Animals ; Hepacivirus ; genetics ; Hepatitis C ; immunology ; prevention & control ; therapy ; virology ; Humans ; Mutation ; Viral Hepatitis Vaccines ; immunology

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.

Objective To assess whether dynamic arterial elastance (Eadyn)can be used to predict the reduction of arterial pressure after decreasing norepinephrine (NE) dosage in patients with septic shock.Methods A prospective observational cohort study was conducted.Thirty-two patients with septic shock and mechanical ventilationwere enrolledfrom January 2014 to December 2015 in ICU of Wuxi People's Hospital of Nanjing Medical University.Hemodynamic parameters were recorded by pulse contour cardiac output(PiCCO) monitoring technology before and after decreasing norepinephrine dosage.Eadyn was defined as the ratio of pulse pressure variation (PPV) to stroke volume variation (SVV).Mean arterial pressure (MAP) variation was calculated after decreasing the dose of NE.Response was defined as a ≥ 15％decrease of MAP.AUC was plotted to assess the value of Eadyn in predicting MAP response.Results A total of 32 patients were enrolled in our study,with 13 responding to NE dose decrease where as the other 19 did not.Eadyn was lower in responders than in nonresponders (0.77 ± 0.13 vs 1.09 ± 0.31,P ＜ 0.05).Baseline Eadyn was positively correlated with systolic blood pressure variation,diastolic blood pressure variation,systemic vascular resistance variation and MAP variation (r =0.621,P =0.000;r =0.735,P =0.000;r =0.756,P =0.000;r =0.568,P =0.000 respectively).However,stoke volume variation,baseline level of systemic vascular resistance and NE baseline dose were not correlated with Eadyn baseline value (r =0.264,P =0.076;r =0.078,P =0.545;r =0.002,P =0.987 respectively).Eadyn ≤ 0.97 predicted a decrease of MAP when decreasing NE dose,with an area under the receiver-operating characteristic curve of 0.85.The sensitivity was 100.0％ and specificity was 73.7％.Conclusions In septic shock patients treated with NE,Eadyn is an index to predict the decrease of arterial pressure in response to NE dose reduction.

Objective To study the kidney histological categories of isolated hematuria in children.Methods Twenty-three children with isolated hematuria were performed renal biopsy under real time ultrasound guidance utilizing menghini style negative pressure biopsy device after local anesthesia or general anesthesia.The renopuncture tissue was directly sent by the mail-boxes to the remote pathologic service.All of the biopsies were examined by light microscopy,electron microscopy and immunohistochemistry.Results Biopsies were classified as measangial proliferative glomerulonephritis(MsPGN)(8 cases),minimal change nephropathy(MCN)(5 cases),IgA nephropathy(IgAN)(4 cases),thin basement membrane nephropathy(TMN)(3 cases),Alport′s syndrome(AS)(1 case),focal segmental glomerulosclerosis(FSGS)(1 case)and IgM nephropathy(IgMN)(1 case).Conclusions In this series,MsPGN,MGA,IgAN are the most common biopsy diagnosis.TMN and Alport′s are account for some proportion.A few IgMN and FSGS may also present as isolated hematuria.

Objective To evaluate the clinical features and key points in treatment of ovarian torsion in children. Methods The clinical data of 64 children with ovarian torsion, hospitalized in our hospital from January 2005 to October 2012, were analyzed retrospectively. The clinical manifestations in children of all ages were summarized. The anal examina-tion, B ultrasound examination, CT examination were used for the early diagnosis of ovarian torsion. All children were per-formed laparoscopic surgical exploration. All children were found the typical lower abdominal cramps. The B ultrasound and CT examination showed non-homogeneous mass in pelvic, which suggested the early diagnosis of ovarian torsion. The detec-tion rate of anal examination reached 70.3%(45/64). Results All patients were performed laparoscopic surgical explora-tion. Five patients were treated with ovariectomy. The rest were treated conservatively. The postoperative follow-up was good. Conclusion Ovarian torsion in children was likely to be misdiagnosed. Doppler, CT, anal examination and laparo-scopic operation were important for the early diagnosis and treatment of ovarian torsion.

Objective To evaluate the predisposition effects of angiotensin-converting enzyme (ACE) ,angiotensinogen (AGT) and endothelial nitric oxide synthase (eNOS) gene polymorphisms on coronary disease (CHD) as well as their possible synergistic effect in the development of CHD in Chinese aged people. Methods The study included 191 subjects (100 CHD and 91 controls). Gene chip technology was performed. The allele frequency and genotype distribution were compared between groups. Results A significantly higher frequency of the DD genotype of ACE gene was observed in CHD group (28.0% vs 15. 4%, P0. 05). Subjects carrying ACE DD and AGT TT genotypes or those carrying AGT TT and eNOS TT genotypes showed a stronger association withCHD(OR=2. 9, P

Objective To compare distribution and antimicrobial resistance of methicillin-sensitive Staphylococcus aureus(MSSA)and methicillin-resistant Staphylococcusaureus(MRSA)in hospitalized children,and provide refer-ence for empirical use of antimicrobial agents.Methods Isolation and clinical data of Staphylococcus aureus (S. aureus)from hospitalized children in a hospital during 2011-2015 were analyzed retrospectively,distribution and antimicrobial resistance between MSSA and MRSA were compared.Results A total of 919 strains of S.aureus were isolated,632(68.77% )of which were MSSA,287(31.23%)were MRSA.65.03% of MSSA infection and 64.11% of MRSA infection were in children aged 29 day-1 year old.80.38% of MSSA and 79.09% of MRSA were isolated from sputum specimen.MSSA and MRSA were mainly distributed in department of pediatric respiratory medicine(50.73%,45.89% respectively)and department of pediatric neurology(22.98%,26.84% respectively). Resistance rates of MSSA to antimicrobial agents were<20.00% except penicillin and erythromycin;resistance rates of MRSA to penicillin,oxacillin,erythromycin,and clindamycin were all>40.00%;resistance rates of MR-SA to tetracycline,erythromycin,clindamycin,levofloxacin,ciprofloxacin,moxifloxacin,nitrofurantoin,and ri-fampin were all higher than MSSA.Conclusion MSSA is main S.aureus isolated from hospitalized children,in-fants under 1 year of age are the main population,the main distribution departments of MSSA and MRSA from re-spiratory tract specimen are similar,antimicrobial resistance of MRSA is generally higher than that of MSSA.

Objective To investigate the ambulatory changes of the expressions of neuroserpin (NSP) and tissue plasminogen activator (tPA) during hypoxia/reoxygenation (H/R) in primarily cultured rat cortical neurons. Methods Cortical neurons were cultured from SD rats within 24 h after birth, and a H/R model was built. The immunofluorescence double staining and Western blot were used to detect the NSP expression in the cultured neurons. Enzyme-linked immunosorbent assay (ELISA) was used to detect the expression of tPA. Results After oxygen-glucose deprivation (OGD) for 1.5 h, the expression of NSP protein was mildly up-regulated, and it reached the peak at 6 h after reoxygenation (P < 0. 05). Then it decreased slowly and basically restored to the level before hypoxia at 24 h after reoxygenation. The cells expressed a small amount of tPA at 1.5 h after OGD (P < 0. 05 ). With the extension of time for reoxygenation, the tPA content increased gradually. OGD was significantly higher at 6 h after reoxygenation than before (P < 0.01 ). Then it decreased gradually, and it basically restored to the level before reoxygenation at 24 h after reoxygenation. Conclusions The expressions of NSP and tPA Were up-regulated significantly during neuron H/R injury, and the ambulatory changes of NSP and tPA were basically the same.

Nowadays, ceremony education, as a specific education method, is becoming increasingly popular in medical humanistic education.It is a truth generally acknowledged that the importance of ceremony education is located at its extensive scope and plasticity.The cultivation of medical students' human-oriented spirit, strengthening their career identity and enhancing their ideological moralitycan be processed by ceremony education, in which much attention is attached to its four features, identity recognition, emotion polymerization, spirit conduction and cultural inheritance.However, there still exist some problems to be solved in the practice of ceremony education such as overformalization, insufficient individuation and systematization.That is what we mean to discuss in this paper.

Lean management theory is applied to the management of the devices and staffs of radiology department. With the current flow evaluated, the working efficiency and patient satisfaction are increased.