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The elbow is more susceptible to motion loss than other joints after trauma,and elbow stiffness leads to functional impairment in the upper limb and interferes with daily activities.Open arthrolysis is the most common and classical treatment for post-traumatic elbow stiffness.In this paper,we review the treatment protocols like preoperative clinical evaluation,arthrolysis strategies and postoperative rehabilitation program for post-traumatic elbow stiffness,discuss relevant issues and assess their prospects.
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Objective To analyze the distribution and antibiotic resistance of the microorganisms isolated from blood samples in the Cardiovascular Institute,Beijing Fuwai Hospital,for clinicians to improve antimicrobial therapy.Methods Blood samples were cultured and bacterial isolates were identified and tested for their susceptibility to antimicrobial agents.Results A total of 2 017 (8.3％) strains of microorganisms were isolated from 24 348 blood samples.Finally,1 009 nonduplicate strains were analyzed,including gram positive cocci (n=574,56.9％),gram negative bacilli (381,37.8％),and Candida species (54,5.4％).The top gram positive cocci were coagulase-negative Staphylococcus (31.8％),Streptococcus (11.0％),Staphylococcus aureus (5.5％),Enterococcus faecalis (4.0％),and Enterococcus faecium (1.5％).The top gram negative bacilli were Acinetobacter baumannii (6.7％),Pseudomonas aeruginosa (6.0％),Escherichia coli (5.7％),Klebsiella pneumoniae (4.3％),Stenotrophornonas maltophilia (3.5％),and Enterobacter cloacae (3.3％).Candida albicans was the most frequently isolated Candida species.Staphylococcus isolates were sensitive to linezolid,vancomycin,tigecycline,and quinupristin-dalfopristin.Enterococcusfaecalis were sensitive to linezolid,tigecycline,high level streptomycin,high level gentamicin,penicillin,ampicillin,and vancomycin.Enterococcus faecium were less sensitive than Enterococcus faecalis.All Enterococcus strains were sensitive to linezolid,tigecycline,high level streptomycin,high level gentamicin,and vancomycin.Gram negative bacilli were relatively sensitive to cefoperazone-sulbactam,piperacillin-tazobactam,cefepime,amikacin and carbapenems.A.baumannii and P.aeruginosa isolates showed lower susceptibility to carbapenems than E.coli,K.pneumoniae and E.cloacae.Conclusions The distribution of the pathogens isolated from blood samples was relatively stable in the past five years in our hospital.Gram positive cocci are more prevalent than gram negative bacilli in blood samples.Clinicians should select antimicrobial agents according to the distribution of pathogens and the antimicrobial resistance profile.
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Objective Rheumatoid arthritis (RA) is a systemic autoimmune disease, which mainly involves joints across the body, resulting in joint stiffness and loss of daily activity. Recent evidence suggests that numerous self-reacting T cells, including Th1 and Th17, infiltrate the synovium in RA patients, accompanied by functionally-compromised Treg. Iguratimod, a new small molecule with anti-inflammatory and immunomodulatory effects, has shown curative effects in animal models of arthritis. In this study, we aimed to test the clinical effects of Iguratimodˊs on RA patients and its role in immunoregulation. Methods We examined the clinical effects of iguratimod on RA patients in a random controlled clinical trials and analyzed its effects on Th1, Th17 and Treg as well as their associated cytokines and transcription factors by flow cytometry and real-time polymerase chain reaction (PCR). Then t-test, chi-square test and rank sum test were used to conduct statistical analysis. Results Our results revealed that iguratimod therapy provided significantly greater clinical benefit [ACR20, ACR50, ACR70 reached 50%, 20%, 15% respectively in iguratimod treatment group, Z=-2.216,P=0.027] than placebo group with the reduction of Th1 and Th17 but increment of Treg after iguratimod treatment [Th1: week 0 (26.5 ±8.0)%, week 24 (14.2 ±7.3)%, P<0.01; Th17:week 0 (1.7±0.7)%, week 24 (1.3±0.4)%, P<0.05;Treg:week 0 (6.8±1.6)%, week 24 (8.9±2.9)%, P<0.05], which was statistically significant. Conclusion Our results provide theoretical and clinical based evidence for the impact of iguratimod on immunomodulation of RA.
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Objective To explore the thyroid function changes of episodes period and remissions period in children with primary nephrotic syndrome (NS).Methods The urinary protein quantitation and serum albumin,total cholesterol,thyroid hormone level [total triiodothyronine (TT3),total thyroxine (TT4),free triiodothyronine (FT3),free thyroxine (FT4) and thyroid stimulating hormone (TSH)] of episodes period and remissions period in 15 children with primary NS were retrospectively analyzed.Results There were statistical differences in urinary protein quantitation and serum albumin,total cholesterol in children with NS between episodes period and remissions period (P ＜ 0.05).The TT3,TT4,FT3,FT4 in episodes period were significantly lower than those in remissions period [(0.6 ± 0.3) μ g/L vs.(1.3 ± 0.3) μ g/L,(40.0 ± 23.0)μ g/L vs.(68.0 ± 15.0) μ g/L,(1.6 ± 0.3) pmol/L vs.(3.3 ± 0.3) pmol/L,(8.6 ± 2.5) pmol/L vs.(12.2 ± 2.0) pmol/L],TSH was significantly higher than that in remissions period [(5.6 ± 2.1) mU/L vs.(2.5 ± 1.1) mU/L],there were statistical differences (P ＜ 0.05).Conclusions Thyroid function of episodes period in children with primary NS is decreased temporarily,associated with heavy proteinuria leads to thyroid hormone missing from urine.Detecting thyroid function plays an important role in estimating the state and guiding the treatment of primary NS.
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OBJECTIVE To investigate the pathogens and their drug-resistance in Fuwai Cardiovascular Hospital and provide antibiotics use suggestion for clinical treatment.METHODS The pathogens were identified by VITED 32 and analyzed by WHONET 5.4 RESULTS The pathogens mainly consisted of Gram-negative bacilli,which were highly sensitive to imipenem and meropenem except Pseudomonas aeruginosa;E.faecalis was much more sensitive to penicillin and gentamicin than E.faecium.Most coagulase-negative Staphylococcus(CNS) were resistant to oxacillin and showed low susceptibility rates to most antibiotics.No Gram-positive cooci were found to be resistant to vancomycin and teicoplanin.CONCLUSIONS To investigate the pathogens and their drug resistance is very important to prevent and control nosocomical infections.
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OBJECTIVE To investigate the pathogens in the early period after heart transplantation and analyze their drug-resistance.METHODS The pathogens in the early period after heart transplantation were identified and their drug-resistance was analyzed.RESULTS From all of the 121 pathogens,the rate of G-bacilli was 73.6%,the rate of G+ cocci was 17.4%and the rate of fungi was 9.1%;G-bacilli mainly consisted of Klebsiella pneumoniae,Enterobacter cloacae,Acinetobacter baumannii,Pseudomonas aeruginosa and Escherichia coli.G-bacilli showed higher sensitive rates to sulbactam/cefoperazone,cefepime,piperacillin/tazobactam and ceftazidime than to cefotaxime.All G-bacilli showed sensitive to imipenem except Pseudomonas aeruginosa.G+ cocci mainly consisted of negative coagulase Staphylococcus,Staphylococcus aureus and Enterococcus.Fungi mainly consisted of Candida,and they were sensitive to fluconazole,itraconazole and amphotericin B.CONCLUSIONS To observe the pathogens in the early period after heart transplantation and analyze their drug-resistance are important to control and prevent the infection efficiently for the heart transplantation recipients.
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OBJECTIVE To investigate the major pathogens and their antibiotics resistance in surgery wards in Fuwai Cardiovascular Hospital.METHODS The pathogens were classified and their antibiotics resistance was analyzed.RESULTS The pathogens mainly consisted of Gram-negative bacilli,which were sensitive to cefoperazone/sulbactam,pipercillin/tazobactam and amikacin with the sensitive rate of 62.7-97.6%.All Gram negative bacilli were sensitive to imipenem except Pseudomonas aeruginosa,with the sensitive rate of 95.2%~100%.In the Gram-positive bacteria,the susceptibility rates of Enterococcus faecium were lower than E.faecalis.Coagulase negative Staphylococcus and Staphylococcus aureus were mainly resistance to oxacillin and most other antibiotics,all Gram positive bacteria were sensitive to vancomycin.CONCLUSIONS To know the major pathogens and their susceptibility rates can prevent and control nosocomial infections effectively.