0.05). Conclusions Gastric hypersensitivity, impaired proximal gastric accommodation and delayed gastric emptying may be important but independent pathophysiological factors of FD. Different pathophysiological factors can coexist in one patient with FD.

Adolescent ; Adult ; Aged ; Cyclosporine ; blood ; Female ; Genes, MDR ; Genotype ; Humans ; Immunosuppressive Agents ; blood ; Kidney Transplantation ; Male ; Middle Aged ; Polymorphism, Genetic

AIM To study the chemical constituents from Metaplexis japonica (Thunb.) Makino.METHODS The dichloromethane fraction of 95％ ethanol extract from M.japonica was isolated and purified by silica and preparative HPLC column,then the structures of obtained compounds were identified by physicochemical properties and spectral data.RESULTS Nine compounds were isolated and identified as dibutyl phthalate (1),(Z)-2-ethylidene-3-methylsuccinic acid (2),dehydrololiolide (3),medioresinol (4),isovanillin (5),vomifoliol (6),β-sitosterol (7),daucosterol (8),pregnenolone (9).CONCLUSION Compounds2-4 are isolated from genus Metaplexis for the first time,compounds 5-8 are first isolated from this plant.

Objective To assess the efficacy and safety of peginterferon ( PegIFN) α-2b in treatment of HBeAg-positive chronic hepatitis B ( CHB).Methods Thirty two patients with HBeAg-positive CHB admitted in Peking University Shenzhen Hospital during November 2013 and January 2014 were recruited in the study.Patients were center randomly assigned into two groups : 22 patients in test group were treated with 180 μg PegIFN α-2b, 1 /w for 48 wk; 10 patients in control group were treated with 180 μg PegIFN α-2a (Pegasys), 1 /w for 48wk.All patients were followed up for 24wk after treatment.Virology markers, HBV DNA levels and liver functions were monitored regularly , and adverse events were observed . Fisher’s exact test was used to compare the efficacy and safety between two groups .Results There were no statistically significant differences between the control group and test group in ALT normalization rates , HBV DNA negative rates and HBeAg serological conversion rates both at the end of treatment and at the end of 24-wk follow-up (all P >0.05).Both groups had similar adverse effect incidence rates (P >0.05), but retina disease occurred in 7 cases of test group, which was not observed in control group .Conclusion Compared with PegIFN α-2a, PegIFN α-2b has similar efficacy and safety for patients with HBeAg -positive CHB.

OBJECTIVETo evaluate the feasibility of HLA haploidentical peripheral blood hematopoietic stem cell transplantation (PBSCT) for patients with β thalassemia major.

METHODSSixteen patients with β thalassemia major received HLA haploidentical PBSCT from parents. Two conditioning regimens were used. Regimen A was adopted before December 2007, which consisted of fludarabine (total 150 mg/m²), busulfex (total 520 mg/m²), cyclophosphamide (CTX, total 100 mg/kg), antithymocyte globulin (ATG, total 10 mg/kg) and total body irradiation of 3 Gy. Regimen B was adopted after December 2007, which consisted of fludarabine (total 240 mg/m²), busulfex (total 520 mg/m²), CTX (total 100 mg/kg), and ATG (total 10 mg/kg). Combination of cyclosporin (CsA), methotrexate (MTX) and mycophenolate mofetil (MMF) were used for prophylaxis of graft-versus-host disease (GVHD).

RESULTSOf 16 patients, 14 (87.5%) had sustained engraftment. The median days of neutrophil exceeding 0.5 × 10⁹/L and platelet exceeding 20 × 10⁹/L were 13 days (range 10 - 17 days) and 15 days (range 14 - 20 days) after PBSCT, respectively. Complete chimerism was achieved in all the 14 patients at one month after PBSCT. One patient lost his graft with autologous reconstitution 52 days after transplantation. Four patients had grade II-IV acute GVHD and one patient had chronic extensive GVHD. In the 49-month median follow-up duration, 13 of 16 patients were alive in disease-free situation.

CONCLUSIONHLA haploidentical PBSCT, which could provide stable and sustained engraftment for thalassemia major patients with no HLA identical donor, is a promising treatment strategy.

Child ; Child, Preschool ; Female ; HLA Antigens ; genetics ; Haploidy ; Humans ; Male ; Peripheral Blood Stem Cell Transplantation ; Tissue Donors ; beta-Thalassemia ; therapy

Objective:To investigate the clinical effect of large medium thickness skin graft on the back and scalp replantation in the back donor area after complete resection of giant congenital melanoma nevus (GCMN) in children′s upper limbs.Methods:From April 2017 to may 2020, 16 pediatric patients with GCMN of upper limbs were treated in the First Affiliated Hospital of Air Force Military Medical University, including 9 males and 7 females, aged from 2 years to 7 months to 12 years. Giant melanoma nevus area 14 cm×11 cm-23 cm×20 cm, the wound after removing the skin of giant melanocytic nevus of the limb was covered with vaseline oil gauze for 2-3 days, and then a large medium thickness skin graft was cut on the back with a drum skin extractor for transplantation. The wound in the back skin donor area was replanted with a blade thick scalp.Results:The effect of excision of giant nevus of upper limb and skin grafting on the wound of back medium thickness donor area in 16 pediatric patients was satisfactory, and there were no serious complications such as skin necrosis and poor survival. Plasma swelling was formed under the skin graft of one child′s limb, which healed after opening and drainage and three dressing changes. Anti-scar and rehabilitation treatment was performed on the limb and donor site.The patients were followed up for 6-18 months. There was no obvious scar hyperplasia and contracture in the skin graft area and donor area. The skin color and elasticity of the back and limb skin graft area were close to the normal skin around the wound, and the activities of elbow joint, wrist joint and interphalangeal joint were not limited. The parents of the pediatric were satisfied with the function and appearance of the limb skin graft area and back skin donor area of giant nevus.Conclusions:The function and appearance of large medium thickness skin graft on the back after excision of congenital giant nevus of upper limb in pediatric are better; There is no obvious scar formation after scalp replantation in the back donor area, and the repair effect is better.

Objective:To analyze the molecular epidemiological characteristics of the Corona virus disease 2019 (COVID-19) cases in Shijiazhuang, which can reveal the origin of the outbreak and provide a scientific basis for COVID-19 prevention and control.Methods:From January 2 to January 8, 2021, a total of 404 samples from 170 COVID-19 cases were collected from the Shijiazhuang Fifth Hospital. The consensus sequence of 2019 novel Coronavirus(2019-nCoV) was obtained through multiplex polymerase chain reaction-based sequencing. The sequences of 170 COVID-19 cases were analyzed by the PANGOLIN, and the data were statistically analyzed by T-test.Results:Among the 404 COVID-19 samples, a total of 356 samples obtained high quality genome sequences (>95%,100×sequencing depth). The whole genome sequences of 170 COVID-19 cases were obtained by eliminating repeated samples. All 170 sequences were recognized as lineage B1.1 using PANGOLIN. The number of single nucleotide polymorphism arrange from 18-22 and most of the single nucleotide polymorphism were synonymous variants. All of 170 genomes could be classified into 48 sub-groups and most of the genomes were classified into 2 sub-groups (66 and 31, respectively).Conclusions:All cases in this study are likely originated from one imported case. The viruses have spread in the community for a long time and have mutated during the community transmission.

Objective:To investigate the clinical effects of skin-stretching device (hereinafter referred to as stretcher) combined with vacuum sealing drainage (VSD) in repairing diabetic foot wounds.Methods:From March 2016 to January 2020, 25 patients with diabetic foot wounds were admitted to the First Affiliated Hospital of Air Force Medical University, including 18 males and 7 females, with age of 40 to 70 years. After debridement, intermittent VSD was performed for 3 to 10 days, with negative pressure value of -10.67 kPa. Then, the wound area was 5.0 cm×3.0 cm to 10.0 cm×7.0 cm. After infection control and detumescence, the wound was treated with stretcher for 3 to 5 days. The wound area after stretching ranged from 5.0 cm×0.3 cm to 10.0 cm×0.5 cm. The wound was closed with full-thickness suture. Two weeks after the suturing operation, the healing grade of the foot wound of patients was observed, and the serious complications such as recurrence of ulcer wound and gangrene on the foot, scar condition of the wound were observed during follow-up.Results:Two weeks after the suturing operation, the wounds of 23 patients were healed with grade A. Soft tissue infection ulcer relapsed in 2 patients during the stretch period. After anti-infection, thorough debridement, and VSD, the wounds were healed after another 16 days of stretch treatment. During the follow-up of 3 to 36 months, 23 patients had linear scar left on the stretch wounds, and the skin elasticity, color, sensation was similar to the surrounding normal tissue, and the limb mobility was good, and 2 patients had obvious scar hyperplasia. One patient had recurrence of diabetic foot and serious vascular occlusion and gangrene in the affected limb at follow-up of 10 months, which was treated with amputation of the lower leg.Conclusions:The use of stretcher combined with VSD in treating diabetic foot wound can avoid donor site injury, with healed wound achieving similar appearance to adjacent skin and satisfactory repair effects.

Objective:To explore the clinical effects of expanded flap made by skin and soft tissue expander (hereinafter referred to as expander) in repairing the wounds with exposed titanium mesh after cranioplasty with titanium mesh.Methods:A retrospective observational study was conducted. From April 2015 to October 2019, 13 patients with wounds with exposed titanium mesh after cranioplasty with titanium mesh were admitted to the First Affiliated Hospital of Air Force Medical University, including 10 males and 3 females, aged 18 to 70 years. Exposure of titanium mesh occurred 3 months to 4 years after cranioplasty with titanium mesh. The wound area of exposed titanium mesh ranged from 1.5 cm×0.6 cm to 6.3 cm×6.0 cm. In the first stage, one or two square expanders with rated capacity of 50-200 mL were placed under the normal scalp 1 cm away from the edge of the wound surface of exposed titanium mesh. The water injection time was 2 to 3 months with the total water injection volume being 1.6 to 2.0 times of the rated capacity of expander. In the second stage, the expander was removed and the expanded flap (size ranging from 4.1 cm×1.8 cm to 9.1 cm×7.9 cm) was transferred to repair the wound of exposed titanium mesh. The placement site of the expander, the transfer form of the expanded flap, the postoperative wound healing of the titanium mesh exposed site, and the survival of expanded flap were recorded. The scar of the head incision and the appearance of head were followed up.Results:Among the patients in this group, the expanders of 7 were placed in the temporal region, while the other 6 were placed at the top. The 11 patients were treated with advanced expanded flap, while the other 2 patients were treated with pedicled expanded flap. The head wounds of patients in this group successfully healed with retaining of the titanium mesh. The wound was healed after dressing change in 1 patient with necrosis at the tip of the expanded flap. The expanded flaps of 12 patients survived after transfer. Patients in this group were followed up for 12 months after surgery, the exposed titanium meshes were retained, the incisions healed well with the scars concealed, the hair on the scalp grew well, and the appearance of head was comparatively good.Conclusions:Using expanded flap in the repair of the wounds with exposed titanium mesh after cranioplasty with titanium mesh can effectively cover the wound and retain the titanium mesh, achieving good function and appearance.

Objective To compare clinical efficacy of robot-assisted(RA)and remote sensing navigation alignment(RSNA)system-assisted total knee arthroplasty(TKA).Methods From March 2023 to June 2023,60 patients who underwent the first unilateral TKA due to severe knee osteoarthritis(KOA)were admitted and divided into RSNA group and RA group according to different treatment methods,with 30 patients in each group.There were 5 males and 25 females in RSNA group,aged from 56 to 81 years old with an average of(66.33±7.16)years old;body mass index(BM1)ranged from 19.87 to 38.54 kg·m-2 with an average of(28.40±6.18)kg·m-2;the courses of disease ranged from 5 to 36 months with an average of(18.20±8.98)months;RSNA system was used to assist the positioning of osteotomy.There were 7 males and 23 females in RA group,aged from 55 to 82 years old with an average of(67.83±8.61)years old;BMI ranged from 19.67 to 37.25 kg·m-2 with an aver-age of(28.01±4.89)kg·m-2;the courses of disease ranged from 3 to 33 months with an average of(17.93±9.20)months;RA was performed.Operation time,incision length,latent blood loss at 2 weeks after operation and incidence of lower extremity thrombosis were compared between two groups.Hip-knee ankle angle(HKAA),HKAA deviation,lateral distal femoral angle(LDFA),medial proximal tibial angle(MPTA)and posterior tibial slope(PTS)were compared between two groups;Western Ontario McMaster Universities Osteoarthritis Index(WOMAC)and Knee Society score(KSS)were used to evaluate functional recovery before operation,3 and 6 months after operation.Results The operation was performed successfully in both groups,and there were no serious complications such as vascular and nerve injury during operation.The wound healed well at stage Ⅰafter operation,and the follow-up time was 6 months.The operation time,latent blood loss at 2 weeks after operation and inci-sion length in RSNA group were(94.35±5.75)min,(130.54±17.53)mland(14.73±2.14)cm,respectively;while(102.57±6.88)min,(146.33±19.47)ml and(16.78±2.32)cm in RA group,respectively.RSNA group was better than RA group(P＜0.05).No deep vein thrombosis occurred in both groups at 2 weeks after operation,5 patients occurred intermuscular vein throm-bosisin in RSNA group and 8 patients in RA group,the difference was not statistically significant(P＞0.05).In RSNA group,HKAA,LDFA and MPTA were(173.00±5.54)°,(86.96±3.45)°,(82.79±3.35)° before operation,and(178.34±1.85)°,(89.92±0.42)°,(89.84±0.73)° at 1 week after operation,respectively.In RA group,HKAA,LDFA and MPTA were(173.31±6.48)°,(87.15±3.40)° and(82.99±3.05)° before operation,and(178.52±1.79)°,(90.03±0.39)° and(90.15±0.47)° at 1 week after operation,respectively.HKAA,LDFA and MPTA were significantly improved in both groups at 1 week after oper-ation(P＜0.05).There were no significant difference in HKAA,LDFA,MPTA and PTS between two groups before operation and 1 week after operation(P＞0.05).There was no significant difference in deviation distribution of HKAA at 1 week after op-eration(x2=2.61 1,P=0.456).There were no significant difference in WOMAC and KSS between two groups before operation,3 and 6 months after operation(P＞0.05),and postoperative WOMAC and KSS at 3 and 6 months between two groups were im-proved compared with those before operation(P＜0.05).Conclusion Both RA and RSNA system assisted TKA could obtain ac-curate osteotomy,RA has higher surgical accuracy,RSNA system assisted operation has less trauma,and operation is simpler.