Objective:To screen differential proteins in the serum of workers with rare earth samarium oxide pneumoconiosis, in order to provide new ideas for finding its early diagnostic biomarkers.Methods:In April 2019, three male workers diagnosed with samarium oxide pneumoconiosis at a rare earth factory in Baotou City, Inner Mongolia Autonomous Region were selected as the observation group, and three male workers who were not exposed to dust were selected as the control group. The serum was sequenced using the Label-free proteomic method to screen for differentially expressed proteins, followed by cluster of orthologous groups of proteins (COG) annotation, gene ontology (GO) enrichment analysis, and Kyoto encyclopedia of genes and genomes (KEGG) pathway analysis. The interaction gene library retrieval tool database and Cytoscape 3.9.1 software were used to draw protein-protein interaction networks. CytoHubba plugin was used to screen for differentially expressed proteins with high scores, and real-time fluorescence quantitative polymerase chain reaction (RT/q-PCR) was used to validate the proteomic sequencing results.Results:A total of 45 up-regulated differentially expressed proteins and 5 down-regulated differentially expressed proteins were screened out in the serum of workers with rare earth samarium oxide pneumoconiosis. In the COG functional classification, post-translational modifications, protein turnover, and chaperones were the most numerous. GO enrichment included 25 entries for biological processes such as complement activation (classical pathways), 15 entries for cellular components such as extracellular recombinants, and 10 entries for molecular functions such as protein binding. The pathways identified by KEGG enrichment analysis mainly included infectious diseases, immune system, signal transduction, and immune related diseases. The top 10 scoring proteins were haptoglobin, complement C1r subcomponent, complement C1s subcomponent, apolipoprotein C-Ⅲ, apolipoprotein A-Ⅱ, prothrombin, afamin, complement component C8 gamma chain, complement component C6, complement component C7. The RT/q-PCR validation results showed that the mRNA expression levels of haptoglobin, prothrombin and complement C1s subcomponent in the observation group were significantly higher than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusion:Ten differentially expressed proteins in the serum of workers with rare earth samarium oxide pneumoconiosis are screened, which provides a good idea for the screening of biomarkers for early diagnosis of samarium oxide pneumoconiosis.

Objective:To screen differential proteins in the serum of workers with rare earth samarium oxide pneumoconiosis, in order to provide new ideas for finding its early diagnostic biomarkers.Methods:In April 2019, three male workers diagnosed with samarium oxide pneumoconiosis at a rare earth factory in Baotou City, Inner Mongolia Autonomous Region were selected as the observation group, and three male workers who were not exposed to dust were selected as the control group. The serum was sequenced using the Label-free proteomic method to screen for differentially expressed proteins, followed by cluster of orthologous groups of proteins (COG) annotation, gene ontology (GO) enrichment analysis, and Kyoto encyclopedia of genes and genomes (KEGG) pathway analysis. The interaction gene library retrieval tool database and Cytoscape 3.9.1 software were used to draw protein-protein interaction networks. CytoHubba plugin was used to screen for differentially expressed proteins with high scores, and real-time fluorescence quantitative polymerase chain reaction (RT/q-PCR) was used to validate the proteomic sequencing results.Results:A total of 45 up-regulated differentially expressed proteins and 5 down-regulated differentially expressed proteins were screened out in the serum of workers with rare earth samarium oxide pneumoconiosis. In the COG functional classification, post-translational modifications, protein turnover, and chaperones were the most numerous. GO enrichment included 25 entries for biological processes such as complement activation (classical pathways), 15 entries for cellular components such as extracellular recombinants, and 10 entries for molecular functions such as protein binding. The pathways identified by KEGG enrichment analysis mainly included infectious diseases, immune system, signal transduction, and immune related diseases. The top 10 scoring proteins were haptoglobin, complement C1r subcomponent, complement C1s subcomponent, apolipoprotein C-Ⅲ, apolipoprotein A-Ⅱ, prothrombin, afamin, complement component C8 gamma chain, complement component C6, complement component C7. The RT/q-PCR validation results showed that the mRNA expression levels of haptoglobin, prothrombin and complement C1s subcomponent in the observation group were significantly higher than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusion:Ten differentially expressed proteins in the serum of workers with rare earth samarium oxide pneumoconiosis are screened, which provides a good idea for the screening of biomarkers for early diagnosis of samarium oxide pneumoconiosis.

Objective:To study the effect of samarium trioxide (Sm 2O 3) particles on rat lung tissue and compare it with the same dose of silica (SiO 2) particles, in order to find the reference index for early screening of pneumoconiosis. Methods:In October 2018, 72 SPF healthy male rats were randomly divided into control group, SiO 2 group and Sm 2O 3 group. The lungs of rats in each group were perfused with 2.0 ml/kg normal saline and 280 mg/kg SiO 2 and Sm 2O 3 particle suspension by one-time non exposed tracheal perfusion. The lungs of rats were stained with hematoxylin eosin (HE) staining, and the pathological changes of lung tissues were observed. The concentrations of SNAIL homologue 1 (SNAI1) , SNAIL homologue 2 (SNAI2) , and heat shock protein-27 (HSP-27) in rat serum were detected by enzyme-linked immunosorbent assay. 0.5 g of lung tissue from rats in Sm 2O 3 group and control group exposed to dust for 56 days was screened for long-chain noncoding RNA (lncRNA) and circular RNA (circRNA) . Results:After 7 days of dust exposure, the alveoli in SiO 2 group and Sm 2O 3 group were disordered, and lymphoid tissue aggregation and proliferation were observed around the bronchial wall. At 14 days, a large number of lymphocytes infiltrated in SiO 2 group, and a small number of macrophages containing Sm 2O 3 and fibrotic nodules scattered in Sm 2O 3 group. At 28 days, a small amount of lymphocyte infiltration appeared in SiO 2 group, and fibrotic nodules were seen in some areas of Sm 2O 3 group. At 56 days, there was a small amount of fibroblast proliferation in SiO 2 group, and a large number of fibrotic nodules containing gray black matter were seen in Sm 2O 3 group. There was no significant difference in lung organ coefficient among groups at different dust exposure time ( P>0.05) . After 14 days of dust exposure, the contents of SNAI1 and SNAI2 in serum of rats in SiO 2 group were lower than those in control group, the content of SNAI2 in serum of Sm 2O 3 group was lower than that in control group, and the contents of SNAI1 and SNAI2 in serum of Sm 2O 3 group were higher than those in SiO 2 group ( P<0.05) . The content of HSP-27 in SiO 2 group was lower than that in control group ( P<0.05) . After 56 days of dust exposure, the content of HSP-27 in Sm 2O 3 group was lower than that in control group ( P<0.05) . At 56 days, lncRNA in Sm 2O 3 group was up-regulated by 148 and down regulated by 725, circRNA was up-regulated by 16 and down regulated by 153. Conclusion:Sm 2O 3 can cause lung injury in rats, and the change of SNAI2 content can be detected in the early stage, which can be used as a reference index for early screening of pneumoconiosis. There are differences in the expression of lncRNA and circRNA after 56 days of dust exposure in rats, which may be related to the pathogenesis of pneumoconiosis.

Objective:To study the effect of samarium trioxide (Sm 2O 3) particles on rat lung tissue and compare it with the same dose of silica (SiO 2) particles, in order to find the reference index for early screening of pneumoconiosis. Methods:In October 2018, 72 SPF healthy male rats were randomly divided into control group, SiO 2 group and Sm 2O 3 group. The lungs of rats in each group were perfused with 2.0 ml/kg normal saline and 280 mg/kg SiO 2 and Sm 2O 3 particle suspension by one-time non exposed tracheal perfusion. The lungs of rats were stained with hematoxylin eosin (HE) staining, and the pathological changes of lung tissues were observed. The concentrations of SNAIL homologue 1 (SNAI1) , SNAIL homologue 2 (SNAI2) , and heat shock protein-27 (HSP-27) in rat serum were detected by enzyme-linked immunosorbent assay. 0.5 g of lung tissue from rats in Sm 2O 3 group and control group exposed to dust for 56 days was screened for long-chain noncoding RNA (lncRNA) and circular RNA (circRNA) . Results:After 7 days of dust exposure, the alveoli in SiO 2 group and Sm 2O 3 group were disordered, and lymphoid tissue aggregation and proliferation were observed around the bronchial wall. At 14 days, a large number of lymphocytes infiltrated in SiO 2 group, and a small number of macrophages containing Sm 2O 3 and fibrotic nodules scattered in Sm 2O 3 group. At 28 days, a small amount of lymphocyte infiltration appeared in SiO 2 group, and fibrotic nodules were seen in some areas of Sm 2O 3 group. At 56 days, there was a small amount of fibroblast proliferation in SiO 2 group, and a large number of fibrotic nodules containing gray black matter were seen in Sm 2O 3 group. There was no significant difference in lung organ coefficient among groups at different dust exposure time ( P>0.05) . After 14 days of dust exposure, the contents of SNAI1 and SNAI2 in serum of rats in SiO 2 group were lower than those in control group, the content of SNAI2 in serum of Sm 2O 3 group was lower than that in control group, and the contents of SNAI1 and SNAI2 in serum of Sm 2O 3 group were higher than those in SiO 2 group ( P<0.05) . The content of HSP-27 in SiO 2 group was lower than that in control group ( P<0.05) . After 56 days of dust exposure, the content of HSP-27 in Sm 2O 3 group was lower than that in control group ( P<0.05) . At 56 days, lncRNA in Sm 2O 3 group was up-regulated by 148 and down regulated by 725, circRNA was up-regulated by 16 and down regulated by 153. Conclusion:Sm 2O 3 can cause lung injury in rats, and the change of SNAI2 content can be detected in the early stage, which can be used as a reference index for early screening of pneumoconiosis. There are differences in the expression of lncRNA and circRNA after 56 days of dust exposure in rats, which may be related to the pathogenesis of pneumoconiosis.

Objective:To make the early clinical antibiotic regimen by finding out the infection of corynebacterium in the pus of patients with granulomatous mastitis in the early stage.Methods:A total of 42 patients who were diagnosed and treated in the Breast Center of Guangdong Maternal and Child Health Hospital from Jun. 2016 to Mar. 2017 with complete follow-up data were retrospectively analyzed. PCR method was used to detect corynebacterium in the patients’ pus. Patients in the positive group were treated with antibiotics alone, antibiotics + hormones and hormones alone, while patients in the negative group were treated with antibiotics + hormones and hormones alone. The postoperative recurrence rate and cure rate of different groups of patients were observed.Results:The antibiotic regimen for granulomatous mastitis in patients with corynebacterium infection included a combination of short-acting levofloxacin and azithromycin and long-acting anti-mycobacterium drugs. Among the 42 patients in the subgroup, 21 patients were confirmed positive for corynebacterium by PCR detection of pus, and the postoperative recurrence rate was 23.5%. There was a statistically significant difference between the antibiotic group, the antibiotic + hormone group and the hormone group in treatment of granulomatous mastitis infected with corynebacterium ( χ2=5.494, P=0.036) . PCR detection shouwed corynebacterium negative in 21 cases, and postoperative recurrence rate of 16.7%. No statistically significant difference in efficacy was found between antibiotic + hormone group and hormone only group for GM patients without bacterial infection ( χ2=1.129, P=0.719) . Conclusion:Early detection of corynebacterium infection in GM patients is significant for clinical guidance of the application of lipophilic antibiotics.

Objective:To analyze the hepatic hemodynamics changes after partial splenic embolization in patients with cirrhosis and hypersplenism.Methods:A total of 26 patients with cirrhosis and hypersplenism who underwent partial splenic embolization in the General Hospital of Ningxia Medical University from April 2018 to June 2019 were included in this study. The clinical data was retrospectively studied. The study objects consisted of 19 males and 7 females with an average of 55 years. Whole-liver perfusion enhanced CT imaging scan was performed for all patients. Changes in laboratory indexes and the blood perfusion of the liver sections including hepatic arterial perfusion, portal venous perfusion, total liver perfusion and hepatic arterial perfusion indexes before PSE and postoperative 1 month were compared.Results:The postoperative leukocyte and platelet counts increased, and the prothrombin time decreased in the 26 patient, and the differences were significant ( P<0.05). The hepatic arterial perfusion of the left lateral section, left medial section, right anterior section and right posterior section increased in postoperative 1 month, from 10.0 (7.0, 13.5) ml·min -1·(100 ml) -1, 9.3 (5.4, 12.8) ml·min -1·(100 ml) -1, 8.0 (6.0, 11.2) ml·min -1·(100 ml) -1, 10.7 (7.1, 13.8) ml·min -1·(100 ml) -1 to 7.7 (4.2, 11.0) ml·min -1·(100 ml) -1, 6.9 (2.6, 10.2) ml·min -1·(100 ml) -1, 7.1 (4.1, 8.7) ml·min -1·(100 ml) -1, 5.9 (4.4, 8.5) ml·min -1·(100 ml) -1, respectively. The differences were all significantly different ( P<0.05). There were no significant difference in portal venous perfusion and total liver perfusion before and after operation ( P>0.05). The hepatic arterial perfusion index of left lateral section, right anterior section and right posterior section increased after operation ( P<0.05). Conclusion:For patients with cirrhosis and hypersplenism who underwent partial splenic embolization, the state of hypersplenism was relieved, the hepatic arterial blood flow increased, and the liver function improved.

Objective: To investigate the clinical characteristics and outcomes of Maisonneuve fractures. Methods: Data of 21 cases of Maisonneuve fractures from February 2015 to December 2017 were retrospectively analyzed. There were 16 males and 5 females with an average age of 38.8 years (range, 21 to 61 years). The fractures occurred on the left side in 11 patients and on the right side in 10 patients. The causes of injuries were traffic accident in 4 patients, sprain injury in 9 patients and falling injury from height in 8 patients. There were 16 cases of medial malleolar fractures and 5 cases of ruptures of deltoid ligament (4 entirely and 1 partial). There were 17 cases of fractures of the posterior malleolus, among which there were 5 of typeⅠ, 8 of typeⅡ and 4 of type Ⅲ according to the Bartonícek classification of posterior malleolus. There were 4 cases without fracture of posterior malleolus including 1 complete disruption of posterior inferior tibiofibular ligament. Four cases were overlooked of Maisonneuve fracture at the first time. The interval between injury and operation was 2-12 days (mean, 4.9 days). Results: Stabilization of proximal fibular fractures were achieved with plate in 3 cases. There were 16 cases of medial malleolar fractures, and the fixation were achieved with cannulated screws in 13 cases and with anti-glide plates in 3 cases. The entirely rupture of deltoid ligament was repaired in 4 cases with suture anchors, the partial rupture of deltoid ligament was not repaired. There were 17 cases of posterior malleolar fractures, 12 cases treated with open reduction and internal fixation including cannulated screws in 9 cases and anti-glide plates in 3 cases. Stabilization of syndesmosis was achieved with syndesmotic plate in 1 case; the medial and posterior malleolar fractures were stabilized and anterior inferior tibiofibular ligament was repaired with suture anchor in 1 case; the other 19 cases were stabilized with syndesmotic screws, 2 screws in 11 cases and 1 screw in 8. Twenty-one patients were followed up for 13-48 months with an average of 25.6 months. The time of bony union was from 3 to 6 months with an average time of 4.9 months after operation. All patients received anatomical reduction without postoperative complications such as incision infection, reduction lose, breakage of screw and posttraumatic arthritis. In 13 cases, the syndesmotic screw was removed at the mean time of 15.38 weeks postoperative (range, 13-25 weeks). At the latest follow up, AOFAS score was from 84 to 100, with excellent in 13 cases, good in 8 cases, and the excellent and good rate was 100% (21/21). Baird-Jackson score was from 83 to 100, with excellent in 11 cases, good in 8 and fair in 2, and the excellent and good rate was 90.48%(19/21). Conclusion The diagnosis of proximal fibular fracture of Maisonneuve fracture is easily missed. The complete rupture of deep deltoid ligament and displaced obviously of posterior malleolar fracture should be reduction and stabilization. The accuracy of reduction of the syndesmosis is of great concern. The outcome of operation is satisfied.

BACKGROUND:With more and more elderly patients suffering lumbar degenerative disease undergoing internal fixation, infection after spinal internal fixation is a common complication in orthopedic surgeries, but its treatment strategy remains controversial.OBJECTIVE: To explore the curative efficacy of incision infection after internal fixation in the elderly with lumbar degenerative disease.METHODS: 197 patients with lumbar degenerative disease undergoing internal fixation and followed up for more than 2 years admitted in Department of Orthopedics, Beijing Shijitan Hospital Affiliated to Capital Medical University from January 2012 to January 2015, were analyzed retrospectively. The follow-up time was 2-4.9 years. There were 97 cases of lumbar stenosis, 29 cases of lumbar disc herniation, 33 cases of lumbar spondylolisthesis, 17 cases of degenerative scoliosis and 21 cases of lumbar compression fractures.RESULTS AND CONCLUSION: (1) Eleven patients experienced incision infection, including ten acute, and one delayed infection. (2) Among acute infected cases, three were superficial infection in three cases and seven had deep infection,who characterized as exudation (10/10), local pain (8/10) and fever (9/10). Acute infected cases received bacterial culture, drug sensitive test, antibiotic therapy, and debridement of the infected wound, and leaving all internal fixators in situ in all but one case. (3) For delayed infection, one patient had local pain, incision exudation, and intermittent fever,and then the internal fixators were removed. (4) Pseudarthrosis was not founded during 2-year follow-up in all patients.(5) These results suggest that for the elderly patients suffering lumbar degenerative disease with infection after internal fixation, intravenous antibiotics, debridement plus drainage are recommended, but without internal fixator removal, and repetitive debridement and drainage is a rational choice if necessary.

This study aims to learn drug resistance situation of four first-line anti TB drugs among 251 Mycobacterium tuberculosis isolates from Qinghai and to explore their relationships with genotypes by Spoligotyping,so as to provide basis for effective prevention of tuberculosis.Isolates of 251 M.tuberculosis were tested susceptibilities of four first-line drugs including isoniazid (INH),rifampicin (RFP),streptomycin(SM) and ethambutol (EMB) by using conventional proportion method and genotyped by Spoligotyping.Relationship between drug resistance and genotypes was analyzed statistically.Results showed the total drug resistance rate was 56.2％ (141/251) among 251 M.tuberculosis isolates.Resistance rates of four first-line drugs were 43.0％ (108/251) for INH,37.1％ (93/251) for RFP,39.0％ (98/251) for SM,27.9％ (70/251) for EMB respectively.Rate of multidrug-resistant TB (MDR TB) was 31.5％ (79/251).All 251 isolates of M.tuberculosis were typed by spoligotyping.The 185 (73.7 ％) were Beijing genotypes and 66 (26.3.％) were non-Beijing genotypes,and no statistical association was found with drug resistance.This paper concludes that isolates of M.tuberculosis prevail in Qinghai have both high rates of drug resistance and MDR and dominant isolates are Beijing genotypes by spoligotyping.

Objective:To analyze the clinical efficacy of compound honeysuckle decoction hot and humid joint fusidic acid cream in the treatment of targeted drugs-induced rash.Methods:80 cases of patients with targeted drugs-induced rash admitted in our hospitalfrom August 2014 to August 2016 were selected and divided into two groups with 40 cases in each group according to the drawing method.The control group was treated by fusidic acid cream,while the observation group was treated by compound honeysuckle decoction hot and humid joint fusidic acid cream,the changes of symptom score,quality of life after treatment,clinical efficacy and incidence of adverse reactions were compared between two groups.Results:After treatment,the symptoms score of observation group ((6.87± 1.25) points) was lower than that of the control group ((10.29± 2.74) points)(P＜0.05),the quality of life score ((3.15± 0.57)points) of observation group was lower than that of the control group ((6.42± 1.20) points)(P＜0.05).The effective rate of observation group(95.00％) was higher than that of the control group(77.50％)(P＜0.05),no statistical difference was found in the incidence of adverse reactions was observed between two groups (P＞0.05).Conclusion:Compound honeysuckle decoction hot and humid joint fusidic acid cream was effective in the treatment of targeted drugs-induced rash,it could effectively relieve the clinical symptoms,improve the quality of life.