Objective To evaluate the the effect of vancomycin artificial bone on the treatment of elderly patients with chronic osteomyelitis and the influence to TNF-α.MethodsIn Yongkang orthopaedic hospital, 48 cases of elderly patients with chronic osteomyelitis were selected as the object of study, and were randomly divided into the control group and the experimental group, 24 cases in each group.This is a retrospective study.Three days before operation, the control group were given cloxacillin 2g/d by 4 times intravenous drip.The experimental group were given Norvancomycin Hydrochloride 0.8g/d by two times intravenous drip.In the process of operation, the control group were given bone graft substitutes 5-10g and the experimental group were given Norvancomycin Hydrochloride 1g that is added to the water to form a paste.After operation, the control group were given cloxacillin 2g/d by 4 times intravenous dripand the experimental group were given Norvancomycin Hydrochloride 0.8g/d by 2 times intravenous drip.The two groups were treated continuously for two weeks.The effect,CRP, ESR, TNF-α, NF-κB and adverse drug reactions were compared between the two groups.ResultsThe effect in the experiment group was 95.45%,is significant higher than that in the control group 81.82%(P<0.05).The serum level of CRP、ESR、TNF-α and NF-κB decreased post-treatment in the experiment group much lower than that in the control group (P<0.05).The adverse drug reactions was not statistically different between the two groups.ConclusionVancomycin artificial bone on the treatment of elderly patients with chronic osteomyelitis was effective with high safety and it can decrease the level of TNF-α.

From visual teaching aids,experiment phenomenon,imagination,clinical cases and the aspects such as daily life phenomenon and computer supplementary teaching,this article has discussed the application of“Image-thinking” in biochemistry teaching,and from the angle of medical educational reform,it has also discussed the importance of its raising the teaching effect.

Accidents, Occupational ; Humans ; Hydrogen Sulfide ; poisoning

Abstract: Objective To understand the difference of DNA sequence and RNA sequence of paired pol region in HIV patients in constructing HIV genetic transmission network, and to provide scientific data for constructing molecular transmission networks using DNA sequences. Methods　The whole blood and plasma samples of HIV patients living in 2014 and newly reported in 2015-2018 in Liuzhou, Guangxi, were collected, DNA and RNA sequences were extracted, amplified, sequenced, spliced and aligned, and then genetic transmission networks were constructed, and the connectivity consistency of genetic transmission networks constructed by DNA and RNA sequences was compared. Results In this study, a total 2 983 participants were investigated, which were 2014 baseline and 2015-2018 newly reported HIV patients, of which 2 590 participants were only DNA sequences in 2014 baseline, 196 HIV patients were both DNA and RNA sequences of paired pol region in 2014 baseline, and 197 newly reported HIV patients were both DNA and RNA sequences of paired pol region in 2015-2018. In 393 DNA and RNA sequences of paired pol region, the genotype of DNA sequence and RNA sequence were consistent, and there was no statistically significant difference in genetic distance between paired DNA sequences and RNA sequences (Z=-2.72, P=1.00). The connection consistency rate of genetic transmission networks constructed by DNA and RNA sequences of paired pol region of 2015-2018 newly reported with the baseline DNA sequences was 91.4% (108/197). And the connection consistency rate of genetic transmission networks constructed by DNA and RNA sequences of paired pol region of 2015-2018 newly reported with the baseline RNA sequences was 97.0% (191/197). There was no statistical difference in antiretroviral therapy to reduce the risk of HIV secondary transmission between genetic transmission networks constructed by DNA and RNA sequences of paired of pol gene newly reported from 2015 to 2018 with baseline DNA sequence. Conclusion　DNA sequence and RNA sequence of paired pol region of HIV patients have good consistency in genotype, genetic distance, and genetic transmission network construction, and both DNA and RNA sequences can be used for genetic transmission network analysis.

AIM:To investigate how to design personalized cataract surgery programs to achieve surgical correction of preoperative corneal astigmatism with surgical astigmatism under the guidance of corneal topography, improve postoperative visual quality and reduce the cost of treatment.
METHODS: Totally 202 cases ( 226 eyes ) cataract patients were divided into randomized treatment group and individualized treatment group. According to the method and location of the incision, randomized treatment group were divided into 8 groups. Surgical astigmatism after different incision were calculated with the use of preoperative and postoperative corneal astigmatism through vector analysis method. Individualized treatment groups were designed personably for surgical method with reference of every surgically induced astigmatism, the surgical method chooses the type of surgical incision based on close link between preoperative corneal astigmatism and surgically induced astigmatism, and the incision was located in the steep meridian. The postoperative corneal astigmatism of individualized treatment group was observed.
RESULTS: Postoperative corneal astigmatism of individualized treatment group were lower than that of 3.0mm clear corneal tunnel incision in the randomized treatment group, there were statistically significance difference, while with 3. 0mm sclera tunnel incision group there were no statistically significance difference. After 55. 8% of patients with the use of individualized surgical plan could undergo the operation of extracapsular cataract extraction with relatively low cost and rigid intraocular lens implantation, the per capita cost of treatment could be reduced.
CONCLUSION: Personalized cataract surgery programs are designed to achieve surgical correction of preoperative corneal astigmatism under the use of corneal topography, improve postoperative visual quality and reduce the cost of treatment.

Adult ; Aged ; Aged, 80 and over ; Granuloma ; drug therapy ; Humans ; Laryngeal Diseases ; drug therapy ; Male ; Middle Aged

Adult ; Aged ; Aged, 80 and over ; Anthracosis ; complications ; microbiology ; Anti-Bacterial Agents ; pharmacology ; Drug Resistance, Bacterial ; Humans ; Lung Neoplasms ; complications ; microbiology ; Male ; Middle Aged ; Pseudomonas Infections ; microbiology ; Pseudomonas aeruginosa ; drug effects

BACKGROUND:Restoring the stability of the spine has become the consensus of spinal surgery. The canaloplasty technology has been continuously improved, but how can we get the good clinical effect of the canaloplasty, and the price affordable, many domestic scholars have to try al kinds of the improved operation methods. OBJECTIVE:To evaluate the clinical application value of cannulated screws fixation in canaloplasty. METHODS:From February 2011 to February 2013, total y 24 patients with spinal disease treated by canaloplasty using cannulated screw were retrospectively analyzed, of which 12 cases of cervical stenosis, 2 cases of intraspinal tumor in thoracic and 10 cases of intraspinal tumor in lumbar. Al patients were fol owed up after treatment. Postoperative CT and MRI were done in al patients. Clinical symptoms and radiographic changes were observed after treatment. The Japanese Orthopaedic Association score and the spinal canal cross-sectional area measurement were conducted in the patients with cervical stenosis between the preoperation and postoperation. Visual analog scale score was evaluated in patients who have the tumor in the thoracolumbar spine between the preoperation and postoperation. RESULTS AND CONCLUSION:Al patients had no complications such as nerve or blood vessel damage. Al patients were fol owed up 12 to 24 months. Imaging evaluation showed that internal fixator was stable without the hol ow screw loss or displacement. The bone grafting in groove reached bone fusion. There was no occurrence of lamina col apse or“re-close of door”. The Japanese Orthopaedic Association score and spinal canal cross-sectional area of patients with cervical stenosis during the fol ow-up after 12 months of treatment were significantly superior to those in preoperation (P<0.01). After 12 months of treatment, Japanese Orthopaedic Association scores showed that the excel ent rate of classification assessment was 92%. During the fol ow-up after 12 months of treatment, the visual analog scale of patients with thoracolumbar tumor improved from (8.2±1.6) points before treatment to (2.3±1.3) points at the first year after discharge (P=0.004 2). These results suggest that the application of cannulated screws in the canaloplasty can not only enhance the stability of the rear pil ar, and can improve the healing rate of osteotomy, and has the characteristics of inexpensive, easy to operate, and repair effect is good.

Background The pathogenesis of dry eye has not been clearly established.There are more and more evidences to suggest that it is associated with ocular surface inflammation mediated by immunity.But how T helper cell 17 (Th17) plays its role in dry eye remains unclear.Objective The aim of this study was to investigate the expressions of Th17 related cytokines in ocular surface with dry eye.Methods A prospective cohortl study was designed.This protocol was approved by Ethic Commission of Peking University Third Hospital,and written informed consent was obtained from each subject prior to entering this cohort.Twenty female patients with Sjigren syndrome (SS group),20 patients with non-SS dry eyes and 20 normal volunteers were recruited in Peking University Third Hospital during 2011-2012 duration and all the subjects were menopausal female with the age 50 years old or more.The ocular surface disease index (OSDI)questionnaire designed by Schiffman was performed firstly,and then tear breakup time (BUT),corneal fluorescein staining and Schirmer Ⅰ test (S Ⅰ t) were carried out in the subjects.Expression of Th17 related cytokines mRNA were measured using PCR-Array.The correlation between IL-17A and ocular surface parameters was analyzed.Results The OSDI scores of the SS dry eye group,non-SS dry eye group and normal control group were 50.00 (33.50,66.50),45.00 (35.50,55.00) and 3.00 (0.00,5.00),the S Ⅰ t values were 2.50 (1.00,4.00),5.00 (2.00,5.00) and 15.50 (10.00,18.50),the BUT were 2.00 (1.00,4.00),4.00 (3.00,5.00) and 10.00 (10.00,12.00),the corneal fluorescein staining score were 8.50 (6.00,12.00),5.50 (4.00,7.00)and 0.00 (0.00,0.00),respectively,and significant differences were seen among the SS group,non-SS dry eye group and normal control group (x2=34.11,28.13,93.66,92.25,all at P＜0.01).The relative expression values of IL-17A mRNA,IL-6 mRNA,IL-8 mRNA,IL-22 mRNA and IL-23 mRNA in the ocular surface were 1.98±0.16,11.64±1.32,6.67±1.12,1.88±0.18 and 1.78±0.17 in the SS group patients,and 1.45±0.17,1.32±0.14,1.12 ±0.13,1.23 ±0.15 and 1.23 ±0.13 in the non-SS dry eye group patients,respectively,with significant differences between the two groups (all at P＜0.01).IL-17A level on the ocular surface was significantly negative correlated with BUT (r =-0.56,P＜0.01) and positive correlation with corneal fluorescein staining scores (r=0.44,P=0.01).Conclusions Expressions of Th17 related cytokines in the ocular surface increased in patients with dry eye,especially in those with SS.IL-17A level in ocular surface is associated with BUT and corneal fluorescein staining scores,suggesting that immune is involved in the pathogenesis and devlopment of dry eye.

According to the design of medical specialist system and the features of Cancer Prevention and Treatment in China, suggestions of Oncologic specialist training were proposed as following. Applying the training by phases is suitable, the conceptions, principles and protocols for Comprehensive treatment and standardized treatment are core contents for the Oncologic specialist training process, which should be carried out in tumor hospital prior to general hospital, the special therapy for the special disease is the aim of Oncolngic specialist training.