Objective To discuss the effect under the arthroscope surgery and postoperative treat osteoarthritis with rehabilitation training.Methods 34 cases of osteoarthritis patients treated with the arthroscopy detectors were randomly divided into two groups:the therapeutic group(17 cases)and the control group(17 cases).The therapeutic group was treated with arthroscope surgery and rehabilitation training.The control group was treated only with arthroscopy surgery.All patients were followed up for 90 days.The postoperative pain,range of motion and joint function of the two groups were compared.Results The postoperative pain range of motion and joint function of the therapeutic group was significantly better than the control group(t=17.6,6.4,7.6,P＜0.05).Conclusion Rehabilitation training could relieve the postoperative pain and range of motion,improve the function of knee joint and increase the effect of clinical efficacy in the arthroscopic surgery of knee's under the osteoarthritis patients.

Objective To observe the effects of different compatibility ratios of Astragali Radix and Angelicae Sinensis Radix on vascular intimal hyperplasia; To ascertain the effective compatibility of Astragali Radix and Angelicae Sinensis Radix for antagonizing vascular intimal hyperplasia. Methods SD rats were divided into different groups by baseline geometric design method: Astragali Radix and Angelicae Sinensis Radix different compatibility ratios groups, Astragali Radix group, Angelicae Sinensis Radixgroup, positive medicinegroup and sham-operation group. A model of intimal hyperplasia of thoracoabdominal aorta was established by balloon catheter injury in vascular endothelium of rats. Then the thoracoabdominal aorta was taken out after gavage of Astragali Radix and Angelicae Sinensis Radix with different compatibility ratios for 14 days. Bloodletting was used to take thoracoabdominal aorta. Masson staining and Morphometric methods were used to analyze the intimal hyperplasia. Results IA, IT, HRIA and HRIT increased 14 day after intimal injury. Compared with the model group, IA, IT, HRIA and HRIT in Angelicae Sinensis Radix group, Astragali Radix and Angelicae Sinensis Radix 1:2 group, Astragali Radix and Angelicae Sinensis Radix 1:5 group, Astragali Radix and Angelicae Sinensis Radix 1:1 group and Astragali Radix and Angelicae Sinensis Radix 5:1 group were lower, and the effects of Astragali Radix and Angelicae Sinensis Radix 1:1 ratio were strongest. The effects on intimal hyperplasia in Astragali Radix group and Astragali Radix and Angelicae Sinensis 2:1 group had no significant differences compared with model group. Conclusion Astragali Radix and Angelicae Sinensis can inhibit vascular intimal hyperplasia in a certain compatibility ratios, and the effects of Astragali Radix and Angelicae Sinensis Radix 1:1 on intimal hyperplasia are the best.

Objective:To investigate the effect of melatonin (MEL) influence on lipopolysaccharide (LPS)-induced long-term anxiety-like behavior and activation of astrocytes in septic neonatal rats.Methods:Sprague-Dawley rats were randomly(random number) assigned to the control group, LPS group and LPS+MEL group. Sepsis model was intraperitoneally injected with LPS (1 mg/kg), and neonatal rats in the MEL group were administered with MEL (10 mg/kg) 30 min after LPS injection. At different time points after injection, rats in each group were divided into three subgroups: 3 d, 7 d and 28 d. The expression of GFAP and TNF-α in the corpus callosum was detected by immunofluorescence staining and Western blot. Open-field test was applied to observe anxiety-like behaviors. In vitro, cultured neonatal SD rat astrocytes were divided into the control group, LPS group, LPS+MEL group, and LPS+MEL+luzindole group. Immunofluorescence staining was used to observe the expression of GFAP and TNF-α. Expression of GFAP, TNF-α, p-NF-κBp65, NF-κBp65 protein in astrocytes were assessed by Western blot. RT-qPCR was used to investigate the mRNA expression of GDNF and BDNF. One-way ANOVA and two-way ANOVA were used for comparison of multiple groups of variables. A P<0.05 was considered statistically significant. Results:LPS reduced the duration of movement in the central area and distance in the central area/total distance in open-field test, while melatonin evidently reversed the LPS-induced anxiety-like behavior. Compared with the LPS group, the expressions of GFAP and TNF-α were significantly decreased in the corpus callosum at 3 d and 7 d in the MEL group ( P< 0.05). Compared with the LPS group, MEL could significantly decrease the expression of GFAP, TNF-α and p-NF-κBp65 in astrocytes ( P< 0.05), which could be blocked by Luzindole. In addition, compared with the LPS group, MEL pretreatment could reverse the down regulation of GDNF and BDNF induced by LPS ( P<0.05). Conclusions:MEL can relieve LPS-induced long-term anxiety-like behavior in septic neonatal rats. The mechanism may be related to the inhibition of astrocyte activation and inflammatory reaction through NF - κ B pathway.

Objective To analyze the clinical data and TUBB4A mutation of hypomyelination with atrophy of the basal ganglia and cerebellum (HABC)in a family,thus to provide accurate genetic counseling and prenatal diagno-sis for this family with HABC,and also to provide clinical experience for the diagnosis of HABC in China.Methods The clinical data of the proband and her family members were collected at the Department of Pediatrics,Peking Univer-sity First Hospital,December 201 4,including medical history,physical signs,and brain MRI,biochemical tests and metabolic disease screening.The associated gene of hereditary leukoencephalopathy was screened for the proband and her family members were screened by targeting -high -throughput sequencing technology,and then the genetic varia-tions were verified by Sanger sequencing.With those detection methods,the gene mutation was confirmed,and then ge-netic features were analyzed.Results Clinical features were as follows:nystagmus as the first symptom,and motor and mental retardation,dystonia and ataxia followed.Brain MRI indicated hypomyelination of white matter and atrophy of the basal ganglia and cerebellum.The clinical diagnosis of HABC was established based on the clinical features and brain MRI features above.Genetics features showed that one novel TUBB4A c.974G >T heterozygous missense muta-tion was found from the proband,which caused an amino acid change from the Trp into Leu (p.Trp325Leu).Both of her parents with normal phenotype were of wild -type in this site.Conclusions The proband from this family was diagnosed clinically based on her clinical data.One novel TUBB4Ac.974G > T (p.Trp325Leu)was founded in this study.Therefore,the spectrum of TUBB4A mutation will be expanded.In addition,this study elucidated clinical and genetic characteristics in this family with HABC,which may lay a solid foundation for the accurate genetic counseling and prenatal diagnosis.This study reported the first case of HABC caused by TUBB4A mutation in China.

Objective:To systematically evaluate the effect of hydrocortisone combined with vitamin C and vitamin B1 on the efficacy of patients with sepsis or septic shock.Methods:Databases including CNKI, Sino Med, VIP, Wanfang, PubMed, the Cochrane Library, and Embase were searched from inception to January 2021 for the randomized controlled trial (RCT) about hydrocortisone combined with vitamin C and vitamin B1 to treat sepsis or septic shock. The experimental group was given intravenous injection of hydrocortisone, vitamin B1 and vitamin C based on conventional treatment; the control group was given conventional treatment or placebo/hydrocortisone/hydrocortisone+vitamin B1 based on conventional treatment. Outcome indicators included sequential organ failure assessment (SOFA), mortality, the duration of vasoactive drugs, new acute kidney injury (AKI) patients, length of stay in intensive care unit (ICU) and in hospital. Two researchers independently screened the literature, extracted data, and evaluated the risk of bias in the included studies. RevMan 5.3 software was then used to perform Meta-analysis. Funnel plot was used to test publication bias.Results:A total of 6 articles involving 816 patients were included, with 411 patients in the experimental group and 405 patients in the control group. The Meta-analysis results showed that the duration of vasoactive drugs in the experimental group was significantly shorter than that in the control group [mean difference ( MD) = -24.02, 95% confidence interval (95% CI) was -32.36 to -15.68, P < 0.000 01]. However, there were no significant differences in SOFA, mortality, new AKI patients, the length of ICU stay and hospital stay between the two groups [SOFA: MD = -0.14, 95% CI was -1.15 to 0.87, P = 0.79; mortality: relative risk ( RR) = 0.99, 95% CI was 0.81 to 1.21, P = 0.92; new AKI patients: RR = 1.10, 95% CI was 0.42 to 2.87, P = 0.84; length of ICU stay: MD = 1.33, 95% CI was -2.22 to 4.89, P = 0.46; length of hospital stay: MD = 1.02, 95% CI was -0.66 to 2.69, P = 0.23]. The funnel plot showed that most of the points were symmetrical and showed an inverted funnel shape, suggesting that the publication bias among the studies was small. There was no significant publication bias on this Meta-analysis. Conclusions:Hydrocortisone combined with vitamin C and vitamin B1 can shorten the duration of vasoactive drugs in patients with sepsis or septic shock, but it cannot effectively reduce the SOFA score, mortality, new AKI patients, length of stay in ICU and in hospital. Limited by the number and quality of the included studies, further large-scale, multi-center, blinded, RCT are still needed for verification.

Objective To determine the consistency of urogenital hiatus ( U H ) data between the semi‐automatic measurement and manual measurement using transperineal pelvic floor ultrasonography . Methods Total of 286 three‐dimensional images of minimal U H dimension were obtained . And they were divided into study group ( 100 images) and test group ( 186 images) randomly . T hree experts traced and created the w hole profile of the U H of those images in the study group by M AT LAB . T hen the semi‐automatic software was obtained through machine learning algorithms . In the test group , 6 parameters of U H ( including anterioposterior diameter , transverse diameter ,circumference , area ,left and right levator urethral gap distance) were measured by two experts ( D 1 and D2 ) both manually and semi‐automatically . T he time experts spent on measuring was also recorded and compared . Results T he time used for semi‐automatic measurement was significantly shorter than that for manual measurement [ ( 7 .49 ± 1 .51 ) s vs ( 42 .42 ± 11 .08) s ,( 7 .52 ± 1 .37) s vs ( 43 .45 ± 9 .09) s for D1 and D2 , t ＝ －12 .09 ,－13 .64 ,all P＝0 .00] . T he Pearson correlation coefficients between semi‐automatic and manual measurements of 6 parameters were 0 .857 －0 .985 ( P ＜ 0 .01) ,0 .853 －0 .979 ( P ＜ 0 .01 ) in D1 and D2 ,respectively . T he interclass correlation coefficients ( ICC) of six parameters were ranged from 0 .846 －0 .985 for D1 and 0 .843～0 .979 for D2 ( all P ＜ 0 .01 ) . T he Bland Altman plot also showed good agreement between two methods . Conclusions Intellectual recognition and semi‐automatic measurement has simplified the process for U H measurement ,and it is proved to be a reliable and timesaving method that is practical for clinical use .

Objective We aim to evaluate and discuss the feasibility of Hyaline imaging of three-dimension sonography in observation of paravaginal support structure in normal nonporous women.Methods Total of 45 normal infertile women were chosen.Three-dimensional volume datasets were collected at rest by transperineal ultrasound.The three-dimensional Hyaline images were acquired off-line.We observed the morphologic features of paravaginal support structure on the axial plane in middle vagina and measured the anteroposterior and lateral horizontal distances between bilateral paravaginal support structure and ureter.The consistency between two sonographers were analyzed by intraclass correlation coefficient (ICC).Results In three-dimensional Hyaline imaging sonogram,paravaginal support structure was appeared as typically tenting-like shaped.The anteroposterior distances between paravaginal support structure and center of ureter were listed as followed:left (-0.31 ± 1.29) mm,right (0.47 ± O.99) mm.While the lateral horizontal distances were left (12.67 ± 6.70) mm,right (13.01 ± 5.75) mm.There were no statistical differences between bilateral both anteroposterior and lateral horizontal distances.The consistency between two sonographers for distinguishing paravaginal support structure on the middle-vaginal plane and measuring distances between paravaginal support structure and center of ureter was remarkably high (ICC is 0.87 and 0.82).Conclusions Hyaline imaging technology of three-dimensional pelvic floor sonography could be used to observe paravaginal support structure in women.The normal paravaginal support structure is typically showed as bilateral symmetrical tenting-like structure,which is on the same level as the center of ureter.It provides normal anatomic radiological evidence and helps study defect of paravaginal support structure caused by pregnancy or delivery.

Objective: To investigate the clinicopathological characteristics and prognostic factors of gastric stump cancer (GSC). Meth-ods: Clinicopathological data of 105 patients diagnosed with GSC at Tianjin Medical University Cancer Institute and Hospital between May 2004 and July 2017 were retrospectively analyzed. Results: Comparison of clinicopathological features of GSC-B and GSC-M: the average ages of the patients in the GSC-B and GSC-M groups were (63.22±8.95) and (58.93±10.06) years, respectively, and the male: fe-male ratios in the GSC-B and GSC-M groups were 17.5:1.0 and 2.6:1.0, respectively. The time intervals from initial surgery to the diag-nosis of GSC in the two groups were (390.95±95.18) and (64.53±73.15) months, respectively; the numbers of lymph nodes harvested in the GSC-B and GSC-M groups were 17.6±12.5 and 6.2±6.5, respectively; and the ratios of well differentiation to poor differentiation in the GSC-B and GSC-M groups were 0.89:1 and 0.20:1, respectively. The differences between all the above factors were statistically significant (P<0.05). Comparison of clinicopathological features of the anastomotic site group and non-anastomotic site group: there was no statistical difference between all the clinicopathological features (P>0.05). Univariate analysis showed that distant metastasis and R0 resection were prognostic factors in the patients with GSC. Multivariate analysis showed that R0 resection was an independent prognostic factor in the patients with GSC. Conclusions: The clinicopathological features of patients in the GSC-B and GSC-M groups were different. Patients with GSC would not benefit from palliative surgery if they could not receive radical surgery. R0 resection is an independent prognostic factor for patients with GSC.

Febrile infection-related epilepsy syndrome(FIRES)is a lethal encephalopathy with refractory status epilepticus as the main manifestation,and the selection of effective antiepileptic drugs(AEDs)is the focus and difficulty of treatment.This review summarises the mechanism of action,drug administration and adverse effects of different anti-inflammatory immunotherapies in the treatment of this disease,and finds that early initiation of ketogenic diet(KD)is one of the most effective treatments at present,and further studies are needed to clarify the adverse effects of the drugs and the effects of the combination of different drugs.

Objective To investigate the feasibility of the automatic cystocele severity grading software for quantitative evaluation of prolapse of bladder posterior wall by transperineal ultrasound . Methods One hundred and seventy transperineal ultrasound video clips were recorded when the female patients performing the Valsalva maneuver and those clips were divided into training group ( 85 cases) and test group ( 85 cases) randomly ,then the ralated structures of the images from the training group offline were marked . Through machine learning algorithm ,the computer had learned and was able to analyzed the marking information ,then the automatic cystocele severity grading software was obtained . And later the software was ran to mark the structures and get the cystocele severity grading in the images from the test group . Meanwhile , the same structures of the same images manually were marked and after an interval of more than two weeks the process were repeated by 3 doctors . Finally the grading results obtained from the software and the measurers of the 3 doctors were compared . Results The intelligent identification and automatic measurement software obtained from the machine learning algorithm was able to identify the related structures . The grading results of each measurer were of good consistency ( κ :0 .72 －0 .78 ;ICC :0 .980－0 .990) . The grading results between different measurers were of good consistency ( κ :0 .65－0 .75 ;ICC :0 .985－0 .992) . The grading results between automatic software and three different measurers were of good consistency ( κ :0 .63－0 .67 ;ICC :0 .967－0 .969 ; r ＝0 .936 ,0 .943 ,0 .936 ,all P ＜0 .01) . Conclusions The automatic cystocele severity grading software is able to identify the related structures in the images and reliable to apply the software in pelvic floor ultrasound .