This study analyzed the genetic evolution of neuraminidases (NAs) of influenza A subtype N9 viruses with the aim of determining the genetic origin of the novel avian A/H7N9 influenza virus. The NA sequences of influenza A subtype N9 viruses available from NCBI were used to construct a phylogenetic tree using the programs ClustalX 2.0 and MEGA 6.0. This analysis indicated that the novel avian A/H7N9 influenza virus is located in the modern Eurasian phylogenetic cluster. This cluster was then further analyzed by estimating the overall rate of evolutionary change and the selective pressure at the nucleotide level using the program BEAST 2.1.2 and the web interface Datamonkey, and by generating an amino acid sequence entropy plot using Bioedit software. In this cluster, the mean rate of nucleotide substitutions in NA was found to be 3.8354 x 10(-3) and the mean ratio of non-synonymous (dN) to synonymous (dS) substitutions per site (dN/dS) was 0.140413. A particularly high level of amino acid mutation entropy was identified at nucleotides 16, 19, 40, 53, 81, 84, 112, 256, 335, 359, and 401. This genetic evolution analysis suggests that the nucleotide substitutions that characterize the novel avian A/H7N9 influenza virus neuraminidase are likely to result from the overall genetic evolution of influenza A subtype N9 virus NAs, and not from selective stress. Phylogenetic analysis suggests that the influenza A virus (A/duck/Siberia/700/1996(H11N9)) isolated in 1996 appears to be the common ancestor of the more recent influenza A subtype N9 viruses NAs.
Amino Acid Substitution ; Animals ; Birds ; Evolution, Molecular ; Humans ; Influenza A Virus, H7N9 Subtype ; chemistry ; enzymology ; genetics ; Influenza in Birds ; virology ; Influenza, Human ; virology ; Molecular Sequence Data ; Neuraminidase ; chemistry ; genetics ; Phylogeny ; Sequence Homology, Amino Acid ; Viral Proteins ; chemistry ; genetics

Objective To compare the clinical effects of 2 common installation positions of the helical blade in the treatment of senile intertrochanteric fractures with proximal femoral nail antirotation (PFNA).Methods From January 2010 to December 2012,166 old patients with intertrochanteric fracture were treated by PFNA.According to the installation position of the helical blade in the femoral head on the postoperative X-ray films,they were divided into a C/C group (87 cases) where the helical blade was at the center of the femoral head in both anteroposterior and lateral views and an I/C group (79 cases) where the helical blade was at the inferior one-third of the femoral head in anteroposterior view and at the center in lateral view.There were no significant differences between the 2 groups in general data preoperation (P ＞ 0.05).The 2 groups were compared in terms of reduction quality,tip-apex distance (TAD),full weight bearing time,fracture healing time,and Harris Hip Score(HHS) at the last follow-up.Results C/C group had 83 patients followed for an average of 13.6 months and I/C group had 76 patients followed for an average of 13.3 months.There were no significant differences between the 2 groups regarding the good-to-excellent reduction rate [94.0％ (78/83) versus 94.7％ (72/76)],full weight bearing time (9.4 ± 1.5 weeks versus 9.3 ± 1.3 weeks),fracture healing time (17.8 ±2.3 weeks versus 17.2 ±2.3 weeks),or HHS (89.6 ±4.6 points versus 89.3 ±4.7 points) (P ＞ 0.05).There was a significant difference in TAD (21.14 ± 3.17 mm versus 24.96 ± 3.48 mm) between the 2 groups(t =-7.242,P =0.000).No infection or cut-out or other related complications of the helical blade occurred in either group.Conclusion The helical blade may lead to satisfactory clinical effects in the treatment of senile intertrochanteric fractures with PFNA no matter at which of the 2 positions it is installed.

To explore the characteristics of benign paroxysmal positional vertigo (BPPV) and examine the efficacy of Canalith repositioning in elders.A retrospective study was carried out among 47 BPPV cases at our hospital from January 2011 to June 2012.Posterior semicircular canal received Epley maneuver (n =35) and Lempert rolling for horizontal semicircular canal (n =12).Curative effect was evaluated after 1 week and 3 months.After Canalith repositioning,the initial success rate was 91.5％ (43/47) and the effective rate 8.5％ (4/47).After 1 week,the success rate was 100％.Nine patients (19.1％) had recurrence in the same canal previously affected,and all improved with a new repositioning maneuver.Canalith repositioning is both safe and effective in the treatment of BPPV.

BACKROUND: Because the cortical somatosensory evoked potential(CSEP) is easily affected by the anaesthesia drugs, so it needs to be combined with the subcortex somatosensory evoked potential (subcortical SEP)which is less affected by the junk to monitoring the spinal orthomorphia so as to increase the accuracy.OBJECTIVE: To monitor the onset of stretch spinal injury during rhachial orthomorphia with Combined application of subcortical SEP and CSEP.DESIGN: A comparative study of two kinds of evoked potential.SETTING: Department of Orthopaedics of the Second Affiliated Hospital of Sun Yat-sen University.PARTICIPANTS: Totally 104 patients with spinal orthomorphia ,including 40 males and 64 females, aged from 5 to 19 years, were selected from the Department of Orthopaedics of Sun Yi-xian Hospital of Sun Yat-sen University from July 1997 to December 2001.INTERVENTIONS: A Nicolet Viking Ⅳ (NICDLET Company, USA) with intraoperativemonitoring software was used to Record the wave of subcortical SEP and CSEP. The peak and after-following peak of the median N45and tibial P37 cortical responses were tagged manually for peak latency and peak-to-peak amplitude measurements. Reduction of more than 50% in SEP amplitude compared with the baselines measurement was defined as deterioration.MAIN OUTCOME MEASURES: Changes of CSEP and subcortical SEP during the surgery.RESULTS: Data of all 104 patients was entered the final analysis. Among 104 cases, 31 had positive cortex somatosensory evoked potential, 11 had positive infra-cortex somatosensory evoked potential, meanwhile, 3 cases changed into normal after relative treatment, which was related with operation. Accurate of cortex recorded point was 75%, under cortex 92.2%, and combination of cortex and infra-cortex 96.7%.CONCLUSION: The SEP is easily affected by the anaesthesia drugs, but it has good signals to record, however, the subcortical SEP is the contrary condition. The monitoring by combined application of CSEP and subcortical SEP during the spinal surgery can greatly increase the reliability of result.

Objective:To explore the strain experiences by suicides and to test the strain theory of suicide.Methods：A consecutive sample of 155 suicides(91 males and 64 females)aged from 15 to 34 years was studied with the psychological autopsy method.Informants consisted of family members and close friends of the suicides.Suicide stories were composed based on the background information of the suicides and what happened at the suicide site and then content-analyzed and rated by independent judges.Results:All of the victims had experienced at least one type of strain before suicide took place.The sequence of the 4 types of strains beginning with the most frequent one was coping strain,100%;aspiration strain,81%,deprivation strain,72% and value strain,45%.Generally,males experienced more coping strains,especially loss of money or investment than females [(8.85±3.64)vs.(7.72±3.77),(0.35±0.92)vs.(0.09±0.52);Ps<0.05],except for the traditionalism and modernity for status of women,religion and atheism [(0.08±0.37)vs.(0.53±0.97),(0.00±0.00)vs.(0.06±0.30);Ps<0.05].As age increased,value strain tended to increase(r= 0.16,P=0.048),whereas aspiration strain tended to decrease(r= -0.30,P<0.001).Conclusion：With the prevalence of dissonant stresses among suicide victims,it is suggested that crisis intervention and suicide prevention should begin with strain reduction through psychological counseling and therapy.

Adult ; Biomarkers ; blood ; Bone Marrow Transplantation ; Child ; Diagnosis, Differential ; Drug Therapy, Combination ; Hematopoietic Stem Cell Transplantation ; Humans ; Lymphohistiocytosis, Hemophagocytic ; diagnosis ; drug therapy ; therapy ; Practice Guidelines as Topic

Objective To study the residual gallbladder stones and the relationship between the onset of acute pancreatitis and its surgical treatment.Methods Retrospective analysis was made in 13 patients with residual gallbladder admitted tO the hospital from June 1998 to December 2007,of which 8 cases of residual gallbladder stones and acute pancreatitis were invostigated.Thirteen cases of patients had underovent cholecystectomy 2 to 9 years before,the first symptoms occurred before 1 month to 8 years.Other remnants of the gallbladder were diagnosed by B-ultrasound and CT,magnetic resonance cholangiopancreatography (MRCP).Results Two cases were confirmedas pigment stones;6 cases as cholesterol stones(size0.2 cm ～0.5 cm,an average of 3.2 cm);1 cases as anonlalous pancre-aticobiliary junction(anomalous pancreaticobiliary ductal union,APBDU);5 cases as anomal;8 cases(61.5%)as episode of acute pancreatitis.Au patients underwent resection of residual gallbladder,with line choledochal cyst excision and biliary-enteric Roux-en-Y internal drainage in 1 case.choledocholithotomy T-tube drainage in 3 cases.Postoperative follow-up of residual gallstone was done in 8 cases,no pancreatitis attack in 6 cases,pancreatitis attack in 2 cases.Significant difference was found in onset of acute pancreatitis (P=0.019,P<0.05).Five patients without stones in patients with postoperative all none pancreatitis attack.Conclusion Patients with residual gallbladder stones are prone to acute pancreatitis,and cholecystectomy for patients with residual treatment Can reduce the pancreatitis attack.

Autoimmune pancreatitis is a chronic autoimmune-related pancreatitis.It is characterized by a high globulin, IgG~4 increased, anti-carbonic anhydrase antibody and anti-lactoferrin antibodies exist, diffuse swelling of the pancreas, a significant lymphocyte infiltration accompanied by fibrosis, multiple clinical manifestations , and sensitive to the hormone treatment.

Over the past twenty years, with the development of brain science, many acupuncture clinical researchers have used multidisciplinary methods and techniques to perform acupuncture clinical research on cerebrosis. Up to now, many achievements have been obtained such as expanding studied disease entities, standardizing methods, identifying objects, and developing more and more treatment methods and in-depth mechanism research.

During the development of pancreatic cancer,the local and whole immune state of the patients is constantly changing,and through which the cancer cells escape from the immune attack.The main immunologic mechanism includes the induction of tumor immune suppression cells and producing the related cytokines.The changes of the whole immune status include the increase of immunosuppressive cells,the change of the immune function of T cell subsets and the inhibition of natural killers and lymphokine activated killer cells.In the local tumor,the infiltrating lymphocytes loss the function,and the ratio of Thl/Th2 cytokines is imbalance.