Objective To study the dynamic etiological effects of degeneration structure in cervical spine with motion MRI image, and to obtain the early diagnosis of CSM. Methods By flexing the patient forward and backward with the joint motion device, a total of 60 cases received MRI study in open MR feature. The motion MRI technique included the multi-angle scan, the joint motion scan, and the MR Fluoroscopy. Results (1) The spinal cord compression due to degeneration structure in flexion-extension was more significant than that in static position, it even had pile up effect. (2) The disc herniation (in 29 cases), the vertebral osteophyte, the segmental instability (in 7 cases), and the thickening of posterior longitudinal ligament (in 36 cases) could cause more serious mixture compression to the cord in anteflexion than in natural position. (3) In extension, the degenerative yellow ligaments (in 34 cases) often folded and encroached upon the spinal canal, which usually formed pincers effect with anterior compression (in 9 cases). (4) The flexion-extension movement could cause lower cervical instability founded in 14 cases. (5) The anterior space of dural sac could be decreased in flexion (in 41 cases) as well as in extension(in 16 cases), and in 43 cases, the posterior space could also be narrowed in extension, but not evident in flexion(in only 4 cases). Conclusion By using the motion MRI scan, the early, potential and dynamic compression factors of cervical spinal cord could be demonstrated not only in shape but also in pathogenesis. So the motion scan can make the diagnosis of CMS earlier than static scan does.

Objective To investigate the pain-relieving effectiveness of persistent epidural anesthesia and its influence on mothers and infants.Methods 40 pregnant women without any obstetric complications and anesthetic contraindications were selected as the observation group,and persistent epidural anesthesia were applied when the cervicis opened to be larger than 3cm.40 cases with similar obstetric conditions were regarded as the control group without using any anesthesia.We compared the degree of labor pain,duration,delivery mode,the incidence of postpartum hemorrhage,intrauterine distress,neonatal asphyxia between the two groups.Results There were significantly difference in the rate of oxytocin utilization,vaginal delivery and the time of stageⅡ labor.There were no obvious difference in the active phase of labor course,the incidence of cesarean birth,intrauterine distress,neonatal asphyxia and postpartum hemorrhage between the two groups.Conclusions The results indicate that epidural anesthesia could affect the length of stageⅡ labor time and have merits of simple,obvious analgetic effect,but inflecencing delivery mode,therefore it to be improve.

BACKGROUND: The early symptoms of amyotrophic lateral sclerosis (ASL) are usually located at a certain part of the body, and are similar to the clinical manifestations of cervical spondylotic myelopathy (CSM). However, their treatment and prognosis differ greatly. Therefore, multiple-part electromyography and electroneurography possess an important value of reference, particularly electromyography of thoracic paraspinal muscles can be used as an objective parameter for differentiation between ASL and CSM.OBJECTIVE: To investigate the electrophysiological changes in ASL and CSM.DESIGN: A retrospective clinical analysis.SETTING: Neurological Department of Second Hospital Affiliated to Jiangxi Medical College.PARTICIPANTS: Totally 30 inpatients and outpatients with ASL and 30 patients with CSM were selected from the Neurological Department of the Second Hospital Affiliated to Jiangxi Medical College between December 2001 and November 2004.METHODS: Totally 30 inpatients and outpatients with ASL as well as 30 inpatients and outpatients with CSM were subjected to routine electromyographic and electroneurographic examination. Routine electromyography examining three limb muscles + sternocleidomastoid + thoracic paraspinal muscles intended to observe the spontaneous potential at resting stage, time limit and wave-amplitude of motor unit potential, and recruit-ment phase during energetic contraction. Electroneurography was used to detect motsr conduction velocity and sensory conduction velocity,as well as the terminal latency and wave-amplitude of motor evoked potential.limb muscles, sternocleidomastoid and thoracic paraspinal muscles in paASL and SCM.RESULTS: Data of all the 60 patients entered the final statistical analysis.in patients with ALS and CSM, and were more severe in the former. The abnormality rate of spontaneous potential of thoracic paraspinal muscles reached 93.3% (28/30) as compared to 3.3% (1/30) in patients with CSM (P ＜ 0.001). The average time limit and abnormal increment of wave amplitude of motor unit potential were significantly different in patients with conduction velocity: The decrease rate of motor evoked potential amplitude of complex muscles was obviously higher in ASL than in CSM (75.6% and 86.7%, ~=7.25, P ＜ 0.01). So was the decrease rate of motor conduction sory nerve conduction velocity: It was not affected either in ASL or CSM.ALS and CSM, but the abnormality rate of spontaneous potential of thorography indicates that nerve conduction velocity was not affected in both playing decreased conduction velocity and wave amplitude than those with CSM.

Objective To study the prokaryotic expression of fusion gene A?-HBcAg and analyze the immunoreactivity and immunogenicity of expression protein. Methods Recombinant plasmid pBV220/A?-HBcAg was transformed into E.coli DH5?, and expressed by temperature inducing. The bacteria were split by ultrasonic wave. The expression of the fusion protein was studied by SDS-PAGE and Coomassie brilliant blue staining. The immunoreactivity of the fusion protein was determined using ELISA. After immunized intraperitoneally with the fusion protein, 5 Balb/c mice's sera titers of anti- A? and anti-HBc were evaluated by ELISA. Results Fusion protein was in sediment of the split bacteria as inclusion bodies and its expression level was 5% of the total sediment protein. The fusion protein had both immunoreactivity of A? and HBcAg. The titers of anti-A? and anti-HBc were very low after 3 times of immunization. After immunization for 5 times, the titers reached 1∶800 and 1∶3 200 for anti-A? and anti-HBc, respectively. Conclusion Recombinant gene A?-HBcAg can be expressed in E.coli DH5? and the expression protein has certain immunoreactivity and immunogenicity. It indicates that further work should be done to enhance the expression level of fusion gene A?-HBcAg and improve the immunogenicity of the fusion protein.

Objective To prepare a hybridoma secreting stab le monoclonal antibodies against ?-amyloid peptide (A? 1-42) with high titer. Methods By genetic engineering technology, A ? gene was recombined with the MIR of HBcAg to get the A? and HBcAg fusi on protein. Spleen cells from BALB/c mice immunized with A? and HBcAg f usion protein were fused with mouse myeloma cells SP2/0. Results Two strains of hybridomas (1H 7 and 1F 3) secreting stable monoclonal antibodies raised against A? 1-42 were ob tained. The subtypes of A? 1-42 antibodies were IgG 3. C onclusion The A? 1-42 monoclonal antibodies obtained have high titers and specificity.

Objective To compare the results of laparoscope and laparotomy total mesorectal excision(TME)with anal sphincter preservation in the treatment of low rectal cancer.Methods From January 2006 to June 2008,106 patients with low rectal cancer which the distance from the lowest margin of tumor to the dentate line ranged from 3.0 to 7.0 cm underwent TME with anal sphincter preservation.Among them,51 patients received laparoscope operation(laparoscope group)and the other 55 patients received laparotomy(laparotomy group)according to their wills.Results Two groups had no serious complications and death case.after surgery,the rate of sphincter preservation was 100%.Blood loss was(20.2±5.7)ml inlaparoscope group,which was significantly less than that in laparotomy group(P ＜ 0.01),aerofluxus,time to eat half-flow food and hospital stay were(2.4±0.6),(5.4±0.6)and(9.2±3.2)days respectively,which were significantly shorter than those in laparotomy group(P ＜ 0.01 or ＜ 0.05).Bowel function was back to normal in 35 patients of laparoscope group(68.6%)and 39 patients of laparotomy group(70.9%)within 1 month.All patients were followed-up from 6 to 36 months,there were no recurrence in situ local recurrence and mortality in the both groups.Conclusion Laparoscope TME with anal sphincter preservation can be achieved the same effect of oncological clearance,it is feasible and it is a minimal invasive and perspective technique with the benefits of much less blood loss during operation,higher rate of sphincter preservation,earlier return of bowel function and shorter hospitalization.

The laboratory accreditation plan is an effective way to realize the standardization of medical laboratories.The test method validation is required by ISO 15189 guideline and CAP checklists.However,after CBC analyzers and coagulation analyzers are repaired,no solution for the validation is put forward.

Risk management is derived from industry.In recent years,risk management is introduced by many medical laboratories their process management abroad.However,the concept of risk management is still very new for laboratories in China.Therefore,the establishment of the project for risk detection,classification,correction,prevention and supervision could help medical laboratories improve their service quality.

OBJECTIVE To investigate the epidemiology of bacterial infections isolated from liver disease patients with septic shock and analyze the antimicrobial susceptibility of major pathogens to provide reference for clinical therapy. METHODS A retrospective survey was conducted in 83 liver disease patients with septic shock of our hospital from Jan 2005 to Aug 2006. Identification and susceptibility of pathogens were assayed by MicroScan Auto-4 System. RESULTS The infection was frequently identified in intra-abdominal cavity (73.5%),blood stream (24.1%) or respiratory tract (13.3%). The top 3 pathogens were Escherichia coli (36.6%),Klebsiella pneumoniae (15.9%) and Staphylococcus aureus (6.1%). Gram-negative bacilli were usually resistant to multiple antimicrobial agents,but less resistant to imipenem,levofloxacin or piperacillin-tazobactam. Extended-spectrum ?-lactamases (ESBLs) positive rates of E. coli and K. pneumoniae were 53.3% and 7.7%. Asprergillus and Candida glabrata were the predominant pathogens from fungal infections,and they were mostly resistant to fluconazole. CONCLUSIONS Pathogens of liver disease patients with septic shock are mostly multi-drug resistant. The microbiological surveillance is important for guiding clinical therapy.

Objective:To investigate the clinical efficacy of mechanical solitaire AB stents thrombectomy combined with intra-arterial thrombolysis in the treatment of patient with acute ischemic stroke.Methods:Fifteen patients with acute ischemic stroke admitted into our hospital from August 2014 to August 2016 were treated with mechanical thrombectomy with solitaire AB stents plus intra-arterial thrombolysis.The National Institutes of Health Stroke Scale score (NIHSS) of all patients were evaluated before and after treatment to compare the clinical efficacy.The prognosis ofpatients between two groups were compared via evaluating modified Rankin score (mRS)and gelasijia coma score (GCS).Results:After mechanical thrombectomy with solitaire AB stents plus intra-arterial thrombolysis treatment,14 patients achieved complete or part recanalization,and 1 patient was terminated treatment due to vital signs instability,and the rate ofrecanalization was 93.3％.The NIHSS score of patients before treatment was 12.93± 4.25,which was much higher than that after treatment (4.33± 1.45,P＜0.05).After follow-up by 3 months,the good mRS scores were obtained in all 18 patients,including 2 patients with mRS score of 2,5 patients with 1,and 8 patients with 0.Additionally,there was no patient with re-obstruction during follow-up period.Conclusion:Mechanical thrombectomy with solitaire AB stents combined with intra-arterial thrombolysis had a good capability and safety in the treatment of patients with acute ischemic stroke.