Objective To improve the diagnosis and management of closed renal trauma,and to reduce the rate of nephrectomy. Methods A total of 189 cases (146 men and 43 women; mean age,38 years) of closed renal trauma were retrospectively studied. A variety of examinations, including urinary analysis, B-ultrasonography, intravenous urography( IVU) and CT,were used for the diagnosis in these patients. Among them,closed renal trauma was accompanied by celiac viscera injury in 27 cases,by encephalic injury in 5, by fractures of spine and limbs in 13,and by compound trauma and shock in 3. Of the 189 cases, 156 were treated with conservative therapy, including 3 of spleen rupture,2 of encephalic injury,7 of fracture of spine and limbs;27 cases were treated with operation, including 15 with kidney repair,5 with partial nephrectomy, 7 with nephrectomy;3 cases were treated with selective renal artery embolization. Results Three patients with severe closed renal trauma died of compound trauma and shock soon after admission,and the other 186 patients recovered. Of them, 102 cases were followed up from 3 months to 8 years. Among patients undergoing conservative treatment renal hypertension occurred in 3 cases, urinoma in 1 , kidney atrophy in 1 and local hydronephrosis in 1. In patients undergoing surgery or selective kidney artery embolization, no subsequent complication occurred. Conclusions CT scan can provide a major basis for the diagnosis and treatment choice as well as early detection of urinoma of closed renal trauma. For closed renal trauma below grade IV ,conservative treatment is the better option.

AIM　To study the glucose and lipids metabolis m and insulin sensitivity of MSG rats during their growing period, and to evalua te the effects of insulin sensitizer pioglitazone on the model rats. MET HODS　Body weights were measured regularly, and glucose and insulin tole rance tests were taken. In their 3 and 10 months old, rats were given insulin se nsitizer pioglitazone orally, then the effects on serum glucose, triglyceride, c holesteral, free fatty acid and insulin concentrations were determined. RESULTS　Compared with normal rats, a slight but significant increase of glucose in MSG rats was revealed. The serum triglyceride, cholesteral, free fat ty acid and insulin concentrations were significantly higher in model rats. More over, gluconeogenesis increased significantly, and insulin tolerance showed abno rmal. However, glucose tolerance was nearlly normal. Pioglitazone could ameliora te all these metabolic disorders. CONCLUSION　Obesity and insuli n resistance were induced by injecting monosodium glutamate (MSG) to neonatal Wi star rats. Pioglitazone can significantly improve the insulin sensitivity of MSG rats. These results suggested that MSG obese rats can be used as an easily acce ssible and inexpensive insulin resistance animal model for evaluating the effica cy and mechanisms of antidiabetic agents.

AIM To study the glucose and lipids metabolism and insulin sensitivity of MSG rats during their growing period, and to evaluate the effects of insulin sensitizer pioglitazone on the model rats. METHODS Body weights were measured regularly, and glucose and insulin tolerance tests were taken. In their 3 and 10 months old, rats were given insulin sensitizer pioglitazone orally, then the effects on serum glucose, triglyceride, cholesteral, free fatty acid and insulin concentrations were determined. RESULTS Compared with normal rats, a slight but significant increase of glucose in MSG rats was revealed. The serum triglyceride, cholesteral, free fatty acid and insulin concentrations were significantly higher in model rats. Moreover, gluconeogenesis increased significantly, and insulin tolerance showed abnormal. However, glucose tolerance was nearlly normal. Pioglitazone could ameliorate all these metabolic disorders. CONCLUSION Obesity and insulin resistance were induced by injecting monosodi- um glutamate (MSG) to neonatal Wistar rats. Piogli- tazone can significantly improve the insulin sensitivity of Msc rats. These results suggested that MSG obese rats can be used as an easily accessible and inexpensive insulin resistance animal model for evaluating the efficacy and mechanisms of antidiabetic agents.

Peroxisome proliferator activated receptor(PPAR), a member of the hormone receptor superfamily, is a key regulating factor in adipocyte differentiation and lipids metabolism. Recently, with the increased understanding of the precise mechanisms of TZD, thiazolidinedione class of insulin sensitizer, PPAR? has also been identified as the major functional receptor for the drugs. In the study of the relationship between PPAR and insulin resistance, considerable gaps appeared. TZD induced activation of PPAR? is known to promote insulin sensitivity. More interestingly, however, PPAR? +/- heterozygous mice were shown to be less susceptible to insulin resistance. These findings suggest that the relationship between PPAR activation and insulin sensitivity improvement is not simplely positively related. A better understanding of the role of PPAR in insulin action system will be critical in developing more efficacious and safe agents that act on PPAR and benefit patients with type 2 diabetes.

Objective To analyze the causes and pathogens of infectious endophthalmitis in ourhospital.Methods The clinical data and laboratory findings of 282 inpatients with infectiousendophthalmitis were retrospectively reviewed.There were 206 males(73.05%)and 76 females(26.95%)with a mean age of(36.0±11.2)years(range from 2 to 79 years).Except 14 patients who lost theireyeballs as of serious conditions.pathogen examinations of vitreous specimen had been performed for allremaining 268 cases.The clinieal and laboratory data were statistically analyzed by Chi-square and Kappaconsistency tests,when P<0.05 the difference should be considered as statistically significant.ResultsThe 4 major causes of infectious endophthalmitis of those 282 patients included ocular trauma(177cases,62.77%),infectious keratitis(61 cases,21.63%),eye surgery(32 cases,11.35%),andendogenous endophthalmitis(12 cases,4.25%).19.21% of the patients in ocular trauma group was 2-13years old,55.74% of the patients in infectious keratitis group was 14-50 years old,and 60.61% of thepatients in eye surgery group was 51-79 years old.The major pathogens were fungus and staphylococcieach accounted for 30.63% of all cases.Most of the pathogenic bacteria were sensitive to ciprofloxaein(81.81%)and gentamicin(77.92%).Conclusions The major reason of infectious endophthalmitis wasocular trauma,and the major pathogens were fungus and staphylococci.Those findings may help us totreat infectious endophthalmitis patients appropriately.

Objective To evaluate the effect of comprehensive schistosomiasis control in Changzhou City in recent 10 years, so as to provide the evidences for formulating the future prevention and control strategy. Methods The work reports and the da?ta of the schistosomiasis comprehensive control projects in Changzhou City from 2004 to 2014 were collected,the infection sta?tus of residents and livestock as well the Oncomelania hupensis snail situation were analyzed,and the implementation effect of the comprehensive control projects was evaluated. Results From 2004 to 2014,totally 215 368 person?times were examined, and the positive rate of the blood examinations of the population was 0.24%(478/198 356),and there were no positive cases de?tected out by using the miracidium hatching method. Totally 11 935 domestic animals were detected and no positives were found. From 2004 to 2014,the total area with snails was 92.27 hm2,and marshland,inland and mountain environments accounted for 34.75%,34.82%and 30.43%,respectively. The newly discovered area with snails was 34.40 hm2,and marshland,inland and mountain environments accounted for 2.62%,71.22% and 26.16%,respectively. Totally 8 511 snails were dissected and no schistosome infected snails were found. From 2004 to 2014,a total of 242 600 harmless toilets were built,2 704 700 domestic animals were reared in pens,5.82 km?long rivers were dredged,2 250.11 hm2 of protective forests were constructed,a total area of 625.79 hm2 were controlled with molluscicides,and an area of 149.58 hm2 were environmentally transformed. Totally 5.4 mil?lion people received health education. The awareness rate of knowledge on schistosomiasis control of residents was 96.00% in 2014. Conclusions There exists the risks of snails import and diffusion and schistosomiasis resurrection in Changzhou City, but under the condition of continuous implementation of comprehensive control measures,the endemic situation of schistosomia?sis is stable and the control achievement is consolidated in this city.

Objective To understand the current state of staff for Plasmodium microscopy examinations in Changzhou City in the early stage of eliminating malaria action,so as to provide the evidence for achieving the target of malaria elimination. Methods The staff for Plasmodium microscopy examinations from medical institutions and centers for disease control and prevention at differ-ent levels were investigated by questionnaires and tests of the malaria related theory and microscopic operation. Results Totally 95 people were investigated,and among them,40.0%had college degree and 45.3%were university educated. There were 18.9%of them working on Plasmodium microscopy examinations for less than 1 year,40.0%for 2-5 years,18.9%for 6-10 years and 22.1%for more than 10 years. The numbers of person-time of provincial and municipal level training,district-level training,and unit-level training in the last year were 0.57,0.59,and 0.14,respectively. Totally 18.9%of them had the experience of finding Plasmodium at work,and 97.9% of them considered it was necessary or very necessary to do Plasmodium microscopy examina-tions. However,57.9%and 8.4%of them considered Plasmodium microscopy examinations increased their work load and work dif-ficulty,respectively. The average correct rates of knowledge tests on malaria before and after training were 72.5%and 91.6%re-spectively(P<0.05). The average mark of Plasmodium microscopic tests was 25.3 points(full mark being 50 points),and the passing rate(≥30 points)was 58.9%. Conclusion The working experience of staff for Plasmodium microscopy examinations in Changzhou City is relatively poor,and the related training should be enhanced.

Objective To understand the quality of blood smears for Plasmodium detection in Changzhou City,so as to pro?vide the technical support for malaria surveillance in the post?elimination period. Methods The blood smears of fever patients from each cities(districts)in Changzhou City in 2014,including more than 3%of the negatives and all the positives,were se?lected. The quality of the blood smear making,dyeing,cleanliness and results were reviewed by the experts from the municipal malaria microscopy station,and the data were analyzed statistically. Results Totally 996 negative blood smears were reviewed in 2014,with a review rate of 4.52%. The qualified rates of blood smear making,dyeing and cleanliness were 92.87%,93.27%and 94.48%,respectively. A total of 34 positive blood smears were reviewed,and there were no false detections and leak detec?tions. The qualified rates of blood smear making and dyeing were more than 90%in all the seven cities(districts). As for quali?fied rate of cleanliness,except the rate in Qishuyan District(81.36%),those in the other six cities(districts)were all above 90%. The qualified rates of blood smear making,dyeing and cleanliness were all more than 90%in first?class,second?class and third?class hospitals. The major quality defects of the blood smears were sediment,abnormal making and thick membrane shed?ding,and the proportions were 25.91%,21.76%and 19.17%,respectively. Conclusions The quality of blood smears for Plas?modium detection in Changzhou City is satisfying. In the future,the training and supervision still should be strengthened to guar?antee the capacity of microscopic examinations for Plasmodium detection in the surveillance of post?elimination period.

Objective　To evaluate the effectiveness of intratracheal tube suctioning by respiratory mechanics measurement.Methods　The indexes of respiratory mechanics,including respiratory rate,expiratory tidal volume,% leak around the tube,dynamic respiratory compliance and mean airway resistance were measured just before and 20 minutes after intraendotracheal tube suction in mechanical ventilated children with respiratory failure.Results　Fifty-two measurements was carried out in 11 patie nts.The mean values of respiratory risistance was (116.73±27.12)cmH2O/L.s before suctioning and (93.38±26.64)cmH2O/L.s after suctioning,with significant differrence(P＜0.01)；The mean values of % leak around the tacheal tube dereased from(18.12±4.12)% before suctioning to (8.71±3.76)% after suctioning (P＜0.05),The mean values of expiratory tidal valume was markedly increased from(7.31±2.12)ml/kg before suctioning to(5.72±1.2)ml/kg after suctioning(P＜0.01),The total respiraory rate markedly decreased after suctioning.Conclusion　The respiratory mechanics measurement is very useful to evaluate the airway patient.The removal of secretions is crucial in respiratory managemet.

Objective To analyze the results of assessment and authentication of malaria elimination of 7 county?level cities and districts in Changzhou City,Jiangsu Province,and explore the suitable monitoring methods for malaria after the elimination in this region,so as to provide the evidence for formulating and adjusting the malaria elimination strategies and measures. Meth?ods The data from the network reports of malaria epidemic situation,blood examinations of febrile patients,epidemiological questionnaires of malaria cases,investigation of epidemic focuses and disposal tables were collected and analyzed in Changzhou City from 2009 to 2014. The clinicians were assessed with the closed?book written examinations for their ability of the diagnosis and treatment of malaria. The inspection personnel were assessed by the microscopical examinations of Plasmodium. Totally 30 negative blood slides were reviewed. In the natural village where the last local case of malaria was located ,200 blood filter pa?pers were collected for gene detection of Plasmodium. Results From 2009 to 2014,145 malaria cases were reported in Chang?zhou City. Totally 170 638 febrile patients received blood detections for malaria,of which 137 cases were positive and the posi?tive rate was 0.08%. The majority of malaria cases were imported except 8 local malaria infection cases in 2009 and 2 local ma?laria infection cases in 2010. Four of seven county?level cities(districts)gained an average score of 20 points on the microscopi?cal examinations of Plasmodium. Liyang City got a minimum average score of 18.8 points. In capacity assessment of malaria diag?nosis and treatment,Liyang City gained the highest average score of 19.8 points,and Qishuyan District got the lowest average score of 18.0 points. The malaria elimination assessment scores of the 7 county?level cities(districts)were all above 93 points. Four county?level cities(districts)(Xinbei District,Wujin District,Liyang City,and Jintan City)carried out the active case detections. A total of 731 cases were detected and the results were all negative. Liyang City in 2012,Zhonglou District and Jin?tan City in 2013,Tianning District,Qishuyan District,Xinbei District and Wujin District in 2014,passed the malaria elimina?tion assessment at county(district)level,respectively. Conclusions All the 7 county?level cities(districts)of Changzhou City have passed the malaria elimination assessment at a high score. After the malaria elimination ,the monitoring should contin?ue to consolidate the achievements.