Objective To investigate the clinical effect of intra-articular injection of sodium hyaluronate combined with psychological intervention in the treatment of knee osteoarthritis.MethodsA total of 90 patients with knee osteoarthritis treated in our hospital from June 2015 to June 2016 were selected as the research object, according to the different treatment methods, the patients were divided into two groups,with 45 cases in each group.The patients in the control group were treated with conventional treatment, while the observation group was treated with conventional therapy and intra-articular injection of sodium hyaluronate.The experimental data of the two groups were compared.ResultsAfter treatment, the changes of knee joint pain score, joint effusion and joint mobility in the observation group is better than those in the control group.The change of knee function score in the observation group was better than that in the control group.The clinical therapeutic effect of the observation group (95.6%) is better than that of the control group (75.6%);There was significant difference between the two groups (P<0.05);There were no serious adverse reactions in the two groups of patients receiving treatment,and there was no significant difference between the two groups.ConclusionThe clinical effect of intra-articular injection of sodium hyaluronate combined with psychological intervention in the treatment of knee osteoarthritis is good, which is worthy of clinical application.

Analysis of cellular pathways and networks in terms of logic relations is important to decipher the networks of molecular interactions that underlie cellular function.A computational approach for identifying lower and higher order gene logic associations was presented on the base of graph coloring theory and applied it to the colon cancer mRNA microarray data.Then the logic relationships of 51 oncogenes and cancer suppressor genes are analyzed and the logic association network of them was constructed.The signal pathway of TGF? from the network model was found and verified by the colon cancer pathway of KEGG.The model reveals many higher order logic relationships of cancer genes.These relationships illustrate the complexities that arise in cancer cellular networks because of interacting pathways.The results show that this method is feasible and is expected to give a reference to the medical molecular biologist.

Objective To investigate the cause, diagno sis and treatment of acute acalculous cholecystitis(AAC).Method 32 cases of AAC which were treated from 1990 to 2000 were analyzed retrosp ective ly.Results 25 cases were diagnosed by B-ultrasonograph ,th e positive rate of diagnosis was 88.0%(22/25),7 cases were diagnosed by CT,6 c ases were definitely diagnosed(85.7%).All of them underwent operations, cholec ystectomy was performed in 29 patients,cholecystostomy in 2, subtotal cholecyste ctomy in 1 .Of them 31 were cured and one died.Conclusions The cause of AAC is very complication, the preoperative diagnosis is difficult, it is easy to be misdiagnosed. Surgeon should pay more attention to AAC. B-ultra sonograph is the first choice of the diagnosis of AAC,CT can give a hand to diag nosis. The early operation resection is the most effective method.

Animals ; Atherosclerosis ; blood ; drug therapy ; pathology ; Dehydroepiandrosterone ; blood ; physiology ; therapeutic use ; Dehydroepiandrosterone Sulfate ; blood ; therapeutic use ; Hormone Replacement Therapy ; Humans

Objective To explore the differences of presonal backgrounds of patients on their perceived value and service strategy for such patients.Methods Based on a literature review,the survey data of patient perceived value of ten hospitals from 2011 to 2013 were selected for an analysis of typical influences on their perceived value incurred by their background characteristics.Results The patient perceived values of the highest attention were functional value(3.91 in average)and emotional value(3.92 in average);regular changes toward these two values were found among patients of different backgrounds.Comparatively patients tend to demand higher emotional value featuring outpatient visit,minor symptoms,females,youths,higher education background and high income.Conclusions Medical institutions are expected to clarify their value positioning,and provide based on such differentiated services to their patients in view of the characteristic backgrounds and medical visits,thus improving the perceived value of their patient population in general.

It is an obvious contradiction between the shortage of kidney donors and the increasing demand for kidney transplantation.Living- related donor kidney transplantation may be a proper resolution,which has been academically proved to be superior to cadaveric kidney transplantation.However,there are still many ethical problems unsolved.Based on ethical theory and the"Seven Principles",we explore possible solutions to the ethical problems of living - related donor kidney transplantation.

Objective To understand the current economical operation of public hospitals in Hubei province and its effect on their public welfare performance. Methods To collect data in field survey and to analyze the current economic situation of such hospitals in the province based on relevant statistics.Results Financial revenue and expenditure of these hospitals keep rising and achieving a balance in general; for the insufficient government financial subsidy, 90% of the revenue of such hospitals come from their medical services and drugs sold; the per capita revenue of these public hospitals maintains a yearly rising trend; their asset-liability ratio was relatively high. Conclusions The public welfare performance of these hospitals tends to be impeded by the reform on the macro economic system and health policy changes, on top of the attraction of economic interests. Improving the government subsidy mechanism for public hospitals and standardizing the financial management mechanism of public hospitals.

ObjectiveTo generate a prokaryotic expression system of series predominant epitopes (UreB322 and UreB527) of Helicobacter pylori UreB protein,and to synthesize a multiple antigenic peptide (MAP) vaccine by linking both the two epitopes with a peptide carrier (Poly-Asp-Lys),and to determine the immunogenicity and immunoprotection of the MAP vaccine.MethodsLinking primer PCR was performed to generate an enterokinase(EK) site-containing series UreB322 and UreB527 epitope encoding gene for construction of its prokaryotic expression system.The expressed target recombinant fusion protein 8 ×[rEK-UreB322-EK-UreB527-EK] was hydrolyzed with EK and then rUreB322-EK and rUreB527-EK epitope peptides were extracted using a Sephadex G-25 column.rUreB322-EK,rUreB527-EK and Poly-Asp-Lys were linked using carbodiimide method to produce a MAP vaccine (MAP-rUreB322/B527).The antigenicity and immunoreactivity of each of the two epitope peptides and MAP-rUreB322/527 were determined by ELISA and Western blot assay.An animal H.pylori strain SS1-infected model in BALB/c mice was used to detect the immunoprotection of MAP-rUreB322/527.ResultsAn octuple-repeated series UreB322-UreB527 encoding gene and its prokaryotic expression system were obtained.The yield of target fusion protein 8×[rEKUreB322-EK-rUreB527-EK] was as high as 48％ of the total bacterial proteins.EK hydrolyzed the target fusion protein completely into rUreB322-EK and rUreB527-EK peptides.The linking ratio of rUreB322-EK,rUreB527-EK and Poly-Asp-Lys was as high as 92.5％.The antibody against whole cell of H.pylori and rUreB-IgG could recognize and combine with the rUreB322-EK,rUreB527-EK or MAP-rUreB322/527.The specific serum antibody level in MAP-rUreB322/527-immunized mice was significantly higher than that in rUreB-immunized mice (P＜0.05).The immunoprotective rates(83.3％ and 91.7％ ) by immunization with50 or 100 μg MAP-rUreB322/527 in the H.pyloristrain SSI-infected mice were significantly higher that those(d1.7％ and 50.0％ ) by immunization with equal rUreB(P＜0.05).ConclusionAn gene composed for encoding a repeated series predominant epitopes of H.pylori UreB protein and its prokaryotic expression system are successfully generated in this study.MAP-rUreB322/527,the multiple antigenic peptide vaccine based on the two predominant epitopes of UreB,can noticeably increase the immunoprotection in H.py/or/infected mice.

Objective To investigate the effects of dexmedetomdine on hemodynamics and myocardial injury in patients with pulmonary hypertension undergoing mitral valve replacement.Methods Forty ASA Ⅱ or Ⅲ patients with pulmonary hypertension,aged 18-64 yr,undergoing mitral valve replacement,were randomized into 2 groups (n =20 each):control group (group C) and dexmedetomidine group (group D).Anesthesia was induced with iv midazolam 0.05 mg/kg,sufentanil 1 μg/kg,etomidate 0.3 mg/kg and rocuronium 0.6 mg/kg and maintained with combined intravenous-inhalational anesthesia.Narcotrend index values were maintained at 40-50.The patients were tracheal intubated and mechanically ventilated.A loading dose of dexmedetomidine 1 μg/kg was injected intravenously over 10 min after intubation followed by infusion at 0.5 μg· kg-1· h-1 until the end of operation in group D.While the equal volume of normal saline was given in group C.Venous blood samples were taken immediately before dexmedetomidine administration,at 10 min after termination of cardiopulmonary bypass (CPB),at the end of operation,and at 6 and 24 h after operation for determination of plasma levels of creatine kinase MB (CK-MB) and cardiac troponin Ⅰ (cTnI) by ELISA.Before and after administration of dexmedetomidine,at skin incision,at sternum splitting,before and after CPB,and at the end of operation,HR,MAP,mean pulmonary arterial pressure (MPAP),cardiac output (CO),systemic vascular resistance (SVR) and pulmonary vascular resistance (PVR) were detected by using Swan-Ganz catheter and Vigilance Ⅱ monitor.The requirement for vasoactive drugs and condition of spontaneous heart beats were recorded.Results In group D,each hemodynamic parameter was maintained stable at skin incision and sternum splitting,and MPAP was decreased after CPB and maintained at a lower level.The plasma levels of CK-MB and cTnI,consumption of phenylephrine and dopamine,and requirement for epinephrine were significantly lower in group D than in group C (P ＜ 0.05).There was no significant difference in the consumption of milrinone and rate of spontaneous heart beat between the two groups (P ＞ 0.05).Conclusion During mitral valve replacement for patients with pulmonary hypertension,dexmedetomidine infused at 0.05 μg·kg-1· h-1 after a loading dose of 1 μg/kg is helpful in maintaining systemic circulation and pulmonary circulation stable and provides myocardial protection to some extent.

BACKGROUND:There is little evidence on the use of al ogeneic tendon graft in the reconstruction of ankle joint.
OBJECTIVE:To explore the clinical outcome of anatomical reconstruction of the lateral ligaments with cryopreserved al ogeneic tendon graft in patients with chronic ankle instability.
METHODS:Twenty-six patients with chronic lateral instability underwent anatomical reconstruction of the lateral ligaments with cryopreserved al ogeneic tendon. There were 18 cases of simultaneous injury or chalasia in calcaneofibular ligament and anterior talofibular ligament, and 8 cases of anterior talofibular ligament injury or chalasia. The ankle joint function was evaluated according to AOFAS scale and Good classification. The affect ankle and healthy ankle were compared in the extension, plantar flexion activity, and metaleg activity.
RESULTS AND CONCLUSION:Al the 26 patients were fol owed up for 9-24 months with a mean of 15 months. No cases appeared recurrent ankle lateral instability. The mean AOFAS score in the group of calcaneofibular ligament and anterior talofibular ligament was improved from (48.4±3.7) points preoperatively to (88.2±3.8) postoperatively, while that in the group of anterior talofibular ligament was improved from (50.0±6.4) points preoperatively to (89.5±3.4) points postoperatively. According to Good score, there were excellent in 19 feet, good in 6 feet, fair in 1 foot, with an excellent and good rate up to 96%. No serious complication was occurred in this group. Anatomical reconstruction of the lateral ligaments with cryopreserved al ogeneic tendon graft can increase the tendon-bone contact area, improve the rate of tendon healing, and enhance the stability of ankle joint in patients with chronic ankle instability. Further studies are needed to verify its long-term efficacy.