ObjectiveTo observe the clinical therapeutic effect of intra-articular injection with sodium hyaluronate (SH) on osteoarthritis of the ankle.Methods25 patients with osteoarthritis of the ankles (36 ankles) were treated with SH intra-articular injection 2 ml every week for 5 weeks. The degree of pain, swelling and functional disturbance of the ankles were observed to evaluate the effect.ResultsAfter treatment, the degree of pain, swelling and functional disturbance of the ankles improved (P<0.05～0.01). The total efficiency rate was 91.61%.ConclusionSodium hyaluronate injected intra-articular is an effective, ideal and safe treatment for osteoarthritis of the ankle.

32P-HBV-DNA was used as a probe to determine HBV-DNA by molecular hybridization in the sera of 186 chronic asymptomatic HBsAg carriers (ASC). The result of HBV-DNA determination correlated closely with that of the HBeAg/anti-HBe system.The viral DNA was detected in 51(82.2%)of 62 HBeAg (+) cases but only in 1 of 103 anti-HBe ( + ) cases. The prevalence of HBV-DNA was directly proportional to the P/N ratio of RIA for HBeAg. When the P/N was above 8.1. its detection rate was 95.0%; when P/N below 5.0. it was only 12.5%. HBV-DNA determined by molecular hybridization was deemed to be a more direct proof of viral replication in ASC.

[Objective]To investigate the effect of Donepezil on dysgnosia in patients with mild-moderate general paralysis of the insane(GPI).[Methods]Forty-seven patients with GPI were assigned into study group(n=24)or control group(n=23). All these patients were treated with a large dose of penicillin for 2 weeks and then with Benzathine for 3 weeks. And the Donepezil admin-istered to patients in study group.The mini-mental state examination(MMSE)and the clinical dementia rating(CDR)were scored as the measurement of efficiency.[Result]The scores of the MMSE and CDR were not statistically different between the two groups at baseline and 4 weeks after treatment,and both were increased 12 weeks after treatment(P<0.05),especially in study group as com-pared with those in control group(P < 0.05).[Conclusion]Donepezil as an adjunctive therapy may be effective for dysgnosia in patients with mild-moderate GPI. Donepezil is also safe and well tolerated.

Objective To investigate the role of regulatory T (Treg) / T helper type 17 (Th17) cells in the pathogenesis of chronic spontaneous urticaria (CSU).Methods Eighty-nine patients with CSU were enrolled in this study,including 48 in active stage and 41 in remission stage.Forty-eight health check-up examinees,who were collected from the community hospitals in Guangzhou city,served as the healthy controls.Fluorescence-based realtime quantitative PCR was performed to determine the expression of transcription factors FOXP3 and RORγt in PBMCs from these subjects.Results Compared with the patients with CSU in remission stage and healthy controls,the patients in active stage showed a significantly higher level of FOXP3 mRNA (0.57 ± 0.19 vs.0.11 ± 0.21 and 0.13 ± 0.23,both P ＜ 0.05),but a significantly lower level of RORγt mRNA (0.43 ± 0.39 vs.0.89 ± 0.40 and 0.87 ± 0.43,both P ＜ 0.05).Conclusions The expression of Treg cell regulator FOXP3 increases,while the expression of Th17 cell regulator RORγt decreases in patients with CSU,suggesting that the imbalance between Treg and Th17 cells induced by the interaction between FOXP3 and RORγt may be involved in the pathogenesis of CSU.

Objective To investigate the relationship between V-raf murine sarcoma viral oncogene homolog B1 (BRAF)v600E mutation and radioactive iodine (RAI) uptake in distant metastases from papillary thyroid cancer(PTC).Methods From January 2011 to December 2012,40 PTC patients (21 males,19 females,average age 39.8 years) with distant metastases were recruited and divided into mutation group and wild group according to the BRAFv600E mutation in primary lesions.The clinical,pathological and serological differences were compared between the two groups.The relationship between BRAFv600E mutation and RAI uptake capability in distant metastases from PTC,as well as its relationship with Tg change after 131I treatment were investigated.Statistical analysis was performed with two-sample t test,x2 test or Fisher exact test.Results The BRAFv600E mutation rate was 30.0％ (12/40) in patients with metastases from PTC.There was no significant difference in clinical,pathological and serological features between mutation group (n =12) and wild group (n=28; t:from-0.533 to 1.728,x2:from-1.951 to 1.088,all P＞0.05).Twelve PTC patients had no RAI uptake in the distant metastases,of which 10 belonged to mutation group (83.3％,10/12) and 2 belonged to wild group (7.1％,2/28; x2=19.734,P＜0.05).BRAFv600E mutation group was more likely to have no RAI uptake in the distant metastases.Tg change after 131I treatment in 30 patients were analyzed.In the wild group,Tg level decreased in 66.7％ (14/21) patients,stabilized in 19.0％ (4/21)and increased in 14.3％ (3/21)patients.While there was no decrease of Tg in the mutation group (0/9).Two patients had increased Tg level and 7 patients (with no RAI uptake) kept stable in mutation group.Conclusions Due to poor RAI uptake capability in PTC patients with BRAFv600E mutation,both primary and metastatic sites may have poor response to 131I treatment.Molecular detection of BRAFv600E mutation might be helpful for choosing PTC with distant metastases and predicting the effect of 131 I treatment.

Objective To analyze the characteristics of genotyping and gene polymorphism of Neisseria gonorrhoeae(N.go) with azithromycin(AZM)-resistance(AZM-R) and decreased susceptibility to ceftriaxone(CROD).Methods The minimum inhibitory concentration(MIC) of AZM and CRO were determined.AZM-R isolates were detected for mutations in 23S rRNA,mtrR and penA genes.Genotypes were analyzed by using N.go multi-antigen sequence typing(NG-MAST).Results All total of 485 isolates of N.go were detected.77(15.9%) strains were AZM-R(MIC≥1 mg/L),including 33(6.8%) isolates of AZM low-level resistant(AZM-LLR,MIC=1 mg/L) strains and 44(9.1%) isolates of AZM middle-level resistant(AZM-MLR,MIC≥2 mg/L) strains.There were more CROD(MIC≥0.125 mg/L) strains in AZM-MLR isolates(43.2%),compared with those in AZM-LLR isolates(18.2%,P<0.05).The detected rates of 23S rRNA,mtrR,penA single or combined mutations were without significant differences between AZM-LLR isolates and AZM-MLR isolates(P>0.05).Similar results were found between combined AZM-LLR/CROD isolates and combined AZM-MLR/CROD isolates(P>0.05).No mutation of A2059G and AZM high-level resistant(AZM-HLR,MIC≥256 mg/L) isolate were found.Among 77 AZM-R isolates,67 sequence types(ST) were identified by NG-MAST,of which 30 types were novel.Most ST were represented by a single isolate.Conclusion AZM-R and CROD isolates,presented in this area,might be deserved continuous surveillance to identify the mechanism of concurrent resistance.

Objective:To evaluate the diagnostic and therapeutic value of bedside severe ultrasound in children with shock.Methods:Children who were diagnosed shock in the PICU of Shengjing Hospital of China Medical University from May 1, 2019 to April 31, 2020 were included in this study.Rapid ultrasound in shock (RUSH) exam was used to evaluate the morphology and function of heart, lung and abdomen of children with shock, so as to assist the diagnosis and treatment of shock.Results:Twenty-six children with shock were evaluated immediately according to the RUSH exam when they were admitted to hospital.Eight cases were diagnosed as septic shock, six cases as cardiogenic shock, six cases as hypovolemic shock and six cases as mixed shock.The left ventricular ejection fraction (LVEF) of children with cardiogenic shock was (26.5±8.24)%, and the width of inferior vena cava was greater than 10 mm.After the shock was corrected, LVEF increased to (32.17±26.11)%.However, the LVEF of children with septic shock was (73.25±1.28)% at admission and (50.12±31.41)% at shock correction.Nine cases (34.6%) found more B-lines in the lungs after fluid resuscitation for one hour in 26 children with shock.Among them, about 50% of the children with cardiogenic shock found more B-lines in their lungs one hour after fluid resuscitation, and 11 cases(57.9%) of the surviving children showed more B-lines after shock correction, but only six children could hear blisters after physical examination.Conclusion:According to RUSH exam, we can evaluate the volume status, cardiac function, volume responsiveness and focus on infection in children with shock, distinguish the type of shock earlier and more accurately, assist in guiding fluid resuscitation, and facilitate accurate and individualized fluid management and treatment of patients.

Objective To investigate the safety and feasibility of endovascular stent angioplasty in treating symptomatic stenosis of middle cerebral artery.Methods Endovascular angioplasty with coronary stents was performed in 27 patients with symptomatic stenosis of middle cerebral artery.The clinical results were reviewed and analyzed.Results Of the total 27 patients,successful placement of the coronary stents Was achieved in 24.Angiography immediately after the procedure showed that the stenotic degree of the diseased artery was markedly decreased from preoperative (80±19)%to postoperative (8±4)%,the improvement was very obvious.Percutaneous transcatheter angioplasty had to be employed in two cases because of the failure of stent placement.A mean follow-up period of 18 months was carried out.During the following up period no transient cerebral ischemia attack occurred in 25 patients and no newly-developed cerebral infarction in region fed by the responsible vessels occurred either.Re=irrigation cerebral hemorrhage was seen in one patient,which occurred three hours after the placement of the stent.In one case the placed stent fell off and immigrated into the siphon of internal carotid artery,and the displaced stent Was took out later with a catching apparatus.In another case re-stenosis occurred six months after the stenting.Conclusion Percutaneous endovaacular stent angioplasty is a safe and effective treatment for symptomatic stenosis of middle cerebral artery,although its long-term results need to be further evaluated.

OBJECTIVE:To compare the therapeutic effect of surgical approach that should be used for posterior interbody fusion,posterolateral fusion with or without lumbar interbody fusion for adult spondylolisthesis.METHODS:From January 2004 to May 2008,75 patients with adult spondylolisthesis were retrospectively analyzed,comprising 22 males and 33 females,aged 53.3 years (ranging 49-70 years).There were 47 cases in L4,28 in L5;5 cases of degree Ⅰ,24 of degree Ⅱ,37 cases of degree Ⅲ,and 9 of degree Ⅳ.A total of 21 patients were treated with pedicle screw fixation and posterolateral lumbar fusion (group A),26 with pedicle screw fixation and posterior lumbar interbody fusion using cage (group B),and 28 with pedicle screw fixation and posterolateral lumbar fusion with posterior lumbar interbody fusion using cage.The satisfaction rate and fusion rate were compared among the three groups.RESULTS:All 75 patients were followed up for 6 months 3 years.The fusion rate of group A was 57%,and the satisfaction rate was 62%;the fusion rate of group B was 85%,and the satisfaction rate was 89%;the fusion rate of group C was 89%,and the satisfaction rate was 93%.There were no significant differences in the satisfaction rate and fusion rate between groups B and C (P>0.05),but the satisfaction rate and fusion rate of groups B and C were superior over group A (P<0.05).CONCLUSION:Posterior interbody fusion and posterolateral fusion with lumbar interbody fusion display similar treatment effects,which are better than posterolateral fusion.

OBJECTIVETo evaluate preoperative application of recombinant human erythropoietin (rHuEPO) in reducing transfusion requirements in elderly patients undergoing elective surgery for femoral intertrochanteric fractures.

METHODSFrom January 2011 to December 2013,442 cases of elderly patients with femoral intertrochanteric fracture were retrospectively reviewed. According to inclusion and exclusion criteria, 119 cases were eventually included and divided into the treatment group and the control group. There were 12 males and 40 females, with a mean age (71.4 ± 12.8) years old, and the patients received preoperative administration of rHuEPO 10,000 U qod combined with iron dextran 200 mg (3 times each day). While 16 males and 51 females in control group, with a mean age (70.9 ± 16.2) years old, and the patients only received preoperative administration of iron dextran 200 mg (3 times each day). All the patients received closed reduction and PFNA-II or Internal fixation surgeries. The perioperative blood transfusion rate, average amount of blood transfusion, postoperative complications, the length of hospital stay and mortality within 30 days were compared between the two groups.

RESULTSThere were no statistical differences between two groups in the baseline indexes (P > 0.05). Overall,71 of 119 patients (59.7%) received at least one unit allogeneic blood transfusion (ABT). However,there were significant differences in perioperative ABT rates (48.1% vs 68.7%, χ2 = 4.77, P < 0.05) and the average amount of blood transfusion between treatment group and control group, which were (1.8 ± 0.4) U/pte vs (3.6 ± 1.1) U/pte (t = 2.244, P < 0.05). Postoperative hemoglobin (Hb) on postoperative days 7 and 30 was higher in treatment group than that in control group. In addition, in treatment group, Hb levels were higher on postoperative day 30 than those on admission, which were (128.2 ± 20.6) g/L vs (118.2 ± 18.9) g/L (t = 2.133, P < 0.05). There were no statistical differences in postoperative complications, the length of hospital stay and mortality within 30 days.

CONCLUSIONFor elderly patients with femoral intertrochanteric fractures undergoing elective surgery, preoperative application of rHuEPO can significantly reduce perioperative transfusion requirements, and is likely to reduce ABT-related infection, but its long-term safety remains to be evaluated.

Aged ; Aged, 80 and over ; Blood Transfusion ; Case-Control Studies ; Erythropoietin ; administration & dosage ; Female ; Femoral Fractures ; blood ; surgery ; therapy ; Fracture Fixation, Internal ; Hemoglobins ; analysis ; Hip Fractures ; blood ; surgery ; therapy ; Humans ; Male ; Preoperative Care ; Retrospective Studies