Objective To investigate clinical effect of patients with PICU multiple organ dysfunction by continuous blood filtration combined with naloxone.Methods 42 patients with multiple organ function failure were selected and randomly divided into 2 groups.The control group were treated by PICU conventional therapy, the experiment group were treated by continuous blood filtration combined with Naloxone.Vital signs, creatinine, creatine kinase and aspartate aminotransferase levels, length of stay and blood filtration were compared after 1 day and 3 days treatment.ResuIts Compared with control group,heart rate, oxidation index,creatinine and aspartate aminotransferase levels of the experiment group were lower(P<0.05).After 1 day and 3 days, compared with cnontrol group, length of stay and blood filtration of the experiment were lower(P<0.05).ConcIusion Continuous blood filtration combined with naloxone in treatment of multiple organ dysfunction syndrome PICU is effective and reliable.It can significantly improve renal function, shorten the length of hospital stay, and remove inflammatory mediators in plasma of patients.

[Objective] To analyze application of reforming posture to anterior cervical vertebrae surgery.[Methods]The results of 50 cervical myelopathy patients,who underwent anterior cervical decompression and applied of reforming posture,were retrospectively reviewed at a mean follow-up of 2.5 years (2~4 years).[Results]Patients were also evaluated pre-operatively and post-operatively using a modified version of the Japanese Orthopedics Association Scale(JOA).78.4% of patients showed improvement rate,90% of patients showed excellent-to-good results,and the fusion rates were 100%.[Conclusion]With reforming posture,the intervertebral space of cervical vertebra was thoroughly revealed,surgical trauma was reduced,and effectiveness was improved,the time was shortened and bone fusion was enhanced.

OBJECTIVETo compare clinical efficacy of anatomic locking plate and Gamma nail in treating unstable femoral intertrochanteric fractures with external wall fractures.

METHODSFrom June 2010 to June 2014,clinical data of 44 patients with intertroehanteric fractures associated with lateral wall fractures (type 31A2.2-3.3) followed more than 12 months,which treated with Gamma nail or anatomic locking plate,were retrospective analyzed. Sixteen patients were treated with anatomic locking plate, including 6 males and 10 females aged from 32 to 83 years old with an average of 56.5 years old. Twenty-eight patients were treated with Gamma nail including 17 males and 11 females aged from 26 to 87 years old with an average of 60.4 years old. Operative time, intraoperative fluoroscopy times, blood loss (intraoperative and hidden blood loss), hospital stays were observed and compared. PPMS and HHS scoring were used to evaluate postoperative clinical effect.

RESULTSAll patients were followed up from 12 to 24 months with an average of 16.2 months. Operative time in Gamma nail was shorter than anatomic locking plate; while blood loss( intraoperative and hidden blood loss) and intraoperative fluoroscopy times in anatomic locking plate were less than that of in Gamma nail. There was no significant meaning in hospital stays between two groups. Postoperative full weight-bearing time in anatomic locking plate was prolonged than Gamma nail. At the final following-up, PPMS in Gamma nail was 7.50 ± 1.78 and 6.82 ± 1.38 in anatomic locking plate, and there was no obvious meaning between two groups (t = 2.341, P = 0.132); there was no significant differences in HHS score between Gamma nail (83.25 ± 11.18) and anatomic locking plate (86.14 ± 12.36) (t = 1.923, P = 0.243). The incidence of complications in Gamma nail was less than anatomic lock-ing plate (P = 0.005).

CONCLUSIONAnatomic locking plate for intertrochanteric fractures with external wall fractures could avoid re-injury of external wall, especially for severe comminuted fractures, difficult for intramedullary nailing, and there was no significant meaning in hip joint function compared with Gamma nail, while postoperative incidence of complications was higher than Gamma nail, so early weight-bearing was not stress.

Adult ; Aged ; Bone Nails ; Bone Plates ; Female ; Fracture Fixation, Intramedullary ; instrumentation ; methods ; Hip Fractures ; surgery ; Hip Joint ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

Objective To explore the diagnostic value of virtual bronchoscopic navigation (VBN) for peripheral pulmonary lesions. Methods 200 cases with peripheral pulmonary lesions (0.8 cm < diameter < 4.0 cm) were divided into VBN and control group from June 2014 to June 2015. VBN group: VBN guided ultrafine bronchoscope to the target bronchus, control group: ultrafine bronchoscopy with chest CT as a reference guided to the target bronchus. Results There were no significant differences in the diagnosis rates between VBN group and control group in 200 patients (χ2 = 3.31, P = 0.069); But, the diagnosis rates with diameter more than 2.0 cm and less than or equal to 2.0 cm had statistically significant differences of VBN group and control group (χ2 = 13.45, 5.31, P = 0.000, 0.021, respectively); We also found that the mean time of biopsy tool reach to the lesions had significant differences between the two groups (P = 0.047). There were no significant differences in total checking time and complications (P = 0.230, 0.960, respectively). Conclusions Virtual bronchoscopic navigation did not improve the diagnosis rate of pulmonary peripheral lesions, but shortened the time to locate the lesions.

Objective To compare clinical efficacy of inverse less invasive stabilization system (LISS) and Gamma nail in treating unstable femoral intertrochanteric fractures combined with lateral wall fractures.Methods Fifty-two patients with intertrochanteric fractures associated with lateral wall fractures followed up for at least 12 months after surgical treatment between June 2010 and June 2013 were included in this retrospective cohort study.According to the different internal fixation,the patients were assigned to inverse LISS group [16 males and 8 females;(62.5 ± 12.4)years] and Gamma nail group [17 males and 11 females;(60.4 ± 18.6)years].According to the AO classification,there were 6 patients with A2.2 type,5 A2.3 type,5 A3.1 type,6 A3.2 type and 2 A3.3 type in inverse LISS group,and there were 4 patients with A2.2 type,7 A2.3 type,9 A3.1 type,5 A3.2 type and 3 A3.3 type in Gamma nail group.Opcration time,total blood loss (intraoperaive plus occult blood loss),hospital length of stay,bone healing,time of commencing full weight-beating and complication incidence were compared between the two groups.Harris hip score was recorded postoperatively.Results All patients were followed up for 24-36 months (mean,30.2 months).Operation time in Gamma nail group was shorter than that in inverse LISS group (P ＜ 0.05),while relatively more blood loss was found in Gamma nail group(P ＜0.05).There were no significant differences in hospital length of stay and bone healing timebetween the two groups (P ＞ 0.05).Patients in Gamma nail groups started earlier full weight-bearing than inverse LISS group (P ＜0.05).Harris score was (86.1-± 12.4)points in inverse LISS group one year after operation,not significantly different from (83.3 ± 11.2) points in Gamma nail group (P ＞ 0.05).Complication of one patient with coxa vara and one bone nonunion in inverse LISS,showing no significant from one patient with screw breakage and one femoral head osteonecrosis in Gamma nail group (P ＞ 0.05).Conclusions Both techniques are effective in treatment of intertrochanteric fractures combined with lateral wall fractures and achieve similar results in function recovery.But inverse LISS is eccentric fixation,so too early weight-bearing should not be over-emphasized.

BackgroundRetinitis pigmentosa (RP) has the genetic and phenotype heterogeneity.To determine the disease-causing gene is a foundation of gene therapy.Objective This study was to localize the pathogenic gene and screen the gene mutation associated with Han Nationality autosomal dominant retinitis pigmentosa (ADRP) in a Chinese family.MethodsTwenty-one families enrolled this study,including 12 patients with ADRP and 9 individuals with normal phenotype.Perimetry,fundus examination,electrooculogram ( EOG ) and electroretinogram (ERG) were performed in 12 patients.Genetic linkage analysis was performed on the subjects in all known genetic loci related to ADRP with a panel of microsatellite markers.Subsequently,the mutation screening of rhodopsin gene was screened by direct DNA sequencing.This study was approved by Ethic Committee of Zhongnan Hospital of Wuhan University.Informed consent was obtained from each subject.ResultsThe fundus appearance of the proband was in accordance with the ADRP,and the EOG and ERG showed undetectable.Contractive visual field also was exhibited in the proband.Linkage analysis showed that the maximum logarithm of the odds(LOD) score reached 3.6671 at marker D3S1292 at recombination fraction θ =0.0.The results of direct DNA sequencing revealed a C→ G transversion mutation at codon 53 in exon 1 of rhodopsin gene,which resulted in a proline to arginine change (Pro53Arg) in 12 patients.However,no similar mutation was found in the unaffected members of this family.ConclusionsThe missence mutation Pro53Arg in rhodopsin gene cosegregate with the RP disease.It is determined to be a pathogenic factor of this ADRP family.

Objective To investigate the significance of measurement of the expression CD28 on tumor infiltrating lymphocytes in patients with stomach cancer.Methods Subjects for this investigation include the tumor tissues and its nearby normal tissues from 48 patients with stomach cancer.The levels of the expression of CD28, CD8 on tumor infiltrating lymphocytes were analyzed by flow cytometry.Results First, the levels of the expression of CD8+CD28+ and CD8-CD28+ on tumor infiltrating lymphocytes from the tumor tissues were remarkably lower than from its nearby normal tissues (P

ObjectiveTo identify the relationship between urodynamic parameters and vaginal deliveries in women with genuine stress urinary incontinence(GSI).Methods56 women with vaginal delivery history who were diagnosed as stress urinary incontinence underwent urodynamic tests.Their abdominal leak point pressures(ALPP),maximum urethral closure pressure(MUCP) and functional urethral length(FUL) were recorded,and their Correlation to vaginal deliveries was tested using linear correlation coefficient.ResultsCorrelation between vaginal deliveries and ALPP showed a significant relationship(r=-0.349,P<0.05).Neither MUCP nor FUL showed a close relationship with vaginal deliveries(r=-0.219 and r=-0.178 respectively,P>0.05).ConclusionVaginal delivery plays an important role in the pathogenesis of GSI.The more vaginal deliveries,the more serious GSI.

Objective To explore the urban population hyperlipidemia and chronic kidney disease relationship by epidemiological studies.Methods 800 health examiners were randomly investigation.To determine these blood pressure,height,weight;to determine these urinary albumin and creatinine in urine,serum creatinine,serum total cholesterol,triglyceride,high-density lipoprotein cholesterol.To calculate glomerular filtration rate and urinary albu- min and creatinine ratio according to serum creatinine.Diagnastic criteria of CKD was eGFR30mg/g and lasted three months or more.Results 238 patients with high blood lipids was found,the overall prevalence rate was 29.75 %,patients with high blood lipids compared with the normal popula- tion.the incidence of renal injury rates were respectively 15.13 % and 9.07 %.Kidney damage rates were respective- ly 19.69% and 9.91% in the hypercholesterolemia with and without obese patients.Conclusion Hyperlipidemia has become particularly important etiology of CKD.

Objective:The immunological effects of HCV-DNA vaccine with different adjuvants were detected by ELISPOT in mice.Methods:Female BALB/c mice were primed with naked HCV-DNA, HCV-DNA encapsulated by liposome DDAB/EPC or DC-Chol/DOPE, HCV-DNA mixed with Montanide ISA 720 or aluminum hydroxide, respectively, and boosted twice accordingly in a four-week interval. Cytokine production by splenocytes was assessed by ELISPOT.Results:In most cases, splenocytes from mice vaccinated with DDAB/EPC liposome produced more IFN-?. These splenocytes also have significant higher IL-2 production compared with the other groups. In expansion with NS5b, splenocytes from alum group have significance in IL-4 production compared with other groups. The profile of cytokine production revealed that the INF-? overwhelmed IL-4 in naked DNA, DDAB/EPC, and DC-Chol/DOPE groups while IL-4 surmounted IFN-? in alum and Montanide groups.Conclusion:Encapsulation with liposome DDAB/EPC has the strongest adjuvant effect in inducing Th1 dominated immunity. Alum and Montanide can convert the Th1 nature of DNA vaccine to Th2-biased immunity.