OBJECTIVE: To study the pathogenic spectrum and the clinical characteristics of viral diarrhea in children.METHODS: The study was conducted in 400 children with viral diarrhea hospitalized in Children's Hospital from January to December in 2016. The stool specimens(about 5 mL)were collected for detection from the children on the day of hospitalization. The ELISA method and PCR method were used to detect the genotypes of HUCV,HADV,HAsta V and HRV in stool specimens,and the clinical data of children were collected at the same time. RESULTS: In 2016,the total positive rate of HRV,HUCV,EAd V and HAst V in the stool specimens of children with viral diarrhea was 59%(236 cases). The positive detection rates of the four viruses were 178 cases(75.42%),68 cases(28.81%),12 cases(5.08%)and 5 cases(2.12%)respectively,of which 11.42% were double mixed infection and 41% were of unknown pathogens. The HRVG6(93.63%,147 cases)and P3(91.08%)as well as G6[P3](90.45%)combination were the popular superior type in 2016,and about 11.79%couldn't be typed. Norovirus accounted for 92.65% of the calicivirus viruses,and GⅡ accounted for 98.41%. About 81.79%of the children(193 cases)hospitalized for viral diarrhea were less than 24 months old. Pathogens were different at different peak age. The peak season of onset was fromJanuary to March and December. The main clinical manifestations were diarrhea,vomiting and fever. CONCLUSION: It is essential to determine the unknown pathogens and improve the pathogenic spectrum in children with viral diarrhea. Viral diarrhea is often accompanied by extraintestinal clinical manifestations.

BACKGROUND:Usual y, amount of bleeding during replacement and drainage amount after replacement were recorded to evaluate the amount of bleeding in patients with arthroplasty. These are dominant blood loss. Studies demonstrated that recessive blood loss exceeded 50%of total amount. OBJECTIVE:To compare the blood loss during total knee arthroplasty under high negative pressure drainage and common negative pressure drainage and to assess the effect of high negative pressure drainage on hidden blood loss in total knee arthroplasty.
METHODS:A total of 60 patients undergoing lateral total knee arthroplasty were equal y divided into high negative pressure drainage group and conventional drainage group (control group). We calculated the total blood loss (dominant blood loss and hidden blood loss) and blood transfusion amount with the Gross equation. The recovery after surgery and complications were compared.
RESULTS AND CONCLUSION:In high negative pressure drainage group, the total blood loss was (646±184) mL and the hidden blood loss was (215±128) mL. In the control group, the total blood loss was (867±296) mL and the hidden blood loss was (457±268) mL. The total blood loss and hidden blood loss in the high negative pressure drainage group were significantly less than those in the control group (P<0.05). The average blood transfusion amount was 224 mL in the high negative pressure drainage group and 467 mL in the control group. Fol owing unilateral total knee arthroplasty, total blood loss, hidden blood loss and blood transfusion amount after arthroplasty were less in the high negative pressure drainage group than those in the control group. In particular, the decrease in hidden blood loss was helpful to observe and treat the pathogenetic condition and to avoid potential risk, and benefits the recovery of knee joint function after surgery.

[Objective]To find out the reason of patellar clunk syndrome after total knee replacement and define its countermeasure.[Method]From January 2001 to December 2004,total knee replacements were performed on 57 cases(82 knees).Patellar clunk syndromes were found in 14 knees.The reason was analyzed.[Result]The reason of patellar clunk syndrome was abnormality of patellofemoral tracking,including type intercondylar notch and type trochlear groove.[Conclusion]The problem of patellofemoral joint is very important in total knee replacement.With adopting accurate technique of cutting and component implantation,perfecting the design of prostheses,patellar clunk syndrome could be avoided completely.

BACKGROUND: Suture silk or steel ring, Kirschner wire tension wire, modified AO band and screw are always used to treat patellar fractures. These methods cause large wound, slow fracture healing and limited joint function. OBJECTIVE: To analyze the therapeutic effect of Ti-Ni shape memory alloy clamp on patellar fractures. DESIGN, TIME AND SETTING: Retrospective analysis was performed at the Luoyang Hospital of Orthopedics and Traumatics from June 2001 to June 2006. PARTICIPANTS: 121 patients of patellar fractures (123 knees), 78 males (80 knees) and 43 females (43 knees), aged 38.3 years (range 21–67 years). There were 47 cases with left patellar fracture, 72 cases with right and 2 with bilateral; 53 knees were transverse,36 knees were comminuted, 32 avulsion, and 2 vertical fracture; 23 cases were injured by direct violence, and 98 by indirect violence. METHODS: Vertical incisions were made to expose fractures. The deep layer of the tendinous membrane was remained. The fracture was repositioned and the lacerated retinaculum and tendinous membrane were sutured. After the vertical diameter of the patella was measured, suitable clamp was selected and placed. After well repositioned, heat saline gauze was used to make the clamp reposition and fix the fractures. The incision was finally closed. MAIN OUTCOME MEASURES: Material and host responses; functional assessment of the patella fractures using Bostman. RESULTS: 121 cases were followed-up for 8 months8. All fractures were healed. No infection occurred. A little displacement of fractures occurred in 4 cases, early traumatic arthritis in 1 case, and slippage of the clamps in 2 cases. According to the functional assessment of the patella fractures of Bostman, the excellent results were 107 knees, and good were 16 knees. CONCLUSION: Ti-Ni shape memory alloy clamps exhibit reliable fixation, with soft tissue remaining, which is important to retain the blood supply of the patella. Moreover, it accelerates the healing of fractures.

Objective To observe the effect of Yiqi Huayu Recipe on the expression of protein kinase C (PKC) and CyclinE in rats with gastric precancerous lesions (GPL). Methods The model of GPL was established mainly through N-methyl-N-nitro N-nitrosoguanidine (MNNG) together with other factors including alcohol stimulation and undue hunger and overeating. The survived rats after modeling were randomly divided into spontaneous recovery, and high-, moderate- and low-dose Yiqi Huayu group. After the corresponding treatment, the expression of PKC and CyclinE were detected by immunohistochemical method in each group. Results The expression of PKC and CyclinE in trement group were distinctly lower than those in spontaneous recovery group (P

ObjectiveTo investigate the preventive and curative effect of Chaishao Liujunzi Tang （CSLJZT） on colonic mucosal injury induced by dextran sulfate sodium （DSS） in mice with ulcerative colitis （UC） and its mechanism. MethodFifty Balb/c male mice were randomly divided into normal group， model group， CSLJZT low-dose group， CSLJZT high-dose group， and sulfasalazine group. Except for the normal group， other groups were given 2.5% DSS freely for 7 d， and were given drug intervention after successful modeling for 7 d. Bodyweight， feces， and other general physiological statuses of mice were recorded every day， and disease activity index （DAI） scores were calculated.The colon length was measured， and stained by hematoxylin-eosin （HE） staining to observe the morphological changes of the colon.The enzyme-linked immunosorbent assay （ELISA） was used to determine the content of interleukin-1β （IL-1β）， myeloperoxidase （MPO）， and superoxide dismutase （SOD） in the serum. Western blot was used to determine the protein expression levels of Toll-like receptor 4 （TLR4）， myeloid differentiation factor 88 （MyD88）， nuclear factor kappa B （NF-κB）， inhibitor-kappa binding protein （IκB）， Caspase-1， and nucleotide-binding oligomerization domain-like receptor 3 （NLRP3） in the colon tissues. ResultAs compared with the normal group， mice in the model group had significantly decreased body weight （P<0.01）， severe diarrhea and hematochezia， and significantly increased DAI score （P<0.01）. As compared with the model group， the decreasing trend of body weight was significantly alleviated in the CSLJZT groups （P<0.01）， diarrhea and hematochezia were significantly improved， DAI score was significantly decreased （P<0.01）， and colon length increased （P<0.05）. HE staining showed that the pathological damage of colon tissue was significantly improved and the inflammatory cell infiltration was reduced in the CSLJZT groups as compared with the model group. As compared with the normal group， the serum levels of IL-1β and MPO were significantly higher （P<0.01） and SOD levels were significantly lower （P<0.01） of mice in the model group.Compared with the model group， the treated group reduced the serum IL-1β and MPO levels （P<0.01）， and raised the SOD level （P<0.01）. The results of Western blot showed that as compared with the normal group， the expression levels of TLR4， MyD88， NF-κB， Ccaspase-1， and NLRP3 proteins were significantly increased （P<0.01）， whereas the expression level of IκB protein was significantly decreased （P<0.01） in the colonic tissue of mice in the model group. As compared with the model group， the expression levels of TLR4， MyD88， NF-κB， Caspase-1， and NLRP3 proteins were decreased （P<0.01）， whereas the expression level of IκB protein was increased （P<0.01） in the colonic tissue of mice in the CSLJZT groups. ConclusionCSLJZT improves the inflammatory injury of the colon tissue in DSS-induced UC mice through TLR4/MyD88/NF-κB signaling pathway.

Objective:To study the protective effect and mechanism of Ranae Oviductus protein hydrolysate （ROPH） on the expression of pathway-related proteins in ethanol-induced L-02 cell injury. Method:The ROPH was prepared by compound enzymatic hydrolysis. L-02 cell injury model was induced with 400 mmol·L^-1 ethanol. Cell viability was detected by cell counting kit-8 （CCK-8） assay. Cell cycle and apoptosis were examined by flow cytometry. JC-1/Hochest staining was employed for qualitative investigation. The expression of related proteins in apoptosis， mitogen-activated protein kinase （MAPK） signaling pathway， and pyroptosis in L-02 cells was detected by Western blot. Result:The results of the CCK-8 assay showed that 400 mmol·L^-1 ethanol could induce L-02 cell injury within 12 hours. Compared with the blank group， the model group showed decreased viability of L-02 cells （P<0.01）， elevated percentage of the cell cycle in the G₀/G₁ phase （P<0.01）， increased total cell apoptosis rate （P<0.01）， reduced mitochondrial membrane potential （P<0.01）， up-regulated expression of apoptosis-related proteins ［B-cell lymphoma-2 （Bcl-2）-associated X protein （Bax）， Cytochrome C （Cyt C）， and cysteine-dependent aspartate specific protease-3 （Caspase-3）］ （P<0.05， P<0.01） and MAPK signaling pathway-related proteins ［C-Jun amino-terminal kinase （JNK） and p38 MAPK］ （P<0.05， P<0.01）， and potentiated expression of pyrolysis-related proteins Caspase-1 and interleukin-1β （IL-1β） （P<0.05）. Compared with the model group， the ROPH treatment group exhibited improved cell cycle arrest （P<0.05， P<0.01）， diminished total cell apoptosis rate （P<0.01）， elevated mitochondrial membrane potential in a dose-dependent manner， down-regulated expression of Bax， Cyt C， and Caspase-3 proteins （P<0.05， P<0.01）， up-regulated expression of Bcl-2 protein （P<0.05， P<0.01）， and a downward trend in expression of proteins related to MAPK signaling pathway and pyrolysis （P<0.05， P<0.01）. Conclusion:ROPH could inhibit oxidative stress-triggered liver injury in ethanol-induced cells by improving mitochondrial membrane potential， reducing the expression of proteins in the mitochondria-mediated apoptosis pathway， and inhibiting the expression of proteins related to the MAPK signaling pathway and pyrolysis pathway to reduce the mitochondrial dysfunction and inflammatory response in ethanol-induced L-02 liver cells and inhibit oxidative stress， thereby exerting a therapeutic role in alcoholic liver injury.

【Objective】 To study the correlation between platelet transfusion efficacy and KIR receptor-HLA ligand. 【Methods】 Thirty-three leukemia patients with positive HLA antibody were tested for cross-matching with donor platelets. Platelets from suitable donors were selected for transfusion, and the 24-hour platelet corrected count increment (CCI) was used to determine the transfusion effect. KIR and ligand genotyping were performed on blood samples from patients and donors by PCR-SSP method, and the relationship between platelet transfusion effects and KIR receptor-HLA ligand was analyzed. 【Results】 In 74 occasions of platelet transfusion, 42 were ineffective and 32 were effective. When the donor had C2 gene and HLA-B Bw4-80T gene, the frequency of ineffective platelet transfusion in the recipient was 69.0% (29/42) and 52.4% (22/35), respectively, which was significantly higher than that in the effective group [25.0% (8/32) and 25.0% (8/32)]. When the donor had C1 gene, and the frequency of effective platelet transfusion in the recipient was 100.0%(32/32), which was higher than that in the ineffective group [83.3%(35/42)]. When the recipient-donor matching mode was KIR2DL1-C2 and KIR3DL1-(HLA-B Bw4-80T), the frequency of ineffective platelet transfusion was 69.0%(29/42) and 40.5%(22/42),higher than that of the effective group [25% (8/32) and 18.8% (6/32)]. When the recipient-donor matching model was KIR2DL3-C1, the rate of effective platelet transfusion in 32 patients (100.0%), which was higher than that (35 patients 83. 3%) in the ineffective group. When the mismatch mode of recipient iKIR+donor HLA ligand receptor was KIR2DL1-C2, the frequency of effective platelet transfusion in the recipient was 78.1% (25/32), which was much higher than that in the ineffective group [31.0% (13/42)]. When the mismatch mode was KIR3DL1-(HLA-B Bw4-80T), the rate of effective platelet transfusion in the recipient was 68.8% (22/32), which was higher than that in the ineffective group (42.9%, 18/42). The difference between the above groups was statistically significant(P<0.05). 【Conclusion】 HLA-C1 and HLA-C2 genes are the key factors affecting the efficacy of platelet transfusion.For platelet refractorines, HLA-C1 is the protective gene, while HLA-C2 and HLA-B Bw4-80T are the susceptible genes. The recipient iKIR+donor HLA ligand receptor model may play an important role in platelet refractoriness.

ObjectiveTo explore the mechanism of Wutou Chishizhi Wan in regulating autophagy and phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt）/glycogen synthase kinase-3β （GSK-3β） signaling pathway in rats with myocardial ischemia-reperfusion injury （MIRI）. MethodSixty male SD rats were randomly assigned into the normal group （normal saline）， model group （normal saline）， positive control （trimetazidine， 5.4 mg·kg^-1） group， and low-， medium-， and high-dose （1.63， 4.9， 14.7 g·kg^-1， respectively） Wutou Chishizhi Wan groups， with 10 rats in each group. The rats in other groups except the normal group underwent left anterior descending coronary artery ligation for modeling. Electrocardiogram was employed to detect the ST-segment elevation to evaluate the modeling. Hematoxylin-eosin （HE） staining was performed to reveal the damage of myocardial tissue. The levels of aspartate aminotransferase （AST） and creatine kinase （CK） were determined by colorimetry， and those of cardiac troponin T （cTnT） and myoglobin （MYO） by enzyme-linked immunosorbent assay （ELISA）. Western blot was carried out to determine the protein levels of microtubule-associated proteins 1 light chain 3 （LC3）， autophagy-related gene Beclin-1， PI3K， Akt， GSK-3β， p-GSK-3β， and p-Akt. ResultCompared with the normal group， the modeling elevated the serum levels of AST， CK， cTnT， and MYO （P<0.01）， destroyed the arrangement of myocardial cells abd nucle， twisted and broken myocardial fibers， up-regulated the protein levels of LC3Ⅱ/Ⅰ and Beclin-1 （P<0.01）， and down-regulated the protein levels of PI3K， p-Akt， and p-GSK-3β （P<0.01）. Compared with the model group， trimetazidine and Wutou Chishizhi Wan （all the doses） lowered the levels of AST， CK， cTnT， and MYO in serum （P<0.01）， restored the arrangement of myocardial cells and muscle fibers， reduced necrosis， down-regulated the protein level of Beclin-1 （P<0.01）， and up-regulated the protein levels of PI3K， p-Akt， and p-GSK-3β （P<0.01）. Additionally， Wutou Chishizhi Wan （all the doses） down-regulated the protein level of LC3Ⅱ/Ⅰ （P<0.05， P<0.01）. Compared with those in the trimetazidine group， the serum AST level rose in the low-dose Wutou Chishizhi Wan group （P<0.05） and declined in the high-dose group （P<0.01）， and the protein level of Beclin-1 was down-regulated in the medium-dose group （P<0.01）. Additionally， the trimetazidine group had higher protein level of LC3Ⅱ/Ⅰ than medium- and high-dose Wutou Chishizhi Wan groups （P<0.05， P<0.01）， higher protein level of PI3K than low-， medium-， and high-dose groups （P<0.01）， lower protein level of p-Akt than low- and medium-dose groups （P<0.01）， and higher p-GSK-3β protein level than the medium-dose group （P<0.01）. ConclusionDifferent doses of Wutou Chishizhi Wan can ameliorate MIRI， and the high dose has the best effect. Wutou Chishizhi Wan can reduce the activity of myocardial injury markers AST， CK， cTnT， and MYO， and alleviate the pathological damage of myocardial tissue. It can down-regulate the protein levels of beclin-1， LC3Ⅱ/Ⅰ， and up-regulate those of PI3K， p-Akt， and p-GSK-3β. In summary， Wutou Chishizhi Wan may inhibit excessive autophagy and regulate the PI3K/Akt/GSK-3β signaling pathway to exert protective effect on MIRI rats.

Objective: On the basis of traditional experience identification,and appearance characteristics and intrinsic index components of Glycyrrhizae Radix et Rhizoma pieces,a comprehensive evaluation was carried out to explore the method of grading Glycyrrhizae Radix et Rhizoma pieces and establish grading standards. Method: Based on the investigation of 44 batches of Glycyrrhizae Radix et Rhizoma pieces,including their properties,glycyrrhizin content and ammonium glycyrrhizinate content,Glycyrrhizae Radix et Rhizoma pieces were classified according to the market grading to establish the grading standards. Result: Based on the above data,the Glycyrrhizae Radix et Rhizoma pieces were classified into four grades. First-class:average diameter>1.66 mm,average weight>0.54 g,glycyrrhizin content>1.10%,glycyrrhizic acid content>2.12%. Second-class:the average diameter is between 1.40-1.66 mm,the average weight is between 0.42-0.54 g,the content of glycyrrhizin is between 0.74%-1.10%,and the content of glycyrrhizic acid is between 1.95%-2.12%. Third-class:the average diameter is between 1.07-1.40 mm,the average weight is between 0.29-0.42 g,the content of glycyrrhizin is between 0.65%-0.74%,and the content of glycyrrhizic acid is between 1.88%-1.95%. Substandard:the average diameter<1.07 mm,average weight<0.29 g,content of glycyrrhizin<0.65%,content of glycyrrhizic acid<1.88%. Conclusion: This experiment combines the traditional experience and modern analysis method,in order to develop a scientific,reasonable and accurate classification method.