Acupuncture Therapy ; instrumentation ; methods ; Adult ; Aged ; Female ; Hot Temperature ; Humans ; Male ; Middle Aged ; Needles ; Spondylosis ; therapy ; Treatment Outcome ; Young Adult

Anti-Infective Agents ; administration & dosage ; Clinical Competence ; Hematologic Diseases ; Hospitals, Special ; manpower ; Humans ; Medical Staff, Hospital

Objective:To improve the understanding of brucellar spondylitis (BS) and to further improve the diagnosis and treatment ability of BS patients.Methods:The epidemiological and clinical data of 74 cases of BS misdiagnosed in Department of Orthopedics, Zhangye People's Hospital Affiliated to Hexi University from January 2014 to December 2019 were analyzed.Results:The average age of BS onset was 34-71 (54.1±4.5)years old. The incidence rate of female was higher than that of male. The morbility of rural individual farmers were higher than that of herdsmen. These patients were infected mainly through browsing and breeding beasts. It was very common that two adjacent lumbars vertebrae were invaded. It took about mean (10.1±2.2)months to diagnosis and (7.1±1.9)times to visits doctors. All patients were misdiagnosed as lumbar disc herniation, spinal tuberculosis and so on.Conclusions:There are characteristic features in clinical epidemiology of BS.It tends to be misdiagnosed as spinal tuberculosis and lumbar disc herniation in early clinical stage. It can be diagnosed as early as possible according to its epidemiology, clinical symptoms and imaging examination.

Objective To investigate the virologic responses to pegylated-interferon alfa-2a (PegIFNα-2a) plus ribavirin therapy for cryoglobulinemia positive chronic hepatitis C in patients with hepatitis C virus (HCV) genotype 1 b.Methods Clinical data on 60 chronic hepatitis C patients with HCV genotype 1b were collected from Huzhou Central Hospital during January 2008 and December 2012.The patients were divided into cryoglobulinemia positive group (n =22) and cryoglobulinemia negative group (n =38),and both received 48-week PegIFNα-2a (180 μg) plus ribavirin treatments.For those who could not tolerate the treatment,PeglFNα-2a was reduced to 135 μg from 12th week.Rapid virologic response (RVR),end of treatment virologic response (ETVR) and sustained virologic response (SVR) in two groups were observed and compared using Chi-square test.Results RVR,ETVR and SVR in cryoglobulinemia positive group were 59.1％ (13/22),81.8％ (18/22) and 31.8％ (7/22),while those in cryoglobulinemia negative group were 55.3％ (21/38),76.3％ (29/38) and 60.5％ (23/38).There was significant difference in SVRs between two groups (x2 =4.674,P ＜ 0.05).For those completed full course of antiviral therapy with 180 μg PegIFNα-2a,the RVR and SVR in cryoglobulinemia negative group tended to be higher than those in cryoglobulinemia positive group,but the differences were not statistically significant (x2 =1.524 and 1.009,P ＞ 0.05).Serious adverse reactions were observed in 9 (40.9％) patients of cryoglobulinemia positive group,while in 11 (28.9％) patients of cryoglobulinemia negative group (x2 =0.887,P ＞ 0.05).Conclusion Cryoglobulinemia may not have considerable impact on virologic responses to PegIFNα-2a plus ribavirin therapy in patients with chronic genotype 1b hepatitis C.

Magnetic Resonance Imaging (MRI) can form a three-dimensional positioning anatomical imaging.By comparing the tumor volume and signal intensity changes,there is great value of MRI in the assessment of the efficacy of cervical cancer.With the development of imaging,magnetic resonance diffusion weighted imaging (DWI),magnetic resonance spectroscopy (MRS) can provide qualitative and quantitative information of the cellular level,which reflects changes in the treatment of tumor cells.Magnetic resonance imaging can predict early locally advanced cervical cancer neoadjuvant chemotherapy,thus providing an important basis for individualized treatment of patients.

Objective To investigate the degenerative changes in the inner rat retina after photic injury. Methods After 24 hour-dark adaptation, sixty Lewis rats were exposed in a ventilated green plexiglass chamber that transmitted continuous green light between 480-520 nm with an intensity of 900～1 000 lx. After 24-hour exposure, the rats stayed in darkness and were sacrificed after 1 day, 3,7 or 14 days. The neurons in the inner retina were marked by immunohistochemical technique and observed by light and electronic microscope. Results The apoptotic photoreceptor cells were noted after photic injury. The degeneration and decreasing number of rod bipolar cells were found after 3 days; the edema of horizontal cells occurred after 1 day but ameliorated gradually; decreasing number of amacrine cells was found after 1 day; sustained edema of ganglion cells and prolifeeration of the M?ller cells were found after photic injury. Pyknotic and edematous neruronal degenerations of inner retina were found in ultrastructural study. Conclusion The neurons in the inner retina as well as M?ller cells are involved in the degeneration after photic injury. Different neurons manifest different patterns of degeneration.

Several hot questions such as selection of patients and favorable time of transplantation, design of conditioning regimen, monitoring of chimerism and complication of graft versus host disease (GVHD) in allogeneic hematopoietic stem cell transplantation following reduced intensity regimen (RIC-HSCT) as salvage therapy for refractory leukemia are discussed in this article. More and more investigators began to recognize that it was not a fundamental to undergo transplantation in complete remission for patients with refractory leukemia, since it may expend patients' physical status. RIC-HSCT may be substantially considered as a kind of adoptive immunotherapy, so that immunologic attacking targets and the latency of immunoreactian must be considered when making the decision to use, lacking of attacking targets and rapidly growing diseases seemed to be less susceptible to control. Commonly used reduced intensity regimens differed significantly, but it was clear that dose intensity was very important in refractory leukemia. In fact, many investigators used intermediate dosage between criteria of non-myeloablative and conventional myeloablative regimens. Complete donor chimerism is the hallmark of engraftment but often delayed in RIC-HSCT. Since sustained complete donor chimerism induced persistent graft-versus-leukemia (GVL) effect play an important role in patients' long-term survival, it was recommended that sensitive techniques (eg. STR-PCR) should be used to analysis chimerism and should be measured more frequently (every 2-4 weeks), and lineage-specific chimerism (eg. T cell) analysis was also recommended. As compared with traditional HSCT, the incidences of acute and chronic GVHD are similar and the onset of GVHD is associated with the GVL effect. Decrease or interruption of immunosuppressive drugs early after transplantation and donor lymphocyte infusion may facilitate transformation to complete donor chimerism, so that it may benefit patients with advanced disease at time of transplantation from avoiding disease relapse in one hand, but may induce GVHD in the other hand.

The myelodysplastic syndrome(MDS) comprise a heterogeneous group of clonal disorders.A unique aspect of MDS is the notion that both bone marrow failure and the propensity toward development of acute leukemia coexist. Origin of abnormal clone with MDS occurs at the level of multipotent progenitors or above it. Recently some kinds of MDS were observed the abnormal clone has been potentially originated from normal CD+34 CD-38 Thy-1 + hematopoietic stem cells. The abnormal clones with different chromosomal abnormality have different distribution. With the propotion of abnormal clonality increasing MDS has aggravated. Coherent result will provide new insight into the clinical diagnosis, treatment and prognosis of MDS by strengthening the research of MDS clonality.

Objective To evaluate the biomechanical characteristics of the long U-shaped hollow pedicle screw system for percutaneous fixation of thoracolumbar fractures.Methods Models of vertebral compression fracture were created by flexion in 8 fresh cadaveric samples of thoracolumbar spine.The models were divided into 2 equal groups according to the fixation system applied.In group A conventional pedicle screws were used while in group B long U-shaped hollow pedicle screws were used.The yield compressive strength,axial compression stiffness,bending stiffness,torque and torsional stiffness of all the fixated spines in the 2 groups were tested by the bio-mechanical electrical measurement and compared as well.Results The conventional pedicle screws and long U-shaped hollow pedicle screws showed no significant differences regarding yield compressive strength (3450.02 ± 110.03 MPa vs.3430.04 ± 102.12 MPa),axial compressionstiffness (407.52 ± 33.02 N/mm vs.395.04 ± 26.46 N/mm),bending stiffness (305.14 ± 26.53 N · cm/Degvs.295.12±23.80 N · cm/Deg),torque (6.45±0.25 N · m vs.6.25±0.21 N · m) or torsional stiffness (0.54±0.04N·cm/Degvs.0.52±0.03N·cm/Deg) (P＞ 0.05).Conclusion The long U-shaped hollow pedicle screw system can satisfy the biomechanical requirements for fixation of thoracolumbar fractures and can function as well as the conventional pedicle screw system.

Total glucosides of paeony (TGP)is used to treat rheumatoid arthritis(RA)as the first immunoregulatory drug in clinic.The efficacy of TGP in treating RA patients is definite, which is accompanied with mild adverse reaction and slow effects simultaneously.Paeoniflorin (Pae ),the main constituents of TGP,has a bioavailability of 3% ~4%,which may be served as the main reason for its slow effects.Therefore,in this paper,the pharmacokinetics of Pae as well as its influencing factors were re-viewed on basis of pulished papers.In addition,some problems about Pae were also discussed.