Objective To explore the clinical effect of anterior combined with posterior fixation and vertebra reconstruction for unstable lumbar burst fracture via small incision alone posterior median line.Methods This study was based on 40 patients suffering from unstable lumbar burst fracture,who underwent anterior combined with posterior fixation and vertebra reconstruction.All the patients were followed up for 1～2 years.The shape and the function of spinal column were estimated in preoperative stage,postoperative stage and the duration of following.The data in the formal 3 stages were compared.Results Between the preoperative and postoperative data,there were statistically significant differences in the Cobb's angle,angle of kyphosis,anterior height of the fracture vertebral body,sagittal index and JOA scores(t=34.085,31.604,27.988,23.798,31.834,all P＜0.05).But no similar result was detected between the postoperative data and the data during the following(P＞0.05).Conclusion Anterior combined with posterior fixation and vertebra reconstruction via small incision had a significant effect in unstable lumbar burst fracture,and it was worthy of further study and clinical popularization.

Objective To investigate the prognosis of two decompression approaches for cervical spondylotic myelopathy. Methods 86 cases were divided into two groups. 40 cases were underwent decompression by anterior decompression, fusion and internal fixation with titanium screws and plate and 46 cases underwent posterior single opendoor laminoplasty. To investigate the prognosis of two decompression approaches for single compressive segment, two compressive segments, three compressive segments and four compressive segments. Results All cases were followed up for 20 ～ 73 months with an average of 43 months. The mean JOA recovery rate was significant different between single compressive segment group (P ＜ 0.05), and no significant difference between two compressive segments and three compressive segments(P ＞ 0.05), and significant difference between four compressive segments groups (P ＜0.05). Conclusion For single compressive segment, the anterior surgery has a good surgical result,for two or three compressive segments, anterior and posterior surgery had same effect, for the four compressive segments, posterior surgical effect was good.

OBJECTIVETo set up a novel, simple, sensitive, specific, repeatable and rapid assay for diagnosis of influenza.

METHODSMonolayers of MDCK cells were inoculated with the specimens for amplifying viral yield, the feature of receptors on cell surface was changed by treatment of neuraminidases of influenza A and B viruses. Afterward, based on the lectin binds to receptors on cell surface with strict specificity,the phenomenon of red blood cell aggregation was observed under the conventional microscope. Finally, the tested results could be determined by the extent of red blood cell aggregation.

RESULTSThere was a complete (%) consistency rate (100%) for viral isolation between new and routine tests. In general, the results were detected with new assay within 20 h. The sensitivity of new assay was over 100-10,000 times higher than that of routine method. Meanwhile, the novel test could not only be used for rapid diagnosis in the clinic, but also be used for influenza surveillance. The best concentration of red blood cells was 1 in the detection assay. The testing result was not effected by red blood cells taken from either different red blood cell type of human or different individual of guinea pigs.

CONCLUSIONSThe novel method has several advantages: simple, high sensitivity and specificity, accurate and suitable for multiple purposes.

Animals ; Cells, Cultured ; Erythrocyte Aggregation ; drug effects ; Guinea Pigs ; Humans ; Influenza A virus ; enzymology ; isolation & purification ; Influenza B virus ; enzymology ; isolation & purification ; Influenza, Human ; diagnosis ; virology ; Neuraminidase ; analysis ; Reagent Kits, Diagnostic ; Sensitivity and Specificity

Plasma exchange therapy is applied for treatment of severe immune diseases of multiple organ systems and severe liver diseases by removing pathogenic factors and regulating immune function. Regional citrate anticoagulation has no effect on systemic coagulation function and does not increase bleeding risk, and it is one of the optional anticoagulation methods for plasma exchange therapy. This article reviews recent literature on simple plasma exchange therapy with regional citrate anticoagulation to provide a reference for clinical application of this therapy.

Humans ; Kidney Neoplasms ; diagnosis ; pathology ; Lymphoma ; diagnosis ; pathology ; Nephrotic Syndrome ; diagnosis ; pathology

Objective: To analyze the clinical features, treatment and outcomes of primary lymphoma of bone (PLB) . Methods: The clinical data of 11 PLB patients were retrospectively analyzed. Results: 11 patients were enrolled in our study including 7 females and 4 males. The median age of the patients was 45 years old. The main histologic type was diffuse large B cell lymphoma and anaplastic large cell lymphoma. Of the 11 PLB cases, 3 cases were at stage ⅠE, 2 at stage ⅡE, 6 at stage ⅣE respectively. 6 cases were treated with chemotherapy and radiotherapy, 2 cases with total joint arthroplasty and chemotherapy, and 3 cases chemotherapy alone respectively. 5 cases got complete remission, 4 cases partial remission and 2 cases stable disease respectively. The median progression free survival was 17 (5-58) months after a median follow up of 21 (6-58) months. Conclusions Most of PLB patients were clinically in late stage lacking of clinical and imagine features. The optimal treatment for PLB was radiotherapy combined with chemotherapy, and its prognosis was relatively good.

BACKGROUNDTo understand the characterization of genome of a strain of avian influenza A H9N2 virus repeatedly isolated from a child with influenza illness. Thereafter to reveal the origin of this H9N2 virus.

METHODSViruses were passed in embryonated hen eggs and virion RNA was extracted from allantoic fluid and reverse transcribed to synthesize cDNA. cDNA was amplified by PCR and the PCR product was purified with a purification kit. Afterwards RNA sequence analysis was performed by dideoxynucleotide chain termination and a cloning method. Finally, phylogenetic analysis of the sequencing data was performed with MegAlign (Version 1.03) and Editseg (Version 3.69) softwares.

RESULTSGenome of A/Guangzhou/333/99 (H9N2) virus was closely related to avian influenza A H9N2 virus, but obvious difference from that of A/Duck/Hong Kong/Y439/97(H9N2) virus, as well as its genome did not include any RNA segment derived from human influenza A virus. However, the genes encoding the HA,NA,NP and NS proteins of A/Guangzhou/333/99 virus were derived from those of G9 lineage virus, the rest genes encoding the M and three polymerase (PB2,PB1 and PA) proteins were derived from G1 lineage strain.

CONCLUSIONSA/Guangzhou/333/99 virus was a reassortant derived from reassortment betweenG9 and G1 lineages of avian influenzaA(H9N2) viruses. Therefore, the most possibility is that it is derived from avian influenza A virus directly. The results do not only demonstrate that avian influenza A (H9N2) virus could infect men, but also firstly prove that the genetic reassortment could be occurred between different genetic lineages of avian influenza A (H9N2) viruses in the nature.

Animals ; Base Sequence ; Chick Embryo ; Child ; Genome, Viral ; Humans ; Influenza A Virus, H9N2 Subtype ; Influenza A virus ; genetics ; Influenza, Human ; virology ; Phylogeny

Objective:To explore the accuracy and clinical application value of a Multi-Agent Reinforcement Learning framework (MARL framework) in three-dimensional ultrasound to automatically locate the coronal plane of the uterus.Methods:A total of 144 female patients who underwent routine gynecological examinations in Luohu People′s Hospital during May 2020 were selected as the experimental subjects. The three-dimensional volume data of the uterus of all the experimental subjects were collected by using the Resona-8 high-end color Doppler ultrasound system. A sonographer with more than 5 years of clinical experience manually locate the coronal plane of the uterus in all collected data, and at the same time automatically locate the coronal plane of the uterus MARL framework. The coronal plane images of the uterus obtained by the two methods were saved, and the operation time of the two methods was recorded. The coronal plane uterine images obtained by the two methods were mixed together, and the images were scored 0-1 by two senior ultrasound experts in a double-blind manner. The average score greater than or equal to 0.6 points was considered qualified.Results:①In 144 volunteers, among the coronal planes of the uterus located by the two methods, 131 were qualified by the manual method, and 137 were qualified by the automatic method.There was no statistical difference between the manual and automatic coronal plane images of the uterus (χ 2=1.934, P=0.164) by the chi-square test. ②Using interquartile range analysis, the median and interquartile range of the image score of the automatic group was 0.80(0.75, 0.90), while the median and interquartile range of the image score of the manual group was 0.80(0.75, 0.90). The Wilcoxon signed rank test was used to analyze the quality of the coronal plane images obtained by manual and automatic methods, and the difference was not statistically significant ( Z=1.241, P=0.215). ③The paired t test was used to compare the time required to locate the coronal surface of the uterus, by manual method (63.65±10.182)s, by automatic method (3.25±0.294)s, the difference between the two methods was statistically significant ( t=19.52, P<0.001). Conclusions:The method based on MARL framework has a high correlation with the manual locating of the coronal plane of uterus in three-dimensional ultrasound, and greatly reduces the operation time. It can be effectively applied in clinical practice and lays a foundation for the automatic diagnosis of uterine related diseases.

Objective To explore the accuracy of ultrasonic diagnosis using the tele-ultrasound robot system . Methods During the period from May to June 2018 ,42 volunteers were consecutive selected to participate in this study ,and their digestive system and urinary system were examined using the robot method manufactured by GI Tech Co . ,Ltd ,Shenzhen and the traditional method . The results including the ultrasound diagnosis and the inspection time of two methods in each patient were compared . The ultrasonographic diagnosis of each volunteer was obtained by two methods and the time was recorded . The ultrasound images of the two methods were mixed together ,and the quality of the images was evaluated double-blindly by two senior doctors . Results There were actually 25 positive lesions in 42 volunteers . In the ultrasonic diagnosis of the two methods ,22 lesions were positive detected by robot method ,with 5 lesions misdiagnosed . In the traditional method , 24 lesions were positive detected , with 1 lesions misdiagnosed . Using the Wilcoxon signed rank test of paired sample comparison ,the score obtained by the robot method was 4 .79 ± 0 .57 ,and the score obtained by the traditional method was 4 .81 ± 0 .54 ( Z =0 .775 ,P= 0 .439) ,the difference was not statistically significant . There was no statistically significant difference in the images'qulity between the robot method and the traditional method using the chi-square test of the four-grid data( P >0 .05) . The check time for volunteers with negative result was ( 8 .64 ± 2 .95) min in robotic method and ( 2 .55 ± 0 .74 ) min in the traditional method ,the difference was statistically significant ( t =15 .161 , P =0 .000) . Conclusions The robot method has high value in common disease diagnosis and high quality in image acquisition ,and can be used in real-time diagnosis of the remote areas or community medical .

Objective:To explore the imaging rate and diagnostic rate of positioning the fetal conus medullaris by three-dimensional ultrasound method to detect atlantoaxial intervertebral space, comparing it with the traditional two-dimensional and three-dimensional ultrasound methods.Methods:Consecutively 318 singleton fetuses received routine ultrasound screening during the second trimester were enrolled from November 2017 to December 2018 in Shenzhen Luohu People′s Hospital and Shenzhen People′s Hospital. These fetuses included 276 normal cases and 42 abnormal cases. The abnormal group contained 11 cases tethered cords fetuses(tethered cords group) and 31 cases non-tethered fetuses(non-tethered group). A new ultrasound method named detecting atlanto-axial intervertebral space with three-dimensional ultrasound and traditional two-dimensional and three-dimensional ultrasound methods were used to acquire and store the images. The positions of the fetal conus medullaris were analyzed blindly and recorded by three experienced physicians using three different methods with off-line software.Results:①The χ 2 test comparing multiple sample rates was used to compare the imaging acquisition success rate of fetal conus medullaris by three ultrasound methods. The test level was adjusted to be α′=0.05/4=0.0125, the results showed that there were no statistically significant differences between the three methods in the normal group (χ 2=7.39, P=0.025) and the abnormal group (χ 2=5.32, P=0.070). ②The χ 2 test comparing multiple sample rates was used to compare the diagnostic accuracy of fetal conus medullaris position in normal group by three methods, it showed there was no significant difference in the correct rate of conus medullaris position in the normal group (χ 2=2.52, P=0.284). ③The χ 2 test comparing multiple sample rates was used to compare the diagnostic accuracy of the fetal conus medullaris in tethered cord group and non-tethered group using 3 methods, the difference was not statistically significant in tethered cord group (χ 2=1.22, P=0.543), while the difference was statistically significant in non-tethered group(χ 2=9.69, P=0.008). Conclusions:The method of detecting atlanto-axial intervertebral space with three-dimensional ultrasound has a high imaging rate and diagnostic accuracy in positioning the fetal conus medullaris. Positioning of fetal conus medullaris by detecting atlanto-axial intervertebral space with three-dimensional ultrasound is better than traditional two-dimensional and three-dimensional ultrasound in the abnormal non-tethered fetuses, which can provide more valuable information for prenatal diagnosis consultation and prenatal and postnatal care.