Aged ; Anthracosis ; complications ; metabolism ; pathology ; Cyclin-Dependent Kinase Inhibitor p16 ; metabolism ; Humans ; Lung ; metabolism ; pathology ; Lung Neoplasms ; complications ; metabolism ; pathology ; Male ; Middle Aged ; Retinoblastoma Protein ; metabolism

Diagnosis, Differential ; Humans ; Hyponatremia ; diagnosis ; etiology ; therapy ; Inappropriate ADH Syndrome ; diagnosis ; etiology ; therapy

Objective To study the dynamic changes and clinical significance of D-D, t-PA and PAI in patients with acute renal failure during the process of different methods of blood purification. Methods Thirty-seven ARF patients were divided into three groups: HD group, HDF group and HF group. Plasma D-D level, t-PA and PAI activity were determined 1 hour, 4 hours before and after treatment. Normal control group consisted of fourteen healthy people. Results ① Plasma D-D level and PAI activity in ARF patients were obviously higher than those in control group, while t-PA activity was lower(P0.05). ③ After 4 hours of the treatment, compared with HD group, HDF and HF groups had significant difference in plasma D-D level, t-PA and PAI activity(P

OBJECTIVETo evaluate the clinical efficiency of selective cyclo-oxygenase-2 (COX-2) inhibitor compared to traditional nonselective NSAIDs for the prevention of heterotopic ossification (HO) after total hip arthroplasty (THA).

METHODSBy searching Medline, Embase, CENTRAL (Cochrane Central Register of Controlled Trials) and Science Citation Index et al, only randomised controlled studies of selective COX-2 inhibitors VS nonselective COX-1 and COX-2 inhibitors for the prevention of HO after THA were included. The quality assessment of included studies was evaluated according to the standard of the Cochrane Collaboration, and the data were analysised by statistic software Stata 10.0. The HO incidence of both groups in different degrees was compared.

RESULTSFour eligible randomised controlled trials of totally 808 patients were included. Meta-analysis results showed that no statistically significant difference was found in overall incidence of HO (RR = 1.08, 95% CI: 0.71-1.64,P = 0.73), incidence of moderate severe HO (Brooker II and III) (RR = 0.83, 95% CI: 0.48-1.42, P = 0.49) and any grade of Brooker classification between two groups. In all included studies, 16 patients receiving nonselective COX inhibitor (4.4%) discontinued treatment because of gastrointestinal toxicity,whereas 10 patients in the selective COX-2 inhibitor group (2.7%) discontinued for gastrointestinal side effects.

CONCLUSIONThe selective COX-2 inhibitors are as equally effective as nonselective NSAIDs for the prevention of HO after THA. Considering the side effects of nonselective NSAIDs, selective COX-2 inhibitors were recommend for the prevention of HO after THA.

Anti-Inflammatory Agents, Non-Steroidal ; adverse effects ; therapeutic use ; Arthroplasty, Replacement, Hip ; adverse effects ; Cyclooxygenase 2 Inhibitors ; adverse effects ; therapeutic use ; Cyclooxygenase Inhibitors ; adverse effects ; therapeutic use ; Humans ; Ossification, Heterotopic ; prevention & control ; Randomized Controlled Trials as Topic

OBJECTIVETo search for a simple and effective surgical approach to the management of moderate to severe pediatric concealed penis in children.

METHODSWe used Devine's technique via incision between the penis and scrotum in the treatment of 68 cases of moderate to severe pediatric concealed penis. The patients were aged 3 -13 (mean 6.5) years, 30 with moderate and 38 with severe pediatric concealed penis.

RESULTSThis strategy achieved good near- and long-term effects and satisfactory appearance of the penis, which was similar to that of circumcision. At 3 months after surgery, the penile length was 3 - 5.2 cm, averaging (2.35 +/- 0.35) cm.

CONCLUSIONDevine's technique via incision between the penis and scrotum is a simple and effective surgical option for moderate to severe pediatric concealed penis in children.

Adolescent ; Child ; Child, Preschool ; Humans ; Male ; Penis ; abnormalities ; surgery ; Scrotum ; surgery ; Urologic Surgical Procedures, Male ; methods

Objective To evaluate the clinical value of adenosine triphosphate (ATP) determination in CD4+ cells in cytomegalovirus pneumonia after renal transplantation.Methods The ATP level of CD4+ T cells was measured by ImmuKnowTM kit.The ATP levels were determined in 187 renal transplant recipients before and 30,60,90,180 days after operation,and at the time of CMV pneumonia and 4 weeks after treatment of CMV pneumonia.The associations between ATP levels and CMV pneumonia were analyzed.Analysis of variance (ANOVA),Pearson-Spearman and relative risks were used for data analysis.Results 17 cases out of 187 renal transplant recipients were diagnosed as CMV pneumonia (9.1％),and the onset of CMV pneumonia started on the (2.8 ±1.2)month after renal transplantation.ATP concentrations in CD4+ T cells were significantly lower after operation than those before operation (P＜0.01).ATP concentrations reached the lowest on the about postoperative day 90 (P＜0.05),then increased gradually.In 17 recipients with CMV pneumonia,the ATP levels before and 30,90 days after operation,at the time of CMV pneumonia and 4th week after treatment of CMV pneumonia were (376 ±182),(283 ± 146),(196 ± 112),(145 ± 102) and (236 ± 117) μg/L respectively.ATP levels at the time of CMV pneumonia were significantly lower than any other time points (P＜0.05).There was close correlation between ATP levels and CMV pneumonia.Conclusion The determination of ATP in CD4+ cells could reflect the status of cell-mediated immunity in renal transplant recipients,and could evaluate the severity and prognosis of CMV pneumonia and guide the clinical treatment.

Objective To explore the relationship between adjustment of immunosuppressant and prognosis in renal transplantation recipients with pulmonary infection. Methods The clinical data of 98 patients with pulmonary infection following renal transplantation were retrospectively analyzed.Patients were divided into two groups: conventional group (n = 45) and immunosuppressant adjustment group (n = 53). The mortality, recovery time and rejection rate in two groups were analyzed under the statement of serious infection (SOFA≥12) and slight infection (SOFA＜ 12) by sequential organ failure assessment (SOFA) score. Results When the SOFA scores ≥ 12, the mortality and recovery time in immunosuppressant adjustment group were significantly lower than in conventional group (P＜0.05), but there was no significant difference in the rejection rate between two groups (P＞0.05). When the SOFA scores ＜11, there was no significant difference in mortality and recovery time between the two groups (P＞0.05). The incidence of rejection in immunosuppressant adjustment group was significantly higher than in conventional group (P＜0.05).Conclusion Mortality could be decreased and course of anti-infection treatment could also be shortened by adjusting the immunosuppressant in renal transplantation recipients with serious pulmonary infection (SOFA≥12). Immunosuppressant agent was proposed to maintain the original treatment protocol when the infection was slight (SOFA＜12).

Objective To analyze the distribution of main pathogens,antimicrobial susceptibility,and clinical characteristics of osteoarticular infection,and provide evidence for clinical treatment.Methods A retrospective sur-vey was conducted on clinical data and pathogenic results of hospitalized patients with osteoarticular infection diag-nosed by etiology and pathology in Peking University First Hospital from 2009 to 2016,surveyed data were analyzed statistically.Results A total of 99 cases of bacterial osteoarticular infection were enrolled,100 strains of pathogenic bacteria were isolated,gram-positive bacteria accounted for 67.00%,49.00% of which were Staphylococcus spp., Enterobacteriaceae bacteria accounted for 67.74% of 31 strains of gram-negative bacteria.Isolation rate of methicil-lin-resistant Staphylococcus aureus (MRSA)was 16.13%,resistance rates of Staphylococcus spp.to fluoroquino-lones and rifampicin were both lower than 30%.Complication with other site infection (urinary tract infection,in-testinal infection,bloodstream infection)was an independent risk factor for gram-negative bacterial steoarticular in-fection (P＝0.027,OR＝10.536,95% CI:1.300－85.417).Conclusion Staphylococcus spp.is still the main pathogen causing osteoarticular infection,proportion of MRSA is low.Patients with urinary tract infection and in-testinal infection as well as long duration of implant should be considered the possibility of gram-negative bacterial infection when they develop steoarticular infection.

Objective To assess the effectiveness of absorbable screws and metallic devices for treating tibial plateau fractures.Methods Fifty-seven cases of tibial plateau fractures were treated with internal fixation using absorbable screws(Group A),cannulated screws(Group B)and condylar buttress plates(Group C)in our hospital.According to Schatzker classification,there were 15 cases with typeⅠfractures,21 with typeⅡ,nine with typeⅢand 12 with typeⅣ,who were followed up for 6-51 months. Statistical analysis was performed to compare bone union and functional restoration of the knee between three groups.Results Bone union was achieved in all cases.Based on Merchant scale for knee func- tion,excellence rate was 84%(16/19)for Group A,92%(11/12)for Group B and 85%(22/26) for Group C,with no significant statistical difference.Conclusion Absorbable screws is as effective as metallic devices for treating tibial plateau fractures and has advantages of minimal invasion,few complica- tions and avoiding secondary operation.

Objective To evaluate the effect of heparin binding epidermal growth factor-like growth factor (HB-EGF)on liver regeneration after partial orthotopic liver transplantation.Methods Fourty SD rats were used to establish the model of partial orthotopic liver transplantation with ameliorated two-cuff technique.Then all the rats were divided into 2 groups:experiment group and control group.Twenty rats of experiment group were adminis- tered 500?g/kg HB-EGF via vena caudalis immediately after operation twice a day,while the same volume of saline was administered to the rats in control group.Five rats in each group were selected randomly and killed at the 6th hour,day 2,4 and 7 after operation,respectively.The serum levels of albumin(Alb)and alanine aminotransferase (ALT)in the blood sample were detected.Every liver was removed and weighed.The expression of Ki-67 was de- tected by using immunohistochemistry assay.The regeneration activity of hepatocytes was evaluated by flow cytom- etry.Results The wet weights of liver in experiment group were all significantly higher than that in control group at the 6th hour,day 2 and 4 after transplantation(P