Objective To observe the effect of traditional Chinese drug combined with training of musculus quadriceps fexoris on knee osteoarthritis(KOA).Methods70 out-patient clinic KOA patients were divided randomly into the Chinese drug group and control group with 35 cases in each group.The Chinese drug group was treated with Shentongzhuyu medicinal broth PO bid;the control group was treated with Sulindac 0.2 g PO bid.Two groups were combined with the training of musculus quadriceps fexoris,having 10 times per course and 3 courses in total with a 3 days interval between two courses.The therapeutic effect was evaluated with footplate pressure gait analysis and modified JOA marks.ResultsAfter treatment,the effect of the Chinese drug group was superior to the control group(P<0.05),especially 12 weeks post treatment.There maximum weight loading,time integral and weight loading intergral of affected limb of the Chinese drug group significantly improved after treatment(P<0.01),but for the control group,only weight loading intergral improved(P<0.05).ConclusionTraditional Chinese drug combined with training of musculus quadriceps fexoris has better curative effect on the pain and functional disturbance of KOA.

Cognitive estimation is a process in which correct answers can be reasonably estimated by relevant information,instead of be obtained in a direct manner.The cause of cognitive estimation disorder is relevant to executive function and frontal lobe damage.The assessment of cognitive estimation disorder is mainly based on texts such as CET,BCET and TKS,and clinical symptoms are also taken into consideration in this assessment.Future studies include several aspects.Firstly,more efforts should focus on improving diagnostic standard and assessment tools and expanding the related studies.Secondly,it is necessary to focus on the specific brain areas of clinical patients with cognitive estimation disorder,and to strengthen the clinical rehabilitation of cognitive functions.

Objective To evaluate the short-term efficacy of total hip arthroplasty combined with subcutaneous osteotomy in the treatment of CroweⅣ hip dysplasia (DDH).Methods From March 2012 to March 2015,14 patients (16 hips) underwent total hip arthroplasty with femoral distraction osteotomy S-ROM femoral stem prosthesis.And we observed its recent efficacy.Results All patients underwent S-ROM prosthesis.The patients underwent transverse osteotomy of the femoral trochanter.The osteotomy length was 2.0-3.5 cm.The average follow-up time was 19 months.And no complications such as dislocation,vascular nerve injury,deep vein thrombosis and infection were observed during the follow-up.The average Harris scores improved from 42.3 preoperatively to 90.4 postoperatively at 9 months after the operation.The average lengths of preoperative limb shortening and postoperative limb shortening were 6.4 cm and 4.3 cm respectively.The X-ray films showed no dislocation of acetabulum and femoral prosthesis.Bone healing was achieved at 6 months after osteotomy.Conclusion This method could be a good choice for Crowe Ⅳ developmental dysplasia.The short-term efficacy is satisfactory.

We determined molecular characteristics of Listeria monocytogenes foodborne isolates in Hangzhou and investigated the characterization of local strains.Multi-locus sequence typing(MLST) and pulsed-field gel electrophoresis(PFGE) were applied to identify molecular types of Listeria monocytogenes isolates.Results showed that a total of 133 strains of 6 serotypes were divided into 19 MLST types including a new type ST767.ST9 and ST121 were the major ST types.There were 33 and 45 PFGE patterns characterized by AscⅠ and ApaⅠ.The molecular types of Listeria monocytogenes strains were widely distributed in Hangzhou.It is indicated that the major clusters were Lineage Ⅰ and Lineage Ⅱ which will cause listeriosis.The contamination of Listeria monocytogenes in food is serious in Hangzhou and the surveillance and management should be strengthened to prevent the food borne diseases.

Objective Although heart transplantation (HTx) has become a standard therapy for end-stage heart diseases,experience with pediatric HTx is limited in China.In this article,we will try to provide the experience with indications,complications,perioperative management,immunosuppressive therapy,and survival for pediatric HTx based on our clinical work.Method This is a retrospective chart review of the pediatric patients undergoing HTx at Department of Cardiovascular Surgery of Union Hospital from September 2008 to December 2015.We summarized the indications,surgical variables,postoperative complications,and survival for these patients.Result Twenty-three pediatric patients presented for HTx at Union Hospital of Tongji Medical College,of whom 12 were male.The age at the time of transplantation ranged from 3 months to 18years (median 14 years).Patient weight ranged from 5.2 kg to 57.0 kg (median 36.0 kg).Pretransplant diagnosis included cardiomyopathy (16 cases),complex congenital heart disease (5cases) and tumors (2 cases).All recipients received ABO compatible donor hearts.Postoperative complications occurred in 14 patients,including cardiac dysfunction,arrhythmia,pulmonary infection,renal dysfunction,and rejection.Two of them experienced cardiac failure and required extracorporeal membrane oxygenation.The immunosuppression regimen was comprised of prednisone,a calcineurin inhibitor,and mycophenolate.All patients recovered with New York Heart Association (NYHA) Class Ⅰ Ⅱ cardiac function and were discharged.Only one patient suffered sudden death 19 months after transplantation.Conclusion Orthotopic HTx is a promising therapeutic option with satisfactory survival for the pediatric population in China with end-stage heart disease.

·Age-related macular degeneration (AMD) and retinitis pigmentosa (RP) are common outer retinal degenerative problems, which are also the predominant causes of most blinding retinal diseases. Retinal prosthesis is a promising solution for such photoreceptor degeneration diseases.Most of current concepts for a retinal prosthesis are based on neuronal electrical stimulation. In the past twenty years, retinal prosthesis has been developed in two different directions: epiretinal prosthesis and subretinal prosthesis. Each prosthesis technique has its advantages and disadvantages. For epiretinal prosthesis, it is easier to be implanted and has the advantage of keeping most of the electronics in the vitreous cavity, off the retinal surface, which greatly helps in dissipating the heat generated by the implant device. In this paper, a brief overview of retinal prostheses concepts is introduced. After that, several important aspects of epiretinal electrical stimulation will be discussed. Moreover, some practical epiretinal prosthesis devices developed by researchers in United States, Germany and Japan in the past have been reviewed. We hope that the devices will be used widely in the near future.

AIM: To observe the changes in subfoveal choroidal thickness ( SFCT ) after intravitreal injections of ranibizumab ( IVR ) for macular edema secondary to retinal vein occlusion ( RVO) .
METHODS:Thirty-six eyes of 36 patients with macular edema secondary to RVO) were treated with 0. 5mg IVR monthly for 3mo and received additional IVR as needed over the following 1a period. SFCT of the all eyes ( the affected eyes with RVO and unaffected fellow eyes ) was measured by enhanced depth imaging optical coherence tomography images before and after the IVR.
RESULTS: The mean SFCT of the affected eyes with RVO decreased from 246. 7±115. 0μm at baseline to 220. 5±102.0μm at 1mo (P<0.05), 198.3± 114.0μm at 6mo (P<0.01), 212. 6± 96. 0μm at 12mo (P<0. 01). Whereas the fellow eyes changed from 229. 4±108. 0μm at baseline to 226. 3±107. 0μm at 1mo (P>0. 05), 228. 6±127. 0μm at 6mo (P>0.05), 223.6±101.0μm at 12mo(P>0.05). There were statistically significant difference between affected eyes with RVO and unaffected fellow eyes.
CONCLUSION: The SFCT is decreased after IVR for macular edema secondary to RVO. IVR seems to affect the hemorheology of the choroid.

Objective To examine the relationship between gender and intraventricular hemorrhage (IVH) in very low birth weight infants (VLBWI) and extremely low birth weight infants (ELBWI).Methods From January 1,1999 to December 31,2012,data on VLBWI and ELBWI,who were admitted to the neonatal intensive care unit of Yuying Children's Hospital within 14 d after birth,were retrospectively collected.The Chi-square test and t test were used to compare neonatal outcomes between male and female infants.The Logistic model was used to analyze the risk factors for IVH.Results A total of 1 008 cases were enrolled,including 615 males and 393 females,895 VLBWI and 113 ELBWI.The incidence of IVH was 15.1％ (152/1 008) and the incidence of severe IVH was 8.4％ (85/1 008).Compared with females,males had a higher total incidence of IVH [17.2％ (106/615) vs 11.7％ (46/393),x2=5.728,P＜0.05] and severe IVH [9.8％ (60/615) vs 6.4％ (25/393),x2=3.896,P＜0.05].These differences were also seen in VLBWI with a birth weight of 1 250 to 1 499 g [IVH:13.7％ (47/344) vs 7.8％ (17/217),x2=4.473,P=0.034; severe IVH:7.6％ (26/344) vs 2.8％ (6/217),x2=5.684,P=0.017].Logistic regression analysis showed that the risk factors for IVH were as follows:gestational age ＜28 weeks (aOR=2.012,95％CI:1.288-3.143,P＜0.05),neonatal respiratory distress syndrome (aOR=l.584,95％CI:1.007-2.492,P＜0.05),invasive mechanical ventilation (aOR=2.743,95％CI:1.826-4.121,P＜0.05),electrolyte disturbance (aOR=2.128,95％CI:1.092-4.149,P＜0.05) and periventricular leukomalacia (aOR=2.901,95％CI:1.312-6.416,P＜0.05),but not male sex (aOR=1.351,95％CI:0.917-1.991,P=0.128).The risk factors for severe IVH were gestational age ＜28 weeks (aOR=2.200,95％CI:1.305-3.708,P＜0.05),invasive mechanical ventilation (aOR=4.714,95％CI:2.809-7.911,P＜0.05) and electrolyte disturbance (aOR=2.232,95％CI:1.047 4.759,P＜0.05),but not male sex (aOR=1.361,95％CI:0.823 2.252,P=0.247).Conclusions Male VLBWI and ELBWI have a higher incidence of IVH and severe IVH,but male sex is not a risk factor for IVH or severe IVH.

Objective To investigate the effects of bedside blinding method of active indwelling of nasojejunal tube combined with the nasogastric tube gastrointestinal decompression for patients with severe stroke.Methods 50 patients with severe stroke were selected and divided into two groups by using random number tables,which are the observation group and the control group,with 25 cases in each group.The patients in the observation group were treated with bedside blinding method of active indwelling of nasojejunal tube combined with the nasogastric tube gastrointestinal decompression,while the patients in the control group simply received bedside indwelling of nasogastric tube.The enteral nutritional goal -rate of target feeding volume on the 7th day and the 14th day after admission and trace the incidence of gastric stasis,the reflux and aspiration,the aspiration pneumonia in the patients of the two groups within 14 days and the situation of the days of mechanical ventilation,the days in ICU and the 30 -day mortality of patients were compared in the two groups.Results The enteral nutritional goal -rate of target feeding volume on the 7th day and the 14th day in the observation group were superior to those of the control group[The goal -rate of target feeding volume on the 7th day:88% vs.64%,χ2 =3.947,P =0.047;the goal -rate of target feeding volume on the 14th day:80% vs.52%,χ2 =4.367,P =0.037].Meanwhile the incidence of gastric stasis,the reflux and aspiration,the aspiration pneumonia in the patients of the observation group within 14 days were significantly lower than those in the patients of the control group within 14 days[The gastric retention rate:8% vs.56%(14 /25 ),χ2 =10.784,P =0.001;the reflux rate:0% vs.24%(6 /25),χ2 =4.735,P =0.03;the aspiration rate:8% vs.32%,χ2 =4.500,P =0.034;the incidence of aspiration pneumonia:24% vs.68%,χ2 =9.742,P =0.002].The days of mechanical ventilation and the days in ICU of the patients in the observation group are far less than those of the patients in the control group[The days of mechanical ventilation:(11.16 ±4.86)d vs.(13.72 ±3.67)d,t =-2.101,P =0.041;the days in ICU:(15.36 ±5.66)d vs.(18.72 ±2.99)d,t =-2.625,P =0.012].While there was no significant difference between the two groups on the 30 -day mortality(24% vs.32%,χ2 =0.397,P =0.529).Conclusion The bedside blinding method of active indwelling of nasojejunal tube combined with the nasogastric tube gastrointestinal decompression can significantly improve the enteral nutritional goal -rate of target feeding volume for patients with severe stroke and greatly reduce the incidence of gastric stasis,the reflux and aspiration,the aspiration pneumonia,and limit the days of mechanical ventilation and the days in ICU.Accordingly,it has the value of popularization in the clinical application.

ObjectiveTo investigate influence of sedation and analgesia on stress reaction of post-cardiac surgery in infants with congenital heart disease.MethodsForty children with congenital heart disease were randomly divided into 2 groups after cardiac surgery.The analgesia group was given 0.5-2.0 ?g/(kg?h) fentanyl intravenous infusion in 20 children undergoing cardiovascular surgery.The control group was given 5-8 mg/(kg?dose) lbuprofen orally.Midaiolam 0.01-0.20 mg/(kg?h) was used in 2 groups for sedation by intravenous infusion or 0.05-0.10 mg/(kg?dose)by intravenous push intermittently.The effects and adverse effects of sedation and analgesia were observed on 2,8,24,48 h after surgery in each group.The levels of cortisol,growth hormone,insulin and blood glucose were measured,respectively.ResultsThere were significant differences in Ramsay,Comfort value on 2,8,24 h(Pa