Child ; Diagnosis, Differential ; Diagnostic Errors ; Female ; Humans ; Porphyria, Acute Intermittent ; diagnosis ; therapy

Partial fibulectomy is widely used in fibula transplantation and the treatment of fibular tumor and injury. After follow-up surveys and biomechanical experiments, many authors believe it is important to pay attention to the postoperative complications in leg，which now still remains in dispute. For the first time finite element analysis is used to find out the mechanical characteristics of crural bone before and after partial fibulectomy. Our results show that resection would alter significantly the stress distribution in tibia, fibula and the medial & lateral parts of talus, so influent the ankle joint stability. Causes of postoperative complications were also discussed.

OBJECTIVE:To prepare psoralen liposome gel and to conduct a quan titative investigation about its drug re?lease model in vitro.METHODS:Taken psoralen liposome gel that of the same concentration as the control group,the model of drug release in vitro of the testing group was evaluated by dialyzing method and the stability of its drug release after storage for3weeks at4℃was studied as well.RESULTS:Compared with the control group,the testing group showed significant slow-releasing and long-acting effects and the drug release followed the Higuchi(k=4.67%h -1/2 )diffusion model in the first3hours and a zero order drug release model(k=0.74%h -1 )3hours later;The drug release of the control group followed the Higuchi(k=7.18%h -1/2 )diffusion model of within24hours;The drug release model and the envelop rates of the testing group remained stable within the storage date.CONCLUSION:This preparation is characterized by slow drug releasing in vitro and good stability.

The effective quality control in clinical practices is an effective guarantee for the authenticity and scientificity of the findings. The post-marketing reevaluation for traditional Chinese medicines (TCM) focuses on the efficacy, adverse reaction, combined medication and effective dose of drugs in the market by expanded clinical trials, and requires a larger sample size and a wider range of patients. Therefore, this increases the difficulty of quality control in clinical practices. With the experience in quality control in clinical practices for the post-marketing reevaluation for Kangbingdu oral for cold, researchers in this study reviewed the study purpose, project, scheme design and clinical practice process from an overall point of view, analyzed the study characteristics of the post-marketing reevaluation for TCMs and the quality control risks, designed the quality control contents with quality impacting factors, defined key review contents and summarized the precautions in clinical practices, with the aim to improve the efficiency of quality control of clinical practices. This study can provide reference to clinical units and quality control-related personnel in the post-marketing reevaluation for TCMs.
Drugs, Chinese Herbal ; adverse effects ; economics ; therapeutic use ; Humans ; Medicine, Chinese Traditional ; Product Surveillance, Postmarketing ; methods ; Quality Control ; Randomized Controlled Trials as Topic ; Respiratory Tract Infections ; drug therapy

ObjectiveTo report clinical, pathological and molecular genetic features in a Chinese family with hereditary motor and sensory neuropathy type 6. MethodsThe index case is a 15 years old boy.He developed progressive distal limb weakness at the age of 5.The disease deteriorated slowly,accompanied with contracture of achilles' tendon. At the age of 11 years old he suffered from decrease of visual acuity. At the age of 12, he found the muscular atrophy of both hands without sensory disturbances.Visual evoked potential revealed prolonged latency of bilateral P100. Ophthalmological examination showed bilateral optic atrophy. His mother had the similar symptoms at the age of 7 and reduced visual acuity at the age of 10. Nerve conduction velocity revealed in both pat1ents no compound motor and sensory nerve action potentials in most nerves or slightly reduced nerve conduction velocities with severely reduced amplitudes of the compound motor and sensory nerve action potentials. Sural nerve biopsy was performed on the proband.The sequence of MFN2 gene was analyzed in DNA from the index, his mother and 100 healthy controls.ResultsSural nerve biopsy revealed severe loss of myelinated fibers with few regenerating clusters.Ultrapathological examination showed a few of atypical bulbs of myelinated fibers, occasionally regenerating clusters, mitochondrial swelling and aggregation in a few of axons. A new mutation of W740R mutation in MFN2 gene has been identified in the index case, her mother, but not in 50 healthy controls. Conclusions A novel MFN2 gene mutation result in hereditary motor and sensory neuropathy type 6.Mild visual loss appeares after the lesion of spinal nerves. Demyelination of peripheral nerve appears in the disease.

This study was aimed to observe the clinical effect of nerve root cervical spondylosis treatment by muscle meridian manipulation with small-angle sagittal localized rotational pulling of the neck . A total of 60 cases of nerve root cervical spondylosis were randomly divided into two groups , which are the treatment group (by muscle meridian manipulation with small-angle sagittal localized rotational pulling of the neck) and the control group ( by tendon-soothing manipulation ) . The results showed that there were significant differences ( P< 0 . 01 ) in the comparison of cure rate after treatment . The total efficiency of the treatment group was 93 . 33%, and the control group was 70 . 00%. The treatment group showed better clinical effect with significant difference ( P < 0 . 05 ) . It was concluded that the application of muscle meridian manipulation with small-angle sagittal localized rotational pulling of the neck is maneuverable and time-saving in the treatment of cervical spondylosis . It has a remarkable therapeutic effect and is suitable for clinical application .

Objective To study the clinicopathologic features,effective therapeutic regimen and prognosis of human immunodeficiency virus (HIV) infection with acute promyelocytic leukemia (APL) and chronic myeloid leukemia (CML).Methods Two cases of HIV infection concurrent with leukemia,one with APL,one with CML,were studied and relevant literatures were reviewed.Results Case 1 was HIV infection concurrent with APL,ATO was used to induce remission,in the eight day of therapy,the patient died of brain disorder.Case 2 was HIV infection concurrent with CML,hydroxycarbamide and interferon were used to induce remission,three month later,state of an illness progressed to acute phase,after combination chemotherapy,concurrent with lung multiple infection (fungus and pneumocystis carinii),at last,the patient died of respiratory failure.Conclusion HIV infection concurrent with acute and chronic leukemia has poor therapeutic effect,and is easy to infect seriously.

Objectve To explore the application of exercise test use in diagnosis of periodic paraly sis.Methods Forty five cases of hypokalemic periodic paralysis were collected,and 40 health persons as control group.Both groups were measured serum potassium,serum creatase and thyroid function tests.All of them were taken exercise test (ET) and observe 50 minutes,measured before and after the test to seek the changes of compound muscle action potentials (CMAP),and its decreased more than 33％ were considered abnormal.The application of exercise test use was analyzed in diagnosis of periodic paralysis.Results In patients with periodic paralysis,the incidence of ET positive was higher than the control subjects (80％ vs 3.3％,P ＜ 0.001).This trend was significant after 20 minutes,such as 30 min[(37.8 ± 13.2)％ vs (6.2±3.2)％,P＜0.01],40min [(40.3 ±17.6)％ vs (3.2±1.9)％,P＜0.01],50min [(45.26 ± 19.9) ％ vs (-5.1 ± 2.6) ％,P ＜ 0.01].Moreover,linear correlation analysis showed that the serum potassium had negative correlation with serum creatase (r =-0.483,P =0.024).ALL of symptoms improved after a week treatment,the ET positive rate was still higher in patients with periodic paralysis than the control subjects (80.0％ vs 71.1％,P =0.824).Conclusions Exercise test was one of the important objective basis in the diagnosis of low potassium type periodic paralysis,and was not affected by treatment and testing time.

Objective To evaluate the effect of preoperative intravenous drip of tranexamic acid(TXA) on perioperative bleeding in proximal femoral nail anti-rotation(PFNA) operation of elderly intertrochanteric fracture.Methods A total of 115 elderly patient with intertrochanteric fracture undergoing PFNA internal fixation were selected and divided into the treatment group(58 cases) and control group (57 cases).The treatment group was intravenously dripped with 20mg/kg TXA before operation,while the control group had no special treatment.Hemoglobin (Hb) and hematocrit(Hct) were recorded before operation and on postoperative 1,3 d.The total amounts of perioperative blood loss were calculated by using the Gross equation and Nadler equation.The blood transfusion rate and thromboembolic complications occurrence situation in the two groups were performed the statistics.Results The total amounts of perioperative blood loss were (872.21±312.53) mL in the treatment group and (1 162.41±368.64) mL in the control group,the difference was statistically significant(P<0.01).The blood transfusion rate was 3.45% in the treatment group and 17.5% in the control group,the difference was statistically significant (P<0.01).No deep vein thrombosis and pulmonary embolism occurred in both groups.The occurrence rate of venous thrombus was 5.1% in the treatment group and 7.0% in the control group without statistical difference(P>0.05).Conclusion Preoperatively intravenous drip of 20mg/kg TXA in PFNA internal fixation of elderly intertrochanteric fracture can effectively decrease perioperative blood loss without increasing the risk of thrombus formation.

Objective To establish hybridization method by using the DNA-modified colloid gold nanopartieles probes for rapid and specified detection of methicillin resistant Staphylococcus aureus (MRSA). Methods DNA-modified nanoparticles probes were prepared by using two mereapto-modified mecA gene-specific oligonucleotide probes bounding with 6Ohm-diameter colloid gold nanoparticles through covalent binding. Genomic DNA of Staphylococcus aureus strains were extracted and then fragmented by ultrasonic waves. The fragmentized DNA was hybridized with the DNA-modified colloid gold nanoparticles probes. The reaction products were centrifuged and then detected by reversed-phase thinlayer chromatography plate to observe any colloid gold nanoparticles precipitation. The results of mecA gene detected by the colloid gold nanoparticles probes hybridization were compared with the results of PCR and the accuracy of the hybridization method was evaluated. Results Of total 95 tested strains, 71 strains were confirmed as MRSA and 24 swains were confirmed as methicillin susceptible Staphylococcus aureus (MSSA) by PCR. Of 71 MRSA strains, 69 strains were positive by colloid gold nanoparticles probes hybridization, the sensitivity of this method was 97.2%. All of the 24 MSSA strains were negative by using this technique. The specificity of this method was 100%. Of total 95 test strains ,93 strains were detected correctly. The accuracy was 97.9%. Conclusions Colloid gold nanoparticles probes hybridization test is well consistent with the gold standard method of PCR in detection of MRSA. Detection of MRSA by using the technique of the DNA-modified colloid gold nanopartichs probes hybridization is rapid, simple and accurate. It is potent to be a new method for rapid diagnosis of MRSA infection.