Wegener's granulomatosis (WG) is a kind of systemic necrotizing granulomatous vasculitis characterized by capillary and small arteriovenous involvement.The typical WG triad is lesions of the upper and lower respiratory tract and kidneys.Only changes in the respiratory tract without renal lesions are localized WG.Localized WG is very easy to be misdiagnosed because of its nonspecific symptoms and radiological manifestations.The author found one case of localized WG,which showed pulmonary symptoms and refractory heart failure.The chest CT showed that multiple irregular nidus,blurred and density enhanced lesions in both lungs.The patient was misdiagnosed as pulmonary infection for a long time.The patient was eventually diagnosed as asantineutrophil cytoplasmic antibody (ANCA) associated vasculitis and WG after two times of examination of protease-3(PR3) ANCA were positive.This article reviewed the diagnosis and treatment of the patient,and reviewed the relevant literatures.

Objective By using estradiol(E2) as positive control to observe the effects of genistein(GST) on the matrix metalloproteinase inhibitor 1 mRNA levels of HSC-T6 cell in vitro.Methods HSC-T6 cells were exposed to different concentrations of E2 0.1?mol/L and GST 0.5-50?mol/L for 36 hours.The TIMP-1 mRNA levels were measured by the quantitative reverse-transcription polymerase chain reaction(RT-PCR).Results The TIMP-1 mRNA levels of HSC-T6 cells at different concentrations of E2 and GST were lower than those of the normal control(P

AIM: To report the use of modified four ports pars plana vitrectomy in managing a dislocated posterior chamber intraocular lens.METHODS: A young man with bilateral pseudophakia and dislocated PC-IOLs had undergone modified four ports pars plana vitrectomy in relocating a dislocated posterior chamber intraocular lens. This procedure was surgically less tedious and demanding compared with previous methods of IOL retrieval.RESULTS: No significant intra- or post-operative complication was noted. The visual recovery of the operated eye was rapid with the best corrected visual acuity at 14 months post-operation being 0.5. In contrast, the right eye without operation due to patient refusal developed total retinal detachment with hand movement visual acuity.CONCLUSION: Modified four ports pars plana vitrectomy may be a more ophthalmic surgeon friendly alternative in the retrieval of dislocated IOL.

0.05).The median therapy fees in the open group was nine thousand yuan vs.eleven thousand yuan in the laparoscopic group,and the difference was significant(P

recurrence of half a year.Results The rate of symptom improvement in D group was significantly better than the other three groups(P <0.05).Over time,there was no statistical difference between four groups.The recurrence rate of D group (0.00%)was obviously lower than A group (11.76%),the B group (2.00%)and the C group (3.85%)(P <0.05).Conclusion Microscope with the traditional Chinese medicine is a good choice in preventing postoperative the rate of symptom and recurrence.

Objective To discuss the clinical significance of vancomycin plasma concentration monitoring and its relationship with adverse reactions in treatment of elderly patients. Methods The clinical records of 32 patients aged over 70 years admitted in the Emergency Medical Department of Sichuan Provincial People's Hospital were collected. Based on the diagnosis and laboratory examinations on admission, the patients were treated with cefoperazone+sulbactam or moxifloxacin, while in patients with severe infections, intravenous drip of carbapenem antibacterial drugs were given. After treatment for 3-5 days, when no effective results were obtained, according to the pathogenic results achieved from cultures of blood, sputum, secretions, catheter, etc, the corresponding treatment was given. If the infection was caused by positive bacteria mainly methicillin-resistant Staphylococcus aureus (MRSA) sensitive to vancomycin, the original antibiotic was replaced by vancomycin or vancomycin combined with other antibiotic; intravenous drip of vancomycin 1 g in 250 mL normal saline was given, once in 12 hours, with a speed of 10 mg/min or not over 15 mg/min. The function of liver and kidney, and auditory impairment were observed, and the correlation between vancomycin plasma concentration and adverse reactions was analyzed. Results The total incidence of adverse reactions in elderly patients with different serum vancomycin trough concentrations was 37.50%(12/32) in which the highest incidence was kidney damage 18.75%(6/32) followed by the hearing loss 9.38%(3/32) and liver damage 9.38%(3/32). There were no statistical significant differences in the rates of adverse reactions among the different vancomycin trough concentrations (<10, 10-20,>20 mg/L) and [37.50%(6/16), 38.46%(5/13), 33.33%(1/3), all P>0.05], that meant along with the increase of vancomycin concentration, no tendency of increment of adverse reactions was seen. Of the 32 cases, there were 13 treated by vancomycin combined with other antibiotic, the combination rate being 40.63%. There were 2 cases of hepatic impairment (11.83%), 1 case of renal impairment (7.69%) and none hearing damage in patients treated with combination of antibiotic therapy. Therefore no correlation was concluded between the occurrence of adverse reactions and the combination therapy ( r=0.15, P>0.05). Conclusions In elderly patients over the age of 70 years, there is a higher incidence of kidney damage in the application of vancomycin. Thus, the monitoring of vancomycin plasma concentration in elderly patients has instructive significance in its clinical use.

In order to realize an individualized and specialized rehabilitation assessment of remoteness and intelligence, we set up a remote intelligent assessment system of upper limb movement function of post-stroke patients during rehabilitation. By using the remote rehabilitation training sensors and client data sampling software, we collected and uploaded the gesture data from a patient's forearm and upper arm during rehabilitation training to database of the server. Then a remote intelligent assessment system, which had been developed based on the extreme learning machine (ELM) algorithm and Brunnstrom stage assessment standard, was used to evaluate the gesture data. To evaluate the reliability of the proposed method, a group of 23 stroke patients, whose upper limb movement functions were in different recovery stages, and 4 healthy people, whose upper limb movement functions were normal, were recruited to finish the same training task. The results showed that, compared to that of the experienced rehabilitation expert who used the Brunnstrom stage standard table, the accuracy of the proposed remote Brunnstrom intelligent assessment system can reach a higher level, as 92.1%. The practical effects of surgery have proved that the proposed system could realize the intelligent assessment of upper limb movement function of post-stroke patients remotely, and it could also make the rehabilitation of the post-stroke patients at home or in a community care center possible.
Algorithms ; Arm ; physiopathology ; Artificial Intelligence ; Humans ; Movement ; Recovery of Function ; Reproducibility of Results ; Software ; Stroke Rehabilitation

Objective:To investigate the clinical efficacy of gabapentin capsules( GBP)combined with amitriptyline and tramadol in the treatment of patients with postherpetic neuralgia( PHü)and anxiety. Methods:Totally 106 PHü patients with anxiety symptoms at different degree were selected and divided into group A(n=53)and group B(n=53). Group A was given GBP,amitriptyline and tramadol,while group was given GBP only. The anxiety,depression,quality of life and pain-relieving intensity( by VAS)of the pa-tients were determined before the medication( T1 )and in the first week( T2 )and the fourth week( T3 )after the medication. Follow-up was carried out regularly according to the requirements to evaluate the clinical efficacy. Results:The anxiety,depression and VAS scores in the two groups on T2 were statistically significant lower than the corresponding results on T1(P<0.05). On T3,however, there were statistically significant differences between the two groups(P<0. 05). The total adverse reaction rate of group A was signif-icantly lower than that of group B(P<0. 05). The total effective rate of group A was significantly higher than that of group B(P<0. 05). Conclusion:GBP combined with tramadol and amitriptyline in the treatment of PHü patients with anxiety can effectively con-trol the pain of the patients,significantly reduce the scores of VAS and improve the quality of life of the patients.

Objective To discuss the treatment strategy of knee dislocation and to evaluate its outcome.Methods Thirty-six patients with unilateral knee dislocation treated with individualized protocol were studied retrospectively,including 22 males and 14 females with an average age of 35 years (range,19-72 years).There were 30 acute and 6 chronic knee dislocations.According to the modified Schenck's classification of knee dislocation,there were 7 KD- Ⅰ and 23 KD-Ⅲ cases in the acute category,and all 6 chronic cases were KD-Ⅲ.Seven acute KD- Ⅰ and 6 chronic KD-Ⅲ cases underwent one-stage arthroscopic surgery.In 23 acute KD-Ⅲ cases,2 were treated conservatively with splint or brace due to advanced age,18 with staged surgery,3 with one-stage surgery due to concomitant vascular and nerve injury.Functional and clinical evaluation was conducted at final follow-up.Results All 36 patients were followed up for an average of 27 months (range,18-36 months).The Lysholm score (82.0±11.4),Tegner score (5.5±1.3),and knee range of motion (118.3°±19.2°) at final follow-up showed a statistically significant improvement compared with preoperative results (P＜O.O1).Eight (23.5％) patients had residual knee instability:posterior drawer test and Sag sign were positive (++ or +++) in 8 knees,valgus instability (++) in 1 and varus instability (+++) in 1.The remaining 28 knees were stable.Conclusion Special attention should be paid to rotational knee dislocation with single cruciate ligament rupture.Properly individualized treatment plan is the key to optimal outcome.Arthroscopic surgery can lead to successful outcome.Early one-stage arthroscopic surgery is recommended for acute KD-Ⅰ and chronic KD-Ⅲ dislocation,staged arthroscopic surgery for acute KD-Ⅲ dislocation.

A new fluorescent method was developed based on the ulifloxacin-europium (Ⅲ)-sodium dodecylbenzene sulfonate system for the determination of ulifloxacin,the active metabolite of prulifloxacin.Sodium dodecylbenzene sulfonate formed a ternary complex with ulifloxacin-europium (Ⅲ) and significantly enhanced the characteristic fluorescence of europium (Ⅲ).The enhanced fluorescence intensity showed a good linear relationship with the concentration of ulifloxacin in the range of 5.0× 10 8 -2.0× 10-6M with a detection limit of 2.0× 10-10 M (3σ).This method is rapid and sensitive,and has been successfully applied to the determination of ulifloxacin in human urine and serum samples.