Objective To evaluate the diagnostic value of CT myelography (CTM) in brachial plexus injury. Methods Twenty-seven patients with brachial plexus injury were examined by using cervical CTM with spiral scan and bone reconstruction algorithm. CT images were reviewed by the senior radiologists, who determined if the nerve root avulsion was presented. The criteria of diagnosing nerve root avulsion were loss of normal nerve root appearance in the Isovist filled thecal sac in consecutive CTM slices plus companion signs. The sensitivity, specificity, and accuracy of CTM in diagnosing nerve root injuries were calculated with operation findings and follow-up results as gold standard. Results Direct sign of nerve root avulsion was the loss of normal nerve root defect seen in the Isovist filled thecal sac in consecutive CTM slices. Indirect signs included: (1) Pseudomeningocele bulge: The leak of Isovist into nerve root sheath, and extended into foramina; (2) Arachnoid cyst: displacement of spinal cord; (3) Dissymmetry of subarachnoid cavity: deformity of thecal sac, partially lack of Isovist into arachnoid space; (4) Non-integrity of dural capsule wall: one side of capsule cavity was obstructed. Part of the surface of spinal cord was exposed. Brachial plexus injury could be diagnosed by direct sign with one of the indirect signs. Of the 27 patients (128 nerve roots), 91 nerve root avulsions were found on CTM, and 37 was found normal. Compared with operation findings, 84 were true positive, 7 false positive, 34 true negative, and 3 false negative. Based on these results, the sensitivity, specificity, and accuracy were 96.6%, 82.9%, and 92.2%, respectively. Conclusion CTM is accurate in detecting nerve root avulsion of brachial plexus.

Objective To study the limitation analysis of Staphylococcus spp Susceptibility Test Kit ATB STAPH 5 from Bi-oMerieux in clinical application and to propose remedy.Methods The coverage area and break point of antibiotics ATB STAPH 5 from BioMerieux were analysed by using CLSI M100-S23 as standard.Results The kit ATB STAPH 5 did not include chloromycetin,oxazolidinones and lipopeptide three antibiotics that were recommend by CLSI.The 16 kinds of antibi-otics break point in the kit ATB STAPH 5 were all not inconsistent or did not contain with the standard of CLSI M100-S23. It may lead to error drug sensitivity tests,false sensitive or false drug resistance.Conclusion Only using this kit ATB STAPH 5 for Staphylococcus spp ,it may occurre errors or mistakes.Other experiments must be corrected before the re-port.

Objective To evaluate the relationship between ultrasound-assayed detrusor thickness and bladder outlet obstruction (BOO) in old men with benign prostatic hyperplasia (BPH).Methods The 106 BPH patients underwent the urodynamic examination on which the diagnosis of BOO was dependent. The obstruction was defined as the Abrams-Griffiths nomogram (A-G index)≥40 and the grade of linear passive urethral resistance relation (LinPURR)≥Ⅱ . When bladder capacity reached 150 ml, the detrusor thickness was measured by abdominal ultrasound. Results Compared with unobstructed group, the maximum flow rate and average flow rate were both lower in obstructed group [(10.1±3.0) ml/s vs. (17.4±3.1) ml/s, (5.5±2.2) ml/s vs. (11.2±2.2) ml/s, t= 10.26and 11.03, both P＜0.01]. And the residual urine volume and maximum detrusor pressure were significantly higher in obstructed group than in unobstructed group [(47.6 ± 24.3) ml vs. (17.0 ±5.6) ml, (39.3±14.4) cm H2Ovs. (26.8±8.0) cm H2O, t=6.32 and 4.07, P＜0.01 or 0.05].Detrusor thickness was positively correlated with maximum detrusor pressure (r= 0.419, P＜0.01),but negatively correlated with maximum flow rate (r =- 0.749, P＜ 0.01 ), mean flow rate (r=-0.853, P＜0.01) and voided volume (r=-0.556, P＜0.01). There was significant difference in detrusor thickness between obstructed group and unobstructed group [(3.0± 0.2) mm vs. (2.5 ±0.2) mm, t= 11.2,P＜0.05]. According to the diagnostic standard of detrusor thickness≥3.0 mm,it had a sensitivity of 90% and a specificity of 84.6%, a positive predictive value of 93.1% and a negative predictive value of 78.6%. Conclusions Detrusor thickness of 3.0 mm or greater has a certain predictive value for BOO in old men.

Artemisnin is a novel sesquiterpene lactone with an internal peroxide bridge structure, which is extracted from traditional Chinese herb Artemisia annua L. (Qinghao). Recommended by World Health Organization, artemisinin is the first-line drug in the treatment of encephalic and chloroquine-resistant malaria. In the present study, transgenic A. annua plants were developed by overexpressing the key enzymes involved in the biosynthetic pathway of artemisinin. Based on Agrobacterium-mediated transformation methods, transgenic plants of A. annua with overexpression of both HDR and ADS were obtained through hygromycin screening. The genomic PCR analysis confirmed six transgenic lines in which both HDR and ADS were integrated into genome. The gene expression analysis given by real-time quantitative PCR showed that all the transgenic lines had higher expression levels of HDR and ADS than the non-transgenic control (except ah3 in which the expression level of ADS showed no significant difference compared with control); and the HPLC analysis of artemisinin demonstrated that transgenic A. annua plants produced artemisinin at significantly higher level than non-transgenic plants. Especially, the highest content of artemisinin was found in transgenic line ah70, in which the artemisinin content was 3.48 times compared with that in non-transgenic lines. In summary, overexpression of HDR and ADS facilitated artemisinin biosynthesis and this method could be applied to develop transgenic plants of A. annua with higher yield of artemisinin.

Objective To investigate the effect of secondary transurethral electrocision for recurrent superficial bladder cancer.Methods One hundred and twenty patients with recurrent superficial bladder cancer were divided into experiment group and control group by random mechanical sampling method with 60 cases of each.Experiment group underwent secondary transurethral electrocision at 4 weeks after initial transurethral electrocision and received mitomycin bladder perfusion chemotherapy,control group patients underwent initial transurethral electrocision and received mitomycin bladder perfusion chemotherapy.The two groups' follow-up cystoscopy at 3-month intervals,the follow-up time was 6-34 (18.6 ± 6.5) months,the recurrence was compared between each other.Results Within the follow-up period,the recurrence rate in experiment group was significantly lower than that in control group [21.7％(13/60) vs.63.3％(38/60),P＜0.01].Of all the recurrent patients,high grade rumor (G2 and G3 grade) was mainly,the recurrence rate of high grade tumor in experiment group was significantly lower than that in control group [26.2％ (11/42) vs.70.0％(35/50),P ＜ 0.01].Conclusions Secondary transurethral electrocision can reduce the recurrence rate of superficial bladder cancer (especially for the high grade tumor),it can exactly make the classification of malignant tumors and find residual tumor.So it is valuable in the clinical treatment.

Objective To study the characteristics of auditory brainstem response by chirp and click stimuli in normal hearing children.Methods A total of 97 children (194 ears)with normal hearing were recruited,including 50 male (100 ears),and 47 female (94 ears).The CE-chirp and the click acoustic stimulation were used to,and the ABR waveforms and latencies were obtained.ResuIts The chirp-ABR Ⅰ wave recognition rate (36%)was significantly lower than that of click-ABR (100%).At 80 dB nHL,chirp-ABR V wave latency was shorter than click-ABR,the difference was statistically significant (P< 0.05 ).The chirp and click ABR V wave response thresholds showed no significant difference (P>0.05).At 80 dB nHL,no statistical significance of two kinds of a-coustic stimulation of ABR V wave amplitude difference (P>0.05).At 50 dB nHL,chirp-ABR significantly in-creased than click-ABR V wave amplitude with statistically significant differences (P<0.05).At 80,and 50 dB nHL,chirp-ABR showed no differences in the amplitude of V wave (P>0.05 ).ConcIusion The chirp acoustic stimulation produced the larger response amplitude,and was faster,demonstrating the noticeable advantages to tes-ting children.

ObjectiveTo evaluate the short-term effectiveness of tension-free vaginal tapeobturator system(TVT-O) on the type Ⅰ,Ⅱ stress urinary incontinence(SUI) in the elderly female patients. Methods Elderly female patients (73 cases) with SUI type Ⅰ and Ⅱ were selected in 0.5-3.0 years after TVT-O surgical treatment,and they reached the age over 60 years before TVT-O.Difference of daily life and lower urinary tract symptoms before and after surgery were compared by the incontinence impact questionnaire ( Ⅱ Q-7) and the urogenital distress inventory (UDI-6) through telephone survey.Results Totally 73 patients were followed up successfully,aged 60 to 72 years (mean 64.0±4.5).Preoperative patients' daily life quality such as making housework,activities,entertainment,go-out,social contact and emotion had obviously been affected with a score of 9 to 25 by their own scoring (mean 17.0±6.7).Lower urinary tract symptoms including urgency,frequent urination,movement,leakage of urine volume,odynuria and dysuria were from 8 to 21 (mean 14.0±4.7) scores.Mild urinary frequency was 8.2％ (6 cases).Urinal pad usage was in 71 cases (97.3％)After TVT-O,patients' symptoms improved by their own scoring.The Ⅱ Q-7 scores were ranging from 2 to 13 (mean 6.4±3.2),and lower urinary tract symptoms scores from 1 to 9 (mean 5.4±3.2).Mild urinary frequency after surgery was 1.4 ％ (1 case).The urinary incontinence in 39 cases completely disappeared (53.4 ％ ),urinal pad usage were in 34 cases (46.6 ％ ).18 cases (24.7 ％ ) had suprapubic area pain or discomfort postoperatively.Conclusions TVT-O is an ideal choice for type Ⅰ and Ⅱ SUI in elderly female patients.

Objective To construct a large animal model of ischemic heart disease induced by acute myocardial infarction (AMI) . Methods Male Diannan Mini-pigs were selected (n=8), weight 20 ± 4 Kg. After general anesthesia and endotracheal intubation, blood pressure and electrocardiograph were monitored. Parasternal incision was taken and thoracotomyv was performed at 4th-to-5th intercostalgap. Pericardium was opened and left anterior descending artery was ligated. Echocardiography was performed at baseline, postoperative 28 and 60 day. Euthanasia and heart explanted was conducted at 60 day of experimental pig. After gross examination of the heart, the histological examination was used to assess myocardial infarction by using H&E staining. Results All of the pigs were presented with ventricular arrhythmias in varying degrees after ligation of the left anterior descending artery, of whom 2 died of refractory ventricular fibrillation, the mortality was 25%. Echocardiography assessment showed the loss left ventricular function, the thinning of left ventricular apical and the enlargement of left ventricule. Histological examination revealed that myocardial fibrosis and fibrous scar were formed in myocardial infarction area. Conclusion The ligation of left anterior descending artery through thoracotomy under direct vision is a reliable strategy for construction of AMI porcine model and the experimental porcine can develop ischemic cardiac dysfunction progressively.

Atropa belladonna L. is the officially medicinal plant species and the main commercial source of scopolamine and hyoscyamine in China. In this study, we reported the simultaneous overexpression of two functional genes involved in biosynthesis of scopolamine, which respectively encoded the upstream key enzyme putrescine N-methyltransferase (PMT; EC 2.1.1.53) and the downstream key enzyme hyoscyamine 6beta-hydroxylase (H6H; EC 1.14.11.11) in transgenic hair root cultures of Atropa belladonna L. HPLC results suggested that four transgenic hair root lines produced higher content of scopolamine at different levels compared with nontransgenic hair root cultures. And scopolamine content increased to 8.2 fold in transgenic line PH2 compared with that of control line; and the other four transgenic lines showed an increase of scopolamine compared with the control. Two of the transgenic hair root lines produced higher levels of tropane alkaloids, and the content increased to 2.7 fold in transgenic line PH2 compared with the control. The gene expression profile indicated that both PMT and H6H expressed at a different levels in different transgenic hair root lines, which would be helpful for biosynthesis of scopolamine. Our studies suggested that overexpression of A. belladonna endogenous genes PMT and H6H could enhance tropane alkaloid biosynthesis.

Objective To explore the clinical application of antibiotics Ceftazidime(CAZ) and Cefotetan(CTT)by analysis susceptibility and scatter of the CAZ adn CTT against Escherichia coli(ECO) and Klebsiella pneumoniae(KPN).Methods The drug sensitivity analysis of 1 311 strains of ECO and 898 strains of KPN isolated from 2012 to 2015 and the relationship between CAZ and CTT was analyzed by using the Whonet 5.6 software.Results The resistance rate of ESBL+ KPN to CAZ was 41.2％ and the rate to CTT was 14.1％,the difference was statistically significant(P<0.05).The resistance rate of ESBL+ ECO to CAZ was 34.6％ and the rate to CTT was 1.1％,the difference was statistically significant(P<0.05).The average value of MIC of CAZ was highest in group of ESBL+KPN,it was 6.39 μg/mL.And it was lowest in group of ESBL-KPN,it was 1.37 μg/mL.The average value of MIC of CTT was highest in group of ESBL+KPN,it was 6.8 μg/mL.And the lowest was in group of ESBL-KPN.The range of MIC of CAZ was 1-64 μg/mL,and the range of CTT was 4-64 μg/mL in all groups.The cross sensitivity of CAZ and CTT was more than 90.0％.The cross resistance was less than 5.0％.The cross sensitivity of CAZ and CTT was less than 70.0％ in ESBL+ group.And the cross resistance was up to 13.4％.Conclusion The cross resistance and cross sensitivity of the two antibiotics is very important in guiding clinical antibiotic selection or replacement.