Objective To explore the risk factors and targeted therapy for fungus infection in acute exacerbation of chronic obstructive pulmonary disease (COPD) pulmonary.Methods 83 acute exacerbations of COPD patients with pulmonary fungus infection were selected as the observation object(COPD fungal infection group),according to the time sequence of random month by month in acute exacerbations of COPD no secondary fungal infection of the 80 patients hospitalized patients as control group,analysis of risk factors lead to fungal infection.Results Two groups in age,live ICU time,antibiotic use time,hormone use time,albumin level mechanical ventilation people with diabetes mellitus,merger,as cor pulmonale had statistically significant differences (P ＜ 0.05) ; The conditional Logistic multiariate analysis,age,ICU patients live time,antibiotics use time,hormone use time,albumin level was acute exacerbations of COPD factors such as pulmonary fungus infection independent risk factors(P ＜0.01) ;Fungus infection were combined with antimycotic,cured 69 cases (83.13％) improved 12 cases (14.46％),there was no change in 1 case(1.20％),death 1 case (1.20％).Conclusion Patients older age,live long,long time ICU antibiotics and hormones and the low level of albumin is acute exacerbations of COPD pulmonary fungus infection independent risk factors,timely diagnosis and prognosis of patients with antifungal treatment is good.

Objective To investigate the serotypes of human enterovirus B ( HEV-B) species cau-sing hand, foot and mouth disease ( HFMD) and to analyze the genetic characteristics of VP1 region in cox-sackievirus B2 ( CVB2 ) and coxsackievirus B5 ( CVB5 ) strains circulating in Anyang area during 2011 to 2015. Methods Real-time RT-PCR and semi-nested RT-PCR were performed to identify coxsackievirus A16 (CVA16), enterovirus 71 (EV71) and other serotypes of enterovirus in order to obtain the complete etiologic composition of HFMD. The numbers of HEV-B serotypes and the percentages of specimens positive for every serotype in all enterovirus-positive specimens were calculated. As CVB2 and CVB5 were the pre-dominant serotypes of HEV-B species, five pairs of primers targeting the VP1 regions of CVB2 and CVB5 were designed to obtain the complete nucleotide sequences of CVB2 and CVB5 VP1 regions. The phylogenet-ic trees were constructed based on the VP1 sequences obtained in this study and those submitted to GenBank by using MEGA7. 0 and BioEdit7. 2. The selection pressures on VP1 regions of CVB2 and CVB5 strains cir-culating in China in recent years were evaluated with the online program of DataMonkey. Results A total of 57 specimens that belonged to 14 serotypes of HEV-B species were detected in Anyang area from 2011 to 2015. The 14 serotypes of HEV-B species accounted for 56% of all serotypes of enterovirus and the speci-mens positive for HEV-B species accounted for 3. 06% of all enterovirus-positive specimens. The HFMD ca-ses caused by most of the HEV-B serotypes were sporadic cases. Small outbreaks of HFMD could also be caused by some serotypes of HEV-B such as CVB2 and CVB5. The complete sequences of VP1 region were obtained from 8 CVB2 strains and 9 CVB5 strains. The phylogenetic trees based on the VP1 sequences dem-onstrated that the CVB2 strains were classified into four genotypes ( A-D) . The mean evolutionary distances between different genotypes ranged from 0. 191 to 0. 208 and the similarities in nucleotide sequences ranged from 79. 7% to 85. 8%. The CVB5 strains were classified into 6 genotypes (A-F). The mean evolutionary distances and the similarities in nucleotide sequences between different genotypes of CVB5 strains ranged from 0. 170 to 0. 285 and 76. 0% to 86. 8%, respectively. Strains of different genotypes varied significantly in the residues on positons 157 and 263 in the VP1 region of CVB2 strains and on positions 75, 90 and 95 in the VP1 region of CVB5 strains. All of the CVB2 strains isolated in Anyang area belonged to D genotype and located intensively in one lineage. The CVB5 strains circulated in Anyang area belonged to F genotype and located in two lineages. The selection pressures on CVB2 strains of D genotype and CVB5 strains of F geno-type circulating in China in recent years were 0. 037 and 0. 036, respectively. Six positively selected amino acid sites were found in the VP1 region of CVB5 strains, but no positively selected amino acid site was found in the VP1 region of CVB2 strains. Conclusion HEV-B species was an essential component of the etiologic spectrum of HFMD in Anyang area during 2011 to 2015, of which CVB5 and CVB2 were the predominant se-rotypes. The VP1 region of CVB5 was more complex and active than that of CVB2 over the course of evolution.

Objective To explore the possible causes and treatment of nonunion of fractures of diaphysis of radius and ulna. Methods According to different personal conditions and results of X gram, 73 cases of the nonunion fractures of diaphysis of radius and ulna were treated with different internal fixations, autologus spongy bone transplantation, release of scar and interosseous membrane, or local skin flap transposition. All had early functional mobilization of the forearm after operation. Results The patients were followed up for 12 to 29 months. All the cases had bony union, and 64 cases(87.7% ) obtained satisfactory functional rehabilitation. Conclusion The major causes that may lead to the nonunion of the diaphysis of radius and ulna are conditions of local soft tissue, site and severity of the fracture, security of internal fixation, and improper early movement, rather than infection. Proper internal fixation, autologus spongy bone transplantation, and release of scar and interosseous membrane are effective in treatment of the nonunion of the fracture and in the functional rehabilitation of the forearms.

Objective This study was designed to investigate the relationship of the coronary anatomy pattern in 56 arterial switch operation (ASO) with the early outcome.Methods From May 2010 to September 2013,a total of 56 patients with transposition of the great arteries complicated with other defomities(39 males and 17 females,with age of 5 days to 126 months),who were undertook ASO in Capital Medical University affiliated Beijing Anzhen Hospital.There were 19 patients with complete transposition of the great arteries and intact ventricular septum,35 patients with complete transposition of the great arteries and ventricular septal defect.and 1 patient with double outlet right ventricle with subpulmonary ventricular septal defect (Taussing-Bing).33 were complicated with atrial septal defect and 26 with patent ductus arteriosus,20 had severe pulmonary hypertension,2 had pumonic valve stenosis and 1 had coarctatioin of aorta.All patients undertook ASO,coronay distribution were detected during the procedure and coronary artery were grafed.Results Coronary artery:Yacoub type A were 46 cases:4 patients died during the 30 days after the operation,Yacoub type B were 5 cases:2 patients died.Yacoub type C were 2 cases:1 died of low cardiac output on the operating day.Yacoub type D were 1 case and Yacoub type E were 2 cases:none of them died.Conclusion Patients with common coronary variants have undergone ASO without added mortality rate.Those with intramural or single coronary arteries have significant added mortality rate.

Objective To explore the CT manifestations,incidence,etiology and clinical significance of hyperostosis frontalis in-terna (HFI).Methods CT features of 243 cases HFI were analyzed retrospectively.Based on the maximum thickness of the inner table of the frontal bone,HFI was classified into 4 grades as follows:GradeⅠ─ thickness of 2.8-6.0 mm,GradeⅡ─ thickeness of 6.1-10.0 mm,Grade Ⅲ ─ thickness of 10.1-14.0 mm,Grade Ⅳ ─ thickness of greater than 14.1 mm.According to the in-crassating direction,HFI was classified into inward,outward and intermediate type.Results The inner table of the frontal bone was incrassated in all cases (n=243).The thickness ranged between 2.93 mm and 14.64 mm,including GradeⅠin 68 cases (28.0%), GradeⅡin 71 cases (29.2%),Grade Ⅲ in 69 cases (28.4%)and Grade Ⅳ in 35 cases (14.4%).There were inward type in 82 ca-ses (33.7%),outward type in 59 cases (24.3%)and intermediate type in 102 cases (42.0%).The incidence of HFI was 5.47% in postmenopausal women,with 7.14% in overweight and 9.09% in obese women respectively.Conclusion HFI is common in the postmenopausal women,and CT manifestations of HFI are characteristic.

Superior mesenteric vein (SMV) thrombosis is a relatively rare disease. Most patients may be successfully treated with anti-coagulation alone. However, bowel stricture may develop due to intestinal ischemia which may require surgical treatment. This report describes a rare case of small bowel stricture occurring one month after successful treatment of SMV thrombosis. After segmental resection of strictured bowel, the patient's post-operative course was uneventful.

Objective:To investigate the variations in infrared radiation at Taichong(LR3),Taixi(KI3),and control points before and after menstruation and to examine the infrared radiation patterns associated with Yuan-primordial points of Zang-Fu organs during the physiological menstrual cycle. Methods:Using a point infrared radiation spectrum detection system,we detected the infrared radiation spectra of Taichong(LR3),Taixi(KI3),and the control points located 1 cm away from the two points,in a range of 1.50-18.00 μm wavelengths during the premenstrual,menstrual,and postmenstrual phases in 32 healthy adult women.Subsequently,data mining and analysis were conducted. Results:Before,during,and after menstruation,the infrared spectral shapes of bilateral Taichong(LR3),Taixi(KI3),and their control points were generally consistent,with characteristic infrared spectral wavelengths located at 11.25 μm.Prior to menstruation,the total intensity of infrared radiation at the right Taixi(KI3)was significantly lower than that at the control point(P<0.05),and that at the left Taichong(LR3)was significantly lower than that at the control point(P<0.01).During and after menstruation,the total infrared radiation intensity at both Taixi(KI3)was significantly lower than that of the control point(P<0.05).The wavelength points exhibiting significant differences in the infrared radiation intensity between points and control points were concentrated at the primary peak of 7.50-14.25 μm and the secondary peak of 15.00-17.25 μm. Conclusion:During different menstrual phases,the infrared radiation spectra of Taichong(LR3)and Taixi(KI3)exhibited distinct point specificity,mainly evident in the infrared radiation intensity and wavelength.

Objective:To study the effect of moxibustion at head points on vascular dementia in improving clinic symptoms and integration of scale and regulating blood fat. Methods: 63 cases of VaD patients were randomly divided into moxibustion treatment group and the Western medicine treatment group. After 3 periods of treatment, the integration changes of the examination scale (HDS), intelligent scale (MMSE), and scale of daily living (ADL) before and after treatment were compared. And the blood lipid cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDC-C) level were detected. Results: In the two groups, before and after treatment, the HDS, MMSE score compared with the ADL scale were significantly different (P

Objective To perspectively evaluate the long-term efficacy of low dose leflunomide in treatment of rheumatoid arthritis.Methods Twenty-eight patients with rheumatoid arthritis were randomly divided into treatment group( n =15 ) and control group ( n =13 ).The patients in treatment group were treated with low dose leflunomide( omitting the loading dose) and with maintenance dose of 10 mg/day.And the patients in control group were treated with sulphasalazine in the dose of 1.5 ～ 2.0 g/d.The observation lasted for 18 months and the observed indicator were as follows:( 1 ) The primary efficacy indicators:counts of swollen and tender joints,overall assessment of disease status made by patients and physicians; ( 2 ) Secondary efficacy indicators:pain visual analogue scale,duration of morning stiffness,health assessment questionnaire (HAQ),Creaction protein,the American College of Rheumatology Outcome Assessment (ACR20,50).Results Eighteen months after treatment,the primary efficacy indicators in the treatment group were superior to the control group ( swollen joint counts:( - 8.5 ± 6.3 ) vs ( - 7.9 ± 6.4) ; overall assessment by patients:( - 1.4 ± 0.8 ) points vs ( - 1.2 ± 0.6) points; overall assessment by physicians:( - 1.4 ± 1.2 ) points vs ( - 1.3 ± 0.9 ) points; P ＜0.01 ).In the secondary efficacy indicators,pain visual analogue scale,duration of morning stiffness and health assessment questionnaire(HAQ) in the treatment group were significantly improved compared with the control group(VAS score:( - 32.4 ± 23.7) points vs ( - 31.6 ± 24.8) points; duration of morning stiffness:( [ - 97.8 ± 6.2 ] min vs [ - 92.4 ± 5.2 ] min; HAQ:[ - 0.62 ± 0.08 ] points vs [ - 0.57 ± 0.02 ] points,P ＜0.01 ),there was no significant difference on the percentage of patients achieving ACR20 standard between the treatment group and the control group (76.9％ vs 75.0％,P ＞ 0.05 ),but there was significant difference on the percentage of patients achieving ACRS0 standard between the treatment group and the control group( 61.5％ vs 47.0％,P ＜ 0.05 ).The gastrointestinaladverse reactions for patients in the treatment group were mild and there were 2 cases of elevated blood pressure,2 cases of elevated liver enzymes and 2 cases out of the trail,in the control group,there was 1 case out of the trial.Conclusion The long-term treatment of active rheumatoid arthritis with low dose leflunomide can achieve exact efficacy and good tolerability compared with the treatment with sulfasalasine.

Objective Proper selection of reconstruction method is the key point to get a successful result in nasal reconstruction.The purpose of the article is to evaluate the results of repairing the partial nasal defect with different surgical strategies.Methods Different surgical methods were used according to the area and type of nasal defects of nasal defects,the different sub-unit of nasal de fects and the different tissue damage levels.Local skin flaps,auricular composite tissue flaps,nasolabial skin flaps and superficial temporal artery pedicle flaps were used in these patients.Results 23 cases suffering from partial nasal defects were repaired with flaps or tissue graft,including 4 auricular composite tissue flap,5 nasolabial skin flap,3 forehead island flap with a pedicle of superficial temporal vessels,7 local flap,and 1 skin graft.After 5-16 months of follow-up,the color and texture around the nose were basically consistent,the appearance of nose was satisfactory,and the postoperative effect turned out fine.Conclusions The method of surgical reconstruction of partial nasal defects should be considered carefully according to the area of nasal defects,sub-unit of nasal defects and the different tissue damage levels.