153 TMD patients were randomized to be treated by closed treatment of Kenalog(78 cases)and prednisolone(75 cases)respec-tively.Data were analyzed by SPSS 17.0.4-week-follow-up showed that Kenalog closed treatment was more effective than prednisolone(P<0.05).

This article discusses the status quo of mental health,common legal and ethical problems in the diagnosis and treatment of psychological clinical practice,and also puts forward concrete contents and requests for strengthening the self- discipline and right- safeguard in the diagnosis and treatment in psychological clinical practice.

Objective To investigate molecular typing and drug resistance patterns of 98 Klebsiella pneumoniae (K.pneumoniae) isolated from type 2 diabetes patients complicated with maxillofacial infection,to research the virulence and resistance mechanisms.Methods The study was a prospective study that adopted the method of continuous sampling from fixed location,from March 2010 to October 2012.The maxillofacial surgery patients diagnosed with type 2 diabetes complicated with maxillofacial infection were chosen in 7 hospitals in Zhengzhou as the research object,and a total of 431 pus sample were collected continuously,in which 98 strains K.pneumoniae were isolated and identified.The Kirby-Bauer disk diffusion test was conducted in 98 strains to determine the resistance to 19 antibacterial agents.K.pneumoniae chromosomal DNA were digested by restriction endonuclease Xba Ⅰ and analyzed by pulsed-field gel electrophoresis (PFGE).PFGE patterns of K.pneumoniae strains were analyzed using Fingerprinting software.The relationship between the molecular types and resistance phenotype was observed.The extended spectrum β-1actamase-producing K.pneumoniae were screened out by the double disc synergy test (DDST)Polymerase chain reaction (PCR) was used to detect resistant genotypes,serotype and virulence genes.The purified PCR products of resistant genes were cloned and sequenced.Hypermucoviscosity phenotype of all strains were determined by string test.Results Much severer drug-resistance for K.pneumoniae was identified and the result of extended-spectrum beta-lactamase producing rate was 57.1 ％.Ninety-eight strains were dispatched into 13 groups by PFGE.No dominant bands and specific extended-spectrum beta-lactamase DNA bands were found.The results of PCR showed that among the 56 strains of extended spectrum β-lactamase-producing K.pneumoniae,40 were positive for blaSHV (accounting for 71.4％),28 positive for blaTEM (accounting for 50.5％),21 positive for blaCTX-M (accounting tor 37.5％).The sequencing results were as follows:TEM-1,CTX-M-3 and a variety of SHV.Serotype K1,K2,K3,K5,K20,K54 and K57 and 3 kinds of virulence genes were detected,but not in strong toxicity-based.Hypermucoviscosity positive rate was 31.6％ (31/98).Conclusion Much severer drug resistance of K.pneumoniae in this study was identified and resistant mechanism was complex,in which strong toxicity serotype and virulence geues exist,which need more attention from clinical.

Objective To study the pathogenesis,diagnosis and treatment of the compression syndrome of the third common plantar digital nerves.Methods Conservative methods were at first used for all the 34 cases of this disease.Treatment methods includes:wearing shoes with soft bottom and metatarsal pad;the administration of Chinese herbs;the application of direct current iontherapy by filtering Chinese herbs and performing local injection therapy with steroid at the tenderness points.15 patients with no effect following conservative methods and other 3 recurrent cases were treated with section of deep transverse metatarsal ligament and relaxing the nerves compression.Of the 18 cases,5 had additional to excision of the neuroma.Results Of the 34 cases treated with conservative methods,19 had effective results,of which 6 cases recurred,and 15 cases had no effect.18 cases treated with operation had no recurrence.Conclusion Toe extending test and forefoot transversely compressing test provide a valuable basis for diagnosis.Conservative treatment are usually effective in earlier phase.If conservative treatment is not effective,the transverse metatarsal ligament should be sectioned,nerves should be relaxed and the neuroma must be excised.The results of operative treatment are satisfactory.

Objective To compare the concentration of 3-nitrotyrosine and tyrosine and the ratio of 3-nitrotyrosine/tyrosine in the cerebrospinal fluid (CSF) of patients with sporadic amyotrophic lateral sclerosis (SALS) and those with healthy nervous system for definiting the role of free radicals oxidative damage in pathogenesis of SALS. Methods Subjects consisted of 15 patients with SALS and 15 patients with norml nervous system who underwent lumbar anesthesia for surgery. Their CSF was analyzed by using high performance liquid chromatography (HPLC). Results The 3-nitrotyrosine concentration was higher in patients with SALS (228.52?124.30 nmol/L) than that in controls (112.86?47.10 nmol/L) (P

OBJECTIVETo compare the therapeutic effects between close reduction and plaster slab fixation combined with plaster external traction and operation for the treatment of pediatric closed Gartland type III supracondylar humerus fractures without neurovascular injury complications.

METHODSFrom June 2009 to June 2012, 151 children with closed Gartland III supracondylar humerus fractures were retrospectively studied and divided into two groups, including 87 boys and 64 girls, ranging in age from 1 to 12 years old with an average of 5.3 years old. Among them, 76 children (conservative group) were treated with close reduction and plaster slab fixation combined with plaster external traction; 75 children (operation group) underwent surgical operation. The time of elbow joint function exercise, the healing time of fracture, the function recovery of elbow joint and carrying angle was recorded and analyzed. The therapeutic effects were evaluated by the Flynn criteria system.

RESULTSAll patients were followed up from 6 to 36 months (18.3 months on average). The average time of fracture healing and elbow joint functional exercise of the conservative group was shorter than those of operation group (P < 0.001). Motion range of the elbows and carrying angle of two groups were no statistical difference (P > 0.05). According to Flynn criteria system, in conservative group, the result was excellent in 31 cases, good in 35, fair in 7, and poor in 3; in operation group, 27 in excellent, 30 in good, 17 in fair and 1 in poor; there was no significant difference between two groups in therapeutic effects (P > 0.05).

CONCLUSIONClose reduction and plaster slab fixation combined with plaster external traction in treatment of pediatric closed Gartland type III supracondylar humerus fractures without neurovascular injury complications,which has similar effect to surgical treatment, and the time of fracture healing and elbow joint function exercise are significantly shorter.

Case-Control Studies ; Casts, Surgical ; Child ; Child, Preschool ; External Fixators ; Female ; Fracture Healing ; Humans ; Humeral Fractures ; surgery ; Infant ; Male ; Traction ; methods

Objective To investigate the relation of the MR manifestations and the pathological characteristics of dissociated discherniation.Methods Characteristics of pathology and MRI of 23 cases of dissociated disc herniation were retrospectively analysed.Results Of 23 cases,the dissociated disc was low signal intensity(compared with spinal cord) on T_1WI and T_2WI with distinct margine in 7 cases,the adhere and inflammation were slight on pathology;iso-or hypo-signal intensity on T_1WI,low signal intensity in the center and slight high signal intensity at periphery on T_2WI with an distinct margine in 13 cases,while the adhere and inflammation were obvious on pathology;on T_1WI slight high signal intensity on T_1WI and iso-intensity on T_2WI in 3 cases,and fibroplasia was showed on patholgy.In the 12 cases with enhanced MRI,the lesions were slight enhancement at periphery and enhancement in the center in 7 cases,no enhancement in 3 cases,slight enhancement in 2 cases.Conclusion MRI signal characteristic can reflect pathologic changes expressly of the dissociated disc herniation.

Over-expression of P-glycoprotein (Pgp) is associated with the development of multi-drug resistance ( MDR). Pgp has been focused on as the main target in designing chemotherapy strategy. In this article we review some of the latest advancement in designing and evaluation methods of P- glycoprotein inhibitors.

Objective To evaluate the role of multidetector CT(MDCT) and high magnetic field MRI in diagnosis of small cystic-solid renal mass. Methods Fifty-two cases with small renal cystic-solid mass(≤3 cm) were consecutively collected,including small cystic-solid renal cell carcinoma(n=25),carcinoid(n=1),complex cysts(n=16),small angiomyolipoma(n=7) and benign cystic nephroma(n=3).All were examined by both 1.5T MRI and multidetector CT at intervals between 3 days and 2 months. Results All cases were proved by pathology.Multi-planar reconstruction techniques were useful for MDCT in differentiating small cystic-solid renal mass,with the sensitivity of 98.1%,which was as high as MRI.However,the accuracy for MDCT was 71.2%,significantly lower than that of MRI(90.4%)(P=0.001).MRI helped to identify the components and structure of renal masses,and behaved better in the detection of pseudo-capsule of renal cell carcinoma(57.7%).Conclusion High magnetic field MRI may play an important role in the diagnosis of small renal cystic-solid masses,and it may be feasible as a noninvasive examination when CT can not make the ultimate determination.