Health poverty alleviation is an important practice in implementing the basic strategy of precision poverty alleviation. It is also an important measure to win the battle against poverty in rural areas. Through the investigation of local medical and health conditions, West China Hospital of Sichuan University built a demand-oriented framework for medical poverty alleviation in Ganzi Prefecture, and gradually carried out precision top-level design, discipline construction, technical training, talent training, endemic disease prevention and control; through establishinga regional medical cooperation network, built featured specialies, built the backbone of medical and health forces, achieved the prevention of endemic diseases throughout life cycle, and improved the overall medical and health service capacity of Ganzi Prefecture. This article introduces the exploration and practice of the demand-oriented model in Ganzi Prefecture by West China Hospital of Sichuan University, aiming at providing a guide for the precision health poverty alleviation in China.
Cadre education and training is the elementary step in building a high quality, basic, and strategic cadre ranks project. The summer training of cadres in West China Hospital of Sichuan University is one aspect of the training system of cadres in our hospital. This paper introduces the current situation of summer cadre training, the training needs of cadres and the changes of internal and external environment in our hospital from 2009 to 2012, so as to continue constructing our summer cadres training product brand.
Objective To investegate the effectiveness of transarticular approach in treating thoracic spinal stenosis due to ossification of l igamentum flavum (OLF) and ossification of posterior longitudinal l igament (OPLL) at the samelevel. Methods A retrospective analysis was performed in 35 patients with single-level thoracic spinal stenosis of calcifiedl igament who accepted transarticular approaching operation between January 2006 and March 2008. There were 12 males and 23 females with an age range of 40-67 years (mean, 58.6 years), including 16 cases of thoracic OLF, 11 cases of thoracic OPLL, and 8 cases of thoracic OPLL and OLF. The disease duration was 8-48 months (mean, 16 months). The affected segments included T2, 3 in 4 cases, T3, 4 in 3 cases , T4, 5 in 1 case , T6, 7 in 3 cases , T7, 8 in 1 case , T8, 9 in 2 cases , T9, 10 in 5 cases , T10, 11 in 9 cases, and T11, 12 in 7 cases. CT and MRI were taken to definite the ossification position and the condition of thoracic spinal stenosis. The Japanese Orthopaedic Association (JOA) score was 6.1 ± 1.3 before operation. According to Otani scoring system, the results were excellent in 3 cases, good in 16 cases, fair in 11 cases, and poor in 5 cases. Results All operations were successful, and no nerve injury occurred. Allincisions healed at stage I. Cerebrospinal fluid leakage occurred in 5 cases, and recovered after symptomatic treatment. One case had epidural hematoma 6 hours after operation, and the muscle strength recovered after symptomatic treatment. All cases were followed up 1.5-2.6 years (mean, 2.1 years) and the symptoms were improved in different degrees; no neurological symptoms deteriorated and spinal instabil ity occurred. The JOA score had a significant recovery at 3 months (9.2 ± 1.8) and at last follow-up (9.6 ± 2.3) when compared with preoperative value (P lt; 0.05). At last follow-up, the rate of the cl inical improvement was 71.43% ± 18.20%. According to Otani scoring system at last follow-up, the results were excellent in 12 cases, good in 15 cases, fair in 6 cases, and poor in 2 cases with an excellent and good rate of 77.14%, showing significant difference when compared with preoperative value (u=2.711, P=0.007). Conclusion The transarticular approach in treating thoracic spinal stenosis of calcified l igament can obtain goodcl inical results. Moreover, extra attention should be paid to during operation so as to avoid catastrophic spinal cord injury.
Objective To establish a good method and culture system to isolate skin stem cell and expand it in vitro so as to lay a foundation for exploring the proliferation and differentiation mechanism of skin stem cell. Methods Skin stem cells were obtained by explant culture and identified by using alkaline phosphatase(ALP) staining and differentiating experiment in vitro. Stem cell was induced by the cocktail of conditional medium with cell growth factor (insulin like growth factor and epidermal growth factor). Results Skin stem cell colonies were derived from ear skin tissues of adult dairy goats. The colonies had some characteristics of embryonic stem cells, such as the ability to be continously passaged (Passage 5) and the morphology nest-like. They continued to be ALP positive and had the capacity of forming embryoid bodies. These cells were pluripotent and stem-like cells. In vitro these stem cell can be induced to be Follicle-like structure, Astrocyte-like cells, osteoblast-like cell. Conclusion Explant culture is a good method to isolate skin stem cell, which can be induced to be committed differentiation and trans-differentiation.
The ulcer resulting from snake-bite injury was characterized by deep and wide tissue necrosis and secondary infection. The patient was at high risk of loss of function of his extremity. From 1989 to 1996, 16 cases with deep ulcer of the upper extremity resulting from snake-bite injury were treated with different types of axial thoraco-abdominal skin flaps, depending on the location of the ulcer. Thoraco-umbilical skin flap was used in 2 cases, lateral thoracoabdominal skin flap in 1 case, iliolumbar skin flaps in 5 cases, lower abdominal skin flaps in 6 cases, lower abdominal divided foliated skin flap in 1 case and Y-shaped hypogastric skin flap in 1 case. Reparative operation was carried out within 3 weeks after injury and primary repair were undertaken in 6 of them. The pedicles were divided in 17 to 24 days after operation. Twelve flaps survived. Three of the 6 flaps had mild signs of inflammation which disappeared after administration of antibiotics. One had necrosis of the distal part of the flap, and was healed with split skin graft. This type of skin flap was an ideal method for the treatment of snake-bite injury of the upper extremity.
An experimental study was designed on the treatment of 8 superficial burn wounds and 5 wounds after removing the split-thickness skin grafts with 200GS permanent magnetic flat dressings, and some of the wounds were chosen at random which did not received any treatment and would be served as control. It was noted that the volume of exudate in the treatment group was 11.9 50.7％ less than that of the control group, and the total protein, the albumin and globulin contents in the treatment cases were far less in exudate than those of the control cases. It was concluded that the magnetic therapy not only decresed the exudate, but also diminished the amount of total protein, albumin and globulin in the exudating fluid and it was of benefit to wound recovery.
Abstract： Objective To improve therapeutic outcomes for severe leftsided atrioventricular valve regurgitation (LAVVR) after repair of atrioventricular septal defect (AVSD) through discussing pathological changes of the valve and surgical management for these patients, and summarizing the medical experiences of perioperative managements. Methods We retrospectively analyzed the clinical data of 29 patients including 16 males and 13 females with LAVVR after repair of AVSD treated in Xinhua Hospital, Medical College of Shanghai Jiaotong University between January 1995 and December 2009. The age of these patients ranged from 4 to 62 years, averaging at 26.5. According the classification of New York Heart Association (NYHA), there were 10 patients of class Ⅱ, 17 of class Ⅲ and 2 of class Ⅳ before reoperation. Partial repair of AVSD had been carried out for 18 patients, and complete repair had been performed on 11 patients. At reoperation, valve rerepair was performed on 17 patients and mechanical valve replacement (MVR) was necessary in 12 patients. Results In the early period after operation, one patient died of multiple organ failure, one patient had a permanent pacemaker inserted because of complete atrioventricular block, and 1 patient aged 4 years got recovery after 56 hours of circulatory support for severe cardiac failure after reoperation. A mean follow-up of 8.2 years (6 months to 14 years) was done for 25 patients with 3 missing. During the follow-up for 14 patients undergone heart valve repair, there was no obvious acceleration of the forward blood flow of the leftside atrioventricular valve. Ten patients had mild or less LAVVR, 1 had moderate LAVVR and 3 underwent successful left atrioventricular valve replacement at 10 days, 3 years or 6 years after reoperation because of severe LAVVR. Clinical status, as assessed by the NYHA classification, improved after surgery for LAVVR in 25 patients who were followed up with 17 in NYHA class Ⅰ, 6 in class Ⅱ, and 2 in class Ⅲ. Podoid decreased significantly and cardiothoracic ratio was 0.53-0.67 (0.60±0.11) in chest Xray picture. There was no late death. Conclusion With timely surgical treatment, and appropriate surgical method, LAVVR after complete or partial AVSD repair can be managed with excellent shortterm and longterm outcomes.
This article introduces the exploration and practice of the “West China Hospital of Sichuan University-Zhenxiong model”, discusses the model of medical precision poverty alleviation work in the new era. Through in office and online service, the counterpart assistance measures will be deeply integrated with the reality of Zhenxiong, to effectively radiate the high-quality medical resources of West China Hospital of Sichuan University to Zhenxiong, and gradually promote the county to form a cross-regional medical alliance of “West China Hospital of Sichuan University + Zhenxiong medical community”, so as to practice the national medical reform policy. It is hoped that through the practice of this model, non-Communist parties can learn from the experience of participating in poverty alleviation.
OBJECTIVE: To investigate the effect of local application of basic fibroblast growth factor (bFGF) and sucralfate on the skin tissue structure after expansion. METHODS: Continuous tissue expansion (CTE) experimental animal model was made with constant pressure pump in nine white pigs. The bFGF and sucralfate were perfused between tissue and tissue expander. Both bFGF and sucralfate were injected in group I, both bFGF and normal saline in group II, only sucralfate in group III, and normal saline in group IV as control group. The samples were took from each pig for histomorphological assessment on the 3rd day and 6th week after expansion. RESULTS: Compared with control group, epidermal, granular spinous and basal cell thickness increased significantly (P lt; 0.05) in group I; in dermal layer, dermal thickened slightly and the collagen fibers became thicker and orderly; the elastic fiber regenerated significantly; the density of fibroblasts and capillaries significantly increased (P lt; 0.05) in group I. The collagen fibers were broken on the 3rd day and 6th week after expansion in control group. However, the thickness of the fibrous capsule layer was similar in each group. CONCLUSION: Local application of exogenous bFGF and sucralfate combined with CTE can greatly promote the skin growth. It can accelerate the tissue expansion.
Objective To summarize the status of tumor stem cells investigations in gastrointestinal carcinoma. Methods Domestic and international publications online involving tumor stem cells of gastrointestinal carcinoma in recent years were collected and reviewed. Results There are a small quantity of cancer cells shown some stem cell characteristics. They are named tumor stem cell and play an important role in tumorigenesis, proliferation, metastasis and recurrence. And also, tumor stem cells can resist the effect of antineoplastic drugs and lead to tumor recurrence. These tumor-initiating cells are CD133-positive in the gastrointestinal carcinomas, especially in colorectal cancers. CD133-positive colorectal cancer cells have the abilities of clone, proliferation, differentiation and form metastases. And a high CD133 mRNA content was found in the blood of patients who suffered from bone metastases. Conclusion The characteristics of CD133-positive cancer cell and the mechanisms of stem cell-niche system are the basis of developing better methods to tumor diagnosis and treatment, and provide theoretical basis of new methods, such as targeted therapy.
