Objective To explore the effect of immobilization with plaster cast applying in children's rehabilitation after knee arthroscopic surgery,and discuss the clinical significance of immobilization with plaster cast in children's rehabilitation after knee arthroscopic surgery.Methods A total of 72 objectives suffered from knee joint diseases were chosen and received knee arthroscopic surgery from January 2013 to November 2014.They were classified into the experimental group and the control group with the random digit table with 36 patients in each group.The control only underwent the regular rehabilitation exercise.The experimental group was given fixation with plaster caster before they got rehabilitation exercise.The three indexes such as pain degree,the compliance of children knee function exercise and the range of knee motion in different time courses were compared after operation.Results The VAS pain scores of the experimental group and the control group were (2.12±0.70),(2.37±0.61) respectively with statistical significance,P＜0.05.On the third day,one week and two weeks after operation,the complete compliance of children with knee function exercise was 83.3％ (30/36) vs.8.3％ (3/36),97.2％ (35/36) vs.22.2％ (8/36),97.2％ (35/36) vs.22.2％ (8/36) in the experimental group and the control group,Z values were-6.343,-6.400,-6.400,P＜ 0.01.On the second,third and fourth weeks after operation,the good rates of knee motion range in the experimental group and the control group were 50.0％ (18/36) vs.16.7％ (6/36),94.4％ (34/36) vs.83.3 (30/36),97.2％ (35/36) vs.81.6％ (31/36),Z values were-3.345,-2.861,-2.012,P＜0.01.Conclusions The use of immobilization with cast plaster in children's rehabilitation after the knee arthroscopic operation could significantly relieve the pain brought by the surgery,as well as increase the level of appliance of knee function exercises and improve the range of knee motion greatly.Therefore,it could help children to restore the knee function earlier and furthermore to promote life quality after receiving knee arthroscopic surgery.

It is still controversial whether total splenectomy on adult animals would affect their immune function. In this study, total splenectomy and different kinds of splenic preservation operations including splenorrhaphy, partial splenectomy and spleen autotransplantation were performed on adult rats after the porta of the spleen of the rats was artificially ruptured and the splenic artery ligated.In the 4th month after the operations, the hemolysin antibody and the de-layed-type hypersensitivity reaction were determined in the rats. It was found that no significant difference occurred in the hemolysin antibody and the delayed type hypersensitivity reaction among the rats of the control group, the group with total splenectomy, and the groups with different kinds of splenic preservation operations.

Objective To summarize the experiences in the diagnosis and treatment of the hepatic hereditary hemorrhagic telangiectasia (HHHT).Methods The clinical data of 15 HHHT patients who were admitted to the Qilu Hospital,People's Hospital of Mengyin,People's Hospital of Liaocheng,Henan Provincial People's Hospital,the Second Hospital of Hebei Medical University,First Affiliated Hospital of Zhejiang University were retrospectively analyzed.The clinical manifestation,features of imaging and laboratory examination were summarized,and the diagnosis,treatment and prognosis of the disease were investigated.Results HHHT patients had nonspecific symptoms in the early stage,and some patients presented with right upper quadrant discomfort,shortness of breath,anemia and liver bruit.The condition of HHHT patients could be worsened by liver cirrhosis or portal hypertension rapidly.The results of color doppler ultrasound and computed tomography showed intrahepatic telangiectasia,arteriovenous fistula and hepatic artery aneurysm in the 15 patients.Digital subtraction angiography was not clear enough for 2 HHHT patients with more than 1 enlarged hepatic arteries,but computed tomographic angiography was feasible.According to the degree and stages of the HHHT,all the 15 patients were divided into asymptomatic HHHT,simple HHHT and complex HHHT.Among the 6 patients who underwent surgical treatment,5 received ligation or banding of the enlarged hepatic arteries with subsequent disappearance of symptoms.Three patients received interventional treatment,and the treatment for 1 patient with complex HHHT was failed,and the patient died 30 months after medical treatment.Six patients were treated by conservative treatment,2 patients of them had no symptoms at the beginning,then they suffered from hepatic dysfunction and ascites at 21 and 35 months,respectively,and 1 of them died 6 months later.Four patients received medical treatment,and the results of color doppler ultrasound and computed tomography showed the pathological changes were aggravated gradually.Conclusions Telangiectasia,intrahepatic arteriovenous fistula and hepatic artery aneurysm are the main imaging characteristics of HHHT,and imaging diagnosis has significant value in the diagnosis of HHHT.HHHT is a progressive disease,early,active and individualized treatment is beneficial to the patients.The outcome of ligation or banding of the hepatic arteries is satisfactory.

Objective To investigate whether calcitonin gene-related peptide(CGRP) can influence the proliferation and phenotypic modulation of vascular smooth muscle cells(VSMCs),and what is the relationship between them. Methods Vascular smooth muscle cells(VSMCs) were cultured respectively with rat aorta cultivated for 8 days in vitro and with normal aorta(not culture) through the explant-attached method,and CGRP was added into the culture medium of the experimental groups.The proliferation of cells was labeled by 5-bromodeoxyuridine(5-BrdU) with immunocytochemical method,and the mRNA expression of hypertension-related gene-1(HRG-1) and smooth muscle 22 alpha(SM22?) were determined by RT-PCR. Results The proliferating cells labeled by BrDU from the aorta cultured for 8 days in vitro were increased notablly and the mRNA expression of HRG-1 and SM22? were decreased.While the VSMCs were cultured in the culture medium containing CGRP,the proliferous cells labeled by BrdU were obviously decreased and the mRNA expression of HRG-1 and SM22? were significantly increased.Conclusion It is showed that CGRP could inhibit the proliferation of VSMCs and change the phenotype of VSMCs from synthesize to contractile type.It might be a good cellular model which provides a good experimental platform to research the proliferating vascular disease as well as its prevention and treatment.

Objective To explore the status and influencing factors of the integrated service needs of medicine, pension, rehabilitation and care of the community elderly in order to provide a theoretical basis for the construction of an old-age service model in line with the national conditions. Methods A total of 330 elderly people from three communities in Tai'an were selected and investigated by self-made questionnaire of the integrated services needs for medicine, pension, rehabilitation and care of community elderly. Results Nearly 83.54％(259/310) of the elderly had moderate and above pension needs, and the first three were rehabilitation services, family beds and community public health services. Age, educational level, self-rated health and number of chronic diseases were the influencing factors of the integrated service needs of medicine, pension, rehabilitation and care(t =2.374-4.844, all P<0.05). Conclusions The majority of elderly people have the moderate and above health care integration service demand, the elderly have the highest demand for rehabilitation services. Age, education, self-rated health status and the number of chronic diseases have different influence on the needs of the elderly;government, society, education and medical treatment institutions interdisciplinary multi linkage, and strengthen the professionals training of health, rehabilitation, health care, in order to explore the best old-age service model in line with national conditions.

Objective To explore the correlation between death anxiety and quality of life ( QOL) in elderly patients with chronic diseases. Methods Totally 170 elderly inpatients with chronic diseases from a tertiary comprehensive hospital in Taian were investigated by QOL scale ( SF-36 ) and Templer death anxiety scale (TDAS). Results The total score of TDAS in elderly inpatients with chronic diseases was (6.20±3.31);the total score of QOL was (102.21±14.58). The total score and dimensions of death anxiety were negatively correlated with the total score of QOL (r=-0.173--0.410, P<0.05). Conclusions The death anxiety of patients with chronic diseases is negatively correlated with their QOL, which means that the higher of the level of death anxiety is, the lower of the level of QOL will be. Medical staff should focus on the death anxiety of elderly patients with chronic diseases and carry out death education and hospice care in order to decrease their death anxiety and improve their QOL.

Objective To explore the adverse reactions of contrast-enhanced ultrasound and treatments of the adverse reactions. Methods 6035 patients examined by contrast-enhanced ultrasound were closely observed in the process and 20 minutes after the examination. The occurrence and clinical manifestations of adverse reactions were recorded. The patients were gave symptomatic treatments. Results Two of 6035 patients experienced mild adverse reactions related with contrast-enhanced ultrasound. The incidence rate was 0. 031% (2/6035). No moderate or serious adverse reaction occurred. The two patients recovered well after symptomatic treatments. Conclusions The contrast-enhanced ultrasound has high safety and low incidence rate of adverse reaction. Patients should be under close observation in the process of contrast-enhanced ultrasound. The symptomatic treatments should be gave in time.

Objective:To investigate the causes of anemia in newborns delivered by human immunodeficiency virus (HIV) infected mothers.Methods:This was a retrospective study. Forty-two newborns delivered by HIV infected mothers during January 2010 and May 2019 in Beijing Ditan Hospital Affiliated to Capital Medical University were selected. According to the hemoglobin levels of newborns on the days of their birth, newborn cases were divided into two groups, anemia group and non-anemia group. The clinical data including gestational ages, birth weight, maternal anemia status during pregnancy, using of antiviral drugs during pregnancy, percentages of HIV RNA positivity in early pregnancy/pre-treatment and before delivery, maternal percentage of different CD4 + T lymphocyte counts in early pregnancy/pre-treatment and before delivery between two groups were compared. The efficacies of relative indicators for prediction of anemia in newborns were evaluated by the area under receiver operating characteristic curve (AUROC). Differences between groups were compared by chi-square test. Results:Among 42 cases of newborns, 14 cases were in anemia group and 28 cases in non-anemia group. There were no statistical differences in gestational ages, birth weight, maternal anemia status during pregnancy and positive percentage of HIV RNA before delivery between two groups ( χ2=2.211, 1.025, 1.362 and 3.783, respectively, P=0.283, 0.763, 0.181 and 0.092, respectively). In anemia group, 11 mothers took zidovudine during pregnancy, which was 12(42.86%) in non-anemia group. The difference was statistically significant ( χ2=4.359, P=0.037). Eight cases of mothers with HIV RNA positive in early pregnancy/pre-treatment in the anemia group, which was 11(39.29%) in the non-anemia group. The difference was statistically significant ( χ2=6.490, P=0.011). The number of CD4 + T lymphocyte count ≤500/μL was 13 in early pregnancy/pre-treatment in anemia group, which was 20(71.43%) in the non-anemia group. The difference was statistically significant ( χ2=16.396, P<0.01). The number of CD4 + T lymphocyte ≤0.28 was 13 in early pregnancy/pre-treatment in the anemia group, which was 19(67.86%) in the non-anemia group ( χ2=19.908, P<0.01). The number of CD4 + T lymphocyte count ≤500/μL was 14 before delivery, which was 15(53.37%) in the non-anemia group ( χ2=9.536, P=0.008). The number of CD4 + T lymphocyte ≤0.28 before delivery was 14 in anemia group, which was 15(53.37%) in the non-anemia group ( χ2=9.750, P=0.006). According to the receiver operating characteristic curve results, the AUROC, optimal cut-off value, sensitivity and specificity of CD4 + T lymphocyte count before delivery in predicting neonatal anemia were 0.708, 476.0/μL, 100.0% and 50.0%, respectively. The AUROC, optimal cut-off value, sensitivity and specificity of maternal CD4 + T lymphocyte percentage before delivery in predicting neonatal anemia were 0.719, 0.275, 100.0% and 53.6%, respectively. Conclusion:Low CD4 + T lymphocyte level in HIV-infected mothers before delivery, HIV positive in early pregnancy/pre-treatment and using of zidovudine during pregnancy may be associated with neonatal anemia.

Objective:To study the clinical characteristics, diagnosis, complications and prognosis of neonatal varicella.Methods:From September 2008 to December 2019, the clinical data of hospitalized neonates with varicella in our hospital were retrospectively analyzed.Results:A total of 33 cases of neonatal varicella were reviewed, including 18 males and 15 females, 32 full-term infants and 1 premature infant. The gestational age (GA) was (38.8±1.2)w and birth weight (BW) was (3 670±247)g. The onset of the disease occurred at 14.0 (8.0,19.0)d and was diagnosed at 18.0 (11.5,23.0)d. The hospital stay duration was (8.1±3.7)(2~20)d. All mothers denied varicella history or varicella vaccination. Among the 33 infants, 29 had a history of varicella/zoster exposure. All 33 infants had typical rash and 25 had fever, body temperature (38.3±0.6) ℃ and duration (2.4±1.4) d. 13 cases were congenital varicella, 20 cases were acquired varicella. 24 cases abnormality of cardiac enzymes, 11 cases skin infection, 8 cases liver damage, 4 cases pneumonia, 6 cases granulocytopenia/agranulocytosis, 9 cases anemia, 4 cases sepsis and 1 case viral encephalitis were diagnosed. 20 infants received intravenous antiviral therapy (acyclovir), 17 were treated with antibiotics, 15 were given intravenous immunoglobulin (IVIG), 8 received both antiviral therapy and IVIG and 6 were treated with recombinant human granulocyte stimulating factor. 31 infants were cured and discharged. 2 infants were discharged after improvement of rashes. All infants reported complete recovery on telephone follow-up.Conclusions:Most neonatal varicella cases have a definite exposure history. Besides rashes, complications including pneumonia, liver damage, myocardial injury, granulocytopenia/agranulocytosis, viral encephalitis are common. Intravenous antiviral therapy with acyclovir and combined treatment of IVIG and symptomatic support can often achieve a good prognosis.

Objective: To explain the true experience of death anxiety in elderly inpatients with chronic diseases, and provide a theoretical basis for hospice care. Methods: The phenomenological study method was used to deeply interview the true feelings of death anxiety in 13 elderly inpatients with chronic diseases. Results: Through analysis, collation and refinement, the five themes of death anxiety, life regret, death attitude, death reminder and final decision power. Conclusions As clinical medical workers, we must always pay attention to the death anxiety of elderly inpatients with chronic diseases and strengthen the assessment of death anxiety. In particular, patients with cancer and patients at the end of life are provided with personalized care to remind them of the meaning of life and reduce the anxiety level of death.