Objective To explore the therapeutic method and efficacy of discoid meniscus urder arthroscope. Methods 37 patients with 37 discoid menisci underwent arthroscopic lateral partial or total meniscectomy. 33 cases were operated on by reshaping (partial meniscectomy) and 4 cases with extensive laceration in the joint capsule rim of hastring tendon underwent total meniscectomy under arthroscope. Results Bases on Ikeuchi's grading, 19 cases were excellent (51.4%), 13 cases good (35.1%) and 5 cases fair(13.5%). Conclusions Arthroscopic reshaping for discoid meniscus can obtain excellent and good efficacy, so it is recommended that patients with discoid menisci should be treated by reshaping.

Objective To survey the multi-drug resistance among the isolates of methicillinresistant Staphyloeocus from lower respiratory tract in post-cardiothoracic surgery patients and the risk factors contributing to infection aggravation.Methods The clinical data of lower respiratory tract infections were reviewed retrospectively from June 2011 to December 2012.The antimicrobial susceptibility testing was analyzed according to CLSI breakpoints 2010.Results A total of 323 clinical isolates was identified in 264 patients,including gram-positive coccus (126 strains) and gram-negative bacillus (197 strains).The prevalence of methiciIlin-resistant srtains was 88.5 ％ (54/61)in Staphylococus.Aureus (MRSA),and 77.3％ (17/22) in Staphylococcus epidermidis (MRSE).No VISA or VRSA strain was identified.One enterococcal strain was resistant to Vancomycin and teicoplanin.MRSA/MRSE were also isolated from hands and nasal vestibule of nurses,article surfae,pipeline/interface of breathing machine and ward atmosphere.Conclusions Patients after cardiothoracic operation are susceptible to lower respiratory tract infection with gram positive cocci,which should be paid more attention to airway management.Rational administration,sterile operation and antimicrobial therapy are effective ways for control of multi-durg resistance.

Cell Line, Tumor ; Enzyme Inhibitors ; pharmacology ; Heterocyclic Compounds, 1-Ring ; pharmacology ; Humans ; Proteasome Endopeptidase Complex ; drug effects

Objective To investigate the application effects of new-type glove constraint in intensive care unit. Methods A total of 113 eligible patients were randomly divided into two groups by random digits table method, of which 59 patients used the traditional restraint for body constraint in the control group while 54 patients applied the new-type glove constraint in the treatment group. The skin conditions of restraint position, tube coming off and the satisfaction of patients and relatives were compared between two groups. Results The incidence of skin abnormality at restraint position was 0 in the treatment group and 13.6%(8/59) in the control group. The difference had statistical significance (χ2=7.880, P<0.01). The satisfaction of patients and relatives was 33.3%(18/54) in the treatment group and 5.1%(3/59) in the control group, and the difference had statistical significance (χ2=16.619, P<0.01). Conclusions The use of new-type glove constraint may give a maximum activity space to patients;reduce patient′s psychological adverse impacts;and decrease the skin and body damages. It is worthy of clinical promotion and application.

OBJECTIVE:To observe the clinical efficacy and safety of different doses of atorvastatin in the treatment of chron-ic subdural hematoma(CSDH). METHODS:One hundred and tweaty-eighie CSDH patients selected from our hospital during Jun. 2013-May 2015 were divided into observation group(n=62)and control group(n=66)in accordance with random number table. Both groups were given conventional treatment of brain cell nutrition. Control group received Atorvastatin tablet 20 mg,po,qd;observation group received Atorvastatin tablet 40 mg,po,qd. Both groups were treated for 6 months. Clinical efficacy,CSS and ADL score,hematoma volume,the levels of serum inflammatory factors (hs-CRP,MMP-9,IL-6,TNF-α) were observed in 2 groups. ADR was recorded during treatment and recurrence rate was also recorded. RESULTS:2 patients withdrew from observa-tion group and 6 from control group. Finally,120 patients met the criteria were included,with 60 cases in each group. Total re-sponse rate of observation group(88.3%)was significantly better than that of control group(73.3%),with statistical significance (P<0.05). After 1,3,6 months of treatment,CSS score,hematoma volume,the serum levels of hs-CRP,MMP-9,IL-6 and TNF-α in 2 groups were significantly decreased,while ADL score was increased significantly;the improvement of above indexes in observation group was significantly better than in control group,with statistical significance(P<0.05). There was no statistical significance in the incidence of ADR between 2 groups(P>0.05). The recurrence rate of control group(13.3%)was significantly higher than that of observation group(3.3%),with statistical significance(P<0.05). CONCLUSIONS:Daily dose of shows ator-vastatin 40 mg better therapeutic efficacy and lower recurrence rate in the treatment of CSDH with good safety.

Objective To evaluate the curative effect of chemotherapy combined with radiotherapy for limited-stage small cell lung cancer(LD-SCLC).Methods 34 cases of patients with LD-SCLC were rand- mized into interdigitating chemoradiotherapy group and sequential chemoradiotherapy group.All patients re- ceived four to six cycles of alternating CE(C:carboplatin 300 mg/m~2 d_1;E:etoposide100 mg d_(1～5)and CAP(C: cyclophosphamide 600 mg/m~2 d_(1,8);A:adriamycin 40 mg/m~2 d_1;P:cisplatin 50 mg d_(3～5)chemotherapy,three weeks for a cycle.All patients also received thoracic radiotherapy with conventional fraction,2.0 Gy per frac- tion,five fractions per week.The total dose was 60 Gy.Results In interdigitating chemoradiotherapy group, CR was 64.7%,PR was 29.4%,NR was 5.9% and PD was 0 after chemo-radiation therapy.In sequential chemoradiotherapy group,CR was 23.5%,PR was 52.9%,NR was 23.5% and PD was 0 after chemothera- py,and CR was 58.8%,PR was 35.3%,NR was 5.9% and PD was 0 after radiotherapy.Conclusion The therapeutic effect of chemotherapy combined with radiotherapy for LD-SCLC was satisying.There was no sig- nificant difference in the effect between the two groups.

Objective To investigate the MDCT and dual-energy CT (DECT)features of chromophobe renal cell carcinoma (chRCC)and to improve the diagnostic accuracy before operation.Methods The data of MDCT(46 cases of 47 lesions)and DECT (10 cases )of 56 patients with pathologically confirmed 57 chRCC were retrospectively analyzed.All of them underwent plain scan-ning,corticomedullary phase and parenchymal phase scanning after contrast material injection.The lesions were divided into ≤4 cm group and > 4 cm group according to its maximum diameter.Qualitative and quantitative analysis were compared between the groups.Results 64.9% of chRCCs were round and oval,87.7% of chRCCs were solid or mainly solid tumors.The incidence of hemorrhage,necrosis,calcification,cystic degeneration of the tumors was approximately 38.6%,36.8%,10.5% and 12.3%,respec-tively.Central scar(1 7.5%)and vascular sign (24.6% )were seen in part of chRCCs.The tumors showed iso and high attenuation on plain CT scanning in 47.4% and 45.6% of the lesions,respectively.The enhancement pattern of wash-in and wash-out,prolonged enhancement and delayed enhancement were seen in approximately 24.6%,66.7% and 8.8% of the lesions,respectively.The shape, necrosis and cystic degeneration,vascular sign and density uniformity between the two groups were statistically different.The CT value of the lesions were 37.29 HU,82.58 HU and 78.97 HU on unenhanced,corticomedullary phase and parenchymal phase CT scanning.The lesion-kidney ratio on the three phases was 1.29,0.62 and 0.55,respectively.There was no significant difference be-tween CT values and LKR values.The lesions and its subtle signs were much clearer on the 80 kV images of DECT after contrast in-jection.Conclusion The MDCT and DECT findings of chRCC have certain characteristics.However,when the lesions showed atypi-cal CT findings because of its different degree of enhancement and variable enhancement pattern,it would be very difficult to get an accurate diagnosis and the final results depend on pathological diagnosis.

Objective To evaluate the safety and effectiveness of multi-mode interventional therapy for complications occurring after renal transplantation.Methods The clinical data of 26 patients with complications occurring after renal transplantation were retrospectively analyzed.Vascular and non-vascular complications were treated with different interventional techniques,and the curative effects were analyzed.Results Vascular complications were observed in 19 patients and non-vascular complications were seen in 7patients.The technical success rate of interventional therapy was 100％.One week after the treatment,the total creatinine level (SCr) was significantly improved,which decreased from preoperative (372.7±295.5)μmol/L to postoperative (184.3±138.4) μmol/L (P＜0.001).No severe complications occurred.Further analysis indicated that no statistically significant differences in patient's general condition,kidney donor source,anastomosis method existed between vascular intervention group and non-vascular intervention (P＞0.05).However,the onset time of vascular complications was markedly earlier than that of non-vascular complications (1.8± 1.4 months vs.118.3 ±54.4 months),the difference was statistically significant (P＜0.001).During the follow-up period lasting for 4-55 months (mean of 18.6 months),3 patients developed recurrence of complications;interventional therapy had to be carried out in 2 patients and their creatinine level returned to normal after treatment,and transplanted renal artery embolization had to be performed in the other patient as whose pseudoaneurysm became enlarged.Conclusion For the treatment of complications occurring after renal transplantation,interventional therapy is less-invasive,rapidly-effective and safe,this technique can timely and effectively improve the renal function and save the transplanted kidney.

OBJECTIVETo explore the analgesic effect of Zhixin Formula (ZF) and its effects on spinal glial fibrillary acidic protein (glial fibillary acidic protein, GFAP, a marker of astrocyte) , CD11b (a maker of microglia), Toll like receptors (TLR2 and TLR4) and nuclear factor κB (NF-κB) in bone cancer pain model rats.

METHODSTotally 20 male SD rats were randomly divided into the blank control group and the bone cancer pain group, 10 in each group. The bone cancer pain model was induced by injecting ascites tumor fluid containing 3 x 10(3) Walker256 cell line from the left tibia. Ethological tests, X-ray test, and HE staining were performed to confirm a successful modeling. After model was successfully established, 70 male SD rats were randomly divided into seven groups, 10 in each group: the blank control group, the bone cancer pain group (as the model group), the Western medicine (WM) group (Tramadol Hydrochloride), the high dose ZF group, the middle dose ZF group, the low dose ZF group, and the Chinese medicine (CM) group (Wulin Zhitong Capsule). Fourteen days after modeling, rats in the high, middle, and low dose ZF groups were administrated by gastrogavage with 9, 4.5, and 2.25 g/kg ZF water condensed preparation respectively, once a day for seven consecutive days. On day 21 MS typical protein expressions including GFAP, CD11b, TLR (2,4) and NF-κB from cornu dorsal medullae spindis L4-L5 were detected by immunohistochemistry, reverse transcription-polymerase chain reaction (RT-PCR) and Western blot.

RESULTSCompare with the blank control group, increased weight in the model group was slow and showed a decreasing trend (P < 0.01), spontaneous ambulatory pain score (SAPS) obviously increased (P < 0.01), paw withdrawal threshold (PWT) obviously decreased in the model group (P < 0.05, P < 0.01). Results of lateral tibial X-ray and HE staining showed obvious changes and damage occurred in bone structures of rats in the model group. Immunohistochemistry showed that GFAP expression significantly increased in the model group (P < 0.05). Protein levels of NF-κB also significantly increased in the model group (P < 0.05). Compared with the model group, CD11b expressions obviously decreased in the middle and high dose ZF groups (P < 0.01). Meanwhile, protein expressions of TLR2 and TLR4, as well as NF-κB also obviously decreased (P < 0.05).

CONCLUSIONZF had analgesic effect, which might be probably related to inhibiting proliferation and activation of gliocytes, as well as activation of TLRs and NF-κB.

Animals ; Astrocytes ; Bone Neoplasms ; drug therapy ; metabolism ; Drugs, Chinese Herbal ; therapeutic use ; Glial Fibrillary Acidic Protein ; Male ; Microglia ; NF-kappa B ; metabolism ; Osteosarcoma ; Pain ; Rats ; Rats, Sprague-Dawley

Objective To evaluate the methodological performance of the new enzymatic method for detecting glycated hemo-globin(HbAIc)and its influencing factors.Methods HbAIc was detected by the enzymatic method.The precision,anti-interfer-ence,recovery rate,accuracy and the influence of pre-processing(anti-coagulation,preservation,centrifugation)on the detection re-sults were evaluated,its correlation with HPLC and the bias degree were analyzed.Results The within-run coefficients of variation (CVs)for high,middle and low value QC samples in the enzymatic assay were 1.04%,1.26% and 1.37% respectively and the be-tween-run CVs were 1.83%,2.24% and 2.64%,respectively;the enzymatic method showed the linear correlation with HPLC(r=0.996,P <0.01);the HbA1c target value concentrations were 5.20%,6.40%,7.60%,8.80%,10.00% and 11.20% respectively, the recovery rates were 100.15%,98.91%,98.84%,98.20%,103.62% and 99.82% respectively;the interference test showed that this method had no significant interference on the detection results when glucose <15.50 mmol/L,UA<516.00 μmol/L,bili-rubin <217.00 μmol/L,triglyceride<10.20 mmol/L,urea<11.50 mmol/L,albumin<50 g/L and globulin <50 g/L.The HbA1c detection results in the samples with anti-coagulation by heparin sodium,EDTA-2K and sodium citrate stored for 3 d under -20-20 ℃ had no obvious change (P >0.05);the sample was centrifuged at 500,1 000 r/min(R=15 cm)for different time(1,2,5,10 min)and at 2 000 r/min for 1 min,their detection results had statistical differences compared with the sample centrifuged=3 000 r/min for 5 min (P <0.05).Conclusion The precision,anti-interference,accuracy and linearity range of the enzymatic method all conform to the clinical requirement.Compared with the conventional method,its correlation is good with small deviation,which can entirely satisfy the demand of the HbAIc detection in clinic.