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 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 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 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 application of prevention technique for mother‐to‐child transmission of human immunode‐ficiency virus(HIV) in Laibin City .Methods Prevention techniques for mother‐to‐child transmission of HIV were applicated in the city .Women in pregnancy test received acquired immunodeficiency syndrome(AIDS) counseling and test at the same time .Measures were taken to prevent the mother‐to‐child transmission of HIV for women who confirmed HIV positive ,including the use of antiret‐roviral drugs ,safety midwifery and feeding guidance ,and so on .Results The average HIV counseling and testing rate was 99 .1%(176 001/177 738) for the past 5 years .269 cases were HIV positive ,and the positive rate was 0 .15% (269/176 001) .Via health advisory guidance ,pregnant women diagnosed with AIDS understood the dangers of AIDS and the mode of its transmission ,and then free to chose weather to have the pregnancy terminated .Finally ,there were 67 pregnant women chose to terminate the preg‐nancy ,and 202 women decided to have children who were included in the prevention management system of mother‐to‐child trans‐mission .202 infants were born alive ,192 of which took full amount of antiretroviral drugs .The medication rate was 95 .05% (192/202) .42 d and 3 months after birth ,early diagnosis of HIV/AIDS was performed for the infants ,the positive rate of HIV was 0 .50% (1/202) .There were 118 infants at least 18‐months‐old who had underwent HIV test and no positive case was detected . Conclusion AIDS counseling tests in pregnancy test women is necessary ,which could detect HIV positive women .Comprehensive measures are effective methods for the prevention of mother‐to‐child transmission .

Objective To grasp the malaria epidemic situation in Changzhou City from 2010 to 2014,so as to provide the ev?idence for formulating and adjusting malaria control strategies and measures. Methods The epidemiological data of malaria cas?es in the special report system from 2010 to 2014 were collected,and the malaria epidemic situation and the diagnosis and treat?ment of malaria patients were analyzed. Results There were 132 malaria cases reported in Changzhou City from 2010 to 2014, with a decrease of 27.47%compared to 182 cases from 2005 to 2009. Among the 132 cases,2 cases were local infected cases and the remaining 130 cases were imported cases. Four cases were clinically diagnosed and 128 cases were laboratory con?firmed,with 97 cases of malignant malaria,14 cases of vivax malaria,13 cases of ovale malaria,and 4 cases of quartan malar?ia. The 132 cases were distributed in five districts:56 cases in Jintan City,51 cases in Liyang City,19 cases in Tianning Dis?trict,3 cases in Wujin District,and 3 cases in Xinbei District. The median duration between the onset and treatment of the dis?ease was 2 days,and the median duration between the diagnosis and treatment was 1 day. The diagnosing units were concentrat?ed on the county?level disease control agencies,and medical institutions at county and municipal levels,accounting for 92.42%(122/132). From 2011 to 2014,there were no local malaria cases. Conclusions From 2012 to 2014,there have been no local malaria cases in Changzhou City,and the goal of eliminating malaria has been achieved basically. However,there are still many imported malaria cases,and the infected species are diverse. Therefore,imported malaria is still the key of malaria prevention and control.

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.