Objective To assess the diagnostic value of coronary CTA (CCTA) combined myocardial CT perfusion imaging (CTP) in coronary artery disease (CAD) with Meta-analysis.Methods Chinese and English literatures evaluating CCTA combined CTP in diagnosis of CAD in PubMed,Wed of Science,Cochrane Library,China National Knowledge Infrastructure (CNKI) and Wanfang Periodical Database from inception to December 2016 were searched.The extraction was conducted according to the criteria for diagnostic recommended by Cochrane Method Group.The quality of included studies was assessed with quality assessment of diagnostic accuracy studies-2 instrument.The statistical analysis was performed by Meta-disc 1.4 software,the diagnosis efficacy was calculated and the symmetric receiver operating characteristic curves (SROC) was drawn to obtain the area under curve (AUC).Results Five studies involving a total of 611 vessels were included.The pooled sensitivity (SEN),specificity (SPE),diagnostic odds ratio (DOR),positive likelihood ratio (PLR),negative likelihood ratio (NLR) were 0.96 (95％CI [0.92,0.98]),0.91 (95％CI [0.88,0.94],206.14 (95％CI [100,424.94]),9.33 (95％CI [5.57,15.61]),0.06 (95％CI [0.03,0.13]),respectively.The AUC of SROC was 0.977.Conclusion CCTA combined CTP has significant value in diagnosis of CAD.

Objective To explore the clinical features and operative method of complicated spinal tuberculosis. Methods Totally 562 inpatients suffering from spinal tuberculosis during January 1997 to December 2006 were reviewed retrospectively. A new definition of complicated spinal tuberculosis was made. Complicated spinal tuberculosis was classified into different types. Every type had its special surgical operation approach. Results Among the 87 cases being followed up for 45 months, 75 patients were totally recovered, and 12 patients were obvious improved on the mend according to Dr. Fang Xian-zhi’s standard. The classification of function which above good was 97.1%. The fusion rate was 96.3% during 87 patients who received bone grafting treatment 9 months ago. Posterior convex angle was 24? to 57?, average 35.3?. Conclusion We consider that complicated spinal tuberculosis will not be surgical contraindication. Different types of complicated spinal tuberculosis by different operation approach, and careful preparation before operation will gain good curative outcome.

Objective To investigate the anatomy of upper cervical vertebrae's stable reconstruction by poster arch of atlas screw by anatomic study. Methods To collect the anatomical data of 39 dry atlas with the average inner diameter of vessel of atlas, the average high and wide of the screw point of poster arch of atlas, the average high and wide of poster arch of atlas beneath the groove for vertebral artery, the tract length of poster arch screw, the tract length of lateral mass screw, the direction and angle of poster arch screw, and the direction and angle of lateral mass. Statistical comparison were performed with Student test between the tract length of poster arch screw and the tract length of lateral mass screw. Results The average inner diameter of vessel of atlas was (26.8±2.58) mm(21.7-31.0 mm). The screw point high and wide of poster arch of atlas were (6.83±1.97) mm and (6.40±1.36) mm respectively. The average high and wide of poster arch of atlas beneath the groove for vertebral artery were (4.37±1.11) mm and (8.05±1.33) mm respectively. The tract length of poster arch screw were (30.54±1.705) mm. The direction and angle of poster arch screw was 15°-20° incline laterally and 0°-5°incline cephalo. 25.6%(10 cases) patients with the diameter less than 3.5mm beneath the groove for vertebral artery. The direction and angle of lateral mass screw was 32.05°±6.03° incline medially and 5° incline cephalo. There were significant differences between the tract length of poster arch screw and the tract length of lateral mass screw(t=59.528, P＜0.001 ). Conclusion About 74.4% patients can reconstruct the upper cervical stable by poster arch of atlas screw. The technique can gain instant upper cervical stable, and reduce the risk of injury of blood vessel by over explore the atlas arch compare with the technique of lateral mass screw fixation of atlas. The technique is worth to promoting with its character of safe, easy perform and rigid fixation.

Objective To study the protective effect of the thin Recipe of Buyanghuanwu on cerebral ischemic injury of rats. Methods Block model in cerebral artery was established through using the suture method of middle cerebral artery. The rats were randomly divided into sham-operation group, model group, Buyanghuanwu group and thin recipe of Buyanghuanyin high, medium and low-dose groups. Buyanghuanwu group and thin recipe of Buyanghuanyin groups were given gavage with relevant medicine, and sham-operation group and model group were given gavage with the same amount of sterile distilled water for continuous 7 days. Matlab software programming was used to analyze data and observe the changes in neurological function, body weight, the area of cerebral infarction and wet/dry weight ratio of brain of the rats. Results Rats with cerebral ischemia suffered large area of infarction, brain edema and neurological dysfunction. The thin recipe of Buyanghuanwu of medium and low dose groups could effectively improve the indexes of model rats compared with the model group, the difference with statistical significance (P<0.05). Conclusion The thin recipe of Buyanghuanwu has protective effect on cerebral ischemia, and the medium dose is the optimal dose.

Objective To investigate the occurrence of central venous catheter-related bloodstream infection(CRB-SI)in mass severe burn patients,evaluate related risk factors for infection,and effectiveness of prevention and con-trol measures.Methods In August 2014,9 cases of severe burn patients were rescued in a hospital,all patients re-ceived CVC,infection prevention and control intervention measures were performed during the whole process of catheterization.Results All patients received 30 episodes of CVC,total CVC-days were 227 days,bacterial culture for three-cavity catheters of femoral veins in 2 patients were positive,incidence of CRBSI was 8.81 ‰;1 patient was isolated Enterococcus faecium ,1 isolated both Acinetobacter baumannii and Stenotrophomonas maltophilia .2 CRB-SI patients received femoral vein catheterization,catheterization site was trauma surface,duration of catheterization were both ≥7 days,both used three-cavity catheters,and third degree burns were ≥60%,both patients were cured after timely removal of catheters and receiving of antimicrobial agents.Conclusion CVC is helpful for long term, safe and effective fluid infusion,but it can cause CRBSI;infection prevention and control intervention for patients receiving CVC during the whole process of catheterization can reduce the occurrence of CRBSI.

According to the infection characteristics of batches of patients with extensive burns in dust explosion, the article focused on the concept and mode of whole-range fine management.Based on the characteristics and rules of infection prevention in bat-ches of patients with extensive burns, the measurement and examination of infection management were refined, the infection monitoring indexes were designed scientifically, the infection prevention scheme and monitoring table were formulated.By early and whole-range intervention of infection prevention, quantitative evaluation, fine management and precise control at different times, all levels of infec-tion management teams could fully serve their purposes in order to realize effective infection prevention.

Objective To observe the effects of thin recipe ofBuyang Huanwu Decoction on expressions of glutathione (GSH) antioxidant system including GSH, GSH-Px andγ-GCS in the brain of focal cerebral ischemia rats;To study its mechanism of antioxidant effect.Methods Totally 120 SD rats were randomly divided into four groups according to random number table method:sham-operation group, model group,Buyang Huanwu Decoction group and thin recipe ofBuyang Huanwu Decoction group. Except for the sham-operation group, the rest groups established focal cerebral ischemia rat model by middle cerebral arterial occlusion. The treatment groups were given corresponding medicine by gavage, while the sham-operation group and model group were given the same amount of normal saline 2 h after modeling. Each group was detected after cerebral ischemia for 1 day, 3 days, and 7 days respectively. The content of GSH and the activity of GSH-Px were detected. At the same time,γ-GCS mRNA and protein levels were determined by using real time-PCR and Western blot.Results The content of GSH and the activity of GSH-Px at each time point decreased in the model group (P<0.05), compared with the corresponding sham-operation group. But the expression ofγ-GCS mRNA and protein increased, with statistical significance on day 1 (P<0.05). Compared with model group, content of GSH and GSH-Px activity levels increased differently in each treatment group, whileγ-GCS mRNA and protein expression raised, with statistical significance on day 3 (P<0.05).Conclusion The thin recipe ofBuyang Huanwu Decoction plays antioxidant effect by regulating the expression of glutathione antioxidant system GSH, GSH-Px andγ-GCS after cerebral ischemia, which may be one of its therapeutic mechanisms for cerebral ischemia.

Objective To explore the change trend and antimicrobial resistance of pathogens causing infection in extensive burn patients,and provide reference for clinical prevention and treatment.Methods Specimens from 9 extensive burn patients who were admitted to a hospital at the same time were performed pathogenic culture and an-timicrobial susceptibility testing, change trend and antimicrobial susceptibility of pathogens were observed. Results The main specimen was wound secretion,accounting for 93.81 %.The major pathogens causing infection were Acinetobacter baumannii (44.85%),Staphylococcus aureus (32.47%),Pseudomonas aeruginosa (12.37%), and Klebsiella pneumoniae (5.15%).With the prolongation of hospital stay,pathogens changed from one kind to multiple strains, and from susceptibility to resistance,multidrug resistance,and extensive drug resistance. Conclusion Itis difficult to avoid infection in burn patients,timely realizing the changes of pathogens causing infec-tion and antimicrobial resistance play an important role in the control of infection.

Objective To investigate the preventive effects of Buyang Huanwu Decoction (BYHWD) and its recipe composition (BYJJF) in focal ischemic brain injury condition in vivo/in vitro. Methods In vivo studies, SD rats were divided into sham-operation group, MCAO group, BYHWD group and BYJJF group based on rat weight, 10 rats in each group. The body weight, infarct area and brain water contents were determined. In vitro studies, H2O2 was used to damage PC12 cells, and the vitro oxidative stress cell model was established. PC12 cells were divided into normal group, blank control group, BYHWD and BYJJF groups with different concentrations (0.1, 0.2, 0.5, 1.0, 2.0, 3.5 mg/mL). MTT method was employed to determine the protective effects of BYHWD and BYJJF on model cells.Results Vivo studies showed that after 7 days of treatment with BYHWD and BYJJF, those determinated quotas were all significantly improved compared with MCAO model rats (P<0.05), and there were no differences between BYHWD and BYJJF (P>0.05).Vtiro studies showed that the protective effects of BYHWD and BYJJF took place 2 hours later, and it was obvious in oxidative stress injury caused by H2O2, with statistical differences with model group (P<0.05). BYHWD and BYJJF could increase cell viability, and there was no difference between the groups with same concentration (P>0.05).Conclusion The research confirmed that BYJJF plays a significant role in improving the cerebral ischemia injury, which is the same performance as BYHWD, and BYJJF can save TCM resources under the precondition of TCM efficacy.

Aim To evaluate the regulation of thin recipe of Buyang Huanwu decoction on cyclin-dependent kinase 5(Cdk5)expressions in hippocampus tissue of rats after cerebral ischemia.Methods Male SD rats were divided into sham-operation group,MCAO group,Buyang Huanwu decoction group(ig.3.15 g·kg-1)and its thin recipe composition group(ig.2.41 g·kg-1).Each group was then divided into five subgroups based on the time after administration for 1,3,7,14,28 d respectively.Cdk5 protein and mRNA levels in each group were examined by using immunohistochemistry,Western blot and real-time PCR respectively.Results The up-regulation of Cdk5 was observed in model rat hippocampus after cerebral ischemia 1 day,and kept increasing with the aggravation of ischemia injury,the peaked expression was observed after 7～14 d,while the downtrend was observed after 28 days compared with the corresponding sham-operation groups(P<0.01),suggesting that the Cdk5 signal pathway would be activated by cerebral ischemic injury.The expression of Cdk5 in thin recipe of Buyang Huanwu decoction group was significantly lower than that in model group at each time point(P<0.05),and there was also more obvious down-regulation with the extend of intervene time.The regulation effects of thin recipe of Buyang Huanwu decoction was up to the best after 28 days of administration,which indicated the thin recipe was positive to the abnormal expression of Cdk5,and there was no difference between Buyang Huanwu decoction and its thin recipe treated groups(P>0.05).Conclusion The thin recipe of Buyang Huanwu decoction could exert the protective effect by regulating Cdk5 after cerebral ischemia.