Diagnosis of multiple tuberculous muscle abscesses in a patient with systemic lupus erythematosus by metagenomic next-generation sequencing- a case report and literature review.

BACKGROUND: Early diagnosis of muscular tuberculosis (TB) without coexistent active skeletal involvement is often challenging because the disease is very rare and its clinical manifestation is nonspecific and misleading. To raise the awareness and emphasize early diagnosis of muscular TB, we present a case of multiple tuberculous muscle abscesses in a systemic lupus erythematosus (SLE) female, but without pulmonary tuberculosis (PTB), in order to increase awareness of and stress the need of early detection of muscular TB. CASE PRESENTATION: A 44-year-old woman with a 6-year history of SLE who had been treated with methylprednisolone for a long time complained of erythema on her trunk and extremities for five months, along with edema and myalgia for two months, and fever for one month. The patient was first misdiagnosed as SLE overlap dermatomyositis. However, an ultrasound-guided drainage of muscle abscesses revealed positive acid-fast staining combined with positive deoxyribonucleic acid fragment of Mycobacterium tuberculosis using metagenomic next-generation sequencing (mNGS). The patient was cured and released following standard anti-tuberculosis medication, local puncture drainage, and an intravitreal injection of streptomycin. Literature search found only 19 cases of tuberculous muscle abscesses occurring in the extremities reported from 1999 to 2023. CONCLUSIONS: Extrapulmonary TB with predominantly muscle involvement is rare and with no specific clinical presentation. Muscular tuberculosis may be disdiagnosed for dermatomyositis due to the high muscle enzyme levels, delaying diagnosis and treatment. mNGS technology is helpful in the early and rapid diagnosis of muscular TB. On the basis of traditional anti-tuberculosis treatment, an ultrasound-guided percutaneous puncture drainage and intracavitary injection of streptomycin for the treatment of tuberculous muscle abscess is easy to operate, safe and effective, which is worthy of clinical popularization and application.

Application of modified mini-clinical evaluation exercise (Mini-CEX) in probationary teaching of dermatology and venereology for eight-year program students / 中华医学教育探索杂志

Objective:To investigate the application of modified mini-clinical evaluation exercise (Mini-CEX) in the probationary teaching of dermatology and venereology for eight-year program students.Methods:From 2019 to 2020, a modified Mini-CEX was used to grade 58 eight-year program students at the Third Affiliated Hospital of Sun Yat-Sen University at the early, middle, and late stages of the probationary teaching of dermatology and venereology. The modifications included refining various evaluation indicators. Specifically, medical history collection involved dynamic changes in rashes, negative symptoms with differential diagnostic significance, past history/personal history/family history, and other important medical history; physical examination involved the specialized condition of rashes, systematic physical examination, and negative signs with differential diagnostic significance; humanistic care involved caring for patients, health education, and privacy protection; clinical judgment involved principles of diagnosis, differential diagnosis, and treatment; communication skills involved proficiency, prioritization, and body language; organizational effectiveness involved time allocation, patient compliance, and preparation work; overall performance involved calmness and fluency, neat writing, and preliminary clinical thinking. SPSS 20.0 was used to perform the t test. Results:Compared with the early stage of probation, the 58 eight-year program students improved their scores in clinical comprehensive ability evaluation and scores in each specific evaluation at the middle and late stages of probation ( P < 0.001). The dynamic changes in rashes and the specialized situation of rashes (identification and description of rashes) were specific to this discipline. Conclusion:The modified Mini-CEX is an objective, comprehensive, concise, and efficient assessment tool, which meets the needs of teaching reform and practice of dermatology and venereology.

Exploration and consideration on quantitative indicators of clinical final examination for standardized training of residents in dermatology / 中华医学教育探索杂志

Clinical final examination is an important link in the standardized training of residents in dermatology and quantification of evaluation indicators is one of the important parameters. In this study, the scores of clinical examinations of six candidates who participated in standardized training of residents in dermatology of Sun Yat-Sen University in June 2019 were taken as examples to explore the quantitative indicators of standardized and multi-station clinical final examinations. The indicators contained four stations and five links: skin pathological reading, skin biopsy, medical history collection and physical examination, medical record writing, and comprehensive questioning, which covered the main contents of the standardized training outline of residents in dermatology. Each evaluation indicator was refined and quantified. Finally, heuristic ideas were put forward, including a wider range of standardized and multi-station clinical examinations, introduction of new examination places, and utilization of information technology.

Clinical features and long-term outcomes of seizures associated with autoimmune encephalitis: A follow-up study in East China.

PURPOSE: To evaluate the clinical characteristics, treatment outcomes, prognosis and potential risk factors of patients in East China with seizure secondary to autoimmune encephalitis. METHODS: From February 2014 to June 2016, 113 patients diagnosed with autoimmune encephalitis in Huashan Hospital, Fudan University, were enrolled in our study. After at least two years of follow-up, we retrospectively analyzed the patients' clinical details, electroencephalograph performance, brain MRI findings, and the therapeutic outcome. Patients underwent clinical evaluation every 3 months. We compared the clinical characteristics and epileptic prognosis of autoimmune encephalitis per antibody type. The association of the epileptic prognosis and EEG abnormalities was evaluated. GTE (Grand Total EEG) Score was used to evaluate EEG abnormalities. Statistic methods included ANOVA, Bonferroni correction test. RESULTS: Treatment outcomes were assessabled in 103 patients (10 patients died or withdrew), including anti-GABABR encephalitis (11), anti-LGI1 encephalitis (16), anti-NMDAR encephalitis (73), Caspr2 antibody encephalitis (3). 83 patients had seizures, who underwent both immunotherapy and anti-epileptic drugs therapy. In terms of seizure type, 57 (68.7%) patients exhibited focal to bilateral tonic-clonic seizure (FBTCS), 51 (61.4%) patients exhibited focal-impaired awareness seizure (FIAS) or focal aware seizure (FAS). 18 (21.7%) patients developed to status epilepticus. 30 (36%) patients had multiple types of seizures. 39 (47%) patients had daily seizures. 80.7% (67/83) of patients with epilepsy had seizure remission. During the 24 months of follow-up, 11 (11%) patients had clinical relapses. GTE scores were significantly different between the group with seizure reduction < 75% and the group with seizure remission (p = 0.009). Imaging abnormalities existed in 53% of the patients in our cohort, but lacked specificity during the acute phase. CONCLUSION: Autoimmune encephalitis (AE) presents with large seizure burden with differing seizure semiology among different antibody types. Except for anti-GABAb receptor encephalitis, it may not be necessary for other AE types to apply long-term use of anti-epileptic drugs (AEDs). The GTE Score can be used to evaluate the EEG abnormalities and may be a predictor of seizure outcomes. MRI findings during the acute phase are non-specific. Long-term follow-up MRIs may be much more meaningful in evaluating prognosis.

Influence of square dance on the bone mineral density and osphyarthrosis and gonitis of postmenopausal women / 中国基层医药

Objective To investigate the effect of square dance on bone mineral density and osphyarthrosis and gonitis in postmenopausal women.Methods The postmenopausal women who danced on a square in the Second Hospital of Wuxi Mfiliated to Nanjing Medical University from January 2014 to January 2015 were selected and divided into different groups by age.Each group of subjects received the bone mineral density test of their lumbar vertebral body 1-3,so as to analyze the difference between the bone mineral density of each vertebral body and the corresponding age,as well as the relationship between the age and the bone mineral density.The bone mineral density of their lumbar vertebrae was measured one year later,and the incidence rates of osphyarthrosis and gonitis were observed,thus the influence of square dancing on bone mineral density and the incidence of osphyarthrosis and gonitis of postmenopausal women was studied.Results There was statistically significant difference in the bone mineral density for lumbar vertebrae of different age groups (F =74.213,P ＜ 0.01),among which the bone mineral density of lumbar vertebrae 1 ～ 3 in the age group of 45-60 showed a decreasing trend,with a medium negative correlation with age (r =0.978).After dancing on a square for 1 year,the bone mineral density of lumbar vertebral body 1-3 of subjects in the age group of 45-50,the age group of ＞ 50-55,the age group of ＞ 55 ～ 60,the age group of ＞ 60-65,the age group of ＞ 65-70 and the age group of over 70 were (149.51 ± 31.65) mg/cm3,(118.98 ± 34.55) mg/cm3,(103.56 ± 23.44) mg/cm3,(86.88 ± 34.21) mg/cm3,(69.89 ± 29.72) mg/cm3,(61.22 ± 34.21) mg/cm3,respectively,which increased slightly;the bone mineral density of the age group of 45-50,the age group of ＞ 50-55 and the age group of ＞55-60 increased significantly(F =8.012,3.567,4.774,all P ＜0.05).Square dancing had no significant effect on the incidence of osphyarthrosis and gonitis of postmenopausal women.Conclusion The age group of 45-60 is the most obvious period of bone mineral density decline for women.Square dancing can effectively improve the bone mineral density of postmenopausal women in this age group,but has no obvious effect on the improvement of the bone mineral density of women in other age groups.Square dancing has no effect on the incidence of osphyarthrosis and gonitis of postmenopausal women.

Probation teaching practice focusing on ward teaching for dermatology and venereology / 中华医学教育探索杂志

A total of 105 undergraduate students of the class 2014 majoring in clinical medicine in Sun Yat-Sen University received probation teaching in our department from October 2017 to May 2018,according to the syllabus of dermatology and venereology of clinical medicine.Senior teachers in our department were responsible for probation teaching,with the help of the independent wards in our department and probation teaching at the outpatient service.The teachers recorded the whole teaching process and evaluated the students' memory after probation.Through the teaching in wards and at the outpatient service,the students mastered the requirements in the syllabus of dermatology and venereology and achieved good results.

Changes in sensitivity of clinical strains of Ureaplasma urealyticum from the urogenital tract to nine kinds of antibiotics from 2007 to 2018 / 中华皮肤科杂志

Objective@#To analyze changes in sensitivity of clinical strains of Ureaplasma urealyticum (Uu) to 9 kinds of common antibiotics from 2017 to 2018.@*Methods@#The results of drug sensitivity testing of clinical Uu strains, which were isolated from 19 431 patients in Laboratory of Sexually Transmitted Disease (STD) , Department of Dermatology and Venereology, The Third Affiliated Hospital, Sun Yat-Sen University from 2007 to 2018, were analyzed retrospectively. Of the 19 431 patients, 6 076 were males, and 13 355 were females. Their age ranged from 15 to 68 years. The tested antibiotics included minocycline, doxycycline, erythromycin, azithromycin, clarithromycin, roxithromycin, ciprofloxacin, sparfloxacin and levofloxacin.@*Results@#Resistance rates of clinical Uu strains to minocycline and doxycycline gradually decreased from 10.08% and 10.42% in 2007 to 1.15% and 2.61% in 2018, respectively, while sensitivity rates to minocycline and doxycycline gradually increased from 85.88% and 87.56% in 2007 to 97.02% and 96.42% in 2018, respectively. The resistance rate and sensitivity rate of clinical Uu strains to erythromycin fluctuated greatly during 2014—2017, with the resistance rate fluctuating around 20%, and the sensitivity rate fluctuating around 50%. The resistance rate of clinical Uu strains to azithromycin dropped rapidly from 42.02% in 2007 to 8.39% in 2011, and then fluctuated slightly around 10%. However, the sensitivity rate to azithromycin increased from 8.40% in 2007 to 86.05% in2011, and remained above 80% from then on to 2018. During 2007—2018, Uu strains showed low resistance rates (10%-20%) and high sensitivity rates to clarithromycin (80%-90%) , and the resistance and sensitivity rates to roxithromycin were similar to those to erythromycin. Uu strains showed constantly high resistance to ciprofloxacin (more than 80% after 2013) and low sensitivity (persistently less than 10%) . The sensitivity rate of clinical Uu strains to sparfloxacin fluctuated around 40%, while the resistance rate was maintained below 10% after 2011. The resistance and sensitivity rates of Uu strains to levofloxacin were similar to sparfloxacin, but the sensitivity rate to levofloxacin was relatively lower, which had been maintained at about 30%.@*Conclusion@#From 2007 to 2018, clinical Uu strains maintained a relatively stable low resistance rate and a high sensitivity rate to minocycline, doxycycline and clarithromycin, a high resistance rate and low sensitivity rate to ciprofloxacin, and a low resistance rate and sensitivity rate to sparfloxacin and levofloxacin; a relatively stable low resistance rate and a high sensitivity rate to azithromycin were achieved only after 2011; the resistance rate and sensitivity rate to erythromycin and roxithromycin fluctuated greatly.

Influence of square dance on the bone mineral density and osphyarthrosis and gonitis of postmenopausal women / 中国基层医药

Objective@#To investigate the effect of square dance on bone mineral density and osphyarthrosis and gonitis in postmenopausal women.@*Methods@#The postmenopausal women who danced on a square in the Second Hospital of Wuxi Affiliated to Nanjing Medical University from January 2014 to January 2015 were selected and divided into different groups by age.Each group of subjects received the bone mineral density test of their lumbar vertebral body 1-3, so as to analyze the difference between the bone mineral density of each vertebral body and the corresponding age, as well as the relationship between the age and the bone mineral density.The bone mineral density of their lumbar vertebrae was measured one year later, and the incidence rates of osphyarthrosis and gonitis were observed, thus the influence of square dancing on bone mineral density and the incidence of osphyarthrosis and gonitis of postmenopausal women was studied.@*Results@#There was statistically significant difference in the bone mineral density for lumbar vertebrae of different age groups(F=74.213, P<0.01), among which the bone mineral density of lumbar vertebrae 1~3 in the age group of 45-60 showed a decreasing trend, with a medium negative correlation with age(r=0.978). After dancing on a square for 1 year, the bone mineral density of lumbar vertebral body 1-3 of subjects in the age group of 45-50, the age group of >50-55, the age group of >55~60, the age group of >60-65, the age group of >65-70 and the age group of over 70 were (149.51±31.65)mg/cm3, (118.98±34.55)mg/cm3, (103.56±23.44)mg/cm3, (86.88±34.21)mg/cm3, (69.89±29.72)mg/cm3, (61.22±34.21)mg/cm3, respectively, which increased slightly; the bone mineral density of the age group of 45-50, the age group of >50-55 and the age group of >55-60 increased significantly(F=8.012, 3.567, 4.774, all P<0.05). Square dancing had no significant effect on the incidence of osphyarthrosis and gonitis of postmenopausal women.@*Conclusion@#The age group of 45-60 is the most obvious period of bone mineral density decline for women.Square dancing can effectively improve the bone mineral density of postmenopausal women in this age group, but has no obvious effect on the improvement of the bone mineral density of women in other age groups.Square dancing has no effect on the incidence of osphyarthrosis and gonitis of postmenopausal women.

Implementation of standardized teaching rounds in clinical probation sessions of Dermatology and Venereology centered on rash / 中华医学教育探索杂志

Taking the course's characteristics and advantages into account, this study explores the systematic implementation of standardized teaching rounds in the clinical probation sessions of the Dermatology and Venereology course , and evaluates its effect by analyzing the cases of 125 medical students from grade 2015 of Sun Yat-sen University . The results showed that the implementation of standardized teaching rounds has positive effect on the course.

Changes in sensitivity of clinical strains of Ureaplasma urealyticum from the urogenital tract to nine kinds of antibiotics from 2007 to 2018 / 中华皮肤科杂志

Objective To analyze changes in sensitivity of clinical strains of Ureaplasma urealyticum (Uu) to 9 kinds of common antibiotics from 2017 to 2018.Methods The results of drug sensitivity testing of clinical Uu strains,which were isolated from 19 431 patients in Laboratory of Sexually Transmitted Disease (STD),Department of Dermatology and Venereology,The Third Affiliated Hospital,Sun Yat-Sen University from 2007 to 2018,were analyzed retrospectively.Of the 19 431 patients,6 076 were males,and 13 355 were females.Their age ranged from 15 to 68 years.The tested antibiotics included minocycline,doxycycline,erythromycin,azithromycin,clarithromycin,roxithromycin,ciprofloxacin,sparfloxacin and levofloxacin.Results Resistance rates of clinical Uu strains to minocycline and doxycycline gradually decreased from 10.08％ and 10.42％ in 2007 to 1.15％ and 2.61％ in 2018,respectively,while sensitivity rates to minocycline and doxycycline gradually increased from 85.88％ and 87.56％ in 2007 to 97.02％ and 96.42％ in 2018,respectively.The resistance rate and sensitivity rate of clinical Uu strains to erythromycin fluctuated greatly during 2014-2017,with the resistance rate fluctuating around 20％,and the sensitivity rate fluctuating around 50％.The resistance rate of clinical Uu strains to azithromycin dropped rapidly from 42.02％ in 2007 to 8.39％ in 2011,and then fluctuated slightly around 10％.However,the sensitivity rate to azithromycin increased from 8.40％ in 2007 to 86.05％ in 2011,and remained above 80％ from then on to 2018.During 2007-2018,Uu strains showed low resistance rates (10％-20％) and high sensitivity rates to clarithromycin (80％-90％),and the resistance and sensitivity rates to roxithromycin were similar to those to erythromycin.Uu strains showed constantly high resistance to ciprofloxacin (more than 80％ after 2013) and low sensitivity (persistently less than 10％).The sensitivity rate of clinical Uu strains to sparfloxacin fluctuated around 40％,while the resistance rate was maintained below 10％ after 2011.The resistance and sensitivity rates of Uu strains to levofloxacin were similar to sparfloxacin,but the sensitivity rate to levofloxacin was relatively lower,which had been maintained at about 30％.Conclusion From 2007 to 2018,clinical Uu strains maintained a relatively stable low resistance rate and a high sensitivity rate to minocycline,doxycycline and clarithromycin,a high resistance rate and low sensitivity rate to ciprofloxacin,and a low resistance rate and sensitivity rate to sparfloxacin and levofloxacin;a relatively stable low resistance rate and a high sensitivity rate to azithromycin were achieved only after 2011;the resistance rate and sensitivity rate to erythromycin and roxithromycin fluctuated greatly.

Bone cement dry prosthetic with internal fixation treat senile osteoporotic femoral fractures / 中华外科杂志

Objective@#To explore the treatment of senile osteoporotic femoral fractures after using internal fixation of bone cement dry prosthetic.@*Methods@#Twelve patients aged from 74 to 94 years with mean age of (84.0±2.5) years with internal fixation of bone cement dry prosthetic surgery who were treated at Department of Orthopaedics in Nanjing Medical University Affiliated Wuxi Second Hospital between May 2013 and May 2015 were retrospectively analyzed. There were 8 male and 4 female, 10 cases of tumble and 2 cases of traffic injury. The fracture types with AO type included 1 case of A1 type, 5 cases of A2 type, 3 cases of A3 type, 1 case of B1 type, 2 cases of B2 type. The steel plate internal fixation with bone cement dry prosthetic method was chosen to treat senile severe femoral fracture. Postoperative observation of postoperative pain assessment, hip joint activity and walking ability were evaluated. Paired simple t test and Wilcoxon rank sum test were used to compare the differences of pain score and the ability to walk.@*Results@#Twelve cases received an average of (16.0±3.6) months follow-up. The average hospitalization days are (9.0±1.4) days and average of intraoperative time was (68.0±10.6) minutes. Intraoperative blood loss compared to normal was (106.0±24.2) ml. Patients began walking load and activities in two weeks. The gait and joint activities gradually restored and there were no obvious deformity and no loose internal fixation. All of the patients didn′t have fracture shift with breaking plates or screws deformation and have no bone cement reaction. The walking ability was (4.1±0.9) points, the hip joint activities were 98.5°±7.7° and pain scores were 1.22±0.58 by Holden grading standards. The differences of walking ability (Z=-3.126, P<0.05) and pain scores (t=23.047, P<0.001) between pre- and post-operative were statistically significant. One patient had contralateral hip pain, 2 patients had lateral thigh pain, 10 patients returned to preoperative level of activity. Postoperative function recovered satisfactorily, there were statistically differences.@*Conclusion@#The treatment of severe osteoporosis fractures by internal fixation with bone cement dry prosthetic is a new and effective method, making patients less pain, improving joint function and walking ability.

Rosai-Dorfman Disease with Massive Cutaneous Nodule on the Shoulder and Back

Rosai-Dorfman disease is a rare, idiopathic, benign, and self-limiting histiocytic proliferative disorder. A 26-year-old man presented with a single massive cutaneous nodule (reaching 30 cm in diameter) on the left shoulder and back for 15 months. The routine hematological and biochemical tests were normal. Magnetic resonance scanning showed the lesion involved the skin, subcutaneous tissue, and subjacent muscle group, accompanied by obvious lymph node enlargement in the left part of the neck, supraclavicular fossa, and axillary fossa. The histopathology of the left cervical lymph node revealed diffuse effacement of the normal nodal architecture, with patchy chronic inflammatory cell infiltrates comprising lymphocytes and sheets of histiocytes. Some histiocytes contained lymphocytes within their pale cytoplasm. Many multinucleated giant cells were found; however, caseating granulomas were not seen. The skin and muscle biopsy specimen obtained from the back revealed infiltrating lymphocytes and histiocytes diffusely distributed in the dermis, subcutaneous tissue, and crevices of the muscle fibers. The phenomenon of emperipolesis and the presence of multinucleated giant cells were also seen. Immunohistochemical staining revealed that the histiocytes were positive for S-100 protein and CD68 but negative for CD1a. Immunophenotyping of the infiltrating lymphocytes indicated positive reactions to CD3, CD45RO, CD5, CD7, CD4, CD8 (partly), CD79a, CD20 (partly), and Ki-67 (<1%). The final diagnosis was Rosai-Dorfman disease. Owing to the extensive and deep involvement of the subcutaneous tissue and muscles, the patient did not undergo surgery to excise the massive skin nodule. The lesion showed no obvious change at the 12-month follow-up.

Clinical and electroencephalographic manifestations of Hashimoto's encephalopathy / 中华全科医师杂志

Clinically rare with an acute or subacute onset,Hashimoto's encephalopathy (HE) is characterized as autoimmune encephalopathy with elevated anti-thyroid autoantibodies.If timely diagnosed and treated,its prognosis is often fair.Four HE cases admitted from January 2012 to June 2014 were analyzed with a literature review.HE 4 cases had a significantly higher level of thyroperoxidase (TPO) while the lowest increase over four folds.There were cognitive decline,memory loss and even coma.And 50％ had abnormal electroencephalogram (EEG) consistent with radiographic lesions.In short,EEG may aid an early diagnosis of HE.

Percutaneous closed reduction locking compression plate, percutaneous closed reduction interlocking intramedullary nail and open reduction plate in the treatment of tibial fracture:comparison of biostability / 中国组织工程研究

BACKGROUND:The distal tibia shaft fracture is prone to be comminuted after trauma due to the absence of muscle covering and the thin soft tissue, and intraoperative reduction and fixation are difficult. Clinical efficacy is closely related to the type of fracture, degree of soft tissue injury, choice of therapy and internal fixation. Internal fixation is the main treatment for the distal tibia shaft fracture, and a microinvasive, strong fixation is the focus of tibial fracture treatment although many methods for internal fixation are present. ＜br> OBJECTIVE:To explore clinical efficacy of the treatment of distal tibia shaft fracture using percutaneous locking compression plate, interlocking intramedul ary nail and open reduction with internal fixation. ＜br> METHODS:A total of 180 patients with distal tibia shaft fracture were randomized into three groups, receiving internal fixation treatment using percutaneous locking compression plate, interlocking intramedul ary nail or open reduction. Al patients were fol owed up for 12-24 months. The clinical outcomes of the treated patients in three ＜br> groups were compared through the observations of incision length, operation time, intraoperative fluoroscopy time, intraoperative blood loss, complications after fixation. ＜br> RESULTS AND CONCLUSION:After excluding the loss of fol ow-up, 56 cases receiving percutaneous locking compression plate, 52 cases receiving interlocking intramedul ary nail and 48 cases receiving open reduction were involved in the final analysis. The incision length and intraoperative blood loss in the groups of percutaneous locking compression plate and interlocking intramedul ary nail were significantly better than that of open reduction (P＜0.05). Intraoperative fluoroscopy time in the group of percutaneous locking compression plate was significantly longer than that in other two groups (P＜0.05). The operation time showed no significant differences among three groups. The rate of complications was 11%in the group of percutaneous locking compression plate, and 27%in the groups of interlocking intramedul ary nail and open reduction with internal fixation. Percutaneous locking compression plate is a good choice for the distal tibia shaft fracture due to smal injury, good biomechanical stability, and no influence on blood supply at fracture end;interlocking intramedul ary nail is also a useful technique due to simple operations. Open reduction with internal fixation should be chosen careful y due to great dissection, great influence on blood supply and high complication rate.

Development of acetabulum and the content of bone morphogenetic protein 7 after local lesion of cartilago acetabularis in a rabbit model / 中国组织工程研究

BACKGROUND:In a primate model of ulna defect, exogenous recombinant human bone morphogenetic protein-7 can promote the healing of autologous bone defect. OBJECTIVE:To probe into the variation of the development of acetabulum and the content of bone morphogenetic protein 7 after local lesion of cartilage acetabularis in rabbits. METHODS:Thirty-six rabbits (4-week-old) were anesthetized to expose the left hip joint by the anterolateral approach. A 1.5 mm×2.0 mm×0.5 mm sample of the cartilago acetabularis was scraped from each rabbit as experimental group;and the right hip joint was also exposed as control group. To evaluate the hip development, X-rays were used at 4, 6, 8 weeks after the operation, 12 rabbits were kil ed randomly at 4, 6, 8 weeks after operation for general observation, histological examination and immunohistochemical assay. RESULTS AND CONCLUSION:By the radiographic examination, the acetabulums became shal ow and irregular in morphology. The shape of these femoral heads was applanate. Semiluxation and dislocation could be observed in some cases. Hematoxylin-eosin staining showed the regenerated fibrous tissue in the lesion region gradual y migrated from the meager layer to the deep layer to form fibrous cartilage, cartilage cells from proliferative and hypertrophic layers lost their normal columnar structure and arranged disorderly. Immunohistochemistry detection showed that over time, the dyeing of bone morphogenetic protein 7 became light in color. In the control group, a typical structure of articular hyaline cartilage was observed. The results suggest that damaging the cartilago acetabularis led to developmental hip dysplasia, and the content of bone morphogenetic protein 7 from al regions decreased by the extension of time.

Dynamic hip screw plates assisted with blocking screws for treatment of intertrochanteric fracture / 中华创伤杂志

Objective To investigate effects of dynamic hip screw (DHS) fixation assisted with blocking screws in treatment of intertrochanteric fracture.Methods A total of 150 patients with intertrochanteric fracture were selected as the combined treatment group,of which the patients managed by DHS intemal fixation were followed by the parallel placement of a blocking screw closely beneath the main screw for stability with its end rested on the plate.Another 87 patients managed by DHS fixation alone were determined as the control group.The surgical outcomes of the two groups were analyzed and compared.Results Good fixation without external displacement of femoral neck and cut-out of the main screw in femoral head was achieved in the combined treatment group.Also,fracture nonunion or death did not exist in the combined group.The patients in combined treatment group could take care of themselves after operation in the absence of severe pain and functional disturbance,with higher excellence rate (98.7％)than that in control group (P ＜ 0.01).Whereas,the operation failure rate was significantly lower in combined treatment group than in control group (P ＜ 0.05).Conclusion DHS fixation assisted with blocking screws is an ideal treatment of incomplete intertrochanteric fracture in medial wall of calcar femorale for it can achieve reliable fixation and definite curative effect,favor fracture healing,early functional exercise and low incidence of postoperative complications.

Posterior pedicle screw reduction and fixation, decompressive laminectomy and massive autogenous bone grafting for treatment of lumbar spondylolisthesis / 中华创伤杂志

Objective To investigate the effect of posterior pedicle screw reduction and fixation,decompressive laminectomy and massive autogenous bone grafting using bone particles harvested from resected vertebral body in treatment of lumbar spondylolisthesis.Methods Fifty-six cases of lumbar spondylolisthesis treated from June 2005 and June 2006 were reviewed retrospectively.According to Meyerding classification,35 cases were classified as grade Ⅰslippage and 21 cases as grade Ⅱ slippage.There were 19 spondylolisthesis at L4/5 and 37 at L5-S1.After posterior pedicle screw reduction and fixation,decompressive laminectomy and massive autologous bone grafting using particles of resected vertebral body,surgical outcome was analyzed.Results All cases achieved bone fusion without evidence of nail breakage or nerve injury.According to Macrab criteria,the results were excellent in 53 cases and good in three.Moreover,both the full reduction rate and interbody fusion rate were 100％.Conclusion Posterior pedicle screw reduction and fixation,decompressive laminectomy plus massive autogenous bone grafting is one of the ideal treatments for lumbar spondylolisthesis,for it achieves satisfactory fixation,decompression,reduction and fusion.

Study on the exocellular polysaccharide of Ureaplasma urealyticum biofilm in vitro / 中华微生物学和免疫学杂志

Objective To investigate the extracellular polysaccharide distribution and components of Ureaplasma urealyticum (Uu) after biofilm having been developed in.Methods The standard serotype 3 and serotype 14 belong to biovar Parvo,and the standard serotype 4 and serotype 8 belong to biovar T960 were employed to form biofilrns in vitro.Scanning electron microscope and confocal laser scanning microscope were used to analysis the biofilms and extracellular polysaccharide.We used combination of two different labeled lectins,Canavalia ensiformis(FITC-ConA) and Erythrina cristagalli(ECA) which bind to specific polysaccharide residues to visualize extracellular polysaccharide in biofilms,and average uorescence intensity was evaluated Results All the strains can form the biofilmsin vitro.The biofilm was honeycomb-Like structures mainly,and extracellular polymeric substances accounts for majority of proportions.All the extracellular polysaccharide could be combined with FITC-ConA and ECA,and the total average fluorescence intensity of FITC-ConA was higher than ECA( P＜0.001 ).Conclusion Ureaplasma urealyticum biofilm is honeycomb-like structures mainly.The extracellular polysaccharide contains,galactose,and N-acetyl glucan residual,and the glucose,mannose residual are the main components.

Biofilm formation of Ureaplasma urealyticum and its relationship with drug resistance / 中华微生物学和免疫学杂志

Objective To study the ability of standard strain and clinical isolates of Ureaplasma spp. to form biofilms in vitro and to compare the antibiotic susceptibility of sessile cells and their planktonic counterparts. Methods A total of 21 Ureaplasma wealyticum(Uu) isolates recovered from female patients diagnosed with cervicitis and Uu serovar 3 and Uu serovar 8( Uu3, Uu8) were included. Scanning electron microscope and confocal scanning laser microscopy were used to identify biofilm formation. Conventional antibiotic susceptibility tests and biofilm susceptibility assays for tetracycline, erythromycin and ciprofloxacin were carried out. The paired rank sum test and was applied to analyze the statistical differences between the MIC and the minimal biofilm inhibitory concentration. The x2 test was applied to analyze the statistical differences of global resistance percentages between planktonic cells and sessile cells. Results Uu3, Uu8 and 21 Uu isolates all can form biofilms in vitro. Minimal inhibitory concentration of sessile cells compared with planktonic cells were obviously higher for tetracycline, erythromycin and ciprofloxacin (P <0.001). Global resistance percentages between planktonic cells and sessile cells were different for erythromycin (9.52% vs 61.90% , P < 0. 001), ciprofloxacin ( 80. 95% vs 100% , P = 0. 035 ) and tetracycline (4. 76% vs 14.29% , P =0.293). Conclusion Uu isolates and Uu1, Uu8 all can form biofilms in vitro, and biofilm formation can strengthen resistance of Uu to antibiotics, even multidrug resistance was observed.

Standardized medication strategy for new diagnosed epilepsy / 中华神经科杂志

Objective To formulate and detect the efficacy and safety of standardized medication strategy of epilepsy. Methods The normalized medication strategy was worked out in 278 new diagnosed patients, whose effect, retention rate and safety were evaluated after 24 months of treatment. Results Of all the 278 patients, 235 patients were taken mono-therapy while other 43 patients used therapeutic alliance.Most patients took CBZ or VPA as mono-therapy drugs. At the time after 24 months, almost 76. 3%(212/278) patients got seizure free, and the effectiveness was 22. 7% (63/278). The retention rate of those mono-therapy drugs were investigated respectively. CBZ presented 69. 8%, VPA presented 76. 2%,OXC was 68.0%, TPM was 69. 6%, LTG was 83. 3%, LEV presented 85.7%, and 100% for PHT.Conclusions All epileptic patients were well-controlled after taking standardized medication. The standardized medication strategy of epilepsy possesses valuable importance in clinical practice, which deserves further popularization.