OBJECTIVE To study the detectable rate and the antibiotic resistance of Staphylococcus aureus from detention needles of burn patients,and provide instruction of clinic reasonably using antibiotics and clinical treatment.METHODS Totally 175 specimens detention needles of from burn patients were collected to isolate pathogenic organisms.Identification of bacterial strains and susceptibility tests were performed by ATB system.RESULTS S.aureus isolated from the detention needles of burn patients was the predominant pathogen,accounted for 60.3%,and all of them were MRSA.Among these flora,all were resistant to penicillins,oxacillin and gentamicin and more than 50.0% were resistant to lincomycin,tetracyc1ine,rifampicin and so on,2.3% were resistant to minocycline and teicoplanin,and none was resistant to vancomycin, fusidic acid,and quinupristin-dalfopristin.CONCLUSIONS S.aureus isolated from the detention needles of burn patients is the predominant pathogen, which is resistant to many antibiotics.So we should identify the bacterial strains and give susceptibility tests of detention needles from burn patients promptly,in order to provide best instruction on clinic reasonably using antibiotics and slow the development of the resistant bacterial flora.

Objective To observe clinical effect of treating primary dysmenorrhea of congealing cold and blood stasis type with menstruation regulating method.Methods 56 cases of primary dysmenorrhea of congealing cold and blood stasis type were divided into 30 cases as a treatment group and 26 cases as a control group with random number table.The treatment group took Buyang Huanwu decoction in ovulatory period,and took Tongjing decoction in menstrual period.Moderate and severe patients took Jinkui shenqi pill for reinforcing kidney qi for 10 days after menstrual period.The control group took Shaofu Zhuyu granules and stopped to take it until the third day of menstrual period.All patients took the medicines for 3 continuous menstrual cycles.The dysmenorrhea score pre and post treatment,pain degree and effect were observed and compared.Results Menstruation regulating method and Shaofu Zhuyu granules could both improve the clinical symptoms,but the cured and markedly effective rate and total effective rate of menstruation regulating method was better (x2=8.813,P＜0.05),especially for moderate and severe dysmenorrhea.Conclusion Menstruation regulating method can improve symptoms of primary dysmenorrhea of congealing cold and blood stasis type.

Objective To evaluate clinical features, therapeutic regimen and prognosis of unexplained rhabdomyolysis. Method Clinical manifestations, therapeutic regimen and prognosis were recorded in 23 patients,who were admitted to The First Affiliated Hospital of Nanjing Medical University 13 to 27 August,2010.The 23 patients were diagnozed as unexplained rhabdomyolysis. Results The patients all presented myalgia of upper body,like neck,waist and back,maybe with asthenia, nausea,dyspnea,abdominal pain, red urine or changed color of urine. Laboratory examination: obviously step-up of creatine kinase [CK: (4655 ± 2556) U/L( normal: 25 ～ 190U/L) AST:(141 ±78) U/L(normal:10～45 U/L),LDH:(348± 127) U/L(normal: 110～ 250 U/L)]and myoglobin[( Mb ＞ 1000 μg/L (normal: 0 ～ 50 μg/L)]. Therapeutic regimen included treatment of the underlying diseases, volume repletion, alkalization and dealing with the complications. No patients developed acute renal failure.All the patients recovered. Conclusions Rhabdomyolysis is a syndrome with different clinical manifestations.However, early diagnosis, proper treatment could prevent serious complications,and prognosis is good.

Objective To evaluate three different tracer-kinetic models used for dynamic contrast-enhanced MRI (DCE-MRI) data processing in the prediction of the histopathologic grade of cerebral gliomas.Methods Forty-one patients with histopathologically graded gliomas (grade Ⅱ 13,grade Ⅲ 14,grade Ⅳ 14)were imaged with DCE-MRI from March,2013 to November,2014.The values of Ktrans of gliomas were obtained by three tracer-kinetic models,which were Patlak model,Tofts model and Extended Tofts Linear model.All data were analyzed statistically by a Graphpad 6.0 statistical software.Comparison of the differences of Ktrans among different grades of gliomas was conducted using the Kruskal-Wallis test and Dunn's multiple comparisons test for the data not conform to normal distribution.Correlations of Ktrans values among those three models were analyzed using linear regression analysis,The differences of Ktrans between low grades and high grades of gliomas was conducted using the Mann-Whitney U test.Receiver operating characteristic (ROC) curve analyses were performed to determine the cut-off values for Ktrans to distinguish different low grades and high grades of gliomas.Results The Ktrans values obtained by Patlak model was 0.008(0.004-0.043) min-1for grade Ⅱ,0.021(0.005-0.088) min-1 for grade Ⅲ,and 0.035(0.017-0.061) min-1 for grade Ⅳ.The Ktrans values obtained by Tofts model was 0.085 (0.041-0.158)min 1for grade Ⅱ,0.140 (0.063-0.315) min-1for grade Ⅲ,0.229 (0.126-0.419)min 1 for grade Ⅳ.The Ktrans values obtained by Extended Tofts Linear model was 0.012 (0.004-0.092) min 1 for grade Ⅱ,0.048 (0.010-0.188) min-t for grade Ⅲ,0.094 (0.036-0.215)min 1 for grade Ⅳ.All the Ktrans values obtained by three models increased when the histological grades increased,with statistical significance between grade Ⅱ and Ⅲ (H=18.31,18.09,20.18,P＜0.05).Ktrans values among the three models had good linear correlations.The Ktrans obtained by Extended Tofts Linear model had good linear correlations with both Patlak model and Tofts model (r=0.933,0.893,P＜0.05),and the Ktrans obtained by Patlak model had less linear correlation with Tofts model (r=0.822,P＜0.05).The K values were statistically different between LGG and HGG (P＜0.01).The cut-off value of K provided good combination of sensitivity and specificity in the differentiation between LGG and HGG,and the K obtained by Extended Tofts Linear model had the best sensitivity and specificity among the three models (sensitivity 92.3％,specificity 85.7％).Conclusions K from DCE-MRI has a high performance in predicting the histopathologic grade of brain glioma,and the Extended Tofts Linear model is more suitable for the evaluation of cerebral glioma.

Objective The effectiveness of Zhuang nationality medical lotus needle plus back cupping therapy ( Zhuang needle-cupping therapy) , Flixonase aqueous nasal spray and cetirizine tablets in treating allergic rhinitis (AR) was compared for the exploration of the therapeutic mechanism of Zhuang needle-cupping therapy. Methods A total of 200 recruited AR patients were randomly divided into four groups in the proportion of 1:1:1:1. The four groups were Zhuang needle-cupping therapy group, cetirizine group, Flixonase group and blank control group. The blank control group had no medication, and the patients of the other three medication groups were given the corresponding treatment. Ten days constituted one treatment course, and interval between two courses lasted one week. After two courses, the therapeutic effect was evaluated. The changes of specific IgE (S-IgE), leukotriene (LT), interleukin 4(IL-4), IL-9 mRNA, interferon gamma (IFN-γ), Thl / Th2 cells, and Th17 cytokine ( IL-17) were observed before and after treatment. Results ( 1) After two treatment courses, Zhuang needle-cupping therapy group had better therapeutic effect than cetirizine group , Flixonase group and blank control group, and the therapeutic effect of cetirizine group and Flixonase group was better than the blank control group (P<0.05). However, the therapeutic effect of cetirizine group was similar to that of Flixonase group ( P>0.05). ( 2) After treatment, the levels of S-IgE, LT, IL-9 mRNA, IL-4 and IL-17 were decreased, and IFN-γ and Th1/Th2 levels were increased in the three medication groups ( P<0.05 compared with those before treatment) . The differ ences of the laboratory indexes in the blank control group were insignificant before and after treatment ( P>0.05). The results of inter-group comparison after treatment showed that Zhuang needle-cupping therapy group had better effect on improving S-IgE, LT, IFN-γand Th1/Th2 than cetirizine group and Flixonase group (P<0.05). (3) During the trial, no adverse reaction was found. Conclusion Zhuang needle-cupping therapy exerts certain therapeutic effect for AR, and the mechanism may be related with the inhibition of S-IgE, LT, IL-9 mRNA and IL-17 expression, and with the regulation of Th1/Th2 imbalance by decreasing TH2 cytokine level and increasing Th1 cytokine level.

Objective To observe the clinical efficacy of extracorporeal shock wave (ESW) plus electroacupuncture in treating periarthritis of shoulder.Method Ninety patients with periarthritis of shoulder were randomized into an electroacupuncture (EA) group, an ESW group, and an ESW plus EA group, 30 cases in each group. The EA group was intervened by EA, the ESW group was treated with ESW, and the ESW plus EA group by ESW and EA. The three groups were treated once every 2 d, with successive 10 sessions as a treatment course. The Visual Analogue Scale (VAS) score and shoulder range of motion (ROM) score were evaluated before and after the treatment in the three groups. Result The VAS scores dropped significantly in the three groups after the intervention (P<0.05); there was no significant difference in comparing the VAS score between the EA group and ESW group after the intervention (P>0.05); the VAS score in the ESW plus EA group was significantly different from that in the EA group and ESW group after the treatment (P<0.05). The ROM scores were significantly improved in the three groups after the intervention (P<0.05); there was no significant difference in comparing the ROM score between the EA group and the ESW group after the intervention (P>0.05); the ROM score in the ESW plus EA group was significant different from that in the other two groups (P<0.05).Conclusion ESW plus EA can more significantly ease the pain and improve the shoulder ROM in treating periarthritis of shoulder compared with the two methods used separately.

Objective To summarize and evaluate the clinical features,therapeutic methods and prognosis of 197 cases with eating crayfish caused rhabdomyolysis in our hospital within July,2016 to August,2016.Methods Using retrospective method,197 rhabdomyolysis cases induced by eating crayfish were admitted into study.Data of epidemiological character,clinical features,therapy protocol and prognosis were collected and analyzed.Results All the patients had the experience of eating crayfish within 12h before the onset.Patients in this cohort had the common symptoms but varying degrees of myalgia,fatigue of the whole body muscles,and urine color change.Laboratory tests revealed:On day 1 of onset,serum myoglobin level had raised up to the peak with average level at (2 135 ± 1 547) μg/L (0-46 μg/L).Creatine kinase with average level at (4 657 ± 2 178) U/L (25-190 U/L);Aspartate transaminase with average level at 264 ± 83 U/L (10-45 U/L);Lactate dehydrogenase with average level at (1 457 ± 673) U/L (313-618 U/L),all these three markers reached peak on day 2,then gradually declined.All the patients recovered and discharged after relaxation,fluid infusion,alkalization of urine and dealing with the complications.Conclusion Timely diagnosis and treatment of the rhabdomyolysis syndrome induced by eating crayfish could indicate favorable prognosis in these patients from July,2016 to August,2016.

Objective:To investigate the neuroprotective effects of simvastatin on lipopolysaccharide (LPS)-induced rat model ofParkinson's disease(PD) and the mechanisms involved.Methods:Hemiparkinsonian rat models were induced by stereotaxieal injection ofLPS in the right substantia nigra compacta.After2 weeks of simvastatin treatment, rotational behavior test was performed after the intraperitoneal injection of apomorphine.Expression of tyroxine hydroxylase (TH) and glial fibrillary acidic protein were analyzed through immunohistochemical staining of substantia nigra and striatum, and the level ofTNF-α was evaluated using enzyme-linked immunosorbent assay.Results:Comparing with untreated group, behavioral symptoms of the rats were significantly less in the rats that received simvastatin treatment.TheTH positive cell count in substantia nigra and striatum were significantly increased(P<0.05) andTNF-α expression was significantly decreased(P<0.05) in simvastatin group compared to untreated group.Conclusions:Simvastatin could effectively inhibit the activation of astrocytes, reduceTNF-α expression, and exert anti-inflammatory effects, and thus protect the dopaminergic neurons in substantia nigra and striatum of the rat model ofPD.

Objective:To investigate the effects of epidural spinal cord stimulation (ESCS) and treadmill training on the locomotion function and ultrastructure of spinal cord anterior horn after moderate spinal cord injury in rats. (IT, n=3). All rats received a moderate spinal cord injury surgery. Four weeks after surgery, rats in SE group received an electrode implantation procedure, with the electrode field covering spinal cord segments L2-S1. Four weeks after electrode implantation, rats received subthreshold ESCS for 30 min/d. Rats in TY group received 4cm/s treadmill training for 30min/d. Rats in SI group received no intervention, as a control group. All procedures in these three groups lasted four weeks.The open field Basso,Beattie and Bresnahan (BBB) scale was used before and after intervention to evaluate rats' hindlimb motor function. Result:After four weeks intervention, rats in TT group improved their open field locomotion scores to 20. In contrast, no significant improvement was observed in groups SI and SE. The morphology of synapses and neurons were similar regardless of whether rats had undergone ESCS, treadmill training or not. Conclusion:ESCS alone was not sufficient to improve the walking ability of spinal cord injured rats. ESCS or treadmill training alone might not contribute to the changes of ultrastructure in anterior horn of spinal cord that underlie the recovery of walking ability. Further research is needed to understand the contributions of combination of ESCS and treadmill training to the rehabilitation of spinal cord injured rats.

Objective To investigate the effects of epidural spinal cord electrical stimulation (ESCES) on spinal cord reflexes in normal adult rats, and to find out where and how the spinal cord reflexes are generated. Methods Ten adult female Sprague Dawley rats were anaesthetized and an electrode was placed at the S, spinal cord segment. Single electric pulses with 200 μs pulse width and voltages of 400 mV, 600 mV and 1200 mV were used in the ESCES. 1200 mV voltages with 50 Hz, 60 Hz, 80 Hz, 100 Hz frequency were also tested. EMG signals were re-corded with concentric needle electrodes in the rats' semitendinosus muscles to observe the characteristics of spinal cord reflexes. Results The voltage threshold for generating semitendinosus muscle response was 300 mV. The three ESCES voltages induced 2 kinds of spinal cord reflexes. The 400 mV and 600 mV stimulation induced spinal cord reflexes with short latency (5.27±0.36 ms and 5.19±0.67 ms respectively). The 1200 mV stimulation volt-age induced spinal cord reflexes with long latency (2.57±0.23 ms). Spinal cord reflexes could be generated by 50 Hz, 60 Hz, 80 Hz, and 100 Hz ESCES. At the higher frequencies, spinal cord reflexes declined late in the ex-periments and then appeared irregular. In some of the rats, spinal cord reflexes vanished entirely late in the stimula-tion experiments. The latency and duration of the spinal cord reflexes induced by 50 Hz ESCES were (4.46 ± 1.07) ms and (7.33±1.00)ms respectively. These were significantly different from the latency and duration initia-ted by 60 Hz, 80 Hz or 100 Hz ESCES. Conclusions Different ESCES voltages induce different spinal cord refle-xes generated differently. The long latency reflexes might be monosynaptic responses mediated by dorsal root excite-ment, while the short latency reflexes might be sarcous exciting electric activity mediated by direct excitement of mo-tor neurons or motor fibers. The irregular spinal cord reflexes induced by higher frequency ESCES might be one kind of monosynaptic response. Irregularly appearing spinal cord reflexes induced by higher frequency stimulation might due to the inhibitory effect of higher frequency stimulation.