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.

Objective To evaluate the clinical value of gasless video-assisted endoscopic thyroidectomy by infraclavicular wall.Methods 15 cases received gasless video-assisted endoscopic thyroidectomy by infraclavicular wall.13 cases underwent total thyroidectomy,2 cases underwent subtotal thyroidectomy.All 15 cases were protected recurrent laryngeal nerve and parathyroid by inspecting during the operation.Results All 15 patients were cured without hoarse and tetany,and the flaps without hematomas and extravasated blood.Conclusion Gasless video-assisted endoscopic thyroidectomy by infraclavicular also can reach the principle demand by the tradional opening way.As the supremacy way of aesthetic and hidden,it can be used to the patients who want high request on faces.

ObjectiveTo investigate the value of CEUS in differential diagnosis of benign and malignant thyroid solid lesions.MethodsTotally 45 patients with thyroid solid lesions underwent CEUS examination.The enhancement mode and blood perfusion characteristics of malignant and benign lesions were analyzed,and the results were compared with pathology.ResultsCEUS diagnosed 31 benign lesions and 14 malignant masses.The diagnostic accordance rate of CEUS was 93.75％ (30/32) and 92.31％ (12/13) for benign and malignant lesions respectively.In 31 benign lesions,27 (27/31,87.10 ％) showed entire homogeneous enhancement,4 (4/31,12.90％) presented inhomogeneous enhancement.In 14 malignant masses,1 (1/14,7.14 ％) showed homogeneous hypoechoic enhancement,12 (12/14,85.71％) presented inhomogeneous hyperechoic enhancement and 1 (1/14,7.14％) presented non-enhancement.ConclusionCombined with two-dimensional grey scale ultrasound and CDFI,CEUS enables dynamic observation of the microvascular perfusion of thyroid lesions,therefore helps to differentiate benign and malignant thyroid lesions.

Objective To investigate the relationship between white-matter hyperintensities (WMHs) and hemorrhagic transformation and neurological outcome at 3 months after recombinant tissue plasminogen activator (rt-PA) treatment in patients with acute ischemic stroke.Methods The chnical data of 132 patients with acute ischemic stroke who had received intravenous rt-PA therapy were retrospectively reviewed.The severity of WMHs according to the modified Schelten scale was assessed.Hemorrhagic transformation included hemorrhagic infarct (HI) and cerebral parenchymal hemorrhage (PH).Hemorrhagic transformation after thrombolytic therapy and clinical neurological outcome based on modified Rankin scale (mRS) at 3 months was also analyzed.Favorable neurological outcome as mRS 0-1 score and unfavorable neurological outcome as mRS 2-6 scores was defined.Results Hemorrhagic transformation was found in 26 patients (19.7％,26/132) among 132 patients receiving intravenous rt-PA treatment.Seventeen patients were HI type and 9 patients were PH type.Multiple Logistic regression analysis showed that baseline American National Institute of Health Stroke Scale (NIHSS) score,diastolic pressure,WMHs score was not correlated with HI type hemorrhagic transformation (P ＞ 0.05) ; and WMHs score was not correlated with PH type hemorrhagic transformation (P ＞0.05),but baseline NIHSS score,diastolic pressure was the independent risk factor of PH type hemorrhagic transformation (P ＜ 0.05).Dicho-Logistic regression analysis showed that WMHs score was the independent risk factor of unfavorable neurological outcome (OR =1.136,95％ CI 1.037-1.245,P =0.008).Conclusion Severe WMHs are not associated with hemorrhagic transformation but independently associated with unfavorable neurological outcome after thrombolytic therapy in patients with acute ischemic stroke.

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

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.