Objective To explore diagnosis and prognosis of heart failure in children by measuring brain natriurettic peptide(BNP) and cardiac troponin I(CTnI).Methods Forty-one children subjects with heart failure were chosen,and then they were divided into three stages,early stage of heart failure,stage of heart failure and stage of recovery according to the ROSS cardiac function score method.In contrast with the former group,41 healthy children were chosen as control group.BNP and CTnI levels of blood plasma were analyzed by radioimmunoassay(RIA) and chemiluminescent immunoassay(CLIA) respectively,the relationship between the BNP level of blood plasma and prognosis of CHF group was analyzed.Results At early stage of heart failure,BNP and CTnI levels began to rise.They amount to highest peaks at stage of heart failure and went down at stage of recovery.But they were still higher than those of control group(P

Objective: To understand current situation and existing problems in financial security of the center for disease control and prevention system in Jiangxi, to provide scientific references for advancing continuous, fast and healthy development of the system. Methods: combining three methods of questionnaire, group discussions and field surveys to investigate the situation of financial income from 112 centers of disease control and prevention in Jiangxi. Results: The government finance investment increased by year, but the funds of daily work and personnel is insufficient, public and regular business funds of some institution still depend on paid service income. Conclusion: It needs to further enhance financial structure adjustment and disease control investment, increase disease control input, change government appropriation method for disease prevention and control institutions, change the government ’ s funding mode to “purchase system” , reasonably pricing public product, the government on behalf of the people buying services according to quality and quantity from the disease prevention and control institutions.

Objective To retrospectively analyze the serum enzymes in childhood amputees as a result of earthquake,and to discuss their clinical significance.Methods From 150 children amputees who were victims of Sichuan Wenchuan earthquake in 2008 and Sichuan Lushan earthquake in 2013,45 cases with complete records of serum enzymes examinations were reviewed retrospectively.They were divided into three groups:amputation group (n=6),fasciotomy decompression group (n =5),general trauma without injury to extremity group (n =34).Serum enzyme examination data were compared for statistical analysis to find the difference among groups.Ten children who were not victims of earthquake were selected from department of orthopaedics to serve as controls,and 20 adult amputees as a result of earthquake served as another control group.Results There were significant differences in injury severity scale (ISS) and the contents of all serum enzymes,including aspartate transaminase (AST),alanine aminotransferase (ALT),creatine kinase (CK),lactate dehydrogenase (LDH),and hydroxybutyrate dehydrogenase (HBDH),between the amputation group and other patients (FISS=15.474,P＜0.001 ; FAST=10.770,P＜0.001 ; FALT=12.799,P＜0.001 ; FcK=12.848,P＜0.001; FUDH=13.126,P＜0.001; FHBDH=13.186,P＜0.001),and the difference in amputation group was even more significant.AST,LDH,HBDH in childhood amputees group were significantly higher than those in adult amputation group.The contents of ALT and CK were slightly increased.Serum enzyme contents were found to be significantly helpful for prediction of disease condition and prognosis.It was also found that CK was extremely helpful in assessing the degree of illness in patients with severe trauma,especially in patients complicated by severe soft tissue injury.In all the groups,of patients,it was found that CK rose from (129 ± 62) U/L in non-earthquake induced trauma group to (44 208 ± 39 788) U/L in earthquake amputation group,and it was thus increased more than 300 times.Its highest value even reached 117 513 U/L,which was more than 840 times of the normal.If a timely amputation or muscle compartment decompression was performed,CK might decline rapidly down to the normal value.Conclusions The comprehensive and continuous assessment of serum enzymes is mandatory during the treatment of children with acute trauma.It is of important clinical significance to correctly judge the condition and to determine optional treatment measures.

Objective Stress radiography provides an objective tool to measure posterior knee instability.This study was conducted to evaluate the intraobserver and interobserver reliability of measurements using Telos device to quantify posterior knee instability,compared wim KT-1000 and PDT test for consistency analysis.Methods From October 2008 to June 2009,68 stress radiographs in 34 patients with posterior knee instability were taken using Telos device.The amount of posterior displacement on the radiographs was measured independently by 2 surgeons on 2 separate occasions.Changes in intraclass correlation coefficients(ICCs)were examined to assess the intraobserver and interobserver reliability of the measurement,and were compared with those from KT-1000 and PDT test for consistency analysis.Results Intraobserver ICC was 0.992,while interobserver ICC Was 0.991.There was no significant difierence between Telos and KT-1000 in pair-t test.The data from Telos device was consistent with KT-1000.The coincident ratio Of PDT test was 20% while the posterior displacement of the tibia calculated on stress radiography was 5-10 mm.The coincident ratio of the PDT was 71.4% while the posterior displacement of the tibia calculatcd from stress radiography was 10-15 mm.Conclusion Using Telos device for stress radiograph provides a reproducible method to quantify posterior knee instability,and the consistency between Telos divece and KT-1000 was reliable.The coincident ratio of the PDT test with stress radiography increased when the posterior displacement of the tibia from stress view became more severe.

Objective: To investigate the influencing factors of lumbar disc herniation (LDH) among elderly patients with osteoporosis (OP), so as to provide the basis for early prevention of LDH in OP patients. Methods: The patients aged 60 years and above with OP who were treated in the clinic of Beijing Jishuitan Hospital from December 2022 to December 2023 were recruited as the study subjects. The data of demographic and clinical information were collected through the hospital medical record system. LDH was diagnosed according to the LDH Diagnosis and Treatment Guidelines. Factors affecting LDH among elderly patients with OP were identified using a multivariable logistic regression model. Results: A total of 500 patients with OP were included, with 188 males (37.60%) and 312 females (62.40%). The mean age was (69.05±3.28) years, and the course of OP was (6.37±2.11) years. There were 196 patients living alone, accounting for 39.20%. LDH among elderly patients with OP were detected in 78 cases, accourcing for 15.60%. Multivariable logistic regression analysis showed that the patients who were at ages of 70 years and above (OR=1.465, 95%CI: 1.197-1.793), lived alone (OR=1.777, 95%CI: 1.093-2.889), had a history of fracture (OR=1.799, 95%CI: 1.070-3.023) and scored higher in quality of life (OR=1.405, 95%CI: 1.230-1.605) were at higher risks of LDH, while the patients who had a history of taking calcium supplements (OR=0.562, 95%CI: 0.345-0.915) were at lower risks of LDH. Conclusion Age, living situation, history of fracture, history of taking calcium supplements and quality of life were influencing factors for LDH among elderly patients with OP.

Colitis, Ulcerative ; Humans ; Infant, Newborn ; Male

Objective:To describe the clinical results of a one-stage operation for posterior cruciate ligament reconstruction and a posterolateral corner reconstruction of popliteus tendon reconstruction,com-pared with an open popliteofibular ligament reconstruction.Methods:Our study included 33 patients who had undergone posterior cruciate ligament reconstruction with use of an achilles tendon-bone allograft and posterolateral corner reconstruction with arthroscopic anatomical reconstruction of popliteus tendon or open reconstruction of popliteofibular ligament.The patients were assessed for knee instability with use of the dial test at 30°and 90°,together with posterior stress radiography and KT-1000 measurement.Re-sults:The mean time of follow-up was more than 2 years.At the final follow-up evaluation,the tibial posterior translation as measured by stress radiography at 90°of knee flexion,the anterior-posterior trans-lation as measured by KT-1000,and the external rotation of tibia as measured by dial test were reduced postoperatively (P<0.001 )in both groups.Between the two groups,the preoperative tibial posterior translation as measured by stress radiography and the preoperative mean anterior-posterior translation as measured by KT-1000 in the popliteofibular ligament group were a little more than those in the popliteus tendon group (P=0.014,P<0.001).But the other comparisons were not significantly different (P>0.05).The final flexion losses were 3.33°±4.88°and 3.06°±3.38°for the two groups.Conclusion:Combined with posterior cruciate ligament reconstruction,anatomical posterolateral corner reconstruc-tion of the popliteus tendon and open reconstruction of popliteofibular ligament showed similar out-comes.This study demonstrated that both posterolateral corner reconstruction techniques were a reliable alternative method in addressing posterolateral corner and posterior cruciate ligament insufficiency of the knee.

Objective To evaluate the early clinical outcomes of anterior cruciate ligament(ACL)reconstruction combined with anterolateral tenodesis procedure in patient with high grade pivot-shift after ACL injuries.Methods Among the 140 patients diagnosed as ACL injury and undergoing operations in our hospital between June and December 2015,18 presenting high grade pivot-shift 2+ or 3+ under anesthesia were included into this study.During their surgeries,the anterolateral tenodesis procedure using iliotibial tract ITB was applied together with ACL reconstruction.The anteroposterior stability of the knee was examined and pivot-shift test was conducted right after the operation as well as 6 and 12 months after that.The Lysholm score was used to evaluate the clinical function of their knees.Results The mean follow-up period of the 18 patients was 12.7 ± 2.4 months.There were 14 males and 4 females,with an average of 28.3 ± 7.1 years.No patients complained about unstable symptoms during the follow-up.The mean side-to-side difference of anteroposterior knee laxity assessed using KT1000 at 30 degree knee flexion was 2.3 ± 0.7 mm,which was significantly improved compared with preoperative assessment(9.2 ± 2.6 mm)(P＜0.01).For the preoperative examination,the pivot-shift examination indicated 2+ in 13 patients and 3+ in 5 patients.However,all were negative right after the operation.Seventeen patients presented negative pivot-shift at the final follow-up,while 1 had 1+ rotational laxity.Significant differences were found in the Pivot-shift test before and after the operation.The average Lysholm score improved significantly from 67.7 ± 5.9(ranging from 55 to 78)before the operation to 89.0-± 4.6(ranging from 75 to 95)after that.Conclusion The high grade pivot-shift rotational instability could be effectively restored using the anterolateral tenodesis procedure,in addition to ACL reconstruction.The early stage clinical outcomes indicate significant improvement of the knee stability postoperatively.

ObjectiveTo retrospectively determine the prevalence of Ramp lesion (the peripheral attachment of the posterior horn of the medial meniscus) of the posterior horn of the medial meniscus with concurrent anterior cruciate ligament(ACL) ruptures and analyze the relevant risk factors.MethodsFrom April 2002 to October 2007,868 consecutive knees were diagnosed as ACL injury and received arthroscopic surgery for ACL reconstruction(ACLR).All the patients were verified for the tears of Ramp area under arthroscopy.The prevalence of Ramp lesion was evaluated respectively.Then all cases were divided into different groups depending on the time interval from ACL injury to ACLR (TFI) and other relevant risk factors as age and gender.ResultsAmong 868 knees underwent surgery for ACLR,144 knees were diagnosed as Ramp lesion.The average age was 24.7 years,113 males,31 females.The mean TFI to ACLR was 29.3months.The prevalence of Ramp lesion was 16.59％,which was analyzed as logarithmic correlation with TFI.Patients younger than 30-year old and male patients had significant higher prevalence of Ramp lesion.ConclusionRamp lesion is a common meniscus injury that can occur at the time of ACL rupture or as a result of knee laxity associated with ACL insufficiency.The prevalence of Ramp lesion is 16.59％ which increases with time until 24 months after initial injury.Patients younger than 30-year old and male patients have higher prevalence of Ramp lesion.

Aiming at the missing links in traditional models of ideological and political course in medical colleges of our country,we built the3+3+3model teaching paradigm,and selected students of medical laboratory and pharmaceutical profession as the research object to put this mode into practice.We issued questionnaires and test to evaluate teaching effect.The study showed that this model could make up for the loss of traditional teaching pattern,which verified the effectiveness and the significance of the teaching reform.The shortcomings as well as its future direction was also made clear.