Objective To explore the treatment methods of periprosthetic femur fracture after hip arthroplasty.Methods 9 patiens with periprosthetic femur fracture after hip arthroplasty were selected.According to Vancouver classification,there were 1 case in A type,5 cases in B1 type,2 cases in B2 type,1 case in C type.One case were treated by nonoperative method and the other 8 cases were treated by operative method,including 5 cases treated by memory alloy embracing fixator and internal fixation,3 cases treated by long stem prosthetic replacement and iliac bone graft.Results 8 cases were followed up for 8 to 21 months,average 14.2 months.All fractures were united well with good alignment and internal fixation failure except one prosthesis loosing was observed.Conclusion For periprosthetic femur fracture after hip arthroplasty,Vancouver classification methods include the location and stability of the fracture,prosthesis loosening,and the femur in bone mass is importance to the clinical treatment.As to A type fracture,prosthesis is stable,and the conservative treatment can be choosed.As to B1 and B2 type fracture,the aggressive surgical treatment can be choosed based on patients' general condition.If prosthesis loosening after artificial hip arthroplasty,the patients should treated with long stem prosthetic replacement.

Objective To investigate the effects of percutaneous vertebroplasty in the treatment of old symp -tomatic osteoporotic vertebral fractures in elderly .Methods 56 patients with osteoporotic vertebral fractures in elder-ly were selected and treated with percutaneous vertebroplasty .The age of the patients were from 67 to 83 years old, average of 72.5 years old.Among them,there were 15 male cases and 41 female cases.The Cobb angles,Visual Ana-logue Scale score ,and postoperative complications were measured .Results All the operations were successfully com-pleted which took the time from 30 min to 55min.2~5ml bone cement was used in the operation .Pains of 56 patients were significantly reduced or disappeared .VAS:(7.9 ±1.5) of pre-operation,VAS:(2.3 ±1.2) of post operation, Cobb angles:(25.8 ±4.9) of pre-operation,Cobb angles:(12.6 ±3.6) of post operation.The patients could move after operation with the protection of waist in 3 to 9 days.After the follow-up visit of 2 to 14 months,the pains of patients were disappear , no complications of nerves injury , pulmonary embolism and bone cement leakage of spinal canal.Conclusion It suggests that percutaneous vertebroplasty can relieve the pain and improve the life quality of the patients with old symptomatic osteoporotic vertebral fractures .It is worthy of clinical promotion .

0.05).(4) Free pressure of portal vein(FPP) significantly declined at post-operation in the two groups(P

In order to investigate the effect of Arg-Gly-Asp (RGD) peptide-modified silk biomaterial on the adhesion and proliferation of bone marrow-derived mesenchymal stem cells (MSCs), MSCs of third generation were seeded onto the surface of RGD-decorated silk (silk-RGD group), silk alone (silk group) or tissue culture plate (TCP group). After incubation for 4 or 12 h, MSCs were examined quantitatively by using precipitation method for cell attachment. The cell proliferation, which was defined as cell density, was compared among the three groups after culture for 1, 2, 3, and 4 days. Cell skeleton, which was labeled fluorescently, was observed under laser confocal microscope after 24 h of culture. The results showed that cell adhesion rate in silk-RGD group was higher than in silk group (P<0.05), but similar to that in TCP group after incubation for 4 or 12 h (P>0.05). There were no significant differences in the cell proliferation among the three groups at different time points (P>0.05 for all). Laser confocal microscopy revealed that in silk-RGD group, MSCs, strongly fluorescently stained, spread fully, with stress fibers clearly seen, while in silk group, actin filaments were sparsely aligned and less stress fibers were found. It was concluded that RGD peptide could improve the adhesion of MSCs to the silk scaffold, but had no impact on the proliferation of the cells.
Biocompatible Materials/*chemistry ; Bone Marrow Cells/cytology ; Cell Adhesion/drug effects ; Cell Proliferation/drug effects ; Mesenchymal Stem Cells/*cytology ; Oligopeptides/*chemistry ; *Silk/chemistry ; Tissue Scaffolds

Objective To establish the pipeline and evaluate the feasibility of high-throughput sequencing method used in the detection of severe pneumonia pathogens.Methods Clinical control study was used.Bronchi alveolar lavage fluids (BALF) samples from 76 patients with severe pneumonia (treatment group) and 18 patients with tracheal malacia (control group) and without clinical detected pathogens were collected during March 2015 to December 2016 in Shenzhen Children′s Hospital.The pathogens in the samples were detected using clinical tests and high-throughput sequencing respectively.The results of high-throughput sequencing were confirmed by real-time quantitative PCR and the high-throughput sequencing method used in the detection of severe pneumonia pathogens was evaluated.The χ2 test was used to analyze the correlation of detection rate between the high-throughput sequencing group and the non high-throughput sequencing group.Results The pipeline and method of high-throughput sequencing used in the severe pneumonia pathogens detection was established.The pipeline included sample collection, DNA extraction, library construction, sequencing, and bioinformatic analysis.In 76 cases of patients with severe pneumonia, the results of high-throughput sequencing in 66 cases of bronchoalveolar lavage fluid specimens were positive.The sensitivity was 86.84%, which was significantly higher than the total sensitivity of traditional clinical detection methods including bacterial culture, immunofluorescence and quantitative PCR(68.42%,52/76),χ2=7.426,P<0.001.A total of 13 pathogens were detected in 66 positive samples of high-throughput sequencing, including Mycoplasma pneumoniae, Streptococcus pneumoniae, Haemophilus influenzae and adenovirus, etc.Nine kinds of pathogens were detected in these samples through non-high-throughput sequencing.In the experimental group, the results obtained by clinical test and high-throughput (80.26%) were entirely consistent in 61 samples and not completely consistent in 15 samples (19.74%) specimens.These inconsistent results were mainly concentrated in the detection of adenovirus, Streptococcus pneumoniae and Haemophilus influenzae through high-throughput sequencing, whereas clinical cultures and immunofluorescence methods were not able to detect these pathogens.PCR validation showed that there was no significant difference between the results of high-throughput sequencing and the PCR tests (χ2=0.517,P=0.472), and the difference between the results of high-throughput sequencing and traditional clinical detection methods was statistically significant (χ2=11.671,P<0.001).Conclusion The method for the detection of severe pneumonia pathogens based on high-throughput sequencing is highly sensitive and can detect unknown pathogens, which is superior to those used in traditional clinical detection.

Objective This study was to analysis the epidemiologic characteristics of hand-foot-month (HFMD) in Shenzhen during 2015-2016,to provide reference for the prevention and treatment of HFMD.Methods 7 758 statistical data from Shenzhen children's hospital clinical lab during 2015-2016 was included.We used real time fluorescent reverse transcription polymerase chain reaction (RT-PCR) to detect enterovirus general (EV),enterovirus 71 (EV71) and coxsackievirus A group 16 (CoxA16),and analyzed the age,sex and epidemic time of the patients.Results In 2015 and 2016,the positive rate of EV was 67.19％ (2679/3987) and 52.61％ (1 984/3 771) respectively,with statistically significant difference (x2 =71.84,P ＜ 0.05).The radio of male to female children was 1.91∶1 (1 757/922) and 1.83∶1 (l 283/701) in 2015 and 2016,with statistically significant difference (P ＜ 0.05).The age of the children was ＜ 5 years old,accounting for more than 90％ of the total number of patients.April to July and September were the two peaks of HFMD.The enterovirus of hand foot and mouth disease in Shenzhen was dominated by other enteroviruses (more than 82％ of the total number of patients).With the increase of age,the proportion of EV71 in children with severe hand and foot was increasing,and the proportion of other enteroviruses was decreasing.Conclusions Vaccination is one of the important measures of HFMD control.It's beneficial for the diagnosis and treatment of HFMD to collected epidemiologic characteristics data about HFMD in Shenzhen.

Objective:To investigate the effect of three-dimensional printing technique assisted knee arthroplasty in the treatment of knee osteoarthritis with extraarticular deformities.Methods:Twelve patients with knee osteoarthritis and extraarticular deformities in the Sixth People's Hospital of Fuyang were selected as the study subjects from January 2016 to June 2018, and all patients were treated with total knee arthroplasty assisted by 3D printing.The operation time, intraoperative blood loss, preoperative simulated osteotomy value, intraoperative osteotomy value, postoperative drainage volume, joint activity score and Hospital for Special Surgery (HSS) score before treatment, 6 months after replacement and at the last follow-up were observed.Results:The intraoperative blood loss of patients was an average of (389.9±32.6)mL, and the drainage volume of patients was an average of (405.2±85.4)mL.There were no statistically significant difference between preoperative analogue value and intraoperative osteotomy value (all P>0.05). The HSS score ( P<0.001) and knee joint mobility ( P<0.001) were significantly higher at 6 months after operation and the last follow-up, and the mechanical axis deviation of lower limbs was significantly lower than that before operation ( P<0.001). Conclusion:Treatment of knee osteoarthritis with extra-articular deformity by using 3D printing assisted technique can restore the lower limbs and promote the recovery of knee joint function, which has satisfactory short-term effect and deserves further study and discussion.

In order to investigate the effect ofArg-Gly-Asp (RGD) peptide-modified silk biomaterial on the adhesion and proliferation of bone marrow-derived mesenchymal stem cells (MSCs),MSCs of third generation were seeded onto the surface of RGD-decorated silk (silk-RGD group),silk alone (silk group) or tissue culture plate (TCP group).After incubation for 4 or 12 h,MSCs were examined quantitatively by using precipitation method for cell attachment.The cell proliferation,which was de-fined as cell density,was compared among the three groups after culture for 1,2,3,and 4 days.Cell skeleton,which was labeled fluorescently,was observed under laser confocal microscope after 24 h of culture.The results showed that cell adhesion rate in silk-RGD group was higher than in silk group (P<0.05),but similar to that in TCP group after incubation for 4 or 12 h (P>0.05).There were no sig-nificant differences in the cell proliferation among the three groups at different time points (P>0.05 for all).Laser confocal microscopy revealed that in silk-RGD group,MSCs,strongly fluorescently stained,spread fully,with stress fibers clearly seen,while in silk group,actin filaments were sparsely aligned and less stress fibers were found.It was concluded that RGD peptide could improve the ad-hesion of MSCs to the silk scaffold,but had no impact on the proliferation of the cells.

Objective To understand the epidemiological characteristics, genomic variations and macrolide resistance of Bordetella pertussis ( B. pertussis) strains circulating in Shenzhen with clinical data analysis, genotype profiling, phylogenetic analysis and antimicrobial susceptibility test. Methods Clinical data of patients with pertussis in Shenzhen Children's Hospital were collected from the electronic medical re-cord system. Genome sequences of 31 B. pertussis isolates were analyzed with next-generation sequencing and de novo assembled. Multilocus sequence typing (MLST) was performed to identify their sequences types. Sequence alignment by BLASTn was used to identify virulence genotypes and mutations in 23S rRNA gene. A phylogenetic tree was constructed to analyze the relationships among them. E-test was used to identify ma-crolide resistance. Results All of the 31 B. pertussis strains were identified as sequence type-2 (ST-2) by MLST with diverse virulence genotypes. Two were prn-deficient strains. Based on the phylogenetic tree, all of the isolates were distant from vaccine strains. Nineteen isolates were resistant to erythromycin with A2047G mutation in 23S rRNA. Conclusions The virulence genotypes of B. pertussis strains in Shenzhen were diverse with increasing non-vaccine genotypes. Macrolide-resistant strains were prevalent. This study might provide reference for improving the prevention, management and vaccination strategy of pertussis.

Objective:To investigate the current situation of the use of transjugular intrahepatic portosystemic shunt (TIPS) for portal hypertension, which should aid the development of TIPS in China.Methods:The China Portal Hypertension Alliance (CHESS) initiated this study that comprehensively investigated the basic situation of TIPS for portal hypertension in China through network research. The survey included the following: the number of surgical cases, main indications, the development of Early-TIPS, TIPS for portal vein cavernous transformation, collateral circulation embolization, intraoperative portal pressure gradient measurement, commonly used stent types, conventional anticoagulation and time, postoperative follow-up, obstacles, and the application of domestic instruments.Results:According to the survey, a total of 13 527 TIPS operations were carried out in 545 hospitals participating in the survey in 2021, and 94.1% of the hospital had the habit of routine follow-up after TIPS. Most hospitals believed that the main indications of TIPS were the control of acute bleeding (42.6%) and the prevention of rebleeding (40.7%). 48.1% of the teams carried out early or priority TIPS, 53.0% of the teams carried out TIPS for the cavernous transformation of the portal vein, and 81.0% chose routine embolization of collateral circulation during operation. Most of them used coils and biological glue as embolic materials, and 78.5% of the team routinely performed intraoperative portal pressure gradient measurements. In selecting TIPS stents, 57.1% of the hospitals woulel choose Viator-specific stents, 57.2% woulel choose conventional anticoagulation after TIPS, and the duration of anticoagulation was between 3-6 months (55.4%). The limitation of TIPS surgery was mainly due to cost (72.3%) and insufficient understanding of doctors in related departments (77.4%). Most teams accepted the domestic instruments used in TIPS (92.7%).Conclusions:This survey shows that TIPS treatment is an essential part of treating portal hypertension in China. The total number of TIPS cases is far from that of patients with portal hypertension. In the future, it is still necessary to popularize TIPS technology and further standardize surgical indications, routine operations, and instrument application.