Objective To study the influence of long-term use of BZDs on the process and prognosis of elderly CAP.Methods The clinical information of the patients was retrospectively analyzed.According to whether the long-term use of BZDs was divided into the observation group (84 cases) and the control group (103 cases),there was no significant difference between the two groups (P ＞ 0.05).Two groups of patients were treated with conventional CAP,compared the two groups of patients with treatment,progress and prognosis of pneumonia.Results There was significant difference (P ＜ 0.05) in the therapeutic effect between the two groups;CPIS of the observation group after the treatment of 7d was significantly lower than that before treatment (P ＜ 0.05),later than that of the control group.The mortality rate,ICU ratio,hospitalization cost and days of the observation group were significantly higher than those of the control group (P ＜ 0.05).Adverse reactions were no significant difference (P ＞ 0.05) between the two groups.Conclusion Long-term using BZDs is not beneficial to the elderly CAP patients and worsen the prognosis situation.Therefore the clinical application of BZDs to elderly CAP patients should be made with cautiousness.

Objective To study the role of early intravenous nutrition given aggressively combined with early minimal feeding on very low birth weight infants (VLBWI),and to evaluate the clinical value of intestinal barrier protein and MicroRNA.Methods All of 62 cases of VLBWI admitted in NICU,the Maternal and Child Health Hospital of Nantong Affiliated to Nantong University from January 2006 to June 2014 were recruited.Sixty-two VLBWI were randomly divided into group A and group B.Thirty infants in group A were exposed to conventional intravenous nutrition.Thirty-two infants in group B were treated with early intravenous nutrition aggressively combined with early minimal feeding.The time of birth weight recovery,days with intravenous nutrition,hospital stay and complications were recorded.The liver and kidney functions,electrolytes,blood gas analysis were monitored.Enzyme-linked immunosorbent method was used to detect intestinal fatty acid binding protein (Ⅰ-FABP),an intestinal barrier protein in plasma.Infection related MicroRNA155 was detected with fluorescent quantitative polymerase chain reaction (RT-PCR).Results Group B was superior to group A in weight loss after birth [(13.70 ± 3.10) ％ vs (5.46 ± 2.64) ％,P ＜ 0.05],shorter recovery time of body weight [(12.20 ± 3.38) d vs (6.82 ± 3.20) d,P ＜ 0.05],fewer days with intravenous nutrition [(29.62 ± 4.16) d vs (20.80 ± 3.20) d,P ＜ 0.05] and shorter hospital stays [(44.60 ± 6.32) d vs (28.91 ± 4.36) d,P ＜ 0.05].Compared with group A,the infants in group B had less complications,including hyperbilirubinemia (31.2％ vs 56.7％),extrauterine growth retardation (34.3％ vs 73.3％),cholestasis (6.2％ vs 23.3％),feeding intolerance (15.6％ vs 53.3％) and necrotizing enterocolitis (0 vs 16.7％) (all P ＜ 0.05).Although Ⅰ-FABP had a higher plasma concentration in group A than that of group B [(9.083 ± 1.059) μg/L vs (7.563 ± 0.739) μg/L],the difference was not significant (t =1.190,P =0.076 4).However,the plasma levels of Ⅰ-FABP in infants with necrotizing enterocolitis were significantly higher than those of group B [(19.500 ± 3.510) μg/L vs (7.563 ±0.739) μg/L,t =5.231,P =0.035 0].The expression of MicroRNA155 in group A was markedly higher than that of group B (2-△△ct were 0.81 ± 0.12 and 0.24 ± 0.08,respectively,P ＜ 0.05).Conclusions Giving aggressive intravenous nutrition early combined with early minimal feeding was safety and effective to VLBWI,which was of benefit to their growth and development,reducing complications and shorting hospital stays.The detection of intestinal barrier protein Ⅰ-FABP and MicroRNA155 is useful for monitoring feeding complications of VLBWI.

Objective To provide theoretical evidences for diagnosis of bladder neoplasm by using more information of imaging features. Methods MRI images of bladder neoplasm were collected for this research. The ROI (region of interest) area was selected manually,and noise reduction and sharpening were applied to the ROI area by using LoG (Laplacian of Gaussian) filter. The texture features of bladder neoplasm and normal bladder wall (smooth muscle),such as mean grey-level intensity,entropy,uniformity were calculated. A statistical analysis was made at last. Results The values of texture features were analyzed by t-test. Entropy and uniformity show significant differences between the two groups. But Mean grey-level intensity hasn't indicated this difference. Conclusion This texture features may be applied to decide the invasive depth of bladder neoplasm,it also means that the stage of bladder neoplasm may be fixed by this system.

Objective To enhance understanding of the vertebral compressed fracture in old patients so as to reduce its misdiagnosis. Methods 30 aged patients with vertebral compressed fracture were treated from 1998 to 2004 in our department. Their clinic data were retrospectively analyzed. There were 27 males and 3 females, aged from 70 to 90 years (averaging 82.5 years). Results All the patients were diagnosed definitely. There were 2 cases of T11 fracture, 13 cases of T12 fracture, 11 cases of L1 fracture, 3cases of L2 fracture, and 1 case of L3 fracture. At first 1 case was overlooked, and segmental positioning was wrong in 3 cases but the mistakes were corrected later. Conclusion Meticulous review of the history and clinical manifestation in addition to supplemental imageological examination are essential to early diagnosis of the majority of vertebral compressed fractures. As for some difficult early diagnoses, fat suppression MRI and nuclide bone scanning are helpful.

?Objective :To construct human skin with full thickness in vitro using tissue engineering techniques. Metheods: Epithelial cells and fibroblasts were isolated from the back skin of legally aborted human foetus. Fibroblasts were seeded into bovine type I collagen gel and cultured for 3 days. Epithelial cells were seeded on the surface of collagen gel and cultured for another 2 days, then the equivalent skin was exposed to air liquid interface to generate a protective cornified layer. 5 days later, equivalent skin was excised and observed under light microscope and transmission electron microscope. Results: Epithelium and dermis were observed in the equivalent skin,similar to those in normal human skin. Epithelium was made up of stratum basale, stratum spinosum, stratum granulosum and stratum corneum. The cells of different layers were connected with intercellular bridge. Horny pearl were also found in epithelium. Basement member was observed between epithelium and dermis. Epithelial spikes bristles of different length were existed in partial dermis. The results of TEM observation showed that desmosome existed between cells of different layer in epithelium. Conclusion: Human skin with full thickness can be tissue engineered with foetus back skin as the sources of epithelial cells and fibroblasts, and bovine I type collagen as carrier.

Objective To explore the feasibility of applying small private online course (SPOC) in the course of Microcomputer Principle and Interface Technology to solve its problems in complicated knowledge points,abstract contents and difficulty in understanding.Methods The characteristics of the undergraduate students in the military medical university and SPOC mode were analyzed,and then the design and implementation of a SPOC-based Microcomputer Principle and Interface Technology course were explored in the military medical university.Results By applying the SPOC into the teaching of Microcomputer Principle and Interface Technology course,the student could find out the forgotten or leaked knowledge and reiterate them to reinforce the memory of those knowledge points,which promoted their self-regulation of learning.Besides,teaching the students with real cases not only increased the learner's enthusiasm but also strengthened the military medical background.The offline group discussion facilitated the students in understanding and application of knowledge.Conclusion Applying SPOC mode into PMIT teaching no doubt improves the effect and quality of teaching and learning.

To investigate the gene typing, molecular characteristics of virulence and resistance associated gene of Clostridium difficile from clinical isolates in China, the genes tcdA,tcdB of toxin A and B, cdtA,cdt B of binary-toxin, and erm B of clindamycin resistance were detected by conventional PCR. Genotyping of toxic C. difficile were conducted by means of analysis of 16s-23s internal spacer region polymorphism with PCR assay. Then the antibiotic resistance of toxic C. difficile to ampiciline, clindamycin, metronidazole and vancomycin was conducted with E-test. It was found that 8 toxic C. difficile strains were demonstrated out of 12 clinical isolates, in which 5 strains were tcdA+ and tcdB+, and 3 strains tcdA- and tcdB+, accounting for 62.5% and 37.5% respectively. Binary-toxin genes detection were negative in all the strains. Clindamycin resistance associated gene ermB was positive in 4 out of 8 toxic C. difficile strains, accounting for 50%. 8 toxic isolates were typed into 4 gene types, the dominant type was ZR I,accounting for 62.5%. Resistance rate of 8 toxic C. difficile strains against ampiciline(AC), clindamycin(CM), metronidazole(MZ) and vancomycin(VA) was 37.5%,87.5%,12.5%, and 0 respectively. No isolates belonged to ribotype 027 or 078. Isolation rate of toxic C. difficile is high to 66.7%. There is obvious gene polymorphism in clinical isolates of Chinese toxic C.difficite, and ZR I is preponderant genotype in 4 genotypes. C. difficile shows some resistance to ampiciline, clindamycin, metronidazole, but susceptive to vancomycin.

Objective To determine the three-dimensional (3D) texture features extracted from intensity and high-order derivative maps that could reflect textural differences between bladder tumors and wall tissues,in order to achieve bladder cancer and wall tissue identification.Methods A total of 62 cancerous and 62 wall volumes of interest (VOI) were extracted from T2-weighted MRI datasets of 62 patients with pathologically confirmed bladder cancer.To reflect heterogeneous distribution of tumor tissues,3D high-order derivative maps (the gradient and curvature maps) were calculated from each VOI.Then 3D Haralick features based on intensity and high-order derivative maps and Tamura features based on intensity maps were extracted from each VOI.Statistical analysis was proposed to first select the features with significant differences and then obtain a more predictive and compact feature subset to verify its differentiation performance.Results From each VOI,a total of 58 texture features were derived.Among them,37 features showed significant inter-class differences (P≤ 0.01).Conclusion The results suggest that 3D texture features deriving from intensity and high-order derivative maps can reflect heterogeneous distribution of cancerous tissues.

Single photon emission computed tomography (SPECT) is a cost-effective, widely-used diagnostic modality for the assessment of cardiac and cerebral functions. However, most SPECT protocols for clinical use support only qualitative reconstruction. Its lack of quantitative capability compromises the accurate evaluation of diseases. Quantitative SPECT by simultaneous compensation for different degradation factors is in great demand and should improve the diagnosis greatly. The variety of the existing SPECT algorithm can be split into a family of analytical methods and a wide class of iterative techniques. By reviewing the research work published in the past decades, this paper tries to make a state of arts and comprehensive outline of efficient, analytical solutions to SPECT reconstruction problem, which could compensate scatter, photon attenuation, and detector response, as well as suppression of Poisson noise, respectively.
Algorithms ; Humans ; Image Processing, Computer-Assisted ; Tomography, Emission-Computed, Single-Photon

Objective To evaluate the surgical results of spinal stenosis in the elderly and to investigate the indications , surgical technique and factors which may contribute to the outcome. Methods A retrospective study was held, 304 patients aged 65 and over who had different kinds of decompression laminectomy for lumbar spinal stenosis between Jan 1990 and Jun 2005 were recruited. The mean patient age at surgery was 70.4 years (65-86 years old). Results One hundred and seventy-five cases had co-existing illnesses, 62 had concomitant degenerative spondylolisthesis, 138 had spinal instrumentation. Functional results were graded as excellent, good, fair and poor: 86. 8% excellent or good, 11. 2% fair and 6 cases poor. Four patients had re-operations because of post operation hematomas. Multivariate analysis revealed that age, sex, co-morbidity score, number of levels decompressed, and degenerative spondylolisthesis did not predict bad outcomes. Conclusions The surgical results of spinal stenosis in the elderly are favourable and comparable to those reported for the general population . Carefully perioperative preparation is very important in the treatment of elderly patient with lumbar spinal stenosis.