The medium and process parameters were optimized in batchaminoglycoside antibiotic JI-20A fennentation. The optimal medium consists mainly of comstarch 60g/L, peanut meal 30g/L, com slurry 8g/L, maltose 10g/L, inorganic compound and amylase moderate , methionin 1g/L and cobalt chloride 6?g/mL. It was significant to adjust medium pH after autoclaving and oxygenate the fennentation medium for the cell growth and JI-20A product.

Objective To evaluate the clinical outcome and relative factors of intervention treatment for atherosclerotic renal artery stenosis in elderly patients.Methods The clinical data of 79 patients diagnosed as atherosclerotic renal artery stenosis by angiography and treated by revascularization were analyzed.Results There were 55(69.6%)successes and 24(30.4%)failures in decreasing blood pressure and 28(35.4%)successes and 51(64.6%)failures in improving renal function after intervention treatment.Predictors of favorable outcome of intervention treatment in decreasing blood pressure were related to lower urine protein,higher glomerular filtration rate,higher systolic and diastolic blood pressure before treatment,lower resistance index(RI)of renal artery,and no complication of cerebral vascular diseases.Predictors of favorable outcome of intervention treatment in improving renal function were related with percentage of angiographic stenosis,category of antihypertension and lower urine protein.The logistic regression analysis showed that the percentage of angiographic stenosis was the most important predictor of intervention treatment for blood pressure control,age and level of serum creatinine before intervention treatment were the most important predictors of intervention treatment for improving renal faction.Conclusion Percentage of stenosis(≥85%),age(133 ?mol/L)can be used as the predictors of therapeutic success for renovascular stenosis in older patients.

OBJECTIVETo investigate clinical effects of minimally invasive fixation and bone grafting througn medial side for the treatment of Schatzker III tibial plateau fracture.

METHODSFrom April 2009 to August 2011, 18 patients with Schatzker III tibial plateau fracture were treated with minimally invasive fixation and bone grafting through medial side. There were 15 males and 3 females ranging in age from 64 to 73 years, with an average of (69.75 ± 1.22) years. Sixteen patients were caused by falling down, 2 cases were caused by traffic accident. Operative time and length of incision were be recorded. Clinical and radiological follow-up was performed after operation. Hospital for Special Surgery (HSS) score and Kellgren-Lawrence score were used to evaluate clinical effects.

RESULTSThe mean operative time was (45.32 ± 1.58) min, and the mean length of incision was (5.21 ± 0.65) cm. Postoperative X-ray showed excellent reduction. Eighteen patients were followed up for 10 to 13 months with an average of (11.5 ± 1.35) months. The mean HSS score was 86.51 ± 2.71, 12 cases got excellent results,4 good and 2 fair. Three patients were developed mild osteoarthritis according to the Kellgren-Lawrence system.

CONCLUSIONMinimally invasive fixation and bone grafting through medial side, not only could reduce surgical invasive, but also guarantee early function activities. It has advantages of keeping well after reduction. So it has the favorable future in clinic.

Aged ; Bone Transplantation ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Retrospective Studies ; Tibial Fractures ; surgery

Objective To investigate the clinical result of treating Tillaux-Chaput fractures using the full ankle arthroscopy technique.Methods A retrospective analysis was made on 21 patients with Tillaux-Chaput fractures followed up after treatment by the full ankle arthroscopy technique from May 2013 to May 2015.There were 16 males and 5 females,with the age range of 6-55 years [(25.5 ± 12.8)years].Right ankle was involved in 12 patients and left ankle in 4 patients.Sixteen patients had single TillauxChaput fractures and 5 patients had combined proximal fibular fractures.Diagnosis of Tillaux-Chaput fractures was confirmed by X-rays in 18 patients an CT in 3 patients.Ankle arthroscopy was used through the anterolateral and anteriormedal approaches for closed reduction and internal fixation using one or two Herbert screws.Wound healing,bone union and visual analogue score (VAS) were detected postoperatively.Function assessment was performed using the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scoring system.Results All incisions healed by first intention,without evidence of nerve,vessel and tendon injuries.Period of follow-up was (15.3 ± 7.1) months (range,12-25 months).Fracture healed within 12 to 36 weeks [(22.6 ±4.6)weeks] after operation.VAS was (0.8 ± 0.3) points after operation,obviously lower than preoperative (8.3 ± 1.3) points (P ＜ 0.05).At the final follow-up,all patients regained normal ankle function and normal walking gait,without the presence of ankle pain and weight-bearing walking pain.AOFAS score was improved from preoperative (51.2 ± 12.5) points to postoperative (92.7 ± 16.5) points (P ＜ 0.05).Based on the AOFAS score,the results were excellent in 19 patients and good in 2 patients,with the excellent-good rate of 100％.Conclsion Full ankle arthroscopy by the anterolateral and anterionnedal approaches provides a precise and effective method for closed reduction and internal fixation of Tillaux-Chaput fractures and deserves clinical application.

Objective To investigate the correlation between liver and spleen stiffness measured by acoustic radiation force impulse (ARFI) and hepatic venous pressure gradient (HVPG),and to evaluate its efficiency in the diagnosis of portal hypertension.Methods From April 2014 to March 2016,20 cases underwent HVPG measurement because of liver cirrhosis were enrolled.Before HVPG measurement,liver and spleen stiffness were assessed with ARFI.The correlation between HVPG and age,alanine aminotransferase (ALT),aspartate aminotransferase (AST),total hilirubin,serum albumin,platelet count,prothrombin time,aspartate aminotransferase to platelet ratio index (APRI) score,Child-Pugh score,model for end-stage liver disease (MELD) score,liver stiffness and spleen stiffness were analyzed.Pearson correlation and Spearman rank correlation were performed for statistical analysis.Results HVPG,liver and spleen stiffness were successfully measured in all 20 patients.The mean liver stiffness was (1.78±0.29) m/s,the mean spleen stiffness was (3.37±0.44) m/s and HVPG was (16.10±5.14) mmHg (1 mmHg=0.133 kPa).Age,ALT,AST,total bilirubin,serum albumin,platelet count,prothrombin time,APRI score,Child-Pugh score and MELD score were all not correlated with HVPG (all P＞0.05).But HVPG was positively correlated with liver and spleen stiffness (r=0.449,P=0.047;r=0.487,P=0.030).In the diagnosis of HVPG≥12 mmHg,the area under curve (AUC) of liver stiffness was 0.875,the optimal cut-off value was 1.77 m/s,the sensitivity was 68.6 ％ and the specificity was 100.0％.In the diagnosis of HPVG≥20 mmHg,the AUC of liver stiffness was 0.798,the optimal cut off value was 1.85 m/s,the sensitivity was 100.0％ and the specificity was 68.8％.The AUC of spleen stiffness was 0.820,the optimal cut-off value was 3.23 m/s,the sensitivity was 100.0 ％ and the specificity was 56.3％.Conclusion In patients with liver cirrhosis,liver stiffness and spleen stiffness assessed by ARFI are positively correlated with HVPG and therefore ARFI has certain application value in the noninvasive diagnosis of portal hypertension.

Biopsy ; Eosine Yellowish-(YS) ; Gastric Mucosa ; microbiology ; pathology ; Helicobacter Infections ; diagnosis ; pathology ; Helicobacter pylori ; isolation & purification ; Hematoxylin ; Humans ; Silver Staining ; Staining and Labeling ; methods

OBJECTIVETo observe the clinical effects of needle-pricking therapy, a newly medical and minimally invasive technique, for functional retrograde ejaculation and to explore its mechanism. Methods Thirty-six patients with functional retrograde ejaculation were randomly divided into an observation group(19 cases) and a control group(17 cases) In the observation group,needle-pricking therapy was used at Guanyuan(CV 4) and bilateral sacral plexus nerve,lumbar 1 nerve and greater occipital nerve stimulating points,once a week. In the control group, midodrine tablets were prescribed orally,three times a day. All the treatment was given for 9 weeks. The clinical effects of the two groups were observed, and the levels of luteinizing hormone(LH), testosterone(Tes) and estra4 diol(E2) were compared between the two groups.

RESULTSThe total effective rate of the observation group was, 89. 47%(17/19), which was better than 47.06% (8/17) of the control group(P<0. 05). The LH and Tes were obviously increased and E2 was decreased compared with those before treatment in the observation group(all P< 0. 01). Tes was raised(P<0. 05) and E2 was apparently declined in the control group(P<0. 01). After treatment, the differences of serum LH and Tes were statistically significant between the two groups(both P<0. 01).

CONCLUSIONNeedle-pricking therapy has advantages for functional retrograde ejaculation probably in that stimulating lumbosacral nerves can strengthen the function of pelvic floor muscles and urethral expansion muscle and regulate sexual gland axis.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Ejaculation ; Humans ; Male ; Middle Aged ; Needles ; Sexual Dysfunction, Physiological ; physiopathology ; therapy ; Treatment Outcome

Objective To expore the pulmonary function in children with connective tissue disease(CTD),and evaluate lung complication and prognosis of children with CTD.Methods Thirty-five children with CTD(male 16 cases,female 19 cases) who visited children′s hospital of Fudan university during Oct.2006 to Jul.2007 and had non-respiratory symptoms were selected.The pulmonary function of them were measured by Master-Screen Paed and the data were compared with 32 children as the healthy control group(male 13 cases,female 19 cases).The data were analyzed by STATA 7.0 software.Results The abnormality ratio of lung functions were 57.14%,17 cases(48.57%)children with CTD displayed restrictive ventilatory disorder,9 cases(25.71%)children with CTD displayed dropped function of small airway,2 cases(5.71%)children displayed dominant restrictive ventilatory disorder and coexisted with obstructive ventilatory disorder.The parameters of pulmonary ventilation such as maximal vital capacity,forced vital capacity,forced expiratory volume in 1 second,in CTD group were significantly lower than those in healthy control group[(77.66?20.22)% vs(94.39?11.27)%;(79.05?21.45)% vs(94.89?11.46)%;(84.91?23.29)% vs(103.62?12.96)% Pa0.05).Conclusions The most characteristic pulmonary function changes in children with connective tissue disease are restrictive ventilatory disorder with some disorder in small airway function.Pulmonary function test shall become routine test in children with connective tissue disease.

AIM: To explore the curative effect of methylprednisolone with octreotide retrobulbar injection therapy on thyroid associated ophthalmopathy.
METHODS:Fifty- one cases ( 96 eyes ) with thyroid associated ophthalmopathy were treated with methylprednisolone ( 500mg/d ) for 3d, and then retrobulbar injection of octreotide (0. 1mg/mo) for 3mo in one course. Symptoms and signs of the patients were observed before and after the treatment course.
RESULTS: Symptoms of 49 cases were improved significantly. In all cases, the mean value of exophthalmus of the patients was significantly decreased after the treatment by 3. 1 ± 1. 4mm. The height of palpebral fissure was significantly decreased after the treatment by 2. 4 ± 0. 9mm, there were statistically significant difference before and after treatment (P<0. 05).
COCLUSION: Methylprednisolone with octreotide retrobulbar injection therapy can improve symptoms and signs of the patients with thyroid associated ophthalmopathy with high safety and no obvious side effect.

Objective To compare the changes of 11 cytokines in ankylosing spondylitis(AS)before and after treatment with a loading regimen of infliximab and to evaluate the potential AS related discriminating cytokines and explore their value in diseases activity evaluation and possible association with therapeutic response.Methods This was an open-labeled,phase Ⅱ clinical trial conducted in 2 medical centers.All AS patients were infused with infliximab at week 0,2,6.The dosage was 5 mg/kg.Disease activity parameters were assessed at week 0,2,6 and 10.Eleven serum cytokines were detected using protein chip technique,then,serum IL-6 level wag measured by sandwich enzyme-linked immunosorbent assay(ELISA).Results IL-6 was detected by EHSA.Compared with healthy controls.IL-6 level incregsed markediy in AS(P<0.01).After treated with infliximab,IL-6 level decreased at week 2(P<0.01)and maintained at low level until week 10.Baseline serum IL-6 level was positively associated with AS disease activity index(night pain scores、ESRand CRP)(P<0.01).Conclusion Serum IL-6 level is associated with AS disease activity and may become a useful parameter for monitoring the clinical response of infliximab in AS patients.IL-6 is an important cytokine involved in the pathogenesis of AS.