Pulmonary contusion is frequent and a serious injury in the chest trauma patients in emergency department. And it is easy to induce acute respiratory distress syndrome (ARDS) and respiratory failure. Since the development of modern technology and transportation, flail chest with pulmonary contusion happens more frequently than the past. And its complications and mortality are higher. In order to understand it better and improve the effect of the therapy on flail chest with pulmonary contusion, we reviewed the relative literatures. In this article, the main contents are as followed:① The pathophysiological changes of pulmonary contusion; ② The pathophysiological changes of flail chest with pulmonary contusion; ③ Clinical manifestation of flail chest with pulmonary contusion; ④ Imaging change of flail chest with pulmonary contusion; ⑤ progress in diagnosis and treatment.
A microsatellite is a short, repetitive sequence of DNA (usually 2 to 4 nucleotides in length). Multiple primary lung cancers (MPLC) are more than one primary lung cancer lesions arising synchronously in different locations of the same or different side of the lung. These neoplasms may have same or different histological types, but one lesion is not a metastasis from another, as each neoplasm arises independently in the lung. Abnormal microsatellite changes are closely related to the pathogenesis and development of MPLC. In this review, several aspects are discussed:①definition and origin of microsatellite; ②abnormal changes of microsatellite; ③definition and categories of MPLC; ④the influence of microsatellite on early diagnosis, treatment and prognosis of MPLC.
ObjectiveTo investigate the feasibility and security of laparoscopic Whipple pancreaticoduodenectomy(LPD)or laparoscopic pylorus preserving pancreaticoduodenectomy(LPPPD)for the patients with periampullary diseases, estimate the ratio of postoperative complications between LPD and LPPPD. MethodsFourty-five patients who underwent the LPD or LPPPD from January 2010 to March 2014 were reviewed retrospectively. These patients were divided into LPD group and LPPPD group basing on the Whipple or polyrus preservation. ResultsAmong these 45 patients, 25 patients were performed the LPD, the other 20 patients were performed the LPPPD. There were 25(55.56%)complications after operation, including 10 cases of pancreatic fistula, 1 case of bile leakage, 6 cases of delayed gastric emptying, 3 cases of infection, 2 cases of stomach intestine stomatorrhagia, 1 case of mesenteric venous thrombosis, 1 case of ascites, 1 case of chylous fistula. The complication rate had no significant difference between two groups. One patient died after operation in the LPPPD group. ConclusionLaparoscopic pancreaticoduodenectomy is safe and feasible in the treatment of periampullary diseases, the LPPPD could partly prevent the occurrence of reflux of the digestive juice following the resection of pylorus and improve the quality of life.
ObjectiveTo evaluate the reasonableness of anticoagulation management strategy in patients after mechanical heart valve replacement. MethodsAll patients were followed and registered continually at outpatient clinic from July 2011 to February 2013, with a minimum of 6 months after surgery. Targeted international normalized rate (INR) 1.60 to 2.20 and warfarin weekly dosage adjustment were used as the strategy of anticoagulation management. Except bleeding, thrombogenesis and thromboembolism, time in therapeutic range (TTR) and fraction of TTR (FTTR) were adopted to evaluate the quality of anticoagulation management. ResultsA total 1 442 patients and 6 461 INR values were included for data analysis. The patients had a mean age of 48.2±10.6 years (14-80 years) and the following up time were 6 to 180 months (39.2±37.4 months) after surgery. Of these patients, 1 043 (72.3%) was female and 399 (27.7%) was male. INR values varied from 0.90-8.39 (1.85±0.49) and required weekly doses of warfarin were 2.50-61.25 (20.89±6.93 mg). TTR of target INR and acceptable INR were 51.1% (156 640.5 days/306 415.0 days), 64.9% (198 856.0 days/306 415.0 days), respectively. FTTR of target INR and acceptable INR were 49.4% (3 193 times/6 461 times), 62.6% (4 047 times/6 461 times). There were 8 major bleeding events, 7 mild bleeding events, 2 thromboembolism events, and 2 thrombogenesis in the left atrium. ConclusionIt is reasonable to use target INR 1.60-2.20 and warfarin weekly dosage adjustment for patients after mechanical heart valve replacement.
Evolutionary psychology holds such an opinion that negative situation may threaten survival, trigger avoidance motive and have poor effects on the human body function and the psychological quality. Both disgusted and sad situations can induce negative emotions. However, differences between the two situations on attention capture and emotion cognition during the emotion induction are still not well known. Typical disgusted and sad situation images were used in the present study to induce two negative emotions, and 15 young students (7 males and 8 females, aged 27±3) were recruited in the experiments. Electroencephalogram of 32 leads was recorded when the subjects were viewing situation images, and event-related potentials (ERP) of all leads were obtained for future analysis. Paired sample t tests were carried out on two ERP signals separately induced by disgusted and sad situation images to get time quantum with significant statistical differences between the two ERP signals. Root-mean-square deviations of two ERP signals during each time quantum were calculated and the brain topographic map based on root-mean-square deviations was drawn to display differences of two ERP signals in spatial. Results showed that differences of ERP signals induced by disgusted and sad situation images were mainly manifested in T1 (120-450 ms) early and T2 (800-1 000 ms) later. During the period of T1, the occipital lobe reflecting attention capture was activated by both disgusted and sad situation images, but the prefrontal cortex reflecting emotion sense was activated only by disgusted situation images. During the period of T2, the prefrontal cortex was activated by both disgusted and sad situation images. However, the parietal lobe was activated only by disgusted situation images, which showed stronger emotional perception. The research results would have enlightenment to deepen understanding of negative emotions and to explore deep cognitive neuroscience mechanisms of negative emotion induction.
ObjectiveTo observe transforming growth factor β3 (TGF-β3) gene expression and the chondrogenesis of bone marrow mesenchymal stem cells (BMSCs) after TGF-β3 gene is transfected into BMSCs of Diannan small-ear pig. MethodsRecombinant adenovirus 5 (rAd5) was extracted as gene vector and packed into recombinant adenovirus rAd5-TGF-β3, double enzyme digestion and PCR identification were performed. BMSCs were isolated and cultured from bone marrow of 2-month-old Diannan small-ear pigs (weighing, 12-15 kg), and the 2nd generation of BMSCs were harvested for experiments. The experiments were divided into 3 groups. BMSCs were transfected with rAd5-TGF-β3 as experimental group and with empty vector as control group, and non-transfected BMSCs were used as blank control group. The transfection efficiency of exogenous gene was identified by flow cytometry, TGF-β3 protein expression by immunofluorescence and Western blot. The cell morphology of experimental group was observed by inverted phase contrast microscope, and the expression of collagen type II in each group was detected by Western blot. ResultsThe rAd5-TGF-β3 recombinant adenovirus was successfully constructed and transfected into BMSCs. Green fluorescence was observed by immunofluorescence microscope. Flow cytometry test showed the best transfection at 72 hours (transfection efficiency of 84.86%). Immunofluorescence staining showed that the expression of TGF-β3 protein was obvious at 72 hours; Western blot showed that there was a TGF-β3 positive band with a relative molecular mass of 30×103, while the control group and blank control group had no positive band. Obvious chondrogenic differentiation was observed in the experimental group after transfection in vitro, while the control group and blank control group had no obvious chondrogenic differentiation. Western blot showed that there was collagen type II positive band with a relative molecular mass of 130×103 at 21 days after culture, while the control group and blank control group had no positive band. ConclusionrAd5-TGF-β3 gene can be successfully transfected into BMSCs via adenovirus vectors, and stable expression of TGF-β3 protein can be observed, enhancing BMSCs differentiation into chondrocytes, which may provide an experimental basis for gene therapy of joint cartilage defects.
ObjectiveTo investigate the prevalence and risk factors of hypertension in urban and rural residents in Chengdu. MethodsA cluster random sampling survey was carried out from February to October in 2010. A total of 2 011 residents aged 35-70 years in four communities of Chengdu (two communities in urban area, two in rural area) were investigated for the incidence of hypertension. Analysis was performed using SPSS 18.0 software. ResultsThe standardized prevalence of hypertension was 31.30% among residents aged 35-70 years, which was much higher in urban than that in rural:39.03% vs. 24.90% (P < 0.05). The results of multivariate logistic regression analysis showed that, age, waist, heart rate, fasting blood glucose and education level were the major risk factors of hypertension for male; while age, waist, heart rate, fasting blood glucose, triglyceride and uric acid were the major risk factors for female. ConclusionThe prevalence of hypertension in urban is higher than that in rural in Chengdu. Prevention and intervention should be performed more for whom have increased waist circumfluence, abnormal levels of fasting glucose, and increased heart rate.
ObjectiveTo investigate the effectiveness of one-stage arthroscopic reconstruction and strict immobilization for 6 weeks for treatment of knee dislocation. MethodBetween August 2010 and May 2013, 22 cases (22 knees) of knee dislocation were treated with one-stage reconstruction and strict immobilization for 6 weeks. There were 15 males and 7 females, aged 21-54 years (mean, 31.5 years). The left knee and right knee were involved in 8 cases and 14 cases respectively. The disease causes were traffic accident in 12 cases, falling from height in 6 cases, and sports injury in 4 cases. The time between injury and operation was less than 2 weeks in 6 cases, 2-3 weeks in 10 cases, and more than 3 weeks in 6 cases. The results of anterior drawer test, posterior drawer test, and Lachman test were positive in all patients. The posterior displacement of the tibia was more than 10 mm. The results of valgus stress test and varus stress test were positive in 13 cases and 11 cases respectively. The preoperative knee range of motion was (58.2±28.4) °, Lysholm score was 39.7±4.6. All patients had anterior cruciate ligament rupture and posterior cruciate ligament rupture; combined injuries included medial collateral ligament rupture in 11 cases, lateral collateral ligament rupture in 9 cases, both medial and lateral collateral ligament rupture in 2 cases, femoral condylar avulsion fracture in 2 cases, and meniscus injury in 7 cases. No nerve or blood vessel injury was observed. ResultsAll cases obtained primary healing of incision without infection. All the patients were followed up 12-48 months (mean, 27.8 months). At 12 months after operation, the results of the anterior drawer test, posterior drawer test, Lachman test, valgus stress test, and varus stress test were all negative; the knee range of motion increased was significantly to (121.3±7.9) °(t=30.061, P=0.000) ; Lysholm score was 87.2±6.1, showing significant difference when compared with preoperative score (t=24.642, P=0.000) . ConclusionsA combination of arthroscopic one-stage reconstruction and strict immobilization for treatment of knee dislocation is a safe and effective method, good stability and joint function can be achieved.
ObjectiveTo compare the risk factors of angina pectoris and atherosclerotic thrombotic cerebral infarction, and to study the possible risk factors of angina pectoris complicated with atherosclerotic thrombotic cerebral infarction (XNHB abbr. in Chinese) and provide the basis for the prevention of XNHB. MethodsClinical epidemiological cross-sectional survey methods were used. Information of angina pectoris patients, atherosclerotic thrombotic cerebral infarction patients and XNHB patients were collected. The statistical software SPSS 17.0 was used to analyze the single risk factors, and then logistic regression analysis was used to filter the independent risk factors of XNHB. Results1 002 cases of angina pectoris, 963 cases of atherosclerotic thormbotic cerebral infaction and 982 cases of XNHB were included. There were significant differences among the three diseases in the following index:age (P=0.000 0), gender (P < 0.000 1), resting lifestyle (P=0.000 0), body mass index (BMI) (P=0.000 0), diabetes (P=0.001 9), hypertension (P < 0.000 1), diabetes complicated with hypertension (P < 0.000 1), smoking (P < 0.000 1), alcohol consumption (P < 0.000 1), and the combination of more than 3 risk factors (P=0.000 0). Age (OR=1.690, 95%CI 1.420 to 2.012), hypertension (OR=1.558, 95%CI 1.312 to 1.850), abnormal BMI (OR=1.356, 95%CI 1.158 to 1.587) and resting lifestyle (OR=1.319, 95%CI 1.107 to 1.572) were shown as the independent risk factors of XNHB filtering by logistic multiple regression analysis. ConclusionThe elderly with hypertension, abnormal BMI or live a resting way of life are more likely to have XNHB, so positive control of risk factors should be needed.
ObjectiveTo analyze the retrieval status of master and doctoral dissertations entitled systematic review/meta-analysis (SR/MA) in China. MethodsThe China Dissertation Database was searched for master and doctoral dissertations entitled SR/MA from 1980 to March 2015. Two reviewers independently extracted the basic characteristics of included dissertations, the name of retrieval databases, retrieval strategies and the method of screening literature. Then related data were analysed by Stata 12.0 software. ResultsA total of 1 639 master and doctoral dissertations entitled SR/MA were included for data analysis. Among them, 1 259 (79.5%) retrieved both Chinese databases and English databases, 107 (6.5%) retrieved Chinese databases alone, and the other 237 (14.5%) retrieved English databases alone. 1 137 (69.4%) retrieved two or more Chinese databases, while 1 316 (80.3%) retrieved two or more English databases. The most commonly retrieved Chinese databases were CNKI, VIP, CBM, and WanFang Data; while the most frequently retrieved English databases were PubMed, The Cochrane Library, EMbase and Ovid. 89.9% reported the duration of search time, 73.4% reported manual retrieval, 68.6% reported reference retrieval, 23.3% reported conference retrieval, 23.3% reported using search engine and 26.8% reported contact with experts and authors. 45.8% reported their steps of screening papers, 37.5% provided a flow screening chart, and only 14.9% reported the number of papers from each database. ConclusionThe current study suggests that the retrieved databases of master and doctoral dissertations entitled SR/MA in China are still not enough. We suggest the authors of dissertations on SR/MA retrieve at least 3 common databases, reference, engines, conference paper at the same time, and improve information on search strategy and paper screening methods.