Objective To study the classification, management and outcome of the injury of hamatometacarpal joint. Methods Retrospective analysis was carried out in 17 patients with injury of hamatometacarpal joint. There were 16 males and 1 female aged 19-51 years old. 3 in left hand and 14 in right hand were injuried. The dominant hands of all were right hand. The injury of hamatometacarpal joint might be classified into 4 major groups based on the condition of the hamate, and subdivided into 2 subtypes based on the isolated dislocation(subluxation) or fracture-dislocation of metacarpal base. Carpometacarpal joint ligment injury without fracture of hamatum and the fourth or fifth metacarpal base dislocation without fracture was defined as typeⅠa. When there was a fracture of the fourth or fifth metacarpal base following typeⅠa was defined as typeⅠb. Avulsion fracture of the back of hamatum and the fourth and/or the fifth metacarpal base dislocation without fracture was defined as type Ⅱa. With the fracture of the fourth or fifth metacarpal base following the typeⅡa was defined as type Ⅱb. Splintered fracture of the back of hamatum with the fourth and/or fifth metacarpal base dislocation without fracture was defined as typeⅢa. With the fracture of metacarpal base following typeⅢa was defined as typeⅢb. The split fracture of coronal side of hamatum with the fourth and/or fifth metacarpal base dislocation and without fracture was defined as type Ⅳa. With fracture of the fourth and/or fifth metacarpal base following type Ⅳa was defined as type Ⅳb. There were 7 typeⅠb, 2 typeⅡa, 1 typeⅡb, 2 typeⅢb, 1 typeⅣa, 4 type Ⅳb in our group. We chose conservative or operative treatment according to the type of injury. Results The follow-up was 4-96 months. The patients had fracture union rate of 100%, and no traumatic osteoarthritis was occurred. There was a statistical significance when the motion of two-side joints was compared post surgery. There was no significant difference between bilateral hand in grip strength. Subjective evaluations of the patients were good or excellent. No complications was occurred. There is no case involved in any complications such as traumatic arthrositis, inflammation, neural injuries and adhesion of tendon. Conclusion The stable injury of hamatometacarpal joint should be ideally treated by closed reduction and immobilization in a well-moulded cast or splint. Satisfactory outcome can be got if keeping under strict surveillance. The unstable or intra-articular fracture should be treated by surgery. The outcome is also satisfactory and the rate of the complication of traumatic arthritis is low in short period follow-up. The outcome of fresh injury is much better than old one.

BACKGROUND:To inhibit the expressions of prothrombin activator inhibitor 1 and tissue plasminogen activator is one potential target for the treatment of cerebral infarction. OBJECTIVE:To investigate the expressions of serum inflammatory cytokines in rats with cerebral infarction undergoing bone marrow mesenchymal stem cel transplantation combined with edaravone. METHODS:Sixty Sprague-Dawley rats were enrol ed to prepare models of focal cerebral infarction by middle cerebral artery occlusion, and were randomly divided into four groups. Rats were given intravenous injection of PBS via tail veins for 5 consecutive days as model group, rats were subjected to intravenous injection of 2.0×109/L bone marrow mesenchymal stem cel suspension (1 mL) via tail veins, twice daily for 5 days as stem cel transplantation group, and those were given intravenous injection of 30 mg edaravone combined with intravenous injection of 2.0×109/L bone marrow mesenchymal stem cel suspension (1 mL) via tail veins for 5 days, twice daily, as combined group. RESULTS AND CONCLUSION:Compared with the model group, modified neurologic severity scores were lower, expressions of serum prothrombin activator inhibitor 1 and tumor necrosis factor-αmRNA in the brain decreased, and the infarct area reduced in the stem cel transplantation and combined groups. And the changed levels of above indicators in the combined group were significantly larger than those of the stem cel transplantation group. In conclusion, combination of bone marrow mesenchymal stem cel transplantation with edaravone can promote neural function recovery after cerebral infarction.

BACKGROUND:Numerous clinical studies have confirmed that the microenvironment at a spinal cord injury site can be obviously improved through hyperbaric oxygen therapy; however, what effect does hyperbaric oxygen have on the microenvironment of the injured brain? OBJECTIVE:To investigate the effect of hyperbaric oxygen therapy on nerve regeneration microenvironment and the recovery of rat nerve function after focal cerebral infarction. METHODS:Rat models of focal cerebral infarction were established by occlusion of the middle cerebral artery and subjected to hyperbaric oxygen therapy. Sham group and model group were established as comparison. In the sham group, rat models of focal cerebral infarction were established but did not receive any treatment. Rats in the model group were placed in a hyperbaric oxygen therapy chamber but the pressure and oxygen concentration were not administered. RESULTS AND CONCLUSION:Compared with the model group, the score of rat limb function at 16 days after treatment and the expression of growth associated protein 43 in the rat cerebral infarcted area at postoperative 14 days were significantly increased , but infarct volume at postoperative 24 hours was al significantly decreased in the hyperbaric oxygen therapy group (alP < 0.05). These results confirmed that hyperbaric oxygen therapy can improve nerve regeneration microenvironment and promote the recovery of rat nerve function after focal cerebral infarction.

BACKGROUND:Studies have shown that human telomerase reverse transcriptase (hTERT) has the ability to enhance cel proliferation, maintain telomere length, prolonged cel life cultured in vitro. OBJECTIVE:To observe the effect of hTERT gene-modified bone marrow mesechymal stem cel transplantation on neural function recovery of rats with cerebral infarction. METHODS:Rat models of middle cerebral artery occlusion were established and randomized into model group, cel transplantation group and hTERT-modified cel transplantation group, with 20 rats in each group. Rats in the three groups were respectively injected via tail vein with 1 mL PBS, passage 9 bone marrow mesenchymal stem cel suspension (2.5×107/L) and hTERT-modified passage 9 bone marrow mesenchymal stem cel suspension (2.5×107/L), respectively. Modified neurological severity scores were determined before and after transplantation; RT-PCR and western blot assay were used to measure hTERT expression at gene and protein levels; TUNEL method was adopted to detect cel apoptosis in the brain. RESULTS AND CONCLUSION:hTERT-modified bone marrow mesenchymal stem cels had prolonged cel cycle, and with the increase in passage number, the cels showed good growth with no changes in morphology. The expressions of hTERT mRNA and protein were superior in the hTERT-modified cel transplantation group than the cel transplantation group, and there was a significant difference (P < 0.05). Modified neurological severity scores and number of apoptotic cels were decreased significantly in the hTERT-modified cel transplantation group compared with the other two groups (P < 0.05). These findings indicate that hTERT-modified bone marrow mesenchymal stem cels can promote neural functional recovery of rats with cerebral infarction.

Objective To analyze the clinical data of brucellosis,and to provide references for brucellosis therapy.Methods The patients definitely diagnosed brucellosis at the First Affiliated Hospital of Zhengzhou University from January 2013 to June 2016 were assessed,data of clinical features,laboratory examination,treatment and prognosis were analyzed.Results Of all 99 cases,the mean age was (46.7 ± 15.7) years old,83 cases had a history of closely contacted with sheep,2 cases with pig and 1 case with cattle.The occupational distribution of patients included 90 farmers,1 veterinarian,2 cooks,6 children and students.All patients had clinical manifestations such as fever,fatigue,and sweating.There were 18 patients with back and joint pain,13 cases had abnormal manifestation on magnetic resonance imaging (MRI).Blood culture was positive in 54 (71.05％,54/76) and serum test tube agglutination test was positive in 61 (98.39％,61/62).Eighty-one patients received doxycycline combined with rifampicin treatment,six months laters,all patients were cured.Conclusions Sheep are the main sources of infection for brucellosis.Fatigue,sweaty and fever are the most common symptoms,and osteoarticular is the most frequently involved.Serum agglutination test and blood culture are important tests for diagnosis of brucellosis.Doxycycline combined with rifampicin was the most common used antibiotics regimen.Early,combined,regular,full-course antibiotic treatment has a better prognosis.

Objective: To investigate the efficacy and safety of the new investigational drug pegylated interferon α-2b (Peg-IFN-α-2b) (Y shape, 40 kD) injection (180 µg/week) combined with ribavirin in the treatment of patients with genotype 1/6 chronic hepatitis C (CHC), with standard-dose Peg-IFN-α-2a combined with ribavirin as a positive control. Methods: A multicenter, randomized, open-label, and positive-controlled phase III clinical trial was performed. Eligible patients with genotype 1/6 CHC were screened out and randomly divided into Peg-IFN-α-2b(Y shape, 40kD) group and Peg-IFN-α-2a group at a ratio of 2:1. The patients in both groups were given oral ribavirin for 48 weeks in addition and then followed up for 24 weeks after drug withdrawal. Abbott Real Time HCV Genotype II was used to determine HCV genotype, and Cobas TaqMan quantitative real-time PCR was used to measure HCV RNA level at 0, 4, 12, 24, 48, and 72 weeks. Adverse events were recorded in detail. The primary efficacy endpoint was sustained virological response (SVR), and a non-inferiority test was also performed. Results: A total of 561 patients with genotype 1/6 CHC were enrolled, among whom 529 received treatment; 90.9% of these patients had genotype 1 CHC. The data of the full analysis set showed that SVR rate was 69.80% (95% CI 65.00%-74.60%) in the trial group and 74.16% (95% CI 67.73%-80.59%) in the control group (P = 0.297 0). The data of the per protocol set (PPS) showed that SVR rate was 80.63% (95% CI 76.04%-85.23%) in the trial group and 81.33% (95% CI 75.10%-87.57%) in the control group (P = 0.849 8), and the 95% CI of rate difference conformed to the non-inferiority standard. The analysis of the PPS population showed that of all subjects, 47.9% achieved rapid virologic response, with a positive predictive value of 93.8%. The incidence rate of adverse events was 96.30% in the trial group and 94.94% in the control group, and the incidence rate of serious adverse events was 5.13% in the trail group and 5.06% in the control group. Conclusion In the regimen of Peg-IFN-α combined with ribavirin for the treatment of genotype 1/6 CHC, the new investigational drug Peg-IFN-α-2b(Y shape, 40 kD) has comparable clinical effect and safety to the control drug Peg-IFN-α-2a.