Objective To investigate the expression of T helper type 17 cells (Th17) and cell‐related cytokines ,including interleukin (IL)‐21 ,IL‐22 ,IL‐23 in the peripheral blood of different clinical stages of patients with acute hepatitis B (AHB) .Methods Ten cases of AHB patients were enrolled .The frequency of Th17 cells in the three clinical stages (i .e .acute phase ,convalescent phase and resolved phase) were detected by flow cytometry . IL‐21 , IL‐22 and IL‐23 were measured by enzyme‐linked immunosorbent assay (ELISA) .Control group was composed of ten healthy subjects .The comparison between the two groups was done by t test and the differences among multiple groups were compared by one way ANOVA .Pearson correlation analysis was used for correlation analysis .Results The frequency of Th17 in healthy controls was (0 .68 ± 0 .29)% ,while those in acute phase ,convalescent phase and resolved phase of AHB patients were (18 .22 ± 4 .13)% , (3 .14 ± 1 .90 )% and (3 .31 ± 0 .95 )% , The differences between the two groups were significant (t= 13 .405 ,4 .047 and 8 .342 , respectively ;all P< 0 .01) .The levels of IL‐21 ,IL‐22 and IL‐23 in healthy controls were (42 .00 ± 6 .95) ,(315 .89 ± 96 .16) and (11 .95 ± 6 .95) ng/L ,respectively .Those in acute phase of AHB patients were (575 .39 ± 47 .01) ,(648 .44 ± 47 .12) and (38 .29 ± 4 .68) ng/L ,respectively ,those in convalescent phase were (366 .50 ± 33 .74) ,(405 .04 ± 47 .12) and (25 .10 ± 4 .69) ng/L ,respectively ,while those in resolved phase of AHB patients were (46 .62 ± 8 .28) ,(365 .94 ± 45 .62) and (15 .29 ± 4 .69) ng/L , respectively .Compared with healthy controls ,t values of the levels of IL‐21 in three different phases of AHB patients were 35 .497 ,29 .792 and 1 .354 with P value of <0 .01 ,<0 .01 and 0 .193 ,respectively ;those of IL‐22 were 9 .820 ,2 .632 and 1 .487 with P value of < 0 .01 ,0 .021 and 0 .161 ,respectively ;those of IL‐23 were 9 .944 ,4 .961 and 1 .260 with P values of <0 .01 ,<0 .01 and 0 .226 ,respectively . After comparison of IL‐21 ,IL‐22 and IL‐23 among three different phase of AHB ,F values were 622 .784 , 107 .772 and 60 .743 with all P values less than 0 .01 ,respectively .The levels of IL‐21 ,IL‐22 and IL‐23 were all positively correlated with the serum ALT level in acute phase (r= 0 .655 ,0 .666 and 0 .673 , respectively ;all P<0 .05) .Correlation analysis demonstrated that the frequency of Th17 was positively correlated with the levels of IL‐21 , IL‐22 and IL‐23 in acute phase ( r= 0 .879 ,0 .866 and 0 .879 , respectively ;all P<0 .01) .The frequency of Th17 was positively correlated with the level of IL‐21 in the resolved phase . No correlations between the remaining groups were confirmed . Conclusion The expressions of Th17 and cell‐related cytokines ,including IL‐21 ,IL‐22 and IL‐23 decline with the recovery of A HB .

Objective To investigate the effects of sensorimotor therapy on patients with knee osteoarthritis.Methods Ninety-two patients with knee osteoarthritis were divided into a treatment group and a control group by using random digits table. Both groups received conventional rehabilitation therapy, including knee isometric and isotonic contraction training, ultrashort wave diathermy as well as aerobic exercise. The treatment group was also administered with sensorimotor training, in addition to the conventional training,including the muscle strengthening and control training of quadriceps and hamstring muscle using sling exercise therapy system and on the Thera-band mattress. The visual analogue scale (VAS) for pain, manual muscle testing and knee range of motion as well as the Japanese Orthopedic Association knee function evaluation form were used to evaluate the patients. Results There was no statistic difference between the 2 groups before treatment, with regard to the evaluation parameters used in this study. After 2 months of treatment, both groups improved significantly (P ＜0.05),with the treatment group improved to a significantly greater extent (P ＜0.05). Conclusions Sensorimotor training in addition to the conventional rehabilitation treatment can further relieve the pain of patients with knee osteoarthritis joints arthritis and improve the function of patients with knee osteoarthritis.

Objective To explore the status and influencing factors of surgical site infection (SSI)following lapa-roscopic surgery in patients in department of general surgery,so as to take effective measures to reduce SSI. Methods Active monitoring method was used to survey SSI among 401 patients undergoing laparoscopic surgery from January 1 ,2013 to December 31 ,2013,univariate analysis and multivariate analysis on risk factors for SSI were conducted.Results Of 401 investigated patients,12 (2.99%)developed SSI.Univariate analysis showed that risk factors for SSI in patients with laparoscopic surgery were elderly patients,emergency operation,infected wound,gastrointestinal tract operation,and grade Ⅳof ASA score (all P <0.05 ).Multivariate logistic regression analysis revealed that elderly patients (OR,5.02[95%CI ,1 .38 -30.25]),emergency operation (OR,4.37 [95%CI ,1 .96-28.55]),infected wound (OR,7.27[95%CI ,2.54-25.05]),and gastrointestinal tract operation (OR, 8.13 [95%CI ,1 .38 - 18.33 ])were high risk factors for SSI following laparoscopic surgery (all P < 0.05 ). Conclusion Thereare multiple factors influencing SSI after laparoscopic surgery,diversified prevention and control measures can effectively reduce the incidence of postoperative SSI.

Objective To investigate the effects of a new sling exercise treatment combined with injections of sodium hyaluronate on the radiographic findings and clinical variables of patients with patellofemoral pain.Methods Seventy patients with patellofemoral pain syndrome were divided into a group which was treated using a new sling exercise therapy combined with injections of sodium hyaluronate (the combined therapy group,n=34) and another which received only sodium hyaluronate injections (the control group,n=36).The patients of both groups were assessed pre-and post-treatment.The clinical assessment modalities were pain scores (using a visual analogue scale,VAS),quadriceps and hamstring strength and range of motion in the active flexion and extension of the knee.Q angles were measured supine and standing.Patellofemor tilt angle and congruence and sulcus angle were determined by CT scanning.Results After 5 weeks the average VAS pain score of the combined therapy group was significantly lower than that of the control group.Muscle strength and range of motion in the combined therapy group were both significantly higher than pro-treatment,the Q angles were significantly smaller,and the congruence and sulcus angles were significantly better.Conclusion Five weeks of practicing the new sling exercise therapy combined with injections of sodium hyaluronate can yield satisfactory clinical and radiologic outcomes in patients with patellofemoral pain syndrome.

OBJECTIVE:To systematically review the efficacy and safety of cinacalcet in the treatment of hemodialysis pa-tients with secondary hyperparathyroidism,and provide evidence-based reference for the clinical treatment. METHODS:Retrieved from Medline,Cochrane Library,EMBase and CBM,randomized controlled trials(RCT)about cinacalcet in the treatment of he-modialysis patients with secondary hyperparathyroidism (SHPT) were collected. Meta-analysis was performed by using Rev Man 5.3.5 software after data extract and quality evaluation by Cochrane systematic Rev Man 5.3.5. RESULTS:Totally 7 RCTs were en-rolled,involving 1 987 patients. Results of Meta-analysis showed cinacalcet can significantly reduce the rate of surgical parathyroid-ectomy[RR=0.23,95%CI(0.06,0.89),P=0.03],incidence of fracture[RR=0.26,95%CI(0.12,0.60),P=0.002] and increase the incidences of hypocalcemia[RR=9.81,95%CI(3.92,4.59),P<0.001],nausea[RR=1.97,95%CI(1.58,2.46),P<0.001] and vomit-ing[RR=1.91,95%CI(1.50,2.42),P<0.001],while it showed no significant effect on the the incidence of all-cause mortality and cardiovascular death. CONCLUSIONS:The clinical efficacy of cinacalcet in the treatment of hemodialysis patients with secondary hyperparathyroidism is good,but there are common adverse reactions such as nausea and vomiting,hypocalcemia.

Objective To explore the causal relationship between family resilience and mental health in military personnel population.Methods A total of 204 military personnel were recruited from an army unit stationed in Western China with cluster convenience sampling.Family Resilience Scale(FRS)and Symptom Checklist 90(SCL-90)were used to survey them twice,in an interval of 4 months.Amos 26.0 was applied to construct a cross-lag model and analyze the data.Results After controlling mental symptoms from the first survey,family resilience in the first measure significantly predicted mental symptoms in the second measure(β=-0.14,P＜0.05).After controlling for family resilience from the first survey,mental symptoms in the first measure significantly predicted family resilience in the second measure(β=-0.13,P＜0.05).Conclusion The relationship between family resilience and mental health is mutually causal in military personnel,and one predicts the other one.Our findings highlight the key dimensions of the relationship between the two.

The clinical data of a case of neonatal bacterial meningitis complicated with posterior fossa subdural empyema in the West China Second University Hospital in December 2019 were retrospectively analyzed.The 3-day-old male newborn was admitted for jaundice with decreased intake for 1 day.Examinations on admission showed increased C-reactive protein.The count of karyocytes in cerebrospinal fluid (CSF) significantly increased, which were mainly neutrophils, and pyocytes could be found.The protein content in CSF increased, while that of glucose decreased.Both CSF culture and blood culture detected the presence of Escherichia coli.Enhanced magnetic resonance imaging (MRI) of the head indicated large abnormal signals in bilateral occipital extra-cerebellar spaces.T1-weighted images presented mixed low and high signals, and T2-weighted images presented high signals, and marginal enhancement was observed after enhancement.After 6 weeks of antibiotic treatment using Meropenem combined with Ceftazidime, the CSF index of the newborn patient returned to normal, and the subdural empyema of the posterior fossae subsided.Bacterial meningitis complicated with subdural empyema of posterior fossa is a rare and critical disease of the central nervous system.It is easily misdiagnosed due to the atypical clinical manifestations and early imaging features.The disease requires an adequate course of anti-infective treatment.Surgical removal of the empyema should be performed if the anti-infective treatment is unresponsive.

Acute lymphoblastic leukemia is the most common type of leukemia in children. In recent years, the treatment and prognosis of acute lymphoblastic leukemia in children have improved significantly. However, acute lymphoblastic leukemia itself and treatment measures can lead to a variety of adverse oral complications and affect further treatment. These complications have a significant effect on patients and affect further treatment. To improve the quality of life of children, this article reviews the oral health status and oral health management of children with acute lymphoblastic leukemia for clinical reference. The literature review shows that the oral health management measures for children with acute lymphoblastic leukemia mainly include oral health education, active prevention of oral diseases, timely oral treatment before the start of antitumor treatment, elimination of potential sources of infection after blood examination and risk assessment, treatment of oral mucosal problems during therapy, oral emergency during antitumor therapy should be carried out under the guidance of hematologists and regular oral inspection and oral care. However, current studies have found that there is still a lack of effective prevention and treatment measures for oral mucositis. As a common oral disease in children with acute lymphoblastic leukemia, the prevention and treatment of oral mucositis remain to be further studied.