【Objective】 To analyze the clinical characteristics of children with ammonium urate stones in Xinjiang, so as to provide reference for the prevention and treatment of this disease. 【Methods】 The clinical data of all children with ammonium urate stones admitted to the People’s Hospital of Xinjiang Uygur Autonomous Region from 2016 to 2021 were retrospectively analyzed, including age, sex, body mass index, stone site, stone size, stone component, urine pH, urine culture and biochemical examination results. The serum total protein, albumin, sodium, potassium, calcium, magnesium, uric acid and urine pH were compared between the pure and mixed groups. 【Results】 A total of 61 children (31.6%) had ammonium urate stones, their average age was (4.05±3.37) years, and the male to female ratio was 2.21∶1. Among them, there were 37 cases (60.7%) of renal calculi and 50 cases (82.0%) of upper urinary calculi. The most common component of mixed ammonium urate stones was calcium oxalate, including calcium oxalate monohydrate, calcium oxalate monohydrate and calcium oxalate dihydrate. Compared with mixed type, children with pure stone type had a younger age (P=0.001) and a smaller stone size (P=0.003). Positive urine culture was detected in 14 cases (23.0%), 7 of which (50% were infected with Escherichia coli, and 11 (78.6%) with non-urease bacteria. 【Conclusion】 Non-urease bacteria are the main pathogens of urinary tract infection in children with ammonium urate stones. The incidence is higher in boys, and the most common stone location is upper urinary tract. Calcium oxalate is the most common mixed component. Pure type is more common in young children and the stones are relatively small.

Rituximab is currently used as a first-line therapy for phospholipase A 2 receptor-associated membranous nephropathy due to its good efficacy and safety. Although the remission rate after rituximab treatment is more than 60%, nearly 40% patients still do not respond to treatment. We used obinutuzumab to treat 3 cases of rituximab resistant PLA 2R-associated membranous nephropathy. After the first dose of 1 000 mg with or without additional dose, the amount of anti-PLA 2R antibody and urinary protein decreased significantly and the adverse reactions were mild. The results show that obinutuzumab has a certain therapeutic effect on rituximab resistant PLA 2R-associated membranous nephropathy, but the time of follow-up observation is short and can only be used as individual cases, which needs to be confirmed by a large sample and high-quality prospective cohort study.

Objective:To explore the clinical efficacy of Masquelet technique combined with tissue flap transfer in the treatment of infectious composite bone and soft tissue defects in the early and middle stages after internal fixation for tibial fractures.Methods:From October 2017 to November 2020, 12 patients (13 tibial fractures) with infectious bone and soft tissue defects in the early and middle stages after internal fixation were treated in the Department of Orthopaedics, 988th Hospital of the Joint Logistics Support Force of CPLA by two-phased surgery with retaining internal fixation. Phase I procedures were thoroughly removal of the infected lesions and failed screws, preserving internal implants as many as possible, implantation of absorbable calcium sulphate and an antibiotics blended string of beads into the distal and proximal medullary cavity of the fractured bones, filling the bone defect and wrapping the internal implants with antibiotics loaded bone cement. The size of defects was 3.5 cm × 5.0 cm-7.5 cm × 14.5 cm, and the flaps for wound coverage sized 4.0 cm × 5.5 cm-8.0 cm × 15.0 cm. As for the repair of donor site, 8 limbs were sutured directly, 5 limbs could not be closed completely, and the remaining wounds were covered by skin grafting after suture. Based on well control of infection and stable clinical signs, fillings of bone cement were then removed in Phase II surgery, or 6-9 weeks after primary surgery. Autologous cancellous bone pieces or composite allogeneic bone were fully implanted around the induction membrane formed by Masquelet technique, and auxiliary steel plates were implanted for internal fixation of unstable fractures. After discharge, the patients visited the outpatient clinic regularly, and combined with Wechat follow-up. The texture, colour and bone healing were observed. At the last follow-up, the function of the affected limbs were assessed according to Johner-Wruhs evaluation standard.Results:After Phase I surgery, 13 flaps survived smoothly without vascular compromise. The wounds healed in Phase I. Two patients (2 sides) had recurrent infections. Re-debridement was performed and external fixation was applied after removal of internal fixation. After Phase II surgery, all patients were included in 12-26 months of follow-up, with an average of 18 months. Thirteen lower leg fractures healed well, and the time of bone healing was 16-25 (average 19.5) weeks. The Johner Wruhs criteria was used in evaluation of the function of affected limbs, and it was found that 6 patients were in excellent, 5 in good and 2 in fair.Conclusion:It is feasible while preserving the internal implants, to use membrane induction technique (Masquelet technique) combined with flap transfer, together with the absorbable calcium sulphate antibiotic sustained-release beads as a carrier in the phased treatment of infectious bone defects and bone exposure in the early and middle stages after the surgery of tibial internal fixation. It also gives a higher rate of excellence in surgical outcome. This study explores a treatment procedure for traumatic bone infection combined with composite soft tissue defects.

Objective:To investigate the efficacy of the nutrient vessel of medial and lateral sural subcutaneous nerve chimeric tissue flap based on posterior perforating branch of peroneal artery to repair the composite tissue defect in the Achilles tendon area.Methods:From January 2016 to June 2021, 12 patients suffering from infectious wound with defect of Achilles tendon were treated in the Department of Trauma and Microscopic Orthopaedics, 988th Hospital of the Joint Logistics Support Force of PLA. The area of soft tissue defect around Achilles tendon was 2.5 cm× 4.5 cm-8.0 cm×12.5 cm, and the length of the defect of Achilles tendon was 3.0-7.0 cm. The defect around the Achilles tendon were repaired with the nutrient vessel of medial and lateral sural subcutaneous nerve chimeric Achilles tendon flap (ATF) and the posterior perforating branch of peroneal artery was used as the vessel of blood supply. The size of flap was 3.0 cm×5.0 cm-9.0 cm×13.0 cm, and the size of the ATF was 3.0 cm×4.0 cm-3.0 cm×8.0 cm. The donor sites were sutured directly (8 cases) or repaired with skin graft (4 cases). External fixation were put on for 6 weeks after surgery. Then the external fixation was removed and the functional exercise gradually started. Outpatient clinic follow-ups were carried out regularly. Thermann Achilles tendon function assessment system was used to evaluate the last follow-up.Results:The chimeric ATF was harvested and the blood supply of each flap was good during the operation. There was no vascular crisis after surgery. The flaps survived smoothly and the wound achieved grade A healing. All patients were entered follow-up that lasted for 10-24 months. There was good appearance of flaps with minor bloating, and the colour of flaps was similar to the skin around the receiving site. The texture was soft with normal function of the lower legs and ankle. Tendon function was evaluated by Thermann Achilles tendon function assessment system, the result were 8 cases in excellent and 4 cases in good.Conclusion:The nutrient vessel of medial and lateral sural subcutaneous nerve chimeric tissue flap based on posterior perforating branch of peroneal artery can accurately repair a composite tissue defect in the Achilles tendon area, and it is one of the effective methods for the repair of a composite soft tissue wound with Achilles tendon defect.

Objective: To investigate the effect of early intervention on the prevention of delirium in patients undergoing elective surgery. Methods: Totally 200 patients scheduled for surgery and admitted to ICU during Oct. 2016 to Jun. 2018 were assigned to two groups (n=100). Both the observation group (group A) and the control group (group B) received routine nursing care from wards, operating room and ICU nurses. In addition, the observation group (group A) were intervened by ICU nurses by means of nursing measures to prevent delirium the day before surgery. The differences of delirium incidence, delirium duration, and length of stay in ICU, satisfaction and anxiety scores between the two groups were measured. Results: The incidence and duration of delirium, length of stay in ICU, satisfaction rate of ICU, S-AI scores between group A and B were 16% (16/100) vs. 29% (29/100), 4(3.1, 10.6) h vs. 12(9.2, 14.6) h, (33.06 ±16.06) h vs. (39.96±25.47) h and (56.25 ±5.74) vs. (41.59 ±4.94), (50.17±1.56) vs.(52.37±3.52) respectively (χ²=4.129, Z=-2.757, t=2.291,-19.349, 5.718, all P < 0.05). Conclusion Early intervention can effectively prevent and reduce the incidence of ICU delirium in patients undergoing elective surgery.

Objective: To observe the uptake of ⁹⁹Tc^m-3 polyethylene glycol Arg-Gly-Asp dimer (3PRGD₂) in rat models of rheumatoid arthritis (RA), in order to provide theoretical foundation for early diagnosis of RA. Methods: The healthy female SD rats were divided into collagen induced arthritis (CIA) group (n=100), osteoarthritis (OA) group (n=20) and control group (n=20). Bovine collagen type Ⅱ emulsion was used for arthritis induction to establish CIA models. OA models were established by injection of L-cysteine and papain. Gamma imaging was performed before and 15 d, 30 d after the model establishment. The mediastinum was selected as non-target (NT) area and the target (T)/NT ratios were calculated. The serum levels of vascular endothelial growth factor (VEGF), tumor necrosis factor-α (TNF-α), α_Vβ₃ before and after the model establishment were measured. Pathological and immunohistochemical detection were performed. One-way analysis of variance, Pearson and Spearman correlation analyses were used to analyze the data. Results: There were 58 CIA models successfully established. Before the model establishment, T/NT ratios of CIA group, OA group and control group were 0.215±0.049, 0.210±0.050, 0.209±0.051, respectively (F=0.093, P>0.05). The T/NT ratios of the above three groups were 0.405±0.230, 0.223±0.045, 0.211±0.049 (F=12.601, P<0.05) 15 d post-model establishment, and those were 0.572±0.182, 0.238±0.045, 0.212±0.055 (F=65.147, P<0.05) 30 d post-model establishment. T/NT ratios of CIA group were positively correlated with the levels of serum VEGF, TNF-α, α_Vβ₃, pathological score and the levels of immunohistochemical markers (VEGF, TNF-α, α_Vβ₃, CD31, CD34; r values: 0.391-0.721, r_s values: 0.365-0.669, all P<0.05). Conclusion ⁹⁹Tc^m-3PRGD₂ can be specifically up-taken by RA lesions in rat models, thus has the potential in early synovial neovascularization imaging of RA.

The aim of the research was to investigate the pharmacokinetics (PK) of enteric-coated mycophenolate sodium (EC-MPS) by quantification of the active metabolite of mycophenolic acid (MPA) after multiple escalating oral doses in Han kidney transplant recipients. A total of 28 Han postoperative kidney transplant recipients were given a multiple-dose of 540, 720 or 900 mg of EC-MPS two times a day in combination with tacrolimus for 6 days. Blood specimens were collected at each time point from 0 to 12 h after EC-MPS administration. MPA plasma concentrations were measured by UPLC-UV. The relationship between the EC-MPS dose and its PK parameters was assessed. In the range from 540 to 900 mg,and AUCdid not increase with dose escalation. The AUC,,andfor the 540 720 and 900 mg doses were not significantly different, respectively (>0.05). AUCandwere increased less than proportionally with increasing EC-MPS dose levels. Inter-individual variability in AUC,andwere considerable. Nonlinear PK relationships were found from the doses of 540-900 mg of EC-MPS.

BACKGROUND:Because the geographical environment and diet cause obesity and osteoarthritis in Xinjiang Uygur local patients, the number of patients became more. At present, more and more patients received artificial knee replacement. How to master and further apply the technology of soft tissue balance during artificial knee replacement in patients of different physical fitness and nations becomes the focus of many scholars. OBJECTIVE:To analyze the clinical efficacy of soft tissue balance in Xinjiang Uygur patients with knee valgus in total knee replacement. METHODS:A total of 60 cases (72 knees) with severe knee osteoarthritis with a certain degree of knee valgus were subjected to total knee replacement through anterior lateral approach and individualized soft tissue balance from February 2009 to December 2010. Folow-up mode was the clinic visit. X-ray was used to measure tibiofemoral angle (i.e., the supplementary angle of the included angle between anatomic axis of femur and tibia). Clinical score and functional score of American knee society knee score were applied to assess knee joint function. RESULTS AND CONCLUSION:A total of 57 patients were folowed up for 6-35 months. The tibiofemoral angle decreased from 27.9° preoperatively to 5.6° postoperatively. Clinical score of American knee society knee score elevated from 16.7 points preoperatively to 87.5 postoperatively. Functional score of American knee society knee score elevated from 7.9 points preoperatively to 85.2 postoperatively. Significant differences in preoperative and final folow-up scores were detected (P < 0.01). Valgus deformity was corrected and joint stability was good in 57 patients after replacement. These findings indicate that in patients with severe knee osteoarthritis and valgus deformity, to select individualized treatment of soft tissue balance can effectively correct soft tissue imbalance and get more satisfactory clinical results.

OBJECTIVE: To study the effect of MDR1 (P-gp) and ABCG2 on the drug resistance in Hep 2 cells. METHOD: Flow cytometry was used to detect the variations of the antitumor drugs accumulation and discharging, and activity variations when MDR1 and ABCG2 inhibitors were used in Hep-2. RESULT: The accumulation and discharging of mitoxantrone was significantly higher than the control group when ABCG2 inhibitor FTC was used in Hep-2 (P<0. 05). In contrast, P-gp did not appear similar case; To the mitoxantrone and cisplatin, there was no statistical correlation about activity of Hep-2 between P-gp or ABCG2 antagonist and the control; To the doxorubicin, combining FTC and P-gp, the activity of Hep-2 was higher than the control and difference was significant (P<. 05), In contrast, FTC and P-gp did not appear similar case when used alone; To the 5-FU, when PGP used, the activity of Hep-2 was higher than that in the control and difference was significant (P<0. 05), In con- trast, FTC and FTC+P-gp did not appear similar case; To the paclitaxel, when P-gp or FTC+P-gp used, the activity of Hep-2 was higher than that in the control and difference was significant(P<0. 05). CONCLUSION ABCG2 may lead to drug resistance mainly by changing the ability of cell in accumulating and discharging chemotherapy drugs. P-gp has other way. P-gp and ABCG2 play different roles in different drug resistance.
ATP Binding Cassette Transporter, Subfamily B ; metabolism ; ATP Binding Cassette Transporter, Subfamily G, Member 2 ; ATP-Binding Cassette Transporters ; metabolism ; Cell Line, Tumor ; Cisplatin ; pharmacology ; Doxorubicin ; pharmacology ; Drug Resistance, Neoplasm ; Humans ; Mitoxantrone ; pharmacology ; Neoplasm Proteins ; metabolism ; Paclitaxel ; pharmacology

Objective To explore the factors influencing the hyponatremia of hypertensive intracerebral hemorrhage.Methods One hundred and five patients with hypertensive intracere bral hemorrhage recorded 7 parameters in patients:age,gender,the use of furosemide,duration of using mannitol,the frequency of using mannitol every day,hypertensive intracerebral hemorrhage early clinical classification,bleeding broken into the ventricle.To get the obviously variability with the hyponatremia by single variable logistic regression analysis.To get the best equation by multivariable logistic regression analysis.Results The obviously variability with the hyponatremia is age,duration of using mannitol,hypertensive intracerebral hemorrhage early clinical classification,bleeding broken into the ventricle.Conclusion Hyponatremia has intimate relationship with age,duration of using mannitol,hypertensive intracerebral hemorrhage early clinical classification,bleeding broken into the ventricle.