The CR image system is a widely-used device to digitize X-ray images. The superiority of CR image system over a traditional X-ray camera shows that the former has a higher image quality and a less radiation dosage. Moreover, the CR image allows easier post-processes to convince the diagnoses and enables digital storage, reproduction and access on line. By analyzing the basic theory of CR image systems, the potential factors to impact the image quality are discussed. A series of strategy to improve the CR image quality are proposed.

Objective To summarize the experience of ventriculo-peritoneal (V-P) shunt under micro-laparoscope for the treatment of hydrocephalus. Methods Twenty-eight patients with hydrocephalus were treated by V-P shunt under micro-laparoscope from November 2000 to May 2004. An infraumbilical trocar was placed through a 5 mm incision to introduce the operating laparoscope. Under laparoscopic visualization, a 3 mm trocar was introduced into the abdominal cavity along the right side of the ligamentum teres hepatis through an incision just to the right of the xiphoid process. A 1.5 mm subcutaneous incision at the corresponding site of the diaphragmatic surface of the liver on the right anterior axillary line was made and through it a sewing needle with 4-gauge unabsorbable silk suture was delivered into. A grasping forceps was inserted through the xiphoid port into the abdominal cavity to carry the two sides of the suture out. The V-P tubing was fixed in the interspace between the liver and the diaphragm by the ligation from the outside, and then was tunneled to the head. Results All the operations were successfully accomplished. The operation time for iutraabdominal tube placement was 5~10 min.All the patients experienced complete alleviation of symptoms of intracranial hypertension postoperatively. No surgical complications occurred.Follow-up check-ups for 6~36 months(mean,12 months) in 25 patients found no tube obstruction. Conclusions Ventriculo-peritoneal shunt under micro-laparoscope has the advantages of minimal invasion, precise positioning, excellent visualization and rapid recovery, being a safe and feasible method which is worthy of recommendation.

Objective To evaluate the protective effect of genistein on psoralens plus ultraviolet A (PUVA)-induced photoaging in human dermal fibroblasts (HDFs) in vitro.Methods Dermal fibroblasts were isolated from the foreskin of a healthy 5-year-old boy,and subjected to primary culture.After 5-8 passages of subculture,the fibroblasts were collected and used in the following experiment.To determine the optimal concentration of genistein,methyl thiazolyl tetrazolium (MTT) assay was conducted to detect the proliferation of fibroblasts pretreated with 8-methoxypsoralen (8-MOP) and various concentrations (0-20 μg/ml) of genistein for 24 hours followed by UVA irradiation.Then,the fibroblasts were divided into 3 groups:normal control group receiving no treatment,photoaging group incubated with 8-MOP for 24 hours followed by UVA irradiation,and genistein group incubated with both 8-MOP and genistein at the optimal concentration for 24 hours followed by UVA irradiation.After additional culture,invert microscopy was carried out to observe the morphology of fibroblasts,enzyme histochemistry to assess senescent cells by using SA-β-Gal kit,flow cytometry to determine the level of reactive oxygen species (ROS),real-time fluorescence-based quantitative PCR to detect the matrix metalloproteinase-1 (MMP-1) expression.One-way analysis of variance was conducted to assess the differences in these parameters among these groups.Results At 24 hours after UVA irradiation,the percentage of fibroblasts positive for SA-β-galactosidase was (0.67 ± 0.58)％,(96.67 ± 1.53)％ and (51.67 ± 2.08)％ in the normal control group,photoaging group and genistein group respectively,with significant differences among these groups (P ＜ 0.01).The level of ROS in the photoaging group and genistein group was (0.88 ± 0.24) and (0.62 ± 0.02) fold higher than that in the control group(both P ＜ 0.01).Moreover,the MMP-1 expression level in the photoaging group and genistein group was 10 times and 6 times that in the control group,respectively,with significant differences among the 3 groups (P ＜ 0.05).Conclusion In vitro,genistein can protect against PUVA-induced photoaging in human dermal fibroblasts to some extent.

OBJECTIVE:To observe the clinical efficacy and safety of azithromycin combined with Reduning injection in the treatment of children with mycoplasma pneumoniae infection. METHODS:80 children with mycoplasma pneumoniae infection were randomly divided into control group and research group. All the children were given routine treatment,including oxygen inha-lation,defervescence,nutritional support,reducing sputum and relieving asthma,etc. Based on it,children in control group were orally treated by Azithromycin enteric coated tablets 10 mg/kg,once a day. Children in research group were treated by Reduning in-jection 10 ml and 5% glucose injection 100 ml by intravenous infusion,once a day,based on the treatment in control group. The course of both was 14 d. The clinical data was observed,including the clinical efficacy,interleukin-6 (IL-6),interleukin-8 (IL-8),tumor necrosis factor-α(TNF-α)and the incidence of adverse reactions(ADR)before and after treatment. RESULTS:The total effective rate in research group was significantly higher than control group,with significant difference(P<0.05). After treat-ment,the IL-6,IL-8 and TNF-α in 2 groups were significantly lower than before,and research group was lower than control group,with significant difference(P<0.05). There were no significant differences in the incidence of ADR in 2 groups(P>0.05). CONCLUSIONS:Based on the routine treatment,azithromycin combined with Reduning injection has more obvious efficacy than only azithromycin in the treatment of children with mycoplasma pneumoniae infection with similar safety.

Objective:To investigate the expression of AEG-1 gene in NSCLC and its clinical significance. Methods:Selected our hospital cardiothoracic surgical resection of 83 cases of postoperative cancer tissues of NSCLC patients and 20 paracancer to study, immunohistochemical staining was used to detect the expression level of AEG-1 protein in two groups,the clinical and pathological of AEG-1 protein in patients with NSCLC was analyzed. Results:NSCLC tissues AEG-1 protein expression 46 cases ( 55. 42%) was sig-nificantly higher than 2 cases ( 10. 00%) of paracancer ( P<0. 05 ) . The high expression of AEG-1 protein in NSCLC tissue was significantly correlated with T stage,N stage and distant metastasis (P<0. 05),the relationship of AEG-1 between the age,sex,and dif-ferentiation degree of the patients was not significant ( P>0. 05 ) . AEG-1 high expression of NSCLC in patients with a median survival time of 15. 0 months was significantly lower than that of 19. 0 months (log-rankχ2=4. 119 P<0. 05,) in patients with low expression of AEG-1. Conclusion:AEG-1 gene expression has been up-regulated in NSCLC tissue,which was related to the clinical stage and distant metastasis of the patients.

Objective To investigate the effects of different doses of dexmedetomidine on cerebral oxygen saturation and pulmonary shunt fraction in patients undergoing one-lung ventilation (OLV). Methods Sixty ASAⅠ-Ⅱpatients, aged 46-71 years, with body mass index (BMI)18-24 kg/m2 and scheduled for thoracotomy were randomly divided into three groups (n=20 each):high dose dexmedetomidine group (group D1), low dose dexmedetomidine group (group D2) and control group (group C). Dexmedetomidine 1μg/kg was infused in group D1 after anesthesia induction, and then a rate of 0.5μg·kg-1·h-1 was continuously infused. Dexmedetomidine 0.5μg/kg was infused in group D2 after anesthesia induction, and then a rate of 0.3μg · kg-1 · h-1 was continuously infused. Group C was received the equal volume of normal saline. Anesthesia was main?tained with propofol-remifentanil and intermittent iv boluses of rocuronium. Arterial and jugular venous blood samples were collected before anesthesia induction (T0), at 15 min after two-lung ventilation (T1), at 5 min (T2) and 30 min (T3) of OLV for blood gas analysis. Value of Qs/Qt was calculated and SctO2 was recorded at the same time. Results Compared with group C and group D2, Qs/Qt was decreased at T2 in group D1 (P<0.05). Qs/Qt was lower at T3 in group D1 and D2 than that of group C, and which was lower in group D1 than that of group D2 (P<0.05). In group C and group D1 a significant de?crease in SctO2 was observed at T2 and T3 compared to that at T0 and T1 (P<0.05). SctO2 was significantly higher at T2 and T3 in group D2 than that in group C and group D1 (P<0.05). Conclusion Dexmedetomidine given during OLV undergoing thoracotomy can improve oxygenation, decrease pulmonary shunt fraction and reduce the occurrence of low SctO2.

Objective To summarize and analyze the effect of hand hygiene(HH)cost on the incidence of health-care-associated infection (HAI),evaluate continuous improvement method,and provide data for hospital manage-ment.Methods The cost of HH project and incidence of HAI in a hospital from January 2013 to June 2014,as well as HH compliance in the first half year of 2014 were investigated.Results Semiannual statistics were performed, the cost of HH project in the first half of 2013,second half of 2013,and first half of 2014 were 283 490,414 232, and 522 345 yuan respectively,compared with the first half of 2013,the cost of HH in the first half of 2014 in-creased by 84.26%;incidence of HAI were 3.13%,3.33%,and 3.03% respectively,difference was significant(χ2=10.37,P <0.001).In the first half of 2014,HH compliance rate increased from 35.00% in January to 59.49% in June.The top three factors that affecting the implementation of HH were busy work,had no time for handwashing;inadequate HH facilities or supplies;inadequate knowledge about HH.Conclusion Increasing the investment of HH products can improve HH compliance and reduce the incidence of HAI.

Objective To improve the understanding of the clinical features, differential diagnosis and prognosis of pachydermodactyly. Methods The clinical data of 20 patients with pachydermo dactyly and follow-up data of 6 patient were analyzed. Results Seventeen out of 20 patients were male. The average onset age was (15±2) years. All of them had asymptomatic, firm swellings which developed insidiously on both sides of the proximal interphalangeal (PIP) joints. All the patients indicated that they were in the compulsive habit of interlacing their fingers and squeezing them. For all patients, biochemical examinations were normal and there was no rheumatoid factor or antinuclear antibodies. X-ray and MRI showed that the thickening of soft tissue around PIP joints without changes in bones or joints structure. Histopathologic findings from the swellings reveMed marked hyperkeratosis, with slight epidermal hyperplasia, and a markedly thickened dermis with whorled, densely aggregated bundles of coarse collagen. Even though 8 patients in the group had gotten rid of the aforesaid habit for 3 to 22 years, the swellings of their PIP joints did not resolve. Conclusion Pachy-dermodactyly is a benign digital fibromatosis which usually involves the PIP joints. It can be distinguished from juvenile rheumatoid arthritis and knuckle pad.

Objective To investigate the progression of mild cognitive impairment (MCI) to Alzheimer's disease (AD) and the factors influencing the related changes in cognitive ability.Methods Seventy-five subjects with mild cognitive impairment (the MCI group),32 with Alzheimer's disease (the AD group) and 17 others with normal cognition (the NC group) were recruited.The Montreal Cognitive Assessment (MOCA) and the Mini-mental State Examination (MMSE) were used to assess their cognitive ability.At the same time,relevant clinical information such as their general condition and past history of disease were recorded.The subjects were followed up for 20 months on average to evaluate their annual rates of progression (APRs),and logistic regression was used to highlight any influencing factors.Results By the end of the follow-up,9 of the 75 MCI subjects had progressed to AD,with an APR of 5.25％.Thirteen cases had recovered normal cognitive functioning (97.6 per 1,000 person-years).Also,2 cases in the NC group (11.76％) developed MCI (69.1 per 1,000 person-years),but none of them had yet progressed to AD.Both hyperlipidemia and a body mass index (BMI) lower than 24 kg/m2 significantly predicted the deterioration of cognitive functioning.Heart disease was significantly correlated with cognitive improvement,and selfmanagement of cognitive function was also a significant protective factor.Conclusions Patients with MCI are at greater risk of developing AD than normal persons.Prevention and early treatment of hyperlipidemia as well as maintaining a normal BMI may delay the deterioration of cognitive functioning.Self-management of cognitive function can improve cognition.

Objective No related training experience, no systematic training before military training, psychological negative emotions(tension and anxiety) and low frequency of physical activities(less than three times a week) have been considered as crucial risk factors of high intensive military training induced acute kidney injury.This paper aims to discuss whether these risk factors can be used for screening high risk groups.Methods Soldiers were divided into 5 groups based on the questionnaire survey:Group1 had no risk factor, Group2 had 1 risk factor, Group3 had 2 risk factors, Group4 had 3 risk factors, and Group5 had 4 risk factors.Urine samples were collected after 6 h and 24 h of 5 km armed military training.Kidney injury indicators were compared such as urine protein, urine occult blood test, urine micro-albumin ( mALB) , urine N-acetyl-β-D-glucosaminidase( NAG) among different groups.Results As the risk factors increased, the incidence of positive urinary protein 6 h after training increased (x2 =101.8,P<0.001),and the levels of mALB and NAG of urine samples were elevated as well.The analysis among moderate and high risk groups(Group3-5) showed that the levels of mALB and NAG of urine samples 24 h after training increased with the number of risk factors.The mean value of these injury indicators reached to the maximum in Group 5.Conclusion No related training experience, no systematic training before military training, psychological negative emotions( tension and anxiety) and low frequency of physical activi-ties(less than three times a week) are independent risk factors of high intensive military training induced acute kidney inju-ry,which can be used for screening high risk individuals during training.