With the appearance of new biological agents represented by infliximab,the medical therapy of crohns' disease has made breakthrough of progress.However,the controversial still remains about the use of infliximab during perioperative period in Crohn's disease patients.The aim of this article is to explore the influence of infliximab on postoperative complications in Crohn's disease patients.

Objective To investigate the clinical outcomes of patients with chronic hepatitis B and its influencing factors,and provide reference for the prognosis of patients with hepatitis B.Methods 102 patients with chronic hepatitis B from January 2009 to June 2014 were selected and divided into the case group of 32 patients and the control group of 70 patients according to whether to occur with cirrhosis or liver cancer.The two groups of patients were analyzed and compared for general information,HBV DNA,serum ALT and other indicators.Results The cumulative cases of negative HBsAg,chronical hepatitis B,liver cirrhosis and liver cancer were 5,65 and 32,respectively.Univariate Logistic regression analysis showed that the differences between the two groups in age,sex,drinking history,HBV DNA levels and serum ALT levels were statistically significant (all P ＜ 0.05).Whether to cirrhosis or liver cancer was the dependent variable,the statistically significant single factors between the two groups were the independent variable,multivariate Logistic regression analysis showed that older age,male sex,alcohol abuse,high level of HBV DNA and high level of serum ALT were the risk factors of leading to cirrhosis,liver cancer for the patients with chronic hepatitis B (OR values were 9.94,14.36,8.25,13.01,120.32,respectively).Conclusions The older age,male,alcohol history,high level of HBV DNA and high level of serum ALT are higher risk factors for patients with chronic hepatitis B to development of cirrhosis and liver cancer.Patients with risk factors should be gave systematic interventions to reduce progression to cirrhosis,liver cancer and improve the quality of life.

Humans ; Lead ; urine ; Lead Poisoning ; diagnosis ; urine ; Spectrometry, Fluorescence ; methods ; Spectrophotometry, Atomic ; methods

Point-of-care testing(POCT) has developed rapidly in recent years and is widely used in families, communities, hospitals and all kinds of rescue sites.It plays an important role in the fields of infection, tumor, metabolic diseases, acute and severe diseases and so on.It has technical advantages in disease epidemiological investigation, disease diagnosis, condition and curative effect evaluation.With fast, portable, easy to operate characteristics, the future development potential of POCT is huge.

AIM:To study the efficacy and safety of intravitreal injection ranibizumab (IVR) assisted 25G+ minimally invasive vitreoretinal surgery (VRS) in the treatment of severe proliferative diabetic retinopathy (PDR).METHODS: Totally 61 patients and 74 eyes were selected with severe PDR from March 2015 to June 2016 in our hospital.According to the principle of voluntary,37 eyes of 31 cases in the VRS before the IVR treatment was set to the joint group,37 eyes of 30 cases line pure VRS was set to the VRS group.We compared the vitreous volume,logMAR,mean IOP,macular central retinal thickness and complications between the 2 groups.RESULTS: The blood rate of glass in the combination group was 8% after 1wk of postoperative which was significantly lower than that of the VRS group 27% (x2=4.573,P=0.032).The glass volume blood rate of the combined group was 0 after 1mo of postoperative while the VRS was 16%(P=0.033).The blood rate of glass in the combination group was 0 at 3mo of postoperative,and 8% in the VRS group(P=0.238).The LogMAR in the combined group was significantly lower than that in the VRS group(t=2.320,P=0.023).There was no significant difference in the mean IOP between the two groups (t=0.516,P=0.608).The mean macular retinal thickness of the combined group was 298.8±78.3μm which significantly lower than the VRS group 357.1±86.2μm(t=3.045,P=0.003).The combined high ntraocular pressure rate of the combined group was 14% which was significantly lower than 32% of the control group(x2=10.385,P=0.001).The rate of anterior membrane of the retina of the combined group,the rate of recurrent traction and the rate of retinal detachment of the newborn were lower than that of the VRS group,but the difference was not statistically significant (P>0.05).CONCLUSION: IVR assisted VRS,although there is a certain controversy,but in the appropriate dose,frequency and time to achieve significant efficacy,safety is also high.

To establish a determination method for two effective components echinacoside and acteoside in cistanche by quantitative analysis of multi-components by single marker ( QAMS) . Methods:With echinacea glycosides and mullein indican as the examining indices, the relative correction factor ( RCF) between echinacea glycosides and mullein indican was established, and then used to calculate the content of the other components. Meanwhile, the calculated value was compared with that of the external standard method. Results:The RCFs had good reproducibility without significant differences between the quantitative results of QAMS method and those of the external standard method. Conclusion:The described method is reliable and accurate, and can be used to control the quality of echinacoside and acteoside in cistanche.

Objective:To explore the indication and operative procedures with different operation styles of the surgical treatment of condylar fractures. Methods:The results of the surgery styles to condylar fractures were reviewed with the clinical data of 112 condylar fracture cases,by clinical condition,radiodiagnosis,fracture region,degree of displacement and time of trauma,that included 53 cases of anatomical reduction in subcondylar oblique ramus osteotomy without detaching condyle,38 cases of traditional open reduction,18 cases of arthroplasty in oblique ramus osteotomy with detaching condyle upside-down,3 cases of arthroplasty in oblique ramus osteotomy with detaching condyle. Results:The anatomical reduction in subcondylar oblique ramus osteotomy without detaching condyle was an effective treatment of condylar fractures on long term results. Conclusion:Majority condylar fractures may apply the anatomical reduction in subcondylar oblique ramus osteotomy without detaching condyle. Smashed fractures and old fractures of condyle may apply the arthroplasty in oblique ramus osteotomy with detaching condyle upside-down. The high condylar fractures may use the arthroplasty in oblique ramus osteotomy with detaching condyle.

The traditional management of severe intraabdominal infection include source control and antibiotics application.Fluid resuscitation and open abdomen management are recent development in the treatment of severe intraabdominal infection.The overall morbidity of severe intraabdominal infection was decreased under 20％ by these comprehensive treatment.Because of edema,inflammation and gastrointestinal dysfunction,the intraabdominal pressure was increased,the peritoneal infusion pressure was decreased and the perfusion was insufficient,and leaving abdomen open can reverse these condition,and is helpful for debridement and drainage of the source of infection,as well as management of bleeding and intestinal fistula.Entero-atmospheric fistula is the main severe complication after open abdomen,and it should be prevented by temporary abdominal closure and early closure of the wound.

The matrix metalloproteinases/tissue inhibitors of metalloproteinase (MMPs/TIMPs) system plays an important role in the degradation and remodel of the extracellular matrix (ECM).MMPs/TIMPs system is associated with ocular physiological process,such as ocular growth and development,etc.Also,MMPs/TIMPs system is involved in ocular pathological process including inflammation,wound healing,neoangiogenesis,tumor invasion and metastasis.MMPs/TIMPs system also participats in the formation of some ophthalmic diseases such as proliferative vitreoretinopathy (PVR),proliferative diabetic retinopathy (PDR),diabetic cataract,rhegmatogenous retinal detachment (RRD),retinoblastoma (RB),age-related macular degeneration (AMD),ocular trauma,and glaucoma.This review attempts to elaborate the biological characteristics of MMPs/TIMPs,and the current researches of MMPs/ TIMPs system in the diabetic ocular complications,focusing on diabetic retinopathy,cataract and keratopathy.