OBJECTIVETo explore the clinical effects of closed reduction and less invasive stablization system for the treatment of proximal tibial multi-segment comminuted fractures, and to discuss the influence of LISS on reduction and bone union.

METHODSFrom 2003.7 to 2007.12, 19 patients with proximal tibial multi-segment comminuted fractures were treated with closed reduction and LISS fixation. Fourteen patients were male, 5 patients were female, ranging in age from 21 to 49 years, with an average of 39.2 years. Fifteen patients were injured with direct violence, 4 indirect violence. The reasons of the injuries were vehicle crashes for 14 cases and falling from high places for 3 cases and falling to the ground for 2 cases. All the patients were followed up postoperatively. Callus formation and bony union were recorded by X-ray.

RESULTSAll the patients were followed up for a period averaged 12.2 months (ranged 8 to 21 months). No failure of fixation and nonunion. No deformation of plates and screws occurred in patients,no superficial wound infection. According to the criteria of Merchan, 14 patients got an excellent result, 3 good, and 2 poor.

CONCLUSIONClosed reduction and less invasive stabilization systems can provide rigid internal fixation for proximal tibial multi-segment comminuted fractures. The LISS provides stable fixation, a high rate of union, and a low rate of infection for proximal tibial multi-segment comminuted fractures.

Adult ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Comminuted ; surgery ; Humans ; Male ; Middle Aged ; Radiography ; Tibia ; diagnostic imaging ; surgery ; Tibial Fractures ; surgery ; Treatment Outcome ; Young Adult

OBJECTIVETo summarize and analyze the epidemic situation of hantaviruses including geographic distribution, types and prevalent intensity of epidemic areas of hantavirus for the last 30 years in China, and to discuss relative preventive measures.

METHODSCollecting and analyzing the data of hantaviruses epidemics in China.

RESULTSThe annual number of cases of hantavirus disease rapidly increased from 3295 in 1970 to 115,804 in 1986 then sustained between 40,000 and 60,000 cases annually in the 1990's, and then decreased thereafter. The epidemic areas existed in all provinces except Qinhai and Xinjiang and there were the hospitalized cases of hantavirus disease reported in other provinces. In recent years, the prevalence of hantavirus infection had increased in some cities, and the seasonal distribution of the cases changed as well.

CONCLUSIONData suggested that the new epidemic characteristics of hantaviruses had emerged in China suggesting that it was necessary to strengthen surveillance programs and to take comprehensive preventive measures for the control and prevention of hantaviruses in China.

Animals ; China ; epidemiology ; Disease Reservoirs ; Female ; Hantaan virus ; immunology ; Hemorrhagic Fever with Renal Syndrome ; epidemiology ; prevention & control ; transmission ; Humans ; Male ; Mice ; Population Surveillance ; Prevalence ; Rats ; Rodent Control ; Vaccination ; Vaccines, Inactivated ; immunology

The aim of this study was to explore application value of detecting platelet associated antibody and platelet membrane glycoprotein in the diagnosis and prognosis for immune thrombocytopenia. The platelet associated immunoglobulin (PAIg) and platelet membrane glycoprotein (CD41, CD61, GPIIb/IIIa) in 76 cases of immune thrombocytopenia and 30 healthy subjects were determined by FCM. The results showed that PAIg level in ITP patients included PAIgG (31.25 +/- 18.06)%, PAIgM (32.41 +/- 15.51)%, PAIgA (23.39 +/- 16.67)% which were remarkedly higher than in health control (10.48 +/- 5.05)%, (9.40 +/- 4.42)% and (7.23 +/- 3.61)% (P < 0.001). In patients with secondary immune thrombocytopenia (chronic aplastic anemia, SLE, Evans syndrome, liver cirrhosis hypersplenism, etc), PAIg level was higher than that in control group, while the platelet membrane glycoprotein in the blood of these patients was lower than that in control group. The level of PAIg decreased (P < 0.05) after treatment, but platelet membrane glycoprotein increased (P < 0.01). The result suggested that measurements for platelet membrane glycoprotein and platelet associated antibody by FCM were practical with high sensitivity, rapidity and simplicity used as a routine method in diagnosis and evaluation of the therapeutic effects in immune thrombocytopenia patients.
Adolescent ; Adult ; Aged ; Blood Platelets ; immunology ; Child ; Female ; Flow Cytometry ; Humans ; Immunoglobulins ; blood ; Integrin beta3 ; analysis ; Male ; Middle Aged ; Platelet Glycoprotein GPIIb-IIIa Complex ; analysis ; Platelet Membrane Glycoprotein IIb ; analysis ; Platelet Membrane Glycoproteins ; analysis ; Purpura, Thrombocytopenic, Idiopathic ; blood ; diagnosis ; Thrombocytopenia ; blood ; diagnosis

OBJECTIVETo evaluate the diagnostic value of serum angiopoietin-2 (Ang-2) level in pancreatic cancer patients.

METHODSSerum Ang-2 level was measured by enzyme-linked immunosorbent assays (ELISA) in samples from 116 patients with pancreatic cancer, 50 patients with chronic pancreatitis, and 50 normal control subjects.

RESULTSThe serum Ang-2 level in patients with pancreatic cancer [(1539.0 ± 449.3) ng/L] was significantly higher than those in patients with pancreatitis [(1044.6 ± 246.1) ng/L, P < 0.01] and normal control subjects [(1075.6 ± 228.2) ng/L, P < 0.01]. There was no significant difference of serum Ang-2 levels between patients with pancreatitis and normal controls. Pancreatic caner patients with lymph node metastasis had a significantly higher serum Ang-2 level [(1890.1 ± 354.9) ng/L] than those without metastasis [(1212.1 ± 224.2) ng/L, P < 0.01]. The area under ROC curve of serum Ang-2 level for diagnosis of pancreatic cancer was 0.819.

CONCLUSIONThe serum Ang-2 level can be a useful indicator for diagnosis of pancreatic cancer.

Adult ; Aged ; Angiopoietin-2 ; blood ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Pancreatic Neoplasms ; blood ; diagnosis ; pathology ; Pancreatitis ; blood ; ROC Curve ; Retrospective Studies

OBJECTIVEExplore the serum of patients with CHB of HBV large envelope protein (HBV-LHBs) trans-activation function and antiviral therapy effect relationship.

METHODS60 cases of anti-viral treatment of patients with chronic hepatitis B to take every 3 months HBVDNA, HBV-LHBs, as well as detection of hepatitis B immune markers to observe the changes in indexes.

RESULTSIncome group 60 cases of anti-virus group HBVDNA with HBV-LHBs have a higher detection rate of the consistency of the results found no statistical significance (P > 0.05), HBV-LHBs-positive rate and positive rate of HBeAg differences (chi2 = 4.08, P < 0.05). After 24 months of antiviral therapy HBV-LHBs expression always HBVDNA in 29 cases of which occurred 24 months after the negative reaction of the 20 cases, continuous positive were seven cases of non-negative. 60 cases of patients 24 months found no HBsAg seroconversion, four cases of emergence of HBeAg seroconversion.

CONCLUSION(1) detection of serum HBV-LHBs to reflect the hepatitis B virus replication with HBVDNA good correlation. (2) anti-viral treatment of dynamic observation of the process of HBV-LHBs expression can predict the effectiveness of anti-viral therapy.

Adolescent ; Adult ; Antiviral Agents ; therapeutic use ; DNA, Viral ; blood ; genetics ; Female ; Hepatitis B ; blood ; drug therapy ; virology ; Hepatitis B Antigens ; blood ; genetics ; Hepatitis B virus ; drug effects ; genetics ; isolation & purification ; physiology ; Humans ; Male ; Middle Aged ; Treatment Outcome ; Viral Envelope Proteins ; blood ; genetics ; Virus Activation ; drug effects ; Young Adult

OBJECTIVETo explore the clinical effect of talar neck fractures treated by open reduction and internal fixation with screws.

METHODSAmong 28 cases in the study, 20 cases were males and 8 cases were female. The age ranged from 22 to 72 years with an average of 38 years. Based on the Hawkins classification,there were 6 cases of type I,18 of type I and 4 of type II. They were treated by open reduction and internal fixation with screws.

RESULTSTwenty-eight cases were followed up for 1 to 7 years(mean 2.8 years). The evaluation of the results by Hawkins functional rating scale revealed excellent in 14 cases,good in 9 cases, fair in 3 cases and poor in 2 cases. The excellent and good rate were 83.2%. Osteonecrosis occurred in 5 cases with 3 of type II and 2 of type III fractures. Two of 3 cases with talar displacement were found with osteonecrosis or painful arthritis. The subtalar arthritis occurred in 6 cases, 3 of which were associated with ankle arthritis. Two cases underwent arthrodesis because of painful arthritis of the subtalar joint or osteonecrosis of the talar body. Wound infection and anteromedial skin necrosis of the ankle were not found.

CONCLUSIONTreatment of talar neck fractures could obtain satisfactory clinical results through open reduction and internal fixation with screws. Protection of the residual blood supply, anatomically reduction and stable fixation are essential for successful treatment of talar neck fractures.

Adult ; Aged ; Bone Screws ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; diagnostic imaging ; surgery ; Humans ; Male ; Middle Aged ; Radiography ; Talus ; injuries ; surgery

Objective:To investigate the safety of early whole body computed tomography (WBCT) combined with coronary angiography (CAG) in patients with extracorporeal cardiopulmonary resuscitation (ECPR) and its application value in the diagnosis of cardiac arrest and complications of cardiopulmonary resuscitation (CPR).Methods:This was a retrospective study. Patients who underwent ECPR in the Emergency Department of the First Affiliated Hospital of Nanjing Medical University from January 2017 to July 2021 were enrolled in this research. Patients younger than 18 years or with incomplete clinical data were excluded. The results of WBCT and CAG examinations after ECPR were collected.Results:A total of 89 patients with ECPR, aged (47±17) years, were enrolled in the study, all underwent WBCT examination, and no adverse events such as ECMO and tracheal tube shedding occurred. WBCT found 7 cases of pulmonary embolism, 3 cases of aortic dissection and 2 cases of cerebral hemorrhage. WBCT identified CPR-related complications in 42 cases, including rib fractures ( n=20), pneumothorax ( n=5), mediastinal emphysema ( n=5), subcutaneous emphysema ( n=6), and hematoma or swelling at puncture site ( n=6). Fifty-five patients underwent CAG examination, the most common culprit vessels were the left anterior descending branch disease (58.2%) followed by the left circumflex branch disease (27.3%), the right coronary artery disease (21.8%) and left main artery disease (12.7%). Conclusions:Early WBCT and CAG examinations are of great significance and safety for the guidance of treatment in ECPR patients.

OBJECTIVETo evaluated the fundamental role of stage control technology (SCT) on the detectability for Salmonella networking laboratories.

METHODSAppropriate Salmonella detection methods after key point control being evaluated, were establishment and optimized. Our training and evaluation networking laboratories participated in the World Health Organization-Global Salmonella Surveillance Project (WHO-GSS) and China-U.S. Collaborative Program on Emerging and Re-emerging infectious diseases Project (GFN) in Shanghai. Staff members from the Yunnan Yuxi city Center for Disease Control and Prevention were trained on Salmonella isolation from diarrhea specimens. Data on annual Salmonella positive rates was collected from the provincial-level monitoring sites to be part of the GSS and GFN projects from 2006 to 2012.

RESULTSThe methodology was designed based on the conventional detection procedure of Salmonella which involved the processes as enrichment, isolation, species identification and sero-typing. These methods were simultaneously used to satisfy the sensitivity requirements on non-typhoid Salmonella detection for networking laboratories. Public Health Laboratories in Shanghai had developed from 5 in 2006 to 9 in 2011, and Clinical laboratories from 8 to 22. Number of clinical isolates, including typhoid and non-typhoid Salmonella increased from 196 in 2006 to 1442 in 2011. The positive rate of Salmonella isolated from the clinical diarrhea cases was 2.4% in Yuxi county, in 2012. At present, three other provincial monitoring sites were using the SBG technique as selectivity enrichment broth for Salmonella isolation, with Shanghai having the most stable positive baseline.

CONCLUSIONThe method of SCT was proved the premise of the network laboratory construction. Based on this, the improvement of precise phenotypic identification and molecular typing capabilities could reach the level equivalent to the national networking laboratory.

Bacteriological Techniques ; Computer Communication Networks ; Laboratories ; Salmonella ; isolation & purification ; Technology Assessment, Biomedical

Objective: To analyze the clinical epidemiological characteristics including composition of pathogens , clinical characteristics, and disease prognosis acute bacterial meningitis (ABM) in Chinese children. Methods: A retrospective analysis was performed on the clinical and laboratory data of 1 610 children <15 years of age with ABM in 33 tertiary hospitals in China from January 2019 to December 2020. Patients were divided into different groups according to age,<28 days group, 28 days to <3 months group, 3 months to <1 year group, 1-<5 years of age group, 5-<15 years of age group; etiology confirmed group and clinically diagnosed group according to etiology diagnosis. Non-numeric variables were analyzed with the Chi-square test or Fisher's exact test, while non-normal distrituction numeric variables were compared with nonparametric test. Results: Among 1 610 children with ABM, 955 were male and 650 were female (5 cases were not provided with gender information), and the age of onset was 1.5 (0.5, 5.5) months. There were 588 cases age from <28 days, 462 cases age from 28 days to <3 months, 302 cases age from 3 months to <1 year of age group, 156 cases in the 1-<5 years of age and 101 cases in the 5-<15 years of age. The detection rates were 38.8% (95/245) and 31.5% (70/222) of Escherichia coli and 27.8% (68/245) and 35.1% (78/222) of Streptococcus agalactiae in infants younger than 28 days of age and 28 days to 3 months of age; the detection rates of Streptococcus pneumonia, Escherichia coli, and Streptococcus agalactiae were 34.3% (61/178), 14.0% (25/178) and 13.5% (24/178) in the 3 months of age to <1 year of age group; the dominant pathogens were Streptococcus pneumoniae and the detection rate were 67.9% (74/109) and 44.4% (16/36) in the 1-<5 years of age and 5-<15 years of age . There were 9.7% (19/195) strains of Escherichia coli producing ultra-broad-spectrum β-lactamases. The positive rates of cerebrospinal fluid (CSF) culture and blood culture were 32.2% (515/1 598) and 25.0% (400/1 598), while 38.2% (126/330)and 25.3% (21/83) in CSF metagenomics next generation sequencing and Streptococcus pneumoniae antigen detection. There were 4.3% (32/790) cases of which CSF white blood cell counts were normal in etiology confirmed group. Among 1 610 children with ABM, main intracranial imaging complications were subdural effusion and (or) empyema in 349 cases (21.7%), hydrocephalus in 233 cases (14.5%), brain abscess in 178 cases (11.1%), and other cerebrovascular diseases, including encephalomalacia, cerebral infarction, and encephalatrophy, in 174 cases (10.8%). Among the 166 cases (10.3%) with unfavorable outcome, 32 cases (2.0%) died among whom 24 cases died before 1 year of age, and 37 cases (2.3%) had recurrence among whom 25 cases had recurrence within 3 weeks. The incidences of subdural effusion and (or) empyema, brain abscess and ependymitis in the etiology confirmed group were significantly higher than those in the clinically diagnosed group (26.2% (207/790) vs. 17.3% (142/820), 13.0% (103/790) vs. 9.1% (75/820), 4.6% (36/790) vs. 2.7% (22/820), χ²=18.71, 6.20, 4.07, all P<0.05), but there was no significant difference in the unfavorable outcomes, mortility, and recurrence between these 2 groups (all P>0.05). Conclusions: The onset age of ABM in children is usually within 1 year of age, especially <3 months. The common pathogens in infants <3 months of age are Escherichia coli and Streptococcus agalactiae, and the dominant pathogen in infant ≥3 months is Streptococcus pneumoniae. Subdural effusion and (or) empyema and hydrocephalus are common complications. ABM should not be excluded even if CSF white blood cell counts is within normal range. Standardized bacteriological examination should be paid more attention to increase the pathogenic detection rate. Non-culture CSF detection methods may facilitate the pathogenic diagnosis.
Adolescent ; Brain Abscess ; Child ; Child, Preschool ; Escherichia coli ; Female ; Humans ; Hydrocephalus ; Infant ; Infant, Newborn ; Male ; Meningitis, Bacterial/epidemiology* ; Retrospective Studies ; Streptococcus agalactiae ; Streptococcus pneumoniae ; Subdural Effusion ; beta-Lactamases