Objective To evaluate the activities of four demestic macrolides against C. trachomatis and C. pneumoniae by antimicrobiai susceptibility testing. Methods Cell culture and immunoflourescence staining of chlamydial inclusions were used to determine MICs of four demestic macrolides against C. trachomatis and C. pneumoniae. Results MIC (0.5 μg/ml) was found for acylspriramycin,erythromycin and azithromycin against C. trachomatis serovar B while it was 4 μg/ml for acetylspiramycin. Agaisnt C. trachomatis serovar D, MIC was 0.25 μg/mi in both acylspriramycin and azithromycin, and MICs were 0.5 μg/ml and 2 μml in erythromycin and acetylspiramycin, separately. Agaisnt C. pneumoniae TWAR, erythromycin was the most active with MIC≤0. 016 μg/ml, acylspriramycin and azithromycin were the second with same M1C of 0.032 μg/ml. However, acetylspiramycin was less active with 0.5 μg/ml of MIC. Conclusion Except acetylspiramycin, acylspriramycin erythromycin and azithromycin had reliable activities against both C. trachomatis (serovar B and D) and C. pneumoniae.

Objective To explore the etiology of lumbar degenerative spondylolisthesis(DS)by analyzing its CT manifestations.Methods The location,degree and angle of inclination of lumbar facet joints were measured in 125 cases with 131 spondylolisthesis.Results The angle of inclination of lumbar facet joints was

American medical colleges attach great importance to the humanistic education.The rich humanities curriculum is fully integrated into the teaching practice thus the mutual penetration of medicine and the humanities is achieved.They have specific and detailed examination evaluation system and the teaching method was more practical and participatory.By contrast,nost of the medical colleges in our country neglect the humanities construction and the cultivation of medical students' humanistic spirit.The coverage of the humanities curriculum is relatively narrow and the faculty is insufficient.We should promote the development of humanistic cducation,attach importance to the construction of medical humanities,set up appropriate curriculum system,increase the investment in faculty and reform the teaching method and examination method.

Objective: To investigate the characteristics of rabies-exposed population in Wenzhou City, Zhejiang Province from 2014 to 2023, so as to provide insights into the prevention and control of rabies. Methods: Data of rabies-exposed population in Wenzhou City from 2014 to 2023 were collected through Wenzhou Rabies-Exposed Population Summary Sheet reported by dog injury clinics. The species of animals causing injuries, exposure time, exposure grade, exposure site, and post-exposure treatment were descriptively analyzed. Results: Totally 709 900 patients were admitted to dog injury clinics in Wenzhou City from 2014 to 2023, and the exposure rate showed an increasing trend (Z=7.238, P<0.001), with an average annual exposure rate of 750.75/105. The number of cases with exposure to rabies peaked in July (79 230 cases, 11.16%) and August (78 570 cases, 11.07%). Dogs were predominant animals causing injuries (448 900 cases, 63.23%), and the exposure rate showed a downward trend (Z=-5.921, P<0.001); cats were the second (175 142 cases, 24.67%), and the exposure rate showed an upward trend (Z=23.314, P<0.001). The upper (379 695 cases, 53.49%) and lower limbs (287 521 cases, 40.50%) were the main exposure sites. There were 21 034 cases (2.96%) exposed to head and face, and the exposure rate of head and face showed an upward trend (Z=3.549, P<0.001). Grade II exposure was the most common (403 881 cases, 56.89%), and the exposure rate showed an upward trend (Z=8.769, P<0.001). The proportion of using human rabies immune globulin was 23.13% in Grade III exposed population, showing a downward trend (Z=-12.848, P<0.001). Conclusions The exposure rate of rabies in Wenzhou City showed an upward trend from 2014 to 2023, with July and August as the peak months of exposure. Injuries mainly caused by dogs, while the exposure rate of cat bites showed an upward trend. The proportion of using human rabies immune globulin needs to be improved.

Objective To investigate the value of ABCD3-I score in predicting the outcome of acute minor ischemic stroke. Methods Totally 255 patients were valued by ABCD, ABCD2, ABCD3, ABCD3-I and ESSEN score then the clinical characters, outcome and early progression of these patients were investigated. Results Forty-eight patients had poor outcome after 90 days. Univariate logistic regression indicated that the differences of hypertension, diabetes, cardiovascular disease, stenosis of criminal artery, abnormal signal in diffusion weighted imaging (DWI) and other clinical symptoms between poor outcome group and good outcome group were statistically significant (P<0.05). The AUC of ABCD, ABCD2, ABCD3, ABCD3-I and ESSEN score in predicting outcome of acute minor stroke was 0.791 0, 0.798 3, 0.827 9, 0.930 0 and 0.735 9 respectively. There was difference among patients with different ABCD3-I scores both in outcome and early progression. Conclusion ABCD3-I score can predict the outcome of acute minor stroke and supply a new method for personalized treatment.

Objective To investigate the anatomical basic of extensor carpi radialis brevis (ECRB) tendon transferring to extensor pollicis longus (EPL) tendon.Methods Twelve sides of ECRB and EPL in fresh adult cadaver's forearms were collected,and the anatomical model of ECRB transferring to EPL was set up in all the forearms.The anatomical parameters of EPL were measured before and after anatomical model established.Results The effective transferring length of ECRB was (3.5±0.8)cm;the maximum circumferential of ECRB and EPL were (8.5±0.8)cm and (3.6±0.3)cm (P ＞0.05),the ratio of muscle cross-sectional area was 5.57;After the anatomical model setting up,anatomic angles of EPL was (30±7)°,which was a decrease of (20±5) ° comparing with the preoperative angel of (50±9) ° (P ＞0.05);Thumb extension angle was (50± 12) °,which was a decrease of (8±3) ° comparing with the preoperative angel of (58 ± 16) ° (P＜0.05);The dorsal extension angle of first metacarpal was (12±5)o,which was a decrease of (3± 2) o comparing with the preoperative angle (15±8)° (P＞0.05);Thumb tip lifting height was (2.3±0.9) c m,which was a decrease of (1.2±0.6)cm comparing with the preoperative height (3.5±1.2)cm (P ＞0.05).Conclusion Based on the measurement of the anatomic parameters of ECRB and EPL,the ECRB has enough length and muscle force to reconstruct the function of EPL.The thumb had a good extension appearance and accorded with the rule of biomechanics after setting up the anatomical model of ECRB transferring to EPL.This study will provide the anatomical evidence for further clinical application

Objective To explore the strategies of diagnosis and treatment of severe multiple injuries in Emergency Intensive Care Unit (EICU).Methods The clinical data of 226 patients with severe multiple injuries were analyzed retrospectively.188 patients were treated by surgical operation,and 38 patients were not treated by surgical operation.Results Among these patients,46 patients (accounted for 20.3%)were with pulmonary infection and atelectasis,41 patients (accounting for 18.1%)were with multiple -organ dysfunction syndrome (MODS), 35 patients (accounted for 15.5%)were with acute respiratory distress syndrome (ARDS),and 19 patients (accounted for 8.4%)were with stress ulceration and bleeding.198 patients (accounted for 87.6%)were successfully rescued, and 28 patients (accounted for 12.3%)died.The main cause of death in the early stage was the serious craniocerebral injury,and the main cause of death in the later stage was the multiple -organ dysfunction.Conclusion EICU plays a very important role in comprehensive treatment of severe multiple injuries,and can obviously increase the success rate of treatment and cure of severe multiple injuries.

Objective To evaluate the value of intravascular interventional embolization in the emergency treatment of patients with hemodynamically unstable pelvic fracture.Methods The retrospective analysis was made on the medical records of 45 cases treated from October 2012 to December 2014.There were 27 male and 18 females(39.2-± 10.3) years (range,28-54 years).Time from injury to admission was within 3 h.Injury severity score (ISS) was (25.3 ± 8.1) points.The pelvic fracture included 32 cases of Type B and 13 Type C according to Tile classification system.After admission,anti-shock treatment and pelvic immobilization with the belt or external fixator were performed,and emergent intravascular interventional embolization was used to stanch bleeding after the bleeding of other organs was excluded.Vascular intervention,post-treatment vitazl signs and prognosis were evaluated.Results Time from admission to interventional therapy was 1.2-2.7 h [(1.9 ± 0.8) h].Time of interventional treatment was 1.6-3.2 h [(2.3-± 0.6) h].Of the 45 cases,contrast extravasation was seen in 38 cases,abnormal vascular morphology in 5 cases,no obvious bleeding in 1 case,and contrast extravasation in the angiographic venous phase in 1 case.Among the 38 cases of contrast extravasation,the offending vessels involved were internal pudenda artery (26 cases),obturator artery (16 cases),superior gluteal artery (4 cases),inferior gluteal artery (4 cases),inferior epigastric artery (1 case) and external iliac artery (1 case),but 8 cases were noted to have two offending vessels and 1 case had delayed bleeding.Of the 45 cases,the hemostatic effect was good in the early stage.After the interventional embolization therapy,the heart rate was (105.2 ± 14.8) beats/min,arterial pressure was (79.0 ± 10.6) mmHg,central venous pressure was (5.1 ± 0.8) cmH2O,and shock index was 1.1 ±-0.5,showing improved vital signs postoperatively (P ＜ 0.05).Four cases died mainly due to the multiple organ failure.One case had abdominal distention aggravated 3 days after operation,which were confirmed to be bleeding in the branch of external iliac artery,and the symptom was alleviated after embolization therapy.Forty-one cases survived with ICU length of stay of (14.5 ± 5.4) d,hospitalization time of (35.2 ± 12.8) d and medical expense of (96,755.3-± 20,568.1) CNY.Conclusion In the emergency treatment of patients with hemodynamically unstable pelvic fracture,the intravascular interventional embolization has become an important measure of comprehensive treatment that allows fast and mini-invasive procedure hemostasis,and deserves clinical promoting.

Objective To screen microRNAs(miRNAs)related to early mycosis fungoides(MF). Methods A high?throughput miRNA PCR array was used to determine miRNA expression profiles in skin lesions of 6 patients with early MF (early MF group) and 6 patients with lichen planus (control group), followed by screening of differentially expressed miRNAs between the two groups. Then, real?time fluorescence?based quantitative PCR(RT?qPCR)was performed to verify the differentially expressed miRNAs in lesional specimens from 13 patients with early MF and 13 patients with eczema or lichen planus, as well as in Myla cells and normal human T?lymphocytes. Results The high?throughput miRNA PCR array showed that the expressions of hsa?miR?378a?5p, hsa?miR?107 and hsa?miR?302c?3p were significantly higher in the early MF group than in the control group(all P<0.05). For skin lesions, the results from RT?qPCR were similar to those from the miRNA array assay. Compared with normal human peripheral blood T?lymphocytes, Myla cells showed significantly increased expressions of hsa?miR?378a?5p and hsa?miR?107, which was consistent with the results from the miRNA array assay. However, no significant difference was observed in the expression of hsa?miR?302c?3p between the two kinds of cells. Conclusion MiRNA expression profiles in early MF are different from those in inflammatory skin diseases.

Objective:To develop a multi-scale fusion and attention mechanism based image automatic segmentation method of organs at risk (OAR) from head and neck carcinoma radiotherapy.Methods:We proposed a new OAR segmentation method for medical images of heads and necks based on the U-Net convolution neural network. Spatial and channel squeeze excitation (csSE) attention block were combined with the U-Net, aiming to enhance the feature expression ability. We also proposed a multi-scale block in the U-Net encoding stage to supplement characteristic information. Dice similarity coefficient (DSC) and 95% Hausdorff distance (HD) were used as evaluation criteria for deep learning performance.Results:The segmentation of 22 OAR in the head and neck was performed according to the medical image computing computer assisted intervention (MICCAI) StructSeg2019 dataset. The proposed method improved the average segmentation accuracy by 3%-6% compared with existing methods. The average DSC in the segmentation of 22 OAR in the head and neck was 78.90% and the average 95%HD was 6.23 mm.Conclusion:Automatic segmentation of OAR from the head and neck CT using multi-scale fusion and attention mechanism achieves high segmentation accuracy, which is promising for enhancing the accuracy and efficiency of radiotherapy in clinical practice.