Objective To evaluate the efficacy of endobronchial intubation with double-lumen tube using fiberoptic bronchoscope assisted by video laryngoscope.Methods Thirty patients of both sexes,who underwent failed endobronchial intubation with double-lumen tube using direct laryngoscope,aged 25-64 yr,with body mass index of 23-34 kg/m2,were randomly divided into 2 groups (n=15 each) using a random number table:fiberoptic bronchoscope group (group F) and fiberoptic bronchoscope assisted by video laryngoscope group (group VF).The patients were intubated with double-lumen tube under the guide of fiberoptic bronchoscope in group F.The patients were intubated with double-lumen tube under the guide of fiberoptic bronchoscope assisted by video laryngoscope in group VF.The rate of successful intubation,intubation time,and glottis and epiglottis exposure condition when the video laryngoscope was used in group VF were recorded.The patients were followed up postoperatively,and the development of intubation-related complications (sore throat,hoarseness and swallowing difficulty) was also recorded.Results Compared with group F,the intubation time was significantly shortened,and the success rate of intubation at first attempt and second success rate of intubation were significantly increased in group VF (P＜0.05).There was no statistically significant difference in the incidence of intubation-related complications between the two groups (P＞0.05).Conclusion Video laryngoscope provides better efficacy for endobronchial intubation with double-lumen tube using fiberoptic bronchoscope.

Objective To explore the immune status of CD4+ T cell subsets in the peripheral blood of patients with progressive non-segmental vitiligo (NSV).Methods Mononuclear cells were isolated from the peripheral blood of 30 patients with progressive NSV and 30 healthy controls by using Ficoll density gradient centrifugation.Flow cytometry was performed to determine the proportions of CD4+ T cell subsets.Enzyme-linked immunosorbent assay (ELISA) was conducted to detect serum levels of cytokines secreted by CD4+ T cell subsets.Results The proportions of Th1 and Th17 cells in the peripheral blood were significantly higher in the patients with progressive NSV than in the healthy controls (Th1 cells:8.68％ ±4.54％ vs.5.64％ ± 3.83％,P ＜ 0.05;Th17 cells:1.96％ ± 1.07％ vs.1.17％ ± 0.6％,P ＜ 0.05),while there were no significant differences in the proportions of Th2 or Treg cells between the patients and healthy controls (both P ＞ 0.05).The patients with progressive NSV also showed significantly higher ratios of Th 1/Treg and Th17/Treg compared with the healthy controls (Th1/Treg ratio:1.32 ± 0.23 vs.2.38 ± 0.28,P ＜0.01;Th17/Treg ratio:0.29 ± 0.12 vs.0.41 ± 0.24,P ＜ 0.05),while the ratio of Th2/Treg did not differ between the patients and healthy controls.There were no significant differences in serum levels of interferon (IFN)-γ,interleukin (IL)-4 and transforming growth factor (TGF)-β1 between the patients and healthy controls (all P ＞ 0.05),while the serum level of IL-17A was significantly higher in the patients than in the healthy controls (23.08 ± 5.80 pg/mL vs.8.66 ± 1.83 pg/mL,P ＜ 0.05).Conclusions Effector Thl and Th17 cells are the dominant CD4+ T cell subsets in the peripheral blood of patients with progressive NSV,and the imbalance between the effector and suppressor (Treg) CD4+ T cell subsets may be one of the factors for autoimmune response in patients with vitiligo.

Objective To explore the action of immune function in benign infantile convulsions with mild gastroenteritis (BICE) pathogenesis by detecting the T cell activation and cytokine of BICE.Method Thirty-one infant patients with BICE hospitalized in the wards of department of neurology of The Children' s Hospital Zhejiang University School of Medicine from April 2012 to April 2013 were selected as the experiment group,while 23 healthy infants accepting health check-up in the same period were selected as the control group.Flow cytometry was adopted to detect the peripheral blood CD25 +/CD3 + CD4 +,CD69 + /CD3 +CD4 +,HLA-DR/CD3 + CD4 +,CD25 +/CD3 + CD8 +,CD69 +/CD3 + CD8 +,HLA-DR/CD3 + CD8 +,and IL-2,IL-4,IL-6,IL-10,TNF-α,INF-γlevels of the two groups.Results The peripheral blood HLA-DR/CD3 + CD4 +,HLA-DR/CD3 + CD8 + expression levels (7.300％ + 2.725％,29.560％+ 14.079％) of the experiment group were higher than those of the control group (t =2.110,2.649,P =0.040,0.011); the expression level of the peripheral blood IL-10 was 8.100 (5.800-19.700) pg/ml,which was significantly higher than that of the control group (z =-3.342,P ＜ 0.01).Conclusion There is a certain degree of immune dysfunction in BICE patients,and T cell activation subgroup and the cytokines may participate in the morbidity progress of BICE.

Objective To observe the effects of iguratimod ( IT) combined with methotrexate ( MTX) in patients with refractory rheumatoid arthritis ( rRA) . Methods Sixty patients with rRA were randomly divided into 2 groups ( n=30 each group) . The cases in treatment group received 50 mg.d-1 of iguratimod and 10 mg of MTX for 16 weeks. The cases in control group were treated by 10-15 mg of MTX. DAS28 was analyzed. Levels of VEGF and endostatin ( ES) were quantified. Results In the treatment group,after 16-week treatment,DAS28,levels of VEGF and ES were (3.0±1.2),(818.9±178.8) pg.mL-1, (337.8±132.6) ng.mL-1,and those in the control group were (5.7±1.9),(1000.2±245.9) pg.mL-1,(253.8±77.8) ng.mL-1,respectively. In the treatment group,DAS28 and VEGF after the treatment were significantly decreased as compared with those before the treatment ( P<0.01) . The decrement was more significant in the treatment group than in the control group ( P<0.01) . At the 16th week of treatment,ES was significantly increased as compared with that before the treatment ( P<0.01) , and there was a significant difference between the treatment group and the control group (P<0.01). Conclusion Iguratimod combined with MTX have a prominent effect on rRA with high safety. The efficacy of IT on RA might be related with decreasing VEGF release,increasing ES production and alleviating synovium angiogenesis.

Human has used maggot to treat diseases for thousands of years. In recent years, with abuse of antibiotic and the rising incidence of antibiotic resistance, maggot therapy, as a surgical alternative, is mainly applied to treat chronic infected wounds on account of its low cost, efficacy and safety. Its mechanisms are disinfection, bio-debridement and enhancement of tissue regeneration. Maggot therapy which serves as a kind of biological therapy is promising. However, living maggot therapy could result in inevitable complications, so that we should apply traditional Chinese medicine theory to investigate and develop new delivery method of maggot. The review summarizes the past and present of maggot therapy.
Animals ; Chronic Disease ; therapy ; Debridement ; adverse effects ; economics ; history ; methods ; History, 15th Century ; History, 16th Century ; History, 17th Century ; History, 18th Century ; History, 19th Century ; History, 20th Century ; History, 21st Century ; History, Ancient ; History, Medieval ; Humans ; Larva ; growth & development ; physiology ; Medicine, Chinese Traditional ; adverse effects ; economics ; history ; methods ; Treatment Outcome ; Wound Healing ; physiology ; Wound Infection ; therapy

Objective:To discuss the stability of mixed standard application solution by volatilization organic matter (benzene, toluene, xylene, ethylbenzene, acetone, butanone, Ethyl acetate, butyl ester, trichloroethylene) in workplace air.Methods:A total of 11 kinds volatilization organic compounds were separated by capillary chromatographic column, and detected with flame ionization detector. The stability of mixed standard application solution was judged by studying three paratemers during the placement period, such as the linear correlation coefficient of the standard curve, the relative response values of the highest and lowest concentration levels and the accuracy of the measured values of the quality control samples.Results:Within 187 days, the linear correlation coefficient of each compound was ≥0.999. The changes of relative response values at the highest and lowest concentration levels were both <10%; The measured values of toluene were all in the reference range.Conclusion:The mixed standard application solution is stable and reliable within 187 days of storage.

Objective:To discuss the stability of mixed standard application solution by volatilization organic matter (benzene, toluene, xylene, ethylbenzene, acetone, butanone, Ethyl acetate, butyl ester, trichloroethylene) in workplace air.Methods:A total of 11 kinds volatilization organic compounds were separated by capillary chromatographic column, and detected with flame ionization detector. The stability of mixed standard application solution was judged by studying three paratemers during the placement period, such as the linear correlation coefficient of the standard curve, the relative response values of the highest and lowest concentration levels and the accuracy of the measured values of the quality control samples.Results:Within 187 days, the linear correlation coefficient of each compound was ≥0.999. The changes of relative response values at the highest and lowest concentration levels were both <10%; The measured values of toluene were all in the reference range.Conclusion:The mixed standard application solution is stable and reliable within 187 days of storage.

Hip arthroscopy has become a routine treatment for the localized hip lesions.With the rapid development of arthroscopy,the number of surgeries has increased greatly.Though hip arthroscopy is considered as low risk operation,its complications have been constantly reported and noted.There are two major types in hip arthroscopy surgeries:conventional operative complications and special complications.Conventional operative complications include venous thromboembolism,hemorrhage,and pain.Special complications are associated with arthroscopic techniques and local anatomical structures of the hip,such as the perineal nerve,the lateral femoral cutaneous nerve,the acetabular labium or the iatrogenic injury of the cartilage surface of the femoral head.Hip arthroscopy has obvious advantages such as small surgical wound and rapid recovery,but its complications can not be ignored.Joint surgeons must fully recognize it and keep vigilant so as to avoid complications as much as possible.This review will systematically elaborate the complications of hip arthroscopic surgery from general and special aspects so as to provide ideas for reducing the occurrence of complications in hip arthroscopic surgery.

Objective To evaluate the efficacy and safety of non-steroidal anti-inflammatory drugs (NSAIDs) in preventing heterotopic ossification after hip arthroscopy.Methods Literature search was conducted in PubMed,Embase,Cochrane Library,CNKI and Wanfang data with time range from January 1973 to November 2017.Clinical case control articles on NSAIDs in preventing heterotopic ossification after hip arthroscopy were screened based on the inclusion and exclusion criteria.Meta analysis was done using RevMan 5.3 software to investigate the incidence of complications such as heterotopic ossification and gastrointestinal bleeding after hip arthroscopy in patients taking NSAIDs orally.Results Six articles were included in the study,with a total of 754 cases and 536 controls.NSAIDs reduced the incidence of heterotopic ossification after hip arthroscopy (RR =0.09,95％ CI 0.03-0.27,P ＜ 0.05).Selective COX-2 inhibitor celecoxib (RR =0.17,95％ CI 0.03-0.91,P ＜ 0.05) and PG synthase inhibitor of naproxen (RR =0.17,95％ CI 0.09-0.32,P ＜ 0.05) were also effective in preventing heterotopic ossification.There was no significant difference in the incidence of gastrointestinal complications between the cases and controls after NSAIDs prophylaxis (RR =2.17,95％ CI 0.92-5.12,P ＞ 0.05).Conclusion NSAIDs can effectively reduce the incidence of heterotopic ossification after hip arthroscopy and does not increase the incidence of postoperative gastrointestinal complications.Therefore,it is effective and safe to use NSAIDs to prevent the occurrence of heterotopic ossification after hip arthroscopy.

Objective To prepare monoclonal antibodies (mAb) against the type Ⅳ secretion system protein VirB5 of Brucella melitensis and to provide a basis for pathgenic diagnosis and research of brucellosis.Methods Four SPF female BALB/c mice were subcutaneously immunized with purified VirB5 protein at a dose of 60 μg/mice,and immunization was strengthened every 2 weeks at a dose of 30 μg/mice,three times in total.Two weeks later,the orbital venous blood of mice was taken to determine the antibody titer,and then intraperitoneally injected for the fourth time to strengthen immunization.Three days later,mouse spleen cells were fused with mouse myeloma SP2/O cells in a ratio of 5:1.After 3 times of cell screening and monoclonal cloning,the hybridoma cell lines with stable secretion of VirB5 antibody were established;one BALB/c mouse was intraperitoneally injected with hybridoma cells,and ascites were collected and antibody was purified when the mouse abdomen was significantly enlarged.The immunological characteristics of mAbs were identified by indirect enzyme-linked immunosorbent assay (ELISA) and Western blotting.Results A total of 6 monoclonal cell lines (2-2,2-12,2-19,2-25,2-31 and 2-40) capable of secreting VirB5 antibody were established.Among them,the cell line 2-19 can stably secrete an antibody that specifically recognized the VirB5 protein,and the VirB5 antibody secreted by the cell line was identified as an IgG1 subtype,a kappa light chain,a mAb affinity constant of 1.6 × 108.The titer of ascites antibody of mouse intraperitoneally injected with hybridoma cell 2-19 was 1:51 200.Conclusion The high-affinity mAb of type Ⅳ secretion system protein VirB5 is successfully prepared,and the antibody can rapidly bind specifically to pathogens,providing an alternative material for establishment of brucellosis pathogen diagnostic method.