[Objective]To discuss the relation-ship between AAONFH(advanced alcoholic osteonecrosis of femoral head)and extended overdose drinking.[Method]Reviewed 165 cases of total hip arthroplasty,to analyzed the clinical data among 27 AAONFH cases,reviewed the literatures,discussed the pathogenesis of AAONFH and the relation-ship between blood biochemistry and blood cloting funtion and compared the experimental results among literatures.[Result]Theres various factors resulted in osteonecrosis of the femoral head associated with alcohol long-term over intake.Individuals consuming more than 750 ml of alcohol daily were at greater risk of double or half ONFH,Theres no change in biochemical test,but blood clotting funtion in this case would degrade,osteoarthritis of hip would synchronize.[Conclusion]Individuals consuming more than 750 ml of alcohol daily have the potentiality of ONFH;Its no specificity significance in biochemical test,the necrosis extent of the femoral head is relative to the capacity and times of alcohol intake.THR(total hip replacement)is the best treatment for AAONFH,but theres more staxis potentiality in this cases.

Objective:To evaluate the effects of endovascular embolization and microsurgical clipping on cognitive function in patients with intracranial aneurysm.Methods:A total of 80 patients with intracranial aneurysms,who were treated in Chongqing Hospital of Traditional Chinese Medicine from March 2014 to September 2015,were selected and randomly divided into control group(n=40) and experimental group (n=40).The control group was treated with microsurgical clipping,and the experimental group,with endovascular embolization.The postoperative cognitive function was assessed by the mini mental state examination scale (MMSE),and length of stay,in-hospital mortality rate,mortality rate in 1 year and the incidence of postoperative adverse reactions were compared between the two groups.Results:The total score (26.78± 0.85) of MMSE in the experimental group was higher than that (22.25± 0.63) of the control group (P＜0.05).The cognitive dysfunction rate (37.50％) of the experimental group was lower than that (55.00％) of the control group (P＜0.05).The length of stay [(6.7± 3.9) days] of the experimental group was lower than that [(9.6± 4.5) days] of the control group(P＜0.05).There were no significant differences in in-hospital mortality rate and mortality rate in 1 year,and the incidence of adverse reactions between the two groups (P＞0.05).Conclusion:Endovascular interventional therapy can improve the cognitive function of the patients with intracranial aneurysms and shorten the length of hospital stay.

Cerebral apoplexy is one of the main causes of death in the middle-aged and elderly population,which has higher mortality and disability rate.The incidence of the disease is increasing year by year and it is a serious threat to human life and health.Therefore,it is of great significance to find an effective target for the diagnosis and treatment of stroke.Thioredoxin (Trx) is the major thiol reducing agent in the cells,it is involved in many signal transduction pathways in the cells by regulating the redox state of the cell.It has disulphide reductase activity,which can reduce the oxidative stress injury in the rats after the stroke.Thioredoxin interacting protein (TXNIP) is an endogenous inhibitor of Trx,it can destroy the redox balance and promote the oxidative stress by binding/inhibiting the activity of Trx,while the inhibition or knockdown of TXNIP has obvious neuroprotective effects.Recent studies suggest that Trx/TXNIP may be involved in the pathophysiology of cerebral apoplexy by a variety of pathways.This article analyses the research status of Trx/TXNIP and studies the localization of Trx system in the central nervous system and the progress of Trx system in ischemic cerebral apoplexy.It reviews the mechanism of Trx/TXNIP in cerebral apoplexy and prospectes the signaling pathways involved in the pathophysiological process of Trx/TXNIP to provide new ideas for the treatment of cerebral apoplexy.

Objective To analyze the experience of 745 cases of lumbar disc herniation(LDH) and investigate the relevance between the clinical symptoms,signs and operative observation.Methods From 1982 to 2003,745 cases of LDH were treated operatively.In order to investigate the relationship between clinical presentations and operative results,a statistic analysis was conducted using the clinical symptoms,signs and operative observations.Results As the predominant manifestions,the pain in the low back and leg was seen in 96.4% of LDH,the pain aggravated by belly pressure in 93% of LDH,local tenderness and radicular pain around the lumbat spinous process in 70.8% of LDH,rectoleg elevation test(+) in 91.6% of LDH.operation observation:77.6% of LDH was classified as lateral type,10.9% as medial type and 11.5% as rupture or sequestration type.Weakness of extensor hallucis longus could seen in 65.6% of LDH of L_4,L_5,in 32.3% of LDH of L_5S_1.Conclusions Although the extensive usage of computed tomography(CT) and magnetic resonance imaging(MRI) provides a prompt and accurate basis for diagnosis of LDH,the physical examination remains the most important routine way to make a diagnosis.It is suggested that during the diagnosis and treatment of LDH,besides the common features of the disease,some individual presentations should not be neglected in few rare atypical cases,so as to diagnose and treat correctly.

Objective To study the effect and mechanism of tetrandrine (Tet) treatment of severe acute pancreatitis (SAP). Methods 45 SD rats were randomly divided into 3 groups: control group, severe acute pancreatitis group (SAP group) and tetrandrine group (Tet group). 5 rats were randomly taken from each group 3, 6, and 12 h after operation, and then underwent laparotomy for testing. Detection targets included calciumion concentration, pancreatic acinar calcium fluorescence intensity and pancreas pathological evaluation. Results In terms of the value of all detection targets, there was no statistical difference for the control group between different time points (P ＞0.05 )while there was statistical difference for SAP group and TET group in different time points (P＜0.05). Conclusion The experiment confirms that Tet, as a calcium blocker, can inhibit calcium to penetrate into pancreatic acinar cells, thus effectively reduce the pathological damage to pancreas of the experimental rats. Calcium overload plays an important role in SAP development.

Objective Study the production of the?-lactamases in eight pan-resistant citrobact- er freandi and their epidemic characteristics.Methods Modified Hodge test and EDTA-disk syner- gy test were used to screen Metallo-?-lactarnases,and isoelectric focusing to estimate the production of ESBLs and AmpC enzymes.ESBLs,AmpC,MBL genes were amplified and analyzed by PCR and DNA sequencing.Molecular epidemics were investigated by PFGE.Results All the 8 strains pro- duced TEM-1,CTX-M-14,4 of them at the same time producing CTX-M-3.No Plasmid mediated AmpC was found.Furthermore,a new subtype of MBL with one amino acid different from IMP-8 was de- tected.All the 8 strains belong to the same PFGE type.Conclusions Pan-drug-resistant citrobacter freundi produced more than one kind of?-lactamases.All these isolates were clonally related.

HBeAg is an ungranular secretory protein,which encoded by C gene of HBV DNA and it increases with the replication of HBV. So it is one of the markers of active replication of HBV in clinical diagnosis. HBeAg is important biologic raw materials which is widely used in preparation of related diagnostic articles with HBV infection serological detection. The technology of expression and purification of recombinant HBeAg is quite mature,which had successfully expressed the target protein in various expression systems. The key factors on HBeAg expression include important site mutation in precore region ,the choice of vectors,effects of RNA interference(RNAi)and so on. Therefore,in order to meet requirements of related diagnostic products,it need to improve expression level and purity of recombinant HBeAg and avoid cross-reaction with HBcAg. In a word,it showed that acquisition of high quality recombinant HBeAg could lay substantial foundation for improving diagnostic products,provide a reliable evidence for exploiting new type of therapeutic and preventive HBV vaccine and offer possibility of HBeAb detection methodological optimization.

OBJECTIVE: To explore the availability of transcatheter closure of atrial septal defect(ASD)in infants guided by transesophageal echocardiography(TEE). METHODS: The clinical data of 13 infants(under one year old)with ASD who underwent transcatheter closure via right jugular vein through adjustable curved sheath under guidance of TEE from June 2015 to March 2018 in Qingdao Women and Children's Hospital were analyzed retrospectively. The operation effect,time and complications were evaluated. RESULTS: All 13 infants were successfully occluded. TEE can accurately guide the establishment of the delivery track. The operation time was(27.2±15.1)minutes. All patients had satisfactory occluder shape and fixed position,without such complications as arrhythmia,hemolysis,embolism,infection,pneumothorax,hemothorax or vessel injury.CONCLUSION: TEE-guided transjugular closure of ASD is a feasible method,which can avoid surgical risks and vessel complications in young and low-bodyweight infants;Meanwhile,the potential radiation damage can be avoided.

?AlM:To study the relationship between blood lead level and abnormal eye blinking in children.
? METHODS: The patients with chief complaint of frequent eye blinking, whose diagnosis of abnormal eye blinking, were randomized to experimental group. The patients in this group carried out vision and the slit-lamp examination, detected corneal fluorescein staining and tear break-up time, and improved the level of blood lead and trace elements examination. The patients in control group with chief complaint of health physical examination in our hospital, excepted of blood lead level, the other body check results were normal and were divided into boys group and girls group according to the gender. The changes of the experimental group and control group in blood lead level were compared.
?RESULTS: Totally 371 cases ( male:295 cases; female:76 cases) with mean age was 6. 56±2. 41 years and 6. 08±2. 82 years respectively were in experimental groupe. ln control group, there were 300 cases ( male: 186 cases;female:114 cases) with mean age was 6. 99±3. 01 years and 6. 56±2. 80 years respectively. The average of blood lead level of boys in experimental group was 63. 82 ±24. 56μg/L and 53. 98±15. 42μg/L in control group. The average of blood lead level in experimental group was higher than that in control group. The difference between of the two group was statistically significant (χ2=16. 96, P<0. 01 ). The average of blood lead level of girls in experimental group was 56. 96±16. 69μg/L and 48. 18±12. 35μg/L in control group. There was no difference between of the two group (χ2=5. 77, P=0. 56). ln control group, the average of blood lead level with <3 years, 3~6 years and >6 years children were 48. 73±11. 67μg/L, 51. 39 ± 14. 87μg/L, 52. 98 ± 14. 45μg/L respectively. ln expirement group, the results were 56. 57±17. 89μg/L, 59. 92±18. 46μg/L and 67. 00±32. 55μg/L in <3, 3~6 and >6 children, respectively. There was no significant difference with <3 years (χ2=3. 54, P=0. 17). The difference with 3~6 years and >6 years children were statistically significant (χ2 = 9. 62, P = 0. 008 ) and (χ2 = 19. 22, P = 0. 000 ) respectively. The blood lead level were divided into three grades: <50μg/L, 50 ~100μg/L, >100μg/L, and relative risk (RR) were 0. 65, 1. 22, and 10. 11 respectively.
?CONCLUSlON: Blood lead level of experimental group is higher than that of control group. The relationship between blood lead level and abnormal eye blinking in children is positive correlation.

Objective To analyze the CT findings of endobronchial spread in lung adenocarcinoma. Methods The CT findings of 15 lung adenocarcinomas or bronchioloalveolar carcinomas with endobronchial spread were reviewed,the distribution and the progression of the spread were evaluated.Results All of the primary tumors were consolidation form.The spread lesions distributed in one side of the lung or both sides along the bronchus.The pleural surface was spared.The CT findings of the spread included centrilobular nodules(n=5),tree-in-bud(n=7),acinar nodules(n=2),ground-glass opacities(n=10)and air- space consolidations(n=13)in the first CT examination.5 cases of the spread lesions only presented centrilobular nodules(single form)and 10 cases presented several appearances(complex form).All of the cases were diagnosed as tuberculosis or pneumonia,and antituberculotic or antibiotic therapy was taken with no effect.The follow-up CT scans showed progression in all cases,and the spread lesions with single form became multiple consolidations.The spread lesions with complex form deteriorated faster than the single one. Conclusion Although the CT findings of the endobronchial spread of the lung adenocarcinoma is specific, the clinical history and laboratory examination also are important for the differential diagnosis with tuberculosis and other infectious diseases.