OBJECTIVE:To observe therapeutic efficacy of zoledronic acid in the treatment of acute pain of vertebral compres-sion fractures during different courses. METHODS:207 patients with acute thoracic or (and) lumbar vertebral compression frac-tures were selected and randomly divided into trial group(107 cases)and control group(100 cases). Control group was given calci-um carbonate(1 200 mg/d)diclofenac sodium sustained-released tablet(75 mg/d).Trial group was additionally given zoledronic ac-id 5 mg added into 5%Glucose solution 100 ml,intravenous dripping for 15-30 min,on the basis of control group. RESULTS:Af-ter treatment,VAS score of two group decreased significantly,and trial group the decrease was more significant than control group,with statistical significance (P<0.05),there was no statistical significance in VAS score between course≤one month and one month 0.05);after 4d treatment,there was statistical significance in VAS score between course≤one month and one month 0.05);after one week,there was statistical significance in VAS score between one month 2 months (P<0.05).CONCLUSIONS:Zoledronic acid may partly alleviate the pain of acute vertebral fractures,the analgesic effect is more clear in early stage.

Objective To observe the clinical efficacy of combining buprenorphine with joint mobilization in the treatmeut of periarthritis of the shoulder.Methods A total of 103 patients were randomly divided into groups A,B and C.Group A received buprenorphine and joint mobilization;group B was treated with the non-steroidal antiinflammatory drug loxoprofen sodium and joint mobilization;group C received only joint mobilization.One week,3 weeks and three months after the treatment,the subjects used a visual analogue scale (VAS) to rate their level of discomfort,and Constant-Murley scores (CMS) and the degree of shoulder activity were quantified in all 3 groups.Any differences in the intensity of joint mobilization were also observed.Results The VAS ratings,CMS and the degree of activity of the shoulder joint improved significantly in all three groups after the treatment.One week after the treatment,the average VAS score of group A (2.8±1) was significantly lower than that of groups B (3.8±1) and C (4.5± 1.3),but group A's average CMS (60.1±10.7) had increased to significantly more than those of groups B (48.8± 11.0) and C (44.9±9.7).At the same time,the average shoulder joint rear protraction,90° extorsion abduction,internal rotation and external rotation angles of group A were all significantly bigger than those of groups B and C.The differences were maintained until at least three months after the treatment.One week after the treatment,the intensity of the joint mnobilization of group A was significantly higher than in groups B and C,with that discrepancy also continuing until at least 3 months after the treatment.Conclusions Buprenorphine combined with joint mobilization is very effective in the treatment of periarthritis of the shoulder.It is simple,safe and elicits good patient compliance.It is worthy of pronotion among shoulder periarthritis patients.

Objective To evaluate the clinical value of the isothermal RNA amplification assay (SAT) for detection of Mycobacterium tuberculosis in sputum samples.Methods Sputum specimens from 230 patients with diagnosed tuberculosis and 78 cases of other respiratory diseases during September to December 2011 were detected using SAT,BD960 culture,LowenStein-Jensen( L-J ) culture and concentrated smear simultaneously.The samples with different results between SAT and BD960 culture were tested by Mycobacterium tuberculosis PCR fluorescence diagnosis kits.Strains were identified by amplification and sequencing the BD960 culture-positive isolates and SAT amplification products.Positive detection rate of SAT and other three methods for patients with tuberculosis were compared by chi-square test.Results Using the results of BD960 culture as the golden standard (7 cases of pollution bacteria in BD960 culture was rejected ),the sensitivity,specificity,positive predictive value,and negative predictive value of SAT was 90.5％ (95/105),84.2％ (165/196),75.4％ (95/126),94.3％ (165/175),respectively.The agreement rate of SAT and BD960 culture was 86.4％ (260/301).For 223 tuberculosis patients,the positive detection rate of SAT,BD960 culture,L-J culture and concentrated smear was 56.5％ ( 126/223 ),45.7％ ( 102/223 ),41.7％ ( 93/223 ) and 37.2％ ( 83/223 ) respectively.The positive detection rate of SAT is significantly higher than the other three methods (x2 =4.087,P ＜ 0.05 ).Conclusion SAT,as a new technology for laboratory diagnosis of TB,has high specificity and sensitivity.The operation is fast and simple,and the pollution rate is low.It is a promising laboratory diagnosis method.

Objective To understand the bacteriology and the association between drug susceptibility and clinical features from recent hospitalization of tuberculosis(TB)patients with positive tuberculosis bacilli culture.Methods We collected the clinical data of inpatients due to tuberculosis or pulmonary disease with positive tuberculosis bacilli by BACTEC960 culture auto-analysis system and possessing anti-tuberculosis drug susceptibility testing results from January 2008 to November 2008.All isolated strains were tested with first-line drugs included Streptomycin(S),Isoniazid(H),Rifampicin(R)and Ethambutol(E).Some isolate strains were used to test Amikacin(Am),Capreomycin(Cm)and Ofloxacin(Ofx).We recorded the drug-tested results and clinical data and retrospectively analyzed them.The patients with pulmonary disease from nontuberculosis mycobacteria(NTM)were excluded.Results (1)There were 417 patients with positive culture of tuberculosis bacilli (included 294 male and 123 female).The mean age was(47.8 18.1)years(ranging from 6 to 91 years).There were 68 cases complicated with endobronchial tuberculosis(EBTB)and 56 cases with type 2 diabetes mellitus.(2)There were 271 cases for initial treatment and 146 cases of relapsing tuberculosis.The total drug resistant rate was 53.5 percent,and of oflx was as high as 31.86 percent.The initial drug resistant rate was S 22.5%,H 25.8%,R 17.3%,E 21.0%,Am 6.3%,Cm 10.0%,Ofx 16.6% respectively and the required rate was 67.8%,82.9%,68.5%,68.5%,19.9%,25.3%,58.2% respectively.(3)There were 143 patients with multi-drug resistant TB(MDR-TB).The mean age 44.59?16.31 was significantly younger than of other patients(P

Objective To evaluate the clinical efficacy of compound matrine injection combined with fentanyl transdermal patch in the treatment of elderly patients with advanced gastric cancer.Methods A total of 100 elderly patients with advanced gastric cancer were enrolled in this study.All patients were randomly divided into the observation group (n =50) given compound matrine injection plus Fentanyl transdermal patch and the control group given fentanyl transdermal patch alone(n=50).The analgesic efficacy,quality of life and adverse reaction were evaluated and compared between the two groups.Results The analgesic efficacy was significantly higher in the observation group[76％(38/50)]than in the control group[(44％),(x2=4.46,P＜0.05)].Before treatment,the life quality scores were similar between two groups.After treatment,the life quality score of the two groups was significantly improved as compared with pre-treatment.In addition,life quality score was significantly higher in the observation group than in control group(t=8.61,P＜0.05).After treatment,only mild adverse events were observed in two groups,with no significant difference in adverse events between the two groups(x2 =0.00,P＞0.05).Conclusions Compound matrine injection plus Fentanyl transdermal patch are safe and effective in the treatment of carcinoma pain in elderly patients with advanced gastric cancer.

Objective To investigate the relation of autophagy and postherpetic neuralgia in elderly patients,and provide new methods for prevention and treatment of postherpetic neuralgia.Methods One hundred thirty-five specimens were obtained from elderly patients with herpes zoster,containing 83 patients with herpes zoster plus neuralgia and 52 cases with non-neuralgia herpes zoster.The level of autophagy was determined by acridine orange-stain.The protein expressions of autophagy marker protein LC3 and autophagy related protein Beclinl were detected by Western blot.Results Flow cytometer detection after acridine orange-stain showed that mean fluorescence intensity (MFI) of herpes zoster plus neuralgia patients was 0.775±0.068 and non-neuralgia herpes zoster patients was 0.342±0.025.The level of autophagy of non-neuralgia herpes zoster patients was significant lower than herpes zoster plus neuralgia patients (P＜0.05).The expressions of autophagy marker protein LC3 and autophagy related protein Beclin1 detected by Western blot also showed the level of autophagy of non-neuralgia herpes zoster patients was decreased compared with herpes zoster plus neuralgia patients.Conclusions High level autophagy is risk factor for postherpetic neuralgia in elderly patients.

Objective To observe the effect of extracorporeal shock wave (ESW) combined with intervertebral foramen injection on the lumbar facet joint syndrome.Methods Ninety-three patients presenting the syndrome were randomly divided into acombined group,ashock wave group and acontrol group,each of 31,according to a random number tab.All three groups were given a nonsteroidal anti-inflammatory drug,the shock wave group was additionally treated with a course of ESW,while the combined group received the shock wave treatment and lumbar intervertebral foramen injection.The three groups were assessed using theOswestry disability index (ODI),theRoland Morris Disability Questionnaire (RMDQ)and a life quality scale (QOL-SF36) beforetreatment and after 1,4 and 8 weeks of treatment.Pain was reported using a visual analogue scale (VAS).Results Theaverage VAS,ODI,RMDQ and QOL-SF36 scores of the three groups had all improved after the treatment.After one week the average scores of VAS (2.6±1.4),ODI (15.9±8.3),RMDQ (9.9±5.4) and QOL-SF36 (74.6±17.1) of the combined group had improved significantly more than those of the control group [VAS (4.3± 1.3),ODI(22.8± 6.9),RMDQ (14.9±7.7) and QOL-SF36 (61.6±17.7)].Fourweeks after the treatment,the averageVAS,ODl,RMDQ andQOL-SF36 scores [(2.5±1.3),(15.1±7.3),(9.8±5.1) and (76.8±16.8)] of the shock wave group had improved significantly more than those of the control group [(3.9 ± 1.4),(20.3 ± 8.2),(13.9 ± 8.1) and (67.2±20.6)].Such significant improvements lasted until 8 weeks after the treatment.ConclusionsESW combined with intervertebral foramen injection can relieve the pain oflumbar facet joint syndrome,improve lumbar vertebral function and patients' quality of life.It is worthy of clinical application.

Objective:To prepare urokinase targeted thrombus microbubbles combined with low frequency ultrasound to dissolve thrombus in rabbit femoral artery, and to explore the mechanism of thrombolysis through the change of urokinase concentration.Methods:Twenty-four rabbits with thrombosed femoral artery were randomly divided into four treatment groups: urokinase alone (UK) group, ultrasound with non-targeted microbubble and urokinase (US+ M+ UK) group, platelet-targeted microbubble with urokinase (R+ UK) group, ultrasound with platelet-targeted microbubble and urokinase (US+ R+ UK) group. Thrombus-targeted microbubbles were injected through the ear vein and irradiated by ultrasound for 30 minutes, and the pulsed Doppler blood flow meter was used to continuously monitor the blood flow at 0 min, 10 min, 20 min, 30 min, 60 min, 90 min and 120 min after injection. At the same time, the changes in urokinase concentration were monitored, and the characteristics of blood flow and urokinase concentration changes were analyzed.Results:UK and US+ M+ UK groups failed to show recanalization at 120 minutes after treatment.In contrast, the US+ R+ UK and R+ UK groups both achieved persistent recanalization( P<0.001). Compared with the basal state. Both the R+ UK group and R+ UK+ US group showed a decrease at 60 minutes, and the difference was statistically significant( P<0.05). Conclusions:In the thrombolysis process of low-frequency ultrasound combined with a targeted contrast agent carrying urokinase, the targeting can make the local urokinase concentration of thrombus reach the highest level. At the same time, ultrasound and targeted microbubbles promote urokinase to enter the thrombus, and finally achieve the strongest thrombolytic effect.

OBJECTIVE To examine the prevalence and trends of drug resistance of nontuberculous mycobacteria(NTM)in Shanghai.METHODS All NTM strains isolated between 1998 and 2004 in Shanghai were identified with conventional biochemical tests.Antimicrobial susceptibility test for all NTM was performed by standard absolute concentration method.RESULTS The prevalence rate was determined as 1.49%,1.17%,1.98%,2.46%,2.66%,2.72% and 3.0% among mycobacteria culture positive patients per year in 1998,1999,2000,2001,2002,2003,and in 2004,respectively.These data indicated the prevalence rate has continuously increased.Distribution of NTM isolates was Group Ⅰ18.7%,Group Ⅱ 5.1%,Group Ⅲ 25.1%,and Group Ⅳ 51.1% accordingly.Group Ⅳ rapidly growing NTM accounted for majority of them.Most of NTM showed high drug resistance to general antituberculotic drug.In particular Group Ⅳ Mycobacterium chelonae and M.fortuitum appeared multi-drug resistance.CONCLUSIONS The prevalence rate of NTM in Shanghai shows increased tendency.Most of NTM isolates are Group Ⅳ rapidly growing NTM.NTM shows high drug resistance to first line antituberculotic substance.

Objective To modify the existing preparation instrument for medical patch material to realize its scale and automatic production.Methods The instrument had its shaking table improved and a cylindrical processing system added with comprehensive analysis on raw materials and kinds of process flows.A spreading and fixation mechanism for animal materials was placed in the cylindrical processing system,which had the holes for liquid inlet and outlet respectively on its top and bottom.The cylindrical processing system was fixed to the base of the shaking table.Results The instrument enhanced preparation efficiency significantly,and had the raw material utilization rate increased by 20％,product qualification rate raised by 35％,preparation cycle reduced by 33％ and total cost saved by 40％.Conclusion The instrument behaves well in adaptability to multi animals,preparation process,inter-assay difference,raw material utilization rate,product qualification rate and cost reduction,which is of great significance to promote the clinical application of medical biological patch.