Objective To summarize our experience in management of infected femoral artery pseudoaneurysm caused by addictive drugs injection.Methods Clinical data of 45 cases of infeted femoral artery pseudoaneursysm were reviewed retrospectively.When infected femoral artery pseudoaneurysm was diagnosed,the femoral artery or external iliac artery was ligated and the pseudoaneurysm was resected in all of cases.Anticoagulants and antibiotics were used after operation.Results Lower limbs were salvaged in 44 patients.The ambulation function of affected limb was fine in the short-term.One limb was amputated because of lower limb deep venous thrombosis and gangrene.Thirty-four patients(75.6%) were followed up for 3-12 months,the results were satisfactory.Conclusions Femoral artery or external iliac artery ligation is an effective procedure for management of infected femoral artery pseudoaneurysm.

Objective To investigate the risk factors of acute exacerbation of chronic obstructive pulmonary disease(AECOPD) combined with respiratory failure.Methods The clinical data of 120 patients with AECOPD combined with respiratory failure were retrospectively analyzed.The patients were divided into disease improved group (96 cases) and disease serious group (24 cases,including death) according to the treatment outcome.Risk factor and treatment strategies of the two groups were statistically analyzed.Results There was no significant difference in age,sex,disease course and arterial blood oxygen partial pressure(P ＞ 0.05).The body mass index,albumin,pH,successful cough and expectoration rate,nutritional support rate,and noninvasive mechanical ventilation rate in disease improved group was higher than that in disease serious group[(28.5 ± 9.8) kg/m2 vs.(23.3 ± 7.4) kg/m2,(21.4 ± 7.9) g/L vs.(19.3 ± 6.8) g/L,7.23 ± 0.20 vs.7.11 ± 0.17,79.2％ (76/96) vs.25.0％ (6/24),58.3％ (56/96) vs.33.3％ (8/24),81.2％ (78/96) vs.62.5％ (15/24)],arterial blood carbon dioxide partial pressure,mild consciousness obstacle rate,multiple drug-resistant infections rate,fungal infection rate,nasal feeding rate,hormone use time and the incidence of heart failure,pulmonary encephalopathy,hepatorenal function damage and upper gastrointestinal bleeding in disease improved group was lower than that in disease serious group [(10.08 ±1.71) kPa vs.(11.98 ± 2.03) kPa,13.5％ (13/96) vs.58.3％ (14/24),22.9％ (22/96) vs.41.7％ (10/24),0 vs.29.2％ (7/24),50.0％(48/96) vs.75.0％(18/24),(5.3 ± 1.3) d vs.(11.3 ± 3.8) d,8.3％(8/96) vs.25.0％(6/24),13.5％(13/96) vs.70.8％(17/24),28.1％(27/96) vs.41.7％(10/24),5.2％(5/96) vs.12.5％(3/24)],and there was significant difference (P ＜ 0.05).Conclusion Complicating disease,nutritional status,consciousness,capability of sputum exclusion,the degree of respiratory infection,treatment with noninv asive positive pressure ventilation,arterial gas analysis index are the correlated factors of prognosis in AECOPD combined with respiratory failure.

Objective To study the prevalence and variation of influenza B viruses of Shenzhen. Methods Fifty strains influenza B viruses in Shenzhen from 1994 to 2006 were selected. HA1 gene were amplified by RT-PCR and sequenced. Phylogenetic analysis of HA1 was conducted by MEGA program. Results The influenza B viruses of Shenzhen were divided into Yamagata and Victoria lineage. The two lineages prevailed respectively in different years from 1994 to 2006. The variance of glycosylation site and some mutations of antigenic determinants were detected in the two lineages. Conclusion The viruses of Yamagata and Victoria lineage prevailed respectively in different years in Shenzhen but the mutation rates of the two lineages were slowly.

Objective To analyze the genetic characteristics of H1N1 influenza viruses isolated in Shenzhen during 1995 to 2007. Methods The hemagglutinin(HA) gene of these viruses were sequenced. Phylogenetic analysis of the sequences was performed with Simmonic and Mega software. Results The H1N1 influenza viruses isolated in Shenzhen from 1995 to 2007 were divided into chide A, B and C. Some viruses from 2005 to 2006 clustered in the same group with the viruses of 2001. Furthermore, some of the vaccine strains recommended by WHO were found lagged behind the strains isolated in Shenzhen. Some mu-tations occurred on the antigenic sites as well as receptor-binding site(RBS). Except the viruses of 1995, the other viruses had deleted at the site 137. Conclusion Characterization of the HA gene revealed that most of the amino acid substitutions occurred on the antigenic sites and RBS. Furthermore, it was discovered that the mutations occurred on different antigenic regions in different years.

Objective To assess the clinical effect and safety of human blood albumin in treatment of acute cerebral hemorrhage.Methods 88 patients with acute cerebral hemorrhage were randomly divided into 2 groups. Both group were given routine therapy and 45 cases in the treating group were given additional 10% human blood albumin 100 ml ivgtt once a day for 7 days.14 days served as a treatment course.Neurofunction was compared before and after treatment.Results Both the effective rate (P<0.05) and the neurofunction in the treating group were better than that of the control group (P<0.05).No advert effect happened.Conclusion Human blood albumin is an efiective and safe medicine for treatment of acute cerebral infarction.

Objective To evaluate the methods,applicability and results of cndovascular therapy for Stanford type B aortic dissection.Methods The clinical data of 36 cases of Stanford type B aortic dissection were analysed retrospectively.The stent-grafts were introduced via femoral arteriotomy.Stent-grafts were implanted to blockade tears of aortic dissection under the guidance of DSA.Results In all cases,the aortic dissection tears were blockaded,true lumens were opened,and organs function was restored.There were not complications such as internal hemorrhage due to trauma or stent displacement on CTA 3 and 12 months after endovascular therapywhile 2 cases developed new tears.The caliber of the 36 true lumens was restored to near normal.Twenty-two pseudocoeloms were obliterated,while the others were reduced is size and had varying degrees of thrombosis.Conclusions Endovascular thcrapy is safe and effectivc for the patients with Stanford type B aortic dissection.Its clinical application has a favorable outlook.

Objective To analyze neuraminidase(NA) inhibitor resistance of seasonal H1N1 influenza A viruses isolated in Shenzhen during 2008 to 2009. Methods The NA gene of these viruses were sequenced. Phylogenetic analysis of the sequences was performed with Mega3. 1 software. Results In 2008, most isolates of the seasonal H1 N1 virus were susceptible to neuraminidase inhibitors, but the H275Y mutation in the neuraminidase gene region associated with high-level oseltamivir resistance had been detected in 92.6% of the strains isolated in 2009. Furthermore, a strain with Q136K was found, which showed the resistance to Zanamivir. Conclusion In the light of emerging resistance, close monitoring and understanding of the nature and dynamics of resistance mutations in influenza virus should be a priority.

Objective To study the pathogenesis and the effect of early drugs therapy of symptoms after concussion.Methods One-hundred and thirteen patients with symptoms after suffered concussion enrolled in the study and divided randomly into three groups.The patients of different groups were treated respectively with drugs,i.e.erigeron breviscapus,nimodipine,energy mixture.Symptom Check-List 90 ( SCL-90 ) and electroencephalogram(EEG) and cerebral blood flow of trancranial Doppler(TCD) were examined in the early and late stage of post-concussion.Normal population were recruited as control.All examination results and the effect of treatment were compared between treatment group and control group.Results In the scores of SCL-90,the factor scores of somatization symptom,compulsion,depressive disorder,anxiety disorders,and hostile symptom in 113 post-concussion patients in early stage were all higher than those in the normal( t =10.78,2.08,9.53,11.09 and 2.52,P ＜0.01or P ＜0.05),and as well as that of somatization symptom,depressive disorder,anxiety disorders,terror and mental disorder symptom in 12 post-concussion patients in late stage compared to normal( t =3.21,6.85,3.07,3.14 and 4.73,Ps ＜ 0.01 ).The test of EEG was abnormal in 57.4 ％ of patients in early stage and in 33.3％ in the late stage.Of all TCD results,67.0 ％ was abnormal in the early stage and 25.0％ in the late stage,The disappearance rate of post-concussion symptoms in the 14th day was significantly higher in the erigeron breviscapus group ( 45.0％ ) than in the nimodipine group ( 23.7％ ) ( x2 =3.91,P ＜0.05 ) and in the energy mixture group ( 20.0％ ) ( x2 =5.25,P ＜ 0.05 ).The disappearance rate of postconcussion symptoms in the 30th day in the energy mixture group(40.0％ ) was significantly lower than those in nimodipine group( 68.4％ )( x2 =5.94,P ＜ 0.05 ) and in erigeron breviscapus group( 75.0％ )( x2 =9.43,P ＜ 0.01 ).The occurrence rate of post-concussion sequelae was higher in the energy mixture group ( 22.9％ )than in the nimodipine group ( 5.2％ ) ( x2 =4.77,P ＜ 0.05 ) and in the erigeron breviscapus group (5.0％ )( x2 =5.15,P ＜ 0.05 ) three month after injuries.Conclusion The occurrence of symptoms originated from the organic damage of brain tissue.However,its changes were influenced by psychologic factors after concussion.Early vasodilative drugs therapy could improve the recovery of patients with post-concussion symptoms in time and decrease the occurrence of post-concussion sequelae.

ObjectiveTo summarize the experiences in surgical and endovascular treatment for isolated iliac artery aneurysm.MethodsData of 17 cases with isolated iliac artery aneurysm were reviewed and analysed retrospectivel.17 cases were examined with color Doppler ultrasounograpy preoperatively,13 cases underwent computed tomographic angiography (CTA),2 cases did digital subtraction angiography (DSA).Artificial graft interposition were performed in 10 cases with unilateral iliac artery aneurysm,endovascular repair were performed in 6 cases.One case was treated by artificial graft interposition after a failed endovascular repair. ResultsPreoperativaly correct diagnosis was established in all 17 cases,and they were cured after operation.The average operative time was (3.7 ± 1.2) h in group of surgical operation,and ( 1.4 ±0.7) h in group of endovascular treatment (P ＜0.05).The length of hospital stay was ( 16 ± 5 ) d for the group of surgical operation,and ( 9 ± 4 ) d for endovascular treatment ( P ＜ 0.05 ).The percentage of blood transfusion was 72.7％ ( 8/11) in the group of surgical operation,and 16.7％ (1/6) in the group of endovascular treatment.There were a ureteral injury and a ectopic embolism happened during the procedure.There were 2 hip claudication and 2 type Ⅰ endoleaks after operation,which subsided after 3 months.ConclusionsArtificial graft interposition or endovascular repair is effective treatment for isolated iliac artery aneurysm which has the advantage of minimally invasiveness and rapid recovery.

Objective To investigate the clinical efficacy of combined use of calcineurin inhibitor in the treatment of lupus nephritis in induction or maintenance,which is resistant to mycophenolate mofetil.Methods Sixty-six cases of children with lupus nephritis were selected from February 2014 to September 2016 in Huazhong University of Science and Technology,Tongji Medical College Affiliated Wuhan Children's Hospital.The randomized method was used to divide them into the control group and the observation group randomly.Among them,31 cases in the control group were given glucocorticoid,cyclophosphamide combined with traditional medicine for treatment;35 cases in observation group were given glucocorticoid,mycophenolate mofetil,tacrolimus (calcine phosphatase inhibitor) multi-target therapy for treatment.The clinical effect of 2 groups before and after treatment were compared,and the incidence of adverse reactions in the treatment of 2 groups of children were compared.Results After treatment,the levels of systemic lupus erythematosus disease activity index (SLEDAI),serum creatinine and 24 h urine protein [(6.05 ± 1.04) scores,(45.08 ± 18.52) μmol/L,(0.96 ±0.30) g/L] in the observation group were lower than those in the control group [(11.09 ±2.33) scores,(95.33 ±36.74) μmol/L,(2.05 ±0.74) g/L],and the differences were statistically significant (t =3.097,3.356,3.871,all P ＜ 0.05).Serum complement C3,plasma albumin levels [(1.05 ± 0.28) g/L,(63.24 ± 12.98) g/L] were higher than those in the control group [(0.34 ±0.10) g/L,(35.45 ±6.74) g/L],and the differences were statistically significant (t =4.124,3.567,all P ＜ 0.05).After treatment,the levels of serum complement C3 and plasma albumin were significantly higher between 2 groups than those before treatment,the differences were statistically significant (all P ＜ 0.05).The incidence of adverse reaction (14.29％,5/35 cases) in the observation group was lower than that in the control group (38.71％,12/31 cases),and the difference was statistically significant (x2 =5.128,P ＜ 0.05).Conclusion Multi-target combination therapy and traditional cyclophosphamide therapy can effectively control lupus nephritis in children,but the clinical effect of multi-target combination therapy is better and the adverse reaction is less.