS AND CONCLUSION:The anisotropic mechanical properties of skin wound influenced the suture stress significantly. The elastic modulus along the Langer’s line was larger than that in the vertical direction. The stress increased orderly in the Langer’s line direction, the Langer’s line deflected 30°, bias Langer’s line 45° and vertical Langer’s line. These results suggest that the clinical incision should be made along the Langer’s line direction. Additional y, the cut at an angle with Langer’s line can also reduce the stress of suture.

OBJECTIVE To lower the incidence of postoperative pulmonary infection in abdominal major operation.METHODS We performed a retrospective trial analysis on pulmonary infection after major abdominal operation in 402 cases from Oct 2004 to Oct 2005,and in the meanwhile effective preventive procedures were conducted.RESULTS Thirty three cases with pulmonary infection went weel with active treatment and nursing.CONCLUSIONS The predisposing factors for postoperative infection include anesthetic method,incision pain,and environmental pollution.The better methods for prevention of pulmonory infection are good preoperative instruction,planned respiration training,keeping airway confluent postoperatively,effectively reducing incision pain,infection control,and preventing environmental and air pollution.

Objective To study dexmedetomidine on the adverse impact of ketamine based anesthesia and sedative effects in indirect inguinal hemia.Methods Eighty children underwent indirect inguinal hemia surgery were randomily divided into two groups after injected muscle with midazolam and ketamine,Group B was injectded with 0.5 μg/kg DEX,but Group A with normal saline,analgesia was with caudal block (lidocaine).The with hemodynamic,level of sedation,recovery time and CHW score were observed.The adverse reactions were recorded.Results Two groups of children have hemodynamically stable,and recovery time had no statistical significance.The two groups of CHW score in Group A (1.6 ± 0.5) points higher than in group B (0.9 ± 0.3) points (P ＜ 0.05).The restlessness rated group (1.52 ± 0.54) points was higher than in group B (0.51 ± 0.48) points (P ＜ 0.05).Compared with Group B,Group A had 12 cases of psychiatric symptoms,10 cases of involuntary movement of limbs,6 cases of severe postoperative agitation nausea,and 8 cases of vomiting (P ＜ 0.05).Conclusion 0.5μg/kg DEX can be safely and effectively used in the pediatric anesthesia,and reduce the adverse reactions caused by ketamine.

Objective:To observe and study the short-term efficacy of levocarnitine combined with trimetazidine in the treatment of elderly heart failure of ischemic cardiomyopathy. Methods:Totally 106 elderly patients with ischemic cardiomyopathy and heart failure were randomly divided into the observation group and the control group with 53 ones in each. All the patients were given anti-platelet, anti-myocardial ischemia and lipid-lowering therapy as well as the conventional therapy on myocardial ischemia. The control group was treated with trimetazidine,20mg,po,tid,while the observation group was additionally treated with 2g levocarnitine with 0. 9% sodium chloride injections,100ml,ivd,qd. The treatment course was 4 weeks. The improvement of heart function and the changes in cardiac function indices( including LVEDD,LVESD and LVEF)and cardiac ischemia markers( CKMB,TüI and BüP)before and after the treatment were compared between the two groups. The incidence of adverse drug reactions,the rate of re-hospitalization and mortality in the two groups were also compared. Results:The significant efficiency and total effective rate in the observation group were much higher than those in the control group(P<0. 05 or 0. 000 1). After the treatment,LVEDD and LVESD in the two groups were declined, LVEF was increased(P<0. 05),and the changes in the observation group were more notable than those in the control group(P<0. 05 or 0. 000 1). After the treatment,the contents of CKMB,TüI and BüP in the two groups were lower than those before the treat-ment(P<0. 05),and the decrease in the observation group was more notable than that in the control group(P<0. 05). There were no significant differences in the incidence of adverse reactions,re-admission rate and mortality between the two groups(P>0. 05). Conclusion:Levocarnitine combined with trimetazidine on the basis of the conditional therapy in the treatment of elderly patients with ischemic cardiomyopathy and heart failure can effectively improve heart function with better clinical efficacy,which is worthy of promo-tion in clinic.

Objective To study radiation -induced lung damage after lung ionizing radiation and the temporal and spatial release of pro -inflammatory cytokines of interleukin -6(IL-6),interleukin-8(IL-8) and interleukin-10(IL-10)in the irradiated lung tissue.Methods BALB/C male mice weighted around 25 g were randomly divided into two groups:radiation group ( R) and control group ( C) ,with 30 mice in R group and10 mice in C group.The thorax of mice was irradiated by 6 MV X-ray with 25 Gy in 5 fractions.The mice were sac-rificed at 12 weeks post irradiation.Lung tissues were collected and embedded in paraffin .After HE staining,lung histopathological changes were detected by immunohistochemistry to detect IL -6,IL-8 and IL-10 expression in lung tissue.Results Immunohistochemistry results showed that the expressions of IL -6,IL-8 and IL-10 were mainly expressed in macrophages and inflammatory cells .The results showed that the expressions of IL -6 and IL-8 in R group were significantly higher than that in C group .IL-10 expression level was lower than C group.Conclusion After 12 weeks exposing to radiation ,cytokines of IL-6,IL-8 and IL-10 in lung tissue are associated with radiation -induced lung injury .

The disc degeneration disease has been main research focus in spinal surgery,but the pathogenesis of disc degeneration is still not clear.Appropriate animal models are important for the study of pathogenesis of disc degeneration.Presently,models of disc degenetation are mainly classified into two categaries:vitro models and vivo models.The animal vitro models include disc cell models and disc tissue models.The vivo models include mechanics models and trauma models.This review tries to give a short introduction about the status and progress of animal model about disc degeneration.

[Objective]To observe the proliferation and plasticity of neural stem cells in sim in adult rats after spinal cord injury.[Method]Spinal cord injury models were made in 60 wistar rats and the dynamic expression of bromodeoxyuridine(BrDU) and polysialylated ependymal cells adhesion molecule(PSA-NCAM) were determined by immuno-histochemisty.[Result]Compared with the controls,the number of Brdupositive cells in the injured spinal cord increased strikingly on the 1 st day (P

Objective To study the correlation among acute cerebral infarction area ,serum high sensitivity C reactive protein(hs‐CRP)andhomocysteine(Hcy)concentrations.Methods 112acutecerebralinfarctionpatientsreceivedinneurologicaldepartment of the hospital were enrolled in the study .They were divided into small infarction size group(n=56) and large infarction size group (n=56) ,according to the cerebral infarction area determined by using MRI and MRA .Common information of patients such as age , sex ,smoking ,drinking ,hypertension ,hyperlipidemia and diabetes history were recorded ,serum hs‐CRP and Hcy concentrations were also determined .The comparison between the 2 groups were performed on those common information and test results .Results There was no statistically significant difference on age ,alcohol consumption ,smoking ,hypertension and high cholesterol between the two groups(P>0 .05) .Serum concentrations of hs‐CRP ,Hcy and blood glucose in small infarction size group were lower than those in large infarction size group(P<0 .05) ,and the infarct areas were positively correlated with hs‐CRP ,Hcy and blood glucose levels(r=0 .625 ,0 .833 ,0 .651 ,P<0 .05) .Conclusion Serum hs‐CRP ,Hcy level are high risk factor for atherosclerosis plaque for‐mation of acute cerebral infarction patients ,the serum levels help predict the infarction area ,and diabetes is an important cause of cerebral infarction .

The clinical data of one case of laryngeal neuroendocrine carcinoma in our hospital were respectively analyzed. The patient was a 61-year-old male, and complained of progressive pain of right ear for 7-year, it was misdiagnosed as glossopharyngeal neuralgia and larynx hemangioma. This patient was achieved total laryngectomy and bilateral cervical lymph nodes dissection. As of 12 months after surgery, the patient remains under follow-up observation, and no findings indicating obvious recurrence or metastasis has been observed. This disease is a rare and highly malignant tumor that is lack of specific feature in clinical performances. Recognition at larynx is essential so that proper patient management can be initiated.
Carcinoma, Neuroendocrine ; diagnosis ; therapy ; Humans ; Laryngeal Neoplasms ; diagnosis ; therapy ; Male ; Middle Aged

ObjectiveTo observe the effect of cognitive rehabilitation on patients with mild vascular dementia. Methods60 patients with mild vascular dementia were randomly divided into cognitive rehabilitation group(Group A,30 cases) and non-cognitive group (Group B,30 cases).All patients in those groups received medical treatment and PT, OT and ST exercise,and Group A received cognitive rehabilitation exercise additionally. Before and after treatment, the cognitive ability was evaluated with Loewenstein Occupational Therapy Cognitive Assessment Battery (LOTCA) and activity of daily living (ADL) with Functional Independence Measure (FIM).ResultsGroup A significantly improved cognitive ability (P<0.01), ADL (P<0.05) and general subjective impression compared with Group B. Conclusions The cognitive rehabilitation exercise is effective on patients with mild vascular dementia.