Adolescent ; Anti-Bacterial Agents ; therapeutic use ; Child ; Child, Preschool ; Diagnosis, Differential ; Female ; Histiocytic Necrotizing Lymphadenitis ; diagnosis ; drug therapy ; pathology ; Humans ; Lymph Nodes ; pathology ; Male ; Retrospective Studies ; Treatment Outcome

BACKGROUND:In the perspective of traditional Chinese medicine, few studies have focused on the compound preparations though there are many investigations. The present study was undertaken to investigate the effect of Zhenwu Tang Granule on chronic pressure-overloaded left ventricular hypertrophy in rats. METHODS:The study was performed at the laboratory of Guangzhou Institute of Respiratory Disease. Male SD rats were divided randomly into 3 groups:sham operation group (n=8), operation group (n=15) and traditional Chinese medicine (TCM) group (n=15).The model of myocardial hypertrophy was made by gradually constricting the abdominal aorta. Sixteen weeks later, cardiac ultrasonography was performed in all groups in order to ascertain post-operational left ventricular (LV) hypertrophy. And Zhenwu Tang Granule was added at a dose of 12 g/kg in the mixed feedstuff for 8 weeks in the TCM group. In the 24th week, weight, structure as well as function of the heart in each group were measured by high-frequency ultrasonography, and Masson's staining was performed on the cardiac muscles. Meanwhile, total collagen volume fraction (CVF-T) and non-coronary vessel collagen volume fraction (CVF-NV) were analyzed. RESULTS:There was an increase in the weight of the heart in the operation group, with the left ventricule dominated (P<0.05). The heart was enlarged, with diastolic interventricular septal distance (IVSd) and left ventricular posterior wal distance (LVPWd) dominated (P<0.01).There was a significant decrease in the cardiac function (P<0.05). The weight (P<0.01) and volume of the heart decreased in the TCM group compared with the operation group, with IVSd and systolic left ventricular posterior wal dominated (P<0.01). And the cardiac function was improved (P<0.05). Significant interstitial and col agen hyperplasia was shown in the operation group based on pathological analysis, and various improvements were proved in the TCM group, i.e. there was a significant decrease in CVF-T and CVF-NV (P<0.01) compared with the operation group; but no difference (P>0.05) was found when compared with the pseudo-operation group. CONCLUSION:Zhenwu Tang Granule could reduce the weight and volume of the heart, improve the cardiac function, inhibit hyperplasia of collagen, and reverse myocardial hypertrophy in rats with pressure-overloaded left ventricular hypertrophy.

Objective This study was to investigate the role of lactoferrin and C-reactive protein (CRP)assay in ascitic fluid for diagnosis of spontaneous bacterial peritonitis (SBP)in the patients with decompensated liver cirrhosis.Methods Ascites was collected from the inpatients with decompensated liver cirrhosis before and after treatment from May to December 2011 for anal-ysis of polymorphonuclear cells (PMN)and bacterial culture.The level of lactoferrin and C-reactive protein in the ascites were determined.Results A total of 117 ascites samples were collected from 66 patients.Twenty-six patients met the criteria of SBP with PMN ≥ 250×106/L in ascites,were assigned to SBP group.Of these patients,11 presented with fever 37.3℃ to 38℃, and 11 patients had elevated peripheral blood white cell count > 10 × 109/L.Eleven patients had neutrophil cell percentage >0.75.Only 8 patients in this group had positive bacterial culture.Another 12 patients met the criteria of suspected SBP,and assigned to suspected SBP group.The remaining 28 patients did not satisfy the criteria of SBP,and assigned to non-SBP group.The pretreatment lactoferrin level was (768.46 ± 611 .70)ng/mL and (98.28 ± 56.81 )ng/mL in SBP and non-SBP group,respectively.The pretreatment CRP level was (9.397 ±3.737 )mg/L and (1 .786 ±0.52 )mg/L in SBP and non-SBP group,respectively.The lactoferrin and CRP levels decreased sharply after antibacterial and support-ive treatment in SBP group,which were 657.05 ng/mL and 8.13 mg/L,respectively.The cut-off value of lactoferrin for diagnosis of SBP was 233 ng/mL with sensitivity 96.2% and spe-cificity 97.5%.The cut-off value of CRP for diagnosis of SBP was 4.390 mg/L with sensitivity 92.3% and specificity 92.5%. However,lactoferrin combined with CRP had a sensitivity of 99.70% and specificity of 90.18% for diagnosis of SBP.Conclu-sions Lactoferrin and CRP levels in the ascites of patients with liver cirrhosis are useful for diagnosis of SBP with high specifici-ty and sensitivity.

BACKGROUND:Many studies have demonstrated that restoration of femoral offset in revision total hip arthroplasty would contribute to the recovery of joint function.OBJECTIVE:To investigate the importance of restoration of femoral offset in revision total hip arthreplasty on the recovery of joint function.METHODS:An observational study was performed at the Department of Orthopedics,Third Affiliated Hospital of Guangzhou Medical University between February 2004 and May 2007.A total of 15 patients with the revision total hip arthroplasty,including 12 males and 3 females,aging 62 75 years,averaging 67 years old,were recruited into this study.Harris evaluation system was used to evaluate joint function.The femoral neck anteversion and the femoral offset were measured by the method of Sakai.The vertical distance from the teardrop line to the most prominent point of the lesser trochanter was measured from each radiograph.References were combined to investigate the effect of restoration of femoral offset in revision total hip arthroplasty on joint function.RESULTS AND CONCLUSION:All the 15 patients were recruited into this study.The duration of follow-up ranged from 24 months to 5 years.We measured the femoral offset on pre- and post-operative radiographs,and the results indicated that the femoral offset of 4 patients were above 4 mm.The femoral offset of 11 patients was restored.The femoral offset were 22-48 (32.21±0.64) mm pre- and 22-57 (36.13±0.82) mm post-operative radiographs,respectively.The mean difference in femoral offset post-operatively was significant (t=0.424,P=0.01 ).Harris scores were good in 4 cases,passable in 2 cases,and poor in 9 cases pre-operatively,and the scores were excellent in 8 cases,good in 4 cases,passable in 2 cases,and poor in 1 case post-operatively.The score of Harris evaluation system in the patient of restoration group and failed restoration group were 88.72±5.3 (80%) and 72.32±6.5 (27%) post-operative at 1 month respectively.The mean difference of the score was significant (χ~2=1.245,P<0.05).The 3 patients had complication,one was the dislocation of hip,and two had the pain of hip.All the patients with complication were in failed restoration of femoral offset,which was above 4 mm.The restoration of femoral offset contributes to the recovery of joint function and reduce complication occurrence after total hip arthroplasty revision.

OBJECTIVETo evaluate the role of serum level of procalcitonin (PCT), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and white blood cell count (WBC) as predictors in postoperative early infectious complications with fever after posterior lumbar internal fixation (PLIF).

METHODSA retrospective study was conducted from January 2012 to January 2014. Fifty-two patients with fever in the early stage(within 10 days) after the PLIF were collected in the study. They were divided into infection group and non-infection group (group A and group B) according to the results of postoperative blood culture. There were 26 patients in group A and 32 patients in group B. The values of PCT, CRP, ESR, and WBC count were compared and analyzed between two groups.

RESULTSThe values of PCT, CRP, and ESR in group A were higher than those of group B. Meanwhile, CRP and ESR in group B were still higher than the normal range. Among the 26 patients with infections (group A), PCT was superior to CRP and ESR, had a good ability in discriminating different kinds of postoperative infections. The area under the ROC curve of serum PCT levels was the largest (CI 95% was 0.81 to 0.98) in the indexs; and ROC curve of WBC count was no statistically significant. When the cut off points of each predictors were evaluated, the higher sensitive was CRP and reached at 90.27% and the higher specific was ESR and reached at 88.50%.

CONCLUSIONFor the patients with fever at the early stage after the PLIF should be paid attention and reasonable choosing predictors are helpful to identify postoperative infection in the early stage. The CRP and ESR may be influenced by the surgery, and the PCT level is helpful to differentiate infection type.

Adult ; Aged ; Aged, 80 and over ; Blood Sedimentation ; C-Reactive Protein ; analysis ; Calcitonin ; blood ; Calcitonin Gene-Related Peptide ; Female ; Fever ; blood ; diagnosis ; Fracture Fixation, Internal ; adverse effects ; Humans ; Infection ; blood ; diagnosis ; Leukocyte Count ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Postoperative Complications ; blood ; diagnosis ; Protein Precursors ; blood

Objective To evaluate the effectiveness of health education on controlling of coal-burning-borne endemic fluorosis(referred to as endemic fluorosis) in Guizhou,and to provide a scientific basis for development of control strategies.Methods A total of 37 counties were selected in Guizhou province,and 3 townships were chosen in each project county.Heath educational activities were carried out in the classes of grade 5 in the Central Primary School of each selected township.In the meantime,3 villages were chosen in each selected township where the health education for women of child-bearing age in the community was carried out.Survey on knowledge questionnaire of endemic fluorosis control was conducted among 30 students of grade 5 in the Central Primary School and 15 women of childbearing age of each selected township before and after the health educational activities.Results The knowing rate of endemic fluorosis control of pupils in all the 37 counties increased from 45.03％(14637/32505) to 89.79％(52898/58910),of women of child-bearing age increased from 38.97％ (5729/14700) to 76.55％(19198/25080) after the health education.ConclusionsThe knowing rate of endemic fluorosis control among pupils and women of child-bearing age is remarkably increased after implementing the health education projects.They have better life and health habits,and the project has reached desired goal.

Objective To study the follow-up management strategies after improving stoves for controlling coal-burning type endemic fluorosis in Guizhou and to provide a scientific basis for exploring the follow-up management measures.Methods In 2006 - 2009,three counties of Puding,Bijie and Liuzhi with improved stoves in 2005 and implemented follow-up management measures for subsequent three years were chosen,3 towns were chosen randomly in each chosen county,2 villages were selected randomly in each chosen town,10 households were investigated randomly in each chosen village,and 20 students were investigated of the knowledge of fluorosis control.The investigation included also the usage of the stoves,dehydration methods of grain and related conditions.Results ①The head of the family and student awareness of fluorosis control were 82.6％(743/900)and 91.7％ (1650/1800),respectively,and 35.0％ ( 385/1100 ) and 61.0％ (6605/10 835 ),respectively,before the test,and the difference was statistically significant( x2 =33.04,1189.12,all P ＜ 0.01 ).②The rates of chimney out of the house were 88.5％(69/78) and 100.0％(102/102),respectively,compared with those before the trial[74.4％(2125/2856) and 2.1％(104/4984),respectively],the difference was statistically significant(x2 =720.56,4295.38,all P ＜ 0.01).The iron stove and the table stove's airtight utilization rates were 85.9％(67/78) and 100.0％(102/102),respectively.③The corn and the hot pepper's correct drying rates were 100.0％(180/180).Compared with those[27.2％(49/180) and 32.2％(58/180),respectively]before the trial,the difference was statistically significant(x2 =26.68,37.38,all P ＜ 0.01 ).The corn and the hot pepper's washing rates before eating were 95.0％(57/60) and 98.3％(177/180),respectively.Compared with those[85.0％(153/180) and 77.8％(140/180)]before the trial,the difference was statistically significant(x2 =135.00,490.82,all P ＜ 0.01 ).Conclusions The target population's awareness and knowledge of fluorosis prevention and related behavior are significantly elevated and enhanced after implementation of the three years post-management,which has reached the desired goal.The strategies of the follow-up management suits Guizhou province and widespread application is suggested.

Objective To study the effects of emergency operation with 2~5 cm incision to treat fresh closed heel tendon disjunction.Method 23 cases of fresh closed heel tendon disjunction were operated in post-injury 3~12 hours and the incisions were 2~5 cm long. Results None of these cases was complicated with wound infection or cutaneous necrosis.The follow-up was from 6 months to 6 years,averaging 2.2 years;in which,according to the Arner-Lindholm standards,20 were excellent,3 were good.Conclusion A satisfactory effect can be obtained through the smaller incision to treat the fresh closed heel tendon disjunction.

Objective To explore the effect of posterior internal fixation surgery with pedicle screw/rod instrument system in the treatment of thoracic vertebrae fracture-dislocation complicated with a severe thoracic injury. Methods In the 8 cases examined, the range of injury was from T5 to T9, including 1 case of compression fracture-dislocation and 7 cases of burst fracture-dislocation according to Hanley and Eskey’ s classification. According to Frankle’ s classification, 4 were grade A, 3 were grade B, 1 was grade C. All cases were complicated with multiple fractures of bilateral ribs, pulmonary contusion and haemothorax. After the pathogenic condition being stable, reduction and internal fixation were performed with the posterior surgery pedicle screw/rod instrument system. In 5 cases, spinal canal anterolateral decompression was performed homeochronously. The intervals between accidents and operation were 3 to 9 days. Results Operations were performed safely in all patients. The reposition of the alignment and height of vertebraes was good. Postoperative CT scanning showed: in 2 cases, bone block occupied about 10% volume of vertebral canal, and 1 was 50%. The follow-up were 4～36 months, averaging 15 months. No postreduction disposition, internal fixation loosening or breakage occurred. The Frankel’ s classification of neurological function was improved by 1 grade on average. Conclusions After a positive treatment of thoracic injury, it is safe and feasible to treat the fresh thoracic vertebrae fracture-dislocation with the posterior surgery pedicle screw/rod instrument system, and the curative effects are satisfied.

OBJECTIVE To evaluate the difference of efficacy of sublingual immunotherapy on different age patients with allergic rhinitis. METHODS 229 patients with dermatophagoides farina drops allergic rhinitis who have finished SLIT at least 2 years were enrolled and analyzed by retrospective analysis. All patients were divided into different age groups: pre-adolescence(n=107), adolescence(n=53), adulthood(n=69). Indexes for therapeutic effects of SLIT visual analogue scale(VAS) score, rhinitis symptom scores, medication scoreintra- and inter groups were assessed during different stage of treatment(3 months, 1 year and 2 years). Data were analyzed with SPSS 19.0 software. RESULTS Compared with prior treatment, after the SLIT for 3 months, 1 year, 2 years, VAS scores, rhinitis symptom scores, medication scoresof all the patients with allergic rhinitis are significantly decreased; Differences of rhinitis symptom scores(H=0.844, 4.153, 2.669, P>0.05), VAS score(H=1.356, 3.720, 0.313, P >0.05), medication scores(H=1.044, 5.841, 3.399, P>0.05) between groups had no statistical significance at different stage after treatment(3 months, 1 year and 2 years); The differences between 2 years and 1 year of SLIT treatment showed statistical significance in the VAS scores(Z=1.635, P =1.635). CONCLUSION SLIT with dust mites drops had good curative effect and security in patients with allergic rhinitis, which hadno obvious difference between different age groups.