Adult ; Anti-Bacterial Agents ; administration & dosage ; Humans ; Male ; Periodontal Diseases ; therapy ; Subgingival Curettage ; Treatment Outcome

[Objective] To explore the causing and prevention factors of peroneal nerve injury after total knee arthroplasty(TKA).[Method] Nine postoperative peroneal-nerve injury in 9 patients were documented in a retrospective review of 2000 consecutive total knee arthroplasties performed at one institution from Jan.1996 to Jun.2007.Six fresh cadaver knees were executed TKA to observe the causing factors of peroneal nerve injury in operation.[Result]The causing factors of the 9(0.45%)patients were not clear.Cadaver knees TKA suggested the dangerous handlings by turns include the belows:①lifting distal femur by encircle dragging may enhance lesion probability of common peroneal nerve.②risk for common peroneal nerve to set Hoffman crook not paralleling longitudinal axis of tibia or posterior the lateral collateral ligament.③excessive straightening knee joint after the prosthesis had been fixed.[Conclusion]Lifting distal femur by encircle dragging should be avoided while peeling posterolateral joint caps and caput laterale musculi gastrocnemii.The location,inserting orientation and depth of Hoffman crook should be taken care of.Hyperextension of the knee should be avoided.

AIM: To study the transdermal permeability of ephedra extract. METHODS: With Valia Chien diffusion cell to the transdermal experiments are used to observe the effect of different factors on the transdermal permeability. RESULTS: Its transdermal resorption constant increased with the increase of the concentration of ephedrine and ephedra extract. pH value of the diffusioin medium could influence ephedrine permeability. CONCLUSION: The result can offer reference in preparation for Ephera (targeting drug delivery system) (TDS).

Objective To study the clinical efficacy of the treatment of traditional Chinese medicine combined with western medicine for extended -spectrum β-lactamase (ESBLs ) bacterial infection associated pneumonia.Methods 80 patients with ESBLs bacterial infection associated pneumonia in our hospital from January 2015 to June 2016 were randomized into the control group (western medicine routine treatment)and the observation group (treatment of traditional Chinese medicine combined with western medicine)according to the random number method,40 patients in each group.The disappearance time of clinical symptoms and signs and hospitalization time, sputum culture results,and the clinical efficacy of treatment in the two groups were compared.Results Compared with the control group,the disappearance time of cough[(6.5 ±1.3)d vs (8.2 ±1.5)d],t=4.38,P<0.05],fever [(5.1 ±1.2)d vs (6.8 ±1.4)d,t=4.19,P<0.05],pulmonary rales[(6.2 ±1.3)d vs (7.8 ±1.6)d,t=4.27,P<0.05]and the hospitalization time[(9.1 ±1.3)d vs (11.8 ±1.6)d,t=5.06,P<0.05]were significantly reduced in the observation group.Compared with the control group,the negative rates of pneumonia klebsiella (25.0% vs 8.0%,χ2 =4.30,P<0.05)and Escherichia coli (70.0%vs 60.0%,χ2 =4.75,P<0.05)in sputum were obviously increased in the observation group.Compared with the control group,the markedly effective rate of treatment was significantly improved in the observation group(92.5%vs 75.0%,χ2 =4.50,P<0.05).Conclusion The treatment of traditional Chinese medicine combined with western medicine can significantly increase the clinical efficacy of ESBLs bacterial infection associated pneumonia,improve the negative rates of sputum bacteria,and it is worthy of clinical promotion.

Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Pneumonia ; blood ; complications ; diagnosis ; Prognosis ; Retrospective Studies ; Sepsis ; blood ; complications ; diagnosis ; Tumor Necrosis Factor-alpha ; blood

According to content of ‘lipid metabolism’,we crafted a effective case for problem based learning (PBL) and practiced it in biochemistry course.In group discussion,students participated in discussion with great enthusiasm and initiative.During the discussion,students got a better understanding about lipid metabolism and clinical application of the knowledge.As teachers,we maily guided students during PBL,and at the same time,we also summed up the experience and explored how PBL be implemented for freshmen and sophomores who lack clinical practice.

Objective To evaluate clinical application value of critical flicker frequency (CFF),psychometric hepatic encephalopathy score (PHES) and Stroop test in the diagnosis of covert hepatic encephalopathy (CHE).Methods A total of 110 patients with decompensated liver cirrhosis and 54 individuals without liver diseases were enrolled as control group.According to PHES＜-4 points as reference threshold for CHE,the threshold of CFF and time of Stroop test for CHE diagnosis was caculated.Positive results of at least two of PHES,CFF and Stroop tests was considered as the gold standard for CHE diagnosis,and then the value of these three methods in CHE diagnosis was evaluated.Student's t test and receiver operating characteristic curve (ROC) were used for statistical analysis.Results Among the 110 patients with liver cirrhosis,40 patients had no hepatic encephalopathy (HE0),52 patients had CHE,and 18 patients had grade 2 hepatic encephalopathy (HE2).The CFF value and total time of Stroop test of control group were (43.70±1.92) Hz and (201.17±20.65) s,respectively.The CFF value of HE0 group was (41.40 ± 1.85) Hz,which was higher than that of CHE group ((38.33 ± 2.32) Hz),and the difference was statistically significant (t=-7.116,P＜0.01).The total time of Stroop test of HE0 group was (197.91±26.68) s,which was shorter than that of CHE group ((253.24± 33.33) s),and the difference was statistically significant (t=8.936,P＜0.01).When PHES＜-4 points was considered as a reference threshold of CHE,the threshold of CFF for CHE diagnosis was 39 Hz,the sensitivity was 94.9％ and the specificity was 73.1％,the area under the curve (AUC) was 0.879.The threshold of the total time of Stroop test for CHE diagnosis was 233.80 s,the sensitivity was 83.3 ％ and the specificity was 71.1％,the AUC was 0.803.The completion time of the number connection test (NCT)-A,NCT-B and digit symbol test (DST),which were there of five subtests of PHES,of CHE group were (80.27±36.05) s,(124.18±55.96) s and (25.03±8.23) s,respectively,compared with those of HE0 patients ((56.68±18.82) s,(80.00±25.58) s and (34.68±8.75) s,respectively),the differences were statistically significant (t =3.691,4.108 and-4.780;all P＜0.01).Compared with the results of combined PHES and Stroop test in the diagnosis of HE0,CHE and HE2,the consistency rates of CFF＜39 Hz as threshold for diagnosis were 95.0％,61.5％ and 100.0％,respectively.Conclusions NCT-A,NCT-B and DST three subtests of PHES have higher efficiency in CHE diagnosis.CFF and Stroop test are also reliable screening methods for CHE,with advantage of objectivity and high specificity.

BACKGROUND:The anatomical strucure of acetabulum is smal and shal ow in adult acetabular dysplasia patients. The large amount of cal us and scar tissues in the acetabulum make it difficult to identify and instal the acetabular cup during arthroplasty. The comprehensive understanding of the acetabulum before arthroplasty is the premise for selecting the appropriate acetabular prosthesis and making the acetabular reconstruction program. OBJECTIVE:To evaluate the application value of three-dimensional reconstruction technique in choosing the size of acetabular cup before total hip arthroplasty for acetabular dysplasia. METHODS:Spiral CT was carried out in the 11 acetabular dysplasia patients who waiting for total hip arthroplasty. The acetabulum was multi-planar reconstructed, and the size of the acetabular cup was determined through digitized acetabular cup template implantation, and then the mathching degree assessment was performed to compare with the actual size. RESULTS AND CONCLUSION:Spiral CT could clearly show the acetabular morphology, and the 71.4%of the acetabular size chosen in the three-dimensional preoperative plan was the same as actual one, the intraclass correlation coefficient was 0.888. The agreement was much higher than that of two-dimensional preoperative plan based on X-ray plain film. For the patients with acetabular dysplasia, the acetabulum became saml er and shal ower, and there were various extents of bone defects in the superior-lateral acetabulum. Three-dimensional multi-planar reconstruction can effectively evaluate the acetabular morphology, and three-dimensional preoperative plan can provide useful information for the choice of implant.

Objective To explore the predictive value of modified version Essen stroke risk score (ESRS) for recurrent cerebral infarction in 1 year. Methods Factors ofcerebrovascular stenosisand≥ 2 lesions in diffusion weighted imaging (DWI) which reflected large vascular stenosis and unstable plaques to the ESRS were added, and the 2 factors of other cardiovascular diseases and“peripheral vascular disease”which were difficult to operate clinically and had a lower incidence compared with the European and American people were got rid of. Thus, the total score of the modified version ESRS was still 9 scores. The risk of recurrent cerebral infarction in 1 year in 263 patients with cerebral infarction were evaluated by ESRS and modified version ESRS, and the predictive value was evaluated by area under receiver-operating characteristics (ROC) curve. Results The incidence of recurrent cerebral infarction in 1 year in 263 patients with cerebral infarction was 15.59% (41/263). There were statistical differences in the incidences of recurrent cerebral infarction in 1 year for different risk stratification patients by 2 methods (P<0.01). Multiple factor Logistic regression analysis results showed that thecerebrovascular stenosisand≥2 lesions in DWIwere the independent risk factors in predicting recurrent cerebral infarction in 1 year (OR=12.48 and 18.72, 95%CI 5.083-30.641 and 7.718-43.242, P=0.000 and 0.000). The area under ROC of predicting recurrent cerebral infarction in 1 year by ESRS and modified version ESRS was 0.68 (95% CI 0.58- 0.79) and 0.70 (95% CI 0.60-0.79), and there was statistical difference (P<0.01). Conclusions The predictive value of modified version ESRS in recurrent cerebral infarction in 1 year is higher than that of ESRS, and it is an effective method.

AIM:To investigate the effect of oleuropein on interleukin-1β( IL-1β)-induced SD rat articular chondrocytes .METHODS:The SD rat articular chondrocytes were isolated by 2 step enzyme digestions .The chondrocytes were cultured in vitro.Inverted microscopic observation was performed during the culture .Alcian blue staining and type II collagen immunohistochemical staining were used to identify the chondrocytes .The effects of oleuropein on the viability of chondrocytes were determined by CCK-8 assay.The cells in 3rd passage were pretreated with oleuropein at 10, 50 or 100 μmol/L and subsequently stimulated with IL-1βat 10 μg/L for 24 h.Production of prostaglandin E 2 ( PGE2 ) and ni-tric oxide (NO) were evaluated by the Griess reaction and an enzyme linked immunosorbent assay (ELISA).The mRNA expression of matrix metalloproteinase ( MMP)-1 and MMP-13 was measured by real-time PCR.The protein levels of in-ducible nitric oxide synthase (iNOS), cyclooxygenase-2 (COX-2) and nuclear factor-kappa B (NF-κB) were detected by Western blotting .RESULTS:The cell viability of chondrocytes was not significantly impaired by treating with oleuropein at concentration of 10, 50 or 100μmol/L for 24 h compared with control group .Pretreatment with oleuropein significantly in-hibited the production of PGE 2 and NO induced by IL-1β.Oleuropein also significantly decreased the IL-1β-stimulated MMP-1 and MMP-13 mRNA expression in articular chondrocytes .Pretreatment with oleuropein inhibited the IL-1β-media-ted activation of NF-κB by suppressing the degradation of its inhibitory protein IκBαin the cytoplasm .CONCLUSION:Oleuropein inhibits IL-1β-induced inflammatory gene expression by suppressing NF-κB activation at the transcriptional le-vel, suggesting a new mechanism for the anti-inflammatory effects of oleuropein as a novel agent on treating with osteoarthri-tis.