RESUMO
Objective:To compare the laboratory diagnostic methods of Mycoplasma pneumonia(MP) and evaluate its clinical value.Methods:A prospective study.Throat swabs and double sera of children with MP infection were collected from December 2016 to January 2017 in Shengjing Hospital Affiliated to China Medical University; throat swab samples of healthy children aged 3 to 5 in Chaoyang District, Beijing were collected from March to May 2017.Passive agglutination (PA) was used to detect the double serum.Taking the 4-fold increase or decrease of the specific antibody titer of the double serum as the gold standard, the receiver operating characteristic curve (ROC) was drawn, and the laboratory methods for detecting MP infection were compared and evaluated.Results:(1)A total of 93 children with MP infection were clinically diagnosed, including 42 males (45.2%) and 51 females (54.8%), with an average age of 5.5 years.Sixty cases (64.5%) of MP infection were diagnosed.There were 349 healthy children, 198 males and 151 females, with an average age of 4.3 years.The positive rate of throat swab culture was 0.6% (2 cases), and the positive rate of fluorescent quantitative PCR(qPCR) was 18.9% (66 cases). (2) The culture specificity was the highest (100.0%) and the sensitivity was the lowest (65.0%). PA and enzyme linked immunosorbent assay (ELISA) were used to detect a single serum in the acute phase, the sensitivity was 71.7% and 86.5% respectively.ROC curve suggested that the current clinical diagnostic threshold MP specific antibody IgM ≥ 1∶160 was not the best diagnostic threshold.Molecular biological diagnostic methods were the most sensitive, RNA simultaneous and testing (SAT) was 85.0% and qPCR was 93.0%; while the specificity was low, 75.7% (SAT) and 63.6% (qPCR), respectively.(3) At the same time, MP nucleic acid (SAT, PCR) of throat swabs and a single serum (ELISA, PA) of children in acute phase were detected, the sensitivity was increased to 95.0%-100.0%, and the specificity was 63.6%-75.7%.Conclusions:Molecular biology is highly sensitive in diagnosing MP infection.It has asymptomatic infection or is carried after infection.Whether it needs treatment needs to be combined with clinical practice, when MP detection is positive.The detection of a single serum in the acute phase with a course of about 1 week has high sensitivity and is of reference value for the diagnosis of MP infection, but the diagnosis needs to be combined with clinical practice.The sensitivity and accuracy of detecting MP infection by single serological test combined with SAT in acute phase are higher than that by single application.
RESUMO
Objective To evaluate Kangli hollow screws with sliding compression locking plate system (KHS) in the treatment of femoral neck fractures.Methods From February 2015 to October 2016,47 femoral neck fractures were treated at Department of Orthopaedics,Wuhan Fourth Hospital,Wuhan Puai Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology.They were 30 men and 17 women,aged from 26 to 68 years (average,43.5 years).According to the Pauwels classification,there were 24 cases of type Ⅰ,16 cases of type Ⅱ and 7 cases of type Ⅲ;according to the Garden classification,there were 23 cases of type Ⅱ,19 cases of type Ⅲ and 5 cases of type Ⅳ.All the fractures were immobilized with KHS after closed reduction or open reduction (3 cases).The fracture union time,femoral head necrosis and femoral neck shortening were observed after operation.The Harris scores were used to evaluate therapeutic effects at the final follow-up.Results All the patients were followed up for an average of 29.7 months (from 22 to 39 months).All the fractures obtained solid bony union after 9 to 15 weeks (average,12.2 weeks).Femoral head necrosis occurred in one case (2.1％).Femoral neck shortening ≤ 5 mm was observed in 6 cases and femoral neck shortening ＞ 5 mm ＜ 10 mm in 2 cases,giving a total shortening rate of 17.0％.The Harris scores at the final follow-up ranged from 77 to 98 points,averaging 92.2 points.There were 42 excellent,3 good and 2 moderate cases,giving an excellent and good rate of 95.7％.Conclusion KHS can lead to excellent therapeutic effects in the treatment of femoral neck fractures.
RESUMO
Objective@#To evaluate Kangli hollow screws with sliding compression locking plate system (KHS) in the treatment of femoral neck fractures.@*Methods@#From February 2015 to October 2016, 47 femoral neck fractures were treated at Department of Orthopaedics, Wuhan Fourth Hospital, Wuhan Puai Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology. They were 30 men and 17 women, aged from 26 to 68 years (average, 43.5 years). According to the Pauwels classification, there were 24 cases of type Ⅰ, 16 cases of type Ⅱ and 7 cases of type Ⅲ; according to the Garden classification, there were 23 cases of type Ⅱ, 19 cases of type Ⅲ and 5 cases of type Ⅳ. All the fractures were immobilized with KHS after closed reduction or open reduction (3 cases). The fracture union time, femoral head necrosis and femoral neck shortening were observed after operation. The Harris scores were used to evaluate therapeutic effects at the final follow-up.@*Results@#All the patients were followed up for an average of 29.7 months (from 22 to 39 months). All the fractures obtained solid bony union after 9 to 15 weeks(average, 12.2 weeks). Femoral head necrosis occurred in one case (2.1%). Femoral neck shortening ≤ 5 mm was observed in 6 cases and femoral neck shortening >5 mm <10 mm in 2 cases, giving a total shortening rate of 17.0%. The Harris scores at the final follow-up ranged from 77 to 98 points, averaging 92.2 points. There were 42 excellent, 3 good and 2 moderate cases, giving an excellent and good rate of 95.7%.@*Conclusion@#KHS can lead to excellent therapeutic effects in the treatment of femoral neck fractures.
RESUMO
Objective To investigate the antibacterial effect of Fusidic acid on Mycoplasma pneumoniae and antibiotic resistant Mycoplasma pneumoniae in vitro.Methods Twenty-eight clinical strains of Mycoplasma pneumoniae isolated from patients with respiratory tract infection at Beijing Friendship Hospital Affiliated to the Capital University of Medical Sciences from January to December 2016 and 2 Mycoplasma pneumoniae reference strains were enrolled.The minimum inhibitory concentration (MIC) of Fusidic acid and Azithromycin were determined by using micro-dilution ration method.The chessboard method was used to check the antibacterial effect of combination between Fusidic acid and Azithromycin.The antibacterial activity of the Fusidic acid was evaluated by measuring the antibacterial rate of different concentrations.Results One isolate showed no mutation in 23SrRNA,26 isolates had one point mutation in loci 2063 and 1 isolate had one point mutation in loci 2064 among the 28 clinical isolates.The findings by micro-dilution method results showed that the MIC values of all the clinical isolates with mutations associated with macrolide resistance to Azithromycin were ＞ 1.000 0 mg/L,and the MIC values of all the clinical isolates with no mutations to azithromycin were ＜ 0.500 0 mg/L.The findings by micro-dilution method results showed that the MIC value of Fusidic acid for Mycoplasma pneumonia and drug resistance Mycoplasma pneumoniae was 1.000 0 mg/L.The Fractional Inhibitory Concentration index of Fusidic acid and Azithromycin combination was ≤0.500 0 mg/L.When the concentration of the Fusidic acid was lower than or equal to 32 MIC,the antibacterial effect of Fusidic acid against Mycoplasma pneumoniae increased with its higher concentration.When the concentration of the Fusidic acid was lower than or equal to 8 MIC,the longer the strain was exposed to the drug,the stronger antibacterial effect was against Mycoplasma pneumoniae.Conclusion If the treatment of Mycoplasma pneumoniae infection is not effective or the infection of patient is combined with bacteria,the application or combination of Fusidic acid may inhibit pathogenic bacteria effectively.Of course,how to use Fusidic acid in clinical treatment needs further study and discussion.
RESUMO
Objective To compare the biomechanical performance of Kangli hollow screws with sliding compression locking plate system (KHS) and conventional cannulated lag screws for fixation of type Pauwels Ⅲ femoral neck fracture.Methods 7 cadaveric femurs were selected,vertical fractures (Pauwels Ⅲ fracture,at 70° to the horizontal) were artificially conducted in these cadaveric proximal femurs by an orthopaedic surgeon and fixed by KHS screws with plate system or conventional cannulated lag screws.Samples were positioned at 75° of the femoral shaft to the horizontal,embedded in the mould and fixed in the experimental console.Optical sensors were set at the femoral neck around the osteotomy line.Then the loading were input in the vertical,horizontal lateral direction and rotating direction around the femoral neck axis,the maximal and minimal values between the fractured fragments and the corresponding values of the loading were recorded.The values of stiffness in three directions were calculated and compared.The CT data of the left femur of a 25 year-old healthy male volunteer was input into the co(m)esponding software and vertical femoral neck fracture model was generated.Two finite element analysis models were obtained after the fracture being fixed using these two different implants,and the Von Mises stress distribution on the femur,implants and the interface between the fractured fragments and the relative motion between the fractured fragments were compared.Results In the vertical,horizontal lateral direction and rotating direction around the femoral neck axis,the stiffness of the KHS were 3 904±1 148 N/mm,4 324±1 234 N/mm and 11.45±4.95 N · m/° respectively,higher than those of the CSs method with the values of 3 020±1 150 N/mm,3 020± 854 N/mm.and 6.53±4.83 N· m/° respectively.The differences between the two groups were statistically significant (t=2.7194,4.7694 and 2.9424;P=0.0347,0.0050 and 0.0423).In the finite element analysis test,the maximal Von Mises stress values distributing on the femur and the screws in the KHS group were 40.1 MPa and 126.4 MPa,and those in the CSs group were 98.1 MPa and 145.5 MPa respectively,and both values of the former were lower than the latter.But the Von Mises stress value on the interface between the fractured fragments in the KHS group was 14.37 MPa,which was much higher than that in the CSs groupwhich was 9.39 MPa.The gap at the fracture site of the CSs fixation model was dramatically larger than that of KHS fixation model.Conclusion The KHS screws and plate system could provide better immobilization effect for vertical femoral neck fracture compared to the cannulated lag screws.The risk of the screws failure was lower and the fracture union would be easier to obtained by the fixation of KHS screws with plate system.
RESUMO
Objective@#To obtain recombinant major surface glycoprotein(rMsg)of Pneumocystis jirovecii(Pj) and survey anti-Pj rMsg IgG and IgM antibodies using enzyme-linked immunosorbent assay (ELISA) among randomly selected sera from Beijing local children under 14 years of age.@*Methods@#ELISA method were established to detect anti-Pj rMsg IgG and IgM antibodies. We randomly selected sera of 201 cases who were under 14 years of age were screened.@*Results@#There were 78 cases in the age group of 1 day to 30 days, 33 cases in the group of 1 month to 12 months, and 90 cases in the group of 1 year to 14 years. The positive rates of anti-Pj rMsg IgG antibody in these three age groups were 10.3%(8/78), 21.2%(7/33), and 41.1%(37/90)respectively(χ2=21.190, P=0.000). The positive rates of anti-Pj rMsg IgM antibody were 6.4%(5/78), 39.4%(13/33), and 76.7%(69/90)respectively(χ2=84.260, P=0.000). The overall positive rates of anti-Pj rMsg IgG and IgM antibodies were 25.9%(52/201)and 43.3%(87/201)respectively(χ2=53.463, P=0.000). Among these, simultaneously IgG positive IgM positive, IgG positive IgM negative, IgG negative IgM positive and IgG negative IgM negative rates were 22.4%(45/201), 3.5%(7/201), 20.9%(42/201), and 53.2%(107/201)respectively.@*Conclusions@#The overall serological response rate after Pj exposure, either anti-Pj IgG or IgM antibody positive, was as high as 46.8% in children under 14 years of age in Beijing area. The positive rates of anti-rMsg IgG and IgM antibodies increased with age, with highest rate in age group of more than one years old.
RESUMO
BACKGROUND:Rat models of complete spinal cord transection are common models for neural tissue engineering. After transecting the spinal cord by the previous methods, gap length of broken end cannot keep relatively uniform, so we cannot objectively evaluate effects of various treatments or tissue engineering materials. OBJECTIVE:The spinal cord transection models were established by using double edged micro scissors, andthe feasibility of this new model was explored by comparing with the conventional method. METHODS: A total of 42 adult female Sprague-Dawley rats were divided randomly into group A (n=6), group B (n=18) and group C (n=18). Group A only received laminectomy. In the group B, the spinal cord was transected with a sharp-pointed knife. Knife point should touch anterior wal of spinal canal and sidewal bone surface. Complete spinal cord transection models were prepared by repeated cutting. In group C, complete spinal cord transection models were established by using self-made double edged micro scissors. RESULTS AND CONCLUSION: (1) At 1 week after model establishment, in the groups B and C, complete paralysis of the hind limbs was found, and BBB scores were similar. However, significant differences in the spacing of broken end were detected. (2) At 4 weeks after model establishment, hind limb functions could restore to different degrees in both groups, but no significant difference in BBB scores was found. (3) At 8 weeks after model establishment, significant differences in hindlimb motor function scores were detectable between both groups. Biotin glucosamine tracer display: In group B, a few labeled axon fibers were observed at the caudal side of the injured spinal cord. In group C, spinal cord was completely transected, and labeled axon fibers cannot be found at the caudal side. (4) Results suggested that the modeling method of self-made double edged micro scissors could effectively eliminate individual differences, contribute to quantitative analysis and comparative study of therapeutic effects.
RESUMO
[Objective]To compare the difference of percutaneous kyphoplasty in treating osteoporosis compression fractures using the Sky Bone Expander system and the Balloon Bone Expander system,and evaluate its clinical efficacy.[Method]From October 2005 to October 2007,19 patients of osteoporosis compression fractures with intact posterior vertebral body were performed.Nineteen patients were infated while 9 as group A were balloon group and 10 as group B were SKY group,fracture reduction and bone cement augmentation were applied.Preoperative and postoperative symptom levels,variables,complications were recorded and the vertebral height,Cobb′s angle and VAS score were measured and analyzed.[Result]Pain in all patients was alleviated or disappeared without syndrome,and the vertebral height,Cobb′s angle and VAS score of both groups were improved.The contrast between preoperative and postoperative showed obvious differences(P0.05).[Conclusion]Kyphoplasty can provide early relief of pain and improve the function as well as spinal alignment in treating osteoporotic compression fractures owing to recovering the verteberal height and Cobb′s angle of the vertebral body.Balloon inflated kyphoplasty can improve osteoporolic compression fractures as SKY.