Objective To evaluate MRI in diagnosing brachial plexus preganglionic injury.Methods Twenty cases with brachial plexus preganglionic injury underwent M R scanning before operation.MR imaging was obtained by GE Signa EXCITE 1.5 T scanner.The scanning sequences included SE T1 WI,FSE T2 WI,T2 WI STIR and 3D Fast imaging employing steady state with phase cycled(3D-FIESTA-c).All the patients had exploration of the supraclavicular plexus and electrophysiology examination. And the accuracy, sensitivity and specificity of MRI in diagnosing preganglionic brachial plexus iniury were calculated with the standards of surgical and EMG results.Results Among the 73 pairs of i,jured roots.MR imaging detected the abnormalities in 63 pairs.The accuracy, sensitivity and specificity of MRI in diagnosing preganglionic brachial plexus injury were 86.5/(83/96),86.3/(63/73).87.0/(20/23),respectively.The direct signs of brachial plexus preganglionic injury included (1) lack or mutilation of netwe root in 54 pairs (85.7/),(2)coarsening,bending,stiff course and unable to be traced to the intervertebral foramen continuously in 9 pairs (14.3/).The indirect signs included (1)cystic cerebrospinal fluid gathering in the vertebral canal,posttraumatic spinal meningocele in 46 pairs (73.0/),(2)abnormal shape of nerve sleeve in 13 pairs(20.6/),(3)displacement and deformity of spinal cord in 50 pairs(79.4/),(4)abnormal signal of paravertebral muscles in 1 9 patients.Conclusion MRI can distinctly show the nerve rootlets within the vertebral canal,so it is helpful in making a correct diagnosis of brachial plexus preganglionic injuries.

Inhibitor of growth 4 (ING4) is an important member of anti-oncogene family.The expression of ING4 is significantly lower in many malignancies.ING4 involves in multiple processes,such as tumorigenesis,regulation of cell cycle,cell apoptosis,DNA repair and angiogenesis,which have a significant impact on the progression and prognosis of tumor.ING4 may serve as a promising prognostic maker as well as a potential therapeutic target for cancer.

The herpes simplex virus type 1 (HSV-1) infected-cell protein 27 (ICP27) is an essential,highly conserved protein involved in various steps of HSV-1 gene regulation as well as in the shut-off of host gene expression during infection.It functions primarily at the post-transcriptional level in inhibiting precursor mRNA splicing and in promoting nuclear export of viral transcripts.Recently,many novel functions performed by the HSV-1 ICP27 protein were shown,including leptomycin B resistance,inhibition of the type I interferon signaling,regulation of the viral mRNA translation and determining the composition of HSV-1 virions.

90%) was a forepart change of gemcitabine-induced lung injury in the first month in G group, but the exudation, proliferation and fibrosis dominated in the 1,3 and 6 months in R+CG group. Hydroxyproline content of lung-irridiated tissue was increased from the 5th month and lasted to months 6,7 and 8, and its content in the R+CG group was higher than that in the other groups(P

Objective To analyze the prevalence,risk factors of kidney disease in type 2 diabetic patients with KDIGO classification of chronic kidney disease,also to study cardiovascular and cerebrovascular diseases and death in these patients,so as to investigate the significance of the KDIGO classification system.Methods One thousand six hundred and forty-five type 2 diabetic patients who were in hospitalization from June 2008 to December 2012 were grouped according to the KDIGO classification of chronic kidney disease and the incidence of vascular disease was analyzed based on the classification.Clinical features were compared between patients with or without kidney disease.The risk factors of kidney disease and the death of diabetic patients were also investigated.Results There were 915 male and 730 female,aged a median (57.86±12.54) years with (6.35±6.30) years duration of diabetes mellitus among the 1645 cases,and 37.2％ of patients had concomitant kidney disease.According to the classi fi cation of CKD,patients in CKD group 3a,group 3b and CKD group 4-5 accounted for 5.7％,3.5％ and 7.6％,while 33.4％ of patients had proteinuria,among which 19.5％ with microalbuminuria,13.5％ with macroalbuminuria.On complications,patients with hypertension accounted for 49.5％,hyperlipidemia 67.7％,diabetic retinopathy 27.4％,cardiovascular and cerebrovascular diseases 18.5％ (coronary artery disease 16.5％,cerebrovascular diseases 8.8％).Statistical difference was detected in the incidence of diabetic retinopathy,coronary artery disease and cerebrovascular diseases between CKD group 3a and 3b (P ＜ 0.05).The duration of diabetes,concomitant hypertention especially with elevated systolic blood pressure,diabetic retinopathy and hyperuricemia were the independent risk factors for type 2 diabetic patients with kidney disease.Age,Scr,complicating cardiovascular and cerebrovascular diseases and advanced CKD stage were the independent risk factors for the death of type 2 diabetic patients with kidney disease.Conclusion KDIGO classification of chronic kidney disease enables better staging of kidney diseases in diabetic patients for management and prognosis.Diabetic patients have a higher prevalence of renal diseases and cardiovascular and cerebrovascular events than the general population.Early control of factors such as blood pressure and serum uric acid can delay the progression of kidney disease,and the predictive role of diabetic retinopathy should be emphasized.

Objective To analyze the impact factors for early renal damage in type 2 diabetic patients by the classification tree model.Methods A total of 601 patients with type 2 diabetes were enrolled.According to glomerular filtration rates and urine albumin quantification,the patients were divided into type 2 diabetes group (418 cases) and early diabetic renal damage group (183 cases).The clinical data of the patients were recorded to analyze the main influential factors for the microalbuminuria of type 2 diabetic patients using the Exhaustive CHAID classification tree algorithm.Results Six important explanatory variables were screened out by the classification tree model from the 34 candidate variables related to early renal damage,including fibrinogen,history of hypertension,retinopathy,Cys C levels,SBP and peripheral neuropathy.Elevated fibrinogen was the main factor.Conclusion The classification tree model can analyze the major influential factors of early renal damage in type 2 diabetic patients effectively,and it can help develop the prevention and treatment methods.

OBJECTIVETo discuss the curative effect of the dynamic hip system blade (DHS-blade) on the treatment of femoral neck fractures in elderly patients with osteoporosis.

METHODSA retrospective study was conducted to analyse the clinical data of 60 elderly patients with osteoporosis who had been treated for femoral neck fractures with DHS-blade in our department between September 2012 and February 2014. There were 22 males and 38 females with a mean age of (66.8±3.2) years. According to the Singh Index Classification, all the patients'Singh index was below level 3. The Harris criterion and function recovery after operation were analysed.

RESULTSAll patients were followed up for 12-17 months (mean 14 months). No femoral head necrosis, femoral neck shortening, internal fixation loosening or backing out of the nails occurred. Bone nonunion was found in one case and he had a good recovery after total hip arthroplasty. The time for fracture healing ranged from 3-6 months (average 3.5 months). According to Harris criterion, 35 cases were rated as excellent, 22 good, 2 fair and 1 poor. The Harris scale was significantly improved from 28.46±2.35 preoperatively to 91.98±3.26 at 6 months postoperatively (P<0.05).

CONCLUSIONDHS-blade, being minimally invasive, allowing earlier postoperative exercise and avoiding the complications elicited by traditional internal fixation, is advisable for treatment of femoral neck fractured patients with osteoporosis.

Aged ; Female ; Femoral Neck Fractures ; surgery ; Fracture Fixation, Internal ; methods ; Fracture Healing ; Humans ; Male ; Minimally Invasive Surgical Procedures ; Osteoporotic Fractures ; surgery ; Retrospective Studies ; Time Factors ; Treatment Outcome

Objective:To study the clinical effect of internal combined with external fixation in the treatment of pelvic fracture and its effect on the serum alkaline phosphatase (ALP),tumor necrosis factor-a (TNF-α) and transforming growth factor-β (TGF-β).Methods:Eighty-six patients with pelvic fractures admitted in our hospital from August 2014 to July 2015 were selected and divided into the observation group and control group according to the admission order.Conventional internal fixation was used in the control group,and the internal combined with extemal fixation was performed in the observation group.The clinical curative effect,operative time,blood loss,fracture healing time and incidence of complication were compared between two groups.The levels of serum ALP,TNF-α and TGF-β in the two groups were compared before and after treatment between two groups.Results:The excellent rate of observation group was significantly higher than that of the control group [81.40％ (35/43) vs 41.86％ (18/43)] (P ＜0.05).The operative time,blood loss and fracture healing time in the observation group were significantly shorter or less than those of the control group (P＜0.05).There was no significant difference in the serum ALP,TNF-α and TGF-β levels between the two groups before treatment (P＞0.05).After treatment,the serum ALP levels in the two groups were significantly higher than before treatment (P＜0.05).The levels of TNF-α and TGF-β were significantly lowe than those before treatment(P＜0.05),the ALP levels in the observation group was significantly higher than that of the control group (P ＜0.05),and the levels of TNF-c and TGF-β were significantly lower than those of the control group 0.05).The incidence of complications of observation group was significantly lower than that of the control group [0.00％ (0/43) vs 11.63％ (5/43)] (P ＜0.05).Conclusion:Internal and external fixation was effective and safe in the treatment of pelvic fractures,which could significantly increase the serum ALP level and reduce the levels of TNF-α and TGF-β.

Objective To investigate the clinical distribution and antimicrobial resistance of common gram-positive cocci in author's hospital.Methods Identification of these bacteria were done with API analysis system,disc diffusion tests were employed to study the antimicrobial resistance.Results A total of 25 052 clinical isolates were collected in 8 years,of gram-positive cocci accounted for 7907(31.9%).Staphylococcus aureus(3549 strains,44.9%),enterococcus(1760 strains,22.3%)and coagulase-negative staphylococcus(1558 strains,19.7%)were the most common isolates.The prevalence of MRSA increased from 59.6% in 2001 to 76.3% in 2008,and MRSCoN increased from 64.2% to 77.0%.The resistant rate of MRSA to gentamicin,clindamycin,erythromycin and levofloxacin were over 90%,to trimethoprim/sulfamethoxazole and chloramphenicol were less than 20%.The resistant rate of MSSA to gentamicin,levofloxacin,trimethoprim/sulfamethoxazole and chloramphenicol were low 20%,and to beta-lactamase antibacterial agents except penicillin were 0.The resistant rates of MRSCoN to all antimicrobial agents were lower than MRSA,but to trimethoprim/sulfamethoxazole(71.2%)was higher than MRSA(21.2%).No staphylococcus strains were resistant to vancomycin,teicoplanin and linezolid.2.1% enterococcus feacium and 4.4% other enterococcus were resistant to vancomycin.No strains of enterococcus were found resistant to teicoplanin and linezolid.Conclusion The resistant rate of gram-positive cocci were increasing obviously,the prevalence of MRS was high.Vancomycin,teicoplanin and linezolid were the most active agents against severe infection induced by multidrug-resistant gram-positive cocci.

Objective To enhance the test efficiency and management level of medical record quality by designing and using med-ical record quality management system based on new electronic medical record .Methods System design and development were based on JAVA ,consisting of data exchange platform and medical record quality management system .The platform used C/S archi-tecture and the main program used B/S architecture .Achieved the integration with new electronic medical record and clinical infor-mation system through data exchange with business database .Results The supervision model and business workflow of medical re-cord quality were changed ,and the process and terminal medical record quality were promoted .Conclusion Design and application of the system can provides strong support for medical record quality management ,supplys effective supports for supervision of med-ical record quality ,and plays positive role in promoting medical record quality ,clinical work efficiency ,and medical quality .