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

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.

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

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.

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.

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 clinical efficacy and safety of modified Shaoyao Gancao decoction in the treatment of hyperprolactinemia caused by amisulpride. Methods:Ninety patients with hyperprolactinemia caused by amisulpride who received treatment in Kangci Hospital from June 2018 to October 2019 were included in this study. They were randomly divided into the placebo control, control and observation groups ( n = 30/group). The placebo control group was treated with the decoction with the taste and color (without drug ingredients) similar to that of modified Shaoyao Gancao decoction. The control group was treated with Shaoyao Gancao decoction. The observation group was treated with modified Shaoyao Gancao decoction. All patients were treated for 8 weeks. Clinical efficacy, serum prolactin level and Positive and Negative Syndrome Scale score before and after treatment, Treatment Emergent Symptom Scale score after treatment, glucose and lipid metabolism, liver and kidney function before and after treatment were compared among the three groups. Results:The effective rate in the placebo control, control and observation groups was 90.0% (27/30), 96.7% (29/30) and 100.0% (30/30), respectively, and the difference among the three groups was statistically significant (χ 2 = 7.027, P < 0.05). After treatment, serum prolactin level in the observation group [(48.2 ± 15.7) μg/L] was significantly lower than that in the control group [(52.5 ± 13.7) μg/L] and placebo control group [(57.7 ± 16.9) μg/L, t = 7.134, 7.034, both P < 0.05]. After treatment, Positive and Negative Syndrome Scale score in the observation group [(51.02 ± 3.98) points] was significantly lower than that in the control group [(54.07 ± 4.19) points] and placebo control group [(58.13 ± 4.24) points, t = 5.813, 6.317, both P < 0.05]. After treatment, Treatment Emergent Symptom Scale score in the observation group [(5.2 ± 1.3) points] was significantly higher than that in the control group [(4.9 ± 1.4) points] and placebo control group [(4.4 ± 1.2) points, t = 7.011, 7.231, both P < 0.05]. After treatment, blood glucose, low-density lipoprotein cholesterol, triglyceride, total cholesterol, alanine aminotransferase, aspartate aminotransferase levels in the observation group were significantly lower than those in the placebo control and control groups (all P < 0.05). Serum level of high-density lipoprotein cholesterol in the observation group was significantly higher than that in the placebo control and control groups (both P < 0.05). Conclusion:Modified Shaoyao Gancao decoction is highly effective in the treatment of hyperprolactinemia caused by amisulpride. It can reduce serum prolactin level and has good safety.

Objective To explore the prognostic factors of non-small-cell lung cancer (NSCLC) patients with brain metastasis. Methods 122 NSCLC patients with brain metastasis from Jan 2007 to Dec 2012 were incorporated, and followed with death as the end. The influence factors of prognosis were retrospective analyzed. Kaplan-Meier method was used for survival analysis, the Log-rank test for single factor analysis,and Cox regression model for multiple factors analysis. Results The single-factor and multi-factor analysis showed that the influence factors of prognosis were age, pathological type, number of intracranial metastasis, presence of extracranial metastasis, treatment, Karnofsky score, the original site control situation (P<0.05). Gender, the size of the original site had no influence for prognosis (P>0.05). The average survival times of patients with palliative symptomatic treatment, simple whole brain radiotherapy, whole brain radiotherapy local lesion plus the amount of radiation, whole brain radiotherapy local lesion plus the amount of radiation combined with chemotherapy were (2.14 ±0.19) months, (7.28 ±0.60) months, (16.90 ±1.35) months, (17.7±1.12) months, 1 year survival rates were 0, 8.5%, 71.0%, 93.3%. Survival analysis showed that there was statistical significance among the four groups (P= 0.000). Conclusion The age, pathological type, number of intracranial metastasis, presence of extracranial metastasis, treatment, Karnofsky score, the original site control situation are the prognosis factors in NSCLC patients with brain metastasis, therefore the treatment of these patients should be comprehensively analyzed.