Flow-through anterolateral thigh perforator flap or medial sural artery perforator flap in repair of Gustilo Ⅲ C wound of foot / 中华显微外科杂志

Objective:To investigate the therapeutic effect of Flow-through anterolateral thigh perforator flap (ALTPF) or medial sural artery perforator flap (MSAPF) in repair of Gustilo III C wound of foot.Methods:From July 2015 to June 2021, 8 patients with Gustilo III C wound of foot were treated in the Department of Foot and Ankle Surgery of Wuxi No.9 People’s Hospital. The patients were 7 males and 1 female, aged 25-62 years old, and (45.88±12.96) years old in average. Flow-through ALTPF or Flow-through MSAPF were used to repair the defect according to the size of the wound and the length and diameter of the defect vascular. Among the patients, 6 were repaired with free Flow-through ALTPF, and 2 with free Flow-through MSAPF. The size of flap was 9 cm×5 cm-22 cm×8 cm with (115.00±46.16) cm 2 in average, and the vascular bridging was 6-12 cm in length, with (8.75±2.50) cm in average. All patients received outpatient follow-up. The appearance of the flap, blood supply of affected limb, healing of fracture and dislocation and the recovery of limb function were recorded. Maryland score was used to evaluate functional recovery. Results:The flaps survived uneventfully in all 8 patients, and the wounds in donor site healed primarily. All patients were followed-up for 6-22 months with (12.25±5.39 ) months in average. At the last follow-up, all the flaps had satisfactory contour in soft texture and blood supply without occlusion in the bridging vessels. The fractures and dislocation were healed, and the appearance and function of the foot recovered satisfactorily. The Maryland score showed excellent in 3 patients, good in 4 patients and fair in 1 patient.Conclusion:Flow-through ALTPF or MSAPF can selectively used to reconstruct the Gustilo III C wound of foot in one stage. The functional recovery of the affected limb was satisfactory and the clinical effect was good.

Epidemiological trends for human schistosomiasis prevalence in Hubei Province from 2004 to 2018 based on Joinpoint regression analysis / 中国血吸虫病防治杂志

Objective To analyze the trends of human schistosomiasis prevalence in Hubei Province from 2004 to 2018, so as to provide the evidence for formulating the schistosomiasis elimination strategy in the province. Methods All data pertaining to human schistosomiasis prevalence in Hubei Province were collected from 2004 to 2018, and the trends for changes in seroprevalence, egg-positive rate and prevalence of human Schistosoma japonicum infection were analyzed using a Joinpoint regression model. Results Both of the numbers of residents seropositive and egg-positive for S. japonicum infections appeared a tendency towards a decline in Hubei Province from 2004 to 2018, and the prevalence of human S. japonicum infections reduced from 6.85% in 2004 to 0 in 2018. Joinpoint regression analysis showed that the prevalence of human S. japonicum infections appeared an overall tendency towards a reduction in Hubei Province from 2004 to 2018 [average annual percent change (AAPC) = −24.1%, P < 0.01], and the trends for the reduction were both significant during the period from 2004 to 2006 [annual percent change (APC) = −35.1%, P < 0.01] and from 2006 to 2018 (APC = −22.1%, P < 0.01). The prevalence of human S. japonicum infections appeared a tendency towards a decline in islet (AAPC = −25.1%, P < 0.01), inner embankment (AAPC = −26.4%, P < 0.01) and hilly subtypes of schistosomiasis-endemic areas (AAPC = −32.5%, P < 0.01) of Hubei Province from 2004 to 2018, and the prevalence all appeared a tendency towards a decline during the infection control stage (from 2004 to 2008), the transmission control stage (from 2009 to 2013) and the transmission interruption stage (from 2014 to 2018) (AAPC = −28.0%, −24.4% and −63.8%, all P values < 0.01). The seroprevalence of human S. japonicum infections appeared an overall tendency towards a decline in Hubei Province from 2004 to 2018 (AAPC = −14.5%, P < 0.01), and the trends for the reduction were both significant during the period from 2004 to 2012 (APC = −8.4%, P < 0.01) and from 2012 to 2018 (APC = −22.1%, P < 0.01). In addition, the egg-positive rate of human S. japonicum infections appeared an overall tendency towards a decline in Hubei Province from 2004 to 2018 (AAPC = −30.6%, P < 0.05), and the trend for the reduction was significant during the period from 2007 to 2014 (APC = −15.5%, P < 0.01). Conclusions The prevalence of human schistosomiasis appeared a tendency towards a decline in Hubei Province from 2004 to 2018, and the islet and inner embankment subtypes of endemic areas are a high priority for schistosomiasis control during the stage moving towards elimination in Hubei Province.

The outcome predicted value of enhanced MRI for prolapsed or sequestrated lumbar disc herniation / 中华骨科杂志

Objective:To analyze the predictive value of enhanced MRI in the outcome of prolapsed and sequestrated lumbar disc herniation through a retrospective analysis.Methods:A retrospective analysis of the data of 64 patients with prolapsed and sequestrated lumbar disc herniation from January 2015 to December 2018, including 38 males and 26 females; age 35.72±12.44 years (range, 22-64 years) ; 43 cases of prolapsed type, 21 cases of sequestrated type. Conservative treatment was the first choice for all patients, in case of surgical indications during the treatment, percutaneous endoscopic lumbar discectomy or fenestration discectomy will be performed. Enhanced MRI was performed at the first and last inspections, the volume of the protrusion, the thickness of rim enhancement (Tr), and the extent of rim enhancement (Er) were measured and calculated at the same time. According to the ring around the protrusion, the size of the rim-enhancement area was divided into type I-III; then compared the relationship between the rim-enhancement signal differentiation and the resorption rate of protrusions, and the correlation between Tr, Er values and the resorption rate of protrusions during the initial inspection.Results:Among the 64 patients, 42 patients completed conservative treatment, and 22 received surgical treatment. According to the rim-enhancement signal differentiation, 23 cases were treated conservatively for type I, 3 cases were treated by surgery; 16 cases were treated for type II conservatively, 7 cases were treated by surgery; 3 cases were treated for type III conservatively, and 12 cases were treated by surgery. All patients were followed up for 12 to 34 months. Among 42 conservatively treated patients, The volume of the protrusion before treatment was 2 645.67±690.86 mm 3, and the volume of the protrusion after treatment was 842.76±573.35 mm 3. The volume of protrusions before and after treatment was statistical significance ( t=11.897, P<0.001), Tr was 1.38±0.83 mm, and Er was 73.08%±34.39%, the resorption rate of protrusions was 65.10%±24.50%, and 39 cases (92.86%, 39/42) reached the standard for protrusion resorption (resorption rate ≥30%); 23 cases of type I , the resorption rate was 76.54%±18.62%; 16 cases of type II had an resorption rate of 56.81%±21.44%; 3 cases of type III had an resorption rate of 21.58%±12.19%. The resorption rate of type III were compared by single factor analysis of variance, and the difference was statistically significant ( F=12.885, P<0.001); 32 cases of both type I and II (82.05%, 32/39) had significant resorption (resorption rate ≥50%), and no case of type Ⅲ had significant resorption, comparing with type I and II, the difference was statistically significant ( P=0.010); Tr was positively correlated with resorption rate ( r=0.569, P<0.001), Er was positively correlated with resorption rate ( r=0.677, P<0.001). Conclusion:Under close clinical observation, parts of the prolapsed or sequestrated lumbar disc herniations can be conservatively treated, and the herniated disc can be resorption in many people and the clinical symptoms were alleviated. Rim-enhancement signal differentiation by enhanced MR has a better predictive value for the outcome of the herniation, type I is more prone to resorption, preferred conservative treatment, type Ⅲ is not easy to resorption, preferred surgery treatment, and the higher thickness of rim enhancement, the greater extend the rim-enhancement, the more prone to resorption phenomenon.

A 5 year follow-up study on non-surgical treatment of ruptured lumbar disc herniation / 中国骨伤

OBJECTIVE@#To investigate the short-term and mid-term efficacy with non-surgical treatment and to predict the long-term outcomes of ruptured lumbar disc herniation.@*METHODS@#From February 2011 to February 2014, 75 patients with single-segment ruptured lumbar disc herniation treated by non-surgical therapy were selected for prospective study. There were 53 males and 22 females, aged from 18 to 58 (35.62±9.96) years old. The course of disease was from 5 days to 6 months, with an average of (46.45±40.66) days. The lesions were located at L in 4 cases, at L in 29 cases, at LS in 42 cases. Radiation pain in 46 cases on the left and 29 cases on the right. The JOA score, straight leg raising test angle and finger-to-ground distance were assessed pretreatment and at 3 months, 6 months, 1 year, 2 years and 5 years after treatment. The improvement rate of JOA at the final follow up (5 years after treatment) was calculated and the curative effect according to JOA score was evaluated;the volume change of protrusion before treatment and at the final follow-up (5 years after treatment) was analyzed, the volume absorption rate of protrusion was calculated and the absorption of protrusion was observed;the relationship between the improvement rate of JOA and the absorption rate of protrusion were analyzed.@*RESULTS@#Seventy one patients were finally followed up at 5 years after non surgical treatment. The JOA score, straight leg raising test angle and finger to ground distance at 3 months, 6 months, 1 year, 2 years and 5 years after treatment were significantly improved (0.05). There was significant differencein other time points (<0.05). The results of the straight leg raising test angle and the finger-to-ground distance were similar to the JOA scores. The improvement rate of JOA score was (62.69± 2.47)% at the final follow-up. According to JOA score, the results were excellent in 26 cases, good in 26 cases, fair in 14 cases, poor in 5 cases, and the excellent and good rate was 73.24%. The volume of protrusion decreased from (1 981.73±588.72) mm to (1 011.82±395.47) mm3, the total absorption rate was (45.65±2.83)%, the protrusion was obviously absorbed in 24 cases, partially absorbed in 26 cases, not absorbed in 19 cases, and increased in 2 cases. It was found that there was a positive correlation between improvement rate of JOA scores and protrusion absorption rate at 5 years after non surgical treatment (r= 0.679, <0.001).@*CONCLUSION@#Non-surgical treatment of ruptured lumbar disc herniation can achieve good results, clear the characteristics of the ruptured lumbar disc herniation and prognosis, and some patients have "reabsorption" phenomenon.

Curcuma wenyujin Y. H. Chen et C. Ling n-Butyl Alcohol Extract Inhibits AGS Cell Helicobacter pylori Promoted Invasiveness by Down-Regulating Caudal Type Homeobox Transcription Factor and Claudin-2 Expression / 中国结合医学杂志

OBJECTIVE@#To investigate the effects and possible mechanisms of action of Curcuma wenyujin Y. H. Chen et C. Ling n-Butyl alcohol extract (CWNAE) on repression of human gastric cancer (GC) AGS cell invasion induced by co-culturing with Helicobacter pylori (HP).@*METHODS@#AGS cells were cultured with HP of positive or negative cytotoxin-associated gene A (CagA) and vacuolating cytotoxin gene A (VacA) expression (CagA+/- or VacA+/-) and divided into 5 group. Group A was cultured without HP as a control, Group B with HP, Group C with HP, Group D with HP and CWNAE, and Group E with HP and CWNAE. Methylthiazolyldiphenyl-tetrazolium bromide (MTT) and tumor invasion assays, examinations of morphology and ultramicroscopic structures, quantitative real-time polymerase chain reaction and Western blots were performed to measure the effects and uncover the mechanisms behind these effects of HP and CWNAE on the epithelial-mesenchymal transition (EMT) of AGS cells.@*RESULTS@#The 10% inhibitory concentration of CWNAE against AGS cells after a 48 h incubation was 19.73±1.30 μg/mL. More AGS cells were elongated after co-culturing with HP than after culturing with HP. In tumor invasion assays, HP significantly enhanced the invasiveness of AGS cells compared to the other experimental groups (all P value <0.05), and this effect was inhibited by CWNAE. Treatment with CWNAE normalized tight junctions and reduced the number of pseudopodia of AGS cells co-cultured with HP. HP up-regulated zincfinger ebox binding homeobox 1 (ZEB1) in AGS cells after co-culturing for 24 h. Expression of caudal type homeobox transcription factor (CDX-2) and claudin-2 was significantly increased by HP (P<0.05), but not by HP.@*CONCLUSION@#HP promoted the invasiveness of AGS cells through up-regulation of ZEB1 transcription and claudin-2 and CDX-2 expression. CWNAE inhibited these effects of HP on AGS cells by down-regulating ZEB1 transcription, and CDX-2 and claudin-2 expression.

Impact of simulated microgravity on flash electroretinogram and retinal microcirculation in adult mice / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To observe changes in the flash electroretinogram(ERG)and retinal microcirculation in mice suspended by their tails, an animal model that simulates cephalad movement of bodily fluids under conditions of microgravity.<p>METHODS: Thirty-six adult male C57BL/6J mice(36 eyes)were randomly divided into three experimental groups and three control groups. Mice in the experimental groups were tail-suspended for 15d(Group one), tail-suspended for 30d(Group two), or tail-suspended followed by returning to normal position for 30d(Group three). Three control groups were similarly fixed with a harness but kept in the normal position for corresponding periods of 15, 30, and 60d. The mice were immediately examined using scotopic ERG(including oscillatory potentials \〖OPs\〗)and fundus fluorescein angiography(FFA)<i>in vivo</i>, and subsequently sacrificed to analyze the retinal histology(methods including immunohistochemistry and TUNEL staining)<i>in vitro</i>. Independent sample <i>t</i>-test was used for data comparison between the same time-point groups.<p>RESULTS: Following 15-days' tail-suspension, scotopic ERG showed a decline in OPs, but not in the b-wave; the second OP(O2)showed an amplitude of 197±33μV, which was about 60% of the control level(<i>t</i>=-5.938, <i>P</i><0.001). Following 30-days' tail-suspension, ERG recovered, with O2 showing an average value of 264±39μV; when compared to the corresponding control group(308±41μV), no significant difference was observed(<i>t</i>=-1.887, <i>P</i>>0.05). Morphologically, only the 15-days' tail-suspended mice showed FFA with microvascular dilation and tortuosity. Rhodopsin and cone-opsin were almost normal and no apoptotic-positive signals were detected in the retinas of the three tail-suspended groups.<p>CONCLUSION: Simulating cephalad shifting of bodily fluids as under microgravity, using short-term tail-suspension can affect rodent ERG and retinal microcirculation; however, the change is reversible with no obvious permanent injury observed in the retinas.

Clinical study of radical laparoscopic myomectomy in 31 cases / 中国实用妇科与产科杂志

OBJECTIVE: To study the characteristics and clinical application of radical laparoscopic myomectomy.METHODS: Retrospectively analyze the clinical data of 31 patients with uterine leiomyomas undergoing laparoscopic radical myomectomy at the Department of Obstetrics and Gynecology,the First Affiliated Hospital of Soochow University,from January 2016 to December 2018.The surgical indications,operation time,intraoperative blood loss,postoperative menstrual recovery,postoperative uterine fibroid recurrence rate and postoperative sexual and life quality change indicators were analyzed.RESULTS: All patients were with multiple uterine fibroids(averaged 42.6±3.5 years),and all of them received successful operation.There were no patients who underwent laparotomy or hysterectomy.The postoperative fibroids residual rate among the 31 patients was 3.23%(1 case).The recurrence rate of postoperative uterine fibroids half a year later was 9.68%(3 cases).Five patients has no significant change in postoperative menstruation volume while the other 25 patients had volume reduction(t=8.614,P0.05).Only one patient suffered from hot flashes,night sweating and other menopausal symptoms.WHOQOL-BREF scale was used for patients to assess preoperative and postoperative quality of life,and there were obviously improved psychological and physiological score in patients after operation(P<0.05).CONCLUSION: For women with multiple uterine fibroids who have surgical indications and a strong desire to retain the uterine but have no fertility requirements,radical laparoscopic myomectomy may be the most effective surgical therapy,which can achieve the purpose of surgical treatment,improving the resection rate,and maintaining low postoperative recurrence rate,preserving menstruation and the function of uterus and ovary,and increasing the sexual life quality.

Effect of salmon calcitonin on postoperative humeral head replacement in elderly patients / 中国骨伤

OBJECTIVE@#To observe the effect of anti-osteoporosis drugs on the curative effect of femoral head replacement in the elderly patients with proximal humerus fracture.@*METHODS@#From November 2012 to June 2016, 38 patients with proximal humeral fractures received humeral head replacement were divided into the treatment group and the control group according to whether the anti-osteoporosis drugs were used after the operation. The treatment group included 19 cases, of which 11 cases were three part fractures, 18 cases were four part fractures, and bone density was(0.58±0.14) g/cm²; the control group involved 19 cases, of which 10 cases were the three part fractures, 9 cases were four part fractures, and bone density was(0.58±0.11) g/cm². Periprosthetic bone mineral density(BMD) was measured at 4, 8, 12, 24 and 48 weeks after operation, and visual analogue scale(VAS) was used to evaluate the pain and Neer score was used to evaluate the function of the shoulder joint.@*RESULTS@#The incisions of all patients were healed with grade A and no complications occurred. Thirty-five patients were followed up for 1 year. The bone density around the prosthesis of treatment group was higher than that of control group, the difference was statistically significant(0.05). The total score and functional score of Neer in the treatment group were better than those in the control group, the difference was statistically significant(0.05). According to the Neer score, the results of treatment group was excellent in 10 cases, good in 5 cases, fair in 3 cases;in the control group, 3 cases were excellent, 9 cases were good, and 5 cases were fair;the difference between the two groups was statistically significant(<0.05).@*CONCLUSIONS@#Artificial humeral head replacement combined with anti-osteoporosis drugs in the treatment of proximal humeral fractures in elderly patients can effectively improve the bone density around the prosthesis and restore shoulder function. The early clinical effect is satisfactory.

Comparative study of three surgical methods for the treatment of complex proximal humeral fractures in elderly patients / 医学研究生学报

Objective There are few comparative researches on open reduction internal fixation, hemishoulder arthroplasty and reverse total shoulder arthroplasty for the treatment of complex proximal humeral fractures. The purpose of this study was to explore the clinical efficacy of three surgical Methods for the treatment of complex proximal humeral fractures.Methods A retrospective study of 55 cases of complex proximal humeral fractures treated in our department from November 2013 to May 2016. According to different surgical Methods , the patients were divided into three groups: open reduction internal fixation group of 20 cases (open reduction and internal fixation using locking plate), hemishoulder arthroplasty group of 20 cases (artificial humeral head replacement), reverse total shoulder arthroplasty group of 15 cases (head-glenoid inverted shoulder replacement). Regular postoperative review was done to record the ranges of motion. The function of shoulder joint was evaluated by ASES score, VAS pain score, UCLA score and SST score.Results 6 months after the operation, the internal rotation function of the hemishoulder arthroplasty group\[(49.1±3.3)°\] was better than those of reverse total shoulder arthroplasty group \[(43.7±4.5)°\] and open reduction internal fixation group \[(41.7±5.0)°\], but the external rotation function\[(25.7±5.4)°\] was worse than the other two groups\[(38.0±5.6)°, (39.5±4.6)°\], the differences representing statistical significance(P0.05).Conclusion Three surgical Methods can all be used in the treatment of complex proximal humeral fractures with equivalent efficacy. Reverse total shoulder arthroplasty leads to earlier shoulder joint range of motion, but lacks middle-term and long-term curative effect. Clinicians should take surgical indications and individualization into consideration comprehensively to make the choice among three surgical Methods .

A Paired Case Controlled Study Comparing the Short-term Outcomes of Da Vinci RATS and VATS Approach for Non-small Cell Lung Cancer / 中国肺癌杂志

BACKGROUND@#Da Vinci Surgical System is one of the greatest inventions of the 20th century, which represents the development direction of the precise minimally invasive surgical techniques, the aim of this study was to comparing the short-term outcomes between da Vinci robot-assisted lobectomy and video-assisted thoracic surgery (VATS) lobectomy for non-small cell lung cancer.@*METHODS@#45 pairs of non-small cell lung cancer patients underwent pulmonary lobectomy with da Vinci Robotic assisted thoracoscopic (RATS) and VATS approach during the same period from January 2014 to January 2017. The operative time, estimated blood loss (EBL), total number and total groups of dissected lymph nodes, postoperative duration of drainage, the first day volume of drainage, total volume of drainage were compared.@*RESULTS@#No perioperative death and convertion to thoracotomy occured in both groups. There were significant difference between RATS group and VATS group in EBL [(50.30±32.33) mL vs (208.60±132.63) mL], the first day volume of drainage [(275.00±145.42) mL vs (347.60±125.80) mL], the dissected total number [(22.67±9.67) vs (15.51±5.41)] and total team [(6.31±1.43) vs (4.91±1.04)] of lymph node. There were no significant difference in other outcomes.@*CONCLUSIONS@#RATS is safe and effective and took better short-outcomes than VATS in non-small cell lung cancer.

Application of indocyanine green combined with methylene blue in sentinel lymph node biophy in early breast cancer / 中国基层医药

Objective To discuss the feasibility and value of indocyanine green combined with methylene blue in sentinel lymph node biophy (SLNB) for patients with breast cancer.Methods 196 breast cancer patients who received surgery were studied.SLNB was performed by indocyanine green combined with methylene blue .Frozen section was performed,followed by conventional histopathology .The evaluation criterion of Louisvill University on SLNB was adopted to judge the detection rate ,accuracy rate,sensitivity,false negative rate.Results Among the 196 cases,196 cases were detected with SLN ( detection rate was 100.0%).SLN was all stained in 196 cases. Furthermore,56 cases had ALND metastasis,140 cases had no metastasis,and the sensitivity was 91.8%(56/61). The SLN and ALN fully complied with pathological examination in 191 cases,and the accuracy rate was 97.5%(191/196).Five cases were false negative,and the false negative rate was 8.2%(5 /61).No case was false positive.The total SLNs was 705,and average number of detected SLNs was 3.59 pieces(2-6 pieces).The average ALN was 17.66 pieces(12-26 pieces).Conclusion With the advantages of real-time visual,precise positioning,no radio-active pollution and reduce the operation difficulty ,indocyanine green joint methylene blue as lymph tracer shows high detection rate,accuracy when it is used for SLNB in patients with breast cancer ,it is worthy of clinical application.

Change of intestinal flora and its relationship with IL-23/IL-17 axis in pa-tients with ulcerative colitis / 中国病理生理杂志

AIM:To investigate the change of intestinal flora distribution and its relationship with interleukin -23(IL-23)/IL-17 axis in ulcerative colitis(UC)patients.METHODS:The fresh fecal samples from 20 patients with ac-tive UC and 20 healthy controls were collected.The distribution of the flora was analyzed by direct smear and traditional bacterial culture.The changes of bacteria were detected by real-time PCR.The hemoglobin,albumin,erythrocyte sedimen-tation,and C-reactive protein levels were tested routinely.Both normal and damaged mucosal tissues of UC patients were examined and obtained by colonoscopy,and further assessed by Mayo scoring,Baron grading and HE staining.The expres-sion of IL-17 and IL-23 was observed by immunohistochemistry and Western blot.RESULTS:(1)The degree of flora im-balance in active UC patients was higher than that in the healthy controls(P<0.05).(2)The results of aerobic culture showed that the number of Escherichia coli in the UC patients was significantly lower than that in the normal controls(P<0.01),while Enterococcus was increased obviously(P<0.01).The results of anaerobic culture revealed that the numbers of Bacteroidetes,Bifidobacterium bifidum and Lactobacilli in the UC patients were significantly decreased(P<0.01).(3) Quantitative analysis of target bacteria showed that the relative quantification of Escherichia coli,Bacteroidetes,Bifidobacte-rium bifidum and Lactobacilli in the UC patients was significantly lower than that in the normal subjects,and the number of Enterococcus was significantly increased(P<0.01).(4)Compared with control group,no significant change of hemoglo-bin in the UC patients was ovserved,albumin was significantly decreased(P<0.05), but erythrocyte sedimentation and C-reactive protein levels were elevated obviously(P<0.01).(5)The Mayo score, Baron grade, and histopathological score were all increased(P<0.01).(6)High IL-17 and IL-23 expression levels were detected in the UC patients(P<0.01).(7)Correlation analysis showed that the average absorbance values of IL -17 and IL-23 expression were positively correlated with Baron grade(r=0.717,P=0.02;r=0.849,P=0.016)and pathological score(r=0.660, P=0.03;r=0.675,P=0.032).Meanwhile, the average absorbance value of IL-23 expression was negatively correlated with the number of Escherichia coli(r =-0.699, P =0.025), and positively correlated with Enterococcus(r =0.872, P =0.010).Furthermore,the average absorbance value of IL-17 expression was positively correlated with Enterococcus(r=0.764,P=0.046),and both of them were not correlated with other bacteria.CONCLUSION: Obvious flora imbalance exists in active UC patients,changed intestinal microflora is closely related with the degree of inflammation.IL-23/IL-17 axis,as a key factor in the development of UC,may be related to the changes of intestinal microflora.The interaction be-tween intestinal microflora and IL-23/IL-17 axis plays an important role in the pathogenesis of UC.

Percutaneous reduction and Kirschner pin flxation through sinus tarsi approach for the treatment of Sanders type III calcaneal fracture / 中国骨伤

<p><b>OBJECTIVE</b>To investigate clinical effect of percutaneous reduction and Kirschner pin flxation through sinus tarsi approach in treating Sanders type III calcaneal fracture.</p><p><b>METHODS</b>Totally 22 patients (22 feet) with Sanders III calcaneal fracture were treated with percutaneous reduction and Kirschner pin flxation through sinus tarsi approach form September 2013 to December 2015. Among them, including 18 males and 4 females; aged from 20 to 65 years old with an average of (41.73±12.46) years old. Böhler angle, Gissane angle and calcaneal width before and after operation were observed and compared, Maryland scoring system was used to evaluate curative effect; postoperative complications were recorded.</p><p><b>RESULTS</b>All patients were followed up from 18 to 36 months with an average of (27.05±4.92) months. All fractures healed well with an average of (10.73±1.24) weeks. Böhler angle before operation (11.36±5.92) improved to (33.36±3.99) after operation, and had significant differences(<0.05); there was significant difference of Gissane angle between preoperation (99.23±8.61) and postoperation (114.64±6.93); calcaneal width was improved from (46.59±1.40) mm before operation to (42.15±0.75) mm at 3 months after operation (<0.05). Maryland score was (95.05±6.86) points, 16 patients obtained excellent results, 5 patients moderate, and 1 patient poor. No inflammation, flap margin necrosis and osteomyelitis occurred.</p><p><b>CONCLUSIONS</b>Compared with conventional internal fixation through L-shape incision, percutaneous reduction and Kirschner pin flxation through sinus tarsi approach in treating Sanders type III calcaneal fracture obtained satisfied clinical effects, and has advantages of invasive trauma, simple operation, easy to remove and less complication. Meanwhile, careful operation and identification should be done during sinus tarsi approach operation to protect sural nerve and tendon.</p>

A preliminary study on the disappearance time of influenza virus antigen / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the antigen clearance time, time to symptom disappearance, and the association between them using immunofluorescence assay for dynamic monitoring of influenza virus antigen in children with influenza.</p><p><b>METHODS</b>A total of 1 063 children suspected of influenza who visited the Hunan People's Hospital from March to April, 2016 were enrolled. The influenza A/B virus antigen detection kit (immunofluorescence assay) was used for influenza virus antigen detection. The children with positive results were given oseltamivir as the antiviral therapy and were asked to re-examine influenza virus antigen at 5, 5-7, and 7 days after onset.</p><p><b>RESULTS</b>Of all children suspected of influenza, 560 (52.68%) had an influenza virus infection. A total of 215 children with influenza virus infection were followed up. The clearance rate of influenza virus antigen was 9.8% (21 cases) within 5 days after onset. The cumulative clearance rate of influenza virus antigen was 32.1% (69 cases) within 5-7 days, and 98.1% (211 cases) within 7-10 days after onset. Among these children, 6 children (2.8%) achieved the improvement in clinical symptoms within 3 days after onset. The cumulative rate of symptom improvement was 84.7% (182 cases) within 3-5 days after onset, and 100% achieved the improvement after 5 days of onset.</p><p><b>CONCLUSIONS</b>The time to improvement in symptoms after treatment is earlier than antigen clearance time. Almost all of the children achieve influenza virus antigen clearance 7-10 days after onset. Therefore, it is relatively safe for children to go back to school within 7-10 days after onset when symptoms disappear.</p>

Practice and Problem Analysis of Hierarchical Diagnosis and Treatment in China Under the Background of New Medical Reform / 中国医院管理

Hierarchical diagnosis and treatment is the top priority of health care reform,it will provide a solid institutional foundation and institutional protection for the construction of healthy China and the basic health care system.The paper summarizes the present practice of the hierarchical diagnosis and treatment in China,and analyzes the existing problems,on this basis puts forward corresponding countermeasures and suggestions as the references for the construction of hierarchical diagnosis and treatment and deepening reform.

Relationship between HLA antibodies produceand the number of gravidity / 中国输血杂志

Objective Study the relationship between HLA antibodies production and the number of Gravidity.Methods A total of 856 pregnant women of first pretanal in Xiasha Hospital of Sir Run Run Shaw Hospital of Zhejiang University from Nov 2016 to Mar 2017 were recruited.The blood samples were collected during 24-28 weeks of pregnancy,and the expression of platelet-specific alloantibody was detected by solid-phase red cell adherence assay.Results There were 67 positive HLA antibody in pregnant women,and the antibody positive rate was 7.8％.There were 15 positive HLA antibody in 334 first pregnant women,14 in 214 two or more pregnancy pregnant women without abortion,10 in 107 pregnant women with once abortion,28 in 223 pregnant women with two or more abortion.The antibody positive rate respectively is 4.5％,6.5％,9.3％ and 12.6％.The production of HLA antibody was significantly associated with the numberof gravidity.Conclusion The antibody positive rate of two or more pregnancy is significantly higher than the fisrt pregnancy.

Measurement uncertainty assessment of magnesium trisilicate column for determination of Sudan colorants in food by HPLC using C8 column / 华中科技大学学报（医学）（英德文版）

This study aimed to conduct measurement uncertainty assessment of a new method for determination of Sudan colorants (Sudan I, II, III and IV) in food by high performance liquid chromatography (HPLC). Samples were extracted with organic solvents (hexane, 20% acetone) and first purified by magnesium trisilicate (2MgO·3SiO2). The Sudan colorants (Sudan I-IV) were also initially separated on C8 by gradient elution using acetonitrile and 0.1% (v/v) formic acid aqueous solution as the mobile phases and detected with diode-array detector (DAD). The uncertainty of mathematical model of Sudan I, II, III and IV is based on EURACHEM guidelines. The sources and components of uncertainty were calculated. The experiment gave a good linear relationship over the concentration from 0.4 to 4.0 μg/mL and spiked recoveries were from 74.0% to 97.5%. The limits of determination (LOD) were 48, 61, 36, 58 μg/kg for the four analytes, respectively. The total uncertainty of Sudan colorants (Sudan I, II, III and IV) was 810±30.8, 790±28.4, 750±27.0, 730±50.0 μg/kg, respectively. The recovery uncertainty was the most significant factor contributing to the total uncertainty. The developed method is simple, rapid, and highly sensitive. It can be used for the determination of trace Sudan dyes in food samples. The sources of uncertainty have been identified and uncertainty components have been simplified and considered.

Evaluation of the effect of quality control circle on defect rate of perioperative health education / 中国实用护理杂志

Objective To evaluate the application effect of quality control circle on reducing the defect rate of health education in perioperative period of gynecologic surgery patients. Methods To carry out quality control circle activities, analysis of gynecological surgery patients in perioperative health education defect rate to the cause, the development of countermeasures, to achieve the purpose of continuous quality improvement. Results Before implementation health defects rate was 43.3%(303/700), after the implementation health education defect rate was 11.4%(223/1 950). The health defects rate before and after the implementation showed significant difference (χ2=8.387, P=0.004). The incidence of anxiety before and after the implementation was 11.8%(23/195) and 4.1%(8/195), the difference was significantly different (χ2=7.885, P =0.005). Conclusions To carry out the quality circle activity, can effectively reduce the perioperative health education defect rate and improve the quality of care and patient satisfaction, method is simple and easy to operate, it is worth clinical promotion.

Curcuma wenyujin Diterpenoid compound C fought against gastric cancer: an experimental study / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To study the role of nuclear factor (NF)-kappaB pathway with p38MAPK in Curcuma wenyujin diterpenoid compound C (CDCC) fighting against inflammation and inducing gastric cancer cell apoptosis by stimulating gastric cell SGC7901 with tumor necrosis factor-alpha (TNF-alpha).</p><p><b>METHODS</b>Human umbilical vein endothelial cells (HUVECs) and human gastric cancer SGC-7901 cells were in vitro acted by CDCC in different concentrations at different time points. Their growth inhibition ratios were measured by MTT assay. The apoptosis rate of gastric cancer cells was detected by Annexin V-FITC/PI double staining. Nuclear translocation of p65 was detected by cell immunofluorescence. Expression levels of p38MAPK/P-p38MAPK, p65/P-p65, and Caspase 3/P-Caspase 3 were measured by Western blot.</p><p><b>RESULTS</b>CDCC had significant inhibitory effect on the proliferation of SGC-7901. It also could effectively induce the apoptosis of gastric cancer cell SGC-7901. It also could reduce nuclear translocation of p65 in gastric cancer cell SGC-7901. Results of Western blot indicated that expression levels of p38MAPK and p65 were reduced and the expression level of Caspase-3 was elevated along with increased concentrations of CDCC (P<0.05).</p><p><b>CONCLUSION</b>Apoptosis executive protein Caspase 3 activated by regulating p65 via p38MAPK might be one of possible mechanisms for CDCC fighting against inflammation and gastric cancer.</p>

Relationship between deceleration capacity of heart rate and ventricular arrhythmia / 心血管康复医学杂志

Objective:To analyze deceleration capacity of heart rate (DC) in patients with ventricular arrhythmia , and explore its predictive value for ventricular arrhythmia .Methods :Dynamic electrocardiogram (DCG) data of outpatients and inpatients ,who were treated in our hospital from Jan 2012 to Jul 2015 ,were retrospectively ana‐lyzed .A total of 41 rehabilitation patients with ventricular tachycardia (VT) directly detected by DCG were treated as VT group ,another 37 cases with similar general data and non‐tachycardia were enrolled as non‐tachycardia group in the same period .DCG was used to measure and calculate DC in all subjects , DC indexes were compared between two groups .Results:DC<4.5 ms was regarded as abnormal and DC<2.5 ms was regarded as significantly abnor‐mal .Compared with non-tachycardia group ,DC significantly reduced [ (8.72 ± 1.78) ms vs .(4.01 ± 1.90) ms] , P<0.01 ;there were significant rise in abnormal DC rate (5.41% vs .51.22% ) and significant abnormal DC rate (0 vs .29.27% ) in VT group , P<0.01 both .Conclusion:Detection rate of abnormal DC is high in VT patients .DC measurement is helpful for predicting ventricular arrhythmia and sudden cardiac death .