objective To compare the surgical effect of short median incision approach and mini-incision approach in patients with medial unicompartmental knee arthroplasty.Methods A total of 65 patients with knee medial compartment osteoarthritis were treated with Oxford third-generation artificial unicondylar joint from April 2012 to July 2016 in PLA 960 hospital were enrolled.Among them,31 patients were treated with mini-incision approach and 34 patients were treated with short median incision approach.The postoperative incision healing and follow-up status of patients in the two groups were compared.The operating time of two incision approaches was counted,and the total blood loss during and after operation were calculated by Gross equation.The time to get out of bed after operation,the visual analogue scale(VAS)scores before operation,1 day after operation,1 week after operation and 1 month after operation,and the hospital for special surgery(HSS)scores before operation,1 month after operation,3 months after operation and at the last follow-up were counted.Results Three patients with previous diabetes had delayed incision healing after surgery,one patient in the mini-incision group suffered pad dislocation 6 months after operation,and three patients died of other medical diseases within 3 years after operation.The 5-year survival rate of the prosthesis was 93.85%.In the mini-incision group,the average preoperative muscle strength of quadriceps femoris was(3.10±0.60)level,and the average postoperative time to get out of bed was(1.32±0.35)days;In the short median incision group,the average preoperative muscle strength of quadriceps femoris was(3.18±0.63)level,and the average postoperative time to get out of bed was(1.37±0.41)days.There was no statistically significant difference in the postoperative time to get out of bed,operation time,total blood loss during and after operation,VAS score,HSS score of patients between the two groups(P>0.05).Conclusion The short median incision approach and mini-incision approach for unicompartmental knee arthroplasty have similar clinical effects.The short median incision approach has clearer exposure during operation,and the patellofemoral joint can be better treated,which provides conditions for modifying the surgery;the mini-incision approach is highly accepted by patients and minimizes soft tissue damage.Both of them have their own advantages.

OBJECTIVE: To investigate the clinical features, distribution of pathogenic bacteria, and drug resistance of bloodstream infection in children with acute leukemia. METHODS: Clinical data of 93 blood culture-positive children with acute leukemia from January 2015 to December 2019 in Department of Pediatrics, The Second Hospital of Anhui Medical University were analyzed retrospectively. RESULTS: In these 93 cases, 78 cases were in the period of neutrophil deficiency. There were 54 Gram-negative bacteria (G^-) (58.1%) found through blood culture, and the top 4 strains were Escherichia coli (15.1%), Klebsiella pneumoniae (13.9%), Pseudomonas aeruginosa (6.5%), and Enterobacter cloacae (6.5%). There were 39 Gram-positive bacteria (G⁺) (41.9%) detected, and the top 4 strains were Staphylococcus epidermidis (10.8%), Streptococcus pneumoniae (6.5%), Staphylococcus hemolyticus (5.4%), and Staphylococcus human (5.4%). Among 74 strains of pathogenic bacteria from acute lymphoblastic leukemia (ALL) children, there were 29 strains of G⁺ bacteria (39.2%) and 45 strains of G^- bacteria (60.8%). While in 19 strains from acute myeloblastic leukemia (AML) patients, G^- bacteria accounted for 47.4% and G⁺ bacteria accounted for 52.6%. In 15 ALL children without neutropenia, G⁺ bacteria made up the majority of the strains (66.7%). In the 93 strains of pathogenic bacteria, 13 (13.9%) strains were multidrug-resistant. Among them, extended-spectrum β-lactamases accounted for 42.9%, carbapenemase-resistant enzyme Klebsiella pneumoniae 15.4%, and carbapenemase-resistant enzyme Enterobacter cloacae strains 33.3%, which were detected from G^- bacteria. While, 13.3% of methicillin-resistant coagulase-negative Staphylococci accounted for 13.3% detected from G⁺ bacteria, but linezolid, vancomycin, teicoplanin Staphylococcus and Enterococcus resistant were not found. The average procalcitonin (PCT) value of G^- bacteria infection was (11.02±20.282) ng/ml, while in G⁺ infection it was (1.81±4.911) ng/ml, the difference was statistically significant (P<0.05). The mean value of C-reactive protein (CRP) in G^- infection was (76.33±69.946) mg/L, and that in G⁺ infection was (38.34±57.951) mg/L. The prognosis of active treatment was good, and only one case died of septic shock complicated with disseminated intravascular coagulation (DIC) and gastrointestinal bleeding caused by carbapenemase-resistant enzyme enterobacteriaceae. CONCLUSION G^- is the major bacteria in acute leukemia children with bloodstream infection, but the distribution of ALL and AML strains is different. G^- bacteria dominates in ALL, while G⁺ bacteria and G^- bacteria are equally distributed in AML. Non-agranulocytosis accompanied by bloodstream infections is dominant by G⁺ bacteria. The mean value of PCT and CRP are significantly higher in G^- bacteria infection than in G⁺ bacteria.
Acute Disease ; Anti-Bacterial Agents/therapeutic use* ; Bacteremia/microbiology* ; Bacteria ; Child ; Drug Resistance, Bacterial ; Humans ; Leukemia, Myeloid, Acute/drug therapy* ; Microbial Sensitivity Tests ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy* ; Procalcitonin ; Retrospective Studies ; Sepsis/drug therapy*

【Objective】 To investigate the main causes of blood donor deferral in domestic blood center. 【Methods】 The causes of donor deferral were classified into 12 categories as previous medical history, drug use, alcohol consumption, menstrual period, underweight, abnormal blood pressure, abnormal body temperature, abnormal hemoglobin (Hb), lipemic blood, positive hepatitis B surface antigen (HBsAg), elevated alanine aminotransferase (ALT) and others according to the comparison indicators of Asia-Pacific Blood Network (APBN) and the national standard Blood Donor Health Examination Requirements. The relevant data of the top 3 causes of donor deferral, voluntarily reported by the members of Practice Comparison Working Group of China’s Mainland Blood Collection and Supply Institutions from 2014 to 2019, were collected and a histogram was generated. 【Results】 The median donor deferral rate of 20 domestic blood centers from 2014 to 2019 was 12.14%, with the lowest at 0.18% and highest at 32.32%, respectively. The top three causes for donor deferral were elevated ALT, abnormal Hb and abnormal blood pressure in year 2014, 2015, 2018 and 2019; elevated ALT, lipemic blood and abnormal blood pressure in 2016; elevated ALT, abnormal Hb, and lipemic blood in 2017. 【Conclusion】 The main causes of donor deferral were elevated ALT, abnormal Hb, abnormal blood pressure and lipemic blood.

By preparing 15 batches of lyophilized powder samples of substance benchmark in Houpo Wenzhong Decoction,the fingerprint,index component content and extract rate were determined,and the characteristic peaks,the range of similarity with the reference map,the content range and transfer rate range of magnolol,hesperidin,glycyrrhizic acid and pinocembrin,the extract rate range and the change range were clarified. The results showed that the similarity between the fingerprint of substance benchmark and the reference map R generated from the 15 batches of substance benchmark samples was higher than 0. 90. The assignment of the characteristic peaks in the full prescription's fingerprint of the herbs except Poria cocos was clarified. Nineteen characteristic peaks were assigned,and 12 characteristic peaks were assigned by the reference substance,of which 4 were from Magnolia ocinalis Cortex,5 from Exocarpium Citri Rubrum,2 from Radix aucklandiae,3 from Glycyrrhiza Radix et Rhizoma,4 from Semen Alpiniae Katsumadai,and one from Rhizoma Zingiberis and Zingiber officinale Roscoe. The index component content range and transfer rate range were 0. 80%-1. 14% and 20. 25%-39. 61% for hesperidin,0. 49%-0. 79% and 23. 09%-33. 87%for glycyrrhizic acid,0. 03%-0. 07% and 3. 55%-10. 09% for pinocembrin,0. 15%-0. 38% and 8. 08%-24. 35% for magnolol. The extract rate range and the change range were22. 60%-25. 57% and 12. 67%-23. 68% respectively. In this study,we introduced the concepts of index component content,fingerprint,extract rate,explored the transfer relation of quality value transmitting of substance benchmark in Houpo Wenzhong Decoction,and initially established the quality standard of Houpo Wenzhong Decoction,all of which would provide ideas for the development and research of similar prescriptions.
Benchmarking ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; Glycyrrhiza ; Quality Control

OBJECTIVE: To explore the influencing factors in children with chronicity immune thrombocytopenia (ITP), and to provide basis for judging the prognosis and treatment in children with ITP. METHODS: The clinical data of children with ITP admitted to The Second Affiliated Hospital of Anhui Medical University in the past 5 years were retrospectively analyzed and followed up for more than 1 year. According to the inclusion criteria, the eligible cases (328 cases in total) were selected and collected through medical record system retrieval, outpatient clinic and telephone follow-up. Independent influencing factors affecting the prognosis of children with ITP were obtained through single-factor and multi-factor logistic analysis, and their predictive value for the prognosis of ITP in children were evaluated. RESULTS: Of 328 children with ITP, 208 were newly diagnosed with ITP (64%), 54 were persistent ITP (16%), 66 were chronic ITP (20%), and the remission rate within 1 year was 79.9%. The results of univariate analysis showed that, age, pre-morbidity history of infection and vaccination, antinuclear antibodies, initial absolute lymphocyte count（ALC） and treatment options were related to the prognosis of the children (P<0.05). Multivariate analysis showed that the history of infection and vaccination before onset, initial treatment options, and ALC at the time of initial diagnosis were independent factors affecting the prognosis of children with ITP (P<0.05). The time for platelet recovery to 100×10 CONCLUSION The initial treatment plan combined with IVIG can reduce the occurrence of chronicity in children with ITP, and its efficacy is better than that of the single corticosteroids group (the platelet recovery time is shorter); history of preceding infection or vaccination, ALC at the time of initial diagnosis are independent factors affecting the prognosis of children with ITP, and the combination of the two shows a better predictive value for the prognosis.
Child ; Humans ; Immunoglobulins, Intravenous ; Prognosis ; Purpura, Thrombocytopenic, Idiopathic ; Retrospective Studies ; Thrombocytopenia

OBJECTIVE: To evaluate the clinical efficacy of warm moxibustion therapy in the recovery of quadriceps muscle strength in patients undergoing total knee arthroplasty (TKA) with analgesia of the femoral nerve block (FNB). METHODS: A total of 174 patients with KOA were randomized into a warm moxibustion group and a rehabilitation group, 87 cases in each group. In the warm moxibustion group, warm moxibustion combined with conventional quadriceps strength training were used. In the rehabilitation group, conventional quadriceps strength training was given. The warm moxibustion was applied at Liangqiu (ST 34) and Zusanli (ST 36), the treatment was given twice a day, 7 days for one course, with a total of 2 courses.The quadriceps muscle strength of the two groups was recorded and compared at 24 h before FNB, 24, 48, 72 and 96 h after surgery, and the resting and exercise VAS pain scores were also recorded at the same time point. And the first time for standing up and the first straight raising time in the two groups were compared, and the occurrence of adverse reactions in the two groups were observed. RESULTS: At 24, 48, 72 and 96 h after FNB, the quadriceps muscle strength in the warm moxibustion group was better than that in the rehabilitation group (<0.05, <0.01). At 72 h and 96 h after FNB, the resting and exercise VAS scores of the warm moxibustion group were lower than those of the rehabilitation group (both <0.001). The average first straight leg raising time in the warm moxibustion group was postoperative (31.03±10.78) h, and the time in the rehabilitation group was postoperative (47.23±15.78) h. The difference was statistically significant (<0.001). The average time of the first time for standing up in the warm moxibustion group was postoperative (25.76±7.00) h, and postoperative (33.12±11.18) h in the rehabilitation group. The difference was also statistically significant (<0.001). No adverse reactions occurred in both groups. CONCLUSION Warm moxibustion combined with conventional quadriceps strength training can improve the symptoms of quadriceps weakness in patients with femoral nerve block after total knee arthroplasty, and accelerate the recovery of joint function, which is superior to conventional quadriceps strength training.
Arthroplasty, Replacement, Knee ; Femoral Nerve ; Humans ; Moxibustion ; Muscle Strength ; Nerve Block ; Pain, Postoperative ; Quadriceps Muscle ; Treatment Outcome

Objective :To explore effects of Baduanjin combined medication on cardiac rehabilitation in patients with acute myocardial infarction (AMI).Methods :A total of 106 AMI cases treated in our hospital were enrolled .Ac-cording to random number table ,they were randomly and equally divided into medication group (received Tongxin-luo based on routine treatment ) and combined treatment group (received Baduanjin exercise based on medication group) ,both groups were treated for four weeks .Left ventricular end-diastolic volume (LVEDV) ,left ventricular end-systolic dimension (LVESd) ,left ventricular ejection fraction (LVEF) ,levels of tumor necrosis factor (TNF)-α ,high sensitive C reactive protein (hsCRP) ,interleukin (IL)-6 and N terminal pro brain natriuretic peptide (NT-proBNP) were observed and compared between two groups .Results : Total effective rate of combined treatment group was significantly higher than that of medication group (92.45% vs.75.47%,P＝0.017).Compared with be-fore treatment ,after treatment , there were significant rise in LVEDV and LVEF , and significant reductions in LVESd ,levels of hsCRP ,TNF-α ,IL-6 and NT-proBNP in two groups (P＜0.05 or ＜0.01).Compared with medi-cation group after treatment ,there were significant rise in LVEDV [ (153.58 ± 25.17) ml vs .(165.27 ± 25.46) ml] ,LVEF [(51.43 ± 4.28)% vs.(55.37 ± 4.26)% ] ,and significant reductions in LVESd [(33.46 ± 2.24) mm vs. (30.29 ± 2.32) mm] ,levels of hsCRP [ (4.54 ± 1.12) mg/L vs.(3.48 ± 1.05) mg/L] ,TNF-α [ (117.85 ± 15.46) ng/L vs.(96.59 ± 14.23) ng/L] ,IL-6 [ (14.38 ± 3.34) pg/ml vs.(10.67 ± 3.29) pg/ml] ,NT-proBNP [ (456.29 ± 53.76) ng/L vs.(368.49 ± 53.65) ng/L] in combined treatment group ,P＜0.05 or ＜0.01. Conclusion :Baduan-jin combined Tongxinluo capsule can effectively improve cardiac function ,reduce levels of inflammatory factors and improve therapeutic effect in patients with acute myocardial infarction .

PURPOSE: Angiopoietin-1 (Ang1) is a critical factor for vascular stabilization and endothelial survival via inhibition of endothelial permeability and leukocyte- endothelium interactions. Hence, we hypothesized that treatment with umbilical cord mesenchymal stem cells (UCMSCs) carrying the Ang1 gene (UCMSCs-Ang1) might be a potential approach for acute lung injury (ALI) induced by lipopolysaccharide (LPS). MATERIALS AND METHODS: UCMSCs with or without transfection with the human Ang1 gene were delivered intravenously into rats one hour after intra-abdominal instillation of LPS to induce ALI. After the rats were sacrificed at 6 hours, 24 hours, 48 hours, 8 days, and 15 days post-injection of LPS, the serum, the lung tissues, and bronchoalveolar lavage fluid (BALF) were harvested for analysis, respectively. RESULTS: Administration of fluorescence microscope confirmed the increased presence of UCMSCs in the injured lungs. The evaluation of UCMSCs and UCMSCs-Ang1 actions revealed that Ang1 overexpression further decreased the levels of the pro-inflammatory cytokines TNF-α, TGF-β1, and IL-6 and increased the expression of the anti-inflammatory cytokine IL-10 in the injured lungs. This synergy caused a substantial decrease in lung airspace inflammation and vascular leakage, characterized by significant reductions in wet/dry ratio, differential neutrophil counts, myeloperoxidase activity, and BALF. The rats treated by UCMSCs-Ang1 showed improved survival and lower ALI scores. CONCLUSION: UCMSCs-Ang1 could improve both systemic inflammation and alveolar permeability in ALI. UC-derived MSCs-based Ang1 gene therapy may be developed as a potential novel strategy for the treatment of ALI.
Acute Lung Injury/chemically induced/*therapy ; Angiopoietin-1/*genetics ; Animals ; Bronchoalveolar Lavage Fluid ; Cytokines/metabolism ; Endotoxins ; Genetic Therapy ; Interleukin-10/metabolism ; Interleukin-6/metabolism ; Leukocyte Count ; Lipopolysaccharides ; Lung/metabolism ; Male ; *Mesenchymal Stem Cell Transplantation ; Mesenchymal Stromal Cells/metabolism ; Neutrophils/metabolism ; Rats ; Transforming Growth Factor beta1/metabolism ; Tumor Necrosis Factor-alpha/metabolism ; Umbilical Cord/*cytology

BACKGROUNDThe E-26 transformation-specific related gene (ERG) is frequently expressed in cytogenetically normal acute myeloid leukemia (CN-AML). Herein, we performed a meta-analysis to investigate the relationship between the prognostic significance of ERG expression and CN-AML.

METHODSA systematic review of PubMed database and other search engines were used to identify the studies between January 2005 and November 2016. A total of 667 CN-AML patients were collected from seven published studies. Of the 667 patients underwent intensive chemotherapy, 429 had low expression of ERG and 238 had high expression of ERG. Summary odds ratio (OR) and the 95% confidence interval (CI) for the ERG expression and CN-AML were calculated using fixed- or random-effects models. Heterogeneity was assessed using Chi-squared-based Q- statistic test and I2 statistics. All statistical analyses were performed using R.3.3.1 software packages (R Foundation for Statistical Computing, Vienna, Austria) and RevMan5.3 (Cochrane Collaboration, Copenhagen, Denmark).

RESULTSOverall, patients with high ERG expression had a worse relapse (OR = 2.5127, 95% CI: 1.5177-4.1601, P = 0.0003) and lower complete remission (OR = 0. 3495, 95% CI: 0.2418-0.5051, P< 0.0001). With regard to the known molecular markers, both internal tandem duplications of the fms-related tyrosine kinase 3 gene (OR = 3.8634, 95% CI: 1.8285-8.1626, P = 0.004) and brain and acute leukemia, cytoplasmic (OR = 3.1538, 95% CI: 2.0537-4.8432, P< 0.0001) were associated with the ERG expression. In addition, the results showed a statistical significance between French-American-British (FAB) classification subtype (minimally differentiated AML and AML without maturation, OR = 4.7902, 95% CI: 2.7772-8.2624, P< 0.0001; acute monocytic leukemia, OR = 0.2324, 95% CI: 0.0899-0.6006, P = 0.0026) and ERG expression.

CONCLUSIONHigh ERG expression might be used as a strong adverse prognostic factor in CN-AML.

OBJECTIVETo explore the clinical diagnostic value and significance of hepciden level by detecting the expression of serum hepcidin before and after treatment of infant iron deficiency anemia (IDA) with or without vitamin D deficiency.

METHODSA total of 60 cases of infamt IDA were divided into A and B groups, the group A consisted of 20 IDA infants with vitamin D deficiency, group B consisted of 48 IDA infants without vitamin D deficiency and the control group included 26 healthy infants. Blood examination including HGB, MCV, MCH and MCHC was performed by hematological analyzer, the level of serum ferritin was assayed by chemiluminescence immunoassay, the levels of hepcidin and 25- (OH) D were assayed by ELISA.

RESULTSThe levels of serum hepcidin in group A, B and control group before treatment were (29.16 ± 7.50), (27.11 ± 7.10) and (29.25 ± 8.39) ng/ml, respectively (P > 0.05). The level of serum hepcidin in group A and B after treatments was significantly higher than that in control group [ (36.21 ± 5.68) ng/ml vs (29.25 ± 8.39) ng/ml, P < 0.01; (34.16 ± 4.54) ng/ml vs (29.25 ± 8.39) ng/ml, P < 0.01]; but there were no significantly difference between group A and B (P > 0.05). The serum ferritin positively correlated with hepcidin in group B both before and after treatments (r = 0.352 and 0.367, P < 0.05, P < 0.05).

CONCLUSIONThe level of serum hepcidin has an important significance in poccess of evaluatng for therapeutic effect in infant iron deficiency anemia, but the interference effect of vitamin D deficience should be eliminated when the expression level of hepcidin is applicated for diagnosis and differential diagnosis.

Anemia, Iron-Deficiency ; diagnosis ; Case-Control Studies ; Diagnosis, Differential ; Enzyme-Linked Immunosorbent Assay ; Hepcidins ; blood ; Humans ; Infant ; Vitamin D Deficiency ; blood