Objective To test the utility of a new type of inflatable rehabilitation boot in the treatment of Danis-Weber type-A stable external malleolus fractures. Methods Fifty-four patients with stable external malleolus fractures were randomized into two groups. After closed reduction, the observation group was treated by immobilisation with the inflatable rehabilitation boot and the control group with a plaster slab. All were instructed to avoid weight-bearing on the affected side. The swelling volume of the injured limb was measured by drainage measurement before treatment and at the 1st, 3rd and 7th days after treatment. Pain was evaluated using a visual analogue scale (VAS) score before treatment and after 12, 24 and 72 hours. All of the ankles were x-rayed to recheck for displacement after 2weeks. Results The average volume of the injured limbs in the observation group was significantly less than in the control group at every time point. The average VAS score in the observation group was significantly lower than that in the control group. Fracture displacement in the observation group was also significantly better. Conclusions The inflatable rehabilitation boot has better curative efficacy than the typical plaster slab for patients with stable external malleolus fractures in terms of improving edema in the injured limb, relieving pain and preventing fracture displacement.

AIM: To observe the effect on visual quality by traditional Chinese medicine (TCM) warm-reinforcing method for early idiopathic macular epiretinal membrane(IMEM).METHODS: Totally 21 patients (21 eyes) diagnosed as early IMEM with spleen-kidney yang deficiency were treated by Gubenmingmu powder for 2mo.The best corrected visual acuity(BCVA), the contrast sensitivity and the modified vision quality of questionnaire score were detected to compare the life influence of pretherapy with posttherapy in visual changes.RESULTS: The BCVA were separately 0.24±0.07、0.22±0.06、0.27±0.08 in the treating time of 1, 2 and 5mo.Contrast sensitivity function in special frequencies of 6,12 and 18c/d increased than pretherapy (P<0.01), those of 3c/d were no statistically significant (P>0.05).Scales of night fixation difficulty, guidepost difficulty, TV font difficulty, satisfaction, annoyance, understanding, newspaper easiness had significant differences(P<0.01), while the rest of the scales had no significant differences(P>0.05).CONCLUSION: The TCM warm-reinforcing method could improve the visual function of IMEM patients and improve patients` quality of life.

A total of 218 patients on chemotherapeutic regimens containing oxaliplatin were randomly divided into experimental (n =120) and control (n =98) groups.The experimental group received an intravenous infusion of lipoic acid plus sodium potassium magnesium calcium and glucose injection.The control group had only normal saline.Overall incidence of neurotoxicity and toxicity grade of peripheral nerve were observed after 4,8 and 12 cycles.Those with neurotoxic symptoms were followed up for 1 year.No significantly statistical difference existed in the incidence of peripheral neurotoxicity after 4,8 cycles (P ＞0.05).After 12 cycles,31 patients in the experimental group had an onset of neurotoxicity of grade3 (n=8,6.7％) &grade4 (n=0) versus21 cases of grade3 (n=21,21.4％) and grade4 (n=5,5.1％) in the control group.Statistically significant differences existed between grades 3 and 4 neurotoxicity (P ＜0.05).After 1 year of follow-up,the incidence of grade 1 of neurotoxicity was 2.5％ (n =3) in the experimental group versus 23.7％ (n =9) in the control group.And the inter-group difference was statistically significant (P ＜ 0.05).Lipoic acid plus sodium potassium magnesium,calcium and glucose injection can effectively prevent the occurrences of acute and chronic peripheral neurotoxicity associated with oxaliplatin.

The internal medicine of paediatrics is the important major course in paediatrics. Focusing on strengthening the constructionof staff, we cultivate all levels of teachers from different administrative level and personality, do schorlarly research meticulously,standardizing management and improve the teaching evaluation system. Besides we promote the construction and development of theinternal medicine of paediatrics by carrying out teaching research, impsoving teaching methods and making paediatics the key subjectin China.

Objective To investigate the relationship between serum transforming growth factor- β1(TGF- β1) levels and early diabetic nephropathy and clarify whether valsartan plays a role in renal protection by reducing the level of serum TGF-β1. Methods The study subjects were divided into four groups:control group (30 cases); normal albuminuria group 1 (NA1 group with 12 cases, U MA/Cr < 10 μg/mg combined with type 2 diabetes);normal albuminuria group 2 (NA2 group with 19 cases,UMA/Cr 10-30 μg/mg combined with type 2 diabetes); microalbuminuria group ( MA group with 35 cases, U MA/Cr 31-300 μg/mg combined with type 2 diabetes). All these type 2 diabetic patients were suffering from diabetic retinopathy, and valsartan ( 80 mg/d) were medicated for those combined with hypertension. The serum TGF-β1 levels were measured by enzyme-linked immunosorbent assay in all subjects. Results Serum TGF- β1 levels in three diabetes groups were (7.41 ± 2.68 ), ( 10.52 ± 4.10), (22.98 ± 43.74) ng/L, respectively, all of which were higher than those in control group [(4.25 ± 5.82) ng/L] (P < 0.05). There were significant differences in serum TGF- β1 levels among MA group, NA2 group and NA1 group (P < 0.05 ). Serum TGF-β1 levels in NA1 group with valsartan treatment significantly decreased compared with those without valsartan treatment (P < 0.05), whereas there was no significant reduction in NA2 and MA group with valsartan treatment (P > 0.05). Conclusions High serum TGF-β1 level may be associated with type 2 diabetes and early diabetic nephropathy. Early intervention of valsartan may be delay the onset and development of diabetic nephropathy by decreasing the serum TGF-β1 level.

Objective To evaluate the role of gamma curve fitting technique of contrast-enhanced ultrasound in quantitative analysis of microcirculation in renal solid lesions. Methods A total of fifty patients with renal parenchyma solid lesions were performed contrast-enhanced ultrasound. The images were analysed by computer with gamma fitting analysis of contrast-enhanced ultrasonic system. The quantitative parameters were obtained by the time-intensity curves, such as ascending slope (a3), descending slope (a2), arrival time (AT), time to peak intensity (TTP), basic intensity (BI), peak intensity, amplification (AMP), area under the curve (AUC), mean transit time (MTT) and perfusion index (PI). The parameters were compared between renal malignant and benign solid lesions. Results Fast-in and fast-out was the main perfusion mode in renal malignant tumors while slow-in and slow-out was found in renal angiomyolipoma (AML). The perfusion modes in renal malignant tumors and renal AML were fast-in and fast-out in 28 cases and 0 case, fast-in and slow-out in 4 cases and 1 case, slow-in and fast-out in 5 cases and 1 case, and slow-in and slow-out in 1 case and 10 cases, respectively. There were significant differences in the quantitative parameters such as a2, AUC and PI between renal malignant tumors and renal AML obtained by the time-intensity curves (P<0.05). Conclusion Gamma fitting analysis of contrast-enhanced ultrasound system can provide quantitative information of microcirculation of renal tumors, which helps to differentiate benign renal tumors from malignant ones.

Sphingosine-1-phosphate(S1P) is an important bioactive lipid produced from cell membrane sphingomyelin metabolism process.S1P and cell membrane surface S1P receptors(S1PR1-5) are G protein coupled receptors(GPCRs), which influence the formation of new blood vessels in the immune system via combining the related inflammatory signaling pathway.This review describes briefly the effects of S1P and S1PRs on autoimmune disease angiogenesis through intracellular signal transduction, such as rheumatoid arthritis, multiple sclerosis, colitis, systemic lupus erythematosus.Further research will be a new therapeutic target on vascular inflammation of autoimmune diseases.

BACKGROUNDTuberculosis (TB) is a chronic wasting inflammatory disease characterized by multisystem involvement, which can cause metabolic derangements in afflicted patients. Metabolic signatures have been exploited in the study of several diseases. However, the serum that is successfully used in TB diagnosis on the basis of metabolic profiling is not by much.

METHODSOrthogonal partial least-squares discriminant analysis was capable of distinguishing TB patients from both healthy subjects and patients with conditions other than TB. Therefore, TB-specific metabolic profiling was established. Clusters of potential biomarkers for differentiating TB active from non-TB diseases were identified using Mann-Whitney U-test. Multiple logistic regression analysis of metabolites was calculated to determine the suitable biomarker group that allows the efficient differentiation of patients with TB active from the control subjects.

RESULTSFrom among 271 participants, 12 metabolites were found to contribute to the distinction between the TB active group and the control groups. These metabolites were mainly involved in the metabolic pathways of the following three biomolecules: Fatty acids, amino acids, and lipids. The receiver operating characteristic curves of 3D, 7D, and 11D-phytanic acid, behenic acid, and threoninyl-γ-glutamate exhibited excellent efficiency with area under the curve (AUC) values of 0.904 (95% confidence interval [CI]: 0863-0.944), 0.93 (95% CI: 0.893-0.966), and 0.964 (95% CI: 00.941-0.988), respectively. The largest and smallest resulting AUCs were 0.964 and 0.720, indicating that these biomarkers may be involved in the disease mechanisms. The combination of lysophosphatidylcholine (18:0), behenic acid, threoninyl-γ-glutamate, and presqualene diphosphate was used to represent the most suitable biomarker group for the differentiation of patients with TB active from the control subjects, with an AUC value of 0.991.

CONCLUSIONThe metabolic analysis results identified new serum biomarkers that can distinguish TB from non-TB diseases. The metabolomics-based analysis provides specific insights into the biology of TB and may offer new avenues for TB diagnosis.

Adult ; Aged ; Biomarkers ; blood ; Chromatography, High Pressure Liquid ; methods ; Female ; Humans ; Male ; Mass Spectrometry ; methods ; Middle Aged ; Tuberculosis ; blood

Objective To evaluate the efficacy and safety of HLA identical and haploidentical related allogeneic hematopoietic stem cell trans?plantation in the treatment of acute myeloid leukemia(AML)and myelodysplastic syndrome(MDS). Methods A total of 21 patients with AML and 8 patients with MDS who underwent allogeneic hematopoietic stem cell transplantation in our hospital from April 2011 to April 2016 were ana?lyzed retrospectively,including 16 cases of HLA?identical allogeneic HSCT,10 cases of haploidentical allogeneic HSCT,and 3 cases of syngeneic HSCT. BUCY2 or TBI plus CY ± chemotherapeutic agents was the regular conditioning regimen. No graft versus host disease(GVHD)prophylax?is was required for syngeneic HSCT,but cyclosporine in combination with methotraxate was essential for allogeneic HSCT,cyclosporine,methotrax?ate,antithymocyte globulin,mycophenolate mofetil and glucosteroids for haploidentical HSCT. Results All patients achieved fully donor?originat?ed hematopoiesis. Two patients died of severe acute GVHD within 100 days post HSCT. Acute GVHD with gradeⅡ?Ⅳoccurred in 23.1%(6/26) patients,chronic GVHD in 50%patients,therapy and relapse?relevant mortality was 4/29(13.8%)and 6/29(20.7%)cases within a median follow?up of 23(1?60)months,respectively. Two?year overall survival and leukemia free survival rates are 68.09%( 95%CI:45.77%?82.78%)and 60.22%(95%CI:38.19%?76.55%),respectively. High risk AML is still the main challenge to long?term leukemia free survival. Conclusion HLA identical and haploidentical allogeneic HSCT for AML and MDS is safe ,effective and feasible. Minimal residual disease monitoring and pre?ventative as well as preemptive intervention is necessary for improving prognosis of high risk AML.

Objective To observe the antioxidative dosage-effect relationship of Marigold lutein, and provide experimental data for clinical use. Methods The mice were randomly divided into seven groups:blank control group, model control group, 1 mg/kg lutein group, 5 mg/kg lutein group, 25 mg/kg lutein group, 125 mg/kg lutein group and 625 mg/kg lutein group. The mice in blank control group were dealt with saline solution by intraperitoneal injection, the others were dealt with D-galactose (120 mg/kg) by intraperitoneal injection for seven weeks to make oxidative damage model, meanwhile the mice were given corresponding dose of the drug. Subsequently, the level of malondialdehyde (MDA) and activity of superoxide dismutase (SOD) in the serum were measured, and the antioxidative dosage-effect relationship was observed. Results The 1, 5, 25 mg/kg lutein reduced the MDA level and increased SOD activity, and the 125, 625 mg/kg dose of lutein did not show significant antioxidant activity. Conclusion Lutein has significant antioxidant activity in mouse dealt with D-galactose within the dose range of 1-25 mg/kg. The results suggest that the clinical dosage range of lutein should be kept within reasonable limits.