Internal and external fixation combined with second stage perforator flap for the treatment of ankle fracture dislocation of Gustilo-Anderson types ⅢB and Ⅲ C / 中国骨伤

OBJECTIVE@#To explore clinical effect of internal and external fixation combined with second-stage perforator fiap for the treatment of ankle fracture dislocation of Gustilo-Anderson types ⅢB and ⅢC.@*METHODS@#From May 2014 to July 2017, 20 patients with Gustilo-Anderson types ⅢB and ⅢC ankle fracture dislocation were treated with internal and external fixation combined with second-stage perforator fiap, including 14 males and 6 females, aged from 18 to 58 years old with an average of (39.0±9.7) years old;17 patients were type ⅢB and 3 patients were type ⅢC according to Gustilo-Anderson classification;4 patients were type A, 7 patients were type B, and 9 patients were type C according to AO classification. The size of wound ranged from 4 cm×3 cm to 20 cm×9 cm. Second-stage perforator flap, 11 patients were performed with posterior tibial artery perforator flap, 5 patients were performed with fibular artery perforator flap, 1 patient was performed with anterior ankle flap, and 3 patients were performed with posterior tibial artery perforator flap combined with fibular artery perforator flap. Postoperative wound healing, flap survival and fracture healing were observed, AOFAS score was used to evaluate at the latest follow up.@*RESULTS@#All limbs were preserved successfully without amputation. Nine patients occurred superficial infection without deep infection and osteomyelitis occurring. The flaps of 19 patients survived. All patients were followed up for 6 to 18 months with an average of (12.0±2.9) months. The flaps healed well without sinus tract, bone exposure and bone disunion occurring. Fracture healing time ranged from 4 to 10 months with an average of (6.6±1.7) months. PostoperativeAOFAS score was 76.7± 16.4, among which 4 patients got excellent result, 11 patients good, 3 patients fair, and 2 poor.@*CONCLUSION@#Internal and external fixation combined with second stage perforator fiap for the treatment of ankle fracture dislocation of Gustilo-Anderson types ⅢB and ⅢC could effectively close the wound, improve fracture healing and restore appearance and function of limbs to the maximum.

Clinical study of the oxygen drive aerosol inhalation with budesonide and ambroxol in the prevention of adult post-thoracotomy pneumonia / 北京大学学报(医学版)

OBJECTIVE@#To study the clinical effect of the oxygen drive aerosol in halation with budesonide and ambroxol in the prevention of adult post-thoracotomy pneumonia.@*METHODS@#This was a randomized, open and parallel controlled trial. We chose 80 cases of patients in the department of thoracic surgery in the First Affiliated Hospital of Xi'an Jiaotong University which fitted our criteria as the research object. The selected patients were randomly divided into the active group and the control group, and the active group underwent oxygen drive aerosol inhalation (2 mg budesonide combined 60 mg ambroxol) for 3 days before operation, and the control group without preoperative aerosol inhalation, and their postoperative therapy was the same.@*RESULTS@#The baseline data showed that the differences in sex, age, disease and smoking were not statistically significant between the two groups, P>0.05. The results of blood gas analysis before 12 hours of operation suggested that, the PaO₂and PaCO₂values of the active group were (88.40±9.40) mmHg and (38.30±6.10) mmHg; The PaO₂and PaCO₂ values of the control group were (85.09±7.18) mmHg and (41.21±3.15) mmHg. And the two groups' P values were 0.029 and 0.011, with statistical differences. There were 3 patients who developed postoperative pneumonia out of 40 patients in the active group, the incidence was 7.50%, but the incidence of control group was 25.00%. The P value was 0.034, with statistical differences. We also analyzed the influence of different diseases and surgical methods on postoperative pneumonia, and the results showed that in the active group and the control group, the incidence of postoperative pneumonia in the patients with esophageal cancer was lower than that in lung cancer patients, and there was a statistically significant difference (P<0.05). In the active group, the numbers of pulmonary deed resection, lobectomy and pulmonary sleeve resection were 2, 21 and 1 cases respectively, and the corresponding numbers in the control group were 2, 21 and 2. Among the two groups, the incidence of postoperative pneumonia in the patients with different surgical methods of lung cancer was statistically significant (P<0.05).@*CONCLUSION@#If we implement respiratory preparation with budesonide plus ambroxol inhalation for 3 days before operation, we can greatly reduce the incidence of postoperative pneumonia?

Oral fibrinogen-depleting agent lumbrokinase for secondary ischemic stroke prevention: results from a multicenter, randomized, parallel-group and controlled clinical trial / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Elevated fibrinogen (Fg) level is a known risk factor for ischemic stroke. There are few clinical trials on oral fibrinogen-depleting therapies for secondary ischemic stroke prevention. We aimed to assess the effects of one-year therapy with oral lumbrokinase enteric-coated capsules on secondary ischemic stroke prevention.</p><p><b>METHODS</b>This is a multicenter, randomized, parallel group and controlled study that began treatment in hospitalized patients with ischemic stroke and continued for 12 months. Patients were randomized to either the control group that received the standard stroke treatment or the fibrinogen-depleting group that received the standard stroke treatment plus enteric-coated lumbrokinase capsules. The NIH Stroke Scale scores (NIHSSs) and plasma Fg level were recorded. The carotid artery intima-media thickness (IMT) and status of plaques were examined through carotid ultrasound examination. Primary outcomes included all-cause mortality, any event of recurrent ischemic stroke/transient ischemic attack (TIA), hemorrhagic stroke, myocardial infarction and angina, and other noncerebral ischemia or hemorrhage. Kaplan-Meier survival analysis and the Long-rank test were used to compare total vascular end point incidence between the two groups. Comparison of median values between two groups was done by the Student t test, one-way analysis of variance (ANOVA), or non-parametric rank sum test.</p><p><b>RESULTS</b>A total of 310 patients were enrolled, 192 patients in the treatment group and 118 patients in the control group. Compared to the control group, the treatment group showed favorable outcomes in the Fg level, carotid IMT, the detection rate of vulnerable plaques, the volume of carotid plaques, NIHSS scores, and incidence of total vascular (6.78% and 2.08%, respectively) and cerebral vascular events (5.93% and 1.04%, respectively) (P < 0.05). In the treatment group, the volume of carotid plaques was significantly related to the carotid IMT, the plaque diameter, width and number (P = 0.000, 0.000, 0.000, 0.022; F = 13.51, 2.52, 11.33, -3.29, but there was a weak correlation with the Fg level (P = 0.056). After 1-year therapy, the incidence of overall vascular end points was reduced by 4.7%.</p><p><b>CONCLUSION</b>Long-term oral fibrinogen-depleting therapy may be beneficial for secondary ischemic stroke prevention.</p>

Feasibility and efficiency of embolization of spinal dural arteriovenous fistula / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the feasibility and efficiency of embolization of spinal dural arteriovenous fistula (SDAVF).</p><p><b>METHODS</b>From December 2010 to May 2012, there were 104 cases of SDAVF were treated, and 26 cases were selected to be treated with embolization. The inclusion criteria was as follows: (1) No anterior or posterior spinal artery originated from the fistula segment; (2) The segmental artery can be catheterized with guiding or micro catheter; (3) High flow in fistula; (4) Patient's situation was not suitable for surgery or general anesthesia. Among 26 cases, there were 22 male and 4 female patients, the average age was 55.9 years (ranged from 34 to 81 years). The locations of SDAVF were 10 cases in thoracic, 9 in lumbar and 7 in sacral segment. The main symptoms were progressive numbness and weakness in both lower extremities, most cases accompanied with difficulties in urination and defecation. The average history was 17.1 months (from 1 to 156 months). ONYX-18 liquid embolic agent or Glubran-2 surgical glue were used as embolic material. The patients not cured with embolization were treated with surgery in the following 1 - 2 weeks. Follow-up evaluation was done with MRI after 3 months and DSA after 6 months, besides physical examination.</p><p><b>RESULTS</b>Fifteen from 26 cases achieved immediate angiographic cure results: 14 in 20 cases which embolized with ONYX-18; only 1 in 6 cases with Glubran-2. Three in 10 cases of thoracic SDAVF and 12 in 16 cases of lumbar/sacral SDAVF were cured with embolization. Partially embolized cases were treated with surgical obliteration of drainage veins within 2 weeks. Cured patients experienced immediate improvement after embolization and kept getting better in the follow-up. All the patients had MRI follow-up after 3 months and DSA follow-up after 6 months. In 6 month's follow-up, MRI showed the edema and flow void signal in the spinal cord disappeared. DSA showed no fistula recurrence or remnant. There was no deterioration case in all of the embolized cases.</p><p><b>CONCLUSIONS</b>Particular SDAVF is suitable for embolization with ONYX-18. Most lesions located in lumbar and sacral segment are good indications for embolization.</p>

Comparison of the Designing Effects (DE) among different designs related to complex sampling methods / 中华流行病学杂志

To compare the designing effects (DE) among different complex sampling designing programs.Data from the ‘2002 Chinese Nutrition and Health Survey' was used as an example to generate the sampling population,and statistical simulation method was used to estimate the values of DEs from six complex sampling designing programs.It was found that the values of DEs varied among the six complex sampling designing programs.The values of the DEs were associated with the sample sizes in a positive way,with more sample stages and less stratified categories.Reduction of the numbers of sample stages and detailing stratified categories could decrease the DE values so as to improve the DE.

Questionnaire-based survey of allergic diseases among children aged 0 - 14 years in the downtown of Beijing, Chongqing and Guangzhou / 中华儿科杂志

<p><b>OBJECTIVE</b>In recent years, the incidence of allergic diseases in China is increasing. With serious influence on the patients' quality of life and even life-threatening, now allergic diseases have become an important public health problem in our country. This survey aimed to obtain a general epidemic outline of children's major allergic diseases, i.e., childhood asthma, allergic rhinitis and eczema in the downtown of Beijing, Chongqing and Guangzhou.</p><p><b>METHOD</b>Childhood asthma questionnaire was established by Delphi method based on guidelines for childhood asthma diagnosis and prevention made by Chinese medical association in 2008 with reference to the International Study of Asthma and Allergies in Childhood questionnaire (ISAAC). This study was carried out from Oct. 2008-Mar. 2009, in Beijing, Chongqing and Guangzhou by a multi-stage sampling method, covering a sample of 24 290 children aged 0 - 14 years by a multi-stage sampling method, the population of children surveyed in the downtown of Beijing Chongqing and Guangzhou was 10 372, 9874 and 4072 respectively; of whom males were 5545, 5258, 2159, and females were 4917, 4588, 1877; the ratio of males to females in the three cities were 1.11:1, 1.15:1, 1.15:1; the average age of surveyed children were 7.63, 8.74 and 8.30 years old. All the questionnaire was filled in by the parents of children or other guardian of children.</p><p><b>RESULT</b>The self-reported prevalence of asthma in Beijing, Chongqing and Guangzhou was 3.15%, 7.45%, 2.09%, the self-reported prevalence of allergic rhinitis was 14.46%, 20.42%, 7.83%, and the prevalence of eczema was 20.64%, 10.02%, 7.22%. In the survey, asthma combined with allergic rhinitis had the highest rate, 49.54%, 50.14%, 34.83%, respectively in the 3 cities. The self-reported prevalence of asthma and allergic rhinitis was significantly higher in male than female. Besides, the self-reported prevalences of asthma and allergic rhinitis were relatively lower in children under 1 year and over 10 years of age.</p><p><b>CONCLUSION</b>The prevalence of asthma, allergic rhinitis and eczema and other allergic diseases in children 0 - 14 years of age in the three cities gradually increased, and the prevalence of allergic diseases in Chongqing was relatively higher.</p>

Differential expression of hsa-miR-126 and hsa-miR-518b in esophageal squamous carcinoma / 南方医科大学学报

<p><b>OBJECTIVE</b>To identify the differentially expressed microRNAs (miRNAs) between esophageal squamous carcinoma (ESC) and adjacent non-tumorous tissue (NT).</p><p><b>METHODS</b>The expression levels of the miRNAs were detected in 3 fresh ESC and NT samples by hybridization with miRNAs microarray chip. Real-time quantitative RT-PCR was performed to confirm the results of the microarray analysis. The expressions of hsa-miR-126 and hsa-miR-518b in ESC were validated by real-time quantitative RT-PCR in another independent 15 matched samples.</p><p><b>RESULTS</b>A total of 11 miRNAs exhibited differential expressions in ESC samples as compared to their expressions in the NT samples, including a 1 up-regulated miRNA and 10 down-regulated miRNAs. Compared with normal esophageal samples, the ESC tissues showed up-regulated hsa-miR-126 and down-regulated hsa-miR-518b expression.</p><p><b>CONCLUSION</b>hsa-miR-126 and hsa-miR-518b are differentially expressed in ESC, and they might play important roles in the carcinogenesis and progression of ESC.</p>

Current trends of the prevalence of childhood asthma in three Chinese cities: a multicenter epidemiological survey / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To analyze the prevalence of asthma and asthma related symptoms among children aged 0-14 years in three Chinese cities and to obtain a crude estimation of the trend of childhood asthma prevalence in China.</p><p><b>METHODS</b>A cross-sectional, population-based survey of prevalence of asthma was conducted in children aged from 0 to 14 years in 3 major cities of China (Beijing, Chongqing, and Guangzhou) with different geographic locations. All the subjects were randomly selected by a multi-stage sampling method. Three to five schools and kindergartens in 2 urban districts in each city were randomly selected for the survey, and a validated questionnaire that included the core questions of the International Study of Asthma and Allergies in Childhood, Phase III questionnaire and several additional questions were used. All questionnaires were completed by parents or guardians of the selected children. Children whose parents responded affirmatively to the question "Has your child ever been diagnosed as asthma by a doctor" were recognized as victims of asthma.</p><p><b>RESULTS</b>The prevalence of asthma in Beijing, Chongqing, and Guangzhou was 3.15%, 7.45%, and 2.09%, respectively. These values were significantly higher than those obtained 10 years ago in the national epidemiological survey in 2000 which used the same method of investigation and the same diagnotic criteria (χ²=3.938, P=0.047; χ²=73.506, P≤0.001; χ²=11.956, P=0.001, in each city). Of the asthmatic children 57.21%, 69.91%, and 60.00% had their first attack before the age of 3 in Beijing, Chongqing, and Guangzhou, respectively. Wheezing was the primary clinical manifestation for all asthmatic children, followed by persistent cough and repeated respiratory infections. Both the prevalence of asthma and asthma-related symptoms were statistically higher in males than in females.</p><p><b>CONCLUSION</b>The prevalence of childhood asthma is statistically higher than that 10 years ago in the three Chinese cities.</p>

Construction of a prokaryotic expression vector for apoptin and preparation of polyclonal antibody of apoptin / 南方医科大学学报

<p><b>OBJECTIVE</b>To construct a prokaryotic expression vector for apoptin and prepare polyclonal antibody of apoptin.</p><p><b>METHODS</b>Apoptin gene amplified from pGEM-T/Apoptin plasmid by PCR was cloned into pET-28a (+). E.coli BL21 (DE3) was transformed by the recombinant plasmid, and apoptin protein expression induced by IPTG was analyzed by SDS-PAGE. BALB/c mice were immunized with the protein and the titer of the antibody was determined using indirect enzyme-linked immunosorbent assay (ELISA).</p><p><b>RESULTS</b>Apoptin gene was successfully cloned into pET-28a (+), and the expression of a protein with relative molecular mass of about 17 000 was identified by SDA-PAGE. After 5 immunizations of the mice with the protein, the blood antibody titer reached 1:5x10(5).</p><p><b>CONCLUSION</b>The prokaryotic expression vector for apoptin is successfully constructed and the polyclonal antibody of apoptin is obtained, which allows further functional study of apoptin.</p>

Cause-excluded health adjusted life expectancy: a new indicator in measuring the burden of diseases / 中华预防医学杂志

Based on the integration of concept and methods of cause-eliminated life expectancy (CELE), health-adjusted life expectancy (HALE) and disability-adjusted life year (DALY), a new index named cause-excluded health adjusted life expectancy (CEHALE) was developed in this study to evaluate the health impact(both fetal and non-fetal) of single disease. In order to include the impact of both premature death and health problems among those who are alive, the concept of suppositional death was introduced to calculate CEHALE. Cause-excluded health adjusted life expectancy developed in this study, should be not only easy to understand in concept, but also has theoretical support and be not affected by age structure, and be more suitable to use in comparison among different diseases and different population. Moreover, the new index is easy to calculate. So, CEHALE should be an ideal index to evaluate the impact of disease to population health.

Contribution of diabetes to the burden of diseases / 中华预防医学杂志

<p><b>OBJECTIVE</b>To overview the contribution of diabetes in the burden of diseases.</p><p><b>METHODS</b>Based on the data published by MOH, prevalence rate, mortality rate, cause eliminated life year were used to calculate the health burden of disease. Meanwhile, direct economic burden of diseases was presented.</p><p><b>RESULTS</b>According the calculation, about 23 million of people suffered from diabetes and 90,000 died from diabetes. The cause eliminated life year attributed to diabetes is different between urban and rural, 0.21 years for urban and 0.08 years for rural. Moreover, the direct economic burden reached 1.071 billion RMB, about 1.88% of national health expenditure at the same period.</p><p><b>CONCLUSION</b>The burden of diabetes, based on calculation of both health and economic burden, and will give a heavy pressure to the government and society.</p>