[Objective]To examine the relationship of thoracic kyphosis with gender,age,shape of thoracic vertebral bodies and intervertebral discs.[Method]The gender,age data and MR films of Thoracic spines of 61 cases were collected in a retrospective study.The MR films were scanned into computer.Vertebral and disc morphology,as represented by antero-posterior height ratios,were quantified in computer.Kyphosis was indicated by the Cobb angle.Pearsons correlation analysis and stepwise regression were applied to examine relationship between them.[Result]Vertebral morphology was highly related with thoracic curvature,while a poorer association was noted to disc morphology.The combined infuence of both morphology of vertebral body and intervertebral disc accounted for the variability in kyphosis in 81% female,and 72% in male.[Conclusion]The normal kyphosis of the thoracic spine is determined by the morphological state of both the vertebral bodies and intervertebral discs,especially in female.

Objecive To observe the characteristic appearance of veins spatial distribution of lump's tissue by using Photoshop so as to improve the ability of ultrasonic diagnosis.Methods The images of lump's tissue gotten from ultrasonic were converted by using Photoshop.Then the corresponding relations between small wave coefficient and local characteristics were analyzed.Result Image determination and wavelet analysis for lump tissue not only provided frequency spectrum and veins analysis for images,but also acquired quantitative data received from focus and normal tissue.Conclusion Wavelet analysis provides reliable basis for distinguishing and analyzing characteristics of focus in clinical lump diagnosis.

ObjectiveTo investigate the effect of cholinesterase inhibitor on endotoxin-induced brain injury in rabbits.Methods Twenty-one healthy male rabbits were randomly assigned into three groups ( n ＝ 7each):group sham operation (group S),lipopolysaccharide (LPS) group and cholinesterase inhibitor (tacrine hydrochloride,THA) group.LPS 200 μg/kg was intracerebroventricularly injected in LPS group,LPS 200μg/kgand tacrine hydrochloride 150 μg/kg were injected in THA group,while same volume of normal saline was injected in S group.Then blood and tissue samples were collected in different groups after 4 hours.Nuclear factor-kappa B (NF-κB) p65 activity of brain tissues was determined by using Western blot analysis.Tumor necrosis factor-alpha (TNF-α) levels in plasma,cerebrospinal fluid and brain tissues were measured using enzyme linked immunosorbent assay.The brain tissue's myeloperoxidase (MPO) activity and the ratio of wet to dry weight (W/D) were also analyzed.ResultsAs compared with S group,TNF-α level in plasma,cerebrospinal fluid and brain tissues,NF-κB p65 level,MPO activity and W/D ratio increased in LPS and THA groups (P < 0.05).When compared with LPS group,TNF-α level in plasma,cerebrospinal fluid and brain tissues,NF-κB p65 level,MPO activity and W/D ratio decreased in THA group ( P < 0.05 ).ConclusionCholinesterase inhibitor can attenuate the endotoxin-induced brain injury through inhibiting local inflammatory responses.

Objective To investigate the risk factors of thrombopenia(TP)in septic patients complicated with acute kidney injury (AKI).Methods Two hundred and sixty five septic patients complicated with AKI admitted in Intensive Care Unit ICU of Zhejiang Provincial People''s Hospital during January 2012 and December 2016 were enrolled in the study.The clinical data, results of laboratory tests, Acute Physiology and Chronic Health Evaluation (APACHEII) scores, Sequential Organ Failure Assessment (SOFA) scores, therapeutic intervention, and 28-day mortality were documented.Among 265 patients, TP occurred within 7 days in 112 cases (TP group) and did not occur in 153 cases (non-TP group).Multivariable Logistic regression analysis was performed to analyze the risk factors of TP.Results The 28-day mortality rate in TP group was higher in TP group than that in non-TP group (47.3% vs.33.3%, χ2=5.307,P<0.05).Univariate analysis showed that age, C-reactive protein (CRP), procalcitonin (PCT) and APACHEII score, SOFA score, continuous renal replacement therapy (CRRT), heparin anticoagulation, shock, usage of linezolid and bloodstream infections were associated with TP in septic patients with AKI(all P<0.05).Multivariable Logistic regression analysis showed that age≥65 (OR=4.53, 95%CI 1.23-9.24,P<0.05), CRRT(OR=5.24,95%CI 2.14-14.56,P<0.01), heparin anticoagulation(OR=4.56,95%CI 2.13-8.46,P<0.01), usage of linezolid(OR=2.35,95%CI 1.25-5.24,P<0.01), shock(OR=2.15,95%CI 1.03-4.96,P<0.01)and bloodstream infections(OR=4.26,95%CI 1.36-12.48,P<0.01)were independent risk factors for septic patients with TP.Conclusion For septic patients with AKI having these risk factors, the platelet counts should be closely monitored, and intervention measures should be given to reduce the occurrence of TP.

Objective To investigate the effect of CCAAT/enhancer-binding protein homologeus protein (CHOP) in Tan Ⅱ A treated acute promyelocytic leukemia (APL) cells.Methods APL cell differentiation was monitored by morphology and membrane differentiation antigens; expression of CHOP was inhibited by siCHOP; mRNA and protein expression of CHOP in Tan Ⅱ A-intervened APL cells were examined by RT-PCR and Western blot.Results Expression of CHOP was increased in Tan Ⅱ A induced differentiated APL cells (proteins levels 1.933±0.987 vs 0.537±0.110,F =114.852,P ＜ 0.01,mNRA levels 1.587±0.815 vs 0.713±0.090,F =52.256,P ＜ 0.01),combination of CHOP gene silencing with Tan Ⅱ A treatment induced strong APL cell differentiation [(50.767±1.241) ％ vs (16.167±2.122) ％,F =989.431,P ＜ 0.05] and apoptosis [(89.233±5.581) ％ vs (27.433±2.957) ％,F =308.961,P ＜ 0.05].Conclusion CHOP acts as a negative regulator in Tan Ⅱ A induced differentiation.Inhibition of CHOP may be a promising therapeutic strategy.

Objeetive To explore the analgesic and hemostatic effect of lidocaine gelatin fiber used after endoscopic sinus surgery.Methods 86 patients underwent endoscopic sinus surgery were randomly divided into A and B groups.In A group,20％ lidocaine gelatin fiber and expansion hemostatic sponge was packed into 43 patients' nasalcavity,while in B group,only expansion hemostatic sponge was packed.Nasal bleeding in patients while packed material within 24 hours and when extracted the material were observed.The analgesic effects were evaluated after packing material 1,6,12,and 24 hours after surgery.Results In A group,the amount of bleeding was (16.30 ± 5.19)ml,while the amount was(32.30 ± 12.09) ml in group B.Statistical analysis showed significant difference(t =7.97,P ＜0.05).There were no significant differences in nasal bleeding when extracted the stuffing and in analgesic efficiency 1hour after surgery.But the analgesic efficiency of lidocaine gelatin fiber was 20％,which was better than expansion hemostatic sponge 6 ～24 hours after surgery (t =27.163,29.091,16.241,all P ＜ 0.05).Conclusion Lidocaine gelatin fiber not only had better hemostasis,but also had better analgesia than expansion hemostatic sponge after endoscopic sinus surgery.

Objective To explore the risk factors influencing the prognoses by analyzing clinical data of patients with acute paraquat intoxication,and provide a basis for clinical prevention and treatment of the disease. Methods The clinical data of 176 patients with acute paraquat intoxication admitted into our Hospital were retrospectively collected during the period from January 2012 to February 2013. After admission,the conventional medical treatment was given to all the patients,and according to the prognoses of 28 days after poisoning,the patients were divided into death group and survival group. The gender,age,toxic dose,time elapsed from poisoning to admission,time elapsed from poisoning to gastric lavage,number of cases treated with drug lavage,white blood cell count(WBC),alanine amino-transferase(ALT),aspartate amino-transferase(AST),blood urea nitrogen(BUN), serum creatinine(SCr),acute physiology and chronic health evaluation system Ⅱ(APACHE Ⅱ)score,carbon dioxide combining power(CO2CP),number and time of cases revealing arterial blood oxygen saturation(SaO2)<0.90, and the survival rate within 28 days after admission were recorded. Multivariate logistic regression was used to analyze the factors related to the prognosis. Results ①Of the 176 cases,96 survived and 80 died in 28 days,the survival rate being 54.55%.②Univariate analysis showed the poisoning dose(ml),time elapsed from poisoning to admission (minute), WBC(×109/L), ALT(U/L),AST(U/L),BUN(mmol/L),SCr(μmol/L),APACHEⅡ scores, CO2CP (mmol/L),number of cases with SaO2<0.90 in the survival group were significantly lower than those in the death group〔38.14±39.44 vs. 88.50±58.79,41.11±30.29 vs. 90.00±59.31,11.78±3.61 vs. 16.13±5.02,84.46±42.53 vs. 156.35±76.62,76.21±38.69 vs. 184.00±86.48,5.34±2.89 vs. 10.51±6.80,84.17±77.38 vs. 199.74±162.13, 0.96±1.60 vs. 3.60±2.61,22.02±4.47 vs. 18.35±4.19,4(4.17%)vs. 80(100.00%),respectively,all P<0.01〕;there were no statistically significant differences in time elapsed from poisoning to admission(hour),number of cases treated with drug lavage and time of revealing SaO2<0.90(day)between survival group and death group〔7.96±3.39 vs. 8.05±4.26, 20(20.83%)vs. 24(30.00%), 62.25±18.45 vs. 65.70±45.10,respectively,all P>0.05〕.③Multivariate logistic regression revealed poisoning doses>30 ml〔odds ratio(OR)=6.455,95% confidence interval(95%CI)3.177-13.113,P<0.001〕,time elapsed from poisoning to admission>30 minutes(OR=8.639, 95%CI 4.043-18.461, P<0.001), WBC>12×109/L (OR=2.745,95%CI 1.388-5.426, P=0.004),BUN>8 mmol/L(OR=6.713,95%CI 2.650-17.006,P<0.001)and CO2CP≤22 mmol/L(OR=4.737,95%CI 2.389-9.394, P<0.001) were the risk factors correlated with the prognosis of patients with acute paraquat intoxicationl. Conclusion Poisoning doses,time elapsed from poisoning to admission,BUN,CO2CP and WBC are the independent risk factors for predicting prognosis of acute paraquat intoxication.

Objective To observe the clinical efficacy of Shiwei Longdanhua Capsule combined with western medicine on patients with mild acute exacerbation of chronic obstructive pulmonary disease (COPD) with phlegm-heat obstructing lung syndrome. Methods Totally 192 cases of COPD with mild acute exacerbation (phlegm-heat obstructing lung syndrome) were recruited. They were randomly divided into the treatment group (96 cases) and the control group (96 cases). Patients in the control group were treated in line with the regular Western treatment, while patients in the treatment group were additionally treated by Shiwei Longdanhua Capsule. After 10-day treatment, the changes of TCM syndrome score, symptom integral and the lung function before and after treatment were compared. Results After treatment, 14 patients withdrew from the treatment group and 15 patients withdrew from the control group. The total efficiency rate of TCM syndrome was 80.49% (66/82) in the treatment group, while it was 56.79% (46/81) in the control group, with statistical difference between the two groups (P<0.05). The severity and frequency of cough and expectoration of the treatment group were better than the control group (P<0.05). The breathing symptom and pulmonary function of patients in the two groups improved, with similar efficacy. Conclusion The efficiency of Shiwei Longdanhua Capsule combined with Western medicine in the treatment of acute exacerbation of COPD is superior to that of simple Western medicine treatment, especially in terms of relieving cough and expectoration.

This study aimed to analyze the effect of the external method of tonifying kidney and promoting blood circulation on endometrial morphology of rats with kidney deficiency and blood stasis model. A total of 50 normal healthy unmated female SD rats of proestrus were selected with vaginal smear. Rats were randomly divided into the blank group, model group, high dose group and low dose group with the prescription of tonifying kidney and promoting blood circulation and theWu-Zi (WZ) group. Except the blank group, intragastric administration of hydroxyurea was given to other group to establish the kidney deficiency model. Meanwhile, clyster of distilled water was given to the blank group and the model group. And clyster of high dose and low dose prescription of tonifying kidney and promoting blood circulation was given to the high dose and low dose group, respectively. The intragastric administrations ofWu-Zi Yan-Zong(WZYZ) pills were given to theWu-Zi (WZ) group. On the 4th day of pregnancy, 10% of the macromolecule dextran was quickly injected to the caudal vein to induce blood stasis model 1 hour after the last medication administration. The uterus tissue section was observed by HE dyeing. The results showed that the thickness of covering epithelium of endometrium in the model group was lower than the blank group (P < 0.05). There were significant differences on the thickness of covering epithelium of endometrium in the high dose group and low dose group with the prescription of tonifying kidney and promoting blood circulation, the WZ group and the model group (P < 0.01). The sum of gland number and gland area as well as the maximum diameter / minimum diameter of the model group was significantly lower than that of the blank group (P< 0.05, orP < 0.01). The shape factor was the closest to “1”, which had significant difference compared with the blank group (P < 0.01). Compared with the model group, the sum of gland number and glandular lumen of the high dose and low dose group were increased at different levels (P < 0.05, orP < 0.01). The sum of gland number, glandular lumen area, shape factor, and maximum diameter / minimum diameter of WZ group had significant difference compared with the model group (P < 0.05, orP < 0.01). The sum of interstitial cells’ nucleus area, integral optical density of interstitial cells’ nucleus and number of interstitial blood vessels in the high dose and low dose group were significantly higher compared to the model group (P < 0.05, orP < 0.01). The sum of interstitial cells’ nucleus area and the integral optical density of interstitial cells’ nucleus in the WZ group were obviously higher than the model group (P < 0.01). It was concluded that the external method of tonifying kidney and promoting blood circulation can effectively improve the endometrial morphology of kidney-deficiency and blood-stasis rat model, promote the synchronous development of endometrial gland and stroma, in order to play a role to improve the endometrial receptivity.

Objective To analyze the epidemiological characteristic of New Delhi metallo-β-lactamase (NDM)-1-positive bacteria in China and explore its mechanism of drug-resistance.Methods The published papers from 2010 to 2015 about domestic blaNDM-1 were collected and analyzed according to the bacteria species,regional distribution,NDM-1-positive bacteria,infectious source,drug-resistance spectra and transfer mechanism.Results NDM-1-positive bacteria were isola-ted from 25 provinces (municipalities)in China,Guangdong Province was predominant and accounted for 39.49%(P <0.05).The number of Klebsiella pneumoniae and Enterobacter cloacae were predominant in the NDM-1-positive bacteria (P <0.05).Number of patients under the age of ten and among 60 -80 years which infected by NDM-1-positive bacteria were predominant of all the reported patients(P <0.05).The most kinds of samples and diseases were sputum sample (P <0.05)and pulmonary diseases(P <0.05).NDM-1-positive bacteria which found in China had the lowest resistance to amikacin and tigecycline accounted for 7.69% and 2.33%(P <0.05).Conclusion Antibiotic resistant bacteria with NDM-1 resistant gene have become a global public health problem,and significant difference among age,districts and sources,which need active surveillance and more studies to find how it happens and epidemic in the future.