Objective To investigate the changes of interleukin(IL)-2 and interferon(IFN)-γin serum and synovial fluid of patients with joint injure with Kashin-Beck disease(KBD), and study the roles of IL-2 and IFN-γ in KBD joint injure. Methods In accordance with the "Diagnostic Criteria of Kashin-Beck disease"(GB16003-1995),48 cases of KBD patients and 26 healthy people(control group) from KBD endemic area in Long county Shaanxi province were enrolled in the study. KBD patient were 24 males and 24 females, respectively, aged 40 to 65 years (mean age 51 years). Forty-eight serum specimens and 28 synovial fluid specimens of patients(14 males and 14 females,respectively) were collected. Healthy control group were 13 males and 13 females, respectively. Twenty-six serum specimens of healthy controls were collected. Serum and synovial fluid IL-2 and IFN-γ levels were determined by enzyme-linked immunosorbent assay(ELISA). Results In healthy controls and KBD patients, the midian of serum IL-2 were 46.8 ng/L and 55.7 ng/L, respectively, and IFN-γ were 52.3 ng/L and 48.8 ng/L, respectively. The difference was not statistically significant between healthy controls and KBD patients(t = 0.62, 0.70, all P ＞ 0.05).In synovial fluid of KBD patient, the midian of IL-2 and IFN-γwere 48.3 ng/L and 44.1 ng/L, respectively. The difference was not statistically significant between serum and synovial fluid in KBD patients(t = 0.69, 1.72, all P ＞0.05). Conclusion Serum and synovial fluid IL-2 and IFN-γare not significantly increased in KBD patients with articular damage, indicating that IL-2 and IFN-γare not involved in KBD joint injury.

Objective To observe the location of pelvic organs, the morphology and function of levator ani muscle (LAM) in primiparous women post vaginal delivery at 6 months postpartum using static and dynamic MRI, and investigate the correlation between LAM injury and pelvic organ prolapse (POP). Methods A perspective analysis of static and dynamic MRI was performed in fifty-one primiparous women post vaginal delivery at 6 months postpartum and thirty-five nulliparous women without experience of pregnancy and delivery as control group from June 2014 to January 2015. Previous pregnancy and abortion history, previous pelvic surgery and pelvic mass diseases were excluded. Cases with pelvic floor dysfunction symptoms were excluded from the control group. All of the women underwent static and dynamic MRI. The primiparous group was divided into two groups on presence or absence of POP on MRI findings:primiparous POP group and primiparous control group. The levatorani scoring system based on static MRI was used to characterize morphological changes of LAM into none, minor and major injury by the total score of bilateral LAM. A series of parameters including H line (the distance between the inferior margin of pubic symphysis to anorectal junction), M line (the perpendicular distance between the distal end of H line to pubococcygeal line), levator plate angle (LPA), iliococcygeal angle (ICA), and levator hiatus length and area were measured on static and dynamic MR images. Fisher exact test was performed to compare difference in distribution of the LAM injury between the primiparous group and control group, as well as the primiparous POP group and primiparous control group. Independent sample t test or Mann-Whitney test was used to compare difference in LAM parameters between the primiparous POP group and primiparous control group. Results In the 51 cases primiparous group, 44 cases showed none injury, whilst 5 cases with minor and 2 cases with major injury in the puborectal muscle. Thirty two cases showed none injury, whilst 10 cases with minor and 9 cases with major injury in the iliococcygeal muscle. In the 35 cases control group, none injury was shown in puborectal muscle, whilst 32 cases with none, 2 cases with minor and 1 case with major injury in the iliococcygeal muscle. There was no significant difference in the puborectal muscle injury between the two groups (P=0.203), and there was significant difference in the iliococcygeal muscle injury between the two groups (P<0.05). In the 24 cases primiparous POP group, 20 cases showed none injury, whilst 2 cases with minor and 2 cases with major injury in the puborectal muscle. Fourteen cases showed none injury, whilst 6 cases with minor and 4 cases with major injury in the iliococcygeal muscle. In the 27 cases primiparous control group, 24 cases showed none and 3 cases with minor injury in the puborectal muscle, whilst 18 cases with none, 4 cases with minor and 5 cases with major injury in the iliococcygeal muscle. There was no significant difference in the puborectal muscle injury and iliococcygeal muscle injury between the two groups (P=0.588 and 0.559, respectively). The LH during Valsalva status in primiparous POP group and primiparous control group were (6.7 ± 1.1) and (5.0 ± 0.6) cm, respectively, whilst the LHA was (41.6 ± 12.6) and (24.2 ± 5.5) cm2. There were significant difference between the corresponding groups (P=0.042 and 0.004, respectively). There was no significant difference between the corresponding groups of the other LAM parameters on static and dynamic MRI (all P>0.05). Conclusion Vaginal delivery may cause various degrees of LAM injury, the LAM functional deficiency were observed in primiparous women combined with POP.

Abstract: Objective　To investigate the molecular characteristics and drug resistance of non-O1/non-O139 Vibrio cholerae in Zhongshan City, and to provide laboratory basis for cholera prevention and control. Methods　The strains of non-O1/non-O139 Vibrio cholerae isolated from sporadic patients and aquatic products from 2015 to 2021 in Zhongshan city were collected. The identification and cluster analysis of the strains were analyzed by matrix assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF-MS), the ctxA virulence gene of strains were detected by real-time fluorescence quantitative PCR, the cluster analysis of the strains was analyzed by pulsed-field gel electrophoresis (PFGE), and the drug resistance of the strains were analyzed by microbroth dilution method. Results　From 2015 to 2021, 33 strains of non-O1/non-O139 Vibrio cholerae were isolated from Zhongshan City, including 28 strains from sporadic patients and 5 strains from aquatic products. Through MALDI-TOF-MS identification, 33 strains of non-O1/non-O139 Vibrio cholera can be identified to the level of species, and the identification results were all Vibrio cholerae. Among 33 non-O1/non-O139 Vibrio cholerae strains, 1 strain carried the ctxA virulence gene. The drug-resistant strains accounted for 69.7% (23/33), and the multidrug resistant strains accounted for 18.2% (6/33). A total of 7 kinds of drug resistance spectrum were produced, including 3 kinds of multidrug resistant spectrum, and showed drug resistance to 8 antibiotics, among which the resistance rates to streptomycin, cefazolin and compound sulfamethoxazole were above 30%. The 33 strains of non-O1/non-O139 Vibrio cholerae were divided into 32 PFGE fingerprints with a similarity ranging from 61.7% to 100%. MALDI-TOF-MS cluster analysis divided 33 non-O1/non-O139 Vibrio cholerae strains into two clusters. Conclusions The results of molecular typing of non-O1/non-O139 Vibrio cholerae in Zhongshan City presented diversity, and no significant correlation was found between PFGE and MALDI-TOF-MS cluster analysis. The strains demonstrated various degrees of resistance to certain antibiotics, and there were multidrug-resistant and toxigenic strains. Therefore, it is necessary to alert to the harmfulness of non-O1/non-O139 Vibrio cholerae and enhance monitoring.

OBJECTIVETo discuss the effect of surgical staging and using craft bone with vancomycin for the treatment of calcaneal fractures.

METHODSFrom January 2006 to December 2012,13 patients with open calcaneal fractures were treated including 9 males and 4 females with an average of 35.2 years old ranging from 23 to 66. All cases were emergency cases. According to Sanders classification of calcaneal fractures, 2 cases were type II, 7 cases were type III, 4 cases were type IV. According to Gustilo-Anderson soft tissue injury classification, 8 cases were type II, 2 cases were type III A, 2 cases were type III B, 1 case were type III C. Firstly a thorough debridement or VSD procedures were applied,secondly calcaneal fracture were treated with open reduction, plate fixation and bone graft complex with antibiotics. Based on clinical examination, radiographic evaluation, and American Foot and Ankle Surgery Society (AOFAS), ankle function were evaluated after operation.

RESULTSOpen wounds were headed after dressing and repairing,, lateral calcaneal wound were healed during the first period. All patients were followed up for 6 to 36 months (means 14.5 months). Fracture healing time was 14 to 20 weeks (means 16.2 weeks). Last follow-up AOFAS ankle-hindfoot score was (80.0 +/- 7.4) ranging from 55 to 95.

CONCLUSIONFor patients with open fractures, through reasonable clinical evaluation, staging operation, using bone graft with antibiotics can reduce the incidence of postoperative wound infection and promote fracture healing.

Adult ; Aged ; Anti-Bacterial Agents ; administration & dosage ; Bone Transplantation ; methods ; Calcaneus ; injuries ; surgery ; Female ; Fracture Fixation, Internal ; Fracture Healing ; Fractures, Open ; surgery ; Humans ; Male ; Middle Aged

Objective To investigate the consistency and stability of two types of pubococcygeal line (PCL) determined by dynamic MRI used in evaluating pelvic organ prolapse (anterior and apical compartments).The first type of PCL was measured from the inferior pubic symphysis to the tip of coccyx (PCLtip) and the second was to the sacrococcygeal joint (PCLjnt).Methods Dynamic MRI changes of 50 female patients who were diagnosed with pelvic organ prolapse by pelvic organ prolapse quantification were retrospective reviewed.Chi-square test was used to compare the staging of each pelvic compartment (anterior,apical) with the two PCLs.The lengths and the degree of the oblique angle of the two PCLs during the rest and straining were compared using a paried t test.Results Agreement of PCLjnt with PCLtip was 96％ (48/50) for anterior compartment and 94％ (47/50) for apical compartment.There was no difference between the two PCLs in staging of each pelvic compartment (anterior,apical)(x2 values were 2.000 and 3.000,P values were 0.368 and 0.223).The length of the PCLtip at rest and straining was (10.1±0.8),(10.2± 0.8) cm respectively and the result was statistical significance (t=-2.339,P=0.023).Twenty patients (40％) in the 50 pelvic organ prolapse patients demonstrated a shortening of the PCLtip,while the rest including 30 patients (60％) was longer.The oblique angle of the PCLtip at rest and straining was 22°±6° and 18°±11° respectively(t=3.490,P=0.001).The length of the PCLjnt at rest and straining were (11.2±0.8) and (11.2± 0.8)cm respectively(t=-1.845,P=0.071).The oblique angle of the PCLjnt at rest and straining were 29°±6° and 26°± 10° (t=2.836,P=0.007),but the degree of PCLjnt's oblique angle had a mild fluctuate compared with the PCLtip.Conclusions PCLjnt and PCLtip have the equal level in staging of anterior and apical pelvic organ prolapse.Meanwhile the oblique angle and the length of PCLjnt illustrated the better the stability.

Objective To observe the clinical efficacy and safety of acetylcysteine effervescent tablets in the treatment of obstructive sleep apnea hypopnea syndrome (OSAHS).Methods One hundred patients with OSAHS were divided into control group and treatment group with 50 cases per group.Control group was given the conventional treatment with low flow oxygen absorption,functional exercise and diet.Treatment group was given acetylcysteine effervescent tablet 600 mg,qd,oral,on the basis of control group.Two groups were treated for 12 weeks.The clinical efficacy,serum endothelin-1 (ET-1),nitric oxide (NO),interleukin-6 (IL-6),tumor necrosis factor-α (TNF-α) and adverse drug reactions were compared between two groups.Results After treatment,the total effective rates of treatment and control groups were 90.00％ (45 cases/50 cases) and 74.00％ (37 cases/50 cases) with significant difference (P ＜ 0.05).After treatment,the main indexes in treatment and control groups were compared:ET-1 were (39.24 ±5.50) and (46.28 ±0.12)ng · L-1,NO were (56.25 ±7.05) and (48.88 ±5.60)μmol · L-1,IL-6 were (41.48 ±4.91) and (65.77 ±9.10)ng · L-1,TNF-α were (28.37 ±3.42) and (42.32 ± 6.21) ng · L-1,the differences were statistically significant (all P ＜ 0.05).There were no adverse drug reactions occurred between two groups.Conclusion Acetylcysteine effervescent tablet has a definitive clinical efficacy and safety in the treatment of OSAHS,which can adjust the levels of ET-1,NO,IL-6 and TNF-α.

OBJECTIVETo investigate the effcacy of the staple fixation for the treatment of hamate metacarpal joint injury.

METHODSFrom May 2009 to November 2012,16 patients with hamate metacarpal joint injury were treated with staple fixation including 10 males and 6 females with an average age of 33.6 years old ranging from 21 to 57 years. Among them, 11 cases were on the fourth or fifth metacarpal base dislocation without fractures, 5 cases were the fourth or fifth metacarpal base dislocation with avulsion fractures of the back of hamatum. Regular X-ray review was used to observe the fracture healing, joint replacement and position of staple fixation. The function of carpometacarpal joint and metacarpophalangeal joint were evaluated according to ASIA (TAM) system evaluation method.

RESULTSAll incision were healed well with no infection. All patients were followed up from 16 to 24 months with an average of (10.0 +/- 2.7) months. No dislocation recurred, the position of internal fixator was good,no broken nail and screw withdrawal were occurred. Five patients with avulsion fracture of the back of hamatum achieved bone healing. The function of carpometacarpal joint and metacarpophalangeal was excellent in 10 cases,good in 5 cases, moderate in 1 case.

CONCLUSIONThe application of the staple for the treatment of hamatometacarpal joint injury has the advantages of simple operation, small trauma, reliable fixation, early postoperative function exercise and other advantages, which is the ideal operation mode for hamatometacarpal joint injury.

Adolescent ; Adult ; Carpal Joints ; injuries ; surgery ; Female ; Fracture Fixation, Internal ; instrumentation ; methods ; Fractures, Bone ; surgery ; Hamate Bone ; injuries ; surgery ; Humans ; Male ; Metacarpal Bones ; injuries ; surgery ; Metacarpophalangeal Joint ; injuries ; surgery ; Middle Aged ; Sutures ; utilization ; Young Adult

Objective To assess the role of 68Ga-N,N′-bis(2-hydroxy-5-(carboxyethyl)benzyl) ethylenediamine-N,N′-diacetic acid(HBED-CC)-(Ahx)Lys-CO-Glu(PSMA-11) PET/CT on the detection of metastatic lesions from castration-resistant prostate cancer (CRPC).Methods Sixteen patients with CRPC who underwent 68Ga-PSMA-11 PET/CT between January 2015 and November 2015 were recruited in this study.Mean age of patients was (72±9) years.The PSA levels were 4-12 356 μg/L, Gleason score was 7-10.PET/CT was performed at 1 h postinjection of 68Ga-PSMA-11.Patient-based analysis and lesion-based analysis were performed.ROI analysis was used to calculate the tumor uptake (SUVmax).Final diagnosis was based on histopathology and results of other imaging examinations(99Tcm-MDP imaging, MRI).χ2 test was used to compare the diagnostic efficiencies of PET and CT.Results No adverse effects were observed in patients.68Ga-PSMA-11 PET/CT showed moderate physiologic uptake in salivary glands and proximal small intestine, with predominant tracer clearance by the kidneys.All patients were positive on 68Ga-PSMA-11 PET/CT.Bone metastasis was found in 16 patients, liver metastasis in 2 patients (5 lesions), and lymph node metastasis in 4 patients (26 lesions).The SUVmax of liver, lymph node and bone metastases were 15.06±2.77, 7.54±5.20, 19.01±16.96, respectively.The diagnostic sensitivity, specificity and accuracy on bone metastasis with 68Ga-PSMA-11 PET and CT were 96.30%(52/54) vs 61.11%(33/54), 3/3 vs 1/3, 96.49%(55/57) vs 59.65%(34/57).The sensitivities and accuracies of the two modalities were significantly different(χ2=19.943, 22.593, both P<0.01).Conclusions 68Ga-PSMA-11 PET/CT could precisely detect both primary and metastatic lesions of CRPC, suggesting that it is of great value for the clinical management and treatment.

Objective To investigate the prompt value of abnormal vaginal morphology on diagnosing pelvic organ prolapse . Methods Forty eight pelvic organ prolapse female patients diagnosed by pelvic organ prolapse quantification were enrolled in the pelvic organ prolapse group and 51 normal female volunteers were enrolled in the control group in this study. Pelvic MRI T2WI were performed in all cases. The vaginal shape were evaluated according to Delancey Ⅱ level on the transverse images, which were divided into two categories:normal morphology (H-shaped) and abnormal morphology(non H-shaped). The vaginal shape distribution of different prolapse degree(0,Ⅰ,Ⅱ,Ⅲ,Ⅳstage) and types(anterior,middle, posterior pelvic prolapse) were recorded. Chi-square test was used to analyse distribution difference of vaginal shape between the two groups. The ROC curve was used to analyse the diagnostic efficiency of abnormal vaginal morphology for diagnosing pelvic organ prolapse. Results In the control group, there were 40 cases with normal vaginal morphology and 11 cases with abnormal morphology mainly including W-shaped and U-shaped abnormal morphology. In the prolapse group, there were 5 cases with normal vaginal morphology and 43 cases with abnormal morphologymainly including U-shaped (13 cases), W-shaped (26 cases) and O-shaped(4 cases) abnormal morphology. There was significant difference between the two groups(c2=46.137,P<0.01). The area under the curve (AUC) was 0.800. The sensitivity and specificity of abnormal vaginal shape for diagnosing pelvic organ prolapse were 89.6% and 78.4%respectively.The distribution of vaginal morphology in different degrees and types of prolapse were different:vaginal morphology of 0 stage prolapse showed H-typed mainly (40/51, 78.4%), Ⅰ stage prolapse showed W-shaped (16/28 57.1%), Ⅱ,Ⅲ stage prolapse all showed non H-shaped (20/20, 100%), Ⅱstage mainly showed W-shaped (9/14), Ⅲ stage mainly showed O-shaped (3/6). Anterior pelvic organ prolapse were manifested mainly with W-shaped vaginal morphology (4/9) and middle pelvic organ prolapse mainly showed O-shaped vaginal morphology (4/7). Conclusions The abnormal vaginal morphology has the prompt value on diagnosing pelvic organ prolapse.Moreover, the different shape probably indicates the different degrees and types of pelvic organ prolapse.

Objective To study the correlations of VDR FokⅠgene polymorphism with type 2 diabetes in postmenopausal women of Han nationality in south Sichuan. Methods 160 patients with type 2 diabetes (T2DM) and 190 healthy cases were enrolled in the study. The VDR FokⅠgene polymorphisms were detected using RFLP-PCR and DNA sequencing. Results The FF, Ff and ff genotype frequencies were 32.5%, 47.5%and 20% in the T2DM group and 15.8%, 53.7%, 30.5% in the control group, respectively (P < 0.05). The allele frequencies were 56.3%, 43.8% in the T2DM group and 42.6%, 57.4% in the control group, respectively (P < 0.05). The risk of T2DM in the FF genotype people was 2.568 times higher than Ff/ff genotype (adjusted OR = 2.568, 95%CI = 1.246 ~ 5.292, P < 0.05). The levels of 2 h PG and HbA1C in the FF genotype people were significantly higher than those of the Ff/ff genotype people (P<0.05). Conclusions There was an association between the VDR FokⅠgene polymorphism and type 2 diabetes incidence in the postmenopausal women in south Sichuan area.