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Objective:To discuss clinical practice,efficacy and surgical techniques for ear reconstruction with Medpor.Methods:Medpor ear reconstructions were used to treat 19 microtia in 17 patients (including 2 bilateral patients) in Xiangya Hospital,Central South University from January 2011 to December 2015.Reconstructions included 2 patients with one-stage ear reconstruction with temporoparietal fascial flap,2 patients with one-stage operation implanting Medpor directly into skin pocket,and 13 patients with two-stage ear reconstruction.Results:After 1-3 years of follow-up,16 microtia in 14 patients gained ideal appearance.Scaffold exposure occurred in 3 unilateral cases,among which one patient who underwent debridement,removal of superficial exposed scaffold and transposition of local flap to salvage exposure was not significantly influenced,and the other 2 patients' scaffolds were still exposed after repairs and finally removed.One stent was removed at the patient's urging because it induced an exacerbation of periarthritis of the right shoulder.Conclusion:Medpor ear scaffold has advantages,such as easy assembly,good immunologic compatibility,fast vascular ingrowth,simple operation,short operative time and ideal appearance of the reconstructed ear.Medpor is an alternative for microtia repair when patients are unwilling to use autologous rib cartilage or costal cartilages are calcified.However,the relatively high incidence of scaffold exposure reminds us that the indications of Medpor should be taken seriously,and measures to avoid skin necrosis and scaffold exposure should be implemented.Long-term follow-up efficacy needs to be proved.
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To explore the risk factors for and the pathogenic mechanisms of pelvic organ prolapse and urinary incontinence. Methods: A total of 2 668 females who completed pelvic floor functional detection from July 2014 to October 2015 in the Physical Examination Center of the Third Xiangya Hospital of Central South University. The patients were divide into 4 groups: an urinary incontinence group, an organ prolapse group, an organ prolapse with urinary incontinence group, and a normal group. We compared the age, BMI, menopause, gravidity and parity, delivery pattern, the coordination of pelvic floor and abdominal muscles among the 4 groups. Results: There were statistical differences in age and BMI values among the 4 groups (P0.05). In the mode of delivery, there were statistical difference among the normal group and the other 3 groups (P0.05). Among the 4 groups, the normal group was the best one in coordination between pelvic floor and abdominal muscles, following by the organ prolapse group, the pelvic organ prolapse group and the urinary incontinence group. Conclusion: Aging, menopause, number of pregnancies and delivery, BMI, and mode of delivery all affect the occurrence of pelvic organ prolapse and urinary incontinence. Females with urinary incontinence or organ prolapse are not good in coordination between the pelvic floor and abdominal muscles.
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Female , Humans , Pregnancy , Pelvic Floor , Pathology , Pelvic Organ Prolapse , Pathology , Risk Factors , Urinary Incontinence , PathologyABSTRACT
Objective To investigate the clinical efficacy of combined detection of VCA-IgA and Rta-IgG in the diagnosis of nasopharyngeal carcinoma.Methods From May 2013 to November 2014, 3 913 serum samples(male 2 367,female 1 546) from healthy people who had health examination in our medical center were collected and 169 serum samples(male 118,female 51) were collected from the patients who were diagnosed as nasopharyngeal carcinoma by pathological biopsy.Serum samples in two groups were detected by EBV RTA-IgG, VCA-IgA assay ( ELISA ) respectively.SPSS17.0 statistical software and receiver operating characteristic curve ( ROC) were applied to data analysis.Results The Rta-IgG positive rates of EB virus were 93.5%in NPC group (158/169) and 2.4%(93/3 913) in healthy group;while the VCA-IgA positive rates were 79.3%in NPC group ( 134/169 ) and 8.9% ( 349/3 913 ) in healthy group. The sensitivity(χ2 =14.49,P<0.05) and specificity(χ2 =157.15,P<0.05) of Rta-IgG in the diagnosis of nasopharyngeal carcinoma were significantly better than that of VCA-IgA. Using VCA-IgA/Rta-IgG combined detection analysis, not only failed to effectively improve the diagnosis of nasopharyngeal cancer, but to reduce the detection sensitivity to 72.8%( 123/169 ) , compared with Rta-IgG detection only. Conclusions Rta-IgG is significantly better than that of VCA-IgA.There was no significant improvement in the clinical diagnostic efficacy of nasopharyngeal carcinoma using VCA-IgA/Rta-IgG combined detection mode.
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Objective To observe the effect and influence on plasma angiotensin Ⅱ and oxygen radicals in the treatment of children with viral myocarditis by phosphate sodium and captopril,provide reference for clinical treat-ment.Methods 80 children with viral myocarditis met the admissions criteria were randomly divided into the obser-vation group(40 cases)and the control group (40 cases),both group were received conventional therapy,which included rest,vitamin C pin,antiviral and antimicrobial agents,nutritional medicine myocardial metabolism of drugs. The control group was given captopril 0.5mg/kg,bid,the observation group was given phosphate sodium and capto-pril,phosphate sodium 0.5 -1g/d,qd,both groups had been treated for 4 weeks for a course.Plasma angiotensin Ⅱwere detected by radioimmunoassay.The EF,FS,VA /TE were detected by echocardiography instrument.The blood were collected for detecing MDA and SOD.The clinical efficacy and electrocardiogram efficacy were evaluated. Results The clinical efficacy and electrocardiogram efficacy of observation group were 95%,90%,the control group were 70%,70%,and the difference was statistically significant(χ2 =9.367,8.571,both P <0.05).The EF,FS,SOD of the observation group and the control group after treatment was significantly higher than those of before treatment (t =11.689,8.447,9.524 and 7.714,7.985,6.166,all P <0.01).The plasma angiotensin Ⅱ,VA /TE,MDA were significantly lower than those of before treatment(t =17.572,5.772,9.744 and 9.228,3.553,3.855,all P <0.05). The SOD of the observation group after treatment was significantly higher than that of the control group(t =3.932, P <0.05),VA /TE,MDA were significantly lower than that of the control group(t =3.446,3.633,10.315,all P <0.05).Conclusion The method containing phosphate sodium and captopril can collaboratively improve heart func-tion,which may be relate to the decrease in plasma angiotensin Ⅱ and scavenging oxygen free radicals.The method can significantly improve the clinical efficacy and ECG efficacy of conventional therapies,is the better treatment for promoting in the treatment of children with viral myocarditis.
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Objective To observe the effects of electroacupuncture (EA) on c-Jun amino terminal kinase (JNK) signaling pathway and inflammatory cytokines interferon-γ (IFN-γ) in substantia nigra (SN) cells of rotenone-induced rats model of Parkinson's disease (PD),and explore the underlying mechanism of EA on PD.Methods A total of 32 male Sprague-Dawley mice were randomly and evenly divided into a normal group,a shamoperation group,a model group and an EA group.Model group and EA group were injected intradermally with rotenone (1 mg/kg,dissolved in DMSO and saline,concentration:O.25 mg/ml) on the nape of neck.Sham-operation group was injected the same dose of DMSO and saline.Normal group had no intervention.EA group was applied to Fengfu (DU16) and Taichong (LR3) acupoints after the establishment of PD model in rats.Behavioral assessment was conducted after the treatments,the rats were sacrificed for sampling substantia nigra tissue to detect the expressions of tyrosine hydroxylase (TH),p-c-Jun amino terminal kinase (p-c-Jun) and interferon-γ(IFN-γ) protein with Western blotting (WB).Results Model rats showed significant PD syndrome characteristics,comparing with normal group and sham group,the difference was not statistically significant (P ＞ 0.05).The results of open box test showed that the scores of model group rats decreased significantly in terms of the horizontal movement [(19.12 ±2.34) points] and vertical locomotor activity [(5.27 ± 1.04) points] when compared with normal group and sham group,the difference was statistically significant (P ＜ 0.05).After EA treatment,locomotor activity of rats increased significantly when compared with model group (P ＜ 0.05),however,the normal group and sham group was not statistically and significantly different in locomotor activity (P ＞ 0.05).Compared with normal group,the expression of TH protein in (0.183 ± 0.0213) reduced significantly and the expressions of p-c-Jun (0.388 ± 0.0283) and IFN-γ protein(0.453 ± 0.0332) increased significantly in model group,the difference was statistically significant (P ＜0.05).Compared with normal group,the expression of TH protein(0.324 ± 0.0538) reduced and the expressions of p-c-Jun(0.207 ± 0.0592) and IFN-γ protein (0.239 ± 0.0215) increased in EA group,the difference was not statistically significant (P ＞ 0.05).Compared with model group,the expression of TH protein increased significantly in EA group(P ＜ 0.05),the expressions of p-c-Jun and IFN-γ protein reduced significantly in EA group(P ＜ 0.05).Conclusion EA therapy may reduce the expression of IFN-γ protein in SN of PD rats model by regulating the expression of JNK/mitogen-activated protein kinase (MAPK) pathway,which may delay the process of PD.
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Objective To discuss pefioperative nursing observation in patients with hyperthy-roidism. Methods 35 patients with hyperthyroidism were given preoperative psychological guidance, pre-operative preparation, careful postoperative observation, prevention of complications,diet and rehabilitation di-rections. Results 35 patients were discharged smoothly 7 to 8 days postoperation. Conclusions Perfect preoperative preparation and close observation and care is the guarantee of successful operation for patients with hyperthyroidism.
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Objective To study the effect of the surgical procedure of primary incision & thread-drawing for behind abscess and drainage for left and right abscess in the treatment of high horsc-shoe Abscess. Methods Clinical data from 45 patients with this disease were retrospectively analysed. Results 43 cases were cured primarily, the cure rate was 96 %, among the 45 patients, 2 cases were formed anal fistula, accounted for 4 %. No anal incontinence, anorectal stenosis,and anal deformation,etc. Conclusion This surgical procedure can ensure primary cure. It is re- vealed that the procedure is of many advantages,including shorten treatment course, less lession, no malformation.