Objective To explore the curative effect of clinical application of modified McBride's procedure on correcting mild-moderate hallux valgus.Methods We had retrospectively assessed 32 patients(52 feet)treated with the procedure of modified McBride's procedure.All patients were followed up,the follow -up period from 6 months to 6 years(3.1 years on average).There were 2 male(4 feet)patients and 30 female(48 feet)patients in this group.The average age at the time of surgery was 41.6 years old(from 21 to 59 years).Results According to the forefoot score of American Orthopedics Foot and Ankle Society(AOFAS),29 feet(55.8%)were excellent,17 feet (32.7%)were good,And the rate of excellent and good was 88.5%.The average correction of HVA and IMA was 13.68°and 3.24°respectively compared with the preoperative cases.Conclusion This procedure can not only effec-tively reduce the increased hallux valgus angle,but also narrow the angle between the 1st and 2nd metatarsal,relocate the sesamoid system,and effectively relieve patients'pain.This approach is of minor side effects to bone and joint structure,and of rapid recovery.It is a preferential choice to treat mild-to-moderate hallux valgus deformity.

Objective To investigate the prognostic value of serum adenosine deaminase(ADA)and plas-minogen activator inhibitor 1(SERPINE1)levels in patients with type 2 diabetes mellitus(T2DM)complicat-ed with acute cerebral infarction(ACI).Methods A total of 195 patients with T2DM combined with ACI(ACI group)and 174 patients with T2DM alone(control group)admitted to Xi'an Labor Union Hospital from March 2019 to March 2023 were selected.The levels of serum ADA and SERPINE1 were compared be-tween ACI group and control group,and patients with different degrees of neurological defect and prognosis.The influencing factors of poor prognosis in T2DM patients with ACI were analyzed,and the value of each in-dex in predicting poor prognosis was evaluated.Results The levels of ADA and SERPINE1 in ACI group were significantly higher than those in control group(P＜0.05).With the aggravation of neurological deficit in T2DM patients with ACI,serum ADA and SERPINE1 levels increased(P＜0.05).The levels of serum ADA and SERPINE1 in the poor prognosis group were higher than those in the good prognosis group(P＜0.05).Severe neurological deficit and high levels of ADA,SERPINE1 and HbA1c were risk factors for poor prognosis in T2DM patients with ACI(P＜0.05).The area under the curve(AUC)of ADA combined with SERPINE1 for predicting the prognosis of T2DM patients with ACI was 0.896,which was higher than that of Ada and SERPINE1 alone(P＜0.05).Conclusion Elevated serum ADA and SERPINE1 levels are associated with severe neurological deficits and poor prognosis in T2DM patients with ACI.Combined detection of ADA and SERPINE1 can predict poor prognosis in T2DM patients with ACI.

OBJECTIVETo detect memory B lymphocyte (Bm) in peripheral blood (PB) of immune-related pancytopenia (IRP).

METHODS86 patients with IRP and 11 health volunteers were enrolled in this study. Bm (CD5⁺ CD19⁺ CD27⁺) and bone marrow mononucleated cell antibodies (BMMNC-Ab) were determined via fluorescence-activated cell sorting, and clinical outcomes of these patients were analyzed.

RESULTS(1)43 initial patients achieved obvious remission in all 52 initial cases after conventional immunosuppression therapy. 16 relapsed patients with IRP received Rituximab (RTX) and 14 cases achieved obvious remission, among which 7 cases were refractory to conventional immunosuppression therapy, 5 cases exhibited obvious remission, and 2 cases did not respond. Other 18 relapsed cases received conventional immunosuppression therapy and 13 cases achieved obvious remission. (1)The level of Bm in PB in 52 initial patients with IRP was(1.81 ± 0.97)%, and no significant difference was observed between the initial patients and health volunteers (1.75 ± 0.55)% (P>0.05). The level of Bm in PB in 34 relapsed patients with IRP was obviously higher than that in the initial IRP patients and health volunteers (P<0.05). Significant difference was observed in the level of Bm in PB in 16 relapsed IRP patients between pre-therapy and post-therapy with RTX (P<0.05). No statistical difference was found between the remission and no-response groups in relapsed patients treated with RTX. RTX regimen produced more effective outcome than conventional immunosuppression therapy, which better eliminated Bm than the latter (P<0.05). Initial patients with IRP who relapsed within a two-year follow-up period had a lower level of Bm in PB compared with un-relapsed patients (P<0.05). Majority of BMMNC- Ab antibodies in relapsed patients were IgG (82.4%) and IgM (69.2%) autoantibodies in patients with initial IRP.

CONCLUSIONThe level of Bm in PB was associated with relapsed patients with IRP. Bm did not respond to conventional immunosuppression therapy,but responded to RTX.

Adolescent ; Adult ; Antibodies, Monoclonal, Murine-Derived ; therapeutic use ; B-Lymphocyte Subsets ; immunology ; Female ; Humans ; Immunologic Memory ; Immunosuppression ; Male ; Middle Aged ; Pancytopenia ; immunology ; therapy ; Recurrence ; Rituximab ; Treatment Outcome ; Young Adult

OBJECTIVETo investigate the changes of relative telomere length (RTL) of peripheral blood (PB) CD3⁺, CD3⁺CD4⁺, CD3⁺CD8⁺T lymphocytes, CD19⁺B lymphocytes and bone marrow (BM) CD34⁺ cells and its association with disease severity in untreated patients with immuno-related pancytopenia (IRP).

METHODSThe PB CD3⁺ , CD3⁺ CD4⁺ , CD3⁺ CD8⁺ T lymphocytes, CD19⁺ B lymphocytes, and BM CD34⁺ cells were purified by magnetic activated cell sorting (MACS), and RTL were measured with flow-fluorescence in situ hybridization (FLOW-FISH).

RESULTSThe RTL of CD3⁺, CD3⁺CD4⁺ , and CD3⁺CD8⁺T lymphocytes in untreated IRP patients were (27.754 ± 16.323)%, (7.526 ± 3.745)% and (25.854 ± 14.789)%, respectivly, which were significantly shorter than those in healthy-controls (54.555 ± 19.782)%, (12.096 ± 2.805)%, and (38.367 ± 4.626)% (P<0.05). The RTL of CD19⁺ lymphocytes in untreated IRP patients was (22.136 ± 16.142)%, which was significantly shorter than that in healthy controls (42.846 ± 16.353)% (P<0.01). There was no significant difference of BM CD34⁺ cells RTL between the untreated IRP patients (22.528 ± 21.601)% and the healthy controls (23.936 ± 19.822)% (P>0.05). There were significantly positive correlations between the RTL of B lymphocytes and the count of white blood cell (r=0.706, P=0.015). There were negative correlations between RTL of B lymphocytes and the clinical symptoms (r=-0.613, P=0.045) and positive correlations with therapeutic effect (r=0.775, P=0.005).

CONCLUSIONThe shorter RTL of CD3⁺, CD3⁺CD4⁺, CD3⁺CD8⁺, CD19⁺ lymphocytes, and the normal RTL of BM CD34⁺ cells in untreated IRP patients were identified, which might imply that IRP is a type of acquired autoimmune diseases.

Adolescent ; Adult ; B-Lymphocyte Subsets ; immunology ; Child ; Female ; Humans ; Lymphocytes ; ultrastructure ; Male ; Middle Aged ; Pancytopenia ; immunology ; pathology ; T-Lymphocyte Subsets ; immunology ; Telomere ; ultrastructure ; Young Adult