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Objective:To evaluate the effect of the impaction of posterior wall on the prognosis following open reduction and internal fixation for fractures of acetabular posterior wall.Methods:A retrospective study was conducted to analyze the data from the 83 patients with fracture of acetabular posterior wall who had been consecutively treated by open reduction and internal fixation at Department of Orthopaedics and Traumatology, Beijing Jishuitan Hospital from January 2017 to December 2020. The patients were divided into 2 groups based on involvement of posterior wall impaction. In the impaction group of 33 cases, there were 26 males and 7 females with an age of (47.4±11.6) years; in the non-impaction group of 50 cases, there were 43 males and 7 females with an age of (41.3±12.0) years. The quality of postoperative fracture reduction, the function of the affected hip at the last follow-up, and the complication rate during follow-up were compared between the 2 groups. Multifactorial binary logistic regression and age subgroups were used to analyze the effects of posterior wall impaction on functional outcomes.Results:The age, rate of associated injuries in other body parts, and rate of posterior wall comminution in the impaction group were significantly higher than those in the non-impaction group ( P<0.05), but there was no statistically significant difference in other general data of patients between the 2 groups ( P>0.05). All patients were followed up for (44.5±13.3) months after surgery. The rate of anatomical reduction in the non-impaction group (96.0%, 48/50) was significantly higher than that in the impaction group (57.6%, 19/33) ( P<0.05), and the good and excellent rate by the modified Merle d'Aubigné & Postel scale at the last follow-up in the non-impaction group (84.0%, 42/50) was significantly higher than that in the impaction group (51.5%, 17/33) ( P<0.05). There was no significant difference in the incidence of complications between the 2 groups ( P>0.05). After adjusting for age and gender, the difference in hip function was still significantly different between the 2 groups ( OR=0.23, 95% CI: 0.06 to 0.79, P=0.020). The effect of posterior wall impaction on functional outcomes was statistically significant in patients aged ≥50 years ( P=0.008), whereas the difference was not statistically significant in patients aged <50 years ( P=0.194). Conclusions:Compared with non-impaction ones, acetabular fractures of posterior wall impaction tend to lead to poorer quality of reduction, which in turn affects the postoperative recovery of hip joint function. The impact of impaction fractures on functional recovery is more significant in patients aged 50 years and above.
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Objective:To compare the long-term clinical outcomes between cannulated screw internal fixation for stable femoral neck fractures and arthroplasty for unstable ones in the elderly patients.Methods:A retrospective study was conducted to analyze the 542 patients with femoral neck fracture who had been admitted to Department of Orthopedics and Traumatology, Beijing Jishuitan Hospital, Capital Medical University from May 2015 to April 2017. The 542 patients were divided into 2 groups based on fracture stability and treatment method. In the stable group (Garden type Ⅰ, type Ⅱ, and abduction compression type) of 121 cases who underwent cannulated screw internal fixation, there were 28 males and 93 females with a mean age of (77.6±8.1) years, and 20 cases of type Ⅰ, 101 cases of type Ⅱ, and 34 cases of abduction compression type by the Garden classification. In the unstable group (Garden type Ⅲ, type Ⅳ, and type Ⅱ with a posterior tilt angle >20°) of 421 cases who underwent arthroplasty, there were 130 males and 291 females with a mean age of (78.7 ± 6.9) years, and 14 cases of type Ⅱ, 403 cases of type Ⅲ, and 4 cases of type Ⅳ by the Garden classification. The postoperative mortality, reoperation rate, and mobility at the last follow-up were compared between the 2 groups.Results:There were no statistically significant differences in the baseline characteristics, except for serum albumin concentration and peripheral white blood cell count at admission, between the 2 groups, indicating comparability ( P>0.05). The hospital stay in the stable group [5.0 (4.0, 6.0)d] was significantly shorter than that in the unstable group [6.0 (5.0, 8.0)d], and the follow-up time for the stable group [54.4 (49.3, 58.7) months] significantly longer than that for the unstable group [52.2 (46.0, 59.3) months] ( P<0.05). A total of 158 patients (45 cases in the stable group and 113 cases in the unstable group) were lost to the last follow-up. At the last follow-up, the mortality in the stable group (18.4%, 14/76) was significantly lower than that in the unstable group (31.5%, 97/308), the reoperation rate in the former (15.8%, 12/76) significantly higher than that in the latter (3.6%, 11/308), and the capability of daily activities in the former (by the fracture mobility scoring: level 1 in 35 cases, level 2 in 13 cases, level 3 in 3 cases, level 4 in 2 cases, and level 5 in 1 case) significantly better than that in the latter (level 1 in 99 cases, level 2 in 47 cases, level 3 in 24 cases, level 4 in 22 cases, and level 5 in 5 cases) (all P<0.05). Conclusion:Compared with the arthroplasty for unstable femoral neck fractures, cannulated screw internal fixation for stable femoral neck fractures leads to a lower long-term mortality and a better capability of daily activities, but a significantly higher reoperation rate.
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Objective To observe the effect of deep muscle relaxation by rocuronium on oxygenation of normal frequency jet ventilation during rigid bronchoscopy procedures.Methods From December 2021 to February 2023,60 patients with central airway diseases underwent rigid bronchoscopy under general anesthesia,they were randomly divided into deep muscle relaxation group(group D,n = 30)and moderate muscle relaxation group(group M,n = 30).After induction of general anesthesia,the patients were inserted rigid bronchoscopy for jet ventilation,muscle relaxant was rocuronium in induction and maintenance.Train of four(TOF)stimulation was used to measure the depth of muscle relaxation in group M,and the TOF count was maintained at 1 or 2;In Group D,the depth of muscle relaxation was measured by post tetanic count(PTC),and the PTC was maintained at 1 or 2.After operation,Sugammadex antagonized residual muscle relaxation.Results There was no significant difference in operation time,recovery time and extubation time between the two groups(P＞0.05).The total operation time,operation pause time and anesthesia time in group D were shorter than those in group M,the dosage of muscle relaxant in group D was more than that in group M,the incidence of hypoxemia during surgery in group D was less than that in group M,the operators'satisfaction in group D was better than that in group M,and the arterial partial pressure of oxygen(PaO2)in group D was higher than that in group M at 15 min(T1)and 30 min(T2)after jet ventilation,the number of patients with postoperative sore throat in group D was less than that in group M,the differences were statistically significant(P＜0.05).Conclusion The application of deep muscle relaxation by rocuronium in rigid bronchoscopy procedures can improve the oxygenation effect of normal frequency jet ventilation,reduce the operation pause time and anesthesia time,improve the satisfaction of operators,antagonizing residual muscle relaxation with Sugammadex can relieve the worry of delayed recovery from deep muscle relaxation.
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The giant roundworm Ascaris infects pigs and people worldwide and causes serious diseases. The taxonomic relationship between Ascaris suum and Ascaris lumbricoides is still unclear. The purpose of the present study was to investigate the genetic diversity and population genetic structure of 258 Ascaris specimens from humans and pigs from 6 sympatric regions in Ascaris-endemic regions of China using existing simple sequence repeat data. The microsatellite markers showed a high level of allelic richness and genetic diversity in the samples. Each of the populations demonstrated excess homozygosity (Ho 0). According to a genetic differentiation index (Fst=0.0593), there was a high-level of gene flow in the Ascaris populations. A hierarchical analysis on molecular variance revealed remarkably high levels of variation within the populations. Moreover, a population structure analysis indicated that Ascaris populations fell into 3 main genetic clusters, interpreted as A. suum, A. lumbricoides, and a hybrid of the species. We speculated that humans can be infected with A. lumbricoides, A. suum, and the hybrid, but pigs were mainly infected with A. suum. This study provided new information on the genetic diversity and population structure of Ascaris from human and pigs in China, which can be used for designing Ascaris control strategies. It can also be beneficial to understand the introgression of host affiliation.
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Humans , Ascaris lumbricoides , Ascaris suum , Ascaris , China , Gene Flow , Genetic Structures , Genetic Variation , Microsatellite Repeats , SwineABSTRACT
Objective:To investigate the effect of roxithromycin on airway inflammation in chronic obstructive pulmonary disease ( COPD) patients at stable phase to provide evidence for the clinical diagnosis and treatment .Methods:Totally 46 cases of outpatients with stable COPD were divided into the observation group and the control group .The control group received the conventional treatment , while the observation group was treated with roxithromycin capsules 150mg.d-1 additionally, and the treatment course was 10 months. The sputum, serum cytokines γ-IFN, IL-8 and TNF-αlevels, sputum leukocyte , neutrophil count and adverse reactions were observed and compared between the groups .Results:After the 5-month treatment, the levels of γ-IFN, IL-8 and TNF-αcytokines in serum and sputum in the observation group were significantly lower than those before the treatment (P<0.05) and in the control group (P<0.05).After the 10-month treatment, the above indices in the observation were further decreased when compared with those after the 5-month treatment (P<0.05), which were notably lower than those in the control group (P<0.05).There was only one case of ad-verse drug reactions in the observation group , and the patient was out of the study .Conclusion:Long-term use of roxithromycin at low dose can reduce cytokines in serum and sputum and inflammatory cell count in sputum in stable COPD patients , which exhibits the effect on airway inflammation to some extent .
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ObjectiveTo evaluate the value of serum galactomannan platelia aspergillus kit in the diagnosis and treatment of invasive fungal infection(IFI) patients. MethodsA total of 178 serum samples from 74 high risk patients were collected. ELISA assay was used to detect the level of GM antigen. Refer to domestic IFI diagnostic criteria, 16 patients include the proven cases and probable cases were defined as study group, while 29 patients of improbable cases defined as control group. Fourflod table was founded,by which the sensitivity,specificity,positive predictive value, negative predictive value of this GM test were calculated. Meanwhile, a total of 53 patients received antifungal therapy which divided into GM-positive group(21 patients with I≥0. 5) and GM-negative group(32 patients with I ＜0. 5). The therapeutic effect comparison of two groups was made according to curative effect criterion. ResultsAccording to the certainty level of IFI diagnosis, 1,9,10 and 4 patients were identified as GM positive in proven, probable,possible and improbable IFI groups respectively. The prevalence of GM in these 4 groups was 50％ ,64％ ,34％ and 14％ ,respectively. The sensitivity and specificity of galactomannan ELISA assay were 63％ ,86％ respectively. The positive and negative predictive values were 71％ and 81％ respectively. The diagnose accordance rate was 78％, the Younden index was 0. 49. The efficacy of fluconazole in GM-positive patients was significant lower than in GMnegative patients( x2 =4. 95 ,P ＜0. 05) ,while The efficacy of non-fluconazole drug was superior to that in GM-negative patients( x2 =4. 88,P ＜ 0. 05). After antifungal therapy, the GM value of GM-positive patients decreased significantly( t =2. 13 ,P ＜0. 05). ConclusionThe galactomannan ELISA assay with high specificity, could be helpful in diagnosis and choicing effective anti-fungi drug in clinic.
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Objective To study the role of soluble intercellular adhesion molecule-1 ( sICAM-1 ) in the pathogenesis of adults bronchial asthma and analyze the relationship between the level of sICAM-1 and the severity of bronchial asthma.Methods Serum levels of sICAM-1 in 134 cases with different periods of bronchial asthma patients and healthy volunteers were measured by ELISA and pulmonary functions of acute asthma patients were determined by pulmonary function analyzer. Results Serum sICAM-1 levels in 63 cases of acute asthma patients were increased significantly when compared with those in remission asthma patients and healthy volunteers and its value was increased significantly with the exacerbation of asthma;A negatively correlation between FEV1％ of pulmonary function and serum sICAM-1 level in patients with acute asthma was found in this study. Conclusion sICAM-1 was one of the important adhesion molecules in the pathogenesis of bronchial asthma. It could be used as one indicator of disease severity and guide the drug application in clinic.
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Objective An experimental epidemiological study was designed to investigate possible relations of pig-derived Ascaris to the transmission of human ascariasis which might be caused by cross-infection between the pig and humans. Methods In Xinjian County, Jiangxi province, two adjacent villages, Laozhi and Panzhi, with similar baseline of ascariasis in pig and human populations were selected as the study sites with a one-year longitudinal epidemiological follow-up study. People in the two villages received mass chemotherapy. Pigs received mass chemotherapy only in Panzhi village and was twice repeated with two months interval, while pigs in Laozhi village were not treated at all. In the following year after treatment on humans, ascariasis among villagers was studied cross-sectionally five times with Kato-katz technique.Results No significant difference of the re-infection patterns of human ascariasis was found between the two villages in terms of prevalence and intensity during the following year in all the five surveys (χ2＜0.658,F＜1.658 and P＞0.1).Conclusion The results suggested that pig-derived Ascaris were mainly transmitted among pigs but had no important role on the transmission of human ascariasis. The results were in good accordance with the findings through a recent molecular genetic research on the local human-and pig-derived Ascaris worms. Possible confounding factors were discussed.
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Objective An experimental epidemiological study was designed to investigate possible relations of pig-derived Ascaris to the transmission of human ascariasis which might be caused by cross-infection between the pig and humans. Methods In Xinjian County, Jiangxi province, two adjacent villages, Laozhi and Panzhi, with similar baseline of ascariasis in pig and human populations were selected as the study sites with a one-year longitudinal epidemiological follow-up study. People in the two villages received mass chemotherapy. Pigs received mass chemotherapy only in Panzhi village and was twice repeated with two months interval, while pigs in Laozhi village were not treated at all. In the following year after treatment on humans, ascariasis among villagers was studied cross-sectionally five times with Kato-katz technique.Results No significant difference of the re-infection patterns of human ascariasis was found between the two villages in terms of prevalence and intensity during the following year in all the five surveys (χ2＜0.658,F＜1.658 and P＞0.1).Conclusion The results suggested that pig-derived Ascaris were mainly transmitted among pigs but had no important role on the transmission of human ascariasis. The results were in good accordance with the findings through a recent molecular genetic research on the local human-and pig-derived Ascaris worms. Possible confounding factors were discussed.
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Objective To induce the apoptosis of human alveolar epithelial cells(A\-\{549\}) by the extraction of the second stage larvae of Ascaris lumbricoides and investigate the extraction concentration and inducing time related to the apoptosis. \ Methods\ Following to the results of Microculture Tetrazolium Test (MTT), five concentrations of the extraction of the second stage larvae were chosen to induce the apoptosis of A\-\{549\} cells. Meanwhile, control groups without the inducement were set up. For each group, observation was made at five time points since the start of inducement, to assess the existence of apoptosis and percentage of cells showing characteristics of apoptosis. HE stain and diphenylamine reaction methods were used to assess the cell apoptosis. Agarose gel electrophoresis of DNA and flow cytometry were also employed to confirm the apoptosis for some groups. \{\ Results \ \}Observations indicated that the apoptosis ratio of A\-\{549\} cells induced by the extraction at different concentrations were significantly higher than that of the control cells (P
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There has been continued controversy on the taxonomy of Ascaris lumbricoides Linnaeus,1758 from humans and Ascaris suum Goeze,1782 from pigs.This article reviews a range of comparative studies related to host susceptibility,morphology,karyotype,immunology and biochemistry,as well as molecular genetics in recent years.
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This paper deals with the development of Paragonimus westermani (Kerbert, 1878) in mice inoculated with metacercariae or stunted adolescariae. In metacercaria-inoculated mice, all worms were stunted all the time, but when the stunted worms were orally transferred Into mice, some (8.4%) grew so fast that their rudimentory reproductive organs appeared and their length was over 3 times that of stunted worms 3 weeks post inoculation; while 91.6% of the recovered adolescariae were still stunted and morphologically similar to excysted metacercaiae. When the stunted worms were repeatedly transferred through mice by oral route 8.2-10.1% of the recovered worms developed quickly, while the remainder was still stunted (Table 1).After 3 transfers in mice, the stunted worms were still able to infect dogs orally and reach maturity (Table 2).On the basis of the study, it is postulated that cannibalism and preying among wild rats would enable P. westermani to be transferred among rodent paratenic hosts.