Capillary Leak Syndrome ; complications ; Cholestasis, Intrahepatic ; complications ; Humans ; Mucocutaneous Lymph Node Syndrome ; complications

Objective To explore the relationship among HBV load ,IFN-? and IL-4 in sera from patients with CHB.Methods Fluorescence quantitative PCR(FQ-PCR) was used to detect quantity of HBV DNA,and ELISA was used to determine contents of IFN-? and IL-4.According to HBV DNA quantity(copies/ml),the patients with chronic hepatitis B(CHB) were divided into high(≥10 7/ml),middle(10 6～10 5/ml) and low (

0.05). After lamivudine treatment, the rate of the transform negative of HBV DNA in genotype C was significantly higher than that in genotype B, and the rate of the bounce of HBV DNA in genotype B was higher than that in genotype C (P 0.05). CONCLUSION: There may be a relation between the effect of lamivudine and the genotype of Hepatitis B virus. The effect of the lamivudine treatment may be better in the patients with genotype C.

Objective To investigate the prognostic outcome of open reduction and internal fixation(ORIF)with radial head resection in treatment of comminuted radial head fractures so as to discuss the corresponding operation options.Methods A series of 23 patients with Mason type Ⅲ or Ⅳ radial head fractures were enrolled in the study including 11 males and 12 females.Eight patients(three with Mason type Ⅲ and five with Mason type Ⅳ)underwent radial head resection and 15(seven with Mason type Ⅲ and eight with Mason type Ⅳ)received open reduction and internal fixation including nail and plate fixation in eight and screw and K-wire fixation in seven.The outcomes were assessed in regard of range of motion,radiographic findings,visual analogous scale(VAS)of pain,patient satisfaction degree,disabilities of the arm,shoulder and hand score system(DASH)and the Broberg & Morrey elbow performance score system.Results The follow-up period ranged from 12 to 65 months(mean 35 months),which showed fracture healing in all patients,with no traumatic arthritis happened.The mean range of flexion and extension arc at the elbow of ORIF group and resection group was 132°and 79.4°(P＜0.01)and the patient satisfaction was 9.1 and 8.0(P ＜0.05)respectively.According to the Broberg & Money elbow performance score system,the score was average 93.9 in the ORIF group,with excellent result in nine patients,good in five and fair in one,while the score was average 80.6 in the resection group,with excellent result in two patients,good in two and fair in four.There was statistical difference between two groups(P ＜0.01).The DASH score of the ORIF and resection group was 2.9 and 18.1 respectively(P＜0.05).Conclusions ORIF has better elbow motion,elbow function,daily living and satisfactory outcomes than radial head resection and is recommended for treatment of Mason type Ⅲ or Ⅳ radial head fractures for repair of the radial head as far as possible.

Objective To evaluate the clinical value of applying special calcaneal anatomy plate to treat serious comminuted fracture of calcaneus, with consideration of its frequent complications and difficulties in treatment. Methods From January 1999 to august 2001, we applied calcaneal anatomy plates to treat 14 cases of serious crumbled fracture of calcaneus. The vein pump was used to decrease the swelling before and after operation. Anti mycete measures were taken. During operation, we paid attention to the reduction of articular face, Bohler angle and critical angle, and made secure internal fixation with calcaneal anatomy plate and cancellous bone screw. Results 14 cases were followed up for 23 months averagely. 85.7% of the patients were satisfactory with the remission of subjective symptoms, while the rate of excellent foot outline was 92.9% . The rate of excellent joint motion of foot and ankle was 71.4% , and the rate of excellent Bohler angle was 78.6% . The overall excellent and good rate was 98.3% . Conclusion Applying the calcaneal anatomy plate to treat serious crumbled fracture of calcaneus and paying attention to good reduction, can acquire secure internal fixation, and permit patients to exercise earlier after operation, and can greatly decrease complications of calcaneal fracture.

Objective:To apply modified proximal femoral nail anti-rotation ( PFNA ) fixation tech-niques performed by percutaneous placement of guide wire combined with true lateral view and to make the procedures simpler.Methods:A retrospective study was used to analyze the clinical data of femoral intertrochanteric fractures cases, which were treated with conventional PFNA fixation or modified PFNA fixation performed by percutaneous placement guide wire combined with true lateral view in our hospital, from March, 2011 to May, 2014.In the study, 60 cases were followed for average 13 months.The oper-ation time, the amount of bleeding, the fluoroscopy time, postoperative radiographic measurements ( tip apex distance, TAD ) and hip function scores were analyzed.Results:In modified PFNA group, the amount of bleeding, the operation time and the fluoroscopy time were (70.5 ±12.5) min, (34.9 ±6.1) mL, ( 63.6 ±9.7 ) s respectively.In conventional PFNA group, they were ( 80.6 ±17.1 ) min, (47.8 ±6.7) mL, (68.5 ±8.7) s respectively.There were significant differences in the above respects between the two groups (P were 0.006, 0.013, and 0.022 respectively).There were no significant differences in TAD, fracture healing time, postoperative hip scores between the two groups (P>0.05). Conclusion:Fracture line is a natural entry point for some cases of femoral intertrochanteric fractures when we use proximal femoral nail anti-rotation to fix the fracture.Applying percutaneous insertion of the guide pin combined with true lateral view could reduce the operation time, amount of bleeding, and fluo-roscopy time significantly, make the procedures simpler and acquire satisfactory results .

Objective To develop self-locking cannulated compression anti-rotation blade and investigate its design characteristic and manipulation techniques. Methods Femoral neck fracture model was made by osteotomy on seven cadaver femurs and then fixed by self-locking cannulated compres-sion anti-rotation blade under fluoroscopic guidance according to designed procedures. After fixation, bio-mechanic test was performed to evaluate fixation stability. Results Cannulated self-locking compres-sion anti-rotation blade was tightly impacted in proximal femur and compression detected during the process of locking, with successful manipulation and stable fixation. Conclusion Because of advanced design characteristic and simple manipulation, self-locking cannulated compression anti-rotation blade can be a substitute for cannulated cancellous lag screw in treatment of femoral neck fractures.

Objective To investigate mental symptoms of SARS patients and its related factors for three period-admission, discharge and three months after SARS crisis and to carry out mental intervention and effect evaluation.Methods The mental problems of SARS patients in three periods of admission, discharger and three months after discharger were continuously investigated.114 SARS patients came from seven designated hospitals in Taiyuan of Shanxi. The participants were assessed by self- compiled stressor Questionnaire, PSSS, SCSQ, SES, SCL-90 and EPQ.Results 1.Change tendency of factor score: The SCL-90 total and factors scores including obsessive-compulsion, phobic anxiety went up during discharge compared with admission. After that,these factors scores went down. The factors scores of somatization and depression descended continuously for three period. 2.Change tendency of the incidence:The incidence on factors of obsessive-compulsive, interpersonal sensitivity, phobic anxiety ascended during discharge compared with admission. Then,these factors scores descended. The other factors went down continually for three periods.3. The self-esteem was influencing factor on mental symptoms of SARS patients for three periods.Conscientious condition severity was influencing factor in admission and discharge.Negative coping was influencing factor in discharge and three months after SARS crisis. Education was influencing factor in three months after SARS crisis.4.After intervention ,the most mental symptoms of 35 SARS patients had mental problems were improved. Dissimilarly, a part of mental symptoms got severity.Conclusions 1.SARS patients exist severe mood disorders and have different influencing factors for three periods. They should be evaluated continuously and be intervened in time.2.The effect of mental intervention by telephone is not uncertainty.

Objective This paper focuses on the investigation of the occurrence and influential factors of post-traumatic stress disorder (PTSD)in SARS patients, hospital staffs and the public expo sed to SARS. Methodes Three groups were assessed by scale of self-compiled stressor Questionnaire, impact of event scale-revised (IES-R) , PSSS, SCSQ, SES and EPQ. Results 1. The incidence of PTSD symptoms in the three groups were 55.1% ,25.8 % and 31.18 %. 2. The main cause of the different incidence was the difference of the stressor intensity and characters. Negative coping was the risk factor of SARS patients and the public; Self-esteem was the protected factor of SARS patients and the hospital staffs; Social support was a protected factor on the hospital staffs. 3. Comparing to the first investigate in September,2003 ,the data of follow-up study in September,2004 showed that the prevalence items significant decreased. Conclusions 1. The investigation concludes that all three groups of people exposed o SARS exhibit PTSD symptom. SARS patients have the highest occurrence ( P ＜ 0.01 ). 2. The main influencing factors of different incidence of PTSD in different groups are intensities and characteristics of stressors. Different people who had PTSD symptoms have different influencing factors. 3. With the change of time , the PTSD symptoms significant relieve with the attenuation gradually of exposure degree of stressor.

Objective To assess the efficienty of operation in humeral intercondylar fractures by section, reposition, internal fixation by composition nail and replacement of elbow joint. Methods From January, 1999 to May, 2009, Forty-six cases of the humeral intercondylar fracture were treated with operation. Thirty-eight cases were followed for 17 months. Their affected elbow joint function were evaluated by Cassebaum rating system, patients treated with total elbow replacement evaluated by Mayo elbow score, DASH score additionally. Results According to Cassebaum rating system,there were 22 cases rated as excellent,eight cases rated as good,five cases rated as poor,three case rated as poor. The fineness rate is 78. 9% (30/38). Mayo score in patients with joint replacement ranged from 75.0 - 90. 0, averaged 84. 4 ± 1.7. DASH score ranged from 25.0 to 75.0,averaged 41. 1 ±0. 8. There was 1 case of superficial soft tissue nonhealing and 2 cases of ulna nerve symptoms. Myodynamia in elbow joint bend and stretch was Ⅳ in 1 cases. Conclusion It is a good method to treat the humeral intercondylar fracture with rational use of open reduction or elbow replacement according to fracture type and patient condition.