Objective To investigate the clinical effect of sodium hyaluronate combined with glucocorticoid on the treatment of periarthritis of shoulder.Methods106 patients in department of orthopedics, the second hospital of Ningbo with periarthritis of shoulder were randomly divided into 2 groups (n=53).The control group were treated with anti-inflammatory and analgesic treatment, at this basis, the study group were treated with sodium hyaluronate combined with Glucocorticoid.5 weeks for a course of treatment.Levels of serum inflammation, laboratory-related indicators were compared.ResultsCompared with before treatment, shoulder joint activity in the two groups increased, VAS score decreased, the scores of strength of shoulder joint, range of motion and daily activities increased, levels of serum IL-6, IL-10, TNF-α decreased(P<0.05).Compared with the control group, scores of activity in the study group were higher, VAS scores were lower, scores of strength of shoulder joint, range of motion and daily activities were higher, levels of serum IL-6, IL-10, TNF-α were lower(P<0.05).The effective rate in the control group(73.59%) was lower than the study group(90.57%), but there was no statistical difference.ConclusionThe effect is accurate which sodium hyaluronate combined with glucocorticoid was used in the treatment of periarthritis of shoulder, and it can reduce the inflammation index and improve the joint activity.

Objective To evaluate the efficacy and safety of endoscopic sphincterotomy(EST)in treating common bile duct stone or strictive papillitis,and then analyze possible related risk factors for long-term complications after EST.Methods We made a retrospective study of 103 out of 158 patients who had EST from January 2005 to December 2006.Results In the 103 patients,there were 13 cases of long-term complications(≥3 m after EST),the incident rate being 12.6%:recurrent calculus of common bile duct in 8 cases,combined cholangitis in 6;cholangitis in 1;acute calculus cholecystitis in 2;residual calculus in 1 case;chronic pancreatitis in 1 case.Conclusion Endoscopic papillosphincterotomy is an effective and safe way to treat biliary tract obstruction.Preoperative jaundice may be the risk factor inducing long-term complications after EST.

Objective : To investigate the incidence of new HIV infection and its influencing factors among men who have sex with men ( MSM ) in China, so as to provide the evidence for formulating the AIDS control strategy. Methods : Cohort studies pertaining to new HIV infections among Chinese MSM populations were retrieved in Chinese and English electronic databases, including CNKI, Wanfang Data, VIP, PubMed, Web of Science, Embase and Cochrane Library, and the retrieval time was set to build the database until May 2021. A meta-analysis was performed to investigate the incidence of new HIV infection and its influencing factors among Chinese MSM populations. The publication bias was assessed using funnel plot and Egger's test, and the stability of outcome parameters was evaluated using sensitivity analysis. Results : A total of 850 publications were retrieved, and 43 eligible literatures ( 44 studies ) were included in the final analysis. The pooled incidence of new HIV infection was 4.93 ( 95%CI: 4.15 to 5.72) per 100 person-years among Chinese MSM populations. Egger's test showed a publication bias ( t=2.411, P=0.021). Subgroup analysis revealed high incidence of new HIV infection in east ( 5.21 per 100 person-years ), north ( 5.30 per 100 person-years ) and southwest (4.84 per 100 person-years) China, and the lowest incidence in northwest China ( 2.87 per 100 person-years ), and showed higher incidence in first-tier cities ( 5.12 per 100 person-years ) than in nonfirst-tier cities ( 3.89 per 100 person-years ). Syphilis infection ( HR=3.41 ), unprotected anal sex ( HR=2.52 ), multiple sexual partners ( HR=3.51 ), seeking sex partners in bars, public baths and parks ( HR=3.44 ), age of > 25 years ( HR=0.44 ), Han Ethnicity ( HR=0.35 ), awareness of AIDS-related knowledge ( HR=0.20 ) and provision of HIV preventive services ( HR=0.18 ) were associated with new HIV infection in Chinese MSM populations. In addition, publication bias was found in studies reporting syphilis infection ( t=4.841, P<0.001 ), unprotected anal sex ( t=4.114, P=0.006 ) and ethnicity ( t=-5.018, P=0.038 ). Conclusions The incidence of new HIV infection is high among Chinese MSM populations. Interventions targeting the factors affecting new HIV infections are required to reduce in the incidence of new HIV infections among Chinese MSM populations.

Many species of animals contain antimicrobial peptides as components of their immune systems. Many antimicrobial peptides have a broad spectrum of activity not only against gram negative and gram positive bacteria but also against antibiotic resistant bacteria, fungi, viruses, and parasites. Such peptides can act in synergy with other host molecules to kill pathogens. It has been found that certain peptides have a high affinity for bacterial products, allowing them to modulate the host inflammatory response to sepsis. They have also been found that they have the ability to recruit inflammatory cells. These properties as well as some other functions of antimicrobial peptides enable them to have an important impact in innate immunity.

Objective To analyse the efficacy of lamivudine(LAM) combined adefovir dipivoxil(ADV) and entecavir(ETV) in the treatment of naive patients with chronic hepatitis B (CHB) .Methods Cochrane Library ,MEDLINE ,Web of Science ,CNKI (China National Knowledge Infrastructure ) ,WANFANG database and VIP database were searched and the references of eligible studies were screened .All relevant literatures published before March 6th ,2012 were reviewed .Comparison of the efficacy of lami-vudine combined adefovir dipivoxil and entecavir in the treatment of naive patients with chronic hepatitis B was included and Rev Man 5 .1 software was used for Meta analysis .Results Four eligible studies (587 patients in all) were included for the analysis .In the entecavir monotherapy group ,the serum ALT normalization rate was a little higher at the 12 weeks and 24 weeks of the treat-ment compared to the combination group[OR=0 .52 ,95% CI(0 .28 ,0 .97) ,Z=2 .04 ,P=0 .04] ,[OR=0 .45 ,95% CI(0 .22 ,0 .95) , Z=2 .11 ,P=0 .04] ,respectively .But after 36 weeks there was no significance between the two groups .For HBV DNA undetect-able rate ,there were no significant differences between the two groups at the 12 weeks ,24 weeks ,36 weeks ,48 weeks ,18 months , 24 months and 30 months of the treatment (P=0 .22 ,P=0 .30 ,P=0 .86 ,P=0 .31 ,P=0 .93 ,P=0 .84 and P=0 .83 respectively) . At the 48 weeks ,HBeAg negative rate has no significant difference between the two groups [OR=0 .93 ,95% CI(0 .29 ,2 .95) ,Z=0 .13 ,P=0 .90] .Conclusion Both LAM+ADV combination therapy and ETV monotherapy are effective in the treatment of naive patients with CHB ,but further studies are still needed to obtain long term results and safety by high quality ,large scale randomized controlled trials .

BACKGROUND: Chinese medicines have better effects on preventing and treating diabetic nephropathy at early period, and the effects are caused by the diversity of the effective components of Chinese medicines which acts on the different targets of diabetic nephropathy.OBJECTIVE: To observe the effect of Xiaokening on the proliferation of mesangial cells under high glucose, and investigate the possible mechanism. DESIGN: A controlled observation.SETTING: Department of Endocrinology, the First Affiliated Hospital of Nanjing Medical University.MATERIALS: The experiments were completed in the Research Room of Cell Culture, Research Center of Endocrine Metabolism, the First Affiliated Hospital of Nanjing Medical University from July 2003 to May 2004. The rat mesangial cell lines HBZY-1 were bought from Chinese Center for Typical Culture Collection.METHODS: The mesangial cells were passaged and cultured according to the instructions. ① Grouping according to different concentration of stimulation: In the high glucose+Xiaokening group, Xiaokening of 6 concentrations were used, I.e., 20.0, 40.0, 60.0, 80.0, 120.0, 200.0 g/L. Meanwhile,normal glucose control group and high glucose control group were also set,the glucose concentration in the medium was 5.6 and 30 mmol/L respectively. The proliferations were observed after 72 hours. Grouping according to different time points of stimulation: There were normal glucose control group, high glucose control group and high glucose+Xiaokening group, the glucose concentration in the medium was 5.6, 30 and 30 mmol/L respectively, and the Xiaokening concentration was 60 g/L. The proliferations were observed at 24, 48 and 72 hours respectively in the three groups.② The dispensed cell suspension was placed into the 96-well plate, and 200 μL suspension for each well. The culture plate was placed in the inoculation box containing CO2 (0.05 in volume fraction) at 37 ℃ for 24 hours, then the supernatant was deserted, cell solutions containing different drugs of different concentrations were added in each group, 200 μL for each well. The 96-well plate was then placed in the culture box containing CO2 (0.05 in volume fraction) and 100% humidity at 37 ℃ for inoculation.In the groups of different concentrations, 20 μL MTT (5 g/L) was added into the wells after 72 hours. In the groups of different time points, 20 μL MTT (5 g/L) was added into the wells at 24, 48 and 72 hours. Then the plates were inoculated at 37 ℃ for 4 hours. Under microscope, it was observed that MTT get into the cells, the supernatant was sucked away, then 150 μL dimathyl sulfoxide was added to dissolve methyl alcohol, and shaken to even with plate rocking bed for 30 s, and the absorbance (A) values were recorded with the microplate reader at the wavelength of 492 nm.MAIN OUTCOME MEASURES: The proliferations of mesangial cells (A value) were observed at different time points and in Xiaokening of different concentrations.RESULTS: ①Proliferation of mesangial cells at different time points: The A values in the high glucose control group at 24, 48 and 72 hours (0.685 ±0.010, 0.750±0.087, 0.659±0.018) were higher than those in the normal glucose control group (0.586±0.054, 0.598±0.040, 0.527±0.047, P ＜ 0.05). In both the high and normal glucose control groups, the A value at 48 hours was higher than that at 24 hours (P ＜ 0.05), but the A value at 72 hours was lower than that at 48 hours (P ＜ 0.05). The A value in the high glucose+Xiaokening group at 72 hours was 0.538±0.023, and it was lower than that in the high glucose control group (P ＜ 0.05). ② Proliferation of mesangial cells in Xiaokening of different concentrations: Xiaokening high er than 60.0 g/L could obviously restrain the excessive stimulation of high glucose to the mesangial cells, and the effect was in a concentration-de pendent manner, but too high concentration (120.0 g/L) would result in the abscission and death of cells, whereas no survived cells could be observed in extremely high concentration (200.0 g/L). CONCLUSION: Xiaokening could inhibit the proliferation of mesan gial cells stimulated by high glucose after 72 hours in a concentration dependent manner, but too high concentration would cause strong cytotoxicity.

Contents in orthopaedic are independent relatively and finding out the internal relations during them is helpful to improving the effect of orthopaedic teaching.Transfer theory is important tools for clinical teaching practice,and finding out the common characteristics between the orthopaedic chapters is primary for the theory.This research focuses on the following fields:fractures,nerve injury,infection,tumor and deformity.After the common characteristics between these chapters were analyzed and discussed,we concluded that the transfer theory is helpful in orthopaedic teaching practice,especially for students' comprehension and memory,but still we should avoid some negative effects in teaching process.

Objective To investigate the importance of elements of teaching aesthetic(appearance aesthetics; language aesthetics; emotion aesthetics; PPT aesthetics; blackboard-writing aesthetics and model aesthetics) in clinical orthopaedic teaching,and to analyze the reasons and significance of them.Methods Totally 137 medical students(2005 and 2006 grade) were investigated by the questionnaire in resent 2 years.They were asked to choose the first two important elements of teaching anesthetic from six elements displayed by four teachers.Results The percentage of appearance aesthetics,language aesthetics,emotion aesthetics,PPT aesthetics,blackboard-writing aesthetics and model aesthetics were showed as 97.4％,88.7％,67.1％,58.9％,13.6％ and 1.2％ respectively.Conclusion Teaching aesthetics is an indispensible part of teaching aesthetically and it is helpful to promote the teaching.We should be focus on PPT aesthetics and appearance aesthetics,which show high percentage in our research.

Objective To investigate the pathogenesis,clinical characteristics,diagnosis and treatment of Ceftriaxone-associated urinary tract and biliary pseudolithiasis in children.Methods A 6-year-old boy was treated in our hospital in March 2011.The initial diagnosis was acute suppurative tonsillitis.Ceftriaxone was administered intravenously at a dose of 3 g/d [ 117 mg/( kg · d) ]for three days.After that the boy complained of bilateral abdominal pain and nausea.Abdominal sonogram obtained after cessation of ceftriaxone treatment revealed urinary tract and gallbladder stone and hydronephrosis.After cessation of ceftriaxone treatment and intubation tube into the ureters by cystoscope,symptoms gradually disappeared and renal function recovered.Results After cessation of ceftriaxone treatment,symptoms gradually disappeared,with urinary tract CT scan normal after 10 days.Urinary tract and gallbladder sonograms were found to be normal 22 days after diagnosis without specific treatment.Followed up for 1 month,no recurrence of stone was observed.Conclusions Ceftriaxone-associated urinary tract and biliary pseudolithiasis in children is rare.These complications generally resolve spontaneously with cessation of the ceftriaxone therapy.Physicians should be aware of these complications so as to avoid unnecessary therapeutic procedures.

This paper analyzed innovative education management system,innovative education resources,innovative education mode and innovative education evaluation standard through practicing‘integration of production,study and research’ teaching platform. Meanwhile,this paper explored the optimization system of innovative education in medical undergraduate teaching.