ObjectiveTo investigate MR imaging features of endolymphatic sac and vestibular aqueduct in patients with large vestibular aqueduct syndrome (LVAS) and its correlation with hearing loss.MethodsMR imaging findings of LVAS were analyzed in 31 cases (62 ears) retrospectively.MR imaging features were grouped into 4 types.In the first type,the signals of endolymphatic and vesitibular aqueduct were hypointense without any hyperintense area.In the second type,the signals of endolymphatic sac and vestibular were hyperintense which were confined within vestibular fissure.In the third type,the area from vestibular aqueduct backward out of the edge of the petrous bone was hyperintense,but its lower boundary was above posterior semicircular.In the fourth type the area which was hyperintense was below the posterior semicircular.To avoid errors in visual inspection,the hyperintense and hypointense area of endolymphatic and the signal intensity of vestibular aqueduct and cerebrospinal fluid (CSF)were measured.The differences of signal intensity among the vestibular endolymphatic sac between the high-signal areas and lowsignal areas were compared with paired t-test.The correlation of the endolymphatic sac MRI classification and degree of hearing losswasanalyzedby correctedChi-squaretestandSpearmancorrelation analysis.ResultTen ears belonged to type Ⅰ (moderate hearing loss in 1 ear,severe in 4 ears,profound in 5 ears),17 ears belonged to type Ⅱ ( moderate hearing loss in 1 ear; severe in 5 ears,profound in 11 ears),23 ears to type Ⅲ (moderate hearing loss in 3 ear,severe in 5 ears,profound in 15 ears) and 12 ears belonged to Ⅳ(mild hearing loss in 1 ear,moderate in 1 ear,severe 3 ear,profound in 7 ears).The boundary between hyperintense and hypointense area was clear,and the signal intensity ratios was 2.02 ± 0.06.The signal ratios of hyperintense and hypointense area to vestibular and CSF were 0.95 ±0.12,0.49 ±0.10,0.99 ± 0.08 respecitively.So there was statistical significant difference between hyperintense and hypointense area ( t =- 24.966,P ＜ 0.05 ),but there was no statistical significant difference between hyperintense area and vesitbular( t =-24.966,P ＞ 0.05).There was no difference of hearing loss between different MRI types ( likelihood ratio =5.02,P ＞ 0.05 ).Conclusions Not only endolymphatic sac enlarged but also perilymph herniated into skeletal fissures of vestibular aqueduct in patients with LVAS.The signal intensity of the endolymphatic sac did not show significant correlation with degree of hearing loss.

Study the serum level of HGF, Cys C and TGF-beta1 in type 2 diabetic nephropathy (DN), the infect of Pingshen decoction on those index. Selected 69 cases of 2 type DN and randomly divided into therapy group (36 cases) and control group (33 cases). The therapy group were treated with Pingshen decoction 1 dose/d, bid po. The control group were treated with NephritisShu tablet, 6 tablet, tid po. 8 weeks was a course. Before and after treatment, we examine the serum level of HGF, Cys C and TGF-beta1 by ELISA and immunonephelometry, and compare with 30 cases of healthy control group. The study demonstrates that before treatment, the serum level of HGF in both groups were significantly lower than healthy control group (P < 0.01), but Cys C, TGF-beta1 were significantly higher (P < 0.01). After treatment, the serum level of HGF of both groups were increased. The serum level of HGF of therapy group were significantly higher than of control group (P < 0.01), but the serum level of Cys C and TGF-beta1 were significantly lower than control group (P < 0.01). The serum level of HGF was correlated negatively with Cys C,TGF-beta1. In control group, the UAER, urine beta2-MG and quantity of 24-hour urine protein were significantly decreased after treatment (P < 0.01). The index of urine of therapy group were significantly lower than control group (P < 0.01). Results indicate that test of serum level of HGF and Cys C,TGF-beta1 of diabetic nephropathy have important clinical significance. Pingshen decoction can effectively intervene in the serum level of HGF and Cys C, TGF-beta1 and index of urine.
Aged ; Aged, 80 and over ; Case-Control Studies ; Cystatin C ; blood ; Diabetic Nephropathies ; blood ; drug therapy ; Drugs, Chinese Herbal ; adverse effects ; therapeutic use ; Female ; Hepatocyte Growth Factor ; blood ; Humans ; Male ; Middle Aged ; Transforming Growth Factor beta1 ; blood

Objective To evaluate the prevalence of NI in the SICU at our hospital. Methods 181 NI patients in the SICU were retrospectively analysed during Jan 1996～Dec 2000.Results The average NI rate was 9.81%. The major sites of NI were respiratory tract(36.96 %),thoracic/abdominal cavity(25.47 %)and bloodstream infections(9.32 %).The difference in major pathogens of infections in different sites reached statistical significance. For respiratory tract, thoracic/abdominal cavity and bloodstream infections,bacteria were the most common pathogens. Fungi were the moat frequent isolate from urine and stool. Mixed infection proportion was 52.25 %. The most common pathogens were Enterococci, Methicillin resistant Staphylococci、 Pseudomonas Aecruginosa、Escherichia Coli、Candida Albicans and Candida Tropicalis. Conclusions The most common pathogens of NI in SICU are different in different infection sites. The pathogens were complicated and most strains are antibiotics resistant. So it is important to establish NI control and to understand the changes of pathogens so as to prevent the infection.

ObjectiveTo evaluate the safety and efficacy of total pelvic reconstruction surgery with Prosima in treatment of pelvic organ prolapse (POP) stage Ⅲ.Methods From July 2010 to December 2011,31 patients with POP stage Ⅲ undergoing total pelvic reconstruction surgery with Prosima were enrolled in this prospective study.Among two cases complicated with stress urinary incontinence underwent transobturator tension-freevaginaltapeconcomitantlywithtotalpelvicreconstructionsurgerywith Prosima.Clinical parameters during peri-operation were recorded and compared.Pelvic organ prolapse quantitative examiuation(POP-Q)andanatomicimprovementinthesepatientsafter surgery were analyzed.Comparisons of pelvic floor impact questionnaire-short form 7 ( PFIQ-7 ) and pelvic organ prolapse-urinary incontinence sexual questionnaire-short form 12 (PISQ-12) in these patients before and after surgery were used to evaluate quality of life and quality of sexual life.ResultsThe mean operating time was (55 ± 13) minutes,mean blood loss was (66 ± 25 ) ml.No severe intraoperative complications were observed.All patients were able to recover spontaneous mieturation within 5 days.Two cases experienced pelvic hematoma with diameters less than 7 cm,and resolved later.Another case was urinary tract infection.At the median follow-up 6 months ( 1 - 15 months),the rate of anatomic success defined as the leading vaginal edge above the hymen was 94％ (29/31).There were significant improvements in Aa,Ba,Ap,Bp,and C (P ＜0.01 ) by POP-Q.Two patients showed recurrent prolapse at 3 months and 1 year after surgery,without the need of further operation.The median score of post-operative PFIQ-7 was 0 point at 6 months and 0 point at 12 months after operation,respectively,which were significantly lower than that of 50 points pre-operation ( P ＜ 0.01 ).And there was no significant difference in the average score of PISQ-12 before and after surgery [ ( 30 ± 6) points versus (31 ± 4) points ] ( P ＞ 0.05 ).The rate of mesh exposure was 16％ ( 5/31 ),all the 5 cases occurred within 6 months and was cut in clinic.There was no case of de novo urinary incontinence and de novo dyspareunia.Conclusions Pelvic rcconstruction surgery with Prosima is safe and efficacy in treatment of POP stage Ⅲ.It could improve quality of life remarkably without influence on sexual quality of life.

In this study ,we aimed to understand the sequence characteristics ,transmembrane structures ,line B cell epitopes present in the OMP18 from Campylobacter jejuni ,and provide candidate antigens for the antibody detection and vac-cine development .NCBI/Blast ,TMHMM Server V2 and DNA Star softwares were used for the OMP18 sequence analysis . Based on the ELISA ,the whole bacterial antibody IgG of Campylobacter jejuni was used for the identification of the predicted line B cell epitopes .The OMP18 gene was found conserved in different Campylobacter jejuni strains .The OMP18 was predic-ted to be located on the outer surface of the bacteria .And three line B cell epitopes were determined to be present in the OMP18 protein .As a conclusion ,the OMP18 protein was confirmed to be an important outer membrane protein ;three line B cell epitopes were identified in the OMP18 ,which could be further used for Campylobacter jejuni antibody detection and vaccine development .

Objective To evaluate the clinical efficacy and adverse reactions of alizarin combined with anti-tuberculosis therapy for multidrug resistant pulmonary tuberculosis (MDR-PTB).Methods A total of 200 confirmed MDR-PTB patients admitted in the Affiliated Hospital of Hangzhou Normal University during June 2013 and June 2015 were enrolled in the study.Patients were randomly divided into study group and control group (100 in each).Both groups were given standard anti -tuberculosis treatment for 8 months, and additional alizarin was given to study group .Chi-square test was used to assess the differences in clinical efficacy, sputum negative conversion rate, cavity closure and lesion absorption rate , as well as the incidence of adverse reactions between two groups ( including patients categorized according to TCM syndrome ). Results There were 39 markedly effective cases, 51 improved cases, 10 ineffective cases in study group, and 22 markedly effective cases, 35 improved cases, 43 ineffective cases in the control group.The total effective rate in study group was significantly higher than that in control group (90% vs.57%, χ2 =28.262, P <0.01).For patients with TCM syndrome differentiation as phlegm -heat stagnating lung and those with qi-stagnation induced blood-stasis, alizarin combination therapy had significantly higher total effective rate than standard anti -tuberculosis treatment (78.78% vs.63.33%, χ2 =7.187, P <0.05;95.74% vs.42.31%, χ2 =73.997, P <0.01), but the difference was not observed in patients with TCM syndrome differentiation as deficiency of qi and blood (95.00% vs.88.89%, χ2 =5.025, P >0.05). There was no significant difference in sputum negative conversion rate between two groups (76% vs.55%,χ2 =2.190, P >0.05).The cavity closure and lesion absorption rate in study group ( 91%) was significantly higher than that in the control group (54%,χ2 =38.294, P <0.01).The adverse reaction rate in study group was 27%, which was significantly lower than that in control group (66%, χ2 =30.570, P <0.01).Conclusion Alizarin in combination with standard anti -tuberculosis therapy can improve the clinical efficacy and reduce adverse reactions in treatment of MDR -PTB.

Objective To express the receptor binding domain (RBD) protein of the Middle East respiratory syndrome coronavirus (MERS-CoV) and to characterize the antigenicity of the purified recombi-nant protein. Methods The codon-optimized gene encoding the RBD protein of MERS-CoV was synthesized and then cloned into the pET30a ( +) vector to construct the recombinant expression plasmid. The trans-formed E. coli BL21 (DE3) strains carrying expression plasmid were induced by IPTG under different condi-tions. The expressed products were purified by using nickel affinity chromatography and further analyzed by SDS-PAGE and Western blot assay. Indirect ELISA was performed to analyze the antigenicity and specificity of RBD proteins expressed in prokaryotic expression systems in human serological test. Results The recom-binant RBD proteins were mainly expressed as conclusion body in an optimal induction condition of 37℃ and 0. 5 mmol/ L IPTG for 4 h. The high purified recombinant RBD proteins were obtained through denaturation and renaturation with a relative molecular mass of about 29×103 . Results of the Western blot assay showed that the recombinant RBD proteins could have specific reaction with the serum samples collected form mice with MERS-CoV infection. Indirect ELISA revealed that the RBD proteins expressed in the prokaryotic ex-pression system showed better sensitivity and specificity in the detection of antibodies against MERS-CoV in human serum samples. Conclusion This study reported the prokaryotic expression and purification of RBD protein of MERS-CoV for the first time, which might pave the way for further investigation on immunological detection of MERS-CoV and development of vaccines against MERS-CoV infection.

OBJECTIVETo assess the value of computed tomography( CT) in the staging and predicting respectability of primary advanced ovarian carcinoma.

METHODSThe data of preoperative abdomen and pelvis CT scan in 64 women with Stage II or IV ovarian carcinoma were collected from tumor registry database. All CT scans were analyzed retrospectively without knowledge of the operative findings, and the stage as based on CT was compared with the surgical and pathological findings. Residual lesion of < or = 2 cm in maximal diameter was considered as an optimal surgical result. Twenty-senven of these 64 patients (42.2%) underwent optimal cytoreduction surgery for residual disease C2 cm in diameter. Based on the ability of each parameter in predicting cytoreductive surgery outcome, 11 radiographic features were selected for the final model. Each predictive parameter was assigned a numeric value (1 to 7). Sensitivity, specificity, positive predictive value( PPV) , negative predictive value( NPV),and accuracy were calculated for each predictive parameter. Receiver operating characteristic( ROC) curve was used to assess the ability of the model to predict surgical outcome. The correlation between CT stage and surgical-pathologic stage was analyzed by Chi-square test and Spearman's rho analysis.

RESULTSThe overall accuracy of CT staging for advanced ovarian carcinoma was 87. 5% ; 86. 5% and 91.7% for stage III and IV patients respectively. The correlation between CT stage and surgicopathologic stage was found to be comformable. In the final predictive index model, when a predictive index scoreed > or = 2, the overall accuracy, sensitivity and specificity was 70. 3% , 67.6% and 74. 1% for identifying patients for suboptimal surgery. The PPV and the NPV was 78. 1% and 62. 5% , respectively. The ROC curve was generated with an area under the curve = 0. 792+/-0. 055 using the predictive index scores.

CONCLUSIONCT has a high accuracy in staging and a moderate ability to predict resectability for advanced ovarian carcinoma. Therefore, the predictive index model may be useful in the management of ovarian carcinoma patients.

Adenocarcinoma ; diagnostic imaging ; pathology ; surgery ; Adolescent ; Adult ; Aged ; Cystadenocarcinoma ; diagnostic imaging ; pathology ; surgery ; Female ; Humans ; Middle Aged ; Neoplasm Staging ; methods ; Ovarian Neoplasms ; diagnostic imaging ; pathology ; surgery ; ROC Curve ; Reproducibility of Results ; Retrospective Studies ; Tomography, X-Ray Computed ; methods ; Treatment Outcome

To observe of alloantibodies of patients with autoimmune hemolytic anemia (AIHA), the alloantibodies masked by autoiantibody were detected by using chloroquine elution test, and the specificity of autoantibody was identified by ether elution test. The results showed that 19 cases out of 38 patients with AIHA were positive detected by indirect antiglobulin test and in 7 cases of them alloantibodies in sera cases were found (1 case of anti-D, 4 cases of anti-E and 2 cases of anti-CE), in 5 cases of them alloantibody were detected carried blood group specificity (3 cases of anti-E, anti-C and anti-c 1 case respectively). In conclusion, detections of alloantibodies by chloroquine elution test and ether elution test were very important for transfusion safety in therapy of patients with AIHA.
ABO Blood-Group System ; Adolescent ; Adult ; Anemia, Hemolytic, Autoimmune ; immunology ; Autoantibodies ; blood ; Blood Grouping and Crossmatching ; methods ; Erythrocytes ; immunology ; Female ; Humans ; Isoantibodies ; blood ; Male ; Middle Aged ; Rh-Hr Blood-Group System

OBJECTIVETo evaluate the capability of C(N) and determinism% (DET%) together with the linear indices, we detected the surface electromyography (sEMG) signal changes during ramp contractions of biceps brachii.

METHODS5 seconds sEMG signals of 11 male volunteers were recorded to analyze its changes of the linear indices AEMG, mean power frequency(MPF), MF and the non-linear indices C (N), DET%.

RESULTSAverage electromyography (AEMG) inclined linearly from 112.14 microV to 1277.18 microV while DET% displayed an decrease from 74.95 to 46.7 during the 5 voluntary contractions. The spectrum parameters MPF/MF and C(N) leveled off with the increasing of the force.

CONCLUSIONThe linear index AEMG inclined linearly while MPF and MF leveled off with the increasing of the force. The non-linear index DET% declined while C(N) leveled off during the 5 seconds ramp contractions.

Adolescent ; Adult ; Arm ; Biomechanical Phenomena ; Electromyography ; Humans ; Male ; Muscle Contraction ; physiology ; Muscle Fatigue ; physiology ; Muscle, Skeletal ; physiology ; Physical Endurance ; Young Adult