Influencing factors of severe pneumonia in children with respiratory syncytial virus infection / 中国医师杂志

Objective:To explore the influencing factors of severe pneumonia in children with respiratory syncytial virus (RSV) infection.Methods:A retrospective case-control study was used to collect 210 children with RSV infected pneumonia admitted to Hebei Children′s Hospital from October 2017 to October 2020. Among them, 70 children with severe pneumonia were included in the severe pneumonia group, and 140 children with common pneumonia were included in the common pneumonia group; the baseline data and relevant laboratory indicators of the two groups were compared; Logistic regression was used to analyze the influencing factors of severe pneumonia in children infected with RSV.Results:The proportions of wheezing, congenital heart disease, respiratory failure, heart failure and pleural effusion of children in severe pneumonia group were higher than those in common pneumonia group, and the forced vital capacity (FVC) and forced expiratory volume in the first second (FEV 1) were lower than those in common pneumonia group (all P<0.05); the levels of C-reactive protein (CRP), CD8 + cells, RSV load and Beclin-1 in severe pneumonia group were higher than those in common pneumonia group, and the levels of CD4 + cells and 1, 25-dihydroxyvitamin D [1, 25-(OH) 2D] were lower than those in common pneumonia group (all P<0.05). After treatment, the levels of CRP, CD8 + cells and Beclin-1 in children with severe pneumonia were lower than those before treatment, and the levels of CD4 + cells and 1, 25-(OH) 2D were higher than those before treatment (all P<0.05). Multiple regression model analysis was established. The results showed that congenital heart disease, high CRP level, high CD8 + cells, high RSV load and high Beclin-1 level were risk factors for severe pneumonia in children with RSV infected pneumonia (all OR>1, P<0.05), and high CD4 + cells and 1, 25-(OH) 2D level were protective factors (all OR<1, P<0.05). Conclusions:Severe pneumonia in children with RSV infected pneumonia may be affected by congenital heart disease, CRP, CD4 + cells, CD8 + cells, 1, 25-(OH) 2D, RSV load and Beclin-1.

Research progress in complications of hip arthroscopy / 中华创伤杂志

Hip arthroscopy has become a routine treatment for the localized hip lesions.With the rapid development of arthroscopy,the number of surgeries has increased greatly.Though hip arthroscopy is considered as low risk operation,its complications have been constantly reported and noted.There are two major types in hip arthroscopy surgeries:conventional operative complications and special complications.Conventional operative complications include venous thromboembolism,hemorrhage,and pain.Special complications are associated with arthroscopic techniques and local anatomical structures of the hip,such as the perineal nerve,the lateral femoral cutaneous nerve,the acetabular labium or the iatrogenic injury of the cartilage surface of the femoral head.Hip arthroscopy has obvious advantages such as small surgical wound and rapid recovery,but its complications can not be ignored.Joint surgeons must fully recognize it and keep vigilant so as to avoid complications as much as possible.This review will systematically elaborate the complications of hip arthroscopic surgery from general and special aspects so as to provide ideas for reducing the occurrence of complications in hip arthroscopic surgery.

Research progress in risk factors for venous thrombosis after knee arthroscopy / 中华创伤杂志

Venous thromboembolism (VTE) is a common complication of hip and knee arthroplasty and of many major orthopedic surgeries.VTE mainly includes two aspects,ie,deep vein thrombosis (DVT) and pulmonary embolism (PE).Symptomatic PE is likely to endanger patients' life,resulting in irreversible severe consequences.With the return of venous blood,DVT may also fall off at any time,forming a new PE.Therefore,the prevention of VTE in large orthopedic surgeries has been highly valued by scholars worldwide.However,the problem of VTE after arthroscopic surgery has not drawn much attention from clinicians.Researchers have not reached a consensus on whether routine anticoagulation therapy is required after surgery because of VTE's low incidence and discrepancy among various studies (0.42％-17.9％).With a large number of knee arthroscopy being performed per year,the postoperative VTE incidence can not be ignored.For these reasons,some scholars have suggested that patients after knee arthroscopy should be stratified and that patients with a higher risk of postoperative VTE need to be given anticoagulant therapy.Risk factors for VTE after knee arthroscopy may have effects on the clinical treatment of patients.Therefore,a review of the literature to explore the possible risk factors for postoperative VTE was conducted.

Solubilization Comparison between Sulfonated Butyl Ether-β-cyclodextrin and Hydroxypropyl-β-cyclodextrin for Voriconazole by Phase Solubility / 中国药师

Objective: To study the solubilization of sulfonated butyl ether-β-cyclodextrin (SBE-β-CD) and hydroxypropyl-β-cyclodextrin (HP-β-CD) for voriconazole (VCZ) to lay basis for the preparation of inclusion compounds of VCZ.Methods: The phase-solubility method was used, and the solubilization of SBE-β-CD and HP-β-CD at different concentrations for VCZ was studied at various temperatures and the inclusion constant (K) and such inclusion parameters as ΔG, ΔH and ΔS were calculated.Results: Both SBE-β-CD and HP-β-CD could improve the solubility of VCZ in water, while the solubilization of SBE-β-CD was more significant than that of HP-β-CD at the same concentration under the same temperature.The equilibrium phase-solubility diagram of SBE-β-CD vs VCZ was AN type, and that of HP-β-CD vs VCZ was AL type.With the increase of temperature, K of both β-CD decreased.ΔG, ΔH and ΔS were all negative for the inclusion process.Conclusion: Compared with that of HP-β-CD, the solubilization of SBE-β-CD for VCZ is better.The inclusion is spontaneously formed with exothermic process, and the main acting force is Van der Waals'' force.

Cilia Toxicity and Mucosal Irritation of Gastrodin Nasal Temperature-sensitive in situ Gel / 中国药师

Objective:To evaluate the nasal safety of gastrodin nasal temperature-sensitive in situ gel through the studies on cilia toxicity in toads and mucosal irritation in rats. Methods:The toads were randomly divided into four groups, saline group, gastrodin in situ gel group, blank gel matrix group and sodium deoxycholate group, and the cilia toxicity was observed in vivo by a toad palate meth-od. The rats were randomly divided into three groups, saline group, gastrodin in situ gel group and blank gel matrix group, and the mucosal irritation was studied in rats through the observation of nasal mucosal pathological changes and behavioral indices. Results:Compared with the saline group, gastrodin in situ and blank gel matrix showed no notable effect on the cilia movement function in toads, and the effect on cilia movement of sodium deoxycholate showed statistically significant difference when compared with that of sa-line, gastrodin in situ gel and blank gel matrix (P0. 05), and after the 2-day withdrawal, that in the gastrodin in situ gel group and blank gel matrix group decreased significantly when compared with that at the last administration (P0. 05). The number of inflammatory cells in the nasal mucosa in the gastrodin in situ gel group and blank gel matrix group increased complicated with congestion and cilia falling off, and after the with-drawal, the mucosal morphology in the three groups showed no significant difference. Conclusion:The local application of gastrodin in situ gel has high security, which is valuable to be studied further.

Application of beach chair position and lateral decubitus position in shoulder arthroscopy / 中华骨科杂志

The clinical application of arthroscopic minimally invasive treatment of shoulder joint disease technology has become a routine,and it has been widely carried out around the world.Compared with the traditional open surgery,it only needs to establish a few channels in the shoulder and then the diagnosis and treatment of the structure under the acromion and glenoid joint internal lesions can be completed through the arthroscopic technique under direct vision,of course,including local collection of pathological specimens.Shoulder arthroscopic surgery has the advantages of simple operation technique,small economic burden of patients,small tissue trauma,quick recovery and high accuracy of disease diagnosis.At present,there are two main options for shoulder arthroscopy:the beach chair position (BCP) and the lateral decubitus position (LDP).The choice of surgical position for surgeons is closely related to the intraoperative operation,the risk of complications,the efficacy of surgery,and the cost of setting the posture.Shoulder arthroscopy of these two positions have their own advantages and disadvantages:in the BCP,the surgeon gets a better anatomical operation experience,if necessary,can be converted into open surgery at any time.Without continuous traction,upper limb nerve and vascular damage caused by traction can be avoid.But the incidence of cerebral ischemic events in patients may increase in the BCP.There is also possibility of the nerve damage of the pillow small nerve,great auricular nerve,lateral femoral cutaneous nerve and other nerves.In theory the risk of air embolism in the patients will increase in the BCP,and the cost of setting the position is also higher than the LDP.While in the LDP due to the patient's forearm continuous traction,the surgeon can get a more extensive operating space,and the occurrence of cerebral ischemic events is very rare.In the treatment of anterior shoulder instability after shoulder arthroscopic surgery,there is a lower recurrence rate in the LDP.The cost of setting the position is also significantly lower than the BCP.Of course,the disadvantages of the LDP is also obvious.In the LDP,the brachial plexus and other nerves or vascular injury may increase due to the continuous traction of the forearm.Meanwhile sustained traction in the LDP is also a risk factor for thrombosis,and so on.Therefore,there is still a debate about the optimal location of the shoulder arthroscopy.Many clinicians choose shoulder arthroscopic position based on their own experience and habits.

Relationship between clinical feature and serum Titin antibodies in patients with myasthenia gravis / 临床神经病学杂志

Objective To investigate the correlation between level of Titin antibodies (Titin-Ab) and patient's condition and different thymic pathological patterns in patients with myasthenia gravis (MG), and to assess its value in the diagnosis and prognosis of MG.Methods The levels of Titin-Ab in serum from 52 patients with MG (MG group), 18 cases with other neurologic diseases (NMG group) and 50 normal controls (NC group) were detected using enzyme-linked immunosorbentassay (ELISA). 10 cases with MG who received operation on thymus were tested again after therapy.Results The positive rate of Titin-Ab in MG group was 36.5%,but not present in MNG and NC groups.The MG group!was significantly higher than those in NMG group and NC group (all P