China ; Haplopappus ; Humans ; Phytotherapy ; Sesquiterpenes

OBJECTIVETo investigate surgical outcomes of strip nail internal fixation with bone graft in treating tibial plateau fracture.

METHODSFrom May 2012 to May 2014,36 patients with tibial plateau fracture were retrospectively analyzed, including 25 males and 11 females with an average age of 43.5 (ranged from 17 to 65) years old. The time from injury to operation ranged from 3 to 10 days with an average of 5.8 days. All patients were treated with L-shaped and T-shaped strip nail internal fixation with bone graft. It was evaluated by the Knee Functional therapy assessment method of the Special Surgical Hospital of American at final following-up. Varus angle, caster angle and femorotibial angle were recorded and compared at 3 days and 1 year.

RESULTSOperative time was (2.2 ± 0.6) h on average, blood loss was (310.5 ± 36.2) ml on average, hospital stay was (14.8 ± 2.7) days on average. Thirty-six patients were followed up from 12 to 30 months with an average of 18.2 months. Fracture healing time ranged from 4 to 8 months with an average of 6.2 months. The difference is not significant among varus angle, caster angle and femorotibial angle at 3 days and 1 year. According to the knee functional therapy assessment method of the Specialized Surgical Hospital of American, 18 cases got excellent results, 13 good, 4 moderate and 1 poor.

CONCLUSIONStrip nail internal fixation with bone graft for the treatment of tibial plateau fracture could effectively prevent the joint surface from secondary collapse, and achieve anatomic reduction, stable fixation and earlier functional exercise in further to get satisfied clinical effects.

Adolescent ; Adult ; Aged ; Bone Nails ; Bone Transplantation ; Female ; Fracture Fixation, Internal ; methods ; Fracture Healing ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Tibial Fractures ; physiopathology ; surgery

Objective To evaluate interventional therapy in the treatment of interposition graft stenosis or occlusion after mesocaval shunts.Methods The clinical data of 19 cases of artificial vessel stenosis or occlusion after mesocaval shunts for portal hypertension at our department from march 2009 to march 2012 were retrospectively analyzed.Results In the 19 cases with artificial vessels stenosis or occlusion developed after mesocaval interposition shunts for portal hypertension,there were 5 cases in which acute thrombosis occurred within a week after the surgery.Catheter directed thrombolysis was successfully conducted.In 6 cases in which shunt stenosis developing 1 to 8 years after surgery were managed by balloon dilatation or stent angioplasty successfully.The shunt graft occlusion occurred in 8 cases after 1 to 4 years of surgery was successfully managed and the shunt was reopened by balloon dilatation or stent angioplasty in 6 cases,and in 2 the procedure was failed for the guide wire can't go through the anastomotic site of artificial vessel-superior mesenteric vein.In 11 cases embolization of the esophagogastric varices was successfully carried out for postoperative standard anticoagulation.During a period of 3 months to 3 years follow-up,stenosis recurred 1 year after balloon dilatation in one case,and stenosis was managed by angioplasty successfully.Conclusions Interventional radiological techniques by percutaneous puncture through femoral vein-inferior vena cava-artificial vessel-portal vein (including catheter directed thrombolysis,balloon dilatation,stent placement,etc) are less traumatic,highly successful in the treatment of shunt stenosis or occlusion after mesocaval shunts in portal hypertension.

The efficacy of ~(131)I treatment of hyperthyroidism in children and adolescents was evaluated. Being unsuitable for medical therapy,31 patients (aged 11-18 years) with hyperthyroidism received ~(131)I treatment with a dose of 0.925-3.33 MBq/g of thyroid and were followed-up for 20 to 76 months.Fifteen patients were euthyroid,5 suffered from late-onset hypothyroidism,and 11 were still hyperthyroid,but their symptoms and signs of hyperthyroidism were markedly improved.Of the 18 patients with thyroid-associated ophthalmopathy (TAO),8 patients recovered,4 were improved,TAO in 1 patients deteriorated and in S patients remained unchanged.~(131)I is a relative safe and effective treatment for children and adolescents above 10 years old with hyperthyroidism,being unsuitable for medical therapy.

Abstract: To analyze the clinical, therapeutic and laboratory characteristics of disseminated cryptococcosis caused by Cryptococcus neoformans invading the blood stream in patient with liver cirrhosis and splenectomy. A 30-year-old male underwent splenectomy plus pericardial devascularization due to "splenomegaly and hypersplenism" in March in 2016. The patient had intermittent fever after operation for many times, and successively accompanied with back pain, left lower limb abscess and right hip pain. The highest body temperature was 39 ℃. CT and MRI revealed the lung lesion and multiple bone destruction. During that period, the effect of antibiotics was not good. On April 19th, 2017, Gram's stain, India ink stain, API 32C, Vitek 2 Compact, ribosomal ITS and IGS sequence analysis were performed to identify the strain isolated from the pus and blood stream. The serum of the patient was detected for cryptococcal antigen. Antifungal susceptibility test was used to determine drug sensitivity and minimum inhibitory concentration (MIC). The Cryptococcus neoformans isolated from fresh pus specimen showed a prominent, thick capsule after India ink stain. The colonies isolated from pus and blood stream were identified Cryptococcus neoformans using API 32C, Vitek 2 Compact, and sequence analysis of rDNA ITS and IGS. Cryptococcal capsule antigen was positive. The minimal inhibitory concentrations of 5-Flucytosine, amphotericin B, fluconazole, itriconazole, voriconazole against the isolate were <4 μg/mL, <0.5 μg/mL, 4 μg/mL, ≤0.25 μg/mL, 0.125 μg/mL respectively. The patient was initially treated with intravenous amphotericin B and flucytosine. After anti-Cryptococcus treatment for two months, the patient clinically improved, and the lesions were reduced on a follow-up CT scan. The patient made a full functional recovery after treatment for six months. Cryptococcosis has hidden onset, atypical clinical symptoms and lack of specificity. Blood stream is the main channel for Cryptococcus to spread and involve many organs of the whole body, including skin, bone and so on. Therefore, early use of blood culture to monitor blood flow dissemination, actively removing the primary focus and cutting off the infection route in time and carrying out effective anti-Cryptococcus treatment are conducive to the patient's early recovery.

Objective To observe the effects of five flavonoids include rutin(RU),dihydromyricetin(DMY),hesperetin(HP),daidzein(DA)and hydroxysaffor yellow A(HYSA)on myocardiocyte apoptosis induced by H2O2 and to explore their relationships with Keshan disease and the possible mechanism.Methods Primary cultured cardiocytes of neonatal rats were randomly divided into control group,model group,and flavonoids preincubation group.The cardiocyte apoptosis was examined by fluorescent staining,the rates of apoptosis were detected by flow cytometry,the expression of Bcl-2 family proteins associated with apoptosis were observed:by Western blot.Results Compared with model group[(24.33±6.51)%],RU[(13.95±3.80)%],DA[(11.82±3.50)%],HYSA[(12.33±3.78)%]could decreased the rate of apoptosis(P＜0.05).The five flavonoids could up-regulate Bcl-2 expression,down-regulate Bax expression,and increase the Bcl-2/Bax ratio[RU(0.989±0.094),DMY(0.931±0.280),HP(0.980±0.095),DA(1.049±0.092),HYSA(1.031±0.039),vs model(0.490±0.046),the difference had statistical significances(P＜0.05)],but the Bcl-xl did not significantly changed(P＞0.05).Conclusions RU,DMY,HP,DA and HYSA have antiapoptotic effects on cardiomyocyte via regulating Bcl-2 and Bax,which gives us a hint in prevention and treatment of Keshan disease.

Objective To explore the clinical,radiological findings and pathogenic factor of spondylometaphyseal dysplasia.Methods Five cases were reported and the relevant documents were studied retrospectively.Plain X-ray film was performed in all patients.Results There were 4 male and 1 female,age ranged from 4 to 15 years with average of 9 years.The main features of 5 cases included delayed bone age,stature short,short trunk,waddling gait noted,scoliosis in 2 cases,kyphoscoliosis in 1 case,severe genu valgum in 2 cases.The main X-ray appearance of 5 cases is multiple irregularities of long bones metaphyses associated with platyspondylia,epiphysis is normal.Type Ⅰ SMD in 2 cases,Type Ⅱ SMD in 1 case,Type Ⅲ SMD in 2 cases.Conclusion When we meet children with delayed bone age and stature short,and muhiple irregularities of long bones metaphyses associated with platyspondylia were seen in X-ray plain film.we should think about spondylometaphyseal dysplasia.

Objective Mutated inbred animal model is introduced to the practical course of genetic diagnosis in the hope that medical students are able to apply what they have learned to clinical cases, based on a deep understanding of principle and technology on gene mutation detection. Methods We integrated DNA extraction, polymerase chain reaction, agarose gel electrophoresis, and gel imaging analysis into a comprehensive experiment and arranged 4-year-programme undergraduates majoring in preclinical medical sciences to conduct it with the purpose of investigating the internal relations between phenotype and genotype in a hairless Uncv mouse model. Subsequently, the questionnaire aimed at evaluating learning effect on the part of students was handed out and their feedbacks were analyzed. Results More than 90% of respondents are satisfied with the general learning effect. Especially, 98. 7% of students support the enhancing effect of the new teaching mode on their research skills and 96% consider the practical course helpful to their problem-solving ability. Conclusions The introduction of mutated inbred animal model to the practical system of molecular diagnostics proves beneficial to boost students' learning effect and scientific research quality. Our practice also provokes thoughts on the further utilization of animal models in teaching system of medical sciences.

OBJECTIVETo analyze the current status of maternal HIV infection, mother to child transmission, and the work accomplishments in preventing mother-to-child transmission of HIV (PMTCT).

METHODSDuring October, 2001 to May, 2009, HIV voluntary consultation and examination were carried out in 339 866 pregnant women in the urban areas, while 594 pregnant women who tested positive were intervened, and interventions were also conducted among 326 babies who were born to HIV positive mothers, including HIV immune body examination on the babies when they were 12 months and 18 months old.

RESULTSA total of 594 pregnant women were found HIV positive, with the positive rate of 0.17% (594/339 866). And the rate was declining year by year. The highest rate was 0.47% (37/7837) in 2002, and the lowest rate was 0.12% (86/73 343) in 2008. Of the 594 positive pregnant women, 228 (38.38%) terminated pregnancy voluntarily, 43 (7.24%) kept on pregnancy and 317 (53.37%) parturients. Of 326 babies born by the 317 parturients, 317 survived.298 received curbing intervention for mother to child transmission (PMTCT), the ratio was 94.01% (298/317). Of 224 babies who were 18 months old, 221 accepted examination, and 7 HIV positive. The maternal infant transmission rate after intervention was 3.17% (7/221).

CONCLUSIONThrough the prevention of mother-to-child transmission of HIV, the HIV infection status in the pregnant women can be timely observed, which can effectively decrease the level of mother-to-child transmission of HIV.

Acquired Immunodeficiency Syndrome ; prevention & control ; transmission ; Adult ; China ; Female ; Humans ; Infant ; Infant, Newborn ; Infectious Disease Transmission, Vertical ; prevention & control ; Pregnancy

OBJECTIVETo investigate the possible relationship between variation of coxsackievirus B3 (CoxB3) VP1 sequence from cerebrospinal fluid of children with severe and mild central nervous system (CNS) infection and damage to CNS in children from Shandong province.

METHODSThe enteroviruses were detected using VP1 typing and sequencing primer for enteroviruses from 73 enterovirus-infected cases confirmed by detection of cerebrospinal fluid by enteroviruses common primer. VP1 sequences (450 nucleotides) were determined and analyzed for 21 CoxB3 enteroviruses strains isolated in Qingdao and Binzhou, and were compared with that of BLAST search procedures from GeneBank in NCBI. The variation of VP1 gene and amino acids sequence of CoxB3 enteroviruses was analyzed for severe and mild CNS infection.

RESULTSThe nucleotide homogeneity of these CoxB3 appeared to be 97% - 99%, however, the homogeneity among different genotypes were 83% - 76%. Replacement of glutamine by histidine at amino acid locus 856 of VP1 CoxB3 was found in 4 cases with severe encephalitis. There were different variation in VP1 nucleotide sequence of CoxB3 in 3 cases with mild encephalitis and 14 cases with meningitis, but amino acids sequences had no regular variation. The modified Glasgow's coma score was below 7 in all the 4 cases with severe encephalitis. Of these 4 cases, 3 had consciousness disturbance for less than 3 days. Lethargy, restlessness and psychiatric symptoms were major manifestations, of whom 3 also had dysphagia, 1 had encephalatrophy obviously, Glasgow's coma score was 3, deep coma lasted for 9 days, and had concomitant fatal epileptic attacks. Of these 4 cases, 2 completely recovered, 1 had high muscle tone, 1 remained under anti-epileptic drug treatment at follow-up 6 months later.

CONCLUSIONThere were a small epidemic of CoxB3 CNS infection in children in 2005 in this area. The amino acid variation of CoxB3 VP1 possibly caused increased viral virulence and caused damage to CNS.

Amino Acid Sequence ; Base Sequence ; Capsid Proteins ; cerebrospinal fluid ; genetics ; Central Nervous System ; pathology ; virology ; Child ; Coxsackievirus Infections ; cerebrospinal fluid ; epidemiology ; virology ; Encephalitis ; virology ; Enterovirus B, Human ; genetics ; pathogenicity ; Female ; Humans ; Male ; Molecular Sequence Data ; RNA, Viral ; genetics ; Virulence