Objective To study the CT signs of bronchotracheal transparent foreign body and its diagnostic value.Methods The X-ray and CT findings of bronchotracheal trasparent foreign body in 46 cases were analysed comparativly.Results Among 46 cases,9 cases of trachea foreign body,13 cases of right bronchial foreign body,7 cases of left bronchial foreign body,2 cases of both sides of bronchial foreign body were showed directly by CT,and 8 cases of right bronchia foreign body,6 cases of left bronchia foreign body,1 case of both sides of bronchia foreign body showed indirectly on CT,the sensitivity was 100 percent,while the foreign body and its anatomical location could not be showed on X-ray film,but the indirect signs just like pulmonary emphysema,obstructive pulmonitis and drowned lung etc,could be showed by X-ray films in 34 cases.In another 12 cases were negative,the sensitivity was 73.9 percent.Conclusion The transparent foreign body can not be showed but indrect signs by X-ray film;While CT scan can not only shows the anatomical location of foreign body,but also the shape and size of the foreign body,it offers more information than X-ray films and has important refering value to clinicians to take out the foreign body.

Objective To investigate the association between HLA classⅡgenes and bullous pem-phigoid(BP).Methods HLA-DRB1,DQA1,DQB1were determined by polymerase chain reaction se-quence specific oligonucleotide probe methods in56patients with BP and150normal controls from Shanghai area.Results It was shown that HLA-DRB1*10(*1001)was linked to DQB1*0501,and its frequency in-creased significantly in BP group compared to normal controls.There was a positive correlation between DRB1*1001and mucosal involvememt as well as autoantigen BP230.HLA-DRB1*04was linked to DQB1*0302,and its frequency increased significantly in BP group compared with normal control.There was a positive correlaton between DRB1*04and autoantigen BP180.The frequency of HLA-DRB1*12(*1201,*1202)decreased in BP group compared to normal controls.Conclusions It is suggested that HLA-DRB1*1001and DRB1*04be the susceptible genes while DRB1*1201,and*1202be the protective genes of BP patients in Shanghai area.

Objective Concluding the clinical feature and prognosis of primary testicular lymphoma to improve the understanding of this disease.Methods During 1995 and 2010,17 cases of primary testicular lymphoma treated in Beijing Friendship Hospital of Capital Medical University were retrospectively analyzed of its clinical features,diagnosis,treatment and prognosis.Results Seventeen patients with a mean age of 68 years complained the testicular sohd mass as their first symptoms.The mean tumor diameter was 4.7 cm,and all patients underwent orchidectomy,and testicular non- Hodgkin's lymphoma was confirmed by pathologic examination.Fourteen cases were diffuse large B cell type and 3 cases were anaplastic large cell type.The clinical stage of all the patients was IE.Fourteen cases were followed up (3 cases were lost)with mean follow-up time of 37.8 months by outpatient interview and telephone,all patients were treated with CHOP chemotherapy,and some of them were combined with rituximab and preventive lowdose pelvic radiotherapy.Five cases died of other chronic medical complications,1 case with contralateral testicular metastasis received surgery again.There were 9 tumor free survival cases in total.Conclusion Primary testicular lymphoma is rare and more common in older men.Postoperative pathologic diagnosis is gold standard.The systemic treatment and individual therapy is the first choice for primary testicular lymphoma.

Objective To investigate the relationship between the clinical onset of cerebral infarction in anterior cycle and properties of carotid atheromatous plaque.Methods A retrospective analysis was carried out on clinical data of 624 cases of cerebral infarction in anterior cycle from December 2010 to December 2013 in our hospital.The carotid artery plaque Crouse score,index,and intima-media thickness (IMT) were used to evaluate carotid atherosclerosis and plaque lesions.The National Institute of Health stroke scale (NIHSS) questionnaire was used to evaluate neural function defect.Results Compared to the non-lesion side,the lesion side carotid artery plaque Crouse score was decreased and IMT was increased (P ＜ 0.05) ; the lesion carotid artery plaque Crouse was lower,the higher NIHSS scores (r =-0.546,P =0.004) ; IMT score was higher,higher NIHSS score; carotid artery atheromatous plaque Crouse was negatively related to NIHSS score; IMT score was positively related to NIHSS score (r =0.672,P =0.003).Conclusions The clinical onset of cerebral infarction in anterior cycle was correlated with the carotid sclerosis degree.The Crouse score and IMT of the lesion have certain significance in predicting prognosis of cerebral infarction in anterior cycle.

Objective To master the rehabilitation in patients with traumatic brain injury in Eastern China, and provide evidence for clinicians to rehabilitate early,correctly and effectively.Methods All sampling of the TBI patients from 80 hospitals in Eastern China were clustered and were analyzed using SPSS 13.0.Results The rate of in -patients in Eastern China with early rehabilitative intervention was 4.68%,and the rate of male was higher than female(male to female ratio was 3.80:1),mean age was (40.10 ±16.33)years old,but there was no difference in gender(χ2 =3.23,P =0.072)and age(t =-0.819,P =0.413)for the early rehabilitative intervention.Local resi-dent patients in early rehabilitative intervention was lower(χ2 =8.28,P <0.05).The average length of stay for the early rehabilitative intervention patients was(39.57 ±34.22)d(t =-17.74,P <0.05),the average cost of hospitali-zation was(42 741.50 ±43 186.69)yuan(t =-18.96,P <0.05).The rate of average length of stay and average cost of hospitalization of the rehabilitative intervention patients were higher and more expensive than the patients who did not obtain early rehabilitative intervention,but did have higher unfavourable prognosis rate(χ2 =85.45,P <0.05). Conclusion We advocate correct and early rehabilitative intervention for traumatic brain injury in patients with different degree,and promote not only the physical and functional rehabilitation,but also comprehensive rehabilitation such as the psychological treatment,family treatment and social regression.

Objective To systematically evaluate the effectiveness of diabetes self-management education through telemedicine on glycosylated hemoglobin (HbA1c). Methods Randomized clinical trials (RCTs) that assessed the effectiveness of remote diabetes self-management education in patients with diabetes were systematically reviewed using multiple electronic databases. The searching time was from database establishment to May 2015. These articles were analyzed after evaluation of their quality. Results Eight RCTs were included involving 2 047 patients.The results of Meta-analysis showed the effectiveness of remote DMSE on reduction of HbA1c of patients with type 2 diabetes was more significant than that of the control group [WMD=-0.50,95%CI (-0.88,-0.12),P < 0.05],while failing to support the effectiveness of remote DMSE on patients with type 1 diabetes [WMD=0.62, 95%CI(-0.19,1.43), P>0.05]. Conclusions Remote DMSE is effective to improve the glycemic control in patients with type 2 diabetes,while the effect on patients with type 1 diabetes is still not certain. Large-scale and multi-centered RCTs are needed to confirm its effectiveness.

Objective: Endoscopic measurement mainly depends on visual estimation or open biopsy forceps,which have been proved lacking in accuracy due to the image barrel distortion caused by wide-angle lens in endoscope.This study aimed to validate a new concept of "virtual internal standard" proposed by ourselves and develop a new method for endoscopic measurement based on the concept.Methods: We photographed planar grid graphs printed with standard calibrations with an electronic endoscope at different object distances,obtained the information on the virtual internal standard from each photo at the corresponding object distance,and analyzed the digital characteristics of the barrel distortion photos,including the size of the visual field,the image compression ratio,and the credible area for measurement with the virtual internal standard.Based on the analyses,the method of endoscopic measurement by the virtual internal standard was established and experiments both in vivo and in vitro were conducted.Results: The ratio of the object distance to the visual field was 1 ∶ 2 when the former was between 10 mm and 40 mm.Calculation of the compression ratio showed that the credible area of measurement in the central area was 10 mm at the object distance of 10-15 mm,20 mm at 20-30 mm,and 30 mm at 30-50 mm.The credible area of measurement on various planes accounted for 2/5 to 3/5 of the total image width.There was a tendency of double-curve change in the arrangement of pixel values of the central grids on different planes.The differences between the pixel values per centimeter became slight at the object distance of 35-50 mm.Conclusion: Endoscopic measurement by the virtual internal standard is a objective,accurate,simple and practical method.

Objective To understand the drug-resistance of MRSA patients in neurosurgery intensive care unit,raise the prevention of MRSA and provide doctors the basis for controlling it. Methods The 5 year(20012005) MRSA patients were tested by Kirby-Bauer in neurosurgery intensive care unit of a third-tier general hospital in Shanghai. Statistic and analysis the drug-resistance of the patients. Results The rates of 121 MRSA drug-resistance to penicillin G,erythromycin, ciprofloxacin, amikacin and the cephalosporins are 92.3 % to 100 %, totally senaitire to teicoplanin and vancomycin and lower drug-resistance to rifampin,netilmicin and fosfomycin, but it rapidly raised from 10.0 % (2001 ) to 95.2 % (2005) to sulfamethoxazole. Conclusion It is time to take care of the drug-resistance of MRSA. Prevention and use antibiotics properly are the important ways to decrease the hospital infection and to improve the quality of recovered.

ObjectiveTo observe the curative effect of Xiangshaliujunzi decoction on critically ill patients with gastrointestinal dysfunction accompanied by spleen deficiency syndrome of traditional Chinese medicine (TCM) and its influence on tumor necrosis factor-α(TNF-α) and interleukin-6 (IL-6).Methods Forty-eight critically ill patients admitted to Department of Emergency Intensive Care Unit (EICU) in Zhejiang Provincal Hospital of Traditional Chinese Medicine Xiasha Campus from February to December 2015 were enrolled, and they were randomly divided into observation group (26 cases) and control group (22 cases) by random number table method. The patients in both groups were given routine emergency western therapy, and in the observation group, additionally, Xiangshaliujunzi decoction (ingredients: codonopsis pilosula 20 g, atractylodes macrocephala koidz 12 g, poria cocos 12 g, radix glycyrrhizae preparata 4 g, rhizoma pinelliae preparatum 6 g, pericarpium citri reticulatae 5 g, fructus amomi villosi 5 g, radix aucklandiae 4 g, rhizoma zingiberis recens 3 pieces) 80 mL was prepared and divided into two parts for nasal feeding, once 40 mL, twice a day, while the patients in the control group received the nasal feeding with the same amount of warm boiled water. Before treatment and 3 days and 5 days after treatment, the gastrointestinal function scores were assessed, and the changes of the levels of plasma TNF-α, IL-6 were recorded.Results There were no statistical significant differences in gastrointestinal function scores, the levels of TNF-α and IL-6 between the two groups before treatment and 3 days after treatment (allP ﹥ 0.05). But 5 days after the treatment, the gastrointestinal function scores, the levels of TNF-α and IL-6 were obviously decreased in two groups, and the degree of decrease in observation group was more significant [gastrointestinal function score: 0.92±0.85 vs. 2.27±0.77, TNF-α (ng/L): 17.7±2.4 vs. 25.0±4.2, IL-6 (ng/L): 16.9±2.4 vs. 25.0±3.4, allP < 0.01].Conclusion Xiangshaliujunzi decoction has therapeutic effect on critically ill patients with gastrointestinal dysfunction and accompanied by spleen deficiency in TCM, the mechanism may be related to decreasing the levels of TNF-α and IL-6, thereby depressing the inflammation.

Objective To analyze health status and characters of health service demand and utilization among farmers and herdsmen in Kangxiwa and Saitula border areas from the altitude of 3700m to 4300m for offered scientific advices to the health management institutions for optimizing the allocation of health resources.Methods A total of 51 families in the Kangxiwa and Saitula areas in Karakorum-Kunlun Mountains were randomly chosen with stratified sampling method for the family health survey.Physical and biochemical examination were carried out for each herdsman.Results Among the participants,the most disease the two-week medical consultation rate was 1.74％.the hospitalization rate was 0.98％.The two-week medical consultation and hospitalization rate of herds were lower than the national and Xinjiang level for rural area.Herdsmen's doctor poor accessibility and low-income may be the main reasons for the underutilization of health services ;The difficult situation of herdsmen has been initially improved after participating in the new rural cooperative medical care.Conclusion The health status of native herdsmen in Kara Kunlun mountains was poor,and the provision of health services cannot meet the demand for health service of native herdsmen.It's necessary to improve efficiency of utilization of health service and optimize the allocation of health resources.