[Peripheral blood cell factors of Graves ophthalmopathy and effect of intervention with tripterygium glycosides].

To explore the effect of tripterygium glycosides on the level of peripheral blood cell factors of Graves ophthalmopathy (GO). In the study, 64 patients of GO in moderate-severe acute stage were selected, and randomly divided into the treatment group (32 cases) and the control group (32 cases). Both of the two groups were provided with basic treatment. The control group was added with prednisone(0. 75 mg kg-1 d-1 ), which gradually reduced (by 5-10 mg week-1 )to the minimum dose of 5 mg d-1. The treatment group was treated with 20 mg tripterygium glycosides, three times a day. One therapy course is three months. The levels of peripheral blood cells(TNF-alpha , IL-2, IL-10, IFN-gamma)of the two groups before and after the treatment and the clinical efficacy were observed. The study indicated that, before the treatment, TNF-alpha, IL-2, IFN-gamma in both groups were significantly higher than that in the health group, but with IL-10 notably lower than the healthy group. After the treatment, TNF-a, IL-2, IFN-gamma in the treatment group significantly decreased, but with IL-10 significantly increasing (P <0. 01). After the treatment, the two groups showed significant difference (P <0. 01). The total clinical efficacy in the treatment group was 88. 10% , and that in the control group was 57. 14% (P <0. 01). After the treatment, the two groups showed significant changes in the exophthalmos degree (P < 0. 01). The results showed that the level of peripheral blood cells (TNF-alpha,IL-2, IL-10, IFN-gamma)of GO patients was positively correlated with the severity of ocular disease. The combined therapy of tripterygium glycosides and methimazole show such advantages as low side effect and high clin-

Analysis of the risk factors for influenza A (H1N1) pneumonia.

Pneumonia is the most common complication of influenza A (H1N1). However, there has been no identification of any single initial symptom as an independent risk factor. In 2009, 206 patients were diagnosed with H1N1 in the Chengde area, China and they were assembled in the Chengde Hospital for Infectious Diseases. The diagnosis and treatment were performed in accordance with the Protocol for Diagnosis and Treatment of Influenza A (H1N1) (2009, third edition), issued by the General Office of the Ministry of Health, with detailed records by the medical staff assigned by the Bureau of Health of the Chengde government. All the patients had viral nucleic acid-positive throat swabs detected with quantitative reverse transcription polymerase chain reaction (qPCR). Based on the final imaging findings, patients were divided into the pneumonia and non-pneumonia groups for this case control study. The univariate analysis demonstrated that the ratios of patients aged 0-5 and ≥45 years, with underlying diseases, with initial symptoms including cough, expectoration and dyspnea and with onset-to-treatment interval of >48 h were higher in the pneumonia compared to the non-pneumonia group (P<0.001, P<0.001, P=0.018, P<0.001, P<0.001 and P<0.001, respectively). The multivariate logistic regression analysis demonstrated that age 0-5 years, presence of underlying diseases, expectoration as the initial symptom and onset-to-treatment interval of >48 h were the independent risk factors for pneumonia with relative odds ratios (OR) and 95% confidence intervals (95% CIs) of 6.120 and 1.779-21.088, 11.188 and 2.021-61.935, 5.263 and 2.042-13.562, and 22.873 and 6.110-85.631, respectively (P<0.01). Therefore, it is recommended that patients with H1N1 presenting with expectoration as the initial symptom be treated with caution during influenza pandemics.

[A comparison of early and late reconstruction and repositioning of orbital blow-out fracture].

OBJECTIVE: To study and compare the operative results of the early and late treatment of orbital blow-out fracture. METHODS: Orbital blow-out fractures were reconstructed and repositioned. Three dimensional measurements, CT scanning, diplopia analysis, Medpor filling of the orbit were used for the operation and the study. The operative results were compared between 15 cases of early and 16 cases of late reconstruction of blow-out fracture. RESULTS: In the early treatment group, there were 8 cases of diplopia, 15 cases of orbital invagination and 10 cases of disesthesia of the infraorbital nerve. After surgery, diplopia was corrected in 7 cases; invagination was corrected in all the 15 cases; disesthesia of the infraorbital nerve was corrected in 8 cases. In the late treatment group, there were 10 cases of diplopia, 16 cases of orbital invagination and 9 cases of disesthesia of the infraorbital nerve. After surgery, diplopia was corrected in 3 cases, unimproved in 4 cases, aggravated in 2 cases. 5 of them received reoperation of extraocular muscle for diplopia. Orbital invagination was uncorrected in 3 cases. 2 of them were re-operated on. Disesthesia of the infraorbital nerve was unimproved in 2 cases. By comparing the operation results, of the two groups using FISHER accuracy inspection, the significant difference was only in the correction of the double visions (chi 2 = 4.865, P < 0.05). CONCLUSION: Early operation for orbital blow-out fracture is easier, with better results, fewer complications and reoperations than the late operation.