Objective To explore the percentage changes of peripheral T , B cell subsets and NK cells in chronic HBV infectors under different immune states and hepatitis B cirrhosis . Methods Seventy-five chronic HBV infectors, including 20 cases with immune clearance, 20 cases with immunodeficiency (inactive) and 35 cases with cirrhosis, and 20 healthy control were enrolled. The percentages of peripheral T and B lymphocyte subsets and NK cells were detected by Flow Cytometry. The differences of the groups were analyzed. Results Comparing with the control group, CD4+T cells were decreased in the other four groups (P<0.05). The sequence of CD4+T cells, from high to low, was the control group, the immunodeficiency group, the immune clearance group, the compensated cirrhosis group and the de-compensated cirrhosis group. CD4+/CD8+T cell and NK cell were lower , but CD8+T cell and B cell were higher in immune clearance group than that of the control group (P < 0.05). Patients in immunodeficiency group had lower ratio of CD4+/CD8+T cell and higher CD8+T cell than those in the control group (P < 0.05). In all the groups, patients with de-compensated cirrhosis showed highest ratio of CD4+ to CD8+ T cells and B cells, but lowest CD3+T, CD8+ T and NK cells (P < 0.05). Conclusions Results suggests immune dysfunction exists in patients with chronic HBV infection. It has potential clinical value in understanding patients′ immune states and progression of disease by detecting peripheral blood lymphocyte subsets and NK cells.

Objective To investigate the prevalence of colorectal cancer in community people in Shanghai,and clarify the necessity of colorectal cancer screening in community residents.Methods From April 2013 to September 2014,colonoscopy examination was carried out in people who participated in colorectal cancer screening in Shanghai with positive result of fecal occult blood test or with high-risk in colorectal cancer evaluated with the risk factors questionnaire.A total of 1 990 individuals were recruited.The colonoscopic results of them were retrospectively analyzed.Chi-square test was performed for statistical analysis.Results The 1 990 individuals received colonoscopy examination aged from 50 to 92.Among the 1 990 individuals with colonoscopy examination,colorectal polyps,colorectal cancer and carcinoid were found in 1 027 cases,and the total detection rate was 51.6％.The detection rate of colorectal polyps was 48.7％ (969/1 990),and the maximum diameter of polyps was 3.5 cm.The detection rate of colorectal polyps of the male was 59.3％ (532/897),which was higher than that of the female (40.0％,437/1 093),and the difference was statistically significant (x2 =73.7,P＜0.01).The detection rate of colorectal polyps in group 50 to 60 (not include 60) years old,60 to 70 (not include 70) years old,70 to 80 (not include 80) years old and ≥80 years old was 37.5％ (139/371),48.7％ (524/1 075),55.9％ (248/444) and 58.0％ (58/100),respectively.The difference was statistically significant (x2 =31.3,P＜0.01).The detection rate of colorectal cancer was 2.7 ％ (54/1 990).The detection rate of male rectal cancer was 3.8％ (34/897),which was significantly higher than that of female (1.8％,20/1 093),and the difference was statistically significant (x2 =7.2,P＜0.05).The detection rate of colorectal cancer in group 50 to 60 (not include 60) years old,60 to 70 (not include 70) years old,70 to 80 (not include 80) years old and ≥80 years old was 1.6％ (6/371),1.9％ (20/1 075),4.3％ (19/444) and 9.0％ (9/100),respectively.The difference was statistically significant (x2 =23.7,P＜0.01).The detection rate of rectal carcinoid was 0.2 ％ (4/1 990).Conclusions The prevalence of colorectal polyps and cancer is high in screening community people with high-risk of colorectal cancer.Colorectal cancer screening in community people ≥ 50 years old with sequential screening method is important.

Background:Colorectal polyps are common gastrointestinal diseases,which are closely related to the development of colorectal cancer. Aims:To investigate the clinical features of high-risk people with intestinal polyps in colorectal cancer screening. Methods:People in Hongkou District,Shanghai,who were positive in fecal occult blood test or of the high risk category in colorectal cancer questionnaire from April 2013 to December 2014 were enrolled,and colonoscopy was performed at Branch of Shanghai First People’s Hospital. The overall detection rate,gender,age,location of lesion, morphology,and pathology were analyzed. Results:A total of 985 patients with colorectal polyps were recruited in this study. The overall detection rate of polyps was 48. 7% . The prevalence of colorectal polyps was significantly higher in males than in females(58. 7% vs. 38. 9% ;χ2 = 79. 788,P < 0. 01). The detection rates of colorectal polyps in different age groups were statistically significant(χ2 = 23. 820,P < 0. 01). Detection rate of polyps was significantly higher in left colon than in right colon(62. 4% vs. 37. 6% ;χ2 =190. 643,P <0. 01). The overall detection rate of protruding lesion 0-Ⅰwas 94. 5% ,and slightly elevated lesion 0-Ⅱa was 48. 3% . Detection rate of adenomatous pylops was significantly higher than non-adenomatous pylops(59. 3% vs. 47. 1% ;χ2 = 27. 326,P < 0. 01). The histological results were differed between two examination in 119 patients. Only 17. 8% of the patients operated were followed up by colonoscopy,and polyps recurred in 62. 3% of them. Conclusions:A higher incidence of colorectal polyps is found in people with high risk of colorectal cancer screening. High quality colonoscopy examination and effective operation in time can reduce the incidence of colorectal cancer.

Objective To observe the changes of the height of intervertebral discs of the segments adjacent to the fusional and instrumental area after the operation and the relation between the changes of height of intervetebral discs in the adjacent segments and the angle of the pedicle screw.Methods Thirty-one patients who underwent internal fixation from September 2004 to March 2006 were retrospectively analyzed.The intervertebral discs height of adjacent segment was studied.The influence of"Suspensory fixation"on the changes of height of adjacent intervertebral discs was compared.The relation between the changes of the height of the upper adjacent intervertebral discs and the angle of pedicle screw was analyzed.Results The mean follow-up period for the patients was 13.5 months(10-16 months).In the operating-group,the height of the adjacent intervertebral disc decreased slightly,but the changes had no statistical significance(P＞0.05).Between the group fixed between L5 and S1 and group fixed between L4and L5,the changes of the height of the upper adjacent intervertebral discs had no obvious difference(P＞0.05).In the group fixed between L4 and L5,there had no obvious difference between the changes of the height of the upper adjacent intervertebral discs and the changes of the height of the lower one(P＞0.05).When the operating-group were divided into two groups according to the angle of pedicle screw (＜6°or＞6°),the changes of the height of the upper adjacent intervertebral discs had no obvious difference(P＞0.05).But there had positive and correlative relation between changes of the height of the adjacent intervertebral discs and the angle of pedicle screw(r=0.373,P=0.039).Conclusion "Suspensory fixation"has no different influence on the changes of height of adjacent intervertebral discs.There has no difference on the risk of degeneration between upper and lower segment adjacent to the fusional area.There has positive and correlative relation between the changes of height of the upper intervertebral discs adjacent to the fusional area and the angle of pedicle screw,that is,the bigger the angle is,the more clearly the height of adjacent intervertebral discs will change.

To investigate the problem and solution strategy of the clinical medical education of foreign students by applying the simulation teaching in Ob/Gyn clinical clerkship of foreign students. It demonstrates that combing the simulation teaching for diagnosis and treatment with the heuristic teaching can help the student overcome language barrier, the lack of basic theoretical knowledge and shortage of clinical teaching resources and it's of great significance in clinical medical education of foreign students.

Objective To investigate the safety and feasibility of laparoscopic pylorus-preserving pancreaticoduodenectomy.MethodsThe data of 59 patients with laparoscopic pancreaticoduodenectomy in Shangjin hospital of West China hospital of Sichuan University from January 2014 to December 2015 were analyzed retrospectively.The general data,operative time,estimated blood loss,conversion rate,time to liquid diet,postoperative hospital stay and complications were analyzed.Results The laparoscopic pylorus-preserving pancreaticoduodenectomy were successfully performed in 56 cases,the successful rate was 94.9%,the other 3 patients were converted to laparotomy for superior mesenteric vein/portal vein involvement.The operative time was 255~510 minutes,with mean operative time (384±145) minutes,the intraoperatve blood soss was 50~800 mL,with mean estimated blood loss (148±28)mL,the time to liquid diet was 1.0~4.0 days,with average time (3.2±1.1)days,the postoperative hospital stay was 5.0~53.0 days,with average time (10.3±2.6)days.After surgery,16 cases suffered from complication,the rate was 27.1%.The most common complication was pancreatic fistula which occurred in 13 cases including 12 cases of grade A and 1 case of grade pancreatic fistula.No grade C pancreatic fistula occurred in this series.Six patients suffered from delayed gastric emptying.One patient suffered from bile leakage.Conclusion Laparoscopic pylorus-preserving pancreaticoduodenectomy was safe and feasible.Pylorus-preserving does not increase the incidence of delayed gastric emptying.

Scleroglucan produced by Sclerotium spp. is a non-ionic polysacchari de biopolymer which has excellent viscosifying power in a wide variety of reservoi r brines snows high shear resistance and possesses good thermal stability. This article reviews the production of Scleroglucan , the influence of the conditions to the fermentation, and the application in the oil field.

Objective:To study the effect of glucosamine combined with sodium hyaluronate on serum interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) levels in patients with Kashin-Beck disease (KBD).Methods:In a prospective design, patients with KBD admitted to South Hospital of Yantaishan Hospital from January 2017 to January 2019 were selected and divided into control, observation, and replacement groups. The control group was treated with glucosamine sulfate, the observation group was treated with intra-articular injection of sodium hyaluronate on the basis of the control group, and the replacement group was treated with artificial knee arthroplasty. The clinical efficacy, visual analogue scale (VAS) and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) of the three groups were compared before treatment, 6 weeks and 6 months after treatment. Blood samples were collected from the patients, and the serum levels of IL-1β and TNF-α were measured by enzyme-linked immunosorbent assay (ELISA) to compare the serum levels of IL-1β and TNF-α in the three groups before treatment, 6 weeks and 6 months after treatment.Results:The age of patients in the control group was (53.76 ± 7.33) years old, including 19 males and 23 females. The age of patients in the observation group was (54.18 ± 7.06) years old, including 20 males and 22 females. The age of the replacement group was (55.17 ± 6.43) years old, including 17 males and 13 females. The total effective rate in observation group (92.86%, 39/42) was significantly higher than that of the control group (76.19%, 32/42, χ 2 = 4.459, P < 0.05). At 6 weeks and 6 months after treatment, the VAS scores in the observation group [(4.10 ± 1.21), (3.16 ± 0.95) points] were significantly lower than those in the control group [(5.48 ± 1.17), (4.06 ± 0.74) points, P < 0.05]; at 6 weeks after treatment, the VAS score in the replacement group [(3.28 ± 0.89) points] was significantly lower than that in the observation group ( P < 0.05). At 6 weeks and 6 months after treatment, the WOMAC scores in the observation group [(40.72 ± 4.19, 25.86 ± 3.02) points] were significantly lower than those in the control group [(48.29 ± 2.16), (36.81 ± 3.13) points, P < 0.05]; the WOMAC scores in the replacement group [(29.68 ± 4.22), (23.57 ± 3.86) points] were significantly lower than those of the observation group ( P < 0.05). The serum levels of IL-1β [(9.28 ± 2.74), (6.85 ± 2.27) pg/ml] and TNF-α [(12.66 ± 4.54), (10.34 ± 3.48) pg/ml] in the observation group were significantly lower than those in the control group [(12.78 ± 2.79), (10.36 ± 2.63), (15.51 ± 4.63), (14.64 ± 4.27) pg/ml, P < 0.05], the serum levels of IL-1β [(6.12 ± 3.55), (5.39 ± 2.23) pg/ml], TNF-α [(10.42 ± 3.13) , (8.19 ± 3.15) pg/ml] in the replacement group were significantly lower than those in the observation group at 6 weeks and 6 months after treatment ( P < 0.05). Conclusion:Glucosamine combined with intra-articular injection of sodium hyaluronate can relieve inflammation, improve pain and promote joint function recovery in patients with KBD, but there is still a certain gap compared with knee arthroplasty.

OBJECTIVETo compare the early clinical outcomes of primary total knee arthroplasty in the valgus knee between mobile-bearing prosthesis and fixed-bearing prosthesis.

METHODSFrom January 2011 to December 2013, 17 patients (23 knees) treated by the same surgeon were selected for a retrospective study in the First Hospital of Jilin University, including 2 males and 15 females with a mean age of 61.5 years old (48 to 75 years). The pre-operative diagnosis included osteoarthritis (14 patients, 19 knees) and rheumatoid arthritis (3 patients, 4 knees). The patients with valgus deformity were divided into group A and group B. The patients in group A were treated with the fixed-bearing prosthesis (9 patients, 12 knees), and the patients in group B were treated with the mobile-bearing prosthesis (8 patients, 11 knees). The Knee Society Score (KSS), Hosptial for Special Surgery (HSS), Western Ontario MacMaster (WOMAC), the range of motion (ROM) and femorotibial angle were collected at pre-operation and post-operation follow-up for statistical analysis.

RESULTSAll the patients were followed up, and the duration ranged from 6 to 36 months (mean 25 months). The valgus deformity was corrected in all patients, and there were significant differences for all patients between pre-operation and post-operation at the latest follow-up with regard to the KSS knee score, function score, HSS score, WOMAC score, ROM and femorotibial angle (P<0.01). There were no significant differences in KSS knee score, function score, HSS score, WOMAC score, improvement in ROM and femorotibial angle between two groups at the latest follow-up. However there were significant differences in ROM (P<0.05) between fixed-bearing group (101.8±8.8)° and mobile-bearing group (108.4±7.2)° at the latest follow-up. No case with spin-out of mobile bearing was observed. There were no complications in any patient, such as infection, common peroneal nerve injury, dislocation and instability. The X-ary imaging showed no osteolysis or implant loosening.

CONCLUSIONThe early clinical outcomes of primary total knee arthroplasty by using mobile-bearing prosthesis and fixed-bearing prosthesis are satisfactory for the treatment of the valgus knee, and the short term clinical outcomes of mobile-bearing TKA and fixed-bearing TKA are similar.

Aged ; Arthritis, Rheumatoid ; physiopathology ; surgery ; Arthroplasty, Replacement, Knee ; methods ; Female ; Humans ; Joint Deformities, Acquired ; surgery ; Knee Joint ; surgery ; Male ; Middle Aged ; Osteoarthritis, Knee ; physiopathology ; surgery ; Range of Motion, Articular ; Retrospective Studies

BACKGROUND:During degeneration of cervical spine, biochemical changes appeared in intervertebral disc cel s. During this process, a variety of inflammatory cytokines may lead to disc herniation, which stimulates the production of a variety of inflammatory factors from surrounding adjacent tissue.
OBJECTIVE:To explore the expression and significance of interleukin-1β, interleukin-6 and cyclooxygenase 2 in patients with different clinical symptoms of cervical spinal cord oppression.
METHODS:Protrusion of the intervertebral disc or disc of responsibility among patients with anterior disc resection and internal fixation were divided into three groups according to clinical symptoms:myelopathic symptom group, nerve root symptom group and cervical spine trauma group. Intervertebral disc received hematoxylin-eosin staining and immunohistochemical staining for morphological observation. Positive cel s were counted according to the result of immunohistochemical staining.
RESULTS AND CONCLUSION:(1) Hematoxylin-eosin staining results showed visible inflammatory cel infiltration and new blood vessel formation in the myelopathic symptom group and nerve root symptom group. No remarkable inflammatory cel infiltration or new blood vessel formation was seen in cervical spine trauma group. (2) Immunohistochemical staining interleukin-1β-, interleukin-6-positive cel s were seen in the myelopathic symptom group. Cytoplasm was stained tan. Cyclooxygenase 2-positive cel s showed a low number. The numbers of interleukin-1β-, interleukin-6-and cyclooxygenase 2-positive cel s were significantly more in the nerve root symptom group than in the myelopathic symptom group. The numbers of interleukin-1β-, interleukin-6-and cyclooxygenase 2-positive cel s were smal in the cervical spine trauma group. (3) Expression rate and IA value of interleukin-1β, expression rate and IA value of interleukin-6 were significantly higher in the myelopathic symptom group and nerve root symptom group than in the cervical spine trauma group (P<0.05). Expression rate and IA value of cyclooxygenase 2 were significantly higher in the nerve root symptom group than in the cervical spine trauma group. (4) These results suggested that interleukin-1β, interleukin-6 and cyclooxygenase 2 expression could be found in the cervical intervertebral disc after protrusion, and played a role in early degeneration of cervical intervertebral disc. The expressions of these inflammatory factors were significantly different in patients with different clinical symptoms of cervical spinal cord compression.