A pilot study of observing "docking" in patients with developmental dislocation of the hip after closed reduction by serial MRI / 中华骨科杂志

Objective:To utilize MRI and plain films to observe the changes of soft tissue structures in patients with developmental dysplasia of the hip (DDH) after closed reduction, and explore the concentric reduction rate, the "docking" rate and the femoral head necrosis rate after reduction.Methods:Retrospective analysis of unilateral completely dislocated DDH patients with closed reduction and spica casting in our hospital from October 2012 to July 2018. MRI was performed on the day of closed reduction and every 2-3 months after operation. Pelvic plain films were performed before operation and follow-up. The labro-chondral complex (LCC) of the hip was divided into 4 types on MRI images, and the reliability and repeatability of LCC classification were evaluated by intra-class correlation coefficient. Trend chi-square test or Fisher exact probability method was used to analyze the variation of thickening rate of ligamentum teres, transverse ligaments and pulvinar during MRI follow-up, and the difference of cartilaginous acetabular head index was evaluated by analysis of variance of repeated measurements or Mann-Whitney U test. The concentric reduction rate of the femoral head after performing closed reduction, the "docking" rate of the femoral headwhen the cast was changed for the last time were analyzed, and the necrosis rate of the femoral head were followed up for 18 months or more after reduction.Results:A total of 63 DDH patients (63 hips) with closed reduction were included. Intra-class correlation coefficient of LCC classification was 0.84 between observers (95%CI: 0.74-0.91) and 0.94 within observers (95%CI: 0.90-0.97) . Most LCC classifications were type 4 on the day of CR (93.7%, 59/63) , and return to normal (type 1 classifications) at the second follow-up (50.9%, 28/55). ligamentum teres, transverse ligaments and pulvinar were hypertrophic (94.5%-100%) on the day of CR, and decreased to 10.9%-12.7% at the second follow-up, which had statistically differences ( χ2=88.6; χ2=86.4; χ2=97.9, P<0.05). The cartilaginous acetabular head index was 68.1±12.1 on the day of CR, and increased to 84.4±7.0 at the second follow-up, which had statistically difference ( Z=-3.15, P=0.002). 58.7% femoral heads were "docking", 8.6% femoral head had necrosis. Conclusion:The abnormal soft tissue structures in the hip joint mostly recovered gradually after closed reduction, and 60% femoral heads could be docked, the short-term risk of the femoral head necrosis was low.

The role of frontal plane cardiac axis shift in the diagnosis of wide QRS tachycardia / 实用医学杂志

Objective To explore the value of axis shift between the baseline normal sinus rhythm (NSR) and WCT in diagnosis of wide QRS-complex tachycardia (WCT). Methods 390 surface ECGs of 186 patients with WCT were obtained from April 2012 to April 2018 at Ningbo Medical Center Lihuili Hospital at which the arrhythmia diagnosis was proven by intracardiac electrophysiological study. The axis shift between the baseline NSR and WCT was calculated by table lookup method. Then we analyzed the role of axis shift in diagnosis of WCT. Results Among the 186 patients with WCT, 147 (79.03％) were ventricular tachycardia (VT) , and 39 (20.97％) were supraventricual tachycardia (SVT) with conduction abnormalities. In the 95％ confidence interval, the axis shift showed an outstanding discrimination performance. The area under the ROC curve is 0.708 (0.579-0.817, P =0.007). Compared with left axis deviation, right axis deviation, the right axis deviation of LBBB morphology, the axis shift> 68 degree is more sensitive (53.06％) , and the specificity (91.43％) is also more desirable. Moreover, if the axis shift set> 130 degree, the specificity can reach 100％, and the sensitivity (12.24％) is equivalent to northwestern axis. Conclusion A significant axis shift between the baseline NRS and WCT can distinguish WCT accurately. Given the ease of grasping, it can probably be feasible to popularize as a routine diagnosis method for WCT in primary hospitals.

MRI and MRA in Detecting Wrist Triangular Fibrocartilage Tear：A Meta-analysis / 中国医学影像学杂志

Purpose Accurate diagnosis of triangular fibrocartilage (TFC) tear is very important for treatment. MRI is most used for diagnosing TFC tear. This paper aims to evaluate MRI and MR arthrography (MRA) for diagnosing TFC tear by meta-analysis. Materials and Methods The articles were searched in the databases such as Wanfang, VIP, CNKI, Cochrane Library, Medline, Embase and PubMed. The QUADAS items were used to evaluate the quality of the included studies. Heterogeneity of the included articles was tested. The pooled weighted sensitivity and specificity of MRI and MRA in diagnosing TFC tear were calculated, and the pooled receiver operation curve was drawn. Results Fifteen articles met the inclusion criteria, 2 were Chinese articles and 13 were English articles. The subjects and methods of the articles were different and existed heterogeneity. The sensitivity and specificity of MRI for diagnosing TFC tear were 0.66 (95% CI 0.61-0.71) and 0.75 (95% CI 0.69-0.81), and those of MRA were 0.80 (95% CI 0.73-0.87) and 0.86 (95% CI 0.74-0.93). The area under curve and Q* index of SROC of MRI were 0.8566 and 0.7875, respectively. The area under curve and Q* index of SROC of MRA were 0.9123 and 0.8446, respectively. Conclusion The accuracy of TFC tear avulsion for MRA are higher than for MRI, when there is unclear of TFC avulsion using MRI, MRA can be used for diagnosis.

Clinical observation and thinking of procedure for prolaps and hemofrhoids in treatment of mixed hemorrhoids combined with non-functional obstructed defecation syndromes / 中国医师进修杂志

Objective To observe the clinical effect of procedure for prolaps and hemofrhoids (PPH) in treatment of mixed hemorrhoids combined with non-functional obstructed defecation syndromes (ODS).Methods The clinical data of 50 patients with mixed hemorrhoids combined with non-functional ODS treated by PPH were retrospectively analysed.All these patients were followed up for 12 months,the treatment outcome was observed.Results Eleven cases were basic cured,apparently effective in 12 cases,and effective in 12 cases,invalid in 15 cases,the total effective rate was 70％ (35/50),inefficacy patients were mainly combined with rectocele.None patients had serious complications such as death,anastomotic infection and pelvic sepsis.Conclusion PPH convenient operation,small trauma,for the treatment of mixed hemorrhoids combined with internal rectal prolapse is safe and effective,but the effective is poorer in treatment of mixed hemorrhoids combined with rectocele.

Causes and effects of medial meniscus extrusion in patients with knee osteoarthritis / 中华骨科杂志

Objective To investigate causes and effects of medial meniscus extrusion in patients with knee osteoarthritis.Methods A total of 120 patients diagnosed as knee osteoarthritis between January 2011 and March 2012 were enrolled in this study,including 60 patients with medial meniscal extrusion confirmed by MRI (extrusion group) and other 60 patients without medial meniscal extrusion (control group).The extrusion distance of medial meniscus and tibiofemoral angle were measured on MRI.The correlation between tibiofemoral angle and extrusion distance were analyzed.The incidences of genu varum,medial meniscus injury and cartilage lesion of medial tibiofemoral joint were compared between two groups.The effect of medial meniscal extrusion on meniscus injury and effect of genu varum on meniscal extrusion were analyzed.Results In extrusion group,the extrusion distances of medial menisci ranged from 3.76 to 11.6 mm (average,8.3±1.79 mm); all patients had genu varum,and the tibiofemoral angle ranged from 174°to 181°(average,179.0°±2.2°); the incidence of medial meniscus injury was 50.0％ (30/60) in the anterior horn,93.3％ (56/60) in the body,and 93.3％ (56/60) in the posterior horn; the incidence of medial meniscus tear in the root of the posterior horn was 23.3％ (14/60); the incidences of cartilage degeneration in medial tibial plateau and medial femoral condyle both were 100％ (60/60); a significant negative correlation was observed between dimension of tibiofemoral angle and extrusion distance of medial meniscus.In control group,the extrusion distances of medial menisci ranged from 0 to 2.61 mm (average,0.57±0.80 mm); four patients had genu varum,and the tibiofemoral angle in all patients was 180°; the incidence of medial meniscus injury was 0 in the anterior horn,16.7％ (10/60) in the body,and 70.0％ (42/60) in the posterior horn; no medial meniscus tear was found in the root of the posterior horn; the incidence of cartilage degeneration was 26.7％(16/60) in medial tibial plateau and 30.0％ (18/60) in medial femoral condyle.The odd ratio of meniscus injury and the number of genu varum (extrusion group/control group) was 6.0 and 15.0,respectively.Compared with the control group,the incidences and severities of medial meniscus injury and cartilage lesion of medial tibiofemoral joint were higher in extrusion group.Conclusion Genu varum may be one cause of medial meniscal extrusion.Medial meniscal extrusion increases incidence of medial meniscus injury and has a significant influence on generation and development of osteoarthritis in medial tibiofemoral joint.

Application of heuristic teaching in medical psychology teaching / 中华医学教育探索杂志

Objective To investigate the teaching effect of heuristic teaching in medical psychology teaching.Methods Totally 104 students (2010 grade higher vocational nursing class) were divided into experiment group (n=52) and control group (n=52).Heuristic teaching model and conventional teaching model were applied respectively.t test was used to compare the final exam scores of two groups; self-made evaluation sheet was used to evaluate the teaching effect and x2 test was employed to compare the results between two groups,with P＜0.05 standing for statistical significance.Results Final exam scores of experiment group (87.48 ± 3.18) was better than control group (81.43 ± 4.89) (P=0.016).Teaching evaluation was better in experiment group than in control group.Conclusions Heuristic teaching is helpful in improving students' study enthusiasm and training their scientific thinking.

Inhibition of glucoraphenin enzymolysis in Raphani Semen by processing / 中国中药杂志

<p><b>OBJECTIVE</b>To explore material basis of the pharmacological differences between the roasting and pro-roasting Raphani Semen.</p><p><b>METHOD</b>The two new sulfur-containing compounds (A209 and B221) were found changed after processing in the water decoction. The common precursor-C3 of A209 and B211 and the precursor of C3 were seperated and purified. Their transforming relationship was proved.</p><p><b>RESULT</b>The result showed that glucosinolates could decompose into sulforaphane and transform into A209 and B221 further in the boiling process.</p><p><b>CONCLUSION</b>This study provides some experimental evidences for revealing the mechanism of Raphani Semen processing.</p>

Detection of urine neural thread protein for diagnosis of Alzheimer disease and its clinical significance / 中华检验医学杂志

Objective To develop urine AD7C-NTP diagnostic kit,analyze and evaluate its application value on AD.Methods Immunogenicity AD7C-NTP peptide fragments had synthesized by solidphase methods.The animals immunized to prepare antibodies.After matching screening.mouse antibody was uesed as coating antibody.biotin-labeled rabbit antibody wag used as testing antibody,and horseradish peroxidase was labeied with avidin.The urine AD7C-NTP ELISA detective method was established.The AD7C-NTP levels in morning urine samples of 121 AD patients and 118 age-matched controls were collected.Results AD7C-NTP antibodies were identified.Mouse anti-AD7C-NTP antibody titer in ELISAwas 1:8 000,and rabbit anti-AD7C-NTP antibody titer in ELISA was 1:32 000:WB was uesd to detect human brain specimens and there was a single band with molecular weight of 41 000.The lowst detection limit of ELISA methodology was 0.5μg/L The linear range was 0-10μg/L,normal reference value ≤1.5μg/J,the average recovery rate was 100.2%.The intra and inter of CV were 3.8%,4.5%,7.6%,6.8% respectively.The AD7C-NTP levels[2.25(0.43-8.62)μg/L]of urine in AD group was higher than those in contorl group[0.82(0.47-2.77)μg/L,P<0.01].The positive rates in AD group and control group were 89.3% and 15.3% respectively.The sensitivity Was 89.3%and specificity was 84.7%.Conclusions The animals are immunized with the self-designed synthetic peptide fragment to prepare AD7C-NTP antibodies successfully.The established ELISA method for detection of urine AD7C-NTP with high sensitivity,and precision can be used as an assistant examination in clinical diagnosis of AD.

Clinical Significance of Measurment of D-Dimer and High Sensitive C-Reactive Protein in Serum for Acute Cerebral Infarction / 中国康复理论与实践

@#Objective To explore the relationship of D-Dimer and high sensitive C-reactive protein in serum in acute cerebral infarction. Methods 64 patients with acute cerebral infarction were measured with the D-Dimer and Hs-CRP and compared with that of 50 healthy subjects as the controls. Their scores of National Institutes of Health Stroke Scale (NIHSS) were recorded and the correlation with the D-Dimer and Hs-CRP level was analyzed. Results Compared with those in controls, the levels of D-Dimer and Hs-CRP in patients with acute cerebral infarction were significantly higher (P<0.05), and those in patients with large infarction area were significantly higher than those in patients with small infarction area (P<0.01). The levels of D-Dimer and Hs-CRP uncorrelated with the scores of NIHSS.Conclusion The D-Dimer and Hs-CRP level is helpful to assess the acute cerebral infarction.

Comparative studies on the proteomics of Rifampin-dependent and-resistant strains of Mycobacterium tuberculosis / 解放军医学杂志

Objective To analyze the dielectrophoresis patterns of the proteome of the Rifampin-dependent and-resistant stains of Mycobacterium tuberculosis,to search and identify the differently expressed proteins,and to provide the proteomic basis for researching the mechanism of anti-tuberculosis drug dependence of M.tuberculosis.Methods The whole somatic proteins were extracted from two strains of M.tuberculosis.The first dimensional ampholine electrophoresis was performed on immobilized pH gradient(IPG) rod gels(pH 4-7).Then the proteins on IPG strips were separated using SDS-PAGE.The stained gels were scanned with image scanner and the images were analyzed by Imagemaster 2D software.The differentially expressed proteins were detected by matrix-assisted laser desorption/ionization time of flight mass spectrometry(MALDI-TOF-MS).Results Seven hundred and fifty-three spots were detected in Rifampin-dependent strain of M.tuberculosis,while 584 spots were detected in Rifampin-resistant strain,including 404 match spots(the match rate: 61.5%).As to the expression in Rifampin-dependent strain,7 spots significantly up-regulated and 35 spots down-regulated,6 spots were absent in expression,and 5 spots expressed separately,most of the spots were small molecular proteins.Ten spots were selected to run MS analysis.Nine spots were identified as representing 7 proteins.Conclusion The Rifampin-dependent strain of M.tuberculosis is characterized by a rapid and vigorous growth mainly by means of the differential expression of enzymes related to energy metabolism and fatty acid biosynthesis.

Application of multiplex PCR in rapid identification of Mycobacterium tuberculosis and non-tuberculosis Mycobacteria / 解放军医学杂志

Objective To investigate the feasibility of multiplex PCR for rapid identification of Mycobacterium tuberculosis and non-tuberculosis Mycobacteria. Methods According to MTP40 gene sequence of Mycobacterium tuberculosis, 32kD gene sequence of Mycobacterium and IS6110 insertion sequence gene sequence of Mycobacterium tuberculosis complex, three specific pairs of primers (PT1-PT2, MT1-MT2 and IS5-IS6) for Mycobacterium were designed, and the target DNA for MTP40, 32kD and IS6110 was 396bp, 506bp and 984bp, respectively. The genome of 92 Mycobacterium tuberculosis clinically isolated strains and 5 non-tuberculosis Mycobacteria clinical strains were amplified in the same system, and the results were compared with reference strains. Results Among 92 clinical strains of Mycobacterium tuberculosis, the DNA fragments of 396bp, 506bp and 984bp were found in 90 Mycobacterium tuberculosis clinical strains, as well as in the reference strain H37Rv; the sensitivity of multiplex PCR for Mycobacterium tuberculosis was 97.8%, and the specificity was 100.0%. The DNA fragments of 506bp were all found in 5 non-tuberculosis Mycobacteria clinical strains, the sensitivity and specificity for non-tuberculosis Mycobacterium were both 100.0%. Conclusion The multiplex PCR is a rapid, sensitive and specific method for identification of Mycobacterium tuberculosis and non-tuberculosis Mycobacteria, and it may provide an effective way for clinical diagnosis of Mycobacterium tuberculosis and non-tuberculosis Mycobacteria, therefore useful in clinical application.

High glucose changes the expression of GRP78 in COX-2 dependent manner in HUVECs / 中国病理生理杂志

AIM:To investigate the effect of high glucose on the expression of an endoplasmic reticulum stress marker glucose-regulated protein 78(GRP78),and explore its underlying mechanism.METHODS:(1) Human umbilical vein endothelial cells(HUVECs) were exposed to normal glucose(5.5 mmol/L) and high glucose(30 mmol/L) for 24 h,36 h or 48 h.Cell viability was determined by MTT method.Cell apoptosis was detected by flow cytometry analysis.The expression of proteins was evaluated by Western blotting analysis.RESULTS:After treated with high glucose for 24-48 h,the expression of GRP78 increased early but decreased at 48 h of incubation,while cyclooxygenase-2(COX-2) expression increased in a time-dependent manner.COX-2 selective inhibitor nimesulide inhibited high glucose induced changes of GRP78 expression and also inhibited high glucose induced cell apoptosis.CONCLUSION:Prolonged high glucose exposure changes the expression of GRP78 in a COX-2 dependent manner in HUVECs.

Change and its clinical significance of blood concentrations of high sensitive C-reactive protein and D-Dimer in patient with acute cerebral Infarction / 临床神经病学杂志

Objective To explore the change and its significance of blood concentrations of high sensitive C-reactive protein(hs-CRP) and D-Dimer in patients with acute cerebral infarction caused by internal carotid artery.Methods The blood levels of D-Dimer and hs-CRP in 69 patients with acute cerebral infarction were measured,and compared with the normal controls.The relationships between the levels of hs-CRP and D-Dimer and NIHSS or the areas of infarction were analyzed.Results Compared with those in normal control group,the blood levels of D-Dimer and hs-CRP in patients with acute cerebral infarction increased significantly(all P

Puerarin protects high glucose-induced injury of vascular relaxation by activation of heme oxygenase-1 / 中国病理生理杂志

AIM:To investigate the effect of puerarin on acute high glucose-induced attenuation of ACh relaxation in isolated rat aortic rings, and to elucidate its underlying mechanism. METHODS: The thoracic aortic rings with endothelium of male Sprague-Dawley rats were mounted on a bath system. Isometric relaxation of aortic rings was measured. RESULTS: ① After incubation with high concentration of glucose (44 mmol/L), the vascular relaxation responses to ACh decreased. ② After coincubation with puerarin (10-10-10-8 mol/L) and high glucose, the high glucose-induced attenuation of ACh relaxation responses of artery was partly inhibited in a dose-dependent manner. ③ After incubation with puerarin for 2 h, the HO-1 activity of thoracic aorta increased. ZnPPIX (an inhibitor of heme oxygenase-1) abrogated the protective effect of puerarin. CONCLUSION: Puerarin prevents the acute high glucose-induced attenuation of endothelium-dependent relaxation in aortic rings. The mechanism might be involved in the activation of heme oxygenase-1.

Initial investigation on the isoniazid-dependence of M.tuberculosis / 解放军医学杂志

Objective To investigate the isoniazid-dependence of clinical isolated strains of M.tuberculosis.Methods The double-phase Kuang's agar medium was employed to isolate M.tuberculosis from the patient's sputum,and its drug-resistance and drug-dependence were determined.Results 184 clinical isolates of isoniazid-dependent M.tuberculosis were grouped as follows.Type A:the strains grew faster and more vigorous in drug tubes than in control tubes,and there were 12 strains(6.5%)which grew more colonies in high concentration tubes than in low concentration tubes;Type B:the strains grew faster and more vigorous in drug tubes than in control tubes,and there were 10 strains(5.4%)which grew more colonies in low concentration tubes than in high concentration tubes;Type C:the strains grew faster and more vigorous in low concentration tubes than in control tubes,and there were 15 strains(8.15%)which grew less colonies in high concentration tubes than in control tubes;Type D:the strains grew faster and more vigorous in high concentration tubes than in control tubes,and there were 4 strains(2.2%)which grew less colonies in low concentration tubes than in control tubes.The isoniazid-dependent strains covered 22.3%(41/184)of the total clinical isolates.Conclusion The isoniazid-dependent strains did exist in the clinical isolates of M.tuberculosis,and different features of dependence have been detected.