Objective To evaluate the the effect of vancomycin artificial bone on the treatment of elderly patients with chronic osteomyelitis and the influence to TNF-α.MethodsIn Yongkang orthopaedic hospital, 48 cases of elderly patients with chronic osteomyelitis were selected as the object of study, and were randomly divided into the control group and the experimental group, 24 cases in each group.This is a retrospective study.Three days before operation, the control group were given cloxacillin 2g/d by 4 times intravenous drip.The experimental group were given Norvancomycin Hydrochloride 0.8g/d by two times intravenous drip.In the process of operation, the control group were given bone graft substitutes 5-10g and the experimental group were given Norvancomycin Hydrochloride 1g that is added to the water to form a paste.After operation, the control group were given cloxacillin 2g/d by 4 times intravenous dripand the experimental group were given Norvancomycin Hydrochloride 0.8g/d by 2 times intravenous drip.The two groups were treated continuously for two weeks.The effect,CRP, ESR, TNF-α, NF-κB and adverse drug reactions were compared between the two groups.ResultsThe effect in the experiment group was 95.45%,is significant higher than that in the control group 81.82%(P<0.05).The serum level of CRP、ESR、TNF-α and NF-κB decreased post-treatment in the experiment group much lower than that in the control group (P<0.05).The adverse drug reactions was not statistically different between the two groups.ConclusionVancomycin artificial bone on the treatment of elderly patients with chronic osteomyelitis was effective with high safety and it can decrease the level of TNF-α.

From visual teaching aids,experiment phenomenon,imagination,clinical cases and the aspects such as daily life phenomenon and computer supplementary teaching,this article has discussed the application of“Image-thinking” in biochemistry teaching,and from the angle of medical educational reform,it has also discussed the importance of its raising the teaching effect.

Accidents, Occupational ; Humans ; Hydrogen Sulfide ; poisoning

Abstract: Objective To understand the difference of DNA sequence and RNA sequence of paired pol region in HIV patients in constructing HIV genetic transmission network, and to provide scientific data for constructing molecular transmission networks using DNA sequences. Methods　The whole blood and plasma samples of HIV patients living in 2014 and newly reported in 2015-2018 in Liuzhou, Guangxi, were collected, DNA and RNA sequences were extracted, amplified, sequenced, spliced and aligned, and then genetic transmission networks were constructed, and the connectivity consistency of genetic transmission networks constructed by DNA and RNA sequences was compared. Results In this study, a total 2 983 participants were investigated, which were 2014 baseline and 2015-2018 newly reported HIV patients, of which 2 590 participants were only DNA sequences in 2014 baseline, 196 HIV patients were both DNA and RNA sequences of paired pol region in 2014 baseline, and 197 newly reported HIV patients were both DNA and RNA sequences of paired pol region in 2015-2018. In 393 DNA and RNA sequences of paired pol region, the genotype of DNA sequence and RNA sequence were consistent, and there was no statistically significant difference in genetic distance between paired DNA sequences and RNA sequences (Z=-2.72, P=1.00). The connection consistency rate of genetic transmission networks constructed by DNA and RNA sequences of paired pol region of 2015-2018 newly reported with the baseline DNA sequences was 91.4% (108/197). And the connection consistency rate of genetic transmission networks constructed by DNA and RNA sequences of paired pol region of 2015-2018 newly reported with the baseline RNA sequences was 97.0% (191/197). There was no statistical difference in antiretroviral therapy to reduce the risk of HIV secondary transmission between genetic transmission networks constructed by DNA and RNA sequences of paired of pol gene newly reported from 2015 to 2018 with baseline DNA sequence. Conclusion　DNA sequence and RNA sequence of paired pol region of HIV patients have good consistency in genotype, genetic distance, and genetic transmission network construction, and both DNA and RNA sequences can be used for genetic transmission network analysis.

AIM:To investigate how to design personalized cataract surgery programs to achieve surgical correction of preoperative corneal astigmatism with surgical astigmatism under the guidance of corneal topography, improve postoperative visual quality and reduce the cost of treatment.
METHODS: Totally 202 cases ( 226 eyes ) cataract patients were divided into randomized treatment group and individualized treatment group. According to the method and location of the incision, randomized treatment group were divided into 8 groups. Surgical astigmatism after different incision were calculated with the use of preoperative and postoperative corneal astigmatism through vector analysis method. Individualized treatment groups were designed personably for surgical method with reference of every surgically induced astigmatism, the surgical method chooses the type of surgical incision based on close link between preoperative corneal astigmatism and surgically induced astigmatism, and the incision was located in the steep meridian. The postoperative corneal astigmatism of individualized treatment group was observed.
RESULTS: Postoperative corneal astigmatism of individualized treatment group were lower than that of 3.0mm clear corneal tunnel incision in the randomized treatment group, there were statistically significance difference, while with 3. 0mm sclera tunnel incision group there were no statistically significance difference. After 55. 8% of patients with the use of individualized surgical plan could undergo the operation of extracapsular cataract extraction with relatively low cost and rigid intraocular lens implantation, the per capita cost of treatment could be reduced.
CONCLUSION: Personalized cataract surgery programs are designed to achieve surgical correction of preoperative corneal astigmatism under the use of corneal topography, improve postoperative visual quality and reduce the cost of treatment.

Adult ; Aged ; Aged, 80 and over ; Anthracosis ; complications ; microbiology ; Anti-Bacterial Agents ; pharmacology ; Drug Resistance, Bacterial ; Humans ; Lung Neoplasms ; complications ; microbiology ; Male ; Middle Aged ; Pseudomonas Infections ; microbiology ; Pseudomonas aeruginosa ; drug effects

BACKGROUND: Cell apoptosis and ventricle reconstitution following myocardial infarction are of mutual cause-effect, and they cause vicious cycle. How to reduce the apoptosis events following myocardial infarction is one of keys to saving heart function.OBJECTIVE: To observe the effect of umbilical cord blood mesenchymal stem cell (UCBSMC) transplantation on remaining myocardial tissue of dogs with acute myocardial infarction.DESIGN: A randomized controlled observation.SETTING: Department of Cardiothoracic Surgery, Xinhua Hospital.MATERIALS: This study was carried out in the Central Laboratory of Xinhua Hospital from October 2005 to May 2007.Thirty-six adult hybrid dogs, male and female in half, were provided by the Animal Experimental Center of Xinhua Hospital.METHODS: Thirty-six dogs were divided into cell transplantation group and control group, with 18 dogs in each according to table of random digit. Mesenchymal stem cells were isolated from the umbilical cord blood of full-term pregnant hybrid dogs, cultured and amplified. Then, they were labeled with Laz gene, in vitro induced with 5-azacytidine, and transplanted into the dogs with acute myocardial infarction in the cell transplantation group. Rats in the control group were injected with the same amount of normal saline. Each dog was euthanized by anesthesia for harvesting myocardial specimen 1,4 and 8 weeks after transplantation.MAIN OUTCOME MEASURES: ① Remaining and apoptosis index detected by TUNEL method. ② Myocardial cell volume and histomorphology detected by confocal microscopy. ③ Histological change of myocardial collagen network detected by haematoxylin-basic fuchsin-picric acid staining.RESULTS: Thirty-six involved experimental dogs all entered the stage of final analysis. ①The apoptosis index in the cell transplantation group was significantly lower than that in the control group 1, 4 and 8 weeks after cell transplantation (P ＜0.05). ② Myocardial cell volume in the cell transplantation group 1, 4 and 8 weeks after cell transplantation was significantly larger than that in the control group (P ＜ 0.05). ③ Collagen fiber in the myocardial tissue of dogs in the cell transplantation group was arranged in order and regularly, and in contrast that in the control group was not, and fibers in the control group fused partially.CONCLUSION: UCBSMC transplantation reduces the apoptosis of myocardial cells, promotes the hypertrophy of remaining myocardial cells, regulates myocardial collagen network and improves heart function.

Objective To evaluate the clinical value of gasless video-assisted endoscopic thyroidectomy by infraclavicular wall.Methods 15 cases received gasless video-assisted endoscopic thyroidectomy by infraclavicular wall.13 cases underwent total thyroidectomy,2 cases underwent subtotal thyroidectomy.All 15 cases were protected recurrent laryngeal nerve and parathyroid by inspecting during the operation.Results All 15 patients were cured without hoarse and tetany,and the flaps without hematomas and extravasated blood.Conclusion Gasless video-assisted endoscopic thyroidectomy by infraclavicular also can reach the principle demand by the tradional opening way.As the supremacy way of aesthetic and hidden,it can be used to the patients who want high request on faces.

Patients were divided into normal control, liver fibrosis and liver cirrhosis groups. The patients with cirrhosis were categorized according to the Child Pugh classification into Child A,Child B and Child C groups. The waveforms of the right hepatic vein were examined with ultrasonography. HV(hepatic vein)0 waveforms were found in all the control subjects, 70.8% in those with fibrosis and 40.7% in those with cirrhosis. HV1 were found in 16.7% of those with fibrosis and 17.8% of those with cirrhosis. HV2 were found in 12.5% of those with fibrosis and 41.5% of those with cirrhosis. Statistical analysis showed that HV2 waveforms were significantly more often in patients with cirrhosis than in those with fibrosis. HV2 waveforms in the right hepatic vein are suggestive of liver cirrhosis.

Background The pathogenesis of dry eye has not been clearly established.There are more and more evidences to suggest that it is associated with ocular surface inflammation mediated by immunity.But how T helper cell 17 (Th17) plays its role in dry eye remains unclear.Objective The aim of this study was to investigate the expressions of Th17 related cytokines in ocular surface with dry eye.Methods A prospective cohortl study was designed.This protocol was approved by Ethic Commission of Peking University Third Hospital,and written informed consent was obtained from each subject prior to entering this cohort.Twenty female patients with Sjigren syndrome (SS group),20 patients with non-SS dry eyes and 20 normal volunteers were recruited in Peking University Third Hospital during 2011-2012 duration and all the subjects were menopausal female with the age 50 years old or more.The ocular surface disease index (OSDI)questionnaire designed by Schiffman was performed firstly,and then tear breakup time (BUT),corneal fluorescein staining and Schirmer Ⅰ test (S Ⅰ t) were carried out in the subjects.Expression of Th17 related cytokines mRNA were measured using PCR-Array.The correlation between IL-17A and ocular surface parameters was analyzed.Results The OSDI scores of the SS dry eye group,non-SS dry eye group and normal control group were 50.00 (33.50,66.50),45.00 (35.50,55.00) and 3.00 (0.00,5.00),the S Ⅰ t values were 2.50 (1.00,4.00),5.00 (2.00,5.00) and 15.50 (10.00,18.50),the BUT were 2.00 (1.00,4.00),4.00 (3.00,5.00) and 10.00 (10.00,12.00),the corneal fluorescein staining score were 8.50 (6.00,12.00),5.50 (4.00,7.00)and 0.00 (0.00,0.00),respectively,and significant differences were seen among the SS group,non-SS dry eye group and normal control group (x2=34.11,28.13,93.66,92.25,all at P＜0.01).The relative expression values of IL-17A mRNA,IL-6 mRNA,IL-8 mRNA,IL-22 mRNA and IL-23 mRNA in the ocular surface were 1.98±0.16,11.64±1.32,6.67±1.12,1.88±0.18 and 1.78±0.17 in the SS group patients,and 1.45±0.17,1.32±0.14,1.12 ±0.13,1.23 ±0.15 and 1.23 ±0.13 in the non-SS dry eye group patients,respectively,with significant differences between the two groups (all at P＜0.01).IL-17A level on the ocular surface was significantly negative correlated with BUT (r =-0.56,P＜0.01) and positive correlation with corneal fluorescein staining scores (r=0.44,P=0.01).Conclusions Expressions of Th17 related cytokines in the ocular surface increased in patients with dry eye,especially in those with SS.IL-17A level in ocular surface is associated with BUT and corneal fluorescein staining scores,suggesting that immune is involved in the pathogenesis and devlopment of dry eye.