Liver cell transplantation is an attractive technique to treat liver-based inborn errors of metabolism. The feasibility and efficacy of the procedure has been demonstrated, leading to medium term partial metabolic con...Liver cell transplantation is an attractive technique to treat liver-based inborn errors of metabolism. The feasibility and efficacy of the procedure has been demonstrated, leading to medium term partial metabolic control of various diseases. Crigler-Najjar is the paradigm of such diseases in that the host liver is lacking one function with an otherwise normal parenchyma. The patient is at permanent risk for irreversible brain damage. The goal of liver cell transplantation is to reduce serum bilirubin levels within safe limits and to alleviate phototherapy requirements to improve quality of life. Preliminary data on Gunn rats, the rodent model of the disease, were encouraging and have led to successful clinical trials. Herein we report on two additional patients and describe the current limits of the technique in terms of durability of the response as compared to alternative therapeutic procedures. We discuss the future developments of the technique and new emerging perspectives.展开更多
AIM: To examine the allegations in malpractice litigations related to gastrointestinal endoscopy in Japan. METHODS: A retrospective review of cases tried in the civil court system during the 21-year period from 1985 t...AIM: To examine the allegations in malpractice litigations related to gastrointestinal endoscopy in Japan. METHODS: A retrospective review of cases tried in the civil court system during the 21-year period from 1985 to 2005, identified in a computerized legal database, was undertaken. RESULTS: Eighteen malpractice litigations and a total of 30 allegations were identified. Of the 18 (44%) malpractice litigations, 8 (44%) were related to eso- phagogastroduodenoscopy, 4 (22%) to colonoscopy, 4 (22%) to endoscopic sphincterotomy, and 2 (11%) to endoscopic retrograde cholangiopancreatography. Seventeen (94%) cases pertained to complications, and the remaining (6%) case pertained to misdiagnosis. In 10 cases, the patient died of the complications. Allegations were categorized as: (1) performance error during the endoscopic procedure (n = 12, 40%); (2) lack of informed consent (n = 9, 30%); (3) performance error during the treatment after the endoscopic procedure (n = 4, 13%); (4) premedication error (n = 3, 10%); (5) diagnostic error (n = 1, 3%); and (6) indication error for the endoscopic procedure (n = 1, 3%). CONCLUSION: These data may aid in the design of risk prevention strategies to be used by gastrointestinal endoscopists.展开更多
Acupuncture is effective for the treatment of apoplectic hemiplegia, and the acupoint on the paralytic side is often selected for acupuncture. However, some doctor prefers healthy-side needling with quite satisfactory...Acupuncture is effective for the treatment of apoplectic hemiplegia, and the acupoint on the paralytic side is often selected for acupuncture. However, some doctor prefers healthy-side needling with quite satisfactory results. We study and review the treatment of apoplexy by healthy-side needling to further improve its therapeutic effects.展开更多
Yongquan (KI 1) is a jing (well) point of the Kidney Meridian of Foot-Shaoyin. As this point is widely used for treatment of acute or chronic diseases, it has drawn attentions from physicians both in the ancient and i...Yongquan (KI 1) is a jing (well) point of the Kidney Meridian of Foot-Shaoyin. As this point is widely used for treatment of acute or chronic diseases, it has drawn attentions from physicians both in the ancient and in the present times. If this point is taken accurately and the differentiation of disease is made properly, both the needling and the external drug application can achieve satisfactory therapeutic results.展开更多
Autonomous underwater vehicles(AUV) work in a complex marine environment. Its system reliability and autonomous fault diagnosis are particularly important and can provide the basis for underwater vehicles to take corr...Autonomous underwater vehicles(AUV) work in a complex marine environment. Its system reliability and autonomous fault diagnosis are particularly important and can provide the basis for underwater vehicles to take corresponding security policy in a failure. Aiming at the characteristics of the underwater vehicle which has uncertain system and modeling difficulty, an improved Elman neural network is introduced which is applied to the underwater vehicle motion modeling. Through designing self-feedback connection with fixed gain in the unit connection as well as increasing the feedback of the output layer node, improved Elman network has faster convergence speed and generalization ability. This method for high-order nonlinear system has stronger identification ability. Firstly, the residual is calculated by comparing the output of the underwater vehicle model(estimation in the motion state) with the actual measured values. Secondly, characteristics of the residual are analyzed on the basis of fault judging criteria. Finally, actuator fault diagnosis of the autonomous underwater vehicle is carried out. The results of the simulation experiment show that the method is effective.展开更多
Objective: To analyze the features, diagnosis and treatment of limb arterial injuries caused by traffic accidents. Methods: A total of 43 patients with limb arterial injury admitted in our department over the past 30 ...Objective: To analyze the features, diagnosis and treatment of limb arterial injuries caused by traffic accidents. Methods: A total of 43 patients with limb arterial injury admitted in our department over the past 30 years (about 50% of them happened during the last 10 years) were analyzed retrospectively in this article. The popliteal, femoral and brachial arteries were mainly involved, accounting for 43.2 %, 20.5 % and 20.5 % respectively of all the involvements. There were 35 cases of open injury and 9 of close injury. The involved vessels were transected in 43.2 % of the cases and contused in 40.9 %. All the patients had various complications, such as fractures, dislocations and severe soft tissue injuries. The injured vessels were repaired by means of end to end anastomosis in 10 cases, autogenous vein graft in 23 cases and intraluminal hydraulic dilatation in 4 cases. Results: Successful limb salvage was achieved in 34 cases initially, whereas 10 amputations were carried out due to injuries to popliteal arteries in 7, femoral arteries in 2 and humeral artery in 1 and severe soft tissue damages in 9 cases. Twenty nine patients were followed up for 1 156 months, with the average of 48.8 months. There was good circulation in 22 cases and certain ischemia in 5 cases. Two amputations were carried out in the late stage because of popliteal artery thrombosis after repair in 2 cases. There was no death in this series. Conclusions: The limb arterial injuries caused by traffic accidents are severe and complicated. It is proposed that particular attentions should be paid to the features in diagnosis and treatment for this type of injury and special efforts should be made for both life saving and limb salvage.展开更多
Objective : To analyze the data of patients with spinal cord injury (SCI) induced by road traffic crashes in southeastern Iran for better understanding the pattern of these injuries and therefore for better designi...Objective : To analyze the data of patients with spinal cord injury (SCI) induced by road traffic crashes in southeastern Iran for better understanding the pattern of these injuries and therefore for better designing health system planning. Methods : In this historical cohort study, the patients who had been transferred to Level I trauma center in southeastern Iran due to road traffic accidents with radiographic documented SCI were evaluated. Results: Among 64 patients with SCI, 38 patients (59.4 %, 36 males and 2 females, aged 27.42 years ± 9.44 years on average) were injured by road traffic accidents. Car and motorcycle accidents were responsible for 26 cases (68.4%) and 12 cases (31.6%), respectively. And 31patients (81. 6%) had complete SCI. Conus medularis (T12-L2 ) was the most affected level. Conclusions: Results are discussed in terms of preventive measures, specifically those concerning the use of restraint and helmet and driving behavior. This study should be extended nationally to gain a larger case series so that the SCI risk of particular vehicle configurations, considering other crash factors, can be more precisely quantified and the characteristics for low occurrence of SCI can be more precisely identified.展开更多
Multiple pometacarpal (CMC) joints volar dislocations of car- are uncommon and have been reported rarely. A 25 years old male presented with injury to his left hand 6 days following a road traffic accident. Clini- c...Multiple pometacarpal (CMC) joints volar dislocations of car- are uncommon and have been reported rarely. A 25 years old male presented with injury to his left hand 6 days following a road traffic accident. Clini- cal examination revealed gross swelling of the hand and diffuse tenderness over the carpometacarpal area. His ra- diographs of the hand showed volar dislocation of the second, third and fourth CMC joints in association with anextra-articular fracture of the base of thumb metacarpal. He was treated by open reduction and percutaneous fixation using Kirschner wires. The functional results were excellent at one year follow-up.展开更多
Objective: To analyze the characteristics and causes of motorcycle accidents in China from 2000 to 2005. Methods: We collected data on possession of motor- cycles and automobiles, number of traffic crashes, casualty...Objective: To analyze the characteristics and causes of motorcycle accidents in China from 2000 to 2005. Methods: We collected data on possession of motor- cycles and automobiles, number of traffic crashes, casualty and economic loss from 2000-2005 Statistic Annual Report of Traffic Management Bureau, Ministry of Public Security of China. The data was processed statistically by SPSS 11.0 software package. Results: During 6 years, the number of motorcycle accidents were up to 122 300 in 2003, which was the highest, and then gradually decreased. However, the casualty had the tendency of consistent increase, for example, the motorcycle accidents resulted in 26 200 deaths and 157 500 injuries in 2005. The mortality per 10 000 motorcycles and the ratio of deaths to injuries were lower than those of automobiles, but the mortality per 100 motorcycle accidents was significantly higher than that of automobiles (P〈0.01). Conclusions: China has attached great importance to the management of traffic safety, which is beneficial to con- trol and reduce traffic accidents in recent years. However, the casualty keeps increasing annually. Therefore, it is urgent to strengthen the management of motorcycles, promote the education of motorcyclists, take effective traffic measures and improve the first-aid system of traffic injuries.展开更多
Purpose: To investigate efficacy of open reduction and internal fixation with the miniplate and hollow screw in the treatment of Lisfranc injury. Methods: Ten cases of Lisfranc injury treated by open reduction, mini...Purpose: To investigate efficacy of open reduction and internal fixation with the miniplate and hollow screw in the treatment of Lisfranc injury. Methods: Ten cases of Lisfranc injury treated by open reduction, miniplate and hollow screw in our hospital were retrospectively analyzed. There were 6 males and 4 females with age ranging from 25 to 45 years (mean 32 years). Among them, one case was classified as Type A, six Type B and three Type C. Injury mechanism included road traffic accidents (3 cases), fall from height (5 cases) and hit by heavy object (2 cases). All injuries were closed without cerebral trauma or other complicated injuries. The time interval between injury and operation was 6-10 days (average 6.6 days). Postoperatively, the foot function was assessed using Visual Analogue Scales (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) Scales. Healing time and complications were observed. Results: All patients were followed up for 18-24 months (average 20 months). Anatomic reduction was achieved in all patients on images. There was statistical significance between preoperative score (Z89 ± 0.34) and score at postoperative 8 weeks (0.67 ± 0.13). According to the AOFAS score, 5 cases were defined as excellent, 3 cases as good and 2 cases as fair. During follow-up, there was no wound infection or complications except for osteoarthritis in 2 cases. Healing time ranged from 3 to 6 months with an average of 3.6 months. Conclusion: Anatomical reduction of Lisfranc injury can be achieved by open reduction and internal fixation with the miniplate and hollow screw. Normal structure of Lisfranc joint is regained to a great extent; injured ligaments were also repaired. Therefore, this method offers excellent curative effect and can avoid postoperative complications and improve the patients' quality of life.展开更多
文摘Liver cell transplantation is an attractive technique to treat liver-based inborn errors of metabolism. The feasibility and efficacy of the procedure has been demonstrated, leading to medium term partial metabolic control of various diseases. Crigler-Najjar is the paradigm of such diseases in that the host liver is lacking one function with an otherwise normal parenchyma. The patient is at permanent risk for irreversible brain damage. The goal of liver cell transplantation is to reduce serum bilirubin levels within safe limits and to alleviate phototherapy requirements to improve quality of life. Preliminary data on Gunn rats, the rodent model of the disease, were encouraging and have led to successful clinical trials. Herein we report on two additional patients and describe the current limits of the technique in terms of durability of the response as compared to alternative therapeutic procedures. We discuss the future developments of the technique and new emerging perspectives.
文摘AIM: To examine the allegations in malpractice litigations related to gastrointestinal endoscopy in Japan. METHODS: A retrospective review of cases tried in the civil court system during the 21-year period from 1985 to 2005, identified in a computerized legal database, was undertaken. RESULTS: Eighteen malpractice litigations and a total of 30 allegations were identified. Of the 18 (44%) malpractice litigations, 8 (44%) were related to eso- phagogastroduodenoscopy, 4 (22%) to colonoscopy, 4 (22%) to endoscopic sphincterotomy, and 2 (11%) to endoscopic retrograde cholangiopancreatography. Seventeen (94%) cases pertained to complications, and the remaining (6%) case pertained to misdiagnosis. In 10 cases, the patient died of the complications. Allegations were categorized as: (1) performance error during the endoscopic procedure (n = 12, 40%); (2) lack of informed consent (n = 9, 30%); (3) performance error during the treatment after the endoscopic procedure (n = 4, 13%); (4) premedication error (n = 3, 10%); (5) diagnostic error (n = 1, 3%); and (6) indication error for the endoscopic procedure (n = 1, 3%). CONCLUSION: These data may aid in the design of risk prevention strategies to be used by gastrointestinal endoscopists.
文摘Acupuncture is effective for the treatment of apoplectic hemiplegia, and the acupoint on the paralytic side is often selected for acupuncture. However, some doctor prefers healthy-side needling with quite satisfactory results. We study and review the treatment of apoplexy by healthy-side needling to further improve its therapeutic effects.
文摘Yongquan (KI 1) is a jing (well) point of the Kidney Meridian of Foot-Shaoyin. As this point is widely used for treatment of acute or chronic diseases, it has drawn attentions from physicians both in the ancient and in the present times. If this point is taken accurately and the differentiation of disease is made properly, both the needling and the external drug application can achieve satisfactory therapeutic results.
基金Project(2012T50331)supported by China Postdoctoral Science FoundationProject(2008AA092301-2)supported by the High-Tech Research and Development Program of China
文摘Autonomous underwater vehicles(AUV) work in a complex marine environment. Its system reliability and autonomous fault diagnosis are particularly important and can provide the basis for underwater vehicles to take corresponding security policy in a failure. Aiming at the characteristics of the underwater vehicle which has uncertain system and modeling difficulty, an improved Elman neural network is introduced which is applied to the underwater vehicle motion modeling. Through designing self-feedback connection with fixed gain in the unit connection as well as increasing the feedback of the output layer node, improved Elman network has faster convergence speed and generalization ability. This method for high-order nonlinear system has stronger identification ability. Firstly, the residual is calculated by comparing the output of the underwater vehicle model(estimation in the motion state) with the actual measured values. Secondly, characteristics of the residual are analyzed on the basis of fault judging criteria. Finally, actuator fault diagnosis of the autonomous underwater vehicle is carried out. The results of the simulation experiment show that the method is effective.
文摘Objective: To analyze the features, diagnosis and treatment of limb arterial injuries caused by traffic accidents. Methods: A total of 43 patients with limb arterial injury admitted in our department over the past 30 years (about 50% of them happened during the last 10 years) were analyzed retrospectively in this article. The popliteal, femoral and brachial arteries were mainly involved, accounting for 43.2 %, 20.5 % and 20.5 % respectively of all the involvements. There were 35 cases of open injury and 9 of close injury. The involved vessels were transected in 43.2 % of the cases and contused in 40.9 %. All the patients had various complications, such as fractures, dislocations and severe soft tissue injuries. The injured vessels were repaired by means of end to end anastomosis in 10 cases, autogenous vein graft in 23 cases and intraluminal hydraulic dilatation in 4 cases. Results: Successful limb salvage was achieved in 34 cases initially, whereas 10 amputations were carried out due to injuries to popliteal arteries in 7, femoral arteries in 2 and humeral artery in 1 and severe soft tissue damages in 9 cases. Twenty nine patients were followed up for 1 156 months, with the average of 48.8 months. There was good circulation in 22 cases and certain ischemia in 5 cases. Two amputations were carried out in the late stage because of popliteal artery thrombosis after repair in 2 cases. There was no death in this series. Conclusions: The limb arterial injuries caused by traffic accidents are severe and complicated. It is proposed that particular attentions should be paid to the features in diagnosis and treatment for this type of injury and special efforts should be made for both life saving and limb salvage.
文摘Objective : To analyze the data of patients with spinal cord injury (SCI) induced by road traffic crashes in southeastern Iran for better understanding the pattern of these injuries and therefore for better designing health system planning. Methods : In this historical cohort study, the patients who had been transferred to Level I trauma center in southeastern Iran due to road traffic accidents with radiographic documented SCI were evaluated. Results: Among 64 patients with SCI, 38 patients (59.4 %, 36 males and 2 females, aged 27.42 years ± 9.44 years on average) were injured by road traffic accidents. Car and motorcycle accidents were responsible for 26 cases (68.4%) and 12 cases (31.6%), respectively. And 31patients (81. 6%) had complete SCI. Conus medularis (T12-L2 ) was the most affected level. Conclusions: Results are discussed in terms of preventive measures, specifically those concerning the use of restraint and helmet and driving behavior. This study should be extended nationally to gain a larger case series so that the SCI risk of particular vehicle configurations, considering other crash factors, can be more precisely quantified and the characteristics for low occurrence of SCI can be more precisely identified.
文摘Multiple pometacarpal (CMC) joints volar dislocations of car- are uncommon and have been reported rarely. A 25 years old male presented with injury to his left hand 6 days following a road traffic accident. Clini- cal examination revealed gross swelling of the hand and diffuse tenderness over the carpometacarpal area. His ra- diographs of the hand showed volar dislocation of the second, third and fourth CMC joints in association with anextra-articular fracture of the base of thumb metacarpal. He was treated by open reduction and percutaneous fixation using Kirschner wires. The functional results were excellent at one year follow-up.
基金This study was supported by National Natural Science Foundation of China (NO. 30522201)
文摘Objective: To analyze the characteristics and causes of motorcycle accidents in China from 2000 to 2005. Methods: We collected data on possession of motor- cycles and automobiles, number of traffic crashes, casualty and economic loss from 2000-2005 Statistic Annual Report of Traffic Management Bureau, Ministry of Public Security of China. The data was processed statistically by SPSS 11.0 software package. Results: During 6 years, the number of motorcycle accidents were up to 122 300 in 2003, which was the highest, and then gradually decreased. However, the casualty had the tendency of consistent increase, for example, the motorcycle accidents resulted in 26 200 deaths and 157 500 injuries in 2005. The mortality per 10 000 motorcycles and the ratio of deaths to injuries were lower than those of automobiles, but the mortality per 100 motorcycle accidents was significantly higher than that of automobiles (P〈0.01). Conclusions: China has attached great importance to the management of traffic safety, which is beneficial to con- trol and reduce traffic accidents in recent years. However, the casualty keeps increasing annually. Therefore, it is urgent to strengthen the management of motorcycles, promote the education of motorcyclists, take effective traffic measures and improve the first-aid system of traffic injuries.
文摘Purpose: To investigate efficacy of open reduction and internal fixation with the miniplate and hollow screw in the treatment of Lisfranc injury. Methods: Ten cases of Lisfranc injury treated by open reduction, miniplate and hollow screw in our hospital were retrospectively analyzed. There were 6 males and 4 females with age ranging from 25 to 45 years (mean 32 years). Among them, one case was classified as Type A, six Type B and three Type C. Injury mechanism included road traffic accidents (3 cases), fall from height (5 cases) and hit by heavy object (2 cases). All injuries were closed without cerebral trauma or other complicated injuries. The time interval between injury and operation was 6-10 days (average 6.6 days). Postoperatively, the foot function was assessed using Visual Analogue Scales (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) Scales. Healing time and complications were observed. Results: All patients were followed up for 18-24 months (average 20 months). Anatomic reduction was achieved in all patients on images. There was statistical significance between preoperative score (Z89 ± 0.34) and score at postoperative 8 weeks (0.67 ± 0.13). According to the AOFAS score, 5 cases were defined as excellent, 3 cases as good and 2 cases as fair. During follow-up, there was no wound infection or complications except for osteoarthritis in 2 cases. Healing time ranged from 3 to 6 months with an average of 3.6 months. Conclusion: Anatomical reduction of Lisfranc injury can be achieved by open reduction and internal fixation with the miniplate and hollow screw. Normal structure of Lisfranc joint is regained to a great extent; injured ligaments were also repaired. Therefore, this method offers excellent curative effect and can avoid postoperative complications and improve the patients' quality of life.