Objective To observe the effect of continuous blood purification ( CBP ) in treatment of patients with severe viral encephalitis (SVE) combined with status epilepticus (SE).Methods Twenty-four SVE patients combined with SE were collected.Of which 15 cases received conventional treatment was control group, while 9 cases received CBP on the basis of conventional therapy was treatment group.The two groups were observed for curative effects.Results Compared with the control group, the remission time of fever, consciousness recovery, status epilepticus and mechanical ventilation were significantly shortened in treatment group ( all P<0.05 ) .The curative effects between the two groups were no significantly different.Conclusion For SVE patients with SE, the CBP treatment combined with conventional treatment can quickly relieve symptoms and improve the prognosis.

BACKGROUND:Coracoclavicular ligament reconstruction with transclavicular-transcoracoid driling is an effective surgical technique to treat acromioclavicular dislocation. A good driling in the clavicle leads to a perfect bony tunnel and a good surgery. OBJECTIVE: To observe the effects of different driling positions of the clavicle on the location of bony tunnels in coracoclavicular ligament reconstruction. METHODS:Sixty three-dimensional digital models of the clavicle and coracoid process were constructed by Mimics13.0. Virtual transclavicular-transcoracoid bony tunnels were established according to different surgical planes with different driling positions in the clavicle. Parameters of these bony tunnels were measured, and the safety was evaluated. Option 1: The driling was made 30 mm distal to the clavicle, located in the center of the front and rear edges of the clavicle surface. Option 2: The driling was made 40 mm distal to the clavicle, located in the center of the front and rear edges of the clavicle surface. Option 3: The driling was made at the straight line of tapered nodule tip and the midpoint of the base of the coracoid process, located at the rear edge of the clavicle upper surface. RESULTS AND CONCLUSION: Bony tunnels in option 1 were extremely on the inside of the coracoid. Bony tunnels in options 1 and 2 were not in the center of clavicle. Bony tunnels in option 3 were in the center of both clavicle and coracoid. The method of locating the driling position with a certain distance to the distal clavicle leads to different results in man’s and woman’s models. To ensure that the bony tunnel can pass through the center of clavicle and coracoid, it is suggested to dril at the straight line of tapered nodule tip and the midpoint of the base of the coracoid process and nearby the rear edge of the clavicle upper surface.

BACKGROUND:The residual alveolar ridge in edentulous patients with osteoporosis always presents with a poor shape,which increases the difficulty in complete denture restoration.Until now,there are no predictors for residual alveolar ridge resorption or guidelines on the frequency of denture relines.OBJECTIVE:To investigate the correlation between the frequency of complete denture relines and serum bone turnover markers,osteocalcin (OC) and cross-linked carboxy-terminal telopeptide of type Ⅰ collagen (CTX),in elderly edentulous patients with osteoporosis,in order to provide reference for complete denture repair.METHODS:According to inclusion criteria,50 elderly edentulous patients with osteoporosis who had complete dentures were recruited in the study randomly.The frequency of complete denture relines was surveyed by related questionnaire and medical record,and the serum OC and CTX levels were detected by electrochemiluminescence immunoassay.Related data were analyzed statistically via Pearson correlation analysis.RESULTS AND CONCLUSION:It showed a strong positive correlation between the frequency of complete denture relines and the serum OC level (r=0.517,P ＜ 0.01).No significant correlation between relines frequency and the serum CTX level was observed (r=0.278,P=0.051 ＞ 0.05),but it showed a similar tendency between them.These findings indicate that to detect the levels of serum bone turnover markers may be conducive to evaluating curative effect of complete dentures in elderly edentulous patients with osteoporosis as well as to making subsequent diagnostic and therapeutic strategies.

BACKGROUND:Intertrochanteric fracture can obtain good curative effects after active effective internal fixation in early stage.
OBJECTIVE:To compare dynamic hip screw+trochanter stabilizing plate and Gamma nail fixation for treatment of Evans type IIIB and type IV intertrochanteric fracture.
METHODS:A total of 67 patients with Evans type IIIB and type IV intertrochanteric fracture, including 28 cases undergoing dynamic hip screw+trochanter stabilizing plate and 39 cases undergoing Gamma nail, were selected from Chongming Branch, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from February 2009 to November 2012. Al patients received antibiotics and functional exercises after treatment. Time of therapy, intraoperative bleeding amount, fracture healing time and Harris Hip Score were retrospectively analyzed in patients of both groups.
RESULTS AND CONCLUSION:Al patients were fol owed up for 6-45 months, averagely 21 months. (1) One patient affected infection in the dynamic hip screw+trochanter stabilizing plate group. He was healed after fixation removal half a year after drug exchange. One obese patient experienced injury again during out-of-bed activity at 3 weeks after treatment in the Gamma nail group. Fracture appeared at distal end of lock pin, and healed after replaced by Gamma nail. Trochanteric stabilizing plate was unstable in four patients of the Gamma nail group. They affected severe pneumonia after over 6 weeks of lying in bed, and healed after treatment in the medical department (2) Coxa vara appeared in two cases of the dynamic hip screw+trochanter stabilizing plate group, and three cases in the Gamma nail group. Fracture healing was achieved in al patients. (3) The time of therapy was longer, and intraoperative bleeding amount was significantly more in the dynamic hip screw+trochanter stabilizing plate group compared with the Gamma nail group (P<0.05). No significant difference in healing time and Harris Hip Score was detected between the two groups (P>0.05). Dynamic hip screw+trochanter stabilizing plate and Gamma nail are effective methods for treatment of Evans type IIIB and type IV intertrochanteric fracture. To choose a suitable fixator, we should aggregately analyze fracture stability, healing state and the degree of osteoporosis.

Objective To investigate association of pancreatic fat content and lipid levels in individuals with newly diagnosed type 2 diabetes.Methods Fifty four subjects with newly diagnosed type 2 diabetes and 22 volunteers without type 2 diabetes were enrolled in this study.Pancreatic fat content was determined with magnetic resonance imaging.Lipid levels were measured.Results The pancreatic fat content in patients with newly diagnosed type 2 diabetes and control subjects was (17.13 ± 10.35) ％ and (11.62 ±7.15)％, respectively (P =0.025).Median pancreatic fat content of subjects with newly diagnosed type 2 diabetes correlated negatively with total cholesterol level (r =-0.361, P =0.007) and triglycerides level (r =-0.346, P =0.010).Conclusions Increased levels of serum total cholesterol and low density lipoprotein cholesterol might relieve the extent of pancreatic fat content.

Carotid Body Tumor ; surgery ; Humans ; Hypertension ; Pressoreceptors

Objective To survey the status and related demands of advanced clinical training among community general practitioners (GPs) in Shanghai.Methods A survey on the status and demands of advanced clinical training was conducted with a self-designed questionnaire among GPs in Minhang District and Jiading District of Shanghai from January to May 2016.The questionnaire included basic information , experience of advanced clinical training , satisfaction with training and training demands .Results Total 526 questionnaire were distributed and 478 valid questionnaires were returned with a response rate of 90.9%. Among the participants 202 (42.3%) had experience of advanced clinical study ; the training units were mainly secondary hospitals in Shanghai (69.3%, 140/202); 67.2%(131/195) participants considered that the previous training did not fully meet the needs of the community .There was significant difference in the training demands among participants with different ages , professional titles, and working years ( χ2＝12.754, 7.912, 4.501, all P＜0.01); those with younger age, higher education and shorter working years had higher training demands .Survey showed that 57.3%( 274/478 ) of participants demanded further studies in the future; 58.3%( 239/410) of them chose tertiary hospitals in Shanghai as training unit , 79.0%(321/406) chose internal medicine and geriatrics as training specialties , particularly in outpatient clinic (73.2%, 298/407); the length of study should be 3 months (32.8%, 132/402) or 6 months (27.6%, 111/402), and completed in segments (61.5%, 253/411).The purpose of training was mainly to upgrade clinical competence (94.2%, 258/272); busy working schedule (53.4%, 66/116) was the main reason for not intending the advanced clinical studies .Conclusions The community general practitioners in Shanghai have high demands for advanced clinical training .The training should meet the needs of clinical practice in community and the mode of study should be more flexible .

Objective To investigate the associations of IFNL3/IFNL4 single-nucleotide polymorphisms(SNPs)with the efficacy of highly active antiretroviral therapy(HAART)in patients with HIV-1 infection.Methods Sixty-three adult patients with HIV-1 infection receiving HAART for at least 1 year in the First Affiliated Hospital, Zhejiang University School of Medicine were enrolled.HIV-1 RNA loads in plasma and HIV-1 DNA loads in peripheral blood mononuclear cells(PBMCs),and blood SNPs were detected by quantitative polymerase chain reaction(qPCR).Plasma inflammatory cytokines were examined by magnetic beads method,and the CD4 +T and CD8 +T lymphocyte counts in peripheral blood were measured by flow cytometry.According to response to HAART,the patients were classified as low HIV-1 RNA group(viral load <100 copies/mL)and high HIV-1 RNA group(viral load≥100 copies/mL);according to CD4+T lymphocyte counts,the patients were defined as low CD4+T cell group(<250 cells/μL), and high CD4+T cell group(≥250 cells/μL);according to HIV-1 DNA levels,the patients were divided into low(<100 copies/106cells)and high(≥100 copies/106cells)HIV-1 DNA groups.Results Three candidate SNPs rs368234815,rs8099917 and rs4803223 had significantly different distribution between low and high HIV-1 RNA groups(χ2=0.043,0.047 and 0.032,all P<0.05).The levels of interleukin(IL)-10 were declined in the low HIV-1 RNA group(U=4.00,P<0.05);the levels of IL-13 were decreased in the high HIV-1 RNA group and the high HIV-1 DNA group(U=0.00 and 2.00,both P<0.05);the levels of IL-21 were reduced in the high HIV-1 RNA group and in the low CD4 +T cell group(U=3.00 and 2.00, both P<0.05),the levels of IL-28A were decreased in the high HIV-1 RNA group,the high HIV-1 DNA group,and the low CD4 +T cell group(U=3.00, 0.50 and 3.00,P<0.05 or <0.01).In addition, rs368234815 was associated with IL-21 level(H=6.690,P<0.05),the IL-21 level in rs368234815 ΔG/ΔG [131.88(2.66,174.00)]was higher than that in TT/TT[6.79(2.81,26.48)](P<0.05);rs4803223 was correlated with IFN-γlevel(H=6.690, P<0.05),the IFN-γlevel in GG subtype[62.26(19.45, 96.49)]was higher than that in GA subtype[6.98(2.19, 99.14)](P<0.05).Conclusion The polymorphisms of IFNL3/IFNL4 rs368234815, rs8099917 and rs4803223 are associated with efficacy of HAART and immune-associated cytokines levels in patients with HIV-1 infection.

Objective:The article aims to explore the positive promoting effect of the construction of a medical university’s incubation platform on the Industry-University-Institute cooperation and biomedical scientific and technological achievements transformation.Methods:Through literature review, the article studied the existing mode of Industry-University-Institute cooperation in universities, analyzed the main bottlenecks, and summarized the practical exploration experience of ″Shanghai Pharmaceuticals-SJTUSM Innovative Achievements″ incubation platform.Results:The incubation platform effectively promoted the process and system construction of the scientific and technological achievements transformation in the university, and improved the project mining level and platform support function.Conclusions:The practical exploration of the incubation platform lays a foundation for the construction of the biomedical industrial park. Through the in-depth construction of the " Government-Industry-University-Institute-Investment-Inventor" development chain, the platform can help to promote strategic innovation and industrialization of achievements, making the " first-in-class" medicine in China.