Application of trauma time axis management in the treatment of severe trauma patients / 中华创伤杂志(英文版)

PURPOSE@#This study aimed at exploring the application of trauma time axis management in the treatment of severe trauma patients by using the Medicalsystem trauma system.@*METHODS@#We performed a retrospective cohort study involving patients with severe trauma. Patients who were admitted before the application of the Medicalsystem trauma system were divided into before system group; patients who were admitted after the application of the system were divided into after system group. Comparison was made between the two groups. For normally distributed data, means were reported along with standard deviation, and comparisons were made using the independent samples t test. Categorical data were compared using the Chi-square test. The Mann-Whitney U test was used to compare nonparametric variables.@*RESULTS@#There were 528 patients admitted to the study during the study period. There was no significant statistical difference in the time from the start of trauma team to arrive at the resuscitation room between the two groups. The time from arrival at hospital to endotracheal intubation, to ventilator therapy, to blood transfusion, to completion of CT scan, to completion of closed thoracic drainage, to the start of operation, as well as the length of stay in resuscitation room and hospital were significantly lower after the application of the Medicalsystem trauma system. The mortality was decreased by 8.6% in the after system group compared with that in the before system group, but there was no statistical difference.@*CONCLUSION@#The Medicalsystem trauma system can optimize diagnosis and treatment process for trauma patients, and accordingly improve the treatment efficiency and shorten the treatment time. Therefore, the Medicalsystem trauma system deserves further popularization and promotion.

Simultaneous hybrid coronary revascularization versus off-pump coronary artery bypass grafting for diabetic patients with multivessel coronary artery disease / 中国胸心血管外科临床杂志

@#Objective    To compare the in-hospital and midterm outcomes after simultaneous hybrid coronary revascularization (HCR) with off-pump coronary artery bypass grafting (OPCAB) in diabetic patients with multivessel coronary artery disease. Methods    One hundred thirty-two diabetic patients with multivessel coronary artery disease underwent one-stop HCR at Fuwai Hospital from January 2010 to January 2015. These patients were 1∶2 matched with those who underwent OPCAB using propensity score matching. Results    Simultaneous HCR had less chest tube drainage (618 (420, 811) ml vs. 969 (711, 1 213)ml, P<0.001), lower transfusion rate (19.7% vs. 34.1%, P=0.026), shorter mechanical ventilation time (11.6 (8.2, 14.8) h vs. 16.0 (12.1, 18.7) h, P<0.001), and shorter stay in intensive care unit (21.5 (18.8, 42.0)   h vs. 44.6 (23.7, 70.1) h, P<0.001) than OPCAB. During over median 40 months follow-up, simultaneous HCR offered similar major adverse cardiac or cerebrovascular events (MACCE) rate (6.8% vs 9.0%, P=0.826), but lower stroke rate (0%vs 3.0%, P=0.029), compared with OPCAB. Conclusion    For selected patients with diabetes, simultaneous HCR provides a safe and effective revascularization alternative. It decreases perioperative invasiveness and incurred similar and favorable midterm outcomes with OPCAB.

Treatment of intercondylar fracture of the humerus through internal and external elbow approach or elbow posterior olecranon osteotomy approach / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the efficacy, advantages and disadvantages of internal and external elbow joint approach and olecranon osteotomy approach for the treatment of intercondylar fracture of humerus.</p><p><b>METHODS</b>From October 2012 to May 2016, 18 cases of intercondylar fracture of humerus were treated by operation including 12 males and 6 females with a mean age of 33.5 years old (ranged from 4 to 56 years old); 8 cases were operated by internal and external elbow joint approach, 10 cases were operated by olecranon osteotomy approach. According to AO classification, 3 cases were type C1, 8 cases were type C2, 7 cases were type C3. All patients were excluded from neurologic and vascular injuries.</p><p><b>RESULTS</b>All patients were followed up from 12 to 26 months with an average of 15 months. The incision healed well and no heterotopic ossification was found. According to the modified Cassebaum elbow function score, the result was excellence in 14 cases, good in 3 cases, fair in 1 case.</p><p><b>CONCLUSIONS</b>According to the fracture type, the appropriate surgical approach and fixation were selected in order to get anatomic reduction. Rigid fixation, and early functional exercise is important condition for successful operation and satisfactory functional recovery in intercondylar fracture of the humerus.</p>

Processing Technology Optimization of Prepared Morinda Officinalis Based on Nystose Content / 中国药师

Objective:To optimize the processing technology of prepared Morinda officinalis based on nystose content. Methods:Orthogonal experiments and the nystose determination method in Chinese Pharmacopoeia (2010 edition) were used to optimize the pro-cessing technology. A Welch AQ-C18(250 mm ×4.6 mm,5 μm)chromatographic column was applied with methanol-water(3∶97)as the mobile phase, the column temperature was at 25℃, the flow rate was 0. 8 ml·min-1 , the injection volume was 10μl, and the drift tube temperature was at 40℃ with low temperature atomization. Results:The linearity of nystose was good within the range of 0. 214 8-0. 644 4 mg·ml-1 and the recovery was 99. 5%(RSD=3. 5%,n=6). Conclusion: On the basis of nystose content determination, the optimal processing technology of prepared Morinda officinalis is as follows:liquorice of 4%, stir fry time of 15min and the boiling pot temperature of 200℃.

Duchenne and Becker muscular dystrophy complicated with epilepsy / 中华儿科杂志

<p><b>OBJECTIVE</b>To summarize the clinical features of those Duchenne and Becker muscular dystrophy (DMD and BMD) patients who are complicated with epilepsy, and try to analyze the genotype- phenotype correlation.</p><p><b>METHOD</b>By a retrospective analysis of 307 patients with DMD and BMD who attended Peking University First Hospital from February 2006 to September 2014,7 patients complicated with epilepsy were identified and their clinical data were collected. The possible mechanism of epilepsy in DMD and BMD patients was proposed after analyzing the genotype-phenotype correlation.</p><p><b>RESULT</b>(1) Among 307 DMD and BMD patients, 7 cases had epilepsy, the prevalence was 2. 28%. (2) The age of onset of epilepsy ranged from 8 months to 11 years. Focal seizure was the most common seizure type (6 cases) , while other seizure types were also involved, such as generalized tonic-clonic seizure. As to epilepsy syndromes, 1 boy was diagnosed as benign childhood epilepsy with centrotemporal spikes (BECT). Six patients were treated with 1 or 2 types of antiepileptic drugs and seizures were controlled well. On follow-up, 6 of the 7 children had normal mental development, while the remaining 1 patient was diagnosed as mild mental retardation. (3) DMD gene mutations of all 7 patients were analyzed. Exons deletions were found in 6 cases while point mutation was found in 1 case.</p><p><b>CONCLUSION</b>The prevalence of epilepsy in DMD and BMD patients was higher than the prevalence in normal population. The age of onset of epilepsy varies, and focal seizure may be the most common seizure type. Some patients may also present as some kind of epilepsy syndrome, such as BECT. In most patients, seizures can be controlled well by 1 or 2 types of antiepiletic drugs. No clear correlation was found between genotype and phenotype in DMD and BMD patients who were complicated with epilepsy, probably due to limited number of cases.</p>

Effects of gonadotropin-releasing hormone analog treatment on glucose and lipid metabolism in girls with idiopathic central precocious puberty / 中华实用儿科临床杂志

Objective To assess the effects of gonadotropin-releasing hormone analog on glucose and lipid metabolism in girls with idiopathic central precocious puberty(ICPP).Methods A total of 26 girls (aged 6-8 years,breast stage B2) with ICPP were followed up in Department of Endocrinology,Shenzhen Children's Hospital from Jan.2008 to Jun.2011.Those girls received triptorelin therapy for 12 months.Before and the end of the 6th month,the 12th month of the treatment,body mass index(BMI) was calculated,fasting plasma glucose(FPG),fasting plasma insulin(FPI),total cholesterol,triacylglycerols,high density lipoprotein cholesterol,low density lipoprotein cholesterol,apolipoprotein A,apolipoprotein B and estradiol(E2) were measured.Insulin sensitivity was estimated by homeostasis model assessment of insulin resistance(HOMA-IR).Twenty age-matched prepuberty girls were set as controls.Results 1.Before treatment,BMI,FPG,FPI and HOMA-IR in ICPP girls had no significant difference compared with the controls.2.After 6 months treatment of triptrolin,serum E2 concentration in ICPP girls declined from(30.5 ± 9.8) ng/L at the beginning of treatment to (11.2 ± 4.6) ng/L at the end of 6th month (P ＜ 0.01) ; The end of 12 th month of the treatment,FPG and FPI had no significant difference compared with that before of the treatment,but BMI increased from(16.46 ± 1.10) kg/m2 to(18.35 ± 1.30) kg/m2,the difference was significant(P ＜0.05),HOMA-IR increased from 1.24 ±0.30 to 2.08 ±0.40,the difference was significant(P ＜0.05).3.Lipid metabolism parameters remained unchangeable after 12 months of triptrolin treatment.Conclusion Triptorelin may lead to raise of BMI and HOMA-IR in girls with ICPP at 12 months after treatment.

Novel surgery for refractory mixed constipation: analysis of the technical notes and outcome to Jinling procedure / 中华外科杂志

<p><b>OBJECTIVE</b>To discuss a new surgical strategy: Jinling procedure (subtotal colectomy combined with modified Duhamel procedure), of which the indications, technical notes and outcomes were analyzed.</p><p><b>METHODS</b>The 590 patients with refractory slow-transit constipation associated with outlet obstruction was strictly included between February 2000 and December 2011. The patients included 103 males and 487 females. Their age were 14-75 years (average 42 ± 13). The 412 patients received laparoscopic-assistant Jinling procedure, and 178 patients with open Jinling procedure. The pre- and post-operation data were collected. The follow up rate were 100%, 98.1%, 95.8% and 92.7% at 3, 6, 12 and 24 months.</p><p><b>RESULTS</b>There was no surgery-related death. Mean hospital day was (12 ± 9) days. Most complications were managed conservatively without significant events. The common complications after surgery were adhesive intestinal obstruction (9.2%), anastomosis bleeding (8.1%) and anastomosis leakage (2.9%). The gastrointestinal quality of life index score was 72 ± 9 preoperatively and increased to 68 ± 11, 99 ± 6, 105 ± 9, 106 ± 9 at 3, 6, 12 and 24 month follow-up, respectively (t = 62.1, -25.1, -126.5, -143.2, P < 0.01). The Wexner constipation scale was 21.9 ± 4.5 preoperatively and decreased to 9.6 ± 2.4, 5.9 ± 2.1, 4.6 ± 1.9, 4.5 ± 1.8 at 3, 6, 12 and 24 month follow-up, respectively (t = 48.6, 61.8, 58.2, 45.9, P < 0.01). The satisfactory rate was 77.5%, 92.1%, 93.0% and 94.1% at 3, 6, 12, and 24 month follow-up.</p><p><b>CONCLUSIONS</b>Jinling procedure provides a good surgical option for refractory slow-transit constipation associated with outlet obstruction.</p>

Surgical innovation for refractory constipation (Jinling procedure): a long-term follow-up of its safety and efficacy / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To propose a novel surgical procedure for refractory constipation, namely Jinling procedure, and to explore its safety and efficacy through long-term follow-up.</p><p><b>METHODS</b>A total of 614 patients with refractory constipation were admitted to the Department of General Surgery between February 2000 and June 2011. Five hundred and fifty-four patients received Jinling procedure and were included in this study. The general clinical data, complications after Jinling procedure, gastrointestinal quality of life index (GIQLI), Wexner constipation scale and satisfaction rate during follow-up were collected.</p><p><b>RESULTS</b>No operation-associated death occurred. Increased bowel movement frequency was observed during the perioperative period. Temporary difficulty in urination occurred in 24.5% of the patients. Other complications included small bowel obstruction (9.6%), anastomotic bleeding (8.1%), anastomotic leakage (3.1%), sexual dysfunction (3.1%), and wound infection (3.1%). Most postoperative complications were managed conservatively. The most recent follow-up was on August 2011, and the follow-up rate was 100%, 88.8%, 75.1%, 56.3% at 3, 6, 12, and 24 months after surgery. GIQLI temporarily increased from 78.1±9.4 preoperatively to 92.0±9.5 at 3 months follow-up, but continued to decrease during the follow-up at the 6 months (48.4±14.1), 12 months (21.0±4.3), and 24 months (20.0±3.4). Wexner constipation scale decreased from 19.9±4.3 preoperatively to 8.4±2.1 at 3 months follow-up (P<0.01). The low Wexner scale sustained until 24 months after operation. The satisfaction rate at the 3, 6,12 and 24 months follow-up was 78.1%, 91.1%, 94.2% and 94.6%, respectively.</p><p><b>CONCLUSION</b>Jinling procedure provides refractory constipation patients with a novel, safe and effective surgical option.</p>

Changes of defecography pre- and post-Jinling procedure for mixed constipation: a prospective single center study / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the anatomy and functional changes of pelvis before and after Jinling procedure (subtotal colectomy and side-to-side colorectal anastomosis) using defecography.</p><p><b>METHODS</b>Fifty patients with refractory mixed constipation received Jinling procedure in the Jinling Hospital between March 2009 and December 2010 and were included in this prospective study. The defecography was performed at one week before surgery and 6 months after Jinling procedure. Longo outlet obstructed score, Wexner constipation score and Wexner incontinence score were also recorded before and after the procedure.</p><p><b>RESULTS</b>After 6 months follow-up, defecography showed that anterior rectocele, prolapse, intussusception, and descending perineum were significantly improved (P<0.01). Anterior rectoceles were significantly reduced in depth from 22.0±1.8 mm to 2.4±0.4 mm (P<0.01). Intussusception decreased from 1.9±0.4 cm to 0.4±0.5 cm (P<0.01). Compared with preoperative score, Longo score and Wexner constipation score were significantly improved from 17.6±3.8 to 5.3±2.0 and from 19.5±4.8 to 5.5±2.4, respectively (P<0.01).</p><p><b>CONCLUSIONS</b>Jinling procedure can correct the anatomy and functional pelvic disorders in mixed constipation. Clinical improvement of obstructed defecation syndrome after Jinling procedure correlates well with morphologic correction of the rectal redundancy.</p>

Surface modification and DNA-binding assessment of nano-hydroxyapatite / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the impact of surface modification on the DNA-binding ability of nano-hydroxyapatite (nHA).</p><p><b>METHODS</b>Chemical co-precipitation-hydrothermal synthesis was utilized to prepare the nHA particles, and polyethylenimine (PEI) was used for surface modification of the nHA. Transmission electron microscopic (TEM) observation and zeta potential detection of the nHA were carried out before and after surface modification. The abilities of the nanoparticles, at different pH values and different concentrations, for DNA-binding and DNA protection against nuclease digestion were assessed before and after surface modification by electrophoresis.</p><p><b>RESULTS</b>TEM observation showed a short rod-like morphology of PEI-modified nHA with uniform particle size and good dispersion; the nHA without the modification tended to aggregate with poor dispersion. With a positive zeta potential, the PEI-modified nHA showed an obviously enhanced ability of DNA binding at different pH values and concentrations, with strong capacity to protect the DNA against Dnase I digestion. At the concentration of 250 µg/ml and a pH value of 7.0, the nHA-PEI showed an optimal efficiency of DNA-binding and DNA protection.</p><p><b>CONCLUSION</b>nHA with surface modification by PEI can serve as an effective vector for DNA binding and transfer.</p>

Comparison study of small splint fixation and plaster slab fixation for the treatment of distal radius fractures / 中国骨伤

<p><b>OBJECTIVE</b>To study the advantage of fir bark splint for the treatmet of distal radius fracture.</p><p><b>METHODS</b>From January 2006 to June 2008, 80 cases were randomly divided into two groups and treated by fir bark splint fixation or plaster fixation. There were 40 cases in the fir bark splint group, including 18 males and 22 females with an average age of 45.2 years ranging from 20 to 66 years. There were 40 cases in the plaster group, including 19 males and 21 females with an average age of 44.1 years ranging from 23 to 65 years. Four weeks after manipulative reduction and external fixation, the fixtion effect, function recovery, bone mineral density of secondly metacarpus were obsearved by X-ray film, and the clinical effect were evaluated according to healing time ahead of schedule.</p><p><b>RESULTS</b>As compared between the two groups, the fixation effect of the fir bark splint group was better than that of the plaster group (Z = -2.844, P = 0.004 < 0.05); the function recovery of the fir bark splint group was better than that of the plaster group (Z = -3.196, P = 0.001 < 0.05); the bone mineral density of secondly metacarpus of the fir bark splint group were better than that of plaster group (t = 4.56, P < 0.001); the curative effect of fir bark splint group was better than that of the plaster group (Z = -2.601, P = 0.009 < 0.05).</p><p><b>CONCLUSION</b>Fir bark splint could effectively keep fixation stability and promote fracture healing as well as function recovery.</p>

Predictive value of serum inhibin B levels as an indicator of the presence of testicular spermatozoa in nonobstructive azoospermia / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the predictive value of serum inhibin B (INH B) levels as an indicator of the presence of testicular spermatozoa in nonobstructive azoospermia.</p><p><b>METHODS</b>Forty patients with nonobstructive azoospermia (NOA), 20 patients with obstructive azoospermia (OA), and 10 fertile volunteers were involved in this study. A chemoluminescence method was used to measure the levels of FSH; Inhibin B was analysed by using sandwich enzyme-linked immuno-sorbent assay.</p><p><b>RESULTS</b>Patients with nonobstructive azoospermia has significantly higher levels of serum FSH [(21.34 +/- 12.15) IU/L] and significantly lower levels of inhibin B [(53.15 +/- 58.74) ng/L] than patients with obstructive azoospermia [FSH: (3.94 +/- 1.52) IU/L, INH B: (162.49 +/- 78.38) ng/L, P < 0.01] and fertile volunteers [FSH: (4.27 +/- 2.84) IU/L, INH B: (228.49 +/- 110.68) ng/L, P < 0.01]. Mean serum inhibin B were significantly higher in patients with nonobstructive azoospermia who had spermatozoa on TESE than in those in whom no spermatozoa was found on TESE [INHB: (90.31 +/- 72.18) ng/L vs (19.54 +/- 20.38) ng/L, r = 0.528, P < 0.01], but mean FSH levels did not have similar predictive power (P > 0.05).</p><p><b>CONCLUSION</b>Serum INH B level seems to be more accurate than serum FSH in the prediction of presence of testicular spermatozoa in patients with nonobstructive azoospermia. Serum inhibin B determination may be substitute of TESE as a diagnostic index.</p>

Recombinant human interleukin-6 inhibits mRNA expressions of adiponectin,its receptor 1 and adiponectin secretion in SW872 adipocytes / 中华内分泌代谢杂志

SW872 preadipocytes were cultured and induced to differentiate by oleic acid in vitro.The levels of adiponectin and its receptors (AdipoR1 and AdipoR2) mRNA were measured by semiquantitative RT- PCR.The concentration of adiponectin in the culture medium was assayed by ELISA.The results showed that rhIL- 6 could inhibit adiponectin,AdipoR1 mRNA expressions and adiponectin secretion in SW872 adipocytes in a time- and dose-dependent manner,but did not influence adipoR2 mRNA expression.