Objective:To investigate the clinical and chest computed tomography (CT) findings of children with drug-resistant pulmonary tuberculosis (DR-PTB) and drug-sensitive pulmonary tuberculosis (DS-PTB) in Sichuan region.Methods:Active pulmonary tuberculosis children with positive sputum Mycobacterium tuberculosis culture were collected and divided into the drug-resistant and drug-sensitive groups according to the results of the drug susceptibility test who admitted to the Public Health Clinical Center of Chengdu from January 2020 to October 2024. The general data such as age, ethnic, gender, initial or retreatment regimens, body mass index (BMI), clinical symptoms such as cough, sputum, fever, and chest CT features were compared between the two groups. Non-parametric rank sum test, chi-square test or Fisher′s exact probability method were used for comparison between groups. The CT risk factors for the development of DR-PTB were analyzed using binary logistic regression. Results:A total of 110 children were enrolled, including 44(40.00%) males and 66(60.00%) females, with the age of 13.00(12.00, 14.00) years (range from 5.00 to 14.00 years). There were 28 cases in drug-resistant group and 82 in drug-sensitive group. Comparison of the clinical data between the two groups showed that the percentages of retreated patients (25.00%(7/28)) and ethnic minorities (78.57%(22/28)) in the drug-resistant group were higher than those in the drug-sensitive group (1.22%(1/82) and 57.32%(47/82)), which were both statistically significant (Fisher′s exact probability method and χ2=4.03, respectively, both P<0.05). The age of the children in the drug-resistant group was 13.00 (12.00, 13.50) years, which was younger than the age of 13.00 (12.00, 14.00) years in the drug-sensitive group ( U=828.00, P=0.021). There were no statistically differences of gender, BMI, history of bacillus Calmette-Guérin (BCG) vaccination, history of exposure to tuberculosis patients, positive immunological diagnostic tests, and the incidences of cough, sputum, fever, wheezing, shortness of breath and chest pain between the two groups (all P>0.05). Chest CT signs showed that lung lesions involving both right and left lobes accounted for 53.57%(15/28) in the drug-resistant group, and the incidence of solid pulmonary parenchyma (including wall-less cavities) was 92.86%(26/28), which were both higher than those in the drug-sensitive group (15.85%(13/82) and 70.73%(58/82)), and the differences were statistically significant ( χ2=6.95 and 5.66, respectively, both P<0.05). The incidence of small nodules/tree-in-bud pattern in the drug-sensitive group was higher than that in the drug-resistant group (98.78%(81/82) vs 82.14%(23/28)), and the difference was statistically significant (Fisher′s exact probability method, P=0.004). Binary logistic regression showed that bilateral lung involvement and solid pulmonary parenchyma (including wall-less cavities) were positively correlated with DR-PTB in children (odds ratio ( OR)=4.487, 95% confidence internal ( CI) 1.561 to 12.897, P=0.005 and OR=9.670, 95% CI 1.626 to 57.529, P=0.013, respectively). The occurence of small nodules/tree-in-bud was negatively correlated with DR-PTB in children ( OR=0.058, 95% CI 0.006 to 0.584, P=0.016). Conclusions:Among pulmonary tuberculosis children in Sichuan region, ethnic minorities and retreatment patients with DR-PTB are more common than thoses with DS-PTB. Chest CT findings of DR-PTB mainly show multiple solid pulmonary parenchyma with wall-less cavities, and the lesions often involve right and left lung lobes, whereas DS-PTB CT findings mainly show small nodules/tree-in-bud predominantly.

Objective:To investigate the clinical and chest computed tomography (CT) findings of children with drug-resistant pulmonary tuberculosis (DR-PTB) and drug-sensitive pulmonary tuberculosis (DS-PTB) in Sichuan region.Methods:Active pulmonary tuberculosis children with positive sputum Mycobacterium tuberculosis culture were collected and divided into the drug-resistant and drug-sensitive groups according to the results of the drug susceptibility test who admitted to the Public Health Clinical Center of Chengdu from January 2020 to October 2024. The general data such as age, ethnic, gender, initial or retreatment regimens, body mass index (BMI), clinical symptoms such as cough, sputum, fever, and chest CT features were compared between the two groups. Non-parametric rank sum test, chi-square test or Fisher′s exact probability method were used for comparison between groups. The CT risk factors for the development of DR-PTB were analyzed using binary logistic regression. Results:A total of 110 children were enrolled, including 44(40.00%) males and 66(60.00%) females, with the age of 13.00(12.00, 14.00) years (range from 5.00 to 14.00 years). There were 28 cases in drug-resistant group and 82 in drug-sensitive group. Comparison of the clinical data between the two groups showed that the percentages of retreated patients (25.00%(7/28)) and ethnic minorities (78.57%(22/28)) in the drug-resistant group were higher than those in the drug-sensitive group (1.22%(1/82) and 57.32%(47/82)), which were both statistically significant (Fisher′s exact probability method and χ2=4.03, respectively, both P<0.05). The age of the children in the drug-resistant group was 13.00 (12.00, 13.50) years, which was younger than the age of 13.00 (12.00, 14.00) years in the drug-sensitive group ( U=828.00, P=0.021). There were no statistically differences of gender, BMI, history of bacillus Calmette-Guérin (BCG) vaccination, history of exposure to tuberculosis patients, positive immunological diagnostic tests, and the incidences of cough, sputum, fever, wheezing, shortness of breath and chest pain between the two groups (all P>0.05). Chest CT signs showed that lung lesions involving both right and left lobes accounted for 53.57%(15/28) in the drug-resistant group, and the incidence of solid pulmonary parenchyma (including wall-less cavities) was 92.86%(26/28), which were both higher than those in the drug-sensitive group (15.85%(13/82) and 70.73%(58/82)), and the differences were statistically significant ( χ2=6.95 and 5.66, respectively, both P<0.05). The incidence of small nodules/tree-in-bud pattern in the drug-sensitive group was higher than that in the drug-resistant group (98.78%(81/82) vs 82.14%(23/28)), and the difference was statistically significant (Fisher′s exact probability method, P=0.004). Binary logistic regression showed that bilateral lung involvement and solid pulmonary parenchyma (including wall-less cavities) were positively correlated with DR-PTB in children (odds ratio ( OR)=4.487, 95% confidence internal ( CI) 1.561 to 12.897, P=0.005 and OR=9.670, 95% CI 1.626 to 57.529, P=0.013, respectively). The occurence of small nodules/tree-in-bud was negatively correlated with DR-PTB in children ( OR=0.058, 95% CI 0.006 to 0.584, P=0.016). Conclusions:Among pulmonary tuberculosis children in Sichuan region, ethnic minorities and retreatment patients with DR-PTB are more common than thoses with DS-PTB. Chest CT findings of DR-PTB mainly show multiple solid pulmonary parenchyma with wall-less cavities, and the lesions often involve right and left lung lobes, whereas DS-PTB CT findings mainly show small nodules/tree-in-bud predominantly.

To explore the effect of application of soft tissue loosening and acetabular reconstruction in hip replacement for patients with severe femoral head necrosis on joint function.
 Methods: From June 2012 to August 2016, 68 patients with severe femoral head necrosis (Ficat III, IV) underwent total hip replacement with soft tissue release and acetabular reconstruction at the Second Xiangya Hospital of Central South University. Total hip replacement is performed by the posterolateral approach. The acetabulum was rebuilt and the length of the affected limb was prolonged after clearing the scar tissue, proliferating the epiphysis, releasing the abductor muscle group and the adductor muscle group, dissecting the soft tissue around the acetabulum. One year after surgery, Harris score, X-ray positive lateral radiograph for the affected side and full-length X-ray examination for both lower extremities were performed to evaluate the curative effect.
 Results: The postoperative follow-up time ranged from 1.0 to 5.5 years. All patients' femoral heads returned to normal anatomical position and the affected limb length was restored to 1.5-3.5 cm; all patients did not damage the sciatic nerve. The Harris scores for 68 patients increased from 38.6±7.5 to 78.2±5.7 (P=0.029) in the first year after surgery.
 Conclusion: During hip replacement surgery for severe femoral head necrosis, soft tissue dissection and acetabular reconstruction can be used to ensure anatomical reconstruction for the acetabular fossa and to improve abductor function.
Acetabulum ; Arthroplasty, Replacement, Hip ; Femur Head ; Femur Head Necrosis ; surgery ; Follow-Up Studies ; Humans ; Radiography ; Treatment Outcome

Objective To study the effect of paeoniflorin on inflammatory chemokines and their receptor in a rat model of ovalbumin-induced asthma.Methods Sixty 6-week old SPF female BALB/c mice were used in this study.To es-tablish a mouse model of asthma by sensitizing and challenging with ovalbumin.ELISA was used to analyze the serum IL-6 and TNF-α, and the specific IgE against ovalbumin ( OVA-IgE ) , CCL19 and CCL21 in bronchoalveolar lavage fluid (BALF).RT-PCR was performed to determine CCR7mRNA and protein expression of chemokine receptor CCR7, and the level of NF-κB was tested by Western blot.ResultsIn In the paeoniflorin groups, the serum IL-6 and TNF-αlevels were significantly lower, and the OVA-IgE, CCL19 and CCL21 levels in BALF were significantly reduced, compared with that in the control group.CCR7mRNA and protein expression of chemokine receptor CCR7 and NF-κB in the lung were significant-ly reduced by paeoniflorin.Conclusions Paeoniflorin has a remarkably inhibitory effect on the airway inflammatory chemo-kines CCL19/CCL21 and the receptor CCR7 in the mouse model of asthma.

Objective To observe the effects of acupuncture therapy with finger on back-shu point on acid reflux and lower esophageal sphincter pressure (LESP) of the patients with gastroesophageal reflux disease (GERD). Methods Totally 120 patients of GERD were randomly divided into treatment group and control group through random number table method, 60 cases in each group. Patients in the treatment group were treated with the acupuncture therapy with finger on back-shu point, and patients in control group were treated with lansoprazole tablets and dispersible mosapride citrate for two weeks. Total percentage of acid reflux time, the long time acid reflux episodes, and the longest acid reflux time of two groups were observed six months after the treatment. At the same time, the LESP variation of two groups was followed up six months after the treatment. Results The total percentage of acid reflux time, the long time acid reflux episodes, and the longest acid reflux time decreased significantly in all patients after treatment (P<0.01), while the comparison between groups showed no significant difference (P>0.05). After treatment, LESP of two groups was significantly improved (P<0.05) than before treatment. After stopping treatment half a year, the treatment group had obvious difference (P<0.05) compared with before treatment, while the control group had no significant difference (P>0.05). Conclusion The acupuncture therapy with finger on back-shu point can reduce acid reflux, and achieve the goal of treatment of GERD by improving the lower esophageal sphincter pressure. The duration of improving LESP is longer.