Objective To ascertain and evaluate the quality of radiological protection in rural and urban primary health care institutions . Methods Questionnaires were designed to investigate the protection levels in diagnostic radiology in primary health care institutions in six cities in 2013 and to evaluate the results by using the technique for order preference by similarity to an ideal solution ( TOPSIS) combined with the rank sum ratio ( RSR) method.Results The six cities and an integrated case ( all the data of the six prefecture-level citys were merged as one for comprasion ) were ranked based on the comprehensive assessment.The order from good to bad was Suzhou , Dalian, Yichang, integrated case, Shaoxing, Quzhou and Heihe.The results were divided into three grades , with Suzhou, Dalian at best grade, Yichang, integrated case, Shaoxing, Quzhou at middle grade, and Heihe at poor grade. Conclusions The quality of protection in radiation diagnosis varied considerably .Suzhou ranked the first and Heihe ranked the last .The study suggests that efforts should be focused on the management of key cities and indicators to upgrade whole protection level in radiation diagnosis .

Objective To probe multislice spiral computed tomography(MSCT) features of superacute cerebral infarction.Methods 19 cases with superacute cerebral infarction were retrospectively analysed.MSCT scans were performed in all patients at 1～6 h after onset,and the lesions were proved by MSCT or MR at 3 h～5 d after onset.MSCT signs of superacute cerebral infarction were observed.Results 17 cases and 2 cases were diagnosed and suspectively diagnosed with superacute cerebral infarction by CT at first visit of patients.CT features of superacute cerebral infarction included hypodense of cerebral parenchyma in 19 cases,local cerebral swelling in 13 cases and hyperdense sign of cerebral artery in 3 cases.Conclusion MSCT plain scan has significant value in diagnosis of superacute cerebral infarction.

Objective To treat scalp lacerations by using the hair apposition technique (HAT) and to compare the HAT with standard suturing in a controlled prospective trial. Method Fifty patients with scalp lacerations were treated either by HAT or by standard suturing. Two groups were evaluated in consumed times for operation, pain sores, and complications. Results There were 30 HAT patients and 20 patients treated with suturing. The took shorter operation time consumed[(3.33 vs. (6.05 t = 4.85.P < 0.01], and HAT produced significantly lower pain score [(1.73vs. (3.20t = 4.01,P < 0.01]. There was a trend that more and more patients were willing to have HAT performed. Conclusions The advantages of HAT include a shorter time consumed for operation, less pain, satisfactory wound healing, and high acceptance by patients. HAT is acceptable for treating scalp lacerations in emergency room.

OBJECTIVE To understand the distribution of pathogen in very-low-birth-weight or preterm infants septicemia in early-onset and late-onset and drug sensitivity.METHODS Bacterial isolates from inpatients of very-low-birth-weight or preterm infants septicemia over a period of 3 years were retrospectively analyzed,and classified as when septicemia was happened.RESULTS The positive rate of isolates was 43.2% in 970 samples of very-low-birth-weight or preterm infants septicemia.Most of the sepsis detected by blood culture was late-onset neonatal sepsis(58.6%).Pathogen of late-onset neonatal sepsis mostly was Gram-positive cocci,Staphylococcus were found to be the most common isolates(80.5%).In early-onset sepsis group,the isolates rates of Gram-negative and Gram-positive bacteria were mostly in proportion,there were 52.4% and 47.6%,respeitively.The resistance rate of late-onset sepsis group was higher than that of early-onset one.CONCLUSIONS The key of curing infants septicemia is that we should master the distribution of pathogen of very-low-birth-weight or preterm infants septicemia in early-onset and late-onset and drug sensitivity.Antimicrobial therapy should be initiated under the guidance of anti-microbial sensitivity test,in order to avoid abuse of antimicrobial.

OBJECTIVE To investigate the distribution and drug resistance of pathogenic bacteria which caused respiratory infection among suscepted patients and offer scientific basis for reasonable usage of antibiotics.METHODS Oropharyngeal swabs among 709 cases of respiratory infection neonates were investigated by the routine methods and drug resistance was analyzed by K-B method.RESULTS Totally 438 bacterial strains were isolated from 709 neonates.most of these bacteria were Gram-negative bacilli(70.3%),among which Haemophilus influenzae and Klebsiella pneumoniae were accounted for 39.8% and 10.3%,respectively;fungi and Gram-positive cocci were accounted for 23.5% and 6.2%.CONCLUSIONS Most strains present higher resistance rates to penicillin and ampicillin;but cefoxitin,amikacin,vancomycin,imipenem and the third generation cephalosporins are revealed with higher sensitivity rates for pathogenic bacteria in newborns.

Objective To investigate the methods used for evaluating the severity of the patients with acute pancreatitis induced by hyperlipidemia in order to find out some simple and practical biomarkers for predicting the severity of the illness.Methods Sixty-two patients with acute pancreatitis resulted from hyperlipidemia were selected from the in-patients of our hospital from January 2007 to July 2011 and were divided into two groups,namely the mild acute pancreatitis group(MAP,n =32)and the severe acute pancreatitis group(SAP,n =30)as per the Chinese Acute Pancreatitis Guideline.Two groups were comparable verified by the test of homogeneity of variance after grouping.Arterial blood gas analyses were done immediately after admission:Venous blood was taken from forearm for determining renal function and blood coagulation at 6 o＇lock of next day after admission.The data of base excess(BE),creatinine(CR),C-reactive protein(CRP),fibrin(FIB)and D-Dmmer(D-D)were documented.The contrast CT imaging of pancreas was done within 48 hours after admission in all patients.APACHE Ⅱ scores and computed tomography severity index(CTSI)were calculated.The differences in BE,CR,CRP,FIB and D-D between 2 groups were analyzed by using t-test,and the correlation among them and APACHE Ⅱ score and CTSI were analyzed by Spearman test done with SPSS 18.0 software.As BE ＜-4.5 mnol/L,CR ＞ 120μmol/L,CRP ＞ 100 mg/L,FIB ＞5.5 g/L and D-D 800 ng/L were set respectively as a positive screening criterion,positive prediction value(PPV),negative prediction value(NPV),sensitivity and specificity of each marker and combined markers were calculated after they were set at different positive scales in order to get the optimal predictors for evaluating the severity of acute pancreatitis induced by hyperlipidemia.Results The absolute values of BE,CR,CRP,FIB and D-D in group SAP were much higher than those in group MAP(P ＜ 0.01).Each of them had good correlation with APACHE Ⅱ score and CTSI,especially BE and D-D more significant.Each of them used separately for predicting the severity of acute pancreatitis showed PPV and NPV with high specificity but the sensitivity was hot high.The joint use of BE,CR and CRP,and joint use of FIB and D-D could be more valid as PPV and NPV with high specificity for predicting the severity of acute pancreatitis,but the sensitivity decreased.Conclusions BE,CR,CRP,FIB and D-D were good biomarkers for quickly and accurately evaluating and predicting the severity of the acute pancreatitis caused by hyperlipidemia.

Objective To evaluate the therapeutic methods for stones in congenital anomalous kidneys. Methods The clinical outcomes of 126 patients(75 males and 51 females: mean age 39 years, range 12-66 years)who underwent extracorporeal shock wave lithotripsy (ESWL, n= 37), minimally invasive percutaneous nephrolithotomy (MPCNL, n = 41) or open surgery (n = 48) were retrospectively reviewed. There were 40 horseshoe kidneys(31.8%), 51 duplex kidneys(40.5%), 35 malrotated kidneys(27.8%). Seventyl calculi were located in left kidneys(55.6%)and 56 in right kid-neys(44.4%). There were 96 single stones(76.2%)and 30 complex stones(23.8%). The greatest di-ameter of stone ranged from0.8 cm to 2.2 cm(mean 1.5 cm) in ESWL group, 1.0 cm to 4.0 cm (mean 2.5 cm) in MPCNL group and 1.5 cm to 3.8 cm(mean 2.7 cm) in open surgery group. The therapeutic effects of 3 methods were compared. Results The stone-free rate at 1 session was 78.4%(29/31) in ESWL group, 85.4%(35/41) in MPCNL group and 87.5%(42/48) in open sur-gery group. No significant difference was found among the 3 groups(x2 = 1.39,P=0.50). The inci-dence of complications was 13.5% in ESWL group, 9.7% in MPCNL group and 6.3% in open sur-gery group(x2=1.28, P=0.53). Only 1 case of malrotated kidney suffered massive hemorrhage and was cured by selective embolism of renal artery. No major complications occurred in the other pa-tients. Conclusions With rigorous indication, ESWL or MPCNL is as safe and effective as open sur-gery in the management of stones in congenital anomalous kidneys. It should be considered as the pri-mary therapy. But the treatment must be individualized in terms of the type anomalous kidney, stone characteristics and obstruction.

Objective To investigate the effect of valsartan on vascular endothelial function and brachial-ankle pulse wave velocity(baPWV)in patients with essential hypertension(EH).Methods Blood pressure,NO value and brachial-ankle pulse wave velocity were determined and analyzed in 30 patients with essential hypertension before and after therapy of valsartan.Results Both blood pressure and brachial-ankle pulse wave velocity wefe re-duced greafly(P<0.05 and P<0.01),while serum NO increased significantly(P<0.01)following valsartan thera-Py,and brachial-ankle pulse wave velocity was well correlated to serum NO(r=-0.71,P<0.01).Conclusions Valsartan is not onlv effective in the control of blood pressure,but also effective in reveming the impaired endothelial function and artery elasticity in patients with essential hypertension,at the same time brachial-ankle pulse wave ve-locity is also good surrogate of endlothelial functional improvement induced by Valsartan therapy.

Objective To assess the safety and effectiveness of minimally invasive percutaneous nephrolithotomy(MPCNL) in treating renal stones in patients with congenital anomalous kidneys.MethodsFrom January 2000 to November 2007 a total of 41 patients with renal stones complicated with congenital anomalous kidneys,including 12 cases of horseshoe kidneys,19 cases of duplex kidneys,and 10 cases of malrotated kidneys were treated by MPCNL in our hospital.Of the 41 patients,4 had upper calyx calculi,6 had middle calyx calculi,7 had lower calyx calculi,3 had pelvic calculi,4 had the upper segment calculi in duplex kidney,12 had multiple calculi,and 5 had staghorn calculi.The largest diameter of the stones ranged from 1.0 to 4.0 cm(mean 2.5 cm).Ureteral calculi that were found in 13 of the patients were treated at one time.ResultsThe procedure were completed in all of the cases with the operation time ranged from 45 to 210 minutes(mean 95 minutes),and blood loss ranged from 30 to 150 ml(mean 80 ml).The overall stone-free rate at one session was 85.4%(35/41).One of the duplex kidney cases and two of the horseshoe kidney cases were cured by a second operation.And two of the duplex kidney cases and one of the malrotated kidney cases were treated by ESWL after the MPCNL.One patient,who had malrotated kidney,suffered massive hemorrhage(800 ml) during the MPCNL,and was cured by selective embolization of the renal artery.No severe complications occurred in the other patients.The cases were followed up for 5-12 months,during the Period no patient had recurrence.ConclusionsMPCNL is safe and reliable for the treatment of stones in patients with congenital anomalous kidneys.The treatment must be individualized in terms of the type of the renal abnormalities,and the size and location of the stones.

A novel avian influenza A (H7N9) virus recently emerged in the Yangtze River delta and caused diseases, often severe, in over 130 people. This H7N9 virus appeared to infect humans with greater ease than previous avian inlfuenza virus subtypes such as H5N1 and H9N2. While there are other potential explanations for this large number of human infections with an avian influenza virus, we investigated whether a lack of conserved T-cell epitopes between endemic H1N1 and H3N2 inlfuenza viruses and the novel H7N9 virus contributes to this observation. Here we demonstrate that a number of T cell epitopes are conserved between endemic H1N1 and H3N2 viruses and H7N9 virus. Most of these conserved epitopes are from viral internal proteins. The extent of conservation between endemic human seasonal inlfuenza and avian inlfuenza H7N9 was comparable to that with the highly pathogenic avian inlfuenza H5N1. Thus, the ease of inter-species transmission of H7N9 viruses (compared with avian H5N1 viruses) cannot be attributed to the lack of conservation of such T cell epitopes. On the contrary, our ifndings predict signiifcant T-cell based cross-reactions in the human population to the novel H7N9 virus. Our findings also have implications for H7N9 virus vaccine design.