[Objective] To analyze clinical assessment and surgical treatment of rigid cervical kyphosis. [Methods]Thirty-nine cases of rigid kyphosis were retrospectively analyzed (13 cases of idiopathic kyphosis, 8 cases of kyphosis caused by laminectomy, 11 cases caused by old fractures, and 7 cases associated with cervical degenerative kyphosis). The preoperative JOA score was 9.71 ? 2.25, and kyphosis Cobb angles were 9 ?~72 ? (average 22.4 ?). All clinical evaluation had been done to patients and different surgical methods had been implied according to their different clinical manifestations and imaging features, including simple anterior surgery, the one-step anterior-posterior combined surgery, and the two-step of anterior-posterior combined surgery.[Results]The patients were followed up from12 to 36 months (average, 27 months).In the periods of intra-operation or post-operation,no major complication occurred. Neck pain disappeared and neural functions partially recovered postoperatively. Bone graft fusion was achieved.Postoperative JOA score was 14 ? 2.73 (and compared with preoperative t =-9.68 P

Objective To explore the diagnosis and treatment of compartment syndromes of the foot after calcaneal fractures. Methods Between October 1994 and June 1999, the intracompartmental pressures of foot were measured with the Whitesides method for 98 patients with calcaneal fractures. The interstitial pressures in 9 patients averaged 46 mmHg (range from 30 to 55 mmHg). All of the 9 patients were treated by fasciotomy through a hindfoot medial incision, then each intracompartment pressure were measured,respectively. An interosseous compartment pressure still was 40 mmHg. The patient whose foot had a severe crushing injury had fasciotomy of his interosseous compartment through two dorsal forefoot incisions. After a week, the wounds were covered with a split thinkness skin graft. The calcaneal fractures were treated with open reduction and internal fixation at 2 weeks after fasciotomy through a lateral incision. Results All of the 9 patients were followed up for a mean of 2 years (range from 18 to 35 months) after injury. Two patients had occasional hindfoot and ankle pain after walking or standing for a long time. One of them decreased pin stick sensation and two point discrimination. None of the cases developed stiffness of the forefoot or claw toes, nor soft tissue contracture and motor deficit. Conclusion It should not be neglected that the compartment syndromes of the foot may occur after calcaneal fractures. Intracompartment pressure measurements should be performed to confirm the diagnosis. Fasciotomy, which could be performed through a medial hindfoot incision, is the optimal way of treatment.

0.05).[Conclusion]According to the electrophysiology and pathology researching for the diaphragm,it is easy to find that it is possible for respiratory function reconstruction by transposition of accessory nerve to phrenic nerve with upper cervical cord injuries.

Objective To assess the importance of initial resuscitation, prevention and management of the early complication in acute cervical spine injury. Methods Initial resuscitation of 715 early complications of 10 types and their prevention and management in 194 cases with acute cervical spinal cord injury admitted from 1996 to 1998 were reviewed. Results Mortality in early stage could be markedly reduced with routine and normal initial resuscitation, pulmonary complications were the main cause of death. Early complications delayed the possible surgical treatment, affected the treatment results, increased the cost and duration of hospitalization and difficulty of rehabilitation. Conclusions Early complications of cervical spine injury mostly occur in the first few days and can be predicted. Proper prevention and treatment of it will benefit the recovery of the neural lesion and following rehabilitation.

Objective: To understand the use patterns, initial abuse age, initial abuse reasons and the demographic characteristic of opiates abusers at six areas in Hunan Province. Methods: Combined stratified cluster-sampling, household and cue investigation, 370 opiate abusers from 68 192 community residents aged between 15 and 50 years were interviewed. Results:About 95% opiate abuses reported that they had abused heroin in their life time, and the other had abused dolantin and/or methadone. Inhalation and Injection were the first two ways of administration (81.4% and 38.6%). The average initial abuse age was 27?6 years, 90.2% abuses reported that they had abused illicit drug before 35 years. Curiosity, peer pressures and exciting seeking were the first three main reasons of initial abuse (75.1%, 72.7% and 56.5%, respectively). Opiates abusers tended to be male (87.3%), young people aged below 35 years (71.1%), and 78.7% of the abusers got only junior school or below education. Subjects with unstable occupation and marital status had higher use rate than those with stable ones.Conclusion:Heroin was the major opiates abused, the main administration was inhalation and injection in Hunan Province. Young and middle aged male with low educational level or without stable occupation or marital status were the majority of opiates abusers.

Objective To observe the relationship between CT signs, prognosis and the expression of CD44v3 and CD44v6 in peripheral non-small-cell lung cancer (NSCLC). Methods The expression of CD44v3 and CD44v6 was detected with immunohistochemistry (SP method) in 46 patients with peripheral NSCLC confirmed by surgery and pathology. The expression, CT signs and prognosis of NSCLC were analyzed respectively. Results The expression of CD44v3 and CD44v6 correlated with deep lobulation, spinous protuberant sign, short spiculation and lymph node enlargement of hila or mediastinum (P<0.05), but not with the tumor size, vacuole sign, vessel convergence sign and pleural indentation in CT images of peripheral NSCLC (P＞0.05). The expression of CD44v3 and CD44v6 correlated with the three-year survival rate in peripheral NSCLC patients (P<0.05). Conclusion Deep lobulation, spinous protuberant sign, short spiculation and lymph node enlargement of hila or mediastinum may indicate strong potential invasion and metastasis in peripheral NSCLC. The positive expression of CD44v3 and CD44v6 may suggest shorter survival time and poorer prognosis in peripheral NSCLC patients.

Objective To assess the feasibility of low-dose MDCT pulmonary angiography (MDCTPA) by using low kVp combined with individual-adapted low tube current protocol and noise reduction filter algorithms.Methods Fifty-six consecutively patients with MDCTPA were enrolled in the study.The patients were randomly divided into group A (120 kVp,100 mAs) and group B (100 kVp,individual-adapted tube current about 1.0 mAs/kg).Two series of images were reconstructed in group B:B1 with standard filter algorithms (FC13,B1) and B2 with noise reduction filter algorithms (FC11,B2).The image noise,quality and radiation dose in two groups were compared.Results The CTDIvol,DLP and E of group B were 5.1 mGy,83.3 mGy· cm and 1.4 mSv respectively,which were reduced by 64.3％,66.4％ and 66.7％,respectively (F =32.57,12.32,11.98,P ＜ 0.05) when compared with those in group A.Compared with group A,the image noise in B1 was increased by 118.2％ (t =10.05 P ＜0.05),the central and peripheral SNR and CNR and scores were increased by 51.5％,46.6％,50.8％,45.3％and 20.4％,respectively(t =7.20,6.30,6.58,5.54,8.35,P ＜ 0.05).Compared with B1,the image noise in B2 was reduced by 32.5％ (t =6.12,P ＜0.05),the central and peripheral SNR and CNR and scores were increased by 46.2％,46.2％,45.9％,46.9％ and 18.4％ (t =3.19,3.55,2.95,3.37,5.42,P ＜0.05).Compared with group A,the image noise in B2 group was increased by 47.3％ (t =4.03,P ＜0.05),the central and peripheral SNR and CNR and scores were reduced by 29.1％,21.8％,28.2％,19.6％ and 8.2％(t =4.06,2.82,3.68,2.22,3.02,P＜0.05).Conclusions Keeping effective diagnostic image quality,the protocol with low kVp and individual-adapted low tube current for low-dose MDCT pulmonary angiography would be effective and feasible,and the radiation dose would be significantly reduced.

Objective To study the feasibility of reducing radiation dose in aorto-iliac and lower extremity arteries CT angiography (CTA) with low tube voltage (100 kV) and automatic tube current modulation(ATCM).Methods Totally 61 patients requiting aorto-iliac and lower extremity arteries CTA for clinical reasons were prospectively enrolled in study.The patients were randomly assigned to 3 groups:Group A(120 kV),Group B (100 kV) and Group C (100 kV with automatic tube current modulation).Both quantitative and qualitative analysis were included in this research.Group C was divided into obese group(BMI≥ 24.9 kg/m2) and normal group(BMI ＜ 24.9 kg/m2).The radiation doses were analyzed respectively among two groups.Results The subjective evaluations of image quality for axial,MIP and VR were good.There were no significant differences among group A,B and C in SNR and CNR (P ＞0.05).The effective dose of group A,B and C was 8.20 mSv,5.36 mSv,and was 7.48 mSv,respectively Group B was 34.6％ less than group A.Group C was 39.5％ more than group B,and there was no significant differences between group A and C (P ＞ 0.05).The effective dose of group C1 was 7.11mSv,group C2 was 9.69 mSv,the E with group C1 were significantly less than group C2 (t =-3.163,P ＜0.05),the effective dose of group C1 was 13.3％ less than group A (Z =-2.822,P ＜ 0.05),but the group C2 was more than group A (P ＞ 0.05) and group B (Z =-3.426,P ＜ 0.05).Conclusions Lowkilovoltage (100 kV) CT scanning protocol is feasible in multi-detector CT angiography for aortoiliac and lower extremity arteries.Automatic low tube voltage (100 kV) with automatic tube current modulation (ATCM) scanning protocol can be used for someone with BMI less than 24.9 kg/m2.

Objective To identify long non-coding RNA (lncRNA) associated with rheumatoid arthritis-associated interstitial lung disease (RA-ILD) and investigate their mechanisms. Methods Peripheral blood samples were collected from RA-ILD patients (n＝3), RA patients without lung involvement (n＝3), and healthy controls (n＝3). Next-generation sequencing was performed to screen differentially expressed lncRNA. A human fibrotic lung cell model was established by inducing the MRC-5 cell line with transforming growth factor-β (TGF-β). Following siRNA-mediated knockdown of target genes, changes in inflammatory and oxidative stress-related genes were analyzed via real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR). Western blotting and dual-luciferase reporter (DLR) assays were used to validate protein expression, ubiquitination levels, and nuclear translocation of oxidative stress regulators, and antioxidant response element (ARE) transcriptional activity. Rescue experiments were conducted to confirm the role of target lncRNA in oxidative stress and inflammation in fibrotic lung cells. Results High-throughput sequencing revealed significant downregulation of LINC00638 in RA-ILD patients. Knockdown of LINC00638 markedly reduced transcriptional levels of interleukin (IL)-4, nuclear factor erythroid-2-related factor 2 (Nrf2), heme oxygenase-1 (HO-1), and superoxide dismutase 2 (SOD2), while increasing IL-6, IL-1β, interferon-γ (IFN-γ), and reactive oxygen species (ROS) levels. Furthermore, LINC00638 knockdown decreased Nrf2 protein expression, increased its ubiquitination, reduced nuclear translocation, and suppressed ARE transcriptional activity. In MRC-5 cells, LINC00638 knockdown combined with N-acetylcysteine treatment restored Nrf2 and HO-1 levels while reducing IL-6 expression. Conclusions LINC00638 suppresses inflammatory responses in RA-ILD by activating the Nrf2/ARE antioxidant signaling pathway, suggesting its potential as a therapeutic target for diagnosis and treatment.

Objective To investigate the distribution,variability and antibiotic resistance of the pathogen sisolated from bloodstream infections.Methods The bacterial strains were routinely isolated from blood samples and identified.Brucella trains were identified by PCR and gene sequencing.Antimicrobial susceptibility were routinely tested for these isolates.Results A total of 2 152 strains,excluding coagulase negative Staphylococcus,were isolated from blood specimens during the 5-year period from 2009 through 2013.Gram-positive cocci,gram-negative bacilli and fungi accounted for 35.3% (761/2 152), 57.7% (1 242/2 152)and 6.9% (149/2 152),respectively.The top three gram-positive bacteria were S.aureus,E.faecium and E.faecalis.E.coli,K.pneumoniae,P .aeruginosa,A.baumannii,and Brucella were the most frequently isolated gram-negative bacteria.In 2009,only one Brucella melitensis was isolated,but increased to 50 in 2013 (7.1%),including one strain of Brucella suis .The prevalence of MRSA was 54.1% in S.aureus.No staphylococcal isolate was found resistant to vancomycin or linezolid.More than 60% of the E.faecalis isolates still showed low resistance (< 30%)to ampicillin and levofloxacin.But E.faecium strains were highly resistant to most antibiotics (>70%)except glycopeptides and linezolid.E. coli and K.pneumoniae isolates displayed low resistance rate (< 15%)to piperacillin-tazobactam,amikacin,cefoxitin and
were still the most common pathogens in blood stream infections.Attention should be paid to the increasing prevalence of Brucella in blood stream infections.Various levels of antibiotic resistance are found in the pathogens of blood stream infections.Antibiotics should be prescribed reasonably according to local susceptibility testing data.