Objective To explore the benefits of living donor kidney transplantation in child, and to inves-tigate the procedures of renal transplantation, post-operative immunosuppressants regimens and complication management in child. Methods Clinical data, the prognosis of renal transplantation, operative procedure and immunosuppressive agents administrated in 14 children with end-stage renal disease (ESRD) undergo-ing renal transplantation were analyzed. Results The major complications in the early stage after renal transplantation were: 2 cases had acute rejection, 3 cases had severe hypernatremia, 1 case had urological infection, 3 cases had lymphocele. The major complications in the long-term recipients included: 6 cases had hypertension, 3 cases had hyperlipidemia, 4 cases had various kinds of infections, 5 cases had drug-in-duced hepatic injury. The one year survival rates of recipient/graft were all 100%. The average creatinine was 96.43 mmol/L(43-125 mmol/L) for the 14 recipients by the end of this study. All recipients thought their life quality was improved significantly. Conclusions Living donor kidney transplantation is the most ideal method to treat children with ESRD. Adult donor kidneys are suitable to the school age of recipients. The protocol of immunosuppressive therapy (prednisone plus MMF and FKS06) should be applied.

Objective To investigate the effects of repetitive transcranial magnetic acupoint stimulation on hemiplegic patients.Methods60 hemiplegic patients were assigned to treatment group and control group(30 cases for each group). Both groups received rehabilitation therapy. Meanwhile, the treatment group received repetitive transcranial magnetic acupoint stimulation. Fugl-Meyer Assessment (FMA), The Mini-Mental State Examination (MMSE), Barthel Index(BI) were used to measure the outcome.ResultsThe scores of FMA and BI increased significantly in both groups after treatment. However, these scores in treatment group improved more compared with those of control group(P<0.05).ConclusionRepetitive transcranial magnetic acupoint stimulation is helpful to improve the motor function, and ability of daily living of hemiplegic patients.

Objective To compare the effect and safety between cemented and uncemented long-stem hip arthroplasty for treatment of unstable intertrochanteric fracture in the elderly.Methods A retrospective review was made on 70 cases (70-87 years old) undergone artificial long-stem hip arthroplasty of unstable intertrochanteric fracture between June 2012 and June 2014.According to the material of prostheses,the cases were assigned to cemented group (n =36) and uncemented group (n =34).Operation-related index,postoperative complications,ambulation time,Harris hip score and prosthesis stability and excellent results were compared between the two groups.Results There were no significant differences in operation time,bleeding volume and ambulation time between the two groups (P ＞ 0.05).Postoperative drainage volume and blood transfusion volume in cemented group [(277.4 ± 22.0) ml and (245.1 ± 17.8) ml] were lower than these in uncemented group[(294.2 ± 33.7) ml and (262.8 ± 30.9)ml] (P ＜0.05).Harris scores in cemented group were higher than these in uncemented group 1 and 3 months after operation(P ＜0.05),and there were no significant differences 6 and 12 months after operation(P ＞ 0.05).Complication rate had no significant difference between the two groups (P ＞ 0.05).Two cases were died of cement poisoning,one case of subsequent acute myocardial infarction,and two cases of subsequent acute cerebral infarction.Sixty-five cases were followed up for 12-36 months,which showed no complications such as prosthesis loosening,displacement or infection.Prosthesis stability and treatment excellent rate between the two groups were not significantly different (P ＞ 0.05).Conclusions Clinical efficacy of the two treatments is comparable,including good function recovery and early off-bed activity.Cemented long-stem hip arthroplasty reduces blood requirements,but the risk of cement poisoning exists.

Objective To evaluate cerebrospinal fluid adenosine deaminase(CSF-ADA)activity in the diagnosis of tuberculous meningitis(TMB), and to observe its dynamic changes. Methods A total of 160 patients were included and were divided into two groups: 76 cases of TBM and 84 cases of non-TBM.Among the cases of non-TBM, there were 36 cases of bacterial meningitis, 30 cases of viral meningitis and 18 cases of cryptocoocal meningitis. All the patients were measured with their CSF-ADA activity by Enzymecoupled assay(Trinder method)and 47 patients of TBM were measured again after 2 weeks' and 6 weeks'antitubercular therapy. Results were expressed as(-x)± s. Mann-Whitney U test and paired-samples t test were used. Results CSF-ADA activity in TBM group was(12.9 ±6.4)U/L, while that in the non-TBM group was(6.0 ± 4.1)U/L, the difference was of statistical significance(U = 7.860, P ＜ 0.05). With the cutoff value of 9 U/L, the sensitivity and specificity to differentiate TBM from non-TBM was 84.21% and 83. 33%, respectively. CSF-ADA activity decreased in TBM patients after antitubercular treatment.Conclusions CSF-ADA activity can be an effective laboratory marker for early differential diagnosis of TMB with the cut-off value of 9 U/L. Dynamic changes of CSF-ADA activity may be a indicator for the effect of antitubercular treatment.

This study aims to compare the urate-lowering response rate of febuxostat and allopurinol in gout patient using a model-based meta-analysis. The literature search identified 22 clinical trials of gout with a total of 43 unique treatment arms that met our inclusion criteria, and a total of 6 365 gout patients were included in the study. The response rates of allopuriol and febuxostat were characterized by Tmax model and Emax model respectively, and the effect of baseline serum uric acid (sUA) and patient type on the drug effect was tested. The results showed that allopurinol can reach an average maximum response rate of 50.8% while febuxostat can reach a 100% response rate within a very short time, and the ED50 was 34.3 mg. Covariate analysis revealed that baseline sUA has a negative effect on response rate of allopurinol, and a positive effect on the predicted ED50 of febuxostat. For patients who had shown inadequate response to prior allopurinol treatment, the average response rate was about half that of the allopurinol responder patients.
Allopurinol ; therapeutic use ; Febuxostat ; Gout ; blood ; drug therapy ; Gout Suppressants ; therapeutic use ; Humans ; Thiazoles ; therapeutic use ; Uric Acid ; blood

Objective To retrospectively study the perioperative complications and postoperative function recovery of 93 patients treated with simultaneous bilateral total hip arthroplasty (THA). Methods A total of 93 patients (186 hips) undergone simultaneous bilateral THA from January 1999 to January 2009 in our hospital were involved in this study. There were 70 males and 23 females (at age range of 25-65 years, average 41. 8 years). The preoperative diagnosis included bilateral avascular necrosis of femoral head in 48 patients, rheumatoid arthritis in 11, developmental dysplasia of the hip in 26 and ankylosing spondylitis in 8. The intraoperative blood loss, Harris scores before operation and at final followup as well as perioperative complications were analyzed. Results All the patients were followed up for average 65 months (12-118 months), which showed femur fracture in one patient and infection six months after discharge in one patient. The Harris score was increased from (36.7 ±6.1) points preoperatively to (91.2±6.2) points at the final follow-up. Hip pain disappeared in 92 patients after operation and radiograph showed no loosening. Actebular loosening occurred in one patient 49 months after operation and was revised accordingly. Conclusion Under strict control of operation indications, suitable choice and implantation of the prosthesis and emphasis on perioperative management and postoperative rehabilitation, simultaneous bilateral THA is a safe and effective choice for bilateral hip diseases.

Objective To investigate the protective effect and associated mechanism of PNS in spinal cord hemisection injury.Methods fifty-five adult SD rats were randomly divided into three groups,sham group(n =5),spinal cord injury group(n =25),PNS group(n =25).The rats were evaluated in behavioral test with BBB score,pathology and immunohistochemistry at 1 d,3d,7d,14d,21d after the procedures.Results Motor recovery was significantly better in PNS group than the spinal cord injury group at 3d,7d,14d and 21d.Nissl staining showed less neuron necrosis and more integrated neural cells in morphology.cPLA2 expression was inhabited in PNS group,and less number of positive cells were found in the group.Conclusion PNS can inhibit the expression of cPLA2 after spinal cord injury,which may be one of the mechanisms of its effect on promoting motor recovery.

Objective:To investigate the value of ultrasound in evaluating pathologically complete response(pCR) of neoadjuvant chemotherapy(NAC) for breast cancer.Methods:A retrospective analysis was performed in 67 breast cancer patients who received NAC in the Second Affiliated Hospital of Harbin Medical University from January 2018 to December 2019. Ultrasound examination was performed before and after NAC, and two-dimensional, color and elastic images were stored for subsequent analysis. According to the operation pathological results after NAC, the patients were divided into two groups, pCR group and npCR group, using the Miller-Payne criteria as the evaluation criteria. Chi-square test was used to compare the ultrasound characteristics of breast masses in pCR group and npCR group before NAC. The accuracy, sensitivity, specificity, positive predicative value(PPV) and negative predicative value(NPV) of pCR were analyzed using ROC curve. The difference of pCR estimated by ultrasound in different molecular types was also analyzed.Results:①Of the 67 patients, 16 achieved pCR and 51 achieved npCR. Among the 16 pCR patients, 11(68.8%) were evaluated correctly and 5(31.2%) were wrong.Among the 51 npCR patients, 49(96.1%) were evaluated correctly and 2(3.9%) were wrong. ②There was no statistically significant difference between pCR and npCR in ultrasound features of pre-NAC breast masses( P>0.05). ③After the whole process of NAC, the accuracy, sensitivity, specificity, PPV and NPV were 89.6%, 68.8%, 96.1%, 84.6%, and 90.7%, respectively; The area under ROC curve was 0.824. ④The diagnostic efficiency of pCR estimated by ultrasound was higher for Luminal B and HER-2 breast cancer. Conclusions:The accuracy of pCR after NAC evaluated by ultrasound is 89.6%, with different diagnostic efficiency in different molecular types.

Objective To study the expression of Rho kinase and its functional activation in lung tissue from hypoxic pulmonary hypertension(HPH) rat model,and the effects of fasudil on HPH.Methods Seventy-two male Spraque-Dawley rats were randomly divided into the control group,hypoxic model group,and fasudil-intervention group[group with hypoxia and fasudil for 15 mg/(kg?d)],respectively.Mean pulmonary arterial pressure(mPAP) and right ventricle hypertrophy index(RVHI) were measured.Expression of Rho kinase mRNA and protein were examined by reverse transcriptase-polymerase chain reaction(RT-PCR) and Western blot,respectively.The phosphorylation of binding subunit of myosin phosphatase(MBS)-a substrate of Rho kinase was detected by Western blot and defined,as the mark of functional activation of the kinase.Results The expression of Rho kinase mRNA in hypoxic model group was markedly upregulated even before the onset of the third day after the experiment(HPH),and it was much lower in rats of fasudil group than that of hypoxic model group.The phosphorylation of MBS was significantly higher in hypoxic model group than that in control group,and it was positively correlated with the mPAP and RVHI(all P

To explore the clinical classification of hamate hook fracture and the treatment strategy for different type of fractures, 12 patients who suffered from hamate hook fractures were followed up retrospectively. According to the fracture sites and the prognosis, we classified the hamate hook fractures into 3 types. Type I referred to an avulsion fracture at the tip of hamate hook, type II was a fracture in the middle part of hamate hook, and type III represented a fracture at the base of hamate hook. By the classification, in our series, only 1 fell into type I, 7 type II, and 4 type III. The results were evaluated with respect to the functional recovery, recovery time and the association among the clinical classification, pre-operative complications and treatment results. The average follow-up time of this group was 8.4±3.9 months. Two cases were found to have fracture non-union and both of them were type II fractures. Six patients had complications before operation. Five cases were type II fractures and 1 case type III fracture. All the patients were satisfied with the results at the time of the last follow-up. Their pain scale and grip strength improved significantly after treatment. All the pre-operative complications were relieved. The recovery time of hamate hook excision was significantly shorter than that of the other two treatments. The incidences of both pre-operative complications and non-union in type II fractures were higher than those in type I and type III fractures. It was concluded that, generally, the treatment effects with hamate hook fracture are quite good. The complication incidence and prognosis of the fracture are closely related to the clinical classification. Early intervention is critical for type II fractures.