ABSTRACT
【Objective】 To analyze the dynamics of specific SARS-CoV-2 IgG antibodies in blood donors in Fuzhou area after receiving booster doses of inactivated COVID-19 vaccine and breakthrough infections, and to provide evidence for the timing of the collection of specific immune plasma or convalescent plasma and the subsequent vaccine doses. 【Methods】 A total of 109 volunteers who received the first booster dose of inactivated COVID-19 vaccine and 102 volunteers who experienced breakthrough infections were recruited at Fujian Blood Center from October to November 2021. Blood samples were collected at eight time points: 14 (11, 20) days before the booster dose (Time0), 14 (10, 23) days after the booster dose (Time1), 53 (45.5, 61) days after the booster dose (Time2), 88 (78, 101.5) days after the booster dose (Time3), 124 (112.5, 138.5) days after the booster dose (Time4), 158 (146, 174) days after the booster dose (Time5), 194 (179.5, 214) days after the booster dose (Time6) and within one month after the breakthrough infection (Time7). Serum SARS-CoV-2 IgG antibodies were detected using a chemiluminescence immunoassay. The dynamics of antibody levels were analyzed and the effects of age, gender, weight, BMI, blood type and smoking on antibody levels were also analyzed. 【Results】 The positive rate of SARS-CoV-2 IgG antibodies was 53.2% (58/109) at Time0, 100% (109/109) at Time1, and 95.4% (104/109) at Time6. The antibody levels were significantly higher at Time1 and Time6 than at Time0 (P0.05). The IgG antibody level at Time7 was 2.07 times than that at Time1 (P0.05). The IgG antibody level in breakthrough infection group was significantly higher than that in non-breakthrough infection group (P<0.001). 【Conclusion】 Booster doses of inactivated COVID-19 vaccine and breakthrough infections can stimulate stronger immune responses in the body. It is recommended to collect specific immune plasma or convalescent plasma within one month after breakthrough infections or booster doses of COVID-19 vaccine for special purposes. The timing of subsequent vaccine doses should be based on the dynamics of antibody levels. It is necessary to continuously monitor antibody levels to provide evidence for subsequent vaccine doses.
ABSTRACT
【Objective】 To explore the reasons for wrong connection between anticoagulant and normal saline solution during apheresis platelet donation, as well as the preventive measures, so as to ensure the safety of apheresis platelet donors. 【Methods】 Manual checking in the first phase (December 2008 to September 2016) was compared with double checking (manual checking plus information system) in the second phase (October 2016 to October 2020) via bilateral testing using Fisher's Exact Test to study pre-post-improvement differences. 【Results】 The incidence of solution connection errors during apheresis platelet donation in the first phase was 1.02/10 000, and the error incidence between Amicus and Trima + Mcs®+ blood cell separator was statistically significant (P<0.05). The total incidence of errors between the first and second phases was not statistically significant (P>0.05). After the performance of double checking in the second phase, no wrong connection of anticoagulant and saline solution occurred. 【Conclusion】 The double checking method assisted by manual and information system can effectively prevent the wrong connection between anticoagulant and normal saline solution.
ABSTRACT
Objective@#To investigate the primary clinical efficacy of Collinear clamp assisted reduction and proximal femoral nail antirotation(PFNA) in the treatment of medial-lateral irreducible intertrochanteric fractures.@*Methods@#From January 2012 to December 2016, a total of 21 cases of medial-lateral irreducible intertrochanteric fractures of femur who were treated with Collinear clamp assisted reduction and PFNA in Lishui Hospital of Zhejiang University were selected.There were 12 males and 9 females, with a mean age of 76.7 years(ranged 51 to 91). According to Arbeitsge-meinschaft für Osteosynthesefragen/The Association for the Study of Internal Fixation(AO/ASIF) classification, there were 6 cases of type 31-A1 fractures, 11 cases of type 31-A2 fractures, 4 cases of type 31-A3 fractures.All patients were followed and the clinical results and functional rehabilitation were evaluated during perioperative period and after short term followed-up.@*Results@#The mean operation time was 61.7min(ranged 40-110min). The mean intraoperative blood loss was 131.7mL(ranged 45-450mL). The average hospitalization days was 13.6d(ranged 7-29d). There were no severe complications and exacerbation of coexisting medical disease.All patients were followed up for 10 to 18 months (average 13.3 months) after treatment.The fracture union was obtained in all patients at the final follow-up.No poor healing, failure of internal fixation, cut-out of proximal screws, varus deformity, re-fractures occurred after operation.The clinical results were evaluated according to Harris hip score, 6 cases achieved excellent results, 13 cases were good, 2 cases were fair at last follow-up.The excellent and good rate of the hip joint function was 90.5%.@*Conclusion@#Surgical treatment of medial-lateral irreducible intertrochanteric fractures with Collinear clamp assisted reduction and PFNA can result in excellent reduction and function.This technique has less injury and faster recovery.However, the long-term effect needs to evaluate by follow-up.
ABSTRACT
Objective To evaluate the efficacy and accuracy of hammering reverse guide wire technique for safe placement of anterior column retrograde intramedullary screw in pelvic and acetabular surgery.Methods From September 2015 to March 2018,46 patients with pelvic or/and acetabular fracture involving the anterior column were treated with hammering reverse guide wire technique for safe placement of anterior column retrograde intramedullary screw at Department of Orthopaedics,Lishui Municipal Central Hospital.They were 28 men and 18 women,aged from 21 to 85 years (mean,55.6 years).There were 34 pelvic ring fractures,9 acetabular fractures and 3 combined pelvic ring and acetabular fractures.After the anterior lateral spine of pubic tuberosity was drilled by a guide pin and drill bit as the entry point,a reverse guide wire was knocked into the bone lightly by a hammer.For each retrograde intramedullary screwing into the acetabular anterior column,we recorded operation time,fluoroscopic frequency,and attempts to establish an acceptable screw pathway by the guide pin.The accuracy of screwing and the quality of fracture reduction were evaluated by imaging examination.For each patient,we recorded fracture union time and complications.Functional recovery of the pelvis and acetabulum was assessed by postoperative physical examination at the last follow-ups.Results The operation time of retrograde intramedullary screwing for the 46 patients averaged 28.9 minutes (from 16 to 55 minutes);the fluoroscopy frequency averaged 16.3 times (from 9 to 35 times);an acceptable screw pathway was established by the first attempt in 43 of the 46 patients (93.5％) and re-established after adjustment of the guide pin in the other 3.Forty patients were followed up for an average of 15.2 months(from 6 to 36 months).Postoperative CT scan and three-dimensional reconstruction showed that all the screws had been placed safely and accurately in the acetabular anterior column.Implant loosening and fracture displacement occurred in one case and lower limb thrombosis in another.No nail breakage,fracture nonunion,incision necrosis or infection,neurovascular injury or femoral head necrosis was observed.All fractures united after an average of 14.7 weeks (from 12 to 18 weeks).According to the Majeed scoring at the last follow-ups,the pelvic and acetabular function was evaluated as excellent in 29 cases,as good in 9,and as fair in 2,giving an excellent and good rate of 95.0％.Conclusion Hammering reverse guide wire technique is an effective method for safe placement of anterior column retrograde intramedullary screw in pelvic and acetabular surgery,because it can increase accuracy of screwing and reduce intraoperative radiation,operation time and incidence of complications though it is simple.
ABSTRACT
Objective To investigate the primary clinical efficacy of Collinear clamp assisted reduction and proximal femoral nail antirotation(PFNA) in the treatment of medial-lateral irreducible intertrochanteric fractures.Methods From January 2012 to December 2016,a total of 21 cases of medial-lateral irreducible intertrochanteric fractures of femur who were treated with Collinear clamp assisted reduction and PFNA in Lishui Hospital of Zhejiang University were selected.There were 12 males and 9 females,with a mean age of 76.7 years(ranged 51 to 91).According to Arbeitsge-meinschaft für Osteosynthesefragen/The Association for the Study of Internal Fixation (AO/ASIF) classification,there were 6 cases of type 31-A1 fractures,11 cases of type 31-A2 fractures,4 cases of type 31-A3 fractures.All patients were followed and the clinical results and functional rehabilitation were evaluated during perioperative period and after short term followed-up.Results The mean operation time was 61.7min (ranged 40-1 10min).The mean intraoperative blood loss was 131.7mL (ranged 45-450mL).The average hospitalization days was 13.6d(ranged 7-29d).There were no severe complications and exacerbation of coexisting medical disease.All patients were followed up for 10 to 18 months (average 13.3 months) after treatment.The fracture union was obtained in all patients at the final follow-up.No poor healing,failure of internal fixation,cut-out of proximal screws,varus deformity,re-fractures occurred after operation.The clinical results were evaluated according to Harris hip score,6 cases achieved excellent results,13 cases were good,2 cases were fair at last follow-up.The excellent and good rate of the hip joint function was 90.5％.Conclusion Surgical treatment of medial-lateral irreducible intertrochanteric fractures with Collinear clamp assisted reduction and PFNA can result in excellent reduction and function.This technique has less injury and faster recovery.However,the long-term effect needs to evaluate by follow-up.
ABSTRACT
Objective To understand whether it had differences in bile culture and drug susceptibility test between patients with community-acquired acute cholecystitis and patients with community-acquired acute cholangitis at present.Methods 169 patients with community-acquired acute cholecystitis and the 97 patients with community-acquired acute cholangitis in our department were selected prospectively,in which 16 patients suffered from both community-acquired acute cholecystitis and community-acquired acute cholangitis.Bile sample was extracted in operations and delivered to perform aerobic culture and drug sensitivity test.The bile samples coming from cholecyst were divided into group A,while the bile samples coming from bile duct were divided into group B.Results The positive rates of bile culture in group A and group B were separately 24.9% and 64.9%(P0.05).Conclusion Some difference exist in the results of bile culture between patients with community-acquired acutecholecystitis and patients with community-acquired acute cholangitis,but the main bacteria of the both two types of biliary tract infection are Escherichia coli and Klebsiella pneumonia.The drug resistance is serious in the both infections,and the most sensitive antibiotics to gram negative bacteria include amikacin,ertapenem,imipenem,piperacillin/tazobactam,and the most sensitive antibiotics to gram positive bacteria include tigecycline,linezolid in the both infections.
ABSTRACT
Objective To analyze the current status of bacterial spectrum and drug resistance in community-acquired biliary tract infection to provide a basis for clinical medication .Methods The patients with community-acquired biliary tract infection (ex-periment group) and the patients with biliary tract diseases without biliary tract infection (control group) derived from the native ar-ea treated in this hospital from September 2014 to January 2016 were selected .The bile juice was intraoperatively extracted for con-ducting the bacterial culture and drug susceptibility test .Results Thirteen specieses (60 strains) of bacteria were isolated in the ex-periment group .The top 3 specieses were Escherichia coli (35 .0% ) ,Klebsiella pneumonia (21 .7% ) and Enterobacter cloacae (10 .0% ) .Eight specieses (13 strains) of bacteria were isolated in the control group .The top 3 specieses were Escherichia coli (30 .8% ) ,Klebsiella pneumonia(15 .4% ) and Lactococcus garvieae (15 .4% ) .The proportions of drug resistant strains in the two groups were 95 .0% and 84 .6% respectively (P>0 .05) .The proportions of multiple drug resistant strains in the two groups were 30 .0% and 7 .7% respectively(P>0 .05) .The occurrence rates of multiple drug resistance in the top 3 specieses of bacteria in the experiment group were 61 .9% ,7 .7% and 16 .7% respectively .Conclusion The bacterial spectra of community-acquired acute bili-ary tract infection in the native area are dominated by Gram negative bacteria .The total bacterial drug resistance is serious ,but the drug resistance situation in different bacteria pathogens is different .
ABSTRACT
Objective To investigate the mutation characteristics and genotype of hepatitis B virus resistance gene in Nantong area,and provide scientific basis for clinical rational drug.Methods A total of 158 cases of chronic hepatitis B (CHB)pa-tients who were received with nucleos (T)ide analogues therapy for at least 2 years as the research object,and 30 cases of CHB patients who were not received nucleos (T)ide analogues for the treatment as the control group.PCR-sequencing method was used to detect the HBV P resistant gene and genotype,meanwhile,observe the relationship between three main mutation model and the levels of ALT and HBV DNA was also investigated.Results B genotype was detected in 42 (26.58%)out of 158 CHB patients,and 116 cases (73.42%)were C genotype.A total of 131 patients with different site mutations in P region,the mutation rate were 82.91%.There were totally 11 HBV mutation sites,including the main muta-tion site:M204I,L180M,M204V,A181V and A181T,the frequency of drug resistance were 41.14%,37.34%,22.15%, 11.39% and 10.13%,respectively.Moreover,11 mutation sites had 21 mutation patterns.In lamivudine (LAM)resistance associated mutations,the L180M and M204V sites were mainly co-occurrence,followed by M204I alone.In adefovir dipivoxil (ADV)resistance associated mutations,A181V was the main mutation site.Whereas,the drug resistance rate of entecavir (ETV)was low.Conclusion The main genotypes of HBV were type B and C in Nantong area,and C type was the dominant genotype.The resistance mutations mainly concentrated in LAM and ADV resistance associated mutations,while the resist-ance rate of ETV was low.Multi-locus drug-resistant mutation detection may help to detect viral resistance and guide clinical treatment better.
ABSTRACT
Depression is a difficult problem because of its unresolved etiology , complex pathogenic factors ,and unknown path-ogenesis in the field of neuroscience .In recent years,the research of the pathogenesis in depression had made important progress at home and abroad .This article elaborates the mainstream hypothesis of depression mechanism to broaden the understanding depression in the fields of neurobiochemical study , neuroendocrine and neural plasticity studies .
ABSTRACT
Objective To investigate the relationship between serum Golgi protein-73 (GP73)level and related indexes of he-patic fibrosis in patients with hepatitis B cirrhosis diseases and discuss the clinical value of GP73.Methods The level of GP73 was detected by ELISA;the levels of type Ⅳ precollagen (Ⅳ-C)and hyaluronic acid (HA)were measured by radio-immunity in serum from 11 patients with acute hepatitis B (AHB),31 patients with chronic hepatitis B (CHB),71 patients with Hepatitis B Cirrhosis (LC),23 patients with primary hepatic carcinoma (PHC)and 34 healthy people with check-up. The clinical changes and relationship between the GP-73 level and the parameter of fibrous degeneration were studied.Re-sults The GP73 level in CHB group was 118.0±82.2μg/L;the GP73 level in LC group was 154.4±87.7μg/L and the GP73 level in PHC group was 196.5±89.6μg/L.Compared with the normal control group,statistically significant differ-ence were found in GP73 level of CHB group,LC group and PHC group (t values were -7.284,-7.909 and -9.609,re-spectively;P<0.01).As the progress of liver cirrhosis,the levels of GP73,Ⅳ-C and HA all increased gradually and the level of GP73 was significantly positively correlated to Ⅳ-C and HA (r valves were -0.212 and 0.487,respectively;P<0.01). Conclusion The GP73 was high expressed in chronic liver disease,especially in liver cirrhosis.The GP73 was significantly associated with the occurrence of hepatitis b liver fibrosis.There fore,GP73 could be used as a better index to monitor the fi-brosis degree.
ABSTRACT
[Objective]Supracondylar fracture of the humerus is the most common fracture around elbow in children.In recent years,with the progress of minimally invasive technique,closed reduction and percutaneous Kirschner wire fixation has been widely applied in clinics to reduce the complications and surgical trauma.The relative literature concerning supracondylar fracture of the humerus in children was reviewed to find out the latest progress in classification criteria,the manipulation and reference standard of closed reduction,the configuration and effects of different percutaneous Kirschner wire fixation,and the complications and prevention measures for closed reduction and percutaneous pinning fixation.
ABSTRACT
ObjectTo study the application of ultrasonic circulation technique for the extraction of triterpenoids from Ganoderma lucidum (Leyss.ex Fr.) Karst. Methods On the basis of conventional method, the processing steps of ultrasonic circulation treatment were added. Results The comparative experiments showed that less amounts of various solvents and shorter extraction time were needed for ultrasonic circulation extraction, with the product ratio of about 40 percent higher than that of conventional method. Furthermore, a good consistency of the target product analyzed by HPLC was found between two different extraction methods. Conclusion The ultrasonic circulation technique has a potential application to the extraction of triterpenoids from G. lucidum.