Objective To evaluate the role of lung ultrasound in the diagnosis of neonatal pneumonia.Methods From April to October 2015, 100 neonates admitted to the Neonatal Department of Xi′an Children′s Hospital underwent lung ultrasound, using the 12 regions method. All intercostal spaces of the upper and lower parts of the anterior, lateral, and posterior regions of the left and right lung were examined. Arterial blood gas analysis parameters of each case were recorded at the same time, including arterial partial pressure of oxygen (PO2), arterial partial pressure of carbon dioxide (PCO2), pH value and oxygen saturation (SO2). A skilled sonographer analyzed the ultrasound images before being aware of the patient′s clinical condition. According to the ifndings, the patients were classiifed into 2 groups: neonatal pneumonia group and non-pneumonia group. All the patients with neonatal pneumonia underwent lung ultrasound score (LUS), and the correlation between LUS and PO2, PCO2, pH value and SO2 was analyzed.Results A ifnal diagnosis of neonatal pneumonia was conifrmed in 62/100 patients. The ultrasonographic manifestations of neonatal pneumonia were as follows: rocket sign (33/62 patients, 53%), ground-glass sign (35/62 patients, 56%) , waterfall sign (31/62 patients, 50%), white lung (8/62 patients, 13%), subpleural lung consolidation (35/62 patients, 56%), pleural line abnormalities (26/62 patients, 41%), pleural effusion (7/62 patients, 11%), atelectasis (3/62 patients, 4%) , and pneumothorax (1/62 patients, 1%). The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of lung ultrasound in the diagnosis of neonatal pneumonia was 96.77%, 86.84%, 93.00% of 92.30%, of 94.28%, respectively. The correlation coefficients between LUS and PO2, PCO2, pH value, SO2 were-0.82, 0.64,-0.58,-0.74,P<0.05, respectively.ConclusionLung ultrasound is a reliable tool for diagnosing neonatal pneumonia with high sensitivity, with high practical value in assisting clinicians to carry out appropriate treatment in combination with LUS.

ObjectiveTo compare the clinical effect of posterior circumferential fusion with versus without intertransverse process fusion on lumbar instability in aged patients. MethodsThe elderly with lumbar instability were treated with the posterior instrumented circumferential fusion technique in 80 cases. Among 58 patients followed up for at least 2 years, 28 cases (group A)underwent posterior circumferential fusion with intertransverse process, while 30 cases (group B)without intertransverse process. X-ray examination was used before and 1, 3, 6, 12 and 24 months after operation to evaluate the fusion condition of the bone graft, and visul analogue scale (VAS) and Oswestry disability index (ODI) questionnaire were applied to assess the pain of center back and leg,and the conventional activity.ResultsThe operation time and blood loss were more in group A[(185.3±56.6) min and (376.3±92.9) m1] than in group B [(146.4±46.3) min and (234.3±64.5)ml (t=12.37, 37.49, P＜0.01)]. All the 58 cases were followed for at least 2 years. The 27 cases (96.4％) of group A and 28 cases (93.3％) of group B got bone fusion (x2 =0.004, P＞0.05).There were marked differences in the VAS of center back at 1 and 3 months after operation between the 2 groups (t=3.178, 2.158, both P＜0.05), while no difference at the other 3 time point. VAS about the leg pain and the ODI showed no differences between group A and B after operation (all P＞0.05). ConclusionsFor the lumbar instability in the elderly, the posterior circumferential fusion with or without intertransverse process fusion can achieve a similar high rate of fusion and satisfactory clinical results,andtheposteriorcircumferentialfusionwithoutintertranaverseprocess is recommended for less trauma.

Objective To study the clinic imaging features and the clinic applications of the contrastenhanced ultrasound(CEUS) in the diagnosis of gallbladder carcinoma.Methods The characteristics of CEUS were reviewed in 24 patients with gallbladder carcinoma proven pathologically. Results After injection of SonoVue, all gallbladder carcinoma of 24 cases showed enhancement and these lesions looked clearer than those in conventional ultrasound.The analysis of time-intensity curve indicated the upslope of curve was steep in the lesions,which was flat in normal liver parenchyma around.In 10 cases of thick wall of gallbladder carcinoma, quick and obvious enhancement was seen in 9 cases, 1 case showed poor enhancement during scanning,but thick and tortile blood vessels could be seen in the thickening wall.Quick and uneven enhancement was been seen in both 8 cases of soft-tissue mass and 6 cases of nodules within gallbladder.Five cases of gallbladder carcinoma with liver metastasis revealed more liver metastasis depend on CEUS.Conclusions CEUS plays an important role in diagnosis and improving the diagnostic accuracy for gallbladder carcinoma.

Objective To investigate the relationship between spinal neuronal microRNA 212 (miR-212) and phosphorylation of cAMP response element-binding protein (CREB) in a mouse model of bone cancer pain (BCP).Methods Thirty-two male SPF C3H/HeJ mice, aged 4-6 weeks, weighing 20-25 g, were randomly divided into 4 groups (n=8 each) using a random number table: sham operation group (group S), BCP group, BCP + intrathecal negative control locked nucleic acid (LNA) group (group BC) , and BCP + intrathecal miR-212 antisense LNA group (group BL).After the mice were anesthetized with intraperitoneal pentobarbital sodium, 20 μl of α minimal essential medium containing NCTC 2472 cells 2×105 was injected directly into the medullary cavity of the distal femur.In BC and BL groups, negative control LNA and miR-212 antisense LNA 12 pmol/5 μl were intrathecally injected, respectively, once a day for 7 consecutive days, starting from day 14 after inoculation.In S and BCP groups, the equal volume of DNAse/RNAse-free water was given instead.The number of spontaneous flinches (NSF) and mechanical paw withdrawal threshold (MWT) were measured on 1 day before inoculation and 4, 7, 10, 14 and 21 days after inoculation.The mice of each group were sacrificed after measurement of pain threshold on 21 days after inoculation, and the lumbar enlargement segments of the spinal cord were harvested to detect the expression of phosphorylated CREB (p-CREB) and CREB using Western blot.Results Compared with group S, the MWT was significantly decreased, and the NSF was increased on 7-21 days after inoculation, and the expression of p-CREB was up-regulated in BCP, BC and BL groups.Compared with group BCP, the MWT was significantly increased, and the NSF was decreased on 21 days after inoculation, and the expression of p-CREB was down-regulated in group BL, and no significant change was found in the parameters mentioned above in BC group.There was no significant difference in the expression of CREB between the four groups.Conclusion Spinal neuronal miR-212 is involved in the maintenance of BCP probably by promoting phosphorylation of CREB in mice.

Objective To better understand the clinical features and the diagnosis of acquired Gitelman syndrome associated with primary Sj(o)gren syndrome (SS).Methods Two cases of acquired Gitelman syndrome associated with primary SS were investigated.Literature were reviewed.Results Two women with sicca complex presented to our clinic with intermittent muscle cramping and weakness involving both lower extremities for several months.Laboratory findings showed hypokalemic metabolic alkalosis, hypomagnesemia, and hypocalciuria,all these met the criteria for Gitelman syndrome.Diagnostic evaluation identified primary SS as the cause of the acquired Gitelman syndrome.Conclusion Acquired Gitelman syndrome associated with SS is rare.Kidney biopsy is necessary for the diagnosis of Gitelman syndrome.Further studies are needed.

Objective To investigate the effects of repeated intrathecally kinesin superfamily protein 17 (KIF17) antisense oligodeoxynucleotide (ODN) on the expression of mLin10 and NR2B in spinal cord in a mouse model of bone cancer pain.Methods Fifty-six male C3H/HeJ mice,aged 4 ～ 6 weeks,weighting 20 ～ 25 g,were randomly divided into two groups:sham operation group (group S,n=20) and bone cancer pain group (group T,n=36).20μl α-minimal essence medium (α-MEM) which containing 2× 105 NCTC2472 osteosarcoma cells was injected into the intramedullary space of the right femur in group T.In group S,no cancer cell was instead.The number of spontaneous flinches (NSF) and the paw withdrawal mechanical threshold (PWMT) were measured at the day before (base) and the days 4,7,10 and 14 after inoculation.According to the corresponding time points,twenty-four mice were sacrificed for determination the expression of KIF17,mLin10 and NR2B using Western blot.Then,the mice of group T were randomly divided into three groups (n=8,T1,T2,T3,group).In group S and group T1,Saline 5 μl was injected intrathecally.KIF17 sense ODN and antisense ODN,5 μg/5μl were respectively injected in group T2 and T3 for 6 consecutive days.Pain behaviors were assessed at the days 2-6 after the first injection.And determinated the KIF17,mLin10 and NR2B expression,again.Results Compared with group S,the NSF was increased and the PWMT was decreased at the days 7,10 and 14 after inoculation in group T (P＜0.05).Compared with the base ((0.65±0.15),(1.06±0.06),(1.01±0.14)),the expression of KIF17,mLin10 and NR2B (14d:(1.13 ±0.06),(2.17 ± 0.37),(1.85 ± 0.32)) were increased at the days 7,10 and 14 after inoculation in group T(P＜0.05).During the course of the injection,compared with group T1 and T2,the NSF was decreased and the PWMT was increased significantly in the group T3(P＜0.05),the expression of KIF17,mLin10 and NR2B((0.88±0.08),(0.96±0.11),(1.03±0.08)) were reduced in group T3 (P＜0.05).Conclusion Intrathecal KIF 17 antisense ODN in the mice of bone cancer pain improves the pain behaviors,and inhibits the up-regulated of KIF17,mLin10 and NR2B during the course of the injection.

Objective To compare the biomechanical properties of mono-segTnent pedicle instru-mentation and its combination with bone cement fixation in treatment of thoracolumbar fractures. Meth-ods Eight fresh specimens of calf spines ( T11 -L3 ) were used for development of incomplete burst frac-ture models at the vertebral body of L1. Mono-segment pedicle instrumentation and its combination with vertebroplasty were respectively applied in each specimen subsequently to restore spinal stability. A cyclic loading with pure moment of 4 Nm was applied to specimens, with load frequency of 0.5 Hz for 2 000 cy-cles. Range of motion (ROM) at flexion/extension, left/right lateral bending and left/right axial rotation of the fixated segment at different status of intact, injury, fixation and cyclic loading was determined by spinal three-dimensional instability test system. Results ROM after treatment with two fixation tech-niques and that at different directions after cyclic loading were distinctly smaller than that of intact and fractured models (P <0.05 ). Under mono-segment pedicle instrumentation combined with bone cement fixation, ROM at flexion, extension, lateral bending and axial rotation was 0.40°, 0. 53°, 0.86° and 0.55° respectively and that after cyclic loading was 0.10°, 0.07°, 0.19° and 0.08°respectively, which were all lower than those of monosegmental fixation, especially at flexion and axial rotation, with statisti-cal difference (P <0.05 ). Conclusions Both fixation techniques can provide instant stabihty of the fractured spine and have good fatigue resistance effect. However, mono-segment pedicle instrumentation is inferior to mono-segment pedicle instrumentation plus bone cement fixation in treatment of fractured verte-bral body at flexion and axial rotation.

BACKGROUND:Antedor canulated screw has been considered an ideal method to treat odontoid fracture.OBJECTIVE:To compare the biomechanical properties of different anterior screws.DESIGN,TIME AND SETTING:A randomized contrast study was performed at the Biomechanics Laboratory of Southern Medical University from March to September 2006.MATERIALS:Double-thread canulated screws and single-thread canulated screws were made of titanium alloy and provided by Shuangyang Medical Apparatus Co.,Ltd.,Suzhou.METHODS:A total of head-neck complexes (C0-C3) which were collected from 20 corpses were maintained in formaldehyde for less than 3 months;thereafter,the muscles and ligaments were removed to obtain the axis specimens so as to make type Ⅱ odontoid fracture models.The fracture samples were individually treated with double-thread and single-thread canulated screws,with 10 samples for each group.MAIN OUTCOME MEASURES:The shear stiffness and the maximum resistance of the two kinds of screw were tested in this study.RESULTS:The shear stiffness of the double-thread screw group was significantly higher than the single-thread screw group (P＜0.01 );however,there was no significant different in the maximum resistance between the two groups (P＞0.05).CONCLUSION:Double-thread canulated screws have a strong biomechanical stability for treating odontoid fracture;therefore,the first choice of the internal fixation should be double-thread canuiated screws for patients with osteoporosis or those who are susceptible to expanded screw pathway during surgical procedures.

Objective To investigate the potential association between SEPS1 variants and Hashimoto's thyroiditis (HT)in the Chinese Han population and evaulate the effects of SEPS1 haplotypes on the susceptibility to immunity-mediated diseases.Methods We analyzed 7 SNPs with minor allele frequency (MAF)≥0.05 in a cohort of 1013 HT patients and 2998 healthy controls from genetically independent Han Chinese individuals.Single SNP,haplotype and gender-specific associations were performed. Results We found that rs28665122 was significantly associated with HT,and SNP was associated with HT in females.Further haplotypic analysis indicated that a haplotype block (rs2009895-rs28665122)spanning the promoter of SEPS1 gene was highly associated with HT. Additionally,the haplotype CA in the block had an almost 1.5-fold increase in these cases,which remained significantly associated with HT in females.Conclusion SEPS1 plays a role in the pathogenesis and etiology of HT.

ObjectiveTo assess the balance between regulatory T (Treg) cells and T helper 17 (Th17) cells in patients with serofast syphilis.MethodsBlood samples were collected from 26 patients with serofast syphilis and 23 normal human controls.Flow cytometry was performed to determine the proportion of Treg and Th17 cells in peripheral blood and to quantify the expression of specific transcription factors Foxp3 and ROR-γt in CD4+ T cells of these subjects.Correlation analysis was carried out.ResultsThe proportion of Treg cells in CD4+ T cells in the patients with serofast syphilis was 33.28％ ± 11.84％,significantly higher than that in the normal controls(22.13％ ± 7.79％,P ＜ 0.01 ),while the proportion of Th17 cells was significantly lower in the patients than in the normal controls(3.17％ ± 2.32％ vs.8.87％ ± 2.00％,P ＜ 0.01 ).Enhanced expression of Foxp3 and attenuated expression of ROR-γt were observed in CD4+ T cells from the patients compared with the controls(2994.86 ± 1099.18 vs.2539.72 ± 1086.96,P ＜ 0.05; 1473.12 ± 752.20 vs.1778.34 ± 388.13,P ＜0.05).There was a negative correlation between the expression of Foxp3 and ROR-γt in CD4+ T cells from all the subjects (r =-0.481,P ＜ 0.01 ).ConclusionThe Treg/Th17 cell balance is abnormal in peripheral blood of patients with serofast syphilis.