BACKGROUND:Clavicular hook plate fixation is a extensively used method in repair of acromioclavicular dislocation in recent years. The metal hook of the clavicular hook plate occupied subacromial space. Some patients affected joint pain. Therefore, it is necessary to find a better fixation material to replace clavicular hook plate. OBJECTIVE:To explore the curative effect of threaded rivets versus clavicular hook plate in treatment of the Tossy III acromioclavicular joint dislocation. METHODS:We retrospectively analyzed clinical data of 51 cases of type Tossy III acromioclavicular joint dislocation. Al fol ow-up data were obtained including 27 cases in the clavicular hook plate fixation group and 24 cases in the threaded rivets group. Imaging results, clinical therapeutic effects and complications were compared and analyzed after fixation in both groups. RESULTS AND CONCLUSION:No significant difference in Japanese Orthopaedic Association scores was detected between the clavicular hook plate fixation group and threaded rivets group (P>0.05). At 3 months after fixation, the incidences of subacromial impingement syndrome and acromial bone erosion were higher in the clavicular hook plate fixation group compared with the threaded rivets group, and the visual analogous scale scores were significantly higher than the threaded rivets group (P<0.05). Results suggested that both two methods can be used to treat type Tossy III acromioclavicular joint dislocation, with similar clinical curative effects, but the threaded rivets have the advantage of preventing the postoperative complications such as acromial bone impact and erosion, subacromial impingement and lysis.

Objective To explore the feasibility of establishing animal model of schistosomiasis through subcutaneous injection of IMDM liquid and intramuscular injection of IMDM liquid both of which contained the cercariae.Methods The mice were infected with schistosome cercariae by three different ways: subcutaneous injection(Group A),intramuscular infection(Group B) and the classical method: skin infection(Group C).Forty-five days post-infection, the mice were sacrified and the adult schistosomes were investigated. The serum IgG antibodies were detected by indirect ELISA in 15 and 45 days after infection. Results The recovery adult worm rates were 39.2% in Group A,32.3% in Group B and 72.8% in Group C,and there was a significant difference among them (P

Abstract: Objective　To analyze the impact of the flood disaster on the distribution of Oncomelania snails in 2020 in Wuhu City, to provide scientific basis for formulating the "14th Five-Year Plan" for schistosomiasis control and precise prevention and control measures in Wuhu City. Methods　Systematic sampling combined with environmental spot check was used to investigate the distribution of snails in the historical snail's environment, existing snail's environment and suspected snail's environment in Wuhu City. The collected snails were crushed and examined by microscope to understand the death and life of snails and the infection of Schistosoma japonicum, and the density of live snails and other indicators were counted. Results　The historical area of snails was 14 475.24 hm2 in Wuhu City, and the existing area of snails was 4 588.72 hm2, including 4 210.32 hm2 for lake type and 378.40 hm2 for hill type snails. The average occurrence rate of live snails was 14.59%, and the average density of live snails was 0.50 snails/0.1 m2 in Wuhu City. There were 2 745 snail breeding environments, of which 491 were lake type and 2 254 are hill type, accounting for 17.89% and 82.11% respectively. The existing snail area was mainly distributed in the beaches and ditches, accounting for 92.51% and 6.29% of the existing snail area respectively. Some snails were distributed in ponds, paddy fields and other environments. Among all the historical snail habitats, the majority were class Ⅱ and class Ⅲ environments (which still have the basic conditions for snail breeding at present), with a total of 1 739 sites (blocks), accounting for 63.35% of the total environment. No schistosomiasis infected snails have been found, and the newly discovered and recovered snails cover an area of 268.21 hm2 in Wuhu City. Conclusions　The distribution of snails is extensive in Wuhu City, and snails are mostly distributed in beaches, which are vulnerable to the impact of flood disasters. The spread of Oncomelania snails is found in 30 marshlands in 3 counties in this survey. It is necessary to continue to strengthen snail monitoring after disasters, and take class Ⅱ and class Ⅲ environments as key areas for snail monitoring, so as to find, identify and evaluate the risk of schistosomiasis transmission as soon as possible, to avoid or reduce the impact of flood disasters on the process of schistosomiasis control, and promote the process of schistosomiasis elimination.

OBJECTIVE: To investigate the efficacy of combined medical treatment on auditory neuropathy spectrum disorder and the effect of related factors on the prognosis. METHOD: Eleven cases (22 ears) diagnosed as auditory neuropathy spectrum disorder using multiple criteria including pure tone auditory threshold, impedance audiometry, acoustic reflexes, distortion products otoacoustic emission (DPOAE) and auditory brainstem response (ABR) were subjected to combined medical treatment . Eleven auditory neuropathy spectrum disorder patients diagnosed during the corresponding period but refused treatment were selected as control group. The change of pure tone auditory threshold and speech discrimination score after treatment or follow-up were evaluated for both 2 groups, and the relationship between the patients' gender, age, accompanying symptoms and curative effect were also analyzed. Data were analyzed by SPSS 19.0 statistical software using pared-sample t-test, independent-sample test and Pearson's chi-square test. RESULT: The effective rate of combined medical therapy was 59.09% (13/22) in the therapy group. PTA levels before and after-treatment were (53.92 +/- 18.86) dB HL and (47.44 +/- 14.98) dB HL respectively in 22 ears with the combined medical therapy, the improvement of which showed statistically significance (t = 5.20, P < 0.05). No obvious hearing change was noted in the 11 patients who refused therapy (P > 0.05). Speech discrimination score before and after-treatment were (29.20 +/- 25.80)% and (41.60 +/- 22.90)% respectively for the treatment group. The average improvement of speech discrimination score was (12.40 +/- 13.80)% with statistically significant difference (t = 4.02, P < 0.05). Patients accompanied with tinnitus had relatively poorer effect compared with individuals without tinnitus (t = -3.85, P < 0.05). Age is negatively correlated with the prognosis (r = -6.72, P < 0.05). Gender had no effect on the prognosis (P > 0.05). CONCLUSION The combined medical therapy with glucocorticoids helps improving the pure tone auditory threshold and speech discrimination score of auditory neuropathy spectrum disorder. In light of our findings we support the combined medical therapy as an option for patients with auditory neuropathy spectrum disorder.
Adolescent ; Child ; Child, Preschool ; Female ; Glucocorticoids ; therapeutic use ; Hearing Loss, Central ; drug therapy ; Humans ; Infant ; Male ; Treatment Outcome ; Young Adult

To provide theoretical and practical basis for the successful formulation design of physically-mixed inhalation dry powder of proteins and peptides, related references were collected, analyzed and summarized. In this review drug micronization technology and commonly used carriers for inhalation dry powder preparation were introduced. For proteins and peptides, supercritical fluid technology and spray-drying are more suitable because of their capabilities of keeping drug activity. Being approved by U. S. Food and Drug Administration, lactose has been extensively used as carriers in many inhalation products. Formulation and process factors influencing drug deposition in the lung, including carrier properties, drug-carrier ratio, blending order, mixing methods, mixing time and the interaction between drug and carrier, were elucidated. The size, shape and surface properties of carries all influence the interaction between drug and carrier. Besides, influence of micromeritic properties of the dry powder, such as particle size, shape, density, flowability, charge, dispersibility and hygroscopicity, on drug deposition in the lung was elaborated. Among these particle size plays the most crucial role in particle deposition in the lung. Moreover, based on the mechanisms of powder dispersity, some strategies to improve drug lung deposition were put forward, such as adding carrier fines, adding adhesive-controlling materials and reprocessing micronized drug. In order to design physically-mixed inhalation dry powder for proteins and peptides with high lung deposition, it is essential to study drug-carriers interactions systematically and illustrate the potential influence of formulation, process parameters and micromeritic properties of the powder.
Administration, Inhalation ; Drug Carriers ; chemistry ; Dry Powder Inhalers ; Lactose ; chemistry ; Particle Size ; Peptides ; administration & dosage ; Powders ; administration & dosage ; Surface Properties ; Technology, Pharmaceutical

The authors attempted to sort out the training experience of higher education pedagogy in America , and truthfully recorded the understanding and experience of the higher medical elite education of America during visiting the University of Nebraska Medical Center .Combined with the current situation of high medical education in Chi-na, the formation and the embodiment of medical elite education mode of America has also been concretely ana -lyzed , which was expected to bring new enlightenment and reference for the development of high medical elite edu -cation mode and the medical teaching remodeling .

Objective To observe the effect of aerobic exercise of different intensities on type Ⅱ collagen,glycosaminoglycan (GAG) and chondrocyte apoptosis in rabbits modeling knee osteoarthritis (OA),so as to explore the preventive effect and its possible mechanism.Methods Twenty healthy New Zealand white rabbits were randomly divided into Groups A,B,C and D,each of 5.Group A was allowed free activity in a cage for 9 weeks.Group B was allowed free activity for 4 weeks,then an OA model was established using papain and confirmed via MRI 1 week later,Another 4 weeks of free activity were then allowed.Groups C and group D were given running training for 20 minutes a day at 0.5 km/h,3 times a week,and then 20 minutes a day at 1.5 km/h,5 days a week on a treadmill for 4 weeks.Nine weeks later,all 4 groups of rabbits were killed and the articular cartilage damage of each group was compared using Mankin scoring,and expression of type Ⅱ collagen,GAG content and chondrocyte apoptosis in the cartilage.Results After the intervention,the average Mankin score,expression of type Ⅱ collagen and GAG content of groups B,C and D were significantly lower than those of group A,and all of those values in group B were significantly lower than those of group D.After 9 weeks the chondrocyte apoptosis rate of group A was significantly lower than that of the other groups,and that of groups C and D was significantly lower than that of group B.Conclusion Aerobic exercise may prevent knee articular cartilage degeneration through inhibiting reduction in the amount of type Ⅱ collagen and GAG in the cartilage matrix.It may be related to decreasing the chondrocyte apoptosis.

Objective To study the effects of simvastatin on proliferation and apoptosis in rat mesangial cells in vitro, and to investigate the signal pathways involved in apoptosis induced by simvastatin. Methods Cultured mesangial cells were treated with simvastatin. Proliferation of mesangial cells was examined by MTT assay. Simvastatin-treated apoptotic mesangial cells were observed by electron microscopy. Propidium iodide (PI) staining and flow cytometry were employed for quantitative measurement of apoptosis. Caspase-3 activation was determined by CaspGLOW Green Caspase-3 Staining Kit. Results (1)Simvastatin significantly inhibited proliferation of mesangial cells compared with control (P

Objective To explore the value of serum microRNA-155-5p and -133a-3p (miR-155-5p and miR-133a-3p) expression for the diagnosis and prognosis evaluation of sepsis. Methods A prospective observational study was conducted. 105 sepsis patients admitted to emergency intensive care unit (EICU) of the First Affiliated Hospital of Zhengzhou University from January 2015 to January 2016 were enrolled. They were divided into three groups according to the severity: 35 patients with sepsis, 35 with severe sepsis, and 35 with septic shock. At the same time, 35 healthy persons were selected as the control group. According to the prognosis, the patients were divided into improved group (n = 70) and in-hospital death group (n = 35). The clinical data of all the subjects were collected. The mRNA expressions of miR-155-5p and miR-133a-3p were determined by reverse transcription-polymerase chain reaction (RT-PCR). The receiver-operating characteristic curve (ROC) was plotted to evaluate their clinical value for the diagnosis and prognosis of sepsis. The binary logistic regression was used to analyze the risk factors affecting the prognosis of sepsis patients. Results ① The mRNA expressions of serum miR-155-5p and miR-133a-3p were gradually increased with the aggravation of sepsis. The mRNA expression of miR-155-5p (2-ΔCt) in sepsis, severe sepsis, sepsis shock groups was 1.89±0.48, 2.21±0.41, 2.79±0.73 (F = 23.737, P = 0.000), and the mRNA expression of miR-133a-3p (2-ΔCt) was 1.38±0.31, 1.74±0.65, 2.08±0.47, respectively (F = 27.710, P = 0.000). It was shown by ROC curve analysis that the area under the ROC curve (AUC) of serum miR-155-5p and miR-133a-3p for the diagnosis of sepsis was 0.855 [95% confidence interval (95%CI) = 0.761-0.949] and 0.769 (95%CI = 0.666-0.872) respectively. The cut-off value of miR-155-5p for the diagnosis of sepsis was 1.64, the sensitivity was 85.3%, and specificity was 80.6%. While the cut-off value of miR-133a-3p was 0.82, the sensitivity and specificity were 97.9% and 54.8% respectively. ② Compared with improved group, the patients of in-hospital death group were more serious, and procalcitonin (PCT), C-reactive protein (CRP), D-dimer, lactic acid (Lac), sequential organ failure assessment (SOFA) score, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, and the mRNA expressions of miR-155-5p and miR-133a-3p were significantly increased (all P < 0.05). While there was no statistically significant difference in gender, age, white blood cells (WBC), serum creatinine (SCr) between the two groups (all P > 0.05). It was shown by binary logistic regression analysis that Lac [odds ratio (OR) = 0.514, 95%CI = 0.260-0.893, P = 0.024], sepsis severity (OR = 0.039, 95%CI = 0.023-2.955, P = 0.016), SOFA score (OR = 0.668, 95%CI = 0.474-0.825, P = 0.001), serum miR-155-5p expression (OR = 0.117, 95%CI = 0.020-0.530, P = 0.007) were the risk factors affecting the prognosis of patients with sepsis. Conclusions The expression of serum miR-155-5p and miR-133a-3p may be used as specific indicators for the diagnosis of sepsis. And the expression of miR-155-5p can be used as independent impact factor for the estimation of sepsis prognosis.

Objective To summarize the pattern and main characteristics of fatal cases related to medical disputes in Yancheng area. Methods Sixty fatal cases of medical disputes were retrospectively analyzed to elucidate the annual incidence, characters of distribution of hospitals, gender and age of the decedents, types of diseases, and cause of death. Results Among 60 fatal cases, most cases happened in health clinics of county, township and village. There were more males than females. The major medical specialties in-volved included internal medicine, surgery, gynecology and pediatrics, with the internal medicine specialty having the highest incidence. Conclusion Police institutions have advantages in investigation of these cas-es in their jurisdictions, which could enhance the ability of local medicolegal examination.