Early and mid-term results of minimally invasive occlusion via the subaxillary route for ventriculal septal defect: a single institute experience / 中华胸心血管外科杂志

Objective This retrospective,single-center study evaluated short-and mid-term results of minimally invasive surgery to occlude ventricular septal defects(VSDs) through right subaxillary approach.Methods The procedure was performed on 624 children,224 boys and 205 girls;aged(2.4 ± 2.2) years;mean weight(12.3 ± 10.2)kg between January 2014 to December 2017 at the Children' s Heart Center of Henan Province People' s Hospital.An approximately 2 cm right subaxillary incision was made between the third and fifth ribs.The right atrium or ventricle was punctured under the guidance of transencephalographic echocardiography(TEE).The VSD was occluded under TEE guidance.Results The mean size of VSDs was(4.2 ±0.9)mm,and the occluder measured(5.2 ± 1.2)mm.Asymmetrical occluders were used in 28 patieuts and symmetrical occluders in 596 patients.The operative time was(58.5 ± 20.2) minutes,and the time in the intensive care unit (ICU) was(19.4 ±6.7) h.Blood loss was(10.4 ±9.5) ml.There were no deaths among these patients.Occluder displacement occurred in two cases.The complications such as Ⅲ degree atrioventricular block,new aortic regurgitation,reoperation foi massive bleeding,and serious infection were not observed.All patients were followed up for 6-48 months.There were 15 cases of residual shunt after operation.Eight cases were self-closed during follow-up,and 5 cases were still followed up.No complications such as reoperation,aortic regurgitation,atrioventricular block or occluder abscission was observed during the follow-up period.Conclusion Occluding VSDs using the right subaxillary approach is safe and effective.Short-term and midterm results are satisfactory.Further follow-up is required regarding long-term results.

Clinical observation on therapeutic effect of Huangqi granules combined with external therapy in treatment of stress injury / 中国中西医结合急救杂志

Objective To observe the effect of Huangqi granules combined with external treatment on the clinical therapeutic effects of typeⅡand Ⅲ stress injuries. Methods A total of 240 patients with typeⅡ andⅢ pressure injuries admitted to the Hengshui People's Hospital from January 2017 to March 2019 were enrolled. According to difference in therapeutic methods, the patients were divided into astragalus mongholicus granule group and routine treatment of Western medicine group, with 120 cases in each group. In both groups, the patients were given routine nursing treatment such as air cushion bed, regular body turn-over, nutrition support, health education, etc;in routine Western medicine treatment group, according to the principle of aseptic dressing change, the wounds were treated and covered with foam dressing; while in the astragalus mongholicus granule group, the routine nursing care and sterile dressing as above mentioned were also applied, additionally 3 bags of oral astragalus mongholicus granules mixed with boiled water each time, twice a day (equivalent to 10 g for each bag of Chinese herbal slices), 7 days as one course of treatment; at the same time, the wound was sterilized, debrided and washed with normal saline, and after drying, the rubber Shengji ointment for promoting growth of tissue was evenly spread on the wound and covered with foam dressing. In the two groups, the changes of pressure ulcer healing evaluation scale (PUSH) scores before treatment and 7, 14, 21 and 28 days after treatment, as well as the differences in wound healing time and clinical efficacy between the two groups after treatment were observed, and the recurrence rate was followed up for 10 weeks. Results Compared with routine Western medicine group, the Ⅱand Ⅲ wound healing times were significantly reduced in the astragalus mongholicus granule group [the days of wound healing for Ⅱ stress injury (days): 7.81±1.40 vs. 16.52±1.89, the days of wound healing for Ⅲ stress injury (days): 14.60±1.50 vs. 20.23±1.27, both P < 0.05]. With the prolongation of therapeutic time, the PUSH scores of two groups decreased gradually, there was no significant difference in the PUSH scores between the two groups before treatment and 7 days after treatment (both P > 0.05); after 14 days of treatment, the PUSH score of astragalus mongholicus granule group was significantly lower than that of the routine western medicine group (7.82±1.93 vs. 9.96±1.89), and lasted until 28 days (4.16±0.47 vs. 5.29±0.57), the differences being statistically significant (both P < 0.05). The total effective rate of the astragalus mongholicus granule group was significantly higher than that of the routine western medicine treatment group [99.41% (171/172) vs. 74.51% (114/153), P < 0.05], and the recurrence rate of the mongholicus granule group was obviously lower than the routine Western medicine treatment [3.60% (5/139) vs. 17.74% (11/62), P < 0.05]. Conclusion Oral astragalus mongholicus granules combined with myocreatic ointment external therapy can effectively shorten the healing time of type Ⅱand Ⅲ stress injury, improve the cure rate and reduce the recurrence rate.

Mental and behavioral abnormalities after arthroplasty and incomplete cerebral fat embolism / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the relationship between mild consciousness and mental disorders after arthroplasty and incomplete cerebral fat embolism.</p><p><b>METHODS</b>A retrospective analysis of 12 patients with incomplete cerebral fat embolism after arthroplasty was performed from June 2004 to December 2011. There were 5 males and 7 females,ranging in age from 36 to 82 years old,averaged 56.8 years old. Four patients had femoral neck fractures; 3 patients had avascular necrosis of the femoral head; 3 patients had rheumatoid arthritis; 1 patient had ankylosed hip and 1 patient had knee osteoarthritis. The patients had consciousness and mental disorders after arthroplasty (femoral head replacement in 3 cases, total hip replacement in 7 cases, and knee joint surface replacement in 2 cases), changes of vital sign and abnormal brain MRI examination.</p><p><b>RESULTS</b>Twelve patients had mild consciousness and mental disorders,and the NIHSS score was 1.92+/-3.78,which was correlated with incomplete cerebral fat embolism after arthroplasty. The patients recovered conscious within 24 to 72 hours after treatment with expansion of blood volume,dehydrating agent and neuroprotective drugs,improving respiratory and circulatory function, hormone protection and antibiotic application. The patients were followed up with a mean period of 18 months (ranging from 10 to 36 months). The patients had neurological function recovering to normal without sequelae, and the NIHSS score decreased to 0.</p><p><b>CONCLUSION</b>Incomplete cerebral fat embolism after arthroplasty is the main reason causing mild awareness and mental disorders, which is often to be misdiagnosed or ignored because of not typical clinical manifestations.</p>

Bioactive cyclodipeptides extracted from marine microbes in East China Sea / 第二军医大学学报

Objective: To search for bioactive compounds from marine microbes. Methods: Pyricularia oryzae was used to screen microbes. Compounds extracted with EtOAc from the fermentation broth of F8712 strain(an active microbe screened out) were separated. The chemical structures of the separated compounds were identified by HNMR, CNMR and ESI-MS techniques. Results: Six cyclic dipeptides, cyclo(Ala-Leu), cyclo(Ala-Ile), cyclo(Ile-Pro), cyclo(Val-Pro), cyclo(Leu-Pro) and cyclo (Leu-Val), were obtained. Conclusion: None of the 6 cyclodipeptides has any anti-Pyricularia oryzae activities. Compound V has potent inhibitory effects on Vibrio anguillarm with a minimum inhibitory concentration of 0.07 μg/ml.

Effect of electroacupuncture on proliferation of astrocytes after spinal cord injury / 中国针灸

<p><b>OBJECTIVE</b>To explore the mechanism of acupuncture in treatment of spinal cord injury (SCI).</p><p><b>METHODS</b>Adult Wistar rats were used to make SCI model by Allen's method. The SCI rats were treated with electroacupuncture (EA) at acupoints of the Governor Vessel for 3 days, 1 week, 2 weeks or 4 weeks. Normal group and spinal cord injury group were used as controls. The number and morphology of astrocytes in each group were investigated by electron microscope, immunohistochemistry and in situs hybridization methods. The expression of glial fibroblast acid protein (GFAP) mRNA in the injured spinal cord was detected by reverse transcription polymerase (RP-PCR).</p><p><b>RESULTS</b>The mitochondria and ribosomes of astrocytes in the EA group increased. The number of astrocytes increased after SCI, in gray matter being more than that in the white matter, in the caudal being more than that in the rostral. The expression of GFAP mRNA in the EA group was significantly lower than that in the control group.</p><p><b>CONCLUSION</b>Electroacupuncture can inhibit the reactive proliferation of the astrocytes after spinal cord injury and prevent formation of the glial scar.</p>

Management of severe postburn scar contracture in the lower extremities / 中华烧伤杂志

<p><b>OBJECTIVE</b>To summarize the clinical experience in the management of severe postburn scar contracture in the lower extremities.</p><p><b>METHODS</b>The scars in popliteal fossa and ankle joint were excised. Traction and skin grafting were employed in the management of contracture deformity in these areas.</p><p><b>RESULTS</b>Severe postburn scar contracture deformity in sixty postburn patients could be corrected by constant traction and skin grafting.</p><p><b>CONCLUSION</b>Scar excision and lysis with constant traction might be an optimal method in the management of severe postburn scar contracture deformity of joints in the lower extremities and satisfactory results could be obtained without tendon grafting and elongation.</p>

The design of the expanded flap for the repair of the temporal and cheek area / 中华整形外科杂志

<p><b>OBJECTIVE</b>To explore the design of an expanded flap at the temporal and cheek area.</p><p><b>METHODS</b>The expanded flap was used for the repair of 619 temporal and cheek defects secondary to scar, nevus or hemangioma excision. In the frontal area, the rotational flap was usually used. For the repair of the cheek, the applied flap included the rotational, advanced, and transposition flap from the neck, as well as the pedicle flap from the thoracic area.</p><p><b>RESULTS</b>Eight thoracic-deltoid flaps had distal necrosis of 1 approximately 5 cm. Of them, 5 flaps were repositioned with subsequent good result; the other 3 flaps underwent skin grafting. The five facial expanded flaps showed distal necrosis of 0.5 approximately 1 cm. Of them, 4 flaps occurred delayed healing, 1 flap underwent skin grafting. Expander extrusion happened in 41 cases (6.62%), which resulted in deficiency of the expanded area. Satisfactory results were achieved in all the other cases.</p><p><b>CONCLUSIONS</b>According to our experience, careful design of the flap is very important for obtainingbetter surgical results and decreasing complications.</p>

A rare transcription mutation (-90 C-->T) in a Chinese family with beta-thalassemia / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To identify a rare transcription mutation (C-->T) at position -90 of the beta-globin gene previously unreported in the beta-thalassemia carriers from a Chinese family.</p><p><b>METHODS</b>In phenotype analysis, standard hematological techniques were used to measure RBC counts and Hb concentration. Reverse dot blot (RDB) analysis, which can simultaneously detect 18 known types of beta-thalassemia mutations in Chinese, was used to scan beta-globin gene mutations. DNA sequence analysis of the entire human beta-globin gene was performed to characterize the underlying causative mutation of the sample and to identify its genotype. A semi-quantitative RT-PCR method was used to measure beta-globin gene expression in the form of mRNA from the subjects.</p><p><b>RESULTS</b>The proband, his brother and his mother presented a typical beta-thalassemic trait with reduced mean corpuscular volume (MCV, 68.2-73.6 fL) and elevated level of Hb A(2) (5.7%-6.4%) but no known beta-thalassemia mutations were found in the samples by RDB analysis. DNA sequencing of the beta-gene region of these three samples revealed heterozygosity for the C-->T substitution at position -90 within proximal CACCC box of the beta-globin gene promoter element, which was previously unreported in the Chinese population. Analysis of mRNA from the positive carriers demonstrated that the mutant beta-globin gene significantly reduced beta-globin transcription (mutants: 2.233 +/- 0.01 vs normal: 3.779+/-1.19; 95%CI: 3.060, 4.499), showing a level comparable with that of the other beta-thalassemia heterozygotes (2.110+/-0.53, 95%CI: 1.732, 2.488).</p><p><b>CONCLUSION</b>A rare transcriptional mutation that led to beta-thalassemia in Chinese population has been characterized. The findings enrich knowledge of the mutation spectrum of beta-thalassemia.</p>

Fabrication of a blood vessel scaffold with a combined polymer for tissue engineering / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the possibility to fabricate a blood vessel scaffold with a combined polymer for tissue engineering.</p><p><b>METHODS</b>A blood vessel scaffold was designed with a combined polymer composed of rabbit vascular smooth muscle cells(VSMCs), collagen and a non-spinning fabric mesh of polyglycolic acid (PGA). VSMCs were implanted into collagen gel and their growth was observed. The mixed solution of VSMCs and collagen was dropped into the tubular scaffold, followed by 7-day culturing.</p><p><b>RESULTS</b>VSMCs formed many prominences after culturing in gelatinous collagen for 3-4 hours. With cells extending, some cells became shuttle- or spindle-shaped. After VSMCs-collagen complex was implanted into the PGA mesh, most of VSMCs remained in the pore of PGA mesh with the formation of gelation. VSMCs could adhere to and grow on the PGA fiber.</p><p><b>CONCLUSION</b>The non-spinning PGA porous biodegradable material coated with collagen is a good carrier for VSMCs to adhere and grow.</p>

Effect of Circadian Rhythm on Hypnotic Median Effective Dose of Ketamine / 实用儿科临床杂志

Objective To observe the effect of circadian rhythm on hypnotic median effective dose( ED50) of ketamine. Methods Sixty mice were randomly divided into 4 groups which had 15 mice in each group. They were intraperitoneally injected with ketamine at different times of 2 Am,8 Am,2 Pm and 8 Pm, respectively. Righting reflex was recorded and the value of ED50 was measured with sequential experimental method. Results The hypnotic ED50 of ketamine at 2 Am was(54.57?0.82) mg/kg, with 95% confidence limit of ED50 38.06-78.22 mg/kg;ED50 was(49. 27?0. 12) mg/kg at 8 Am, with 95% confidence limit of ED50 40. 21-60. 37 mg/kg;ED50 at 2 Pm was (42.28?0.21) mg/kg, with 95% confidence limit 37.35 - 47 83 mg/kg;and ED50 at 8 Pm was(57.42?0.14) mg/kg, with 95% confidence limit 37.51-73 72 mg/kg,respectively. The ED50 were significant different at 2 Pm and 8 Pm. However, there were no significant difference in ED50 value among other groups. Conclusion The hypnotic effect of ketamine has circadian rhythm - dependent.

The 16S rDNA Sequence Analysis and Phenotypical Study of Strain F12-11-1-2 / 微生物学通报

The strain F12-11-1-2 was isolated from the East China Sea,which had antimitosis activity using Pyricularia oryzae mode.Ac- cording to phenotypical study,salt-aggregation test and 16S rDNA sequence analysis,the strain F12-11-1-2 has been identified to be Bacillus subtilis.