Objective To investigate the effect of patient positioning on the Duplex ultrasound evaluation of great saphenous vein reflux elicited by the pneumatic cuff method. Methods FFifty great saphenous veins (GSV) with relfux (relfux group) and iffteen with no prior history of venous disease (healthy group) were examined by duplex scanning in the supine, 20 degrees reverse-trendelenburg (RT-20), 40 degrees reverse-trendelenburg (RT-40) and standing position. Each GSV was assessed for relfux at three venous sites:two centimeter below the sapheno-femoral junction (SFJ), the greater saphenous vein in the mid thigh (MGV) and the greater saphenous vein in the upper calf (CGV). Pneumatic cuff compression pressure of conifned 100 mmHg (1 mmHg=0.133 kPa) was used onto the calf to elicit relfux. The incidence of positive venous relfux was calculated. The statistical differences of the peak relfux velocity and duration of relfux in four positions were analyzed. Results TThe relfux elicited in the standing position was set as the gold standard. In healthy group, there was no false positive results of relfux in supine, RT-20 and RT-40 positions. In relfux group, false negative results were found at all venous sites when limbs were examined in supine position [false negative rate:59%(19/32), 22%(11/50), 24%(12/50)]. At RT-20 and RT-40 positions, the incidence of venous relfux reached 100% at MGV and CGV, and false negative cases were only detected at SFJ [false negative rate:12%(4/32), 12%(4/32)]. The relfux time in standing, supine, RT-20 and RT-40 positions were (7.75±3.23) s, (5.27±3.66) s, (8.67±3.72) s, (8.55±3.93) s respectively. There were signiifcant differences among different positions in reflux time (F=56.9, P<0.01). In detail, no significant differences were identified between standing position and RT-20 or RT-40 position (q=1.51, 1.33 respectively, both P > 0.05), except for supine position (q=4.11, P<0.01). Peak relfux velocity in standing, supine, RT-20 and RT-40 positions were (55.26±22.24) cm/s, (22.87±12.03) cm/s, (38.46±16.30) cm/s, (45.13±19.21) cm/s respectively. There were also signiifcant differences among different positions in peak relfux velocity (F=13.7, P<0.01). Comparing the supine, RT-20 and RT-40 positions with standing position, differences of the peak relfux velocity between them were all statistically signiifcant (q=12.71, 6.59, 3.98 respectively, all P<0.01). Conclusions When GSV reflux was examined by pneumatic cuff compression, false negative rate was higher in the supine position. RT-20 and RT-40 position were effective to detect GSV relfux, espically for GSV at mid-thigh and upper calf.

0.05 by ? 2 test (? 2=0.487). CT angiography of SSD, MIP, and CT virtual vascular endoscopy could show the location, extent and degree of occlusion or stenosis of internal carotid arteries clearly. CT angiography could also detect calcific plaque in 21 internal carotid arteries and soft plaque in 15 internal carotid arteries. Conclusion Two slices CT perfusion imaging could be made with regular helical CT scanner. CTA could also evaluate the status of plaque. The combination of CT perfusion imaging and CTA are useful not only in observing the morphology of internal carotid arteries, but also in observing the hemodynamic information of the brain, which are important for further general individual analysis.

Objective　To evaluate the value of CT MRI in diagnosing skull base chondromas.Methods　8 cases of skull base chondromas were analyzed with etiology,pathology,imaging fetures and differential diagnosis.5 cases were female,3 cases were male,age ranged from 25 to 48 years.The clinical presentation of 8 cases of skull base chondromas had neurologic syndrome.And 3 cases were examined with CT,MR imaging ,4 cases with MR imaging,1 case with CT scanning.Results　In this series of 8 chondromas,3 located in the cavernous sinus,2 in the clival region,2 in the region of jugular foramen,1 in the frontal cranial fossa.Intratumoral calcification was found in 4 cases with CT examination.Heterogeneous enhancement was found in 4 cases with CT examination.The margin of chondromas on CT was well defined.Conclusion　CT have a very important diagnosis values for detecting tumors on chondromas.MRI is superior to CT for delineating the growth style of the tumor and its relationship to the surrounding anatomic structures.

OBJECTIVE To investigate the clinical characteristics and risk factors of nosocomial infection in advanced lung cancer patients during and after chemotherapy. METHODS A retrospective analysis of 119 cases suffered from nosocomial infections from 628 cases with lung cancer was made. RESULTS The nosocomial infection rate was 18.9%.The most common infection site was respiratory tract,followed by gastrointestinal and urinary tracts.The ratio of G-bacilli to total bacteria examined was 49.5%,and the bacilli were mainly Pseudomonas aeruginosa,followed by Escherichia coli.The ratio of G +bacilli and fungi to total bacteria examined were 27.8% and 22.7%,respectively. CONCLUSIONS It is found that the risk factors of nosocomial infection in lung cancer patients are central type of lung cancer,retreated patients,hypoalbuminosis,lower CD4 +/CD8 + ratio,invasive operation,time of using broad-spectrum antibiotics and longer hospital stay and the higher risk factors are grades 3-4 neutropenia and infections due to accompanying persons.

Objective To evaluate the clinical effects of partial fascicle from the ulnar nerve to biceps branch of musculocutaneous nerve to treat brachial plexus injury. Methods Six cases of brachial plexus injury were involved in this group.3 cases were upper trunk injury and 3 cases were accompanied partial lower trunk injury.A partial fascicle of ulnar nerve transfered to repair biceps branch underwent in all cases,phrenic nerve or accessory nerve were transfered to repair suprascapular nerve.The mean time from injury to surgery was 2.8 months.Patients were evaluated with regard to elbow flexion and should abduction ansle,grip strengthen,morbidity of ulnar nerve function lose. Results Five cases out of six got follow up.The mean period of follow-up was 18 months(range from 9-30 months).The average reinnervation time for the biceps muscle was 3.3 months. All the patients' recovery of elbow flexion Was M_3~+-M_5; and the shoulder adduction was 90°-180°;the grip strength was not downgraded. No notable impairment of the donor site nerve function was observed in 4 cases,just 1 case with a little more fascicle been harvested had partial ulnar nerve impairments. Conclusion The use of ulnar nerve partial fascicle to biceps branch combined with phrenic nerve or accessory nerve to suprascapular nerve to reconstruct upper roots avulsion of the brachial plexus is a valid and convenient procedure.It can obtain good functional restoration in elbow flexion and shoulder adduction in a resonable time.The cases with partial lower trunk injury of brachial plexus,the partial fascicle of ulnar nerve can still be used for repair the musculocutaneous nerve.

Abstract] Objective To establish an assay for the detection of porcine parvovirus ( PPV) and to verify its application for monitoring cells used for production.Methods A pair of primers and one probe were designed according to the conserved sequence encoding non-structural protein 1 (NS1).Based on the designed primers, a real-time fluorescent quantitative PCR assay for the detection of PPV was developed. Several parameters including the linearity, precision, minimum detection limit and anti-interference of the established assay were evaluated.A stock of PPV strains was prepared by infecting swine testicle ( ST) cells with PPV strains.An assay for the detection of PPV infection was developed by using ST cells as sensitive cells.A combined ST cell infection-PCR test was developed by combining the ST cell infection assay with the real-time fluorescent quantitative PCR assay.The sensitivity of ST cell infection-PCR test was analyzed.The cell samples used for production of biological products were detected by using the established assay.Results The real-time fluorescent quantitative PCR assay was specific for the detection of PPV without cross-reaction to other species of parvovirus virus, SV40 virus and other porcine viruses.The linear range of the assay was 1×109-1×104 copies/μl with a R2 value more than 0.98.The sensitivity of the real-time quantitative PCR assay was 1×104 copies/μl.Both of the intra-and inter-coefficient of variation (CV) were less than 5%in Ct values.The intra-and inter-CV in copies of detection were 5%-15% and 30%-40% respectively.The minimum detection limit of the real-time fluorescent quantitative PCR assay was 1CCID50/ml.The PPV strains were detected in cell samples with no interference.The sensitivity of ST cells infection-PCR test was 0.01CCID50/ml.All of the 22 cell samples were negative for PPV by using the real-time fluorescent quanti-tative PCR assay.Conclusion The real-time fluorescent quantitative PCR and the ST cell infection-PCR test for the detection of PPV in cells were established successfully.The application of the two assays was conducive to further enhance the safety of using cells for production and therapy.

Center for faculty development (CFD) in Shanghai University of Traditional Chinese Medicine is one of the earliest agencies of the university targeted for professional development of the teachers.In recent years,CFD took learning community as one of the main way to promote teacher professional development and made in-depth researches.This paper discussed on organization and form of community as well as teachers' training and assessment.

Objective To evaluate the diagnostic value of ultrasound-guided pleural biopsy combined with thoracic biochemical detections in malignant and tuberculous pleural effusions. Methods Sixty-four patients with moderate or large pleural effusions and pleural thickening received the ultrasound-guided diagnostic pleural biopsy. All patients had chest CT enhancement scans to find out the suspicious pleural thickening preoperatively, facilitating the selection of puncture sites by ultrasound. Pleural tissue samples were sent for pathological examinations immediately. After successful achievements of pleural biopsy, ultrasound-guided aspiration or drainage was performed to alleviate symptoms, more importantly, to get pleural effusions for biochemical analysis. Biological results including carcinoembryonic antigen(CEA), CA125, CYFRA21 and lactate dehydrogenase(LDH) in malignant and tuberculous effusions were analyzed by group design t tests. The positive rates of CEA, CA125, CYFRA21, LDH in malignant and tuberculous effusions were compared by chi square tests. Results Pleural tissues in all cases were got by one pleural biopsy procedure. The strategy of pleural biopsy we used in this study had a successful rate reaching 100%(64/64), and 73% (46/64) patients had a definitive diagnosis as malignant or tuberculous effusion. Twenty-seven cases were diagnosed as malignant effusions and thirty-seven cases as tuberculous effusions based on the deifnitive clinical diagnosis. The positive rates of CEA, CA125, CYFRA21, LDH in malignant effusions were 100%(27/27), 100%(27/27), 100%(27/27), 89%(24/27) respectively, and 0%(0/37), 84%(31/37), 78%(29/37), 76%(28/37) respectively in tuberculous effusions. The positive rate of CEA between malignant and tuberculous effusions differed signiifcantly (χ2=64.0, P < 0.01), so did CA125 (χ2=3.1, P < 0.01) and CYFRA21(χ2=4.8, P<0.01). The average levels of CEA, CA125, CYFRA21, LDH in pleural effusion were (727.1±658.8)μg/L, (795.2±1249.6)×103 U/L, (296.2±320.7)μg/L, (1077.9±1058.5) U/L respectively, and (1.7±1.1)μg/L, (336.3±208.6)×103 U/L, (20.7±14.9)μg/L, (309.2±182.7) U/L in tuberculous effusions.There were signiifcant differences in CEA, CYFRA21 and LDH concentrations among malignant and tuberculous effusions (t=45.1, 27.4, 18.8 respectively, all P<0.01). Conclusion Ultrasound-guided pleural biopsy combined with CEA, CYFRA21 and LDH in pleural effusions had an important value in the etiological diagnosis of pleural effusions, while CA125 showed little value in the differential diagnosis.

Objective To search for a more efficient method to induce bone marrow stromal cells (BMSCs) into Schwann-liked cells (SLCs) in vitro. Methods On the base of the method which was used by Dezawa (it was looked as the traditional inducing method),some steps were modified,namely,to use all the reagents in half dose in the same time and two times intervally,this method was looked as the modified inducing method.After induced by the two methods,the cells morphologic characteristic,the positive ratio of immunocytochemical dye with anti-S-100 and anti-GFAP,the cells activity measured by MTT method and the DNA percentage in S period measured by flow cytometry were compared with each other respectively to evaluate the methods'effects. Results Compared with the traditional method,the cells induced by the modified method were more similar to the primary Schwann cells in morphology,more positive proportion in immunocytochemic dye with anti-S-100 and anti-GFAP,less damage in the activity and more percentage in S period. Conclusion The modified method had more advantages such as less damage on cells and more efficiency in inducing BMSCs into SLCs.

Objective To evaluate CT and MRI for the diagnosis of cranial extradural empyema.Methods The imaging features in 4 patients with cranial extradural empyema were analyzed.Results 2 cases in frontal,1 case in frontalparietal,1 case in posterier cranial fossa,in this series of 4 cranial extradural empyemas was found homogenous enhancement of dural,and thickened meninges surrounding the empyema.In the series of 1 case show bony thickening and thin.Conclusion The CT and MR of cranial extradural empyema can well demonstrate the morphological and pathological evidence of ivolved menings.Therefore,CT and MR is the most diagnostic value in cranial extradural empyema.