Objective To introduce a new optimal operation for the reconstruction of thumb opposition in patients with late median nerve injury. Methods From July 1992 to January 2002, 46 patients of late median nerve injury with loss of thumb abduction were treated surgically by transposition of the flexor pollicis brevis muscle for the reconstruction of thumb opposition. There were 35 males and 11 females aging from 18 to 46 years with the average of 32 years. All of the patients suffered from median nerve injury and nerve repair had been undergone. The interval from injury to the second operation was 2.25 years ranging from 6 months to 4 years. Results All patients were followed up for 4-36 months with an average of 20 months. According to our functional evaluation system designed in 1992, the recovery ratio with favorable function was 100%, no complications and disadvantages were found. Conclusion The new optimal transpositional operation of the flexor pollicis brevis muscle for the reconstruction of thumb opposition is suitable for the patients with late median nerve injury, especially when the ulnar nerve branch to the deep head of the flexor pollicis brevis muscle is uninjured. This method has the following advantages: 1) Minimal operative trauma, only a small incision is required in contrast to the conventional method that need multiple incisions; 2)No other tendon transposition is needed, it does not interfere with other functions of the hand; 3) Postoperatively, it is unnecessary to keep many neighbouring joints in extreme flexion position, except for the thumb in opposition position, movements of all fingers and the wrist are not restrained.

BACKGROUND:To inhibit the expressions of prothrombin activator inhibitor 1 and tissue plasminogen activator is one potential target for the treatment of cerebral infarction. OBJECTIVE:To investigate the expressions of serum inflammatory cytokines in rats with cerebral infarction undergoing bone marrow mesenchymal stem cel transplantation combined with edaravone. METHODS:Sixty Sprague-Dawley rats were enrol ed to prepare models of focal cerebral infarction by middle cerebral artery occlusion, and were randomly divided into four groups. Rats were given intravenous injection of PBS via tail veins for 5 consecutive days as model group, rats were subjected to intravenous injection of 2.0×109/L bone marrow mesenchymal stem cel suspension (1 mL) via tail veins, twice daily for 5 days as stem cel transplantation group, and those were given intravenous injection of 30 mg edaravone combined with intravenous injection of 2.0×109/L bone marrow mesenchymal stem cel suspension (1 mL) via tail veins for 5 days, twice daily, as combined group. RESULTS AND CONCLUSION:Compared with the model group, modified neurologic severity scores were lower, expressions of serum prothrombin activator inhibitor 1 and tumor necrosis factor-αmRNA in the brain decreased, and the infarct area reduced in the stem cel transplantation and combined groups. And the changed levels of above indicators in the combined group were significantly larger than those of the stem cel transplantation group. In conclusion, combination of bone marrow mesenchymal stem cel transplantation with edaravone can promote neural function recovery after cerebral infarction.

Objective To discuss a optimal culture method of primary hippocampal neurons and a more suitable method of mor-phological observation ,and provide basis to the study of synapse in Alzheimer′s Disease .Methods Postnatal 0 -1 days (P0 -1 ) C57BL/6J mice were decollated and bilateral hippocampus were separated .Low level concentration of trypsin and mechanical disso-ciation were adopted .And culture medium without serum was used to culture neurons .After 17 days culturing ,transfected neurons with Green Fluorescent Protein(GFP) by calcium phosphate precipitation ,and then observed neurons and spines by fluorescence mi-croscope .Results The neurons looked good and healthy by using this method .And the axons ,dendrites and spines which were typ-ical structure of neurons were observed clearly after transfected with GFP .Conclusion The cultured hippocampal neurons look good by this method .And the morphological characteristics of neurons and spines are observed much more clearly after transfected GFP by calcium phosphate precipitation .

BACKGROUND:Numerous clinical studies have confirmed that the microenvironment at a spinal cord injury site can be obviously improved through hyperbaric oxygen therapy; however, what effect does hyperbaric oxygen have on the microenvironment of the injured brain? OBJECTIVE:To investigate the effect of hyperbaric oxygen therapy on nerve regeneration microenvironment and the recovery of rat nerve function after focal cerebral infarction. METHODS:Rat models of focal cerebral infarction were established by occlusion of the middle cerebral artery and subjected to hyperbaric oxygen therapy. Sham group and model group were established as comparison. In the sham group, rat models of focal cerebral infarction were established but did not receive any treatment. Rats in the model group were placed in a hyperbaric oxygen therapy chamber but the pressure and oxygen concentration were not administered. RESULTS AND CONCLUSION:Compared with the model group, the score of rat limb function at 16 days after treatment and the expression of growth associated protein 43 in the rat cerebral infarcted area at postoperative 14 days were significantly increased , but infarct volume at postoperative 24 hours was al significantly decreased in the hyperbaric oxygen therapy group (alP < 0.05). These results confirmed that hyperbaric oxygen therapy can improve nerve regeneration microenvironment and promote the recovery of rat nerve function after focal cerebral infarction.

BACKGROUND:Studies have shown that human telomerase reverse transcriptase (hTERT) has the ability to enhance cel proliferation, maintain telomere length, prolonged cel life cultured in vitro. OBJECTIVE:To observe the effect of hTERT gene-modified bone marrow mesechymal stem cel transplantation on neural function recovery of rats with cerebral infarction. METHODS:Rat models of middle cerebral artery occlusion were established and randomized into model group, cel transplantation group and hTERT-modified cel transplantation group, with 20 rats in each group. Rats in the three groups were respectively injected via tail vein with 1 mL PBS, passage 9 bone marrow mesenchymal stem cel suspension (2.5×107/L) and hTERT-modified passage 9 bone marrow mesenchymal stem cel suspension (2.5×107/L), respectively. Modified neurological severity scores were determined before and after transplantation; RT-PCR and western blot assay were used to measure hTERT expression at gene and protein levels; TUNEL method was adopted to detect cel apoptosis in the brain. RESULTS AND CONCLUSION:hTERT-modified bone marrow mesenchymal stem cels had prolonged cel cycle, and with the increase in passage number, the cels showed good growth with no changes in morphology. The expressions of hTERT mRNA and protein were superior in the hTERT-modified cel transplantation group than the cel transplantation group, and there was a significant difference (P < 0.05). Modified neurological severity scores and number of apoptotic cels were decreased significantly in the hTERT-modified cel transplantation group compared with the other two groups (P < 0.05). These findings indicate that hTERT-modified bone marrow mesenchymal stem cels can promote neural functional recovery of rats with cerebral infarction.

Objective To observe the clinical efficacy of ebastine combined with Runzao Zhiyang capsules in the treatment of patients with chronic urticaria. Methods A total of 126 patients with chronic urticaria admitted to Department of Dermatology of Tianjin Third Central Hospital from January 2015 to May 2017 were enrolled and they were divided into two groups by the random number table method. The patients in control group (62 cases) were given oral ebastine administration 10 mg once per day, and those in observation group (64 cases) received oral administration of ebastine 10 mg once per day combined with Runzao Zhiyang capsule 2 g, 3 times per day, the therapeutic course being 4 weeks. The changes of clinical efficacy and the symptom scores, including urticaria activity score (UAS) and dermatolo-gical disease life quality index (DLQI) scores of the two groups were observed after treatment of 4 weeks;the incidence of adverse reactions and the recurrence situation after drug withdrawal for 4 weeks at follow-up were analyzed. Results Compared with the control group, the total effective rate of the observation group was significantly increased [92.2% (59/64) vs. 79.0% (49/62), P ＜ 0.05]. After treatment, the overall UAS score and DLQI score in two groups were both significantly decreased, the degree of decrease in observation group were more siginificant than those in control group [UAS: 1.26 (0.52 - 7.35) vs. 1.68 (0.75 - 8.65), DLQI: 0.56±0.52 vs. 1.57±0.96, P ＜ 0.01]. In addition, the total decrease degree of symptom score reducing index (SSRI) in the observation group was significantly greater than that in the control group [(76±21)% vs. (69±23)%, P ＜ 0.05], the incidence of adverse reactions [7.8% (5/64) vs. 12.8% (8/62)] and recurrence rate [8.3% (3/64) vs. 23.8% (5/62)] in the observation group were obviously lower than those in the control group (both P ＜ 0.05). Conclusion The efficacy of ebastine combined with Runzao Zhiyang capsule in the treatment of patients with chronic urticaria is prominent and superior to that of using ebastine alone, the combined method is capable of elevating the therapeutic effect obviously and has less adverse reactions.

Objective To analyze the clinical data of brucellosis,and to provide references for brucellosis therapy.Methods The patients definitely diagnosed brucellosis at the First Affiliated Hospital of Zhengzhou University from January 2013 to June 2016 were assessed,data of clinical features,laboratory examination,treatment and prognosis were analyzed.Results Of all 99 cases,the mean age was (46.7 ± 15.7) years old,83 cases had a history of closely contacted with sheep,2 cases with pig and 1 case with cattle.The occupational distribution of patients included 90 farmers,1 veterinarian,2 cooks,6 children and students.All patients had clinical manifestations such as fever,fatigue,and sweating.There were 18 patients with back and joint pain,13 cases had abnormal manifestation on magnetic resonance imaging (MRI).Blood culture was positive in 54 (71.05％,54/76) and serum test tube agglutination test was positive in 61 (98.39％,61/62).Eighty-one patients received doxycycline combined with rifampicin treatment,six months laters,all patients were cured.Conclusions Sheep are the main sources of infection for brucellosis.Fatigue,sweaty and fever are the most common symptoms,and osteoarticular is the most frequently involved.Serum agglutination test and blood culture are important tests for diagnosis of brucellosis.Doxycycline combined with rifampicin was the most common used antibiotics regimen.Early,combined,regular,full-course antibiotic treatment has a better prognosis.

OBJECTIVETo perform a retrospective cohort study in order to determine the differences in short-term curative effect of ribavirin in combination with interferon alfa (IFNa)-2a vs. pegylated (Peg)-IFNa-2a in patients with chronic hepatitis C (CHC).

METHODSOne-hundred-and-eighty-eight treatment of the CHC patients who were administered combination therapy of ribavirin with IFNa from 2010 to 2012. One-hundred-and-thirty-three of the patients received the therapy with IFNa-2a and the remaining 55 received Peg-IFNa-2a. Hepatitis C virus (HCV) load and levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were measured at treatment weeks 4, 12, 24, and 48. Adverse reactions were recorded. Differences between the groups were assessed by statistical analysis.

RESULTSThe patients in the Peg-IFNa-2a group and the IFNa-2a group showed no significant difference in sex distribution, age, smoking habits, or drinking habits at baseline (all P more than 0.05). Both antiviral therapies significantly reduced the HCV load and levels of ALT and AST (baseline levels vs. all treatment weeks examined, P less than 0.05); however, the reduction in the HCV load at week 4 was significantly more robust with the Peg-IFNa-2a therapy (2.96 ± 0.66) log10 IU/ ml vs. (3.47 ± 1.42)1og10 IU/ml; F =4.14, P=0.04). The Peg-IFNa-2a group also showed a significant higher rate of rapid virological response (RVR) than the IFNa-2a group (72.72% vs .57.14%; x²=4.37, P=0.04), but there were no statistically significant differences found between the two groups for early virological response rate (EVR), endpoint antiviral treatment virologic response rate (ETR), biochemical response rate, or rate of adverse reactions (all P more than 0.05).

CONCLUSIONRibavirin in combination with Peg-IFNa-2a produces a better RVR than in combination with IFNa-2a .Yet, the EVR, ETR, biochemical response rate, and rate of adverse reactions is similar for the two forms of IFNa-2a. Further studies are required to determine the potential superiority of Peg-IFNa-2a for a long-term curative effect.

Adolescent ; Adult ; Aged ; Antiviral Agents ; therapeutic use ; Child ; Child, Preschool ; Drug Therapy, Combination ; Female ; Hepatitis C, Chronic ; drug therapy ; Humans ; Infant ; Infant, Newborn ; Interferon-alpha ; therapeutic use ; Male ; Middle Aged ; Polyethylene Glycols ; therapeutic use ; Recombinant Proteins ; therapeutic use ; Retrospective Studies ; Ribavirin ; therapeutic use ; Treatment Outcome ; Young Adult

Objective:To investigate the perinatal outcomes and risk factors of perinatal complications in preg-nant women with hypertrophic cardiomyopathy(HCM).Methods:A retrospective analysis was carried out on clini-cal data of 100 pregnant women with HCM who delivered in Obstetrical Cardiology Intensive Care Center of Shanghai Renji Hospital between Jan.2000 and Dec.2022.Analyze the incidence of perinatal complications inclu-ding miscarriage,premature birth,small for gestational age infants,neonatal asphyxia,neonatal cardiac malforma-tions and perinatal mortality.Independent risk factors of perinatal complications in pregnant women with HCM were identified using univariate and multivariate Logistic regression.Results:①The mean age was 29.21±4.41 years old,the average gestational age upon admission is 34.46±6.43 weeks.There were 16 patients with a fam-ily history of cardiomyopathy(16％),21 cases with obstructive HCM(21％)and 79 cases of non-obstructive HCM(79％),91 cases with abnormal ECG(91％),mainly with ST-T changes(77 cases,77％).The average in-terventricular septum was 19.39±6.13mm by echocardiography.②Among the 100 pregnancies of 100 HCM pa-tients,6 cases(6％)were miscarriages,94 newborns survived(94％),including 91 cases of cesarean section(91％)and 3 cases of vaginal delivery(3％).The predominant perinatal complications were preterm delivery(39 cases,39％),small for gestational age(5 cases,5％),neonatal asphyxia(3 cases,3％)and neonatal cardiac malformation(2 cases,2％).There were no perinatal deaths.③Univariate Logistic regression analysis showed that pre pregnancy heart function ≥ Grade Ⅱ,increased left atrial diameter,and concomitant pulmonary hyperten-sion were risk factors for perinatal complications in pregnant women with HCM(OR＞1,P＜0.05).Multivariate Lo-gistic regression analysis found that pre pregnancy heart function ≥ Grade Ⅱ was an independent risk factor for predicting the occurrence of perinatal complications in pregnant women with HCM(OR 6.270,P＜0.05).Conclu-sions:HCM during pregnancy can induce poor perinatal outcome.More attention should be paid to risk assess-ment and pregnancy management.Early detection of risk factors can reduce the incidence of perinatal complica-tions.

Objective:To investigate the perinatal outcomes and risk factors of perinatal complications in preg-nant women with hypertrophic cardiomyopathy(HCM).Methods:A retrospective analysis was carried out on clini-cal data of 100 pregnant women with HCM who delivered in Obstetrical Cardiology Intensive Care Center of Shanghai Renji Hospital between Jan.2000 and Dec.2022.Analyze the incidence of perinatal complications inclu-ding miscarriage,premature birth,small for gestational age infants,neonatal asphyxia,neonatal cardiac malforma-tions and perinatal mortality.Independent risk factors of perinatal complications in pregnant women with HCM were identified using univariate and multivariate Logistic regression.Results:①The mean age was 29.21±4.41 years old,the average gestational age upon admission is 34.46±6.43 weeks.There were 16 patients with a fam-ily history of cardiomyopathy(16％),21 cases with obstructive HCM(21％)and 79 cases of non-obstructive HCM(79％),91 cases with abnormal ECG(91％),mainly with ST-T changes(77 cases,77％).The average in-terventricular septum was 19.39±6.13mm by echocardiography.②Among the 100 pregnancies of 100 HCM pa-tients,6 cases(6％)were miscarriages,94 newborns survived(94％),including 91 cases of cesarean section(91％)and 3 cases of vaginal delivery(3％).The predominant perinatal complications were preterm delivery(39 cases,39％),small for gestational age(5 cases,5％),neonatal asphyxia(3 cases,3％)and neonatal cardiac malformation(2 cases,2％).There were no perinatal deaths.③Univariate Logistic regression analysis showed that pre pregnancy heart function ≥ Grade Ⅱ,increased left atrial diameter,and concomitant pulmonary hyperten-sion were risk factors for perinatal complications in pregnant women with HCM(OR＞1,P＜0.05).Multivariate Lo-gistic regression analysis found that pre pregnancy heart function ≥ Grade Ⅱ was an independent risk factor for predicting the occurrence of perinatal complications in pregnant women with HCM(OR 6.270,P＜0.05).Conclu-sions:HCM during pregnancy can induce poor perinatal outcome.More attention should be paid to risk assess-ment and pregnancy management.Early detection of risk factors can reduce the incidence of perinatal complica-tions.