Although chronic lateral instability of the ankle is a common disorder, there are not many reports and researches on it in China. This is because most patients with the condition do not seek a thorough cure of it and consequently surgeons pay little attention to it. In this article, we discuss some of the problems about its diagnosis, describe and compare several surgical procedures for reconstruction of the lateral ligament. We hope this paper can help surgeons know more about how to make an accurate diagnosis of the chronic lateral instability of the ankle and how to deal with it.

A volunteer was scanned by spiral CT,the Dicom format images were imported into Mimics software to reconstruct 3-D mandibular model,then optimized by Geomagic and meshed in Ansys software. A good geometric precise three-dimensional finite element model was constructed. The displacement of dentition was similar with clin-ical situation by computer.

Antibodies ; immunology ; Antibody Formation ; Complement C4b ; immunology ; pharmacology ; Diagnosis ; Graft Rejection ; diagnosis ; immunology ; Humans ; Kidney Transplantation ; immunology ; Peptide Fragments ; immunology ; pharmacology ; Transplantation, Homologous ; immunology

China ; Food ; Food Contamination ; prevention & control ; Food Inspection ; methods ; Plants ; chemistry

Background Pterygium is a relatively common eye disease,but its aetiology and pathogenesis remain uncertain.At present,the study on pterygia focuses on understanding its underlying mechanism.Objective This study was to detect the expression of 8-hydroxy-2'-deoxyguaine (8-OHdG),a marker of oxidative damage of DNA,and bcl-2,a gene related with apoptosis,on the pterygium tissue.Methods Thirty pterygium tissue specimens were obtained during the surgery with the primary pterygium 24 cases and recurrent pterygium 6 cases.In addition,20 normal conjunctival specimens from retinal detachment surgery and strabismus surgery were collected.The expressions of 8-OHdG and bcl-2 in pterygium tissue were detected using immunochemistry and compared with the normal conjunctival tissue.The difference in the expressions of 8-OHdG and bcl-2 among different specimens was compared by x2test,and the relationship between 8-OHdG expression and bcl-2 expression was evaluated by Kappa test.Results The positive expressing rate of 8-OHdG in the pterygium tissue was 62.5％ and 83.3％ in the primary and recrudescence pterygium tissue,respectively,but the expression of 8-OHdG was absent in the normal conjunctiva tissue.No significant difference was found in the positive expressing rate of 8-OHdG between primary and recrudescence pterygium tissue(x2 =0.938,P＞0.05).The bcl-2 expressing rate was 90.0％ and 87.5％ in the primary and recrudescence pterygium tissue,respectively.However,that in the normal conjunctival tissue was absent.No significant difference was seen in the bcl-2 expression rate between primary and recrudescence pterygium tissue (x2=0.833,P ＞ 0.05).Of the 27 pterygium tissue with bcl-2 positive expression,8-OHdG showed the positive expression in 20 specimens,and 3 specimens with the bcl-2 negative response were absent reactive to 8-OHdG,showing insignificant difference between them (P＞0.05).The relationship between 8-OHdG expression and bcl-2 expression was concord in a certein extent (Kappa =0.464).Conclusions The upregulation of 8-OHdG in the pterygium tissue indicates that oxidative damage of DNA plays a role in the development of pterygium.Oxidative damage of DNA caused by ultraviolet may be an upriver factor,which induces raising up of expression of bcl-2 and inhibits the apoptosis of normal cells and further proliferation of the conjunctiva tissue,resulting in the genesis and development of pterysium.

ObjectiveTo investigate the protective effect of astragalosideⅣ pretreatment against liver ischemia/reperfusion (I/R) injury in mice.MethodsSixty male C57BL/6 mice were randomized into four groups (15 mice in each group):group A:sham surgery with saline injection,group B:sham surgery with astragalosideⅣ injection,group C:I/R group with saline injection,group D:I/R and astragalosideⅣ injection.Mice were pretreated by daily intraperitoneal injection of saline or astragalosideⅣ (24 mg · kg-1 · d-1 ) for one week.The mouse partial liver model of I/R injury was established,and samples were collected at the 24 h after the I/R injury.Serum ALT and AST levels were determined,the histologic changes were observed by H&E staining under the light microscopy,whereas the nuclear factor (NF)-κB was assessed with Western blotting.Serum IL-1β,IL-6,and TNF-α levels were measured by enzyme-linked immunosorbent assay (ELISA). ResultsSerum ALT and AST levels significantly decreased and the histological damage was significantly alleviated in astragalosideⅣ treated I/R group as compared with saline I/R group [ AST:C:(4290± 292) U/L vs.D:(2373± 416) U/L t =0.844 ; ALT:C:(4146±500) U/L vs.D:(2318±289) U/L t =7.08 P ＜0.05].In comparison with group 3,astragalosideⅣ reduced NF-κB nuclear expression.ELISA showed astragalosideⅣ significantly inhibit the levels of IL-1 β,IL-6,and TNF-α in the serum (IL-1β:t =10.04;IL-6:t =6.281;TNF-α:t =6.817; P ＜0.05).ConclusionsPretreatment with astragaloside Ⅳ effectively protect against liver ischemia/reperfusion injury in mice.

Objective To compare the result of percutaneous or open drainage for muhilocular bacterial liver abscess. Methods The clinical data of 45 patients with multilocular bacterial liver abscess were reviewed retrospectively over the past 5 years. Twenty-one cases underwent B-us or CT-guided pereutaneons drainage (PD) and 24 received surgical drainage (SD) as the first-line treatment. The treatment outcomes in both groups were compared, and clinical end-points included time to defervescence, failure of treatment, secondary procedures, hospital stay, morbidity, and mortality. Results The time of defervesecnce was not statistically different between the two groups (4.85 day vs. 4.38 days, P＞0.05). However, patients in SD group suffered from less treatment failures (2 cases vs. 9 cases, P<0.05), less requirement for secondary procedures (1 cases vs. 11 cases,P<0.01), and shorter hospital stay (8 day vs. 11 days, P<0.05). There was no difference in morbidity or mortality rates between the two groups. Conclusions It was concluded that for multilocular liver abscess, SD provides better clinical outcomes than PD in terms of treatment success, number of secondary procedures, and hospital stay with comparable morbidity and mortality rates. SD should be considered as first-line treatment for multilocular bacterial liver abscesses.

A description of the concept,origin and development,and key contents of the system safety theory,and an analysis of the presence and future of China's medical safety management,holding that such a theory enjoys a promising perspective in medical safety managemenL Medical safety management needs to follow such a theory as fl guideline,and its principles to set system safety objectives,and to determine the scope of the safety system_By building a comprehensive feedback mechanism,clarifying the responsibility borders and advocating a safety culture,medical safety management can be significantly upgraded.

Objective To investigate the high-risk factors leading to a poor prognosis of small renal cell carcinoma, and provide theoretical basis for the individualized treatment regimen. Methods This retrospective study analyzed the clini?cal and histological data of 18 patients with small renal cell carcinoma treated in the Department of Urology of the Second Hospital of Tianjin Medical University from January 2004 to July 2015. All the patients underwent ultrasound, plain and en?hanced CT examinations, also, received the surgeries. The tumor diameters, pathological types, pathological stages, Fuhrman grading of tumors and the prognosis of patients were analyzed. Results Preoperative CT examination revealed that 18 pa?tients with the average tumor diameter of (3.1 ± 0.6) cm (ranged 2.0 to 4.0 cm). Five patients were diagnosed as T1aN0M0, 4 patients with T1aN0M1 (3 cases with lung metastasis, 1 case with brain metastasis), 3 patients with T1aN1M0 (CT examina?tion showed a lymph node metastasis), 6 patients with T3aN0M0 (renal vein invasion or renal vein tumor thrombus). Patholog?ical examination after surgery showed that 12 patients were Fuhrman gradeⅡ, 5 were gradeⅢand 1 was gradeⅣ;15 cases were clear cell carcinomas, 1 case was papillary carcinoma, 1 was hybrid cellular tumor (malignant rhabdoid tumor with sar?comatoid differentiation) and the last case was sarcomatoid carcinoma renal cell carcinoma (Fuhrman grade V). 4 patients (T3a, Fuhrman grade Ⅱ) underwent retroperitoneal laparoscopic partial nephrectomy and the remaining underwent laparo?scopic radical nephrectomy. The median follow-up time was 22.5 months (ranged 6 to 48 months). Four cases died (2 cases with tumor diameters of 3.8 cm and 4.0 cm at preliminary diagnosis,2 cases with sarcomatoid renal carcinoma and 1 with brain metastasis), 1 case was lost. Other patients were found no tumor recurrence and metastasis. Conclusion The small re?nal cell tumor with diameter≥3.0 cm, FuhrmanⅢ/Ⅳgrade,sarcomatoid cancer or metastasis should be considered as high-risk factors of small renal cell carcinoma. The high-risk small renal cell carcinoma is heterogeneous in its biological behav?ior, which is expressed as aggressive growth and early invasion of renal tissue and even metastasis. The individualized treat? ment should be made based on preoperative imaging findings and postoperative pathology.

Objective To investigate the epidemiological characterization , effect of prevention and control measures during an outbreak in a military unit caused by Mycoplasma pneumoniae.Methods All the cases were investigated to learn about their basic characteristics , clinical symptoms and aggregation activities using epidemiological cross-sectional study . Results From May 16 to June 11,2013, forty-nine confirmed cases and thirty-five suspected cases who were all males were found at an attack rate of 7.8%.The epidemic peak period was from May 27 to Jun 2(seven days), and the number of total cases was 66(75.9%).During the outbreak, the attack rate of the 10th cadet team, other cadet teams and a non-student population was 47.5%, 4.5% and 1.2% respectively.The difference was significant (P<0.01).The age of forty-nine confirmed cases ranged from 17 to 26 years old , the attack rate did not differ significantly between different age groups, and no aggregation was found in the place of birth and soldier source .The most frequent clinical symptoms were fever and cough for the confirmed cases , 62.5% of whom showed unilateral or bilateral lung inflammation change , while few positive lung symptoms were present .All the confirmed cases were hospitalized and no severe or critically ill cases were present.The outbreak was controlled effectively after implementation of case surveillance , contact precaution , termination of aggregation activities , dispersed habitation and prescription of azithromycin for disease prevention .Conclusion The confined and crowed environment for learning and training can increase the risk of M.pneumoniae outbreak , making it nec-essary to enhance disease prevention awareness , improve case management , live dispersed , reduce close contact and imple-ment personal hygienic measures .