Objective To investigate feature on the diagnosis and treatment and care and recovery of tuberculous tenosynovitis.Methods From October 1998 to March 2008,7 cases of tuberculous tenosynovitis at the wrist,hand and ankle,food were treated using surgery and antitubercular agents.The outcomes,misdiagnosed reason and treatment points and revovery instruction were analyzed respectively.Results All cases were cured.There was no recurrence after postoperative 0.3 to 10 year follow up.Excellent function was obtained in 6 cases.There was 1 case with somewhat disability because of late treatment.Conclusions Early diagnosis of tuberculous tenosynovitis depends on the clinical manifestation、lab test and MRI.Healing could be achieved if focal cleaning,antitubercular medication and functional rehabilitation ware performed on time.

After acupuncture,histamine flares are often found on skin arround acupuncture points in most patients,histamine and other biologically active substances are always present in the local soft tissues.“Meridian phenomena”,such as urticarious skin reaction or red line along the meridian may be shown in a few patients.It is well known that mast cells release histamine and other active mediators.The purpose of this paper is to observe the distribution of mast cells in the connective tissue at points in albino rats and if there is any difference in the distribution pattern of mast cells between adult and new born rats. 52 albino rats,including adult,new born and developing ones were investigated. Points selected on the lower extremities were identified by decreased electric resistance and were marked with indian ink:the electric resistance of skin beside points was detected simultaneously as control.The mast cells in the spread preparations of subcu- taneous connective tissue(fascia)in albino rats were fixed in alcohol-formalin and stained with toluidin blue.Most specimens of fascia were fixed at first and spread on the slides later,while some specimens were spread before fixation.No essential difference between both kinds of specimens was found. In the adult rats,the mast cells in fasciae are distributed not uniformly,they are oval in shape and are usually arranged in rows along the cell length with polarity. Many rows of mast cells are packed to form an elongated zone.Several zones oriented in the direction of the longitudinal axis of lower extremities are found.The mast cells are crowded in the field of marked points along the zone.Besides,it is found that the mast cells along small blood vessels are slender and fusiform in shape. However,in new born rats,mast cells are distributed uniformly and most of them are round in shape.The mast cells are arranged in random way without polarity.In the arrangement of mast cells neither row nor zone is found,and there is no difference in distribution of them everywhere. In the developing rats aged one month or so,the morphology of mast cells is similar to that of the new born,except that they are more numerous at the points. In the adult rats,electric resistance at various points is 260 kilo-ohm,while that of control is more than 500 kilo-ohm.In contrast with the adult,the electric resistance on any part of skin(at point or not)of the new born is equal,more than 500 kilo- ohm,and the electric resistance of points is decreased with development of albino rats in which an apparent decrease may be demonstrated in the rats aged about one month.It seems to be that there are parallel changes with growth of individuals between the morphological character of mast cells in the fasciae and functional property detected by electric resistance at points. It has been considered that the morphology and amount of mast cells may indicate the activity of metabolism of connective tissue.It suggests thence that the metabolism of fasciae at points may be more active and the points may be formed with the developed function in individuals after birth in albino rats.

OBJECTIVE To investigate the epidemiological characteristic of lower respiratory infection among the hospitalized patients in Tianlin Community Health Service Center so as to take effective measures to control the infection and reduce the emergence of drug resistant strains.METHODS Totally 6150 cases of patients discharged from our Center during from Jan 2004 to Sept 2006 were collected and among them 141 cases occurred hospital onset of lower respiratory infection and drug resistance was analyzed through contrasting.RESULTS The incidence rate of hospital onset of lower respiratory infection and drug resistance were 2.29% and 58.62%.Among the 141 cases,the incidence rate of ESBLs was 28.36% which mainly produced from Escherichia coli and Klebsiella pneumoniae.CONCLUSIONS Primary affection should actively treated and antibiotics should use rationally according to the drug sensitive cultivation to control the abuse of antibiotics and reduce the emergence of drug resistant strains.

Objective To develop a multivariate logistic regression model , and to predict the risk of ma-lignant partially cystic thyroid nodules .Methods 470 patients(662 nodules)treated with surgery and confirmed by pathological diagnosis were screened out .Their ultrasonographic morphology and vascularity of thyroid nod-ules, thyroid stimulating hormone(TSH)and clinical information were collected and analyzed retrospectively .The model was developed to calculate the individual risk and ROC curve was used to evaluate the predictive index . Results The regression model was:Z=-3.60+1.40X2+2.47X3+1.05X4+0.57X9+0.07X10+1.02X12 ( X2 represents eccentric acute-angle configuration , X3 represents microcalcification , X4 represents cystic-solid margin,X9 represents echogenecity of solid portion , X10 represents TSH,X12 represents gender );M=eZ/1+eZ (M represents probability of malignancy , e represents natural constant 2.72).When applied the model to the ver-ification group, the accuracy, sensitivity, specificity, misdiagnosis rate, missed diagnosis rate, negative likeli-hood ratio(LR-)and positive likelihood ratio(LR+)was 96.95%,100%, 96.68%, 3.32%, 0%, 0 and 30.12 respectively.The largest area under the receiver-operating characteristics curve (AUC)was 0.88,which proved the model has high diagnostic value .Conclusions The model has high accuracy to predict the risk of malignan-cy.M is closely related to malignant risk of partially cystic thyroid nodules .

The cholinesterase(ChE)and lactate dehydrogenase(LDH)activities in blood smears of 37 patients were observed before and 20 minutes after electroacupuncture.Hegu and Zusanli were mainly chosen as the acupuncture points.Karnovsky method was used to demonstrate ChE,activity,and tetrazolium-formazan reaction for LDH activity. Before acupuncture,all formed elements of blood showed both ChE and LDH acti- vities.In red blood cells ChE and LDH activities were localized at the cell membrane, while in white blood cells they were found throughout the cytoplasm as colored granu- les.The granulocytes showed greater ChE and lesser LDH activities than the lymph- ocytes.The platelets also showed greater LDH and ChE activities,especially the former. On the whole,platelets and leucocytes,as compared with erythrocytes,showed greater activities for ChE and LDH. Under microscopic observation,according to the amount and color of granules,the degrees of GhE and LDH activities for each kind of blood formed elements before and after acupuncture were recorded as different markes,such as +、++、+++ and so on.The degrees of GhE or LDH activity in various formed elements of blood were compared by means of statistical tests.After acupuncture,both GhE and LDH activities of all blood formed elements were increased(p

70 patients including 60 cases under acupuncture anesthesia and 10 cases under drug anesthesia were observed. Before and 20 minutes after acupuncture the blood samples were taken from the patient ear lobes respectively, and in some patients taken once again 24 hrs after acupuncture. The electroacupuncture point Hegu or Zusanli was mainly adopted. As the method for detection of cell-mediated immunity(CMI) in vitro the improved microtechnique of whole blood for E-rosette (active and nonactive) and lymphocyte transformation tests was used. In performance of active rosetting the total leucocyte count and the differential lymphocyte count were done for calculation of absolute number of active rosette forming cells (RFC). The mean value of increase of active RFC was 12.7?1.43, the decrease was 6.8?1.77 after acupuncture. The increment of the absolute number of active RFC was 175?63.59. However no marked effect on the drug anesthesia group was found. In the lymphocyte transformation assay the increase was 12.7?1.49, the decrease was 7.0?2.19, and the enhancement effect still exhibited 24 hrs after acupuncture. In these tests an increase was mostly found in those with a lower or a usual CMI level; a decrease often found in those with a higher CMI level prior to acupuncture. The increase or decrease level in the results of three kinds of test (active, nonactive RFC and lymphocyte transformation) was similar, the increase range was 12～13%, the decrease range 6～7%. As the former compared with the latter, the promotion was prominent by all means.

Primary biliary cholangitis (PBC) is a chronic cholestatic liver disease with unknown etiology, and patients with poor response to ursodeoxycholic acid and obeticholic acid may eventually progress to liver cirrhosis and even liver failure. Liver transplantation is the only effective treatment method for PBC at present. This article elaborates on liver transplantation, survival time after liver transplantation, complications, recurrence of PBC after liver transplantation, and prospects and challenges of liver transplantation in patients with PBC, so as to provide a reference for clinical outcome and treatment after liver transplantation for PBC.

BACKGROUNDSepsis-induced myocardial injury (SIMI) is caused by a variety of mechanisms. The aim of the study is to investigate the effects of metalloproteinase-8 (MMP-8) on SIMI and its mechanisms in rats.

METHODSForty male Sprague Dawley rats were randomly divided into four groups: MMP-8 inhibitor (M8I), dexamethasone (DEX), sepsis, and sham groups. The sepsis model was established by cecal ligation and puncture (CLP). Rats in the M8I group immediately received an intraperitoneal injection of M8I (0.1 mg/kg) after CLP. Rats in the DEX group immediately received an intraperitoneal (IP) injection of DEX (2 mg/kg). Rats in the sepsis and sham groups received intraperitoneal injections of normal saline. Rats were sacrificed 12 hours after CLP. Paraffin sections were stained with hematoxylin and eosin to observe the myocardium. The myocardial ultrastructure was observed with transmission electron microscopy. MMP-8, tumor necrosis factor-α (TNF-α), and interleukin-1β (IL-1β) were detected by immunohistochemistry. The expression of MMP-8 was measured by Western blotting. TNF-α and IL-1β levels in serum and myocardial tissue were determined by enzyme-linked immunosorbent assay.

RESULTSCompared with the sham group, the myocardium in the sepsis group was seriously injured. MMP-8, TNF-α and IL-1β expression was higher in the sepsis group than in the sham group. Treatment with M8I or DEX, however, attenuated sepsis induced histopathological changes in the heart, and was associated with significant reductions in serum and myocardial levels of TNF-α and IL-1β (P < 0.05). M8I significantly inhibited MMP-8 expression in myocardial tissue (P < 0.05). In addition, treatment with DEX was not associated with a change in myocardial levels of MMP-8 (P > 0.05).

CONCLUSIONMMP-8 inhibitor attenuated myocardial injury in septic rats, which might be related to reduced expression of TNF-α and IL-1β.

Animals ; Dexamethasone ; therapeutic use ; Disease Models, Animal ; Enzyme-Linked Immunosorbent Assay ; Heart Diseases ; drug therapy ; etiology ; Interleukin-1beta ; metabolism ; Male ; Matrix Metalloproteinase 8 ; metabolism ; Matrix Metalloproteinase Inhibitors ; therapeutic use ; Rats ; Rats, Sprague-Dawley ; Sepsis ; complications ; drug therapy ; Tumor Necrosis Factor-alpha ; metabolism