Objective To report the results of the surgical treatment of cervical spondylotic myelopathy(CSM) secondary to athetoid cerebral palsy and clarify the characteristics and the principle of treatment of the disease. Methods The age of the patient, segments of vertabrae involved and operated upon, results and complications of 32 cases with CSM secondary to athetoid cerebral palsy were statistically analyzed and compared with 93 patients who had isolate CSM operatively treated at the same time. Results 1)The average age of the patients in the group of CSM secondary to athetoid cerebral palsy was 37.94 years,and in the group of isolate CSM was 52.48 years, with significant statistic difference(P

ObjectiveTo investigate the extracorporeal clearance rate of imipenem in severe infection patients in the mode of continuous vena-venous hemofiltration (CVVH) during continuous renal replacement therapy (CRRT), in order to approach if the concentration of imipenem in plasma could achieve effective levels of anti-infection, and to explore the effect of time and anticoagulation measure on imipenem clearance during CRRT treatment.Methods A prospective observational study was conducted. All adult severe infection patients complicating acute kidney injury (AKI) in the Department of Critical Care Medicine of the Fourth Hospital of Hebei Medical University from March 2013 to September 2014, who were prescribed imipenem as part of their required medical care, and CRRT for treatment of AKI were enrolled. 0.5 g doses of imipenem was administered intravenously every 6 hours or 8 hours according to random number table, and infused over 0.5 hour. The unfractionated heparin was used for anticoagulation in the patients without contraindications, and no anticoagulation strategy was used in the patients with high risk of bleeding. At 24 hours after first time of administration, postfilter venous blood and ultrafiltrate samples were collected at 0, 0.25, 0.5, 0.75, 1, 2, 5, 6, and 8 hours after imipenem administration. The concentration of imipenem in above samples was determined with liquid chromatography-mass spectrometer/mass spectrometer (LC-MS/MS).Results A total of 25 patients were enrolled. Thirteen patients received imipenem intravenously every 6 hours, and 12 patients, every 8 hours. The anticoagulation was conducted with heparin in 13 cases, and 12 cases without anticoagulation. The intra-day precision, inter-day precision, matrix effect, and recovery rate in low, medium, and high concentration of plasma and ultrafiltrate, and the stability of samples under different conditions showed a good result, the error of accuracy was controlled in the range of±15%. With the application of Prismaflex blood filtration system and AN69-M100 filter, under the mode with CVVH, the total clearance rate of imipenem was (8.874±2.828) L/h when the actual dose of replacement fluid was (31.63±1.48) mL·kg-1·h-1, the total CRRT clearance rate of imipenem in vitro was (2.211±0.539) L/h, which accounting for (30.1±15.7)% of the total drug clearance. In 6 hours interval dosage regimen, the percentages of the time> 4×minimum inhibitory concentration (MIC) at specific 4×MIC of 2, 4, 6, and 8μg/mL of imipenem were more than 40% of the dosing interval. But in the 8 hours interval dosage regimen, when the level was above the 4×MIC of 4μg/mL, maintaining time would drop below 40% of the dosing interval, with significant differences compared with that in 6 hours interval dosage regimen [4×MIC = 2μg/mL: (60.84±20.25)%vs. (94.01±12.46)%,t = 4.977,P = 0.001; 4×MIC = 4μg/mL: (39.85±15.88)% vs. (68.74±9.57)%,t = 5.562, P = 0.000; 4×MIC = 6μg/mL: (27.58±13.70)% vs. (53.97±8.36)%,t = 5.867,P = 0.000; 4×MIC = 8μg/mL:(18.87±12.43)% vs. (43.48±7.83)%,t = 5.976,P = 0.000]. No significant change in sieving coefficient of imipenem was found within a short time (6 hours), which indicated that there was no effect of anticoagulation on clearance of imipenem by AN69-M100 filter, and no statistical significance was found with repeated measure analysis (F = 0.186, P> 0.05).ConclusionsThe clearance rate of imipenem is increased significantly in vitro under the mode of CVVH with the actual dose of replacement fluid was (31.63±1.48) mL·kg-1·h-1 in severe infective patients with severe sepsis complicating AKI, affecting the level of plasma drug concentration, need to adjust the dosage regimen. When the time of the dosing interval was shortened, the concentration of imipenem in patients' plasma could be increased significantly. In a short period of time, the sieving coefficient of imipenem through AN69 filter is not affected by anticoagulation measures and time cleaning efficiency will not decline.

Objective To study the value of lung window and soft tissue window in measuring colon diseases with experimental CTVC examination.Methods Twenty-four artificial polypoid diseases were placed with glue in a thoroughly cleaned porcine colon(overall length,150 era)that was distented with air and submerged in a water phantom and scanned 10 times on a 64-MSCT(GE Light speed)with identical scanning parameters.The data were reconstructed every 0.625 mm and reviewed using 2D images, navigation,MPR and 3D volume-rendered images on a GE AW 4.2 workstation.The maximum diameters of the artificial polypoids were measured by two radiologists with more than 10 years working experience in lung window(W = 1000,L =-700)and soft tissue window(W =400,L =40),respectively.The average value of maximum diameters of the artificial polypoids were measured for 10 times and were compared with the actual diameter.Results Twenty-four artificial polypoid diseases and their shape,size,loeation and relation of diseases with bowel wall were all showed excellently.The maximum diameter measured was close to the actual diameter.The average value was mostly less than actual diameter and a few of them more than the actual diameter.The maximum diameter measured in lung window was close to the actual diameter,and there was no difference between the two data sets(t =0.431,P =0.669).There was difference between the maximum diameter measured in soft tissue window and the virtual diameter(t = 2.691,P = 0.010). Conclusion In screening the colon diseases,CTVC is a good method of choice with no insult or less insult, and higher repeatability.The lung window should be chosen in measuring colon diseases in CTVC examination.

Objective To investigate the clinical efficacy of nephrotic syndrome in children adjunctively treated by underatured lactalbumin.Methods Thirty-six cases of nephrotic syndrome were studied for about 1 year.The changes in red blood cells of reduced glutathione(GSH) were analyzed in 18 cases of underatured lactalbumin treatment group and 18 cases of control group.The clinical presentations were observed in both groups.Results GSH levels increased in underatured lactalbumin treatment group when compared with control group.The frequency of relapse and upper respiratory tract infection in underatured lactalbumin treatment group were significantly reduced compared with control group.Conclusion Underatured lactalbumin can provide support for the potential use of an antioxidant therapy in these patients.

Carcinoma, Non-Small-Cell Lung ; diagnostic imaging ; radiotherapy ; Humans ; Image Processing, Computer-Assisted ; methods ; Lung Neoplasms ; diagnostic imaging ; radiotherapy ; Radiotherapy Planning, Computer-Assisted ; methods ; Radiotherapy, Intensity-Modulated ; methods ; Tomography, Spiral Computed ; methods

Objective To study the state of erythrocyte immune function in neonates with hyperbilirubinemia,and analyze the influence of various clinical status on erythrocyte immune function.Methods Fifty-two neonates with hyperbilirubinemia were enrolled and 104 healthy neonates as the control group.The adherence rate of complement 3b-receptor on the surface of red blood cell(RBC-C3bRR) and the immune complex adherence rate of red blood cell(RBC-ICR) were detected with erythrocyte saccha-romycete rosettet test.Results 1.The level of RBC-C3bRR in neonates with hyperbilirubinemia was lower than that in control group,and the level of RBC-ICR in neonates with hyperbilirubinemia was higher than that of control group(Pa0.05).3.Comparing the neonates with unconjugated bilirubin of different concentrations,there were significant difference in RBC-ICR(Pa0.05).4.There were positive correlation between RBC-ICR and bilirubin,unconjugated bilirubin in the neonates(Pa0.05).Conclusion Erythrocyte immune function in neonates with hyperbilirubinemia is obviously lower than that of control group and it is influenced by the concentratron of bilirubin and the time of phototherapy.

Autophagy is a common phenomenon which widely ex-ists in eukaryotic cells. Researches have shown that autophagy plays a critical role in maintaining cellular hemostasis, cell com-ponents update and keeping a normal physiological state. In re-cent years, the study has found that autophagy is closely related to the growth, the development of cardiovascular diseases and tumors. Further studies show that in different pathological condi-tions, autophagy could both promote angiogenesis and inhibit the formation of blood vessels. Therefore, it is particularly critical to elucidate the mechanisms of autophagy in the regulation of angio-genesis in different pathological conditions. The role of autophagy in cardiovascular diseases especially in the regulation of angio-genesis is discussed in this paper. Besides, the paper also in-cludes the discussion about the mechanisms of autophagy in the regulation angiogenesis, which may provide references for follow-up research and clinical treatment.

Bacterial disinfectant resistance is the phenomenon that minimal inhibitory concentration or minimal bactericidal concentration of a certain disinfectant increases after a certain bacterium contacts with it many times. It exists widespread. Many species of bacteria are may resistant to a certain disinfectant, and a species of bacterium is may resistant to many disinfectant Disinfectant selectivity pressure is the extrinsic agent of bacterial disinfectant resistance. Resistance mechanisms include bacterial biochemistry structure, genetics pathway and enzymology pathway. There is relationship in disinfectant resistance and drug resistance. We should strengthen study and monitoring, enact unified standard and application specification to reduce bacterial disinfectant resistance.

To determine the relationship between the intercellular adhesion operon (ica) and the biofilm production in Staphylococcus epidennidis isolates from nosocomial infection, and the affection of ica on the antibiotic susceptibility of the isolates, we collected 106 strains, epidermidis isolates from nosocomial infection specimen to detect their biofilm production by quantitative and qualitative method and investigate the existence of ica operon by PCR. The minimal inhibitory concentration (MIC) to erythromycin, ampicillin, cefoxitin, ceftriaxone, teco-planin, ciprofloxacin, tetracycline, trimethoprim-sulfamethoxazole and vancomycin were tested. Among the isolates, 33 (31. 1% ) of them were detected out carrying ica operon. The rate of biofilm production of the ica-posi-tive isolates was higher than that of the ica-negative (P =0. 001) . By adding glucose and NaCl into the culture the detection rate of biofilm production could be increased. The antibiotic susceptibility of the plankton cells of ica-positive isolates to erythromycin, cefoxitin and ceftriaxone , except ampicillin, ciprofloxacin, tetracycline and tremethoprim-sulfamethoxazole, were lower than those of ica-negative isolates. This study showed that the existence of ica operon was close related to the biofilm formation in 5. epidermidis isolates from nosocomial infection. However, the mechanism of antibiotic resistance of the strains inside the biofilm still needed to be illustrated.

Objective To determine the genotypes and their epidermiology of microlide, lincosamide and streptogramin B(MLS_B)resistant S.epidermidis isolates causing nosocomial infection.Method 126 isolates were collected from inpatients in three hospitals in Beijing from 2003-2004 for testing the antibiotic susceptibility to the macrolide erythromycin,the lincosamide clindamycin.The resistance phenotypes of erythromycin-resistant isolates were determined by the double-disc test with erythromycin and clindamycin.The presence of the relative genes(ermA,ermB,ermC and msrA)to MLS_B resistance was identified by PCR and the similarity of the isolates was analyzed by PFGE.Result The isolates were mostly resistant to macrolide and lincosamide.In the constitutive phenotype cMLS_B isolates,the methicillin resistant S.epidermidis(MRSE)proportion appeared high(78.5%),whereas high methicillin susceptible S.epidermidis(MSSE)proportion was found in the inducible MLS_B phenotype(iMLS_B) (69.2%).ermC was shown as the most frequent determinant to the resistance,not only in MRSE and MSSE (70.8% and 6.8%),but also in iMLS_B and cMLS_B(76.9% and 90.3%).No specific endemic strain was found by PFGE analysis.The same resistance phenotype pattern was not clustered together and distributed into type A～F at the similarity of 60%.Among the phenotypes(cMLS_B,iMLS_B and MS phenotype),no significant difference was shown in the PFGE genotype distribution.Conclusion Our results indicate that the MLS_B resistance in S.epidermidis causing nosocomial infection is prevalent in the hospital and MLS_B antibiotics should be used iudiciously,ermC was shown as the most frequent determinant to the resistance.