Objective To investigate the influence of Zafirlukast on the inflammatory factors and immune function of patients with seasonal allergic asthma.Methods 182 patients with seasonal allergic asthma from the department of respiratory in our hospital were selected and divided into two groups, 91 cases in each group.The control group treated with budesonide and formoterol fumarate powder for inhalation, the experiment group received Zafirlukast on the basis of the control group,serum levels of inflammatory cytokines,peripheral blood T lymphocyte subsets,serum immunoglobulin levels, lung function,and the clinical effect were compared after the treatment.Results Compared with the control group, serum levels of TNF-,IL-4,IL-6 were lower, level of IL-10 was higher in the experiment group after treatment, CD8 +T lymphocyte levels was lower, CD3 +, CD4 +T lymphocyte and CD4 +/CD8 +ratio levels were higher after treatment, serum levels of IgE, IgG, IgA were lower after treatment, levels of PEF,FEV1 ,FEV1/FVC were higher after treatment, the difference was statistically significant (P<0.05).The effective rate in the experiment group 94.51% was higher than the control group 81.32% (P<0.05).Conclusion Zafirlukast can significantly reduce the levels of serum inflammatory factors in patients with seasonal allergic asthma, improve the cellular immune function, reduce the level of immunoglobulin, effectively improve lung function, shorten the length of hospital stay, has better clinical curative effect.

Objective To investigate the effect of methylprednisolone (MP) combined with puerarin in preventing the spinal cord ischemia-reperfusion injury (SCII).Methods The model of ischemia-repeffusion injury was established by clipping the abdominal aorta of rats for 30 min.Eighty male SD rats were randomly and equally divided into 4 groups: the blank group in which the abdominal aorta was only exposed,the positive drug group in which intravenous MP injection (30 mg/kg) was conducted 30 min before the establishment of the ischemia-reperfusion injury model,the therapy group in which intravenous MP (10 mg/kg)and puerarin (30 mg/kg) injection was conducted 30 min before the establishment of the model,and the model group in which the physiological saline equivalent to the volume of MP in the positive drug group were injected into the caudal vein of rats 30 min before the establishment of the model.Ten rats were taken from each group and the homogenation of the spinal cord was used to test expression level of superoxide dismutase (SOD) and sodium-potassium adenosinetriphosphatase (Na-K ATPase).For another 10 rats in each group,the BBB scoring system was used to evaluate the neural function of the hind limb immediately after recovery from anesthesia,12 h and 24 h after reperfusion,and the spinal cord was obtained 24 h after reperfusion to observe the morphous of the spinal cord neurons.Results The expression levels of SOD and Na-K ATPase in the model group,positive drug group and therapy group 3 h after reperfusion were significantly lower than that in the blank group; the expression levels of SOD and Na-K ATPase in positive drug group and therapy group were significantly higher than that in the model group,and there was no significant difference between the positive drug group and the therapy group with regard to the levels of SOD and Na-K ATPase.The BBB score was better in the positive drug group and the therapy group than those in the blank group and model group.Microscope observation showed that the degree of injury between positive drug group and therapy group was equivalent,while each of them was lower than that in the model group.Conclusion MP combined with puerarin plays a great role in the prevention of the SCII.

Objective To study the application of extracellular laccase from endophytic fungi to total flavonoid extraction. Methods The extracellular laccase vitality of an endophytic Fusarium sp.C-8 from Artemisa annua reached 36.1 U/mL when the fungus was cultivated in revised PDA medium with initial pH 7.0 at 20℃ on a rotary shaker incubator for 6 d. The crude laccase from the cultural medium was applied for extraction of flavonoid from the buds of Sophara japonica. The optimization on the ratio of dry buds to crude enzyme liquid,temperature,time,and pH value was carried out during the process of laccase-assistant treatment. Results After incubation with 40∶1 of crude enzyme (pH 7.0) at 20℃ to dry buds for 1 h,the extraction rate of total flavonoids was 11.4 %,a more increase of 28.7 % than that in regular extraction process. Conclusion The results present a practical method of laccase-assistant extraction process on total flavones in S. japonica buds.

Objective:To evaluate the curative efficacy of a buttress plate combined with Kirschner wires for treatment of Regan-Morrey type Ⅱ coronoid fracture after elbow terrible triad injury.Methods:A retrospective study was conducted of the 20 patients who had been surgically treated for Regan-Morrey type Ⅱ coronoid fracture after elbow terrible triad injury from August 2014 to August 2018 at Department of Pelvic Trauma, Henan Luoyang Orthopedic-Traumatological Hospital. They were 12 men and 8 women, aged from 18 to 60 years (average, 39 years), with 6 left and 14 right sides affected. All the coronoid fractures were fixated with Kirschner wires plus a buttress plate through the anterior approach, the radial head and lateral collateral ligaments (LCL) were repaired through the posterolateral approach, and the medial collateral ligament (MCL) was repaired or fixated with a hinged external fixator if necessary. The curative efficacy was evaluated at the last follow-up by range of motion (ROM) of the elbow, Mayo elbow performance score (MEPS), American Shoulder and Elbow Surgeons Scale (ASES) and radiographs of the elbow. Complications were also recorded.Results:The mean follow-up time was 18 months (from 12 to 24 months) and the mean healing time 5 months. At the last follow-up, ROM in flexion and extension of the affected elbow joint averaged 132.5°, ROM in elbow pronation-supination 150°, MEPS 88, and ASES 87. No subluxation or dislocation occurred after elbow surgery. The fracture of coronoid process was slightly displaced in one case but eventually healed without affecting any elbow function; fat liquefaction occurred around the posterolateral incision in 2 cases but healed after debridement; traumatic arthritic changes occurred in 5 patients but no significant dysfunction of the elbow was observed.Conclusion:A buttress plate combined with Kirschner wires can lead to fine curative efficacy for Regan-Morrey type Ⅱ coronoid fracture after elbow terrible triad injury.

Objective To explore the indication and the functional advantages of the high-flexion posterior stabilized (PS) rotating-platform mobile-bearing (RP-MB) total knee system. Methods A prospective randomized, controlled trial was performed. Osteoarthritis was the indicators for total knee arthroplasty.From Feb. 2009 to Apr. 2009, 75 patients (94 knees) were randomly assigned to to receive either a highflexion PS, RP-MB total knee system(PFC sigma RPF) or a standard one (PFC sigma RP). There were no statistical difference in the baselines, the preoperative scores of the Hospital for Special Surgery (HSS) and the knee range of motion (ROM) of both groups. The functional status were assessed with Hospital for Special Surgery and the ROM of the knee at the postoperative 1, 6, 12, 18 months. The satisfaction rates were assessed at the postoperative 18 months. The radiographic measurements were t assessed at the postoperative 3days and 3, 6, 12, 18 months. Results A total of 70 participants (87 knees) completed the 18-month followup. At the time of the final follow-up, the average Hospital for Special Surgery knee score was 92.4±5.0points in the standard group and 94.7±7.0 points in the high-flex ion group. The difference was not statistically significant(P ＞0.05). The average maximal flexion was 131.9±14 degrees in the high-flexion group and 123.0±15.3 degrees in the standard group. There was a statistical difference. But it was not enough to confirm our hypothesis that the difference should be higher than 10 degrees. Moreover, the satisfaction rate were 100% in both groups, and no statistical significant difference was found. Conclusion No significant differences were found between standard and high-flexion posterior-stabilized rotating-platform mobile-bearing total knee prostheses in terms of clinical outcomes or range of motion.

Objective To assess the different methods and their outcomes of interventional therapy for stenosis or occlusion in superior vena cava and its branches. Methods Sixty patients with stenosis or occlusion of SVC and its branches were retrospectively analyzed after interventional therapy. Among them, 38 were males and 22 were females, with age range from 15 to 72 years old(mean age 58). Seventeen patients were treated by thrombolysis, and the rest 43 patients accepted percutaneous angioplasty and stenting. Before and after that, the pressures within the vein were measured at the inflow side. The paired-t test was used for statistical analysis. Results After treatment, the pressure at the inflow side dropped from (24.8±2.3)mm Hg to (7.1±1.5)mm Hg(1 mm Hg=0.133 kPa), with a significant difference(t=3.232,P＜0.01). The clinical outcomes included complete relief in 27 patients, partial relief in 28 patients and non-relief in 5 patients. No major complications occurred. During 6 months follow up, restenosis occurred in 10 patients, among whom 6 received repeat intervention with good results. The other 4 patients turned to surgery .Conclusion Interventional therapy for stenosis or occlusion in SVC and its branches could recanalize the vessels, restore the blood flow and relief the clinical symptoms.

Objective To analyze the cause and treatment of the postoperative complications using one-stage posterior spinal osteotomy in the treatment of severe spinal deformity.Methods From September 2006 to May 2013,17 patients with severe spinal deformity (congenital scoliosis in 11 cases,congenital kyphosis in 4 cases,and congenital kyphoscoliosis in 2 cases) underwent one-stage posterior spinal osteotomy,including 5 males and 12 females with an average age of 22.6 (14-51) years.The preoperative mean coronal Cobb angle was 109° (85°-160°) while the mean sagittal Cobb angle was 104° (65°-152°).Two patients had neurological symptoms preoperatively whose spinal cord function was D,evaluated by ASIA classification.All patients were treated with pedicle subtration osteotomy and pedicle screw internal fixation,which SPO osteotomy 2 cases,PSO osteotomy 11 cases,VCR osteotomy 4 cases.Results There were 17 cases of complications in 147 patients,the complication rate was 11.6％(17/147).The causes were as followed,screw malposition in 2 cases,compromised by close of resected areas in 2 case,residual bone compression in 1 case,acute spinal cord injury in 2 cases,infection in 2 cases,broken stick or loosen hat in 3 cases,and superior mesenteric artery syndrome in 5 cases.Postoperative neurological complications occurred in 7 cases.Two cases with preoperative ASIA D became ASIA C,5 cases with normal nerve function became ASIA C in 2 cases and ASIA D in 3 cases.After surgical exploration,given Methylprednisolone and neurotrophic drugs,removal or changing of the internal fixation,anti-infection and symptomatic treatment,15 cases recovered completely and 2 cases improved partially.Conclusion One-stage posterior spinal osteotomy for severe spinal deformity is technical demanding and risky,and the postoperative complications are common.Appropriate operative procedure,close observation of sensation and motor function,timely surgical exploration and nerve decompression,and early brace wear are all required.

BACKGROUND:Idiopathic scoliosis is most common among al the scoliosis. Accompanied by the nervous system, the endocrine system as wel as nutritional and metabolic abnormalities, patients usual y cannot be redressed and cured by conservative treatment, but often require surgical operation. Surgery for malformation is a very complicated project, and is real y of great significance for an in-depth research on treatment and turnover of idiopathic scoliosis.
OBJECTIVE:To observe the correction effect of posterior screw-rod fixation for idiopathic scoliosis, and explore the relevant factors influencing its effectiveness.
METHODS:We retrospectively analyzed 80 cases receiving pedicle screw fixation in the treatment of idiopathic scoliosis in the latest four years. Age, gender, disease duration, preoperative and postoperative X-ray measurement of coronal Cobb’s angle, and trunk deviation were recorded, and statistical y analyzed.
RESULTS AND CONCLUSION:Univariate analysis showed that gender and disease duration were not significantly correlated with postoperative correction results (P>0.05). However, the age distribution of patients, the location of scoliosis, and scoliosis flexibility were associated with curative effects of internal fixation (P<0.05). Posterior screw-rod fixation for idiopathic scoliosis can achieve significant effects. The patient’s age, location and flexibility of scoliosis have a significant effect on the effects of fixation. The patient’s gender and disease duration had no significant effect on fixation effects.

Objective:To explore the price formation method and price standard in the big data diagnosis-intervention packet.Methods:The expenditure data and income data of 95 medical institutions in Shanghai in 2018 were used for analysis, including 33 municipal hospitals and 62 district hospitals. After using the standardized data of disease score, the medical institutions in the region were divided into four quadrants with the regional average of unit price per index and cost per index as the coordinate axis. The best quadrant of income and cost was found out, namely the high quality range. The geometric center was calculated in the high quality range, and the unit price per index of the geometric center was taken as the cost standard.Results:For the district hospitals, there were 20 hospitals in the first quadrant, 8 in the second quadrant, 24 in the third quadrant and 10 in the fourth quadrant; For the municipal hospitals, there were 7 hospitals in the first quadrant, 5 in the second quadrant, 12 in the third quadrant and 9 in the fourth quadrant. In the third quadrant, the average income and cost of medical institutions were lower than the average of the city, and the income could cover the cost. The third quadrant was the high quality range. The unit price per index of the third quadrant geometric center of district hospitals was 14 115.4 yuan, and that in municipal hospitals was 15 559.1 yuan, which could be used as the corresponding cost standard.Conclusions:The price discovery mechanism based on objective data and high-quality interval geometric center method can remove the impact of unreasonable charges or unreasonable behavior on medical income, and reflect the guidance of the standard price of medical insurance payment.

Hypoxia is an important basic feature of the solid tumor microenvironment. With the deepening of the research on the pathogenesis of renal cell carcinoma (RCC), the expression and function of hypoxia and hypoxia inducible factor (HIF) in RCC have attracted more and more attention. The hypoxia signal pathway has become a research hotspot of tumor and other diseases in recent years. This article reviews the current understanding of hypoxia signal pathway, its correlation with the occurrence and development of RCC, and the application prospect of HIF inhibitors, in order to guide the precise treatment of clinical RCC.