Objective To understand the role of increasing peripheral blood platelet count in the diagnosis and prognosis of patients with active pulmonary tuberculosis.Methods This analysis included 80 inpatients with active pulmonary tuberculosis evidenced by positive sputum smear,43 patients in recovery and 89 healthy controls during the period from January to June in 2012.Peripheral white blood cell,platelet count,and neutrophil percentage were assayed.Erythrocyte sedimentation rate (ESR)and serum C-reactive protein (CRP)were measured and compared.The data were analyzed by using SPSS 13.0 software.Results ESR and CRP values were significantly higher in the patients with active pulmonary tuberculosis than in the patients in recovery (P=0.006 5 and P=0.007 3,respectively).The peripheral blood platelet count exceeded normal range in 41.94% of the patients with active pulmonary tuberculosis,which was significantly higher than that in the patients in recovery (P=0.001 4)and controls (P=0.000 0).Platelet count was positively correlated with CPR (r=0.515,P<0.000 1)and ESR (r=0.398,P<0.001)value.However,peripheral white cell count and neutrophil count were not different from the corresponding values of controls.Conclusions Increasing peripheral platelet count may play a role in assessment of tuberculosis disease activity and the effect of anti-tuberculosis treatment.

Objective To understand the bacteriology and the association between drug susceptibility and clinical features from recent hospitalization of tuberculosis(TB)patients with positive tuberculosis bacilli culture.Methods We collected the clinical data of inpatients due to tuberculosis or pulmonary disease with positive tuberculosis bacilli by BACTEC960 culture auto-analysis system and possessing anti-tuberculosis drug susceptibility testing results from January 2008 to November 2008.All isolated strains were tested with first-line drugs included Streptomycin(S),Isoniazid(H),Rifampicin(R)and Ethambutol(E).Some isolate strains were used to test Amikacin(Am),Capreomycin(Cm)and Ofloxacin(Ofx).We recorded the drug-tested results and clinical data and retrospectively analyzed them.The patients with pulmonary disease from nontuberculosis mycobacteria(NTM)were excluded.Results (1)There were 417 patients with positive culture of tuberculosis bacilli (included 294 male and 123 female).The mean age was(47.8 18.1)years(ranging from 6 to 91 years).There were 68 cases complicated with endobronchial tuberculosis(EBTB)and 56 cases with type 2 diabetes mellitus.(2)There were 271 cases for initial treatment and 146 cases of relapsing tuberculosis.The total drug resistant rate was 53.5 percent,and of oflx was as high as 31.86 percent.The initial drug resistant rate was S 22.5%,H 25.8%,R 17.3%,E 21.0%,Am 6.3%,Cm 10.0%,Ofx 16.6% respectively and the required rate was 67.8%,82.9%,68.5%,68.5%,19.9%,25.3%,58.2% respectively.(3)There were 143 patients with multi-drug resistant TB(MDR-TB).The mean age 44.59?16.31 was significantly younger than of other patients(P

Objective To explore curative effect of Xiyanping and vidarabine in treatment for children with viral encephalitis and its impact on T cells subgroup.Methods Methods In June 2012~October 2014, randomly selected 106 cases of children patients with viral encephalitis, as the research object.Randomized divided into observation group (n=53) cases, control group(n=53).Both two group were performed routine therapy, and then control group was given Xiyanping treatment, observation group was given Xiyanping combined with vidarabine treatment.1 continuous week treatment, compared two groups of T cell subgroup number and symptoms disappear time.Results In the two groups after treatment of T cell subgroup CD3 +, CD4 +,CD8 +was significant increase in the number of observation group increased number was significantly higher than the control group,and statistically significant differences ( P<0.05 ) .The observation group’s antifebrile time ( 2.5 ±1.1 ) d; headache, vomiting disappear time ( 3.6 ±2.2 ) d;disturbance of consciousness disappear time (2.6 ±1.3) d and length of hospital stay (9.3 ±2.4) d were significantly lower than the control group (4.7 ±2.8) d, (6.5 ±2.3)d, (4.3 ±2.2) d, (14.2 ±3.6) d, which were statistically significant differences (P<0.05).Observation group’s curative effect for instituting accounted for 73.58%, good rate 92.45%, were significantly higher than the control group 52.83%, 77.36%.which were statistically significant differences (P<0.05).The complication rate of observation group was 16.98%, mortality was 0%,were significantly lower than that of 33.96%, 9.43% of the control group;Cure rate of observation group (90.57%) was significantly higher than that of 49.06% of control group. Observation group severe sequela incidence 11.32% was significantly lower than that of 39.62% of control group and statistically significant differences (P<0.05).Conclusion Xiyangping combined with vidarabine in treatment for children with infantile viral encephalitis can significantly increase the number of T cell subgroup, improve immune function in children with, and curative effect is remarkable and high security.

Objective To explore the effect of Yuduqing on the apoptosis of CML K562 cells cultured in vitro and its molecular mechanism.Methods In serologic pharmacological test,the K562 cells were divided into 8 different groups.Serum with imatinib plus Yuduqing (high-dose,middle-dose,low-dose) were added into the cells respectively in the 8 groups of K562 cells.Morphological assessment of apoptosis was performed with optical microscope,the rates of apoptosis and the cell cycles analysis was performed with flow cytometry at 12 h,24 h,48 h and 72 h time points respectively after the intervention.Results The primary cell of normal control group had a low rate of apoptosis,while the blank control group K562 cell apoptosis rate was lower,the difference is significant (P＜0.05).The differences between the rates of apoptosis in high-dose,middle-dose and low-dose Yuduqing groups and those in normal control group and blank control group were significant in 12 hours or 24 hours (P＜0.05).Drug groups showed significant differences of pair-comparison in groups and a certain time dose dependence.But the rate of apoptosis(31.48± 6.58) in k562 cells in high-dose Yuduqing group did not increase further at 72 hours after the intervention and it was not statistically different from that of 48 hours,nor statistically different from that of middle-dose group at 72 hours(27.54±5.89) after the intervention (P＞0.05).The rate ofapoptosis in k562 cells in imatinib group (23.80±6.94) was relatively high at 12 hours after the intervention and it was significantly different from that in blank control group (P＜0.05).The rates of apoptosis in imatinib and Yuduqing (high-dose,middle-dose,and low-dose) groups were significantly higher than those in imatinib group or Yuduqing high-dose,middle-dose,and low-dose)groups (P＜0.05).Conclusion Serum with Yuduqing could induce apoptosis of K562 cells cultured in vitro and its action was dose-time dependent; Serum with Yuduqing (high-dose and middle-dose) was similar to serum with imatinib in inducing apoptosis of K562 cells cultured in vitro; Yuduqing could enhance the efficacy of imatinib.

BACKGROUND:Abnormal gaits are very common in children with cerebral palsy, and how to improve the gait is the focus of rehabilitation therapy. OBJECTIVE:To analyze the biomechanical parameters of gaits in cerebral palsy children and to observe the effects of brace control on the exercise capacity of dyskinetic cerebral palsy children. METHODS:In this paper, we compared the biomechanical parameters of children with cerebral palsy and normal children in the initial process of walking and during walking. Biomechanical parameters in the initial process of walking include spatial and temporal parameters, kinematic and kinetic parameters of the range of motion of the knee and ankle. Biomechanical parameters during walking include spatial and temporal parameters. With the aid of hand brace, dyskinetic cerebral palsy received postural control, gait training, and sling exercise therapy for 3 months. The Gross Motor Function Measure (GMFM-88) assessment and video control were conducted for evaluation of therapeutic efficiency. RESULTS AND CONCLUSION:Biomechanical parameters in the initial process of walking showed significant differences between children with cerebral palsy and normal children except for the peak of ground reaction force at frontal axis with the right foot to start walking. Biomechanical parameters during walking showed that the stance phase and bipedal stance phase were prolonged, while the step length and stride length were shortened in the children with cerebral palsy compared with the normal children. For cerebral palsy children with brace control, the GMFM-88 scores were significantly decreased after treatment, involuntary movements were reduced shown on the video, the neck and body were stable, and life skil s were improved. Children with epilepsy and cognitive impairment or who had imaging changes in the basal ganglia showed a little improvement, and children with dance-athetoid type and dystonia type had a better progress than those with athetoid spasm.

[Objective] To explore the risk factors for mortality of bloodstream infections in the patients with hematologic diseases,so as to provide evidence for reasonable and effective application of treatments.[Methods] The clinical data of 242 cases of bloodstream infections who were hospitalized from Jan 2012 to Jun 2016 were analyzed retrospectively,then the analysis was performed for risk factors.The statistical analysis was processed by SPSS 19.0.[Results] A total of 266 strains of pathogens were isolated,including 99 strains of gram-positive bacteria,accounting for 37.2％,and 164 strains of gram-negative bacteria,accounting for 61.7％.Multivariate analysis showed that the significant independent risk factors for mortality were active states of hematologic diseases (P =0.007,OR =5.622,95％ CI 1.586 ～ 19.924),presentation with septic shock(P =0.007,OR =4.978,95％ CI 1.560 ～15.884),cardiac insufficiency (P =0.001,OR =11.878,95％ CI 2.760 ～ 51.120),level of albumin less than 35 g/L (P =0.036,OR =3.468,95％ CI 1.087 ～ 11.066),polymicrobial infection (P =0.010,OR =6.024,95％ CI 1.540 ～ 23.563),and Staphylococcus haemolyticus (P =0.001,OR =19.308,95％ CI 3.392 ～ 109.888)/Enterococcus (P =0.002,OR =15.266,95％ CI 2.817 ～82.728) infection.The survival curves show that the inappropriate initial antimicrobial therapy group or presentation with any one of the independent risk factors had a lower probability of survival than the control group.[Conclusions] Bloodstream infections in patients may cause high mortality rate,so it is necessary that we use antibiotic reasonably and spare no effort to reduce the mortality rate by appropriate application of antimicrobial therapy and effective intervention of the risk factors.

Objective To study the clinical features and prognostic factors of patients with acute paraquat poisoning.Methods The clinical data of 108 patients with acute paraquat poisoning in Affiliated Hospital of Southwest Medical University from June 2013 to June 2015 were collected and followed up for half a year.The clinical features and prognostic factors were analyzed.Results Of 108 patients,about 90.00％ cases were from the rural areas,the married population accounted for 81.48％.Among them,53 people were living,55 cases were dead,and the death rate was 51.00％.The average amount of poison,average hospitalization time,poison to gastric lavage time interval in the survival group were (22.08 ±5.32) mL,(16.5 ± 3.72) d,(2.00 ±0.49) h,respectively,which in the death group were (88.12 ± 14.96) mL,(5.50 ± 1.20) d,(8.56 ± 1.65) h,respectively.The average amount of poison in the death group was far greater than that of the survival group,about 3.6 times,and the average hospitalization time was significantly reduced,only 1/3 of the survival group.The gastric lavage time interval was also lengthened 1.7 times than that of the survival group,the differences were statistically significant (all P ＜ 0.05).The proportions of fever,increased serum creatinine,liver function damage and pulmonary fibrosis in the death group were significantly higher than those in the survival group,the differences were statistically significant (x2 =12.20,8.35,8.84,50.68,all P ＜ 0.05).Conclusion Mortality rates are still high in patients with acute paraquat poisoning.The amount of poison is still the key factor of death in patients.Early gastric lavage and blood purification,as soon as possible to clear the poison,as far as possible to reduce the absorption of the toxic chemical and aggressive treatment can significantly improve the prognosis of patients.Early fever,liver and kidney function damage and pulmonary fibrosis may predict the poor prognosis of patients.

Objective The study explored the feasibility of PBL teaching approach and mini-CEX scores evaluation method in hematology probation teaching practice. Methods 54 medical students of eight-year program were selected in the study and they were in hematology department of Sun Yat-sen Memorial Hospital for clinical probation. The study compared PBL teaching approach with traditional training method, and used mini-CEX to evaluate the students' clinical competence. Results The performance of PBL teaching group is better than traditional teaching group in the aspect of inquiry skill, clinical diagnosis, therapy plan and humanistic care (P<0.05). There is no significant difference of basic knowledge, physical examination skill and clinical operational skills between these two groups. More than 85％of the students in PBL group are satisfied with the teacher in the aspect of participation, feedback, guidance, correction and assistance. Conclusion Through this teaching practice, the study provides new methods for improving the teaching of pre-internal clinical practice in hematology department.

Objective:To compare the efficacy of arthroscopic all-inside ligament repair with suture augmentation and ligament reconstruction with tendons in the treatment of chronic ankle instability with poor remnant quality of the anterior talofibular ligament (ATFL) tissue.Methods:A retrospective cohort study was conducted to analyze the clinical data of 37 patients with chronic ankle instability treated at Huashan Hospital Affiliated to Fudan University from January 2018 to August 2020, including 34 males (34 ankles) and 3 females (3 ankles); aged 18-57 years [(32.2±7.2)years]. The time from injury to operation ranged from 3-360 months [48(12, 120)months]. All patients underwent arthroscopic all-inside ankle stabilization surgery, of which 19 underwent ligament repair with suture augmentation (augmented repair group) and 18 underwent traditional ligament reconstruction with allograft/autograft tendons (tendon reconstruction group). The degree of ATFL injury and intra-articular lesions (osteophytes, loose bodies and cartilage damage) were recorded during the operation. The Karlsson scale and Tegner scale were evaluated before operation and at the last follow-up. The number of patients who were able to complete partial weight-bearing/return to normal walking/return to sports postoperatively and the time required were compared between the two groups. Postoperative complications were observed.Results:All patients were followed up for 12-32 months [21(16, 28)months]. There were no significant differences in the degree of ATFL injury and intra-articular lesions (osteophytes, loose bodies and cartilage damage) seen during the operation between the two groups (all P>0.05). At the last follow-up, the Karlsson score in augmented repair group and tendon reconstruction group [95.0(90.0, 98.5)points and 95.0(87.8, 99.3)points] was significantly higher than the preoperative level [65.0(51.0, 75.0)points and 65.0(53.3, 78.0)points] (all P<0.01). At the last follow-up, the Tegner score in augmented repair group and tendon reconstruction group [5.0(3.5, 6.0)points and 5.0(3.3, 6.0)points] were significantly higher than the preoperative level [3.0(2.0, 4.0)points and 2.5(1.3, 4.0)points] (all P<0.01). There were no significant differences in Karlsson score and Tegner score between the two groups (all P>0.05). All patients completed partial weight-bearing after 3.0(2.0, 4.0)weeks in augmented repair group and 4.0(3.5, 6.0)weeks in tendon reconstruction group. All patients returned to normal walking after 8.0(6.0, 9.0)weeks in augmented repair group and 8.0(5.5, 12.0)weeks in tendon reconstruction group. A total of 13 patients (63%) in augmented repair group and 13 patients (72%) in tendon reconstruction group successfully returned to sports postoperatively and the time required was 6.0(3.5, 8.0) months and 6.0(4.5, 12.0)months, respectively. There were no significant differences in the above indicators between the two groups (all P>0.05), but augmented repair group had a trend of faster completion of partial weight-bearing than tendon reconstruction group. There was 1 patient [5%(1/19)] in augmented repair group and 1 patient [6%(1/18)] in tendon reconstruction group who reported feelings of instability during exercise postoperatively ( P>0.05). None of the patients in augmented repair group had limited ankle range-of-motion, not different from 1 patient [6%(1/18)] in tendon reconstruction group ( P>0.05). Conclusion:In the treatment of chronic ankle instability with poor remnant quality of the anterior talofibular ligament (ATFL) tissue, both arthroscopic all-inside ligament repair with suture augmentation and ligament reconstruction with tendons can improve the short-term postoperative ankle function and activity level of the patients, and the former one has advantages such as simple operative procedures and none use of grafts.

Objective: To investigate the regulatory effect and mechanism of specific antagonist of acid-sensitive ion channel 3 (APETx2) on visceral sensitivity in mice with post-infectious irritable bowel syndrome (PI-IBS) ． Methods: The PI-IBS model was established by National Institutes of Health (NIH) mice infected with Trichinella spiralis．Gastrointestinal transport function was assessed by measuring the time to first black stool and the number of fecal pellets collected for 6 hours ; abdominal wall withdrawal reflex (AWR) was used to assess visceral sensitivity ; the expression of calcitonin gene-related peptide ( CGRP) in the colon tissue was detected by immunohistochemistry ; the expression of brain-derived neurotrophic factor (BDNF) and CGRP mRNA in the colon tissues was detected by quantitative real time polymerase chain reaction ( qRT-PCR) ． The expression levels of acid sensing ion channel 3 (ASIC3) ，CGRP，and transient receptor potential vanilloid 1 (TRPV1) protein in brain tissue were detected by Western blot analysis. Results: Compared with the control group，the PI-IBS group significantly reduced the time of first black stool，the number of fecal particles and AWR score within 6 hours significantly increased，the protein expression of CGRP in colon tissue，BDNF and CGRP mRNA significantly increased，and the protein expression of CGRP，ASIC3 and TRPV1 in brain tissue significantly increased．Compared with the control group，the PI-IBS group significantly reduced the time to first black stool，the number of fecal particles and AWR score within 6 hours significantly increased，the expression of CGRP protein in colon tissue，the expression of BDNF and CGRP mRNA significantly increased，and the protein expression of CGRP，ASIC3 and TRPV1 in brain tissue significantly increased ; compared with the PI-IBS group，the first time of black stool clearance in the APETx2 group was significantly prolonged，the number of fecal particles and AWR score within 6 hours were significantly reduced，the expression of CGRP protein in colon tissue，the expression of BDNF and CGRP mRNA was significantly reduced，the protein expression of CGRP，ASIC3 and TRPV1 in brain tissue was significantly reduced，and the difference was statistically significant (P＜0. 05) ． Conclusion APETx2 can alleviate visceral sensitivity and regulate gastrointestinal motility in PI-IBS mice by downregulating the expression of BDNF，CGRP，ASIC3 and TRPV1．APETx2 may provide a new therapeutic option for the treatment of IBS.