Objective To explore the relationship between the expression of Hypoxia-induciable factor-1α (HIF-1α) and changes of hepatitis microcimulation in patients with chronic hepatitis B (CHB).Methods 120 patients with CHB were studied. The expression of HIF-1 α was observed by immunohistochemistry and the morphotogic changes were observed with transmission eletron microscope. Results Stenosis, blockage, dilataltion, capillarization of hepatic sinusoids were the main morphotogic changes of liver. The expression of HIF-1α was positive or stronger positive. There is a positive correlation between the expression of HIF-1α and microcirculation disturbance of liver.Conclusion The disturbance of liver with CHB could exacerbate the dysbolism of nutrient substance and oxygen between hepatic cells and blood circulation. Hypoxia of hepatic cells was an important reason of the liver's pathological changes.

ObjectiveTo investigate the relationship between the level of plasma D-dimer(D-D) and hepatic functional reserve status in patients with hepatitis B (HB).Methods77 cases with HB were divided into two groups, hepatic function compensated group and hepatic function decompensated group.Plasma D-D, hepatic functional indexes and PT of all patients were detected.ResultsThe level of D-D in the hepatic function decompensated group was higher than that in the hepatic function compensated group(299.0 ± 498.5) μg/L vs (27.9 ± 34.0) μg/L(t =3.1, P ＜ 0.01).D-D negatively correlated with ALB and PA(r =-0.6,-0.6, all P ＜ 0.01), and positively correlated with TBIL and PT(r = 0.4,0.6, all P ＜ 0.01).ConclusionThe level of plasma D-D related with hepatic functional reserve status,and detecting the level of D-D could be helpful to estimate hepatic functional reserve and prognosis of patients with HB.

ObjectiveTo investigate the clinical efficacy of coiling-dragon warm needling atHuatuo jiaji points plus Chinese herbal fumigation in treating ankylosing spondylitis (AS).MethodEighty AS patients were randomly allocated to treatment and control groups, 40 cases each. The treatment group received coiling-dragon warm needling at Huatuo jiaji points plus Chinese herbal fumigation and the control group, oral administration of salicylazosulfapyridine (SASP). An investigation was made of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the patients’ overall assessment, the Bath Ankylosing Spondylitis Functional Index (BASFI), the total number of swollen joints, the Bath Ankylosing Spondylitis Measurement Index (BASMI) and laboratory inflammatory indices: erythrocyte sedimentation rate (ESR), platelet (PLT) and C reactive protein (CRP).ResultThere was a statistically significant difference in the marked efficacy rate between the two groups (P<0.05). Clinical indices: disease activity index and functional index and laboratory indices: ESR, PLT and CRP improved somewhat inboth groups of patients after treatment (P<0.05). After two courses of treatment, the therapeutic effect was better in the treatment group and there was a statistically significant difference compared with the control group (P<0.05).ConclusionCoiling-dragon warm needling at Huatuo jiaji points plus Chinese herbal fumigation can effectively relieve the clinical symptoms and reduce inflammatory reactions in the active stage in AS patients. It is an effective way to treat AS.

Objective To compare the clinical effect of the two surgical methods of posterior pedicle screw fixation decompression in treatment of thoracolumbar burst fractures,and in order to provide the basis for choosing the rational treatment.Methods Retrospectively analyzed the clinical data of 98 patients with thoracolumbar burst fractures underwent surgery of posterior pedicle screw fixation decompression from January 2007 to January 2011.Fifty-six patients were given posterior fixed indirect decompression surgery (indirect decompression group) and 42 patients were given posterior fixed direct decompression (direct decompression group).The patients were followed up for (1.03 ± 0.36) years after surgery,the image,recovery of neurological function,postoperative complications and capacity for independent living of the two groups were compared and evaluated.Results After surgery,the vertebral height ratio,Cobb angle,canal compromise rate in indirect decompression group were (91.67 ± 26.19)％,(10.10 ± 2.89)°,(18.61 ±5.32)％,in direct decompression group were(86.23 ± 24.64)％,(11.98 ± 3.42)°,(22.37 ± 6.39)％.There was significant difference compared with before surgery (P ＜ 0.05) and no significant difference between two groups (P ＞0.05).After surgery,the neurological function of the two groups were improved,and the improvement in indirect decompression group was better than that in direct decompression group (P ＜ 0.05).The postoperative complications ratio in indirect decompression group was 23.2％ (13/56),significantly lower than that in direct decompression group[83.3％(35/42)](x2 =10.370,P＜ 0.01).There was 60.7％(34/56)patients with capacity for independent living in indirect decompression group,significantly higher than that in direct decompression group [40.5％ (17/42)] (x2 =4.329,P ＜ 0.05).Conclusion The posterior pedicle screw fixation indirect decompression in treatment of thoracolumbar burst fractures is a feasible operation method,and is worth to utilize in clinic.

ObjectiveTo monitor the early blood lactic acid concentration of patients with severe trauma who have been experienced routine surgery or damage control surgery,and explore the influence of surgical methods for the early lactate clearance rate.MethodsSelected 40 patients with severe trauma,they were divided into two groups with 20 cases each in accordance with the adopted operation mode,reference group by damage control surgery,and control group by routine surgery.Recorded acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ ) in patients after admission,blood lactic acid concentration at 6 h after admission and admission,calculated the early lactate clearance rate.ResultsIn reference group,blood lactic acid concentration at 6 h after admission was significantly lower than that in control group[ (3.5 ± 1.1 )mmol/L vs.(4.2 ± 1.4) mmol/L,P＜ 0.05 ],early lactate clearance rate was higher than that in control group [ (24.6 ± 6.3 )％ vs.( 11.4 ± 5.3 )％,P＜ 0.05 ].Conclusions Damage control surgery in patients with severe trauma in favour of the early removal of lactic acid,maintaining the homeostasis of the organism,is the key to improve the achievement ratio of treatment with severe trauma.

Objective To evaluate the effect of polydatin on neuropathic pain in rats.Methods Forty male Sprague-Dawley rats,aged 6-8 weeks,weighing 200-230 g,were randomly divided into 5 groups (n =8 each) using a random number table:sham operation group (group S),neuropathic pain group (group NP),polydatin 5 mg/kg group (group P1),polydatin 10 mg/kg group (group P2),and polydatin 20 mg/kg group (group P3).Neuropathic pain was induced by chronic constriction injury in NP and P1-3 groups.In group S,the sciatic nerve was only exposed but not ligated.In S and NP groups,normal saline 0.1 ml was injected intraperitoneally immediately after operation and at 1,3,5 and 7 days after operation (T1-4).In P1-3 groups,polydatin 5,10 and 20 mg/kg (in normal saline 0.1 ml) were injected intraperitoneally immediately after operation and at T1-4.At 1 day before operation (T0) and T1-4,the mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured.After measurement of pain threshold at T4,the rats were sacrificed,and L4-6 segments of the spinal cords were removed for determination of the expression of high-mobility group box 1 (HMGB1),Toll-like receptor 4 (TLR4),interleukin-1beta (IL-1β),tumor necrosis factor-alpha (TNF-α) and monocyte chemotactic protein-1 (MCP-1) by Western blot.Results Compared with group S,the MWT was significantly decreased,and the TWL was significantly shortened at T1-4 in group NP,the MWT was significantly decreased at T1-4,and the TWL was significantly shortened at T2-4 in group P1,the MWT was significantly decreased at T1-4,and the TWL was significantly shortened at T3.4 in group P2,the MWT was significantly decreased at T1-4 in group P3,and the expression of HMGB1,TLR4,IL-1β,TNF-α and MCP-1 was significantly up-regulated in NP,P1 and P2 groups (P＜0.05).Compared with group NP,the MWT was significantly increased at Tt-4,and the TWL was significantly prolonged at T1,2 in group P2,the MWT was significantly increased,and the TWL was significantly prolonged at T1-4 in group P3,the expression of HMGB1,TLR4,IL-1β,TNF-α and MCP-1 was significantly down-regulated in P2 and P3 groups (P＜0.05),and no significant change was found in the parameters mentioned above in group P1 (P＞0.05).Compared with group P1,the MWT was significantly increased at T4 in group P2,and the MWT was significantly increased at T14,the TWL was significantly prolonged at T3,4,and the expression of HMGB1,TLR4,IL-1β,TNF-α and MCP-1 was significantly down-regulated in group P3 (P＜0.05).Compared with group P2,the MWT was significantly increased at T3,4,and the expression of TLR4,IL-1β,TNF-α and MCP-1 was significantly down-regulated in group P3 (P＜0.05).Conclusion Polydatin can alleviate neuropathic pain through inhibiting inflammatory responses in the spinal cord of rats.

Objective To study the effects of inflammation of blood vessels to microcirculation disturbance in liver of patients with chronic hepatitis B(CHB). Methods188 cases of hepatic tissue with CHB were observed by light microscope and electronmicroscope.They were graded according to the inflammation of blood vessels in liver,and to discuss the relationship between the inflammation of blood vessel and microcirculation disturbance. ResultsAccording to the inflammation of blood vessels in liver,188 cases of CHB were divided to 3 grades,67 cases in grade 1,89 cases in grade 2 and 32 cases in grade 3.The rate of hepatic sinusoidal stenosis,hepatic sinusoidal blockage,the formation of microthrombus,decreased sizes and reduced numbers of sinusoidal endothelial cells' penestrate,the formation of collagen in Disse's spaces and the formation of basilar membrane increased along with the aggravation of inflammation of hepatic blood vessels. ConclusionInflammation of hepatic blood vessels was an important factor on microcirculation disturbance in liver of patients with CHB.It should be done something to improve the microcirculation,and decrease inflammation at the same time.

OBJECTIVE: To explore the effection of the pulmonary function of patients of chronic rhinosinusitis (CRS) with asthma which treated with endoscopic sinus surgery (ESS) based comprehensive treatment. METHOD: There were 50 cases of chronic rhinosinusitis with asthma whom met the study criteria. 35 cases enrolled in the tri al group, which treated with endoscopic sinus surgery, and routine perioperative tratment. Another 15 cases as control group which underwent conservative treatment. Both groups underwent the rule treatment of asthma. The main monitoring indexes, which included visual analogue scale (VAS) score, endoscopic Lund-Kennedy score, control of asthma symptoms, the pulmonary function which involved forced expiratory volume in first second (FEV1), forced vital capacity (FVC), the ratio of forced expiratory volume in first second and forced vital capacity (FEV1/FVC) and peak expiratory flow (PEF), were measured in the patients of each groups before surgery, follow-up for 1 year and 3-year. RESULT: Our study found that the VAS score of CRS with asthma was significantly negatively correlated with FEV1 and PEF (P < 0.05), endoscopic Lund-Kennedy score was significantly negatively correlated with PEF (P < 0.05); After the trial group underwent ESS based comprehensive treatment, the improvement of VAS score and endoscopic Lund-Kennedy score of postoperative compared with preoperative and the same period in the control group were significantly (P < 0.05). The difference of the postoperative asthma control rate of trial group after 1 year and after 3 years, respectively, compared with the same period control group were statistically significant (P < 0.05). The preoperative FEV1, FVC, FEV1/FVC and PEF of trial group compared with preoperative were significantly (P < 0.05). Even the difference of them compared with the same period control group were significantly (P < 0.05), except the FVC in the follow-up 3 years (P = 0.088). CONCLUSION The CRS may aggravate asthma symptoms and affect negatively the pulmonary function, and poor asthma control or aggravate may exacerbate the CRS in the course of CRS with asthma patient. With ESS based on combined therapy, it can improve the condition of CRS significantly and improve the control of asthma symptoms and pulmonary function else.
Adolescent ; Adult ; Asthma ; complications ; Chronic Disease ; Endoscopy ; Female ; Humans ; Male ; Middle Aged ; Nose ; surgery ; Pulmonary Ventilation ; physiology ; Rhinitis ; complications ; surgery ; Sinusitis ; complications ; surgery ; Young Adult

Objective To investigate the epidemiological characteristics and related risk factors of elderly patients with osteoporosis. Methods The basic data of 900 elderly people in Xining City from February 2015 to February 2018 were investigated. The proximal femur and L2～4 bone mineral density were measured by dual-energy X-ray absorptiometry. Osteoporosis was diagnosed and its epidemiological characteristics and risk factors were analyzed. Results Among the 900 elderly people in Xining,276 had osteoporosis,624 did not have osteoporosis, and the prevalence rate was 30. 67%. There were significant differences in gender,body mass index,smoking,alcoholism,family history of osteoporosis between elderly people with osteoporosis and those without osteoporosis ( all P＜0. 05) . The incidence of osteoporosis was 26. 63%(192／721),47. 41%(64／135) and 45. 45%( 20／44) in the elderly of Han nationality,Tibetan nationality and Hui nationality,respectively. The average bone density of femoral trochanter,bilateral femoral neck,Ward＇s triangle and L2～4 in the elderly of different age groups in Xining city was 2. 63%(192／721) . The prevalence of femoral trochanter,bilateral femoral neck,Ward＿s triangle and L2～4 was lower in male elderly than in female elderly ( all P＜0. 05) . By logistic regression analysis, female ( OR＝2. 573, 95%CI1. 319～3. 086), age growth ( OR＝3. 076,95%CI1. 128～3. 746),bad living habits ( OR＝1. 796,95%CI1. 154～5. 286) and family history of osteoporosis(OR＝1. 641,95%CI1. 128～4. 376) were elderly in Xining. Risk factors of osteoporosis ( all P＜0. 05) . Conclusion The prevalence of osteoporosis in 900 elderly people in Xining City was 30. 67%. With the increase of age,the bone mineral density of the elderly gradually decreased. The average bone mineral density of L2～4 was higher than that of proximal femur,and the average bone mineral density of females was lower than that of males. The occurrence of osteoporosis was attributed to females,age growth,bad living habits and family history of osteoporosis. Risk factors can provide reference for prevention and treatment of osteoporosis in the elderly in Xining.

Objective:To observe the image characteristics of optical coherence tomography (OCT) in patients with primary vitreoretinal lymphoma (PVRL).Methods:A retrospective clinical study. Thirty-two eyes of 19 patients diagnosed with PVRL by vitreous pathology in the Department of Ophthalmology, Beijing Tongren Hospital from September 2016 to October 2019 were included in this study. There were 7 males and 12 females. The median age was 56 years. The mean time from symptom onset to final diagnosis was 6.1±3.8 months. The first diagnosis was uveitis in 12 cases (63.1%, 12/19), retinal vein occlusion in 2 cases (10.5%, 2/19), central retinal artery occlusion in 1 case (5.3%, 1/19), and suspected PVRL of camouflage syndrome in 4 cases (21.1%, 4/19). Routine ophthalmic examination and frequency-domain OCT examination were performed in all the patients, and typical images were stored for analysis. According to the examination results, PVRL OCT signs were divided into vitreous cells, inner retinal infiltration, outer retinal infiltration, retinal pigment epithelial (RPE) infiltration, sub-RPE infiltration, and subretinal fluid.Results:Vitreous cells were found in all eyes (100.0%, 32/32). RPE infiltrated were observed in 19 eyes (59.4%, 19/32), RPE infiltration in 16 eyes (50.0%, 16/32), outer retinal infiltration in 8 eyes (25.0%, 8/32), inner retinal infiltration in 16 eyes (50.0%, 16/32), and subretinal fluid in 4 eyes (12.5%, 4/32).Conclusions:PVRL OCT signs can involve vitreous and retinal anatomical levels, including vitreous cells, inner retinal infiltration, outer retinal infiltration, RPE infiltration, sub-RPE infiltration and subretinal fluid. The same patient can show multiple signs at the same time.