Animals ; Hepacivirus ; genetics ; Hepatitis C ; immunology ; prevention & control ; therapy ; virology ; Humans ; Mutation ; Viral Hepatitis Vaccines ; immunology

ObjectiveTo observe the clinical therapeutic effect of intra-articular injection with sodium hyaluronate (SH) on osteoarthritis of the ankle.Methods25 patients with osteoarthritis of the ankles (36 ankles) were treated with SH intra-articular injection 2 ml every week for 5 weeks. The degree of pain, swelling and functional disturbance of the ankles were observed to evaluate the effect.ResultsAfter treatment, the degree of pain, swelling and functional disturbance of the ankles improved (P<0.05～0.01). The total efficiency rate was 91.61%.ConclusionSodium hyaluronate injected intra-articular is an effective, ideal and safe treatment for osteoarthritis of the ankle.

Objective To study the kidney histological categories of isolated hematuria in children.Methods Twenty-three children with isolated hematuria were performed renal biopsy under real time ultrasound guidance utilizing menghini style negative pressure biopsy device after local anesthesia or general anesthesia.The renopuncture tissue was directly sent by the mail-boxes to the remote pathologic service.All of the biopsies were examined by light microscopy,electron microscopy and immunohistochemistry.Results Biopsies were classified as measangial proliferative glomerulonephritis(MsPGN)(8 cases),minimal change nephropathy(MCN)(5 cases),IgA nephropathy(IgAN)(4 cases),thin basement membrane nephropathy(TMN)(3 cases),Alport′s syndrome(AS)(1 case),focal segmental glomerulosclerosis(FSGS)(1 case)and IgM nephropathy(IgMN)(1 case).Conclusions In this series,MsPGN,MGA,IgAN are the most common biopsy diagnosis.TMN and Alport′s are account for some proportion.A few IgMN and FSGS may also present as isolated hematuria.

Objective To assess whether dynamic arterial elastance (Eadyn)can be used to predict the reduction of arterial pressure after decreasing norepinephrine (NE) dosage in patients with septic shock.Methods A prospective observational cohort study was conducted.Thirty-two patients with septic shock and mechanical ventilationwere enrolledfrom January 2014 to December 2015 in ICU of Wuxi People's Hospital of Nanjing Medical University.Hemodynamic parameters were recorded by pulse contour cardiac output(PiCCO) monitoring technology before and after decreasing norepinephrine dosage.Eadyn was defined as the ratio of pulse pressure variation (PPV) to stroke volume variation (SVV).Mean arterial pressure (MAP) variation was calculated after decreasing the dose of NE.Response was defined as a ≥ 15％decrease of MAP.AUC was plotted to assess the value of Eadyn in predicting MAP response.Results A total of 32 patients were enrolled in our study,with 13 responding to NE dose decrease where as the other 19 did not.Eadyn was lower in responders than in nonresponders (0.77 ± 0.13 vs 1.09 ± 0.31,P ＜ 0.05).Baseline Eadyn was positively correlated with systolic blood pressure variation,diastolic blood pressure variation,systemic vascular resistance variation and MAP variation (r =0.621,P =0.000;r =0.735,P =0.000;r =0.756,P =0.000;r =0.568,P =0.000 respectively).However,stoke volume variation,baseline level of systemic vascular resistance and NE baseline dose were not correlated with Eadyn baseline value (r =0.264,P =0.076;r =0.078,P =0.545;r =0.002,P =0.987 respectively).Eadyn ≤ 0.97 predicted a decrease of MAP when decreasing NE dose,with an area under the receiver-operating characteristic curve of 0.85.The sensitivity was 100.0％ and specificity was 73.7％.Conclusions In septic shock patients treated with NE,Eadyn is an index to predict the decrease of arterial pressure in response to NE dose reduction.

Objective To evaluate the clinical features and key points in treatment of ovarian torsion in children. Methods The clinical data of 64 children with ovarian torsion, hospitalized in our hospital from January 2005 to October 2012, were analyzed retrospectively. The clinical manifestations in children of all ages were summarized. The anal examina-tion, B ultrasound examination, CT examination were used for the early diagnosis of ovarian torsion. All children were per-formed laparoscopic surgical exploration. All children were found the typical lower abdominal cramps. The B ultrasound and CT examination showed non-homogeneous mass in pelvic, which suggested the early diagnosis of ovarian torsion. The detec-tion rate of anal examination reached 70.3%(45/64). Results All patients were performed laparoscopic surgical explora-tion. Five patients were treated with ovariectomy. The rest were treated conservatively. The postoperative follow-up was good. Conclusion Ovarian torsion in children was likely to be misdiagnosed. Doppler, CT, anal examination and laparo-scopic operation were important for the early diagnosis and treatment of ovarian torsion.

Objective To evaluate the predisposition effects of angiotensin-converting enzyme (ACE) ,angiotensinogen (AGT) and endothelial nitric oxide synthase (eNOS) gene polymorphisms on coronary disease (CHD) as well as their possible synergistic effect in the development of CHD in Chinese aged people. Methods The study included 191 subjects (100 CHD and 91 controls). Gene chip technology was performed. The allele frequency and genotype distribution were compared between groups. Results A significantly higher frequency of the DD genotype of ACE gene was observed in CHD group (28.0% vs 15. 4%, P0. 05). Subjects carrying ACE DD and AGT TT genotypes or those carrying AGT TT and eNOS TT genotypes showed a stronger association withCHD(OR=2. 9, P

Objective To investigate the clinical feature,image of CT scan pulmonary,diagnosis and treatment response in children with pulmonary cavity,and discuss the method of diagnosis and the tactics of treatment for pulmonary cavity in children.Methods A retrospective study of 6 patients with pulmonary cavity,who were diagnosed and treated from Jul. 2003 to Oct. 2009 in Department of Pediatrics of the First Hospital Affiliated to China Medical University.The clinical manifestations,laboratory tests,image of CT scan pulmonary,microbiological evidence,diagnostic procedure and treatment response were collected and evaluated.Results Six patients all didn′t have history of lung di-sease,there were 4 boys and 2 girls,8-15 years old,average age was 10.5 years old.Two cases of them had unrelated pulmonary underlying diseases,1 case had hyperthyroidism,and the other had juvenile idiopathic arthritis and had complication of macrophage activation syndrome,the other 4 cases had no obvious history.All cases had fever (38-40 ℃),3 cases had cough and 1 case had chest pain.Staphylococcus aureus were cultured in 2 cases,no bacteria was cultured in other 4 cases;the count of white blood cell decreased in 2 cases and increased in 4 cases;C-reactive protein increased in 5 cases and was normal in 1 case;plasma IgE level increased in 2 cases and was normal in other 4 cases;plasma 1,3-beta-D-glucan of all 6 cases were negative.Pulmonary cavities were found in the first CT scan of the lungs in 5 cases and only 1 case of patient′s pulmonary cavities was found in the second CT scan of the lung.Five cases were diagnosed infective causes,1 case was diagnosed noninfectious cause,5 cases of infective causes had been treated with anti-microbial drugs for at least 1 week,1 case of noninfectious cause were treated with methylprednisolone cobined cyclosporin A for 2 weeks.Pulmonary CT scan was rechecked in all cases,and the state of the cases were improved before discharged from hospital.Conclusions The causes of pulmonary cavity in children are not only infective factors,but also some non-infective disease,especially some changes of image of pulmonary CT scan has diagnostic value,detailed past medical history and appropriate rechecking of chest radiographic check are very necessary for diagnosis,according to the result of microbial inspection and evaluation of treatment effect in time and then adjust the treatment protocols.

Nowadays, ceremony education, as a specific education method, is becoming increasingly popular in medical humanistic education.It is a truth generally acknowledged that the importance of ceremony education is located at its extensive scope and plasticity.The cultivation of medical students' human-oriented spirit, strengthening their career identity and enhancing their ideological moralitycan be processed by ceremony education, in which much attention is attached to its four features, identity recognition, emotion polymerization, spirit conduction and cultural inheritance.However, there still exist some problems to be solved in the practice of ceremony education such as overformalization, insufficient individuation and systematization.That is what we mean to discuss in this paper.

Objective To systematically review the efficacy of dexmedetomidine or midazolam for sedation in critically ill patients. Methods We searched the PubMed, EMBaes, Cochrane Library, Wanfang Database,CNKI and VIP for all randomized controlled trials (RCTs) about the efficacy of dexmedetomidine versus midazolam for sedation in severe cases. The quality of the studies was evaluated by the method recommended by Cochrane Collaboration. Meta-analysis was conducted using the Cochrane Collaboration's RevMan 5.0 software. Results Six RCTs involving 613 patients were included in our Meta-analysis. The results of Meta-analysis showed that the length of ICU stay was significantly shorter in group dexmedetomidine than in group midazolam. There were no significant differences in the duration of mechanical ventilation, incidences of bradycardia, hypotension and delirium and mortality rate between the two groups. Conclusion Dexmedetomidin can shorten the length of ICU stay and is beneficial for the outcome in critically ill patients.

Objective To investigate the ambulatory changes of the expressions of neuroserpin (NSP) and tissue plasminogen activator (tPA) during hypoxia/reoxygenation (H/R) in primarily cultured rat cortical neurons. Methods Cortical neurons were cultured from SD rats within 24 h after birth, and a H/R model was built. The immunofluorescence double staining and Western blot were used to detect the NSP expression in the cultured neurons. Enzyme-linked immunosorbent assay (ELISA) was used to detect the expression of tPA. Results After oxygen-glucose deprivation (OGD) for 1.5 h, the expression of NSP protein was mildly up-regulated, and it reached the peak at 6 h after reoxygenation (P < 0. 05). Then it decreased slowly and basically restored to the level before hypoxia at 24 h after reoxygenation. The cells expressed a small amount of tPA at 1.5 h after OGD (P < 0. 05 ). With the extension of time for reoxygenation, the tPA content increased gradually. OGD was significantly higher at 6 h after reoxygenation than before (P < 0.01 ). Then it decreased gradually, and it basically restored to the level before reoxygenation at 24 h after reoxygenation. Conclusions The expressions of NSP and tPA Were up-regulated significantly during neuron H/R injury, and the ambulatory changes of NSP and tPA were basically the same.