Objective To investigate the clinical significance of plasma prothrombin activity (PTA) and serum alpha fetoprotein (AFP), prealbumin (PALB) in severe hepatitis patients treated with artificial liver plasma exchange. Methods The clinical data of 31 patients with severe hepatitis were retrospectively analyzed. The patients were treated with artificial liver plasma exchange based on the comprehensive treatment. The patients were divided into survival group (17 cases) and death group (14 cases) according to the clinical outcome. The plasma prothrombin time (PT) and serum AFP, PALB levels were detected before treatment, 3rd, 9th and 18th day after treatment and at the last time (prior to discharge/ in extrimis), and the PTA was counted. Results There was no statistical difference in PTA before treatment and 3rd day after treatment between 2 groups (P>0.05). The PTA levels 9th and 18th day after treatment and at the last time in death group were significantly lower than those in survival group:(30.17 ± 4.79)％vs. (39.74 ± 4.77)％, (25.47 ± 6.46)％vs. (42.79 ± 6.88)％and (21.40 ± 9.17)％vs. (47.17 ± 5.46)％,and there were statistical differences (P<0.05). There was no statistical difference in AFP before treatment between 2 groups (P>0.05);the AFP levels 3rd, 9th and 18th day after treatment and at the last time in death group were significantly lower than those in survival group:(121.9 ± 31.7)μg/L vs. (134.6 ± 31.8)μg/L, (88.7 ± 40.8)μg/L vs. (169.9 ± 41.7)μg/L, (56.9 ± 29.7)μg/L vs. (176.8 ± 48.1)μg/L and (29.8 ± 15.7) μg/L vs. (204.3 ± 41.2) μg/L, and there were statistical differences (P<0.05). There was no statistical difference in PALB before treatment between 2 groups (P>0.05); the PALB levels 3rd, 9th and 18th day after treatment and at the last time in death group were significantly lower than those in survival group: (107.2 ± 17.4) mg/L vs. (126.3 ± 33.2) mg/L, (91.2 ± 11.9) mg/L vs. (137.9 ± 35.7) mg/L, (54.7 ± 14.8) mg/L vs. (151.9 ± 27.9) mg/L and (43.3 ± 19.7) mg/L vs. (159.3 ± 41.2) mg/L, and there were statistical differences (P<0.05). Conclusions The plasma PTA and serum AFP, PALB levels are closely related with curative effect of artificial liver plasma exchange in severe hepatitis patients, and dynamic observation of its changes can help to determine the condition.

Objective To explore factors associated with incision infection in elderly patients undergoing general surgery and thus provide a basis for its clinical prevention.Methods Retrospective clinical data of 2985 elderly patients who underwent routine surgical operation after admission to the Department of General Surgery from Feb.2009 to Dec.2013 were analyzed.Patients with incision infection following surgery were assigned into the infection group,while patients without incision infection served as the control group.Single factor analysis and multivariate Logistic regression analysis were conducted to identify factors responsible for incision infection.Results There were 91 cases with incision infection,constituting a rate of 3.0％.Compared with the control group,patients in the infection group showed an older average age [(67.3±5.8) years vs.(63.0± 5.6) years,t=1.906,P＜0.05],a longer average operating time [(2.13±0.26) hours vs.(1.87±0.24) hours,t=10.149,P＜0.001],and a longer average incision length [(8.14±2.62) cm vs.(7.59±2.14) cm,t=2.396,P＜0.01].In addition,compared with the control group,more patients in the infection group received prophylactic antibiotics (74.7％ vs.83.3％,x2 =4.819,P=0.032),exhibited malnutrition (20.9％ vs.10.0％,x2 =11.418,P=0.001),and had diabetes mellitus (11.0％ vs.5.1％,x2 =5.968,P=0.015).Therefore,independent risk factors for incision infection included age (OR=1.89),operating time (OR=3.32),nutritional status (OR=2.08) and diabetes mellitus (OR=3.18).Conclusions A few risk factors may contribute to incision infection.Clinicians should take necessary preventive measures accordingly to minimize its occurrence.

Objective To investigate the application of serum NT-PROBNP and cTn level detection in senior acute coronary syndrome(ACS) patients during PCI perioperative.Methods 67 ACS patients who need PCI treatment in the Second People’s Hospital of Liaocheng from April 2013 to April 2014 were selected and their perioperative serum NT-PROBNP and cTn levels were detected.At the same time,30 healthy senior people were chosed as control and their serum NT-PROBNP and cTn levels were also detected.Perioperative serum NT-PROBNP and cTn levels between ACS patients and heathy people were compared,the relationship between serum NT-PROBNP,cTn level and cardiac function of ACS patients were analyzed,and the ROC curve was used to analyze the predictive value of serum NT-PROBNP and cTn joint detection on cardiac function in ACS patients. Results Serum cTnT,cTnI and NT-PROBNP levels of ACS patients were higher than that of healthy senior people (P<0.05 ).Serum cTnT,cTnI and NT-PROBNP levels of ACS patients in postoperative 4h,12h and 24h were higher than that of preoperative,and serum cTnT,cTnI and NT-PROBNP levels in postoperative 72 were lowered,and the differences were statistically significant(P<0.05 ).Pearson correlation analysis results showed that serum cTnT, cTnI and NT-PROBNP levels and heart function of senior ACS patients were negatively correlated (rcTnT=-0.706,rcTnI =-0.841,rNT-PROBNP =-0.822, P<0.05).Area under the ROC curve was 0.678 to 0.945,which belongs to 0.6 -0.9,serum NT-PROBNP and cTn joint detection could well predict the heart function of senior ACS patients.Conclusion Serum cTnT,cTnI and NT-PROBNP levels and heart function of senior ACS patients are negatively correlated.Serum NT-PROBNP and cTn joint detection can be used as predictor of cardiac function of senior ACS patients treated with PCI.

The left ventricular systolic function before and after right ventricular pacing was studied in 26 patients by Doppler and M-mode echocardiography. The results showed that there were increases in cardiac output and heart rate, respectively (P

Amyloidosis ; classification ; diagnosis ; Cardiomyopathies ; classification ; diagnosis ; Humans

Objective To investigate the effect of smoking and smoking cessation on the phosphorylation of IKK-β in type 2 diabetic rats. Methods Forty-two six-week-old Wistar rats were randomly divided into 4 groups: normal control(NC, n =7), diabetes control (DC, n =7), diabetes with smoking (DS, n = 14) and diabetes with smoking cessation(SC, n = 14). Rats in DS and SC groups were further assigned randomly into 8w and 12w subgroups. DS group was given passive smoking twice a day for 8 or 12 weeks, while SC group ceased passive smoking for 4 weeks after 8 or 12 weeks of smoking . Western blot method was used to detect the level of IKK-13 phosphorylation in skeletal muscle. Results Compared with the NC group,the phosphorylation of IKK-β protein in DC group was increased (0. 16±0. 05 vs 0. 30±0. 08, P < 0. 01). There was an increasing trend with the phosphorylation level of IKK-β in the DS (8w) subgroup, but there was no statistical difference between the DC group and SC(8w) subgroup (0. 40±0. 09 vs 0. 30±0. 08,0. 36±0. 10, P >0. 05). The phosphorylation level of IKK-β in DS(12w) group increased obviously, being significantly higher than that in the DC group and SC (12w) subgroup(0. 74 ± 0. 11 vs 0.30±0.08,0.35±0.07,P < 0.01). Conclusion With the prolongation of smoking duration, the phosphorylation of IKK-β in type 2 diabetic rats increased. After smoking cessation, the phosphorylation of IKK-β decreased. The phosphorylation of IKK-β may be involved in the mechanism by which smoking causes type 2 diabetes.

BACKGROUND: Recently biodegradable hydrogel has been extensively used to delivery anticancer drug and bioactive macromolecule. However, to protect the activity of the bioactive macromolecule, we need to obtain series of hydrogel which have milder hydrogelation conditions and shorter hydroglation time.OBJECTIVE: To prepare enantiomeric poly(L-Lactic acid) (PLLA)-poly(ethylene glycol (PEG)-PLLA/ poly(D-Lactic acid) (PDLA)-PEG-PDLA stereocomplex hydrogel which has shorter hydroglation time, to physically encapsulate a model drug-lysozyme and sustained release it from the hydrogel. METHODS: Triblock copolymers of PLLA-PEG-PLLA and PDLA-PEG-PDLA were synthesized by ring-opening polymerization of L(D)-lactide using PEG as the initiator and Sn(Oct)2 as the catalyst. The triblock copolymers were characterized by 1H nuclear magnetic resonance, FT-IR and X-Ray diffractometry. A hydrogel was prepared from an aqueous mixture of PLLA20-PEG227-PLLA20 and PDLA21-PEG227-PDLA21 (10 wt% concentration) at room temperature for 12 hours. X-Ray diffractometry test was used to research the gelation mechanism. The release profile of the lysozyme as a model drug from the hydrogel was tested. The morphology of the freeze-dried hydrogel was investigated by scanning electron microscope. The cytotoxicity of the hydrogel was evaluated by 3-(4,5-dimethylthiazol-2-yl-2,5-diphenyl tetrazolium bromide) assay.RESULTS AND CONCLUSION: Triblock copolymers of PLLA-PEG-PLLA and PDLA-PEG-PDLA were obtained. Both the PEG and PLA blocks in the copolymers could crystallize, but the crystallization of the PEG block was predominant. The stereocomplex formation between the PLLA and PDLA blocks within the hydrogel was confirmed by the X-Ray diffractometry analysis. The release profile of the lysozyme from the hydrogel exhibited a sustained-release pattern with a duration period of 7 days. The hydrogel exhibited a 3D interconnected porous structure with 50-100 μm pore size after being freeze-dried. The mouse fibroblast cell viability percentage was 99.3% after the cells contacted with the 100% extracted liquid for 72 hours.

Objective:To study the effectiveness of inferior pole fracture of patella treating by the new tension band.Methods:From Dec.2011 to Dec.2013, 21 patients with inferior pole fracture of patella were treated with the new tension band which consisted of cannulated screw, titanium cable and shims. There were 21 patients[10 males, 11 females, the average age was 54 years(21 to 79)],of whom,all were“fell on knees”.Results:The average operation time was 89 min (57-197 min),the follow-up visits were done from 7-31 months ( average 18 months) , the bone healing time was from 8-12 weeks (average 10.5 weeks).The post operation assessment was done by Bostman score, from 20 -30 (average 27),10 excellent,and 11 good.No complication occurred.Conclusion:The new tension band is the effective treatment for inferior pole fracture of patella.The internal fixation is reliable, it is simple to operate, and patients can take exercises as early as possible.Therefore, the new tension band has a bet-ter clinical value.

Objective To investigate the factors influencing prognosis in surgical treatment of thoracolumbar spinal injury combined with spinal cord injury so as to assist in the clinical treatment.Methods A retrospective study was made on 77 cases of acute thoracolumbar spinal injury combined with spinal cord injury admitted from July 2005 to April 2011.There were 66 men and 11 women,aged 14-66 years (mean,36.5 years).Neurological performance evaluated using American Spinal Injury Association (ASIA) scale was grade A in 31 cases,grade B in 11 cases,grade C in 10 cases,and grade D in 25 cases.Potential factors affecting the prognosis of spinal cord injury were identified using univariate analysis and incorporated into the Logistic regression equation to filter out the main influencing factors.Results Fifteen cases dropped out at a mean 55.5-month follow-up (range,24-96 months) and follow-up rate was 81％.Univariate analysis selected fracture or dislocation types (P ＜ 0.01),combined injury (P ＜ 0.05),use of glucocorticoid within 8 hours postinjury (P ＜ 0.05),standard transport by medical professionals (P ＞ 0.1),complete injury (P ＜ 0.01),visiting time (P =0.055),cause of disease before operation (P ＜ 0.05) and canal encroachment rate (P ＜ 0.01) as predictors of neurologic recovery in spinal cord injury (P ＜ 0.1).Logistic regression analysis revealed significant prognostic factors were canal clearance (P ＜ 0.01) and use of steroids within 8 hours postinjury (P ＜ 0.05).Conclusion Glucocorticoid pulse therapy within 8 hours postinjury and adequate spinal cord decompression may effectively improve the neurologic prognosis in thoracolumbar spinal injury with spinal cord injury.

Objective:To evaluate the curative effects of Masquelet technique and 3D printing in repair of Cierny-Mader type Ⅳ long bone osteomyelitis.Methods:A retrospective study was conducted of the 8 patients who had been treated at Department of Orthopaedics, The Third Affiliated Hospital to Peking University for Cierny-Mader type Ⅳ osteomyelitis of the lower extremity from June 2017 to December 2019. They were 6 males and 2 females, aged from 27 to 79 years (average, 54.6 years). The defects involved femoral shaft in 5 cases, femoral metaphysis in one, tibia shaft in one, and tibial metaphysis in one. The defect lengths ranged from 7.7 to 15.5 cm, averaging 10.2 cm. Stage one was local infection control and temporary stability reconstruction using Masquelet technique, stage two design and 3D printing of the prosthesis and stable pattern design, and stage three prosthesis implantation and rehabilitation. The ranges of motion of the knee and ankle were recoded postoperatively and the functions evaluated using the Johner-Wruhs scores.Results:The average follow-up time for the 8 patients was 12.6 months (from 6 to 18 months). The total treatment time from the first admission to the last discharge ranged from 62 to 125 days (average, 91.0 days), the time for stage one from 13 to 57 days (average, 28.7 days), that for stage two from 30 to 87 days(average, 48.3 d), and that for stage three from 28 to 84 days (average, 63.0 days). The infection was controlled and there was no recurrence, implant loosening or breakage. Seven patients were capable of full weight-bearing at 14.7 days (from 4 to 42 days) after surgery. One patient recovered full weight-bearing 6 months after surgery due to severe osteoporosis. Fine functional recovery was achieved in the 8 patients, with a range of motion from 0° to 100° for the knee and a range from 35° dorsal flexion to 40° toe flexion for the ankle. The Johner-Wruhs scores at the last follow-up showed 2 excellent, 5 good and one moderate cases.Conclusion:In repair of Cierny-Mader type Ⅳ long bone osteomyelitis, Masquelet technique and 3D printing can shorten the treatment process and allow for early recovery.