Objective To analyze clinical features of patients with eosinophilia-myalgia syndrome (EMS).Methods Clinical manifestations,response to treatment and prognosis of 89 cases with eosinophilia hospitalized at Peking Union Medical College Hospital(PUMCH)during the past nine years were analyzed retrospectively,including four cases conformed with the diagnostic criteria for EMS set by the Centers for Disease Control and Prevention of the US.Results Infection,tumor and other diseases that could cause increased eosinophil count were excluded in all but four cases,with all female,average age of 48.8 years,and mean count of eosinophil of 42.75 percent of blood cells.Multi-organs and systems were involved in the patients,with the most common clinical manifestations of myalgia,skin rash,joint swelling,arthralgias,respiratory symptoms and paresthesia.Patients responded well to prednisone at acute phase of illness,but prognosis was poor as severe pulmonary hypertension occurred.Occurrence of EMS closely associated with environmental factors and special attention should be paid to patient's history of medication and diet in its diagnosis.Conclusion EMS is characterized by the increasing of eosinophils and myalgia,while multi-organs and systems were involved.Glucocorticoid plays an important role in the treatment at acute phase of illness.

The article put across Meta-analysis well by giving its definition and analyzing its development. It empha-sized its effect in the clinical medicine and dwelled on dealing with the problems encountered when meta-analysis wasapplied and the solutions to the problems. It also pointed out its significant role in raising the level of clinical medicine,teaching and scientific research.[

OBJECTIVE To introduce the characteristic and advantage of a kind of therapeutic method for chronic tibial osteomyelitis by cleaning the focus,iodophor sterilizing and then bone grafting at some selective time.METHODS Ribbon-gauze immersed with iodophor was used for tamponade and constant hydropathic compress after a surgery of debridement,then intramedullary bone grafting was performed.RESULTS This treating manner was applied in 18 patients with chronic tibial osteomyelitis and 17 cases(94.4%) healed,1 case recrudesced.CONCLUSIONS It is reliable for this kind of therapeutic method by debriding the focus,followed by an open and constant hydropathic compress with iodophor,and then grafting bone,which may promote the healing rate of chronic tibial osteomyelitis.

Objective To observe the effect of shenfu injection on ischemia/reperfusion injury in skeletal muscle of rats. Methods To make a model of ischemia/reperfusion injury in skeletal muscle of rats, and observe the plasma level of LDH, CK, MDA and the change of MDA, MPO, W/D in the skeletal muscle. Result Shenfu injection can reduce the heightened plasma level of LDH, CK, MDA and MDA, MPO, W/D of the skeletal muscle, lighten the injury of the ultrastructure. Conclusion Shenfu Injection can protect ischemia/reperfusion injury in skeletal muscle.

BACKGROUND: Alginic sodium diester (ASD) possesses neuroprotective function because of its selective calcium antagonist effects.OBJECTIVE: To compare the influences of ASD on intraneuronal Ca2+content and nerve cell apoptosis before and after reperfusion in focal cerebral ischemic rats.DESIGN: Randomized controlled observation.SETTING: Neurological Department of Xiangya Hospital Affiliated to South China University; Laser Orthopedic Surgery of the First Hospital Affiliated to Southern China University.MATERIALS: This experiment was carried out between November 2003and April 2004 at the Neurological Department of Xiangya Hospital Affiliated to South China University. A total of 65 male SD rats were recruited and randomized into 6 groups; 17 got lost during the experiment, and the other 48 rats completed the experiment with 8 rats in each group.METHODS: In sham operation group, an incision was made on rats' cervical skin and sutured. Right cerebral middle artery was occluded in rats of ischemic group, ASD 5 mg/kg preischemic group, ASD 5 mg/kg postischemic group, ASD 10 mg/kg preischemic group, and ASD 10 mg/kg postischemic group. After that, rats in all but ischemic group were subjected to intraperitoneal injection of various dosage of ASD or excipient 30minutes before reperfusion and 5 hours after reperfusion. FCM was used to determine intraneuronal Ca2+ content and rate of nerve cell apoptosis;meanwhile, neurological dysfunction was scored.MAIN OUTCOME MEASURES: [1] Influence of ASD on the score for neurological dysfunction, intraneuronal Ca2+ fluorescence intensity, and neuronal apoptosis in rats with right cerebral middle artery ischemia. [2]Correlation of behavioral obstacle score with intraneuronal Ca2+ fluorescence intensity and neuronal apoptosis in rats with right cerebral middle artery ischemia.RESULTS: Totally 65 rats were enrolled in this study, 17 of which got lost and the other 48 rats entered the result analysis. [1] Influence of ASD on the score for neurological dysfunction, intraneuronal Ca2+ fluorescence intensity, and neuronal apoptosis in rats with right cerebral middle artery ischemia: The score was obviously reduced in ASD 5 mg/kg preischemic group, ASD 5 mg/kg postischemic group, ASD 10 mg/kg preischemic group and ASD 10 mg/kg postischemic group as compared with ischemic group (1.80±0.21, 2.20±0.23, 1.20±0.11, 2.00±0.22, 3.40±0.65); moreover,functional improvement was more obvious due to pre-reperfusional administration than post-reperfusional administration. Intraneuronal Ca2+ concentration was reduced after ASD administration at different degrees and lower than that of ischemic group. Decrement of intraneuronal Ca2+ concentration was found most obvious due to 10 mg/kg ASD administration 30 minutes before reperfusion, approximately reduced by 70%; moreover, neuronal apoptosis rate on the ischemic side was obviously suppressed by ASD administration, displaying time-dependent manner, with apoptotic suppression effect more obvious in pre-reperfusional group than in post-reperfusional group (5.68%, 10.03%; 4.00%, 9.91%). [2] Correlation of behavioral obstacle score of right cerebral middle artery ischemic rats with intraneuronal Ca2+ fluorescence intensity and membrane associated protein/propidium iodide apoptosis: Obvious positive correlation was found between behavioral obstacle score and intraneuronal Ca2+ fluorescence intensity and detection rate of membrane associated protein/propidium iodide apoptosis (r=0.51,0.62, P ＜ 0.05); intraneuronal Ca2+ fluorescence intensity was also positively correlated with the detection rate of membrane associated protein/propidium iodide apoptosis (r=0.84, P ＜ 0.05).CONCLUSION: [1] ASD can exert anti-apoptosis effect by suppressing the increment of intraneuronal Ca2+ concentration, thus having neuroprotective function and ultimately improving neurological dysfunction. [2] Its effect displays time-dependent manner, and neurological functional improvement is more obvious by pre-reperfusional administration than by post-operational administration.

BACKGROUND:Valgus knee deformity is rare in the clinic. The therapeutic effects of artificial knee arthroplasty are worse than varus knee deformity. There is no unified opinion for replacement approach, soft tissue release method and procedure and prosthetic choice at present.
OBJECTIVE:To summarize case data and to observe clinical effects of total knee arthroplasty for valgus knee deformity.
METHODS:Clinical data of 37 cases of valgus knee deformity (42 knees) undergoing total knee arthroplasty, who were treated by the same group of physicians in the First Department of Orthopedics, Gansu Provincial Hospital of Traditional Chinese Medicine from January 2010 to December 2012 were retrospectively analyzed. There were 11 males (13 knees) and 26 females (29 knees), at the age from 56 to 78 years, with an average age of 63.7 years. The differences in range of motion, femorotibial angle and Hospital for Special Surgery knee score were compared before and after replacement. Clinical effects of total knee arthroplasty for valgus knee deformity were evaluated.
RESULTS AND CONCLUSION:The postoperative fol ow-up lasted from 6 to 36 months. Knee joint range of motion increased from preoperative 68.5° to an average of postoperative 108.5°. Femorotibial angle reduced from preoperative 16.82° to postoperative 5.62° on average. The average Hospital for Special Surgery knee score increased from preoperative 39 points to postoperative 88 points (P<0.05). These results suggested that the curative effect of total knee arthroplasty for valgus knee deformity is proved. Total knee arthroplasty is an effective way to improve deformity.

Objective To assess the immune protective effect of donor spleen perfusion on the renal allografts in specific sensitized canine recipients.Methods Male dogs were operated as donors and recipients for kidney transplantation.Eighteen dogs were previously sensitized by a method of multi-infusion of small number of lymphocytes from a paired donor and were then randomly divided into 3 groups equally.In donor specific spleen perfusion group,the artery and vein of the excised do- nor canine spleen were connected to the abdominal aortic artery and inferior vena cava of the recipient with processed fistula tubes,perfused at a speed of 18-25 ml/min for 40 min and then kidney from the same donor was transplanted to the recipient;In non-specific spleen perfusion group,the methods of excised spleen perfusion and kidney transplantation were indifferent to the above group except for the organs which removed from a non-specific donor;In control group,kidney transplantations were per- formed after an exclusion time of 40 min in the open abdominal surgery.Cross-match between paired dogs monitored by means of complement dependent cytotoxicity(CDC)and mixed lymphocyte culture (MLC)test before and after donor spleen perfusion was investigated.Rejection episodes and serum creatinine level in each group were assessed after kidney transplantation.Results Immune sensitization was successfully induced in all 3 groups after 3 to 4 times of donor lymphocyte stimulations.CDC as well as lymphocytes proliferation in MLC and CH50 of recipients was significantly declined after spe- cific spleen perfusion,and white blood cell count in peripheral blood also decreased transiently.After kidney transplantation between the paired sensitized dogs,the advanced rate of renal allograft function deterioration was slower in specific spleen perfusion group than in other two groups.The pathologic investigation suggested that severity of rejection in spleen perfusion group was milder than in other two groups.Conclusions Donor spleen perfusion can present a specific absorption efficacy for pre- formed antibodies and activated lymphocytes in sensitized recipients,as well as simultaneously deplete part of platelets in peripheral blood.So donor spleen perfusion may delay the presenting time of rejec- tion in early phase after kidney transplantation between the paired sensitized dogs,ameliorate the se- verity of rejection so as to improve the renal allograft function.

Objective To explore the risk factors causing tetany in patients with hyperventilation syndrome. Meth?ods A total of 103 patients with hyperventilation syndrome treated in our hospital were included in this study. According to whether there was tetany, patients were divided into tetany group and non-tetany group. Values of gender, age, electrolyte, pH and p(CO2) were analysed between two groups. The factors of P<0.1 were engaged in binary Logistic regression. Logistic regression (Forward Wald) was used to analyze the risk factors of tetany in patients with hyperventilation syndrome. Re?sults In 103 patients there were 70 patients with tetany (68%), 33 patients without tetany(32%). The serum K+, serum phos?phorus and p(CO2) values were significantly lower in tetany group than those of non-tetany group (P<0.01), while the pH value was significantly higher in tetany group than those of non-tetany group (P<0.01). There were no significant differences in gen?der, age, serum Na+, serum Cl-, serum calcium (bound calcium and ionized calcium), ionized calcium and serum Mg2+levels be?tween two groups (P>0.05). It was revealed that the younger age, the lower level of the serum K+, serum phosphorus and p(CO2) were the risk factors of tetany through binary Logistic regression analysis. Conclusion The risk factors of tetany in patients with hyperventilation syndrome include younger age, lower level of serum K+and serum phosphorus and reduced p(CO2).

Objective To evaluate the clinical effect of tibial plateau bone defects repair using osteotomy and bone grafting with autogenous bone gain way in total knee arthroplasty.Methods From Mar.2011 to Mar.2015,28 knees of 20 patients with bone defects in medial tibial plateau were in total knee arthroplasty,the bone defects were repaired into horizontal steps,then with autogenous bone grafting by osteotomy.Results The bone defects could be repaired effectively to support the knee joint prosthesis,all the patients were followed-up through outpatient from 1 year to 4 years with the average of 2.6 years,the HSS kness score increased from (20.9 ± 1.2) before opearation to (87.6 ± 1.6) after operation.Hss score were paired t test,there was statistically significant difference (P ＜ 0.05).The location was good and there was no bone defect image,no bone resorption and no joint dislocation under X-ray.Conclusions To repair the bone defects in total nkee arthroplasty,it can use the autogenous bone by osteotomy reasonably,achieve good repair defect site,reserve the bone mass maxium,reconstrust the balanced mechanical support of tibia.

OBJECTIVE:To provide reference for rational use of antibacterial drugs in the clinic. METHODS:In retrospective study,outpatient and emergency antibacterial drugs prescriptions were randomly selected from a hospital during 2013-2014,and then analyzed statistically. DDDs of antibacterial drugs were analyzed by using DDD method. RESULTS:From 2013-2014,the ap-plication rate of antibacterial drugs in the hospital declined substantially from 13.8% to 11.9%,and the rate of irrational use dropped from 2.7% to 1.2%. The application rate of antibacterial drugs was higher in pediatric department,emergency department and urology department;drug cost per capita was higher in infectious department,nephrology department and emergency depart-ment. The application rate of antibacterial drugs in pediatric department decreased greatly in 2014,compared with 2013,maintain-ing about 40%. The application rate of antibacterial drugs in emergency department during Jan.-Sept. in 2014 was lower than corre-sponding period in 2013,and that of the hospital during Jan.-Sept. in 2014 was lower than corresponding period in 2013,but dur-ing Oct.-Dec. in 2014 was slightly higher than corresponding period in 2013. Single type of antibacterial drugs were mainly used in outpatient department,accounting for 91.50% and 90.77% of antibacterial drug prescriptions in 2013 and 2014;two-drug account-ed for 8.44% and 9.11%. The top 3 antibacterial drugs in the list of DDDs during 2013-2014 were roxithromycin,cefuroxime and cefminox. CONCLUSIONS:The use of antibacterial drugs is up to the requirements of Nation Special Rectification Actirity for Clin-ical Application of Antibacterial Drugs in 2013. The prescription comment improve the quality of antibacterial drug prescriptions and rational use index greatly in outpatient department,but the application rate of antibacterial drugs is too high in some depart-ment. There still is irrational use of antibacterial drugs.