Objective:To investigate the clinical efficacy of arthroscopic limited incision of the articular capsule to repair the glenoid labrum in the treatment of borderline developmental dysplasia of the hip (BDDH) complicated with labral tear.Methods:A retrospective study was conducted to analyze the data of 18 patients with BDDH complicated with labral tear who had been admitted to Department of Orthopaedics, The Second Hospital Affiliated to Suzhou University from January 2016 to December 2019 (observation group). There were 12 males and 6 females with an age of (41.8 ± 8.5) years. Simultaneously, another 18 patients were selected as the control group whose hip development was normal but age and gender were matched with those in the observation group. There were 9 males and 9 females with an age of (43.5 ± 10.3) years. Both groups were treated by arthroscopic limited incision of the articular capsule to repair the glenoid labrum. The 2 groups were compared in terms of modified Harris hip score (MHHS), Hip Outcome Score Activities of Daily Living Subscale (HOS-ADL), and visual analogue scale (VAS).Results:There was no significant difference in the demographic data like age, gender ratio, body mass index, severity of labral tear or time from injury to operation between the 2 groups, indicating comparability between groups ( P>0.05). The observation and control groups were followed up for (38 ± 7) and (43 ± 6) months, respectively. For the observation and control groups, respectively, MHHS was (97.1 ± 3.3) points and (95.4 ± 4.2) points, HOS-ADL (92.6 ± 2.8) points and (91.4 ± 4.1) points, and VAS (0.6 ± 0.5) points and (1.0 ± 0.8) points, all showing no significant difference between groups ( P>0.05). Conclusion:In the treatment of BDDH patients complicated with labral tear, simple arthroscopic limited incision of the articular capsule to repair the glenoid labrum can lead to the same good medium-term efficacy as it can in those with normal hip development.

Objective:To explore the efficacy and safety of intraarterial microguidewire electrocoagulation in arterial aneurysms.Methods:(1) SilverSpeed, a kind of microguidewire used in clinical intravascular treatment for intracranial aneurysms, was used to conduct in vitro electrolysis gas generation experiment with isolated arterial blood of anticoagulant New Zealand white rabbits as medium, and thrombus attachment on the surface of microguidewire was observed under scanning electron microscope. (2) Rabbit common carotid artery aneurysm models were established by using vein bag transplantation method, and divided into microguidewire electrocoagulation treatment groups ( n=40) and blank control group ( n=10). The number of closured tumor cavity and the quality of formed thrombus were observed after electrocoagulation simulation treatment with SilverSpeed microguidewire (charging at 6, 9, 12, 15, and 18 V voltage, respectively for 1, 3, 6, 9, 12, and 15 min). DSA was used to observe whether there was ruptured aneurysms or thrombosis of parent artery. Twelve h later, head MRI diffusion weighted sequence scan was performed to detect whether there were new cerebral ischemia foci in the distal cerebral blood supply area of the parent artery. DSA was performed again 6 months after surgery to observe whether the aneurysms recurred. Results:(1) Electrolytic gas generation experiment results showed that bubbles were generated after electrification of SilverSpeed microguidewire; the higher the voltage, the more severe the reaction. Scanning electron microscope showed that thrombus attached to the surface of the microguidewire after electrification in isolated blood; and the higher the voltage, the denser the thrombus. (2) Under the same charging time, the higher the voltage, the larger the number of closured tumor cavity in rabbits of the microguidewire electrocoagulation treatment groups. Under the same voltage, the longer the charging time, the better the quality of thrombosis. Ischemic events occurred only in the microguidewire electrocoagulation treatment group with voltage>9 V, and the charging duration was not associated with the incidence of embolic events. When the voltage was 15 V, 2 experimental rabbits died due to aneurysm rupture 3 min after electrification. When the voltage was 18 V, 4 experimental rabbits died of cardiac arrest 9 min after electrification, and another 2 rabbits died of aneurysm rupture 6 min after electrification.Conclusions:High voltage is the main cause of adverse events in the microguidewire electrocoagulation treatment of aneurysms. After setting the appropriate voltage, prolonging the electrification time can improve the electrocoagulation effect without increasing the safety risk.

Objective:To investigate the clinical features of patients with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis misdiagnosed as mental disorder, improve the early diagnosis rate and reduce misdiagnosis.Methods:The clinical data of patients with anti-NMDA receptor encephalitis diagnosed at the First Affiliated Hospital of Zhengzhou University from 2012 to 2018 were collected. Patients misdiagnosed as mental disorders were screened out. Their psychiatric symptom characteristics, disease course characteristics, imaging and laboratory findings, treatment and prognosis were retrospectively analyzed.Results:A total of 121 cases of anti-NMDA receptor encephalitis were collected, and 43 cases of mental disorders were screened out. Sixteen of the 43 patients (37.2%) had prodromal symptoms, and all the patients had psychiatric behavioral abnormalities (100%), including 32 cases (74.4%) of seizures, 13 cases (30.2%) of decreased level of consciousness, 21 cases (48.8%) of involuntary movements, 15 cases (34.9%) of decreased memory, 8 cases (18.6%) of speech dysfunction, and 8 cases (18.6%) of other neurological symptoms (central hyperventilation, autonomic dysfunction). Memory loss was observed in 15 cases (34.9%), speech dysfunction in 8 cases (18.6%), other neurological symptoms (central hypoventilation, autonomic dysfunction) in 8 cases (18.6%), and various symptoms may appear simultaneously or successively in the same patient. Thirty-eight cases had complete resolution of symptoms or only minor physical impairment, and 5 cases had recurrent admissions with mental abnormalities and seizures. The recurrence rate accounted for 11.6% (5/43).Conclusions:The clinical manifestations of anti-NMDA receptor encephalitis are complex and varied. Most of them have mental behavior abnormalities as the first symptom, which is easily misdiagnosed as mental disorder and delayed treatment will lead to prolonged disease course and poor prognosis.

Antibodies, Neutralizing ; Antibodies, Viral/isolation & purification* ; B-Lymphocytes/virology* ; COVID-19/virology* ; Humans ; Immunity/genetics* ; RNA, Viral/immunology* ; SARS-CoV-2/pathogenicity* ; Single-Cell Analysis

Objective To observe the evolution of astrocytes,GDNF,BDNF and Jak-STAT signal pathway after spinal cord ischemia-reperfusion injury in rabbits.Methods Spinal cord ischemia was induced by means of balloon occlusion of the infrarenal aorta for 22 minutes in 54 male New Zealand white rabbits.We assigned rabbits to 9 groups (n =6),one sham group,eight operation groups.The operation process in the sham group was the same as the operation group except the ischemia reperfusion of the spinal cord.At 0 h,1 h,2 h,3 h,8 h,24 h,48 h and 72 h after reperfusion,animals were sarcrificed and the spinal cord was removed for histologic,immunohistochemical study and western blotting.Results Normal neurons were decreased with the extension of reperfusion time.Levels of GFAP increased at 3 h and reached a peak at 48 h after reperfusion.GDNF was increased reaching two peaks after injury,the first peak was at 3 h,the second was at 72 h.BDNF level was increased and peaked at 24 h after reperfusion.The expression of p-STAT3 showed a biphasic pattern which peaked at 1h and 48 h.GFAP,GDNF,BDNF were rare and the level of p-STAT3 could be neglected in sham group.Conclusion Spinal cord ischemia-reperfusion injury could induce the activation of astrocytes,the expression of GDNF,BDNF and the activation of JakSTAT signal pathway.They showed different expression rules in this study.

Objective To explore the difference in pain threshold between related acupoints and the specificity of acupoints in cholecystitis patients.Method Actual measurement was made in 80cases, a normal group of 30 cases (volunteers without psychological and physiological diseases) and a patient group of 50 cases (volunteers with cholecystitis). The probe of an algometer was perpendicularly placed on the selected acupoint, the pressure point was pushed and pressing was stopped immediately after the subject felt pain. The pain thresholds displayed by the measured acupoints were recorded. The pain thresholds of the selected acupoints were compared between the normal and patient groups and thedifferences were analyzed to explore the specificity of acupoints.Result A comparison of the pain thresholds of the Back-Shu points of the Bladder Meridian of Foot-Taiyang between the patient and normal groups showed that there were no significant differences in the thresholds of the left Back-Shu points Geshu (BL17), Ganshu (BL18), Danshu (BL19), Pishu (BL20), Weishu (BL21) and Dachangshu (BL25) of the bladder meridian between the two groups (P>0.05) and there were significant differences in the thresholds of the right Back-Shu points Geshu, Ganshu, Danshu, Pishu, Weishu and Dachangshu of the bladder meridian between the two groups (P<0.01). The pain threshold was significantly lower in thepatient group than in the normal group. A comparison of the pain thresholds of the main points of the Liver Meridian of Foot-Jueyin, the Gallbladder Meridian of Foot-Shaoyang and the stomach meridian between thepatient and normal groups showed that there were significant differences in the thresholds of the right points Liangmen (ST21), Riyue (GB24) and Qimen (LR14) of the liver, gallbladder and stomach meridians (P<0.01) and no significant difference in the threshold of the right point Taichong (LR3) between the two groups (P>0.05). The pain thresholdwas significantly lower in thepatient group than in the normal group. There were no significant differences in thethresholds of the left points Liangmen, Riyue, Qimen and Taichong of the Liver Meridian of Foot-Jueyin, the Gallbladder Meridian of Foot-Shaoyang and the stomach meridian between the patient and normal groups (P>0.05).Conclusion The pain sensitivity of ipsilaterali related acupoints increase and the relative specificity of acupoints exist in cholecystitis patients.

Objective: To observe the activation of microglia and the changing rule of inflammatory cytokine as IL-6, IL-10 and nuclear factor-κB (NF-κB) in experimental rabbits after spinal cord ischemia reperfusion (SCIR) injury in order to provide theoretical basis for post-conditioning time. Methods: Rabbit SCIR injury model was established by thoracic aorta balloon occlusion. 54 New Zealand male adult white rabbits were divided into 9 groups: Sham group (the animals received balloon implantation without occlusion), SCIR-0h group (reperfusion was conducted at 0 hour of spinal cord ischemia), SCIR-1h, -2h, -3h, -8h, -24h,-48h and -72h groups. n=6 in each group. The number of normal and apoptosis neurons, the levels of Iba-1, IL-6, IL-10 and NF-κB in spinal tissue were examined and compared among different groups respectively. Results: The number of normal neuron was decreasing with the extended reperfusion time, TUNEL-positive neuron began to increasing in SCIR-8h group and the peak was reached in SCIR-24h group. The expression of Iba-1 began to elevating in SCIR-2h group and the peak was obtained in SCIR-8h group; NF-κB began to rising in SCIR-3h group and the peak was observed in SCIR-8h group; both IL-6 and IL-10 arrived the peak in SCIR-24h group. The expressions of NF-κB, IL-6 and IL-10 were positively related to Iba-1 level. Conclusion: Microglia activation had dynamic changes in experimental SCIR rabbits and the expression levels of NF-κB, IL-6 and IL-10 were positively to microglia activation; post-conditioning time at front and back to microglia activation may reduce neuron injury.

Objective To optimize the treatment plan for dermatitis medicamentosa in a patient with abnormal liver function associated with infection.Methods The culprit medication for drug eruption was identified by reviewing the patient′s liver and kidney function, routine blood count, therapeutic drugs, allergic history, by analyzing the characteristics of the compounding medication, combined with literature search on drug eruption diagnosis and treatments.Following the antihistamines and glucocorticoid use guidelines, the treatment plan was optimized by selecting appropriate antihistamines and glucocorticoids based on their metabolism and excretion pathway.Results The rash was poorly controlled after clinical pharmacist′s initial recommendation to use chlorpheniramine (intramuscular injection) and cetirizine (oral).The clinical pharmacist further suggested dexamethasone intravenous drip.The patient recovered well with the combination therapy of antihistamines and glucocorticoid.Conclusion When drug eruption occurred, clinical pharmacists should evaluate patient′s disease and medications comprehensively, provide timely and accurate pharmaceutical care to patients.

OBJECTIVETo compare the pain thresholds of acupoints in the meridians related to irritable bowel syndrome(IBS) between IBS patients and healthy people.

METHODSThirty-four healthy adults were collected into a normal group,and 60 patients with IBS were arranged into an IBS group. Pain thresholds were detected on the acupoints of large intestinal,small intestinal,stomach,spleen,gallbladder meridians and some commone use acupoints for IBS by pain measuring apparatus three times. Bilateral-well,-spring,-stream,-river,-sea,front-alarm,lower-sea,-primary,-connecting and back-transport points of each meridian were selected as the main acupoints. And pain thresholds of acupoints common used in clinic were compared between the two groups.

RESULTSThe thresholds of five-transport points and-connecting point of the large intestinal meridian in the IBS group were apparently lower than those in the normal group(all<0.05),with Hegu(LI 4),Tianshu(ST 25),Shangjuxu(ST 37) and Dachangshu(BL 25) more decreasing(all<0.01). The thresholds of five-transport points,front-alarm point and-primary point of the small intestinal meridian in the IBS group were obviously lower than those in the normal group(all<0.05),with Zhizheng(SI 7),Xiajuxu(ST 39) and Xiaochangshu(BL 27) more decreasing(all<0.01). The thresholds of Zusanli(ST 36),Weishu(BL 21),Yanglingquan(GB 34),Danshu(BL 19),Pishu(BL 20),Neiguan(PC 6),Taichong(LR 3),Taixi(KI 3),Sanyinjiao(SP 6) and Qihai(CV 6) in the IBS group were markedly lower than those in the normal group(all<0.05).

CONCLUSIONSThe pathological changes of IBS often appeared in the stomach,large intestinal,small intestinal,bladder meridians,and some acupoints in the liver,spleen and kidney meridians. When the functions of viscera are abnormal,the pain thresholds of related acupoints tend to decrease,and meridians and acupoints become sensitized from quiet state.

L6.A longitudinal column of HRP-labeled motoneurons was found in the dorsolateral and mediolateral portions of the spinal cord,distributing in the lamina Ⅸ from the caudal L4 to the rostral L6.Additionally,the transganglionic HRP-labeled central projection axonal terminals were found to be dense in the central part of laminae Ⅰ-Ⅱ from L4 to the rostral L6,and to scatter in the central part of gracile nucleus.Conclusion HRP-labeled primary afferent and efferent innervating acupoint "Taixi"(KI 3) are DRGs of L4-L6,the dorsolateral and mediolateral motoneuron columns of L4-L6,and the centrally projecting axonal terminals of laminae Ⅰ-Ⅱ of the spinal cord and the gracile nucleus.