[Objective] To investigate all-inside techniques for repairing lateral meniscus anterior horn tear with cysts.[Methods]Nineteen patiants with lateral meniscus anterior horn tear with cysts were collected from August 2006 to May 2008 with 7 males and 12 females.Five cases of isolated memberane cysts and 14 of lateral meniscus anterior horn tear with cysts were analyzed by MRI.Fifteen cases of lateral meniscus anterior horn tear with cysts and 4 of isolated memberanes cysts were finally diagnozed by arthoscopy.The apparatus of shoulder arthoscopy to sutured lateral injuried meniscus anterior horn were used after sheared cysts.Lysholm scores before and after operation were compared.Re-arthoscopy evaluation was performed for 13 patients.[Results]No case had complication after operation during short-term follow-up.Preoperative Lysholm scores was(64?5)points,postoperative scores was(94?7)ponits.Lysholm scores had significance between preoperation and postoperation(P

Objective To investigate the cost-effectiveness of cefoperazone sulbactam sodium in treating nosocomial infection (lower respiratory tract infection).Methods 80 cases of nosocomial infection in Jincheng Second People's Hospital from January 2014 to January 2017 were treated as the subjects: the observation group was treated with cefoperazone sulbactam sodium and the control group was treated with cefodizime sodium.The data of two groups of patients were recorded and the data were analyzed statistically.The cost-effectiveness of cefoperazone sulbactam sodium in hospital infection was discussed.Results There was no significant difference in the clinical curative effect between the two groups.The cost of observation group (cefoperazone sulbactam sodium) was lower than that of the control group (cefodizime sodium), the difference was statistically significant (P< 0.05).Conclusion Patients with nosocomial infection choose to use cefoperazone sulbactam sodium as the treatment method, which has exact clinical efficacy, high cost-effectiveness.It is worthy of clinical wide application.

OBJECTIVETo compare the efficacy difference in the treatment of senile insomnia among western, medication, acupuncture and the integrated therapy of acupuncture and western medication.

METHODSNinety-eight patients of senile insomnia were randomized into a western medication group (30 cases), an acupuncture group (35 cases) and an integrated acupuncture and medication group (35 cases). In the western medication group, estazolam 1mg was prescribed, taken 30 min before going to bed, oryzanol 20 mg, oral administration, three times a day, for 4 weeks totally. In the acupuncture group, the simple acupuncture therapy was applied at Shenmen (HT 7), Sanyinjiao (SP 6), Anmian (Extra), Baihui (GV 20) and Sishencong (EX-HN 1), as well as the supplementary points selected according to the differentiation. The acupuncture treatment was given once a day, 5 treatments a week, for 4 weeks totally. In the integrated acupuncture and medication group, the western medication was combined with acupuncture. The dosage and usage of western medication were same as those in the western medication group; and acupoints in acupuncture treatment were same as those in the acupuncture group. The treatment lasted for 4 weeks in the three groups. Pittsburgh sleep quality index (PSQI) and clinical efficacy were observed before treatment, after 4 weeks' treatment and in 4 weeks after discontinuity of treatment in the three groups.

RESULTSFour weeks after treatment, the clinical curative rates were 3. 3% (1/30), 21. 2% (7/33) and 25. 7% (9/35) in the western medication group, the acupuncture group and the integrated acupuncture and medicines group separately. The total effective rates were 70. 0%(21/30), 93. 9%(31/33) and 97. 1%(34/35) in the three groups separately. The curative rates and the total effective rates in the integrated acupuncture and medication group and the acupuncture group were higher than those in the western medication group separately (all, P<0. 01). PSQI scores after 4 Weeks' treatment were all improved as compared with those before treatment in the three groups (all P<0. 05). PSQI score in either the integrated acupuncture and medication group or the acupuncture group was lower than that in the western medication group, indicating the significant difference (both P< 0. 05). Four weeks after discontinuity of treatment, the efficacy was stable in the acupuncture group and the integrated acupuncture and medication group. PSQI score did not change as compared with that in the 4th week of treatment. The score in the western medication group ran back, close to that before treatment (P>0. 05). During the treatment, a few patients had dry mouth in the western medication group. The adverse reactions were not discovered in the other two groups.

CONCLUSIONThe integrated therapy of acupuncture and medication achieves the quick efficacy on senile insomnia and rapidly relieves the symptoms, with quite high clinical curative rate and total effective rate obtained. The long-term efficacy is better than that of western medication. The integrated therapy is the first option among the three therapeutic programs.

Acupuncture Points ; Acupuncture Therapy ; Administration, Oral ; Aged ; Aged, 80 and over ; Combined Modality Therapy ; Estazolam ; administration & dosage ; Female ; Humans ; Male ; Phenylpropionates ; administration & dosage ; Sleep Initiation and Maintenance Disorders ; drug therapy ; therapy ; Treatment Outcome

OBJECTIVE:To compare clinical efficacy of bivalirudin vs. tirofiban combined with heparin in the treatment of acute ST elevation myocardial infarction (STEMI) complicated with diabetes mellitus (DM). METHODS:195 patients diagnosed as STEMI complicated with DM were selected for retrospective study,and divided into bivalirudin group(100 cases)and tirofiban group(95 cases)according to the different treatment plan. All patients received emergency PCI within 12 hours and conventionally took aspirin and clopidogrel before and after PCI. Bivalirudin group was given bivalirudin 0.75 mg/kg intravenously before PCI, and continuous intravenous dripping of 1.75 mg/(kg·h)till the end of operation. Tirofiban group was given heparin 100 U/kg and ti-rofiban 10 μg/kg intravenously before PCI,and continuous intravenous dripping of 0.75 μg/(kg·h)tirofiban for 36 h. Postoperative reperfusion indexes,UCG monitoring indexes and safety were compared between 2 groups,and the content of serum BNP were compared before and after treatment. RESULTS:For the TIMI grade,TIMI frame count,the peak of CK-MB and peak time,ST segment decline percentage immediately after PCI,contents of serum BNP,LVEF,LVESD,LVEDD 7,30 d after treatment,the differences were not statistically significant between 2 groups (P>0.05). The incidence of MACE events was 36.8% in tirofiban group and 41.0% in bivalirudin group,there was no statistical significance between 2 groups(P>0.05). The incidence of bleeding events was 24.2% in tirofiban group and 7.0% in bivalirudin group,the difference was statistically significant (P<0.05). CON-CLUSIONS:Bivalirudin and tirofiban combining with heparin have same efficacy in the treatment of STEMI complicated with DM,while bivalirudin may significantly reduce the incidence of bleeding events during primary PCI.

Programmed death-1 (PD-1) and its ligand PD-L1 are the major members of inhibitory costimulatory molecules and express high in a variety of tumor cells and their associated cells surface,while the proportion of regulatory T cells (Tregs) are abnormally elevated in tumor infiltrating T lymphocytes cells.PD-L1 combined with PD-1 and Treg help tumors evade immune clearance,weaken immune responses and induce immune tolerance.New researches find that PD-L1 plays an important role in the development and function maintenance of inducible Treg (iTreg),and PD-L1 signal can change initial CD4 + CD25-T cells into iTreg to play a role of immunosuppression.Research on PD-1 signaling pathway can provide a new theoretical basis for the inhibition of tumor immune escape in clinical application of immunotherapy and better treatments.

Objective To investigate the risk factors of incision infection in elderly patients of general surgery.Methods The clinical data of 306 elderly patients of general surgery were analyzed retrospectively.The risk factors of incision infection were analyzed.Results The rate of incision infection was 10.5％ (32/306).The rate of incision infection in chronic disease patients was higher than that in non-chronic disease patients [12.9％(27/210) vs.5.2％(5/96)],the rate of incision infection in summer was significantly higher than that in spring,autumn and winter[16.3％(15/92) vs.8.4％(7/83),8.5％(6/71) and 6.7％ (4/60)],the rate of incision infection in operative time longer than 120 min patients was higher than that in operative time less than 120 min patients [15.0％ (18/120) vs.7.5％ (14/186)],the rate of incision infection in emergency surgery patients was higher than that in non-emergency surgery patients [12.3％ (20/162) vs.8.3％(12/144)],there had significantly difference (P＜ 0.05).Conclusion Chronic disease,summer,operative time longer than 120 min,emergency surgery in elderly patients are the mainly risk factors of incision infection in general surgery.

To investigate and analysis the multiple medical adverse events about disposable umbilical cord clamp during clinical using in Zhejiang province, and put forward some opinions some suggestions to improve the processing technology, to strengthen the professional training of medical staff in medical institutions of umbilical cord clamp using, and to take precautions against more adverse events.
Disposable Equipment ; Humans ; Product Surveillance, Postmarketing ; Umbilical Cord

Background Retinal vascular caliber changes can reflect the development status of cardiovascular disease and diabetes-associated vascular diseases,so it is very important to quantitatively measure retinal vascular caliber in the study of systemic diseases and retinal vascular disease.However,the methodology study is rately seen in China within our knowledge.Objective The present study was to investigate the repeatability and reproducibility of IVAN software in measuring retinal vascular caliber.Methods This study was approved by Ethic Committee of Affiliated Hospital of Inner Mongolia Medical University,and written informed consent was obtained from each subject prior to medical examination.A prospectively diagnostic trail was performed.The digitized fundus color photograph centered on the disc from 192 eyes of 96 healthy volunteers were collected in Affiliated Hospital of Inner Mongolia Medical University from January,2013 to December,2014,and central retinal arteriolar equivalent (CRAE),central retinal venular equivalent (CRVE) and arteriovenous ratio (AVR) were analyzed by IVAN measurement software.The repeatability and reproducibility of IVAN software for random repeat measurement of retinal vessel caliber from consecutive 85 right eyes of 85 volunteers were evaluation by interobserver and intraobserver measurement with interclass correlation coefficient (ICC).The correlations of measuring results between two observers or two-time measuring were analyzed with Pearson linear correlation analysis.Bland-Altman agreeement analysis was employed to assess the agreeement of the outcomes.Results No significant differences were found in CRAE,CRVE and AVR between the right eyes and the left eyes (t=-1.009,1.090,-1.259,all at P＞0.05).The CRAE,CRVE and AVR values from observer 1 were (145.02±12.94) μm,(400.72±9.12) μm and 0.36±0.03,and those from observer 2 were (145.10 ± 11.86) μm,(401.17 ± 9.85) μm and 0.36 ± 0..03,with no significant differences between observer 1 and observer 2 (t =-0.074,-0.913,0.116,all at P＞0.05).The repeat CRAE,CRVE and AVR values from observer 1 were (145.02 ± 12.94) μm,(400.72 ±9.12) μm and 0.36 ±0.03,which were significantly different from the initial values (t =-0.777,-0.048,-0.745,all at P＞0.05).In two-time measurements of intraobserver,all ICC were ≥0.738 and showed good correlations (all at r≥0.739).The two measurements of interobserver,showed good correlations (r≥ 0.662),with all ICC ≥ 0.657.Bland-Altman plots showed good agreements in CRAE and CRVE measurement with 95％ limits of agreement(LoA) ranged from-18.5 μm to 17.3 μm and-9.8 μm to 9.6 μm in intraobserver,and from-19.3 μm to 20.0 μm and-10.2 μm to 9.0 μm in interobserver,respectively.Conclusions IVAN measurement software yields good repeatability and reproducibility in the quantitative measurement of retinal vascular caliber.

Immunology teaching course includes both basic immunology and clinical im-munology.This paper points out the problems of teaching and knowledge integration between the basic immunology and clinical immunology and suggests that teaching team should include the basic immunology and clinical immunology related content clinical experts to promote teaching quality.

Purpose To investigate the imaging features of lumbar spinal epidural angiolipoma, and to improve the imaging diagnostic capability of the disease. Materials and Methods Four patients with lumbar spinal epidural angiolipoma confirmed by pathology were recruited in the study. CT and MRI images were reviewed and the imaging characteristics including the shape, size, location, density, and signal intensity were analyzed. Results The lesions located at the right front of the spinal canal in two cases, at the left front in one case, and the residual one case located directly behind the spinal canal. The longitudinal axis of the lesions paralleled to the longitudinal axis of the spine. The dura mater spinalis was compressed and inward shifted. All of the four cases showed homogeneous iso- or hypo-density on CT without calcification or necrosis in the lesions. The maximum diameter was 3 to 5 cm. The boundary was clear and smooth. Three lesions showed dumbbell-shaped and crossed foramen, but the adjacent bone were not absorbed or destructed. One lesion showed scallop-like. On MRI, four cases displayed slightly hypointense on T1WI and hyperintense on T2WI. On STIR images, the lesions showed hyperintense with patchy low signal intensity in it. The boundary of the lesions was clear. After administration of contrast media, two lesions presented remarkably homogeneous enhancement, one lesion showed dual tail sign, and one lesion displayed pen-tip-like at the both ends. Conclusion MRI plays an important role in locating the lesion and distinguishing internal tissue components of spinal angiolipoma, which is the gold standard for the diagnosis of the tumor. CT provides excellent supplement. The Combination of CT and MRI will improve the diagnostic accuracy of the spinal angiolipoma.