Objective To study the practical methods for the diagnosis of clinical etiology of acute respiratory infection(ARI).Methods 108 patients with ARI were the expermental group and forty healthy peoples were the control group.The specimens from throaty excretions were collected in the both groups.Adenovirus(ADV),coxsackie virus(COX),respirator syncytial virus(RSV),chlamidia pneumonia(CP) and mycoplasma pneumonia(MP) in the specimens were detected with polymerase chain reaction(PCR).Results The detected positive rates were 10 2% for ADV,17 6% for COX,28 7% for RSV,33 3% for CP and 13 9% for MP respectively in ARI.There was significantly difference between the ARI group and the healthy control group(P

Objective To study changes in neural stem cell proliferation in ischemic brain tissue after cerebral ischemia/reperfusion injury treated with mild hypothermia. Methods The middle cerebral arteries (MCA) of Sprague-Dawley rats were occluded for 2 hours, then reperfused for 3, 7, 11, 14, 18 and 28 days. Using immunohisto-chemical staining, the bromodeoxyur-idine ( BrdU)-positive cells in the brain tissue of the operationally intervened side were examined in a sham-operation group, a control group, and in rats treated using mild hypothermia. Results There were a few BrdU-positive cells in the sham-operated rats, but there were obviously more in the mild hypothermia group than in the control group. The peak period for proliferation of neural stem cells in the ischemic brain tissue was longer in the mild hypothermia group than that in the control group. Conclusion Mild hypothermia may promote proliferation of neural stem cells in ischemic brain tissue after cerebral ischemia/reperfusion injury.

Objective To compare the internal fixation methods for treatment of intertrochanteric fractures in elderly patients.Methods One hundred and sixty four elderly patients with intertrochanteric fractures were treated from June 2006 to September 2011.The fractures were fixed with dynamic hip screws (DHS,n =42),locking proximal femur plate (LPFP,n =40),Gamma nails (n =36) or proximal femoral nail anti-rotation (PFNA,n =46),respectively.The clinical data were collected and the operative time,blood loss,time of clinical healing,postoperative complications and Harris hip scores of 6 months after surgery were compared among groups.Results All patients were followed-up for 6 to 36 months.The operative times of DHS,LPFP,Gamma nails and PFNA groups were (103 ± 15),(90 ± 13),(79 ± 11)and (65 ±9)min,respectively(F =2.87,P ＜0.05).The blood loss of 4 groups was (202 ±23),(181 ±23),(98 ± 13) and (87 ± 11) ml,respectively (F =3.21,P ＜ 0.05).The times of clinical fracture healing were (16.1±1.9),(14.6±1.8),(12.9±1.7) and (11.5±1.4) weeks,respectively(F=2.66,P＜0.05).The postoperative complications of 4 groups were 4/42,3/40,2/36 and 1/46,respectively (x2 =5.67,P ＜0.05).The Harris hip scores of 6 months after surgery of 4 groups were 81％ (34/42),85％ (34/40),89％ (32/36)and 93％ (43/46),respectively(H =20.03,P ＜0.05).Conclusions In treatment for intertrochanteric fractures in elderly patients,the efficacy of intramedullary fixation (Gamma nails and PFNA) is better than extramedullary fixation DHS and LPFP).PFNA is more effective than other 3 methods and should be preferentially chosen.

Objective:To explore the efficacy of online pulmonary rehabilitation (PR) management among community-dwelling patients with stable chronic obstructive pulmonary disease (COPD).Methods:This study was a single-center randomized controlled trail with an unblinded design. A total of 130 patients with stable COPD who visited Zhuanqiao Community Health Service Center in Shanghai Minhang District from October 2020 to March 2022 were randomly divided into study group and control group with 65 cases in each group. Both groups received conventional treatment, while patients in study group attended online rehabilitation management, including face-to-face rehabilitation instruction and multiple online guidance. Pulmonary ventilation function including forced vital capacity (FVC), forced expiratory volume in the first second (FEV 1) and percentage of forced expiratory volume in the first second to forced expiratoty volume (FEV 1%pred), modified British Medical Research Council Dyspnea Scale (mMRC), chronic obstructive pulmonary disease assessment test (CAT), score of 6 minutes walking distance (6MWD) and DOSE (dyspnea, degree of airflow obstruction, smoking status, the number of exacerbation) index were measured at baseline and after 8 weeks of rehabilitation, and compared between two groups. Results:The baseline data of the two groups were comparable. After 8 weeks of management, FVC, FEV 1, FEV 1%pred, mMRC, CAT, 6MWD and DOSE index of both groups were improved compared with the baseline level(control group: t=-7.799, -7.581, -9.010, 3.565, 9.887, -16.677, 3.795; study group: t=-12.623, -13.914, -17.644, 7.404, 22.457, -26.826, 7.968; all P<0.05). The FEV 1%pred, CAT and 6MWD in the study group were better than those in the control group ( t=-2.939, 2.277,-2.130, all P<0.05); while there were no significant differences in FVC, FEV 1, mMRC and DOSE index between the two groups( t=-0.162, -1.280, 0.925, 1.939,all P>0.05). Conclusions:The online pulmonary rehabilitation management can better improve lung function, dyspnea symptoms and exercise tolerance of patients with stable COPD, which can be used for rehabilitation training and management of community-dwelling patients.

Chronic refractory wound (CRW) is one of the most challengeable issues in clinic due to complex pathogenesis, long course of disease and poor prognosis. Experts need to conduct systematic summary for the diagnosis and treatment of CRW due to complex pathogenesis and poor prognosis, and standard guidelines for the diagnosis and treatment of CRW should be created. The Guideline forthe diagnosis and treatment of chronic refractory wounds in orthopedic trauma patients ( version 2023) was created by the expert group organized by the Chinese Association of Orthopedic Surgeons, Chinese Orthopedic Association, Chinese Society of Traumatology, and Trauma Orthopedics and Multiple Traumatology Group of Emergency Resuscitation Committee of Chinese Medical Doctor Association after the clinical problems were chosen based on demand-driven principles and principles of evidence-based medicine. The guideline systematically elaborated CRW from aspects of the epidemiology, diagnosis, treatment, postoperative management, complication prevention and comorbidity management, and rehabilitation and health education, and 9 recommendations were finally proposed to provide a reliable clinical reference for the diagnosis and treatment of CRW.