Objective To evaluate the clinical outcome associated with the core decompression in combination with the nano-hydroxyapatite/collagen composite rod combined with decalcified bone matrix in a consecutive series of patients with osteonecrosis of femoral head,especially the prevention of collapse of femoral head and its predisposing factors.Methods From August,2012 to May,2013,46 pationts (50 hips) who had undergone core decompression in combination with nano-hydroxyapatite/collagen composite rod insertion in corporated with decalcified bone matrix in our hospital were involved in this study.Postoperative care consisted of prophylactic intravenous antibiotic and anticoagulation therapy.Patients were instructed to be non-weight-bearing for 3 weeks,to partial weight-bear for the next 3 weeks,and to weight bear as tolerated thereafter.All patients were evaluated both clinically and radiographically.The primary clinical outcome of this study was functional improvement assessed with the Harris hip score.Serial radiograms of the pelvis were taken at 1,3,6,12 months post-operatively to analyze the process of osteonecrosis.Results All patients followed up for 12 months,no one suffer complications.The mean Harris score pre-operation was 65.6 ± 10.6,post-operation score was 87.5 ± 15.3,with a mean improvement of 21.8 ± 13.2 (P ＜ 0.05).According to Harris hip score system,excellent for 30 hips,good for 14 hips,fair for 2 hip and poor for 4 hips.Refer to the Kaplan-Meier survivorship curve,the success rate at 12 months post-operatively was 92％.Radiological changes coincided with clinical changes.Conclusion Core decompressionin combination with nano-hydroxyapatite/ collagen composite rod insertion in corporated with decalcified bone matrix provided a minimally invasive surgical treatment option to treat early stage osteonecrotic hips(stage Ⅰ and Ⅱ) and to prevent femoral heads from collapsing,with clinical outcomes and success rates priorto other commonly used surgical procedures.

OBJECTIVE To understand characteristics of TEM-116 ?-lactamases through comparative study on resistance to antibiotics of clinical isolates of Klebsiella pneumoniae producing TEM-116 ?-lactamases.METHODS K.pneumoniae susceptibility to ?-lactamases was determined by disk diffusion tests,and their isoelectric points(PI) were detected using analytic isoelectric focusing(IEF),and resistance to antibiotics of clinical isolates of K.pneumoniae producing TEM-116 and TEM-1?-lactamases was studied.RESULTS Both of K.pneumoniae producing TEM-116 ?-lactamases and producing TEM-1 ?-lactamases were 100% resistant to AMP,and highly resistant to the first and second generation cephalosporin,but greatly susceptible to FEP and IPM.There was greatly difference between resistance to AMC,TZP,AMK,and GEN of clinical isolates of K.pneumoniae producing TEM-116 ?-lactamases and that of K.pneumoniae producing TEM-116 ?-lactamases,the TEM-116 isolates were higher resistant than TEM-1 isolates.Analytic IEF results showed that PI of TEM-116 ?-lactamases was 5.4,and most strains of K.pneumoniae TEM-116 ?-lactamases displayed two electrophoresis bands or more,only one strain of them just displayed one band,resistant to majority of antibiotics.CONCLUSIONS The results show that K.pneumoniae producing TEM-116 ?-lactamases are more resistant to antibiotics than K.pneumoniae producing TEM-1 ?-lactamases,and indicate TEM-116 ?-lactamases work as ESBLs.

Objective To investigate the resistance and ?-lactamase of cefoxitin-resistant Klebsiella pneumoniae. Methods The minimal inhibitory concentrations were determined by standard agar dilution.Isoelectric focusing was used to measure the PI(s) of an isolate,s ?-lactamase,AmpC and ESBLs activity was confirmed by a three-dimensional extract method. Results The resistant rates of 40 strains were as follows: imipenem and meropenem 0.0%,cefepime 20.6%,cefotaxime(22.5%),ceftazidime 60.0%.The most isolates were demonstrated two or more ?-lactamase bands by IEF.Of 39 strains tested,ESBLs was detected in 31(70.5%) strains and AmpC-type?-lactamase in 16(41.0%) strains by three dimensional extract test. Conclusions These cefoxitin-resistant Klebsiella pneumoniae produced two or more ?-lactamases.It is imperative for clinical microbiology laboratories to detect and research ?-lactamases,especially AmpC enzyme.

Objective To study the influence of conflict vessels of trigeminal neuralgia (TN) in microvascular decompression (MVD) efficacy.Methods The clinical data of 86 patients accepted MVD for TN,admitted to our hospital from July 2008 to August 2012,were retrospectively analyzed.According to the number of offending vessels under intranperative microscope,the patients were divided into single offending vessel group and multi-offending vessels group;the clinical features,distributions of offending vessels,imaging results and surgical findings of the two groups were compared.Results Forty-nine patients (57.0％) were enrolled to single offending vessel group,and 37 (43.0％) were enrolled to multi-offending vessels group;ratio of offside pain was higher than that of left side in both two groups.Conflict vessels in the single offending vessel group mainly were superior cerebellar artery (SCA,n=29,59.2％) and anterior inferior cerebellar artery (AICA,n=19,38.8％);conflict vessels in the multi-offending vessels group mainly were SCA+AICA (n=21,56.8％) and SCA+ petrosal vein (n=8,21.6％).Follow-up at 6 months after the operation showed an efficient outcome of 96.5％:the effective rate of single offending vessel group was 98.0％ while that of multi-offending vessels group was 94.6％ with significant difference(x2=0.003,P=0.958).No mortality or severe complications,such as hearing loss,cerebellar bleeding or cerebellar infarction,were recorded.Conclusions MVD is a safe and effective treatment for TN.MVD on multiple conflict vessels TN and that on single conflict vessel TN have approximate efficacy.

【Objective】 To comprehensively explore the serological characteristics of anti-PP1P^k and potential therapeutic strategies for recurrent miscarriage in p-blood type pregnant women. 【Methods】 Neutralization with pigeon egg white and human plasma, disruption of IgM antibodies by 2-mercaptoethanol reagent, and complement adding were conducted. Anti-PP1P^k titers under different processing conditions, media and temperatures were determined, and neutralizing effect of human plasma on anti-PP1P^k and its sensitization complement ability were analyzed. 【Results】 The titers of anti-PP1P^k in saline and column agglutination were 4 and 8, respectively. Low temperature increased titers, while β-mercaptoethanol treatment significantly reduced them. Pigeon egg white partially neutralized anti-PP1P^k antibodies. Human plasma was also capable of reducing anti-PP1P^k titers with neutralization capability surpassing that of pigeon egg white, and there were individual differences in neutralization capability. 【Conclusion】 The anti-PP1P^k was a blend of antibodies encompassing both IgM and IgG types, exhibiting cold reactivity, and having the potential for complement activation. Human plasma emerges as an effective modulator for diminishing the efficacy of anti-PP1P^k. Plasma transfusion holds promise as a therapeutic avenue for addressing recurrent miscarriages in pregnant individuals with the p phenotype.

Objective To explore the clinical characteristics of patients with autoimmune glial fibrillary acidic protein(GFAP) astrocytosis with central nervous system inflammation as the main manifestation.Methods Twenty-one patients with autoimmune GFAP astrocytosis with positive cerebrospinal fluid GFAP antibody were collected from January 2017 to April 2020.The clinical data of 14 patients with cerebrospinal fluid GFAP antibody positive were retrospectively analyzed.Results Among the 14 patients,4 were female and 10 were male.The age of onset was(42±16) years old.The main clinical manifestations of the patients were headache(13/14),fever(13/14),disturbance of consciousness(11/14),mental symptoms(10/14),epilepsy(4/10),defecation disorder(8/14),hypoxemia(6/14),limb paralysis(2/14),etc.MRI showed abnormal enhancement of intracranial meninges in 13 cases(13/14) and spinal cord involvement in 5 cases(5/14).Conclusion There are more males than females with autoimmune GFAP astrocytosis with cerebrospinal meningitis and other central system inflammation.MRI manifestations are complex.Intracranial and spinal cord can be involved at the same time.Intracranial lesions mainly involve meninges,which can be combined with cerebral cortex damage.In myelopathy,both the spinal cord and the spinal cord are involved,and the spinal cord membrane is mainly involved.

Background and Objectives: The influence of pre-intervention coronary physiologic status on outcomes post percutaneous coronary intervention (PCI) is not well known. We sought to investigate the prognostic implications of pre-PCI fractional flow reserve (FFR) combined with post-PCI FFR. Methods: A total of 1,479 PCI patients with pre-and post-PCI FFR data were analyzed. The patients were classified according to the median values of pre-PCI FFR (0.71) and post-PCI FFR (0.88). The primary outcome was target vessel failure (TVF) at 2 years. Results: The risk of TVF was higher in the low pre-PCI FFR group than in the high pre-PCI FFR group (hazard ratio, 1.82; 95% confidence interval, 1.15–2.87; p=0.011). In 4 group comparisons, the cumulative incidences of TVF at 2 years were 3.8%, 4.1%, 4.8%, and 10.2% in the high pre-/high post-, low pre-/high post-, high pre-/low post-, and low pre-/low post-PCI FFR groups, respectively. The risk of TVF was the highest in the low pre-/low post-PCI FFR group among the groups (p values for comparisons <0.05). In addition, the high pre-/low post-PCI FFR group presented a comparable risk of TVF with the high post-PCI FFR groups (p values for comparison >0.05). When the prognostic value of the post-PCI FFR was evaluated according to the pre-PCI FFR, the risk of TVF significantly decreased with an increase in postPCI FFR in the low pre-PCI FFR group, but not in the high pre-PCI FFR group. Conclusions Pre-PCI FFR was associated with clinical outcomes after PCI, and the prognostic value of post-PCI FFR differed according to the pre-PCI FFR.