BACKGROUND:Different embolic materials can be used for bronchial artery embolization in patients with pulmonary tuberculosis hemoptysis. Sodium alginate microspheres and gelatin sponge are two commonly used materials; however, there are relatively few related reports about the comparative analysis on the application effect of these two materials. OBJECTIVE:To investigate the clinical efficacy of sodium alginate microspheres for bronchial artery embolization on pulmonary tuberculosis hemoptysis. METHODS:Totaly 157 patients with pulmonary tuberculosis hemoptysis, including 98 male and 59 female patients, aged 22-75 years, were enroled and subjected to bronchial artery embolization using different embolic materials: sodium alginate microspheres group (n=74) and gelatin sponge group (n=83). During the 12 months of folow-up, the clinical curative effect, recurrence and complications condition of these two groups were observed. RESULTS AND CONCLUSION:The total effective rates of sodium alginate microspheres and gelatin sponge groups were respectively 91.19% and 81.93%, and there was a significant difference between groups (P < 0.05). The recurrence rates of sodium alginate microspheres and gelatin sponge groups were respectively 6.8% and 26.5%, and there was a significant difference between groups (P < 0.05). Additionaly, there was no significant difference in the complications between groups (P > 0.05). These results demonstrate that sodium alginate microspheres for bronchial artery embolization has a better result in the clinical treatment of pulmonary tuberculosis hemoptysis with a high clinicaly effective rate and low recurrence rate.

Objective To evaluate the results of patients operatively treated transverse plus posterior wall fractures of the acetabulum.Methods Review forty-five patients who had operated for transverse plus posterior wall fractures of the acetabulum 1 retrospectively with fracture displacement,from August 1993 to January 2005 in Department of Orthopaedics,Beijing Shunyi Hospital.The radiographs were graded according to the criteria described by Matta.The functional outcome was evaluated using a modification of the clinical grading system developed by Merle d'Aubigné and Postel.Result Forty-five patients were followed up 16 to 48 months with an average of 34 months.The radiographic result was excellent in seventeen patients,good in eighteen,fair in seven,and poor in four.The clinical outcome at the time of final follow- up was graded as excellent in fourteen patients,good in twenty- two,fair in eight,and poor in two.Conclusion Operative treatment for transverse plus posterior wall fractures of the acetabulum has a satisfying therapeutic effect.The appropriate operation time,reasonable operation approach,anatomic reduction and stable internal fixation is the key to obtain good results.

ObjectiveTo summarize 20 ABO-incompatible liver transplantation cases in our hospital and explore the treatment strategy. MethodsFrom January 2009 to July 2011,20 cases donorrecipient ABO blood type not-identical liver transplantation was performed at our hospital. 16 cases were ABO-incompatible(ABO-Ⅰ) and 4 were ABO-compatible(ABO-C ).The median follow-up was (13.3 ± 9.2) months.ResultsExcept preoperative MELD score,there were no significant difference in other perioperative data,the incidence of postoperative complications and the cumulative survival rate between ABO-C and ABO-Ⅰ group.There were 5 deaths in 20 cases,2 cases in ABO-C group and 3 cases in ABO-Ⅰ group,survival rate was 75％.The cause of death was perioperative multiple organ failure in 2 cases,liver cancer recurrence in 2 cases and cerebral hemorrhage in 1 case.There were 2 cases of acute rejection,3 cases of biliary complications and 3 cases of portal vein thrombosis developing postoperatively. Eleven patients had increased serum creatinine after operation,preoperative high creatinine existed in 6 cases and it maintained posttransplant high level for more than 7 days,the serum creatinine level in other 7 patients was back to normal level in 7 days.ConclusionsA combination splenectomy before the portal vein reperfusion,the protocol of basiliximab,tacrolimus (TAC)/mycophenolate mofetil (MMF)/steroids immunosuppression treatment,postoperative peripheral vascular dilatation treatment by Alprostadil,help achieve favorable outcome in selected patients who underwent ABO-incompatible liver transplant.

BACKGROUND:Clavicular hook plates have been used widely to treat acromioclavicular dislocations in recent years. However, it remains controversial whether coracoclavicular ligament should be repaired during the surgery.
OBJECTIVE:To study the clinical effect and MRI manifestations after treatment of type III and V acute acromioclavicular Rockwood dislocation with clavicular hook plate, and to discuss the necessity of repairing coracoclavicular ligament during the surgery.
METHODS:A total of 44 patients with type III and V acute acromioclavicular Rockwood dislocations were treated with clavicular hook plates without repair of coracoclavicular ligaments, and underwent plate removal operations later. At 24 months after the second surgery, X-rays were taken to measure the width of coracoclavicular joints in both normal and affected limbs, Constant-Murley scores were calculated in both sides, and MR images were used to observe the healing of coracoclavicular ligaments.
RESULTS AND CONCLUSION:39 patients (89%) were fol owed up for 36.9±3.1 months (range, 30 to 45 months). The mean duration for retaining clavicular hook plates was 12.9±3.1 months (range, 6 to 21 months). The mean width of coracoclavicular joints was 6.04±1.21 mm (range, 4.3 to 8.8 mm) in normal limb, while 5.09±1.18 mm (range, 3.4 to 7.8 mm) in affected side without significant difference (P>0.05). The mean Constant-Murley score was 98.9±1.2 (range, 96 to 100) in normal limb, while 96.7±3.4 (range, 90 to 100) in affected side without significant difference (P>0.05). MRI showed healing of the coracoclavicular ligaments and the presence of continuous scar tissue in 38 patients, excluding one patient with recurrence of acromioclavicular joint dislocation. The clinical effects after treatment of type III and V acute acromioclavicular Rockwood dislocation with clavicular hook plate are satisfactory, and it is unnecessary to repair coracoclavicular ligament during the surgery. MR images reveal scar healing of the coracoclavicular ligaments without operative repair.

To study on the phylogenetic characterization of the VP1 genes of coxsackievirus A16 (CVA16) causing hand-food-mouth disease (HFMD) isolated from Anhui province in 2014. A total of 413 throat swab specimens from HFMD patients were collected during January to November, 2014 for the isolation and identification of enteroviruses using real-time RT-PCR assays. The VP1 regions of CVA16 isolates were amplified using RT-PCR and sequenced. And the phylogenetic tree was constructed among the VP1 regions of those isolates, the different genotypes and sub-genotypes of CVA16 strains. A total of 97 enteroviruses were isolated from 413 samples, the positive rate was 23.49% (97/413), including seventeen CVA16, seventy six HEV71 and four other enteroviruses. The results of the phylogenetic tree showed that 17.CVA16 strains isolated from Anhui in 2014 clustered within B1b evolution branch of B1 genotype. The nucleotide and amino acid sequence identities were 95.30%-100% and 98.70%-100% among the isolates, respectively, but within B1b branch of 17 strains formed several small transmission chains. The nucleotide acid of 17 CVA16 isolates in Anhui province were closed to the strains isolated from Yunnan, Hunan, Guangdong, Tibet and Jiangsu, especially from Hunan in 2013 and from Shenzhen of Guangdong in 2014, the identity were 96.40%-99.70%. The CVA16 strains isolated from Anhui in 2014 were all belong to genetic subtype B1b of B1 genotype was dominant, and among those isolates, several small virus transmission chains had formed with co-circulating and evolution.
China ; Enterovirus A, Human ; classification ; genetics ; isolation & purification ; Enterovirus Infections ; virology ; Genotype ; Humans ; Molecular Sequence Data ; Phylogeny ; Viral Proteins ; genetics ; metabolism

Pathogen biology is a main course of curricula in medical university.In developing quality courses,we optimized Pathogen biology course content,created the PBL teaching mode suitable for this course,set up network teaching platform,enhanced teachers' qualification,constructed comprehensive and exploratory experiment teaching system,wrote new teaching syllabus and other measures,made the Pathogen biology course construction more reasonable and perfect.

Objective To explore the efficacy of liver retransplantation for hepatocellular carcinoma (HCC) patients with or without HCC recurrence.Method 131 cases of retransplantation performed between 2003 and 2012 were analyzed retrospectively.Their first and second liver transplantations were both performed in our hospital.Diagnoses of their primary diseases before transplantations were confirmed pathologically after the first transplantation.Patients were divided into two groups in terms of benign causes and HCC.Results Sixty cases were fallen into benign disease group and 65 cases into HCC group.The proportions of main causes of retransplantation were similar between two groups.The graft survival rate of early retransplantation (retransplantation performed within 30 days after the first transplantation) and late retransplantation (retransplantation performed beyond 30 days after the first transplantation) was calculated and compared respectively due a great difference in survival rate between the two phrases.The deaths of HCC patients with HCC recurrence before retransplantation were more than those without HCC recurrence (P＜0.01) and benign disease group.The 5-year cumulated survival rate was close between HCC patients without recurrence before retransplantation (51.0％) and benign disease group (51.8％).Conclusion The retransplantation after HCC recurrence has an unacceptable prognosis.The survival rate was similar between patients without HCC recurrence and patients with benign diseases.HCC patients without recurrence should not be restrained from retransplantation just for the HCC history.

Objective To investigate the effectiveness and safety of ultrasound-guided percutaneous microwave ablation in the treatment of benign thyroid nodules.Methods A total 456 patients (912 nodules) underwent microwave ablation in our department.Microwave ablation was carried out using microwave antenna under local anesthesia.Nodule volume,thyroid function and clinical symptoms were evaluated before treatment and at 1 ,3,6 and 12 months after the treatment to monitor changes in the volume,adverse effect and complications.Results 912 nodules were all studied with contrast-enhanced ultrasound immediately after the ablation,and all results showed “black hole”sign.The mean follow-up period after microwave ablation was (9±6)months (range,3-24 months).At 6-month follow-up,the mean volume reduction ratio of the solid nodules,mixed nodules and the cystic nodules was (61 ± 50 )%,(81 ± 33 )%,(89 ± 46 )%, respectively.The treatment was well tolerated and no major complications were observed except pain and transient voice changes (2.4%).Conclusions Microwave ablation is a safe and effective technique for the treatment of benign thyroid nodules.

Objective To evaluate the feasibility and efficacy of ultrasound-guided percutaneous microwave ablation combined with hormone suppression therapy for solitary papillary thyroid microcarcinoma.Methods A total of 25 patients with 25 nodules pathologically proven solitary papillary carcinoma 3.7 to 10.0 mm in diameter without clinically apparent lymph node,or distant metastasis were treated with microwave ablation equipement.Microwaves were emitted at 40 W for 200 -400 seconds and prolonged as necessary to attain confluent ablation zones.All patients were treated with both extended ablation therapy and levothyroxine that maintain TSH levels below 0.1 mU/L.Thyroid function test,nodule volume and clinical symptom were evaluated before ablation and during 1 ,3,6,9 and 12 months after treatment according to changes in tumor size,adverse reactions,complications and metastatic tumors.Three out of 25 patients received surgical treatment and the other 22 patients were followed up with routine ultrasound and contrast enhanced ultrasound.Results All 25 tumors were completely ablated by using mutiple plane fixed melting method and no serious or permanent complications occurred.No recurrence at the treatment site or distant metastase were detected,with a mean follow-up of 1 8 months.Histological examination showed no evidence of a tumor in the treated lesions in the 3 surgery patients.Conclusions Ultrasound-guided percutaneous microwave ablation appears to be a safe and effective technique for the therapy of solitary papillary thyroid microcarcinoma.

Objective To investigate the effect of salmeterol/fluticasone (SM/FP) on serum inflammatory factors in the treatment of bronchial asthma in children.Methods 80 children with bronchial asthma from January 2015 to October 2015 in department of pediatrics of first affiliated hospital of Zhejiang Chinese medicine university were selected and randomly divided into two groups.The control group were given routine clinical treatment, the experimental group were treated on the basis of the control group with salmeterol/fluticasone (SM/FP), for 4 weeks.The serum IL-2, IL-4, IFN-α, T-lymphocyte subsets and clinical efficacy between the two groups were compared.Results Compared with control group, the serum levels of IL-2 and IFN-γin experimental group were higher, IL-4 in experimental group was lower ( P <0.05 ); the serum CD3 +T, CD4 +T and CD4 +T /CD8 +T levels in experimental group were higher, the serum CD8 +T was lower than those in control group (P<0.05); the total efficiency of the experimental group (92.5%) was significantly higher than that of control group (75.0%) (P<0.05).Conclusion The salmeterol/fluticasone (SM/FP) has the good efficacy in the treatment of bronchial asthma in children, which could effectively regulate T lymphocyte subsets proportion and the level of cytokines.