Objective To explore early prognostic value of quantitative detection of paraquat (PQ) plasma concentration and urine sodium dithionite assay for prognosis in patients with acute PQ poisoning. Methods A prospective study was conducted. The patients with acute PQ poisoning admitted to Department of Emergency of First Hospital of China Medical University from August 2013 to December 2015 were enrolled. At admission, blood samples and urine samples were collected. The PQ plasma concentration was determined by high-performance liquid chromatography (HPLC), and the PQ urine concentration was determined by sodium dithionite, meanwhile the biochemical parameters were determined to carry out sequential organ failure assessment (SOFA) score. According to the prognosis of 90-day follow-up, the patients were divided into survival group and death group. Logistic regression analysis was used to analyze the relationship between the prognosis and the indexes, and the receiver operating characteristic curve (ROC) was drawn to evaluate the prognosis. Results There were 148 patients with acute PQ poisoning, with 43 alive and 105 dead, and the 90-day mortality rate was 70.9%. The ingestion volume (mL: 22.69±18.57 vs. 9.91±4.61), plasma concentration of PQ (mg/L: 2.28±1.52 vs. 0.91±0.38) and positive rate of urine sodium dithionite (87.6% vs. 14.0%) in death group were significantly higher than those of survived group (all P < 0.01), but no significant differences in gender, age, poisoning time, gastric lavage time between the two groups were found. Significant differences in white blood cell count [WBC (×109/L): 13.45±6.12 vs. 23.03±7.67] and blood lactate [Lac (mmol/L): 1.50±0.45 vs. 8.10±4.51] between survival group and death group were found (both P < 0.01), while no significant difference in SOFA score was found (0.98±0.72 vs. 1.34±1.29, P > 0.05). It was shown by logistic regression analysis that the key factors affecting the prognosis of patients with PQ poisoning were urine sodium dithionite assay [odds ratio (OR) = 8.731, 95% confidence interval (95%CI) = 2.828-26.954, P = 0.000], PQ plasma concentration (OR = 2.082, 95%CI = 1.204-3.603, P = 0.009) and ingestion volume (OR = 1.175, 95%CI = 1.048-1.318, P = 0.006) respectively. It was shown by ROC curve that the area under ROC curve (AUC) of plasma PQ concentration, urine sodium dithionite assay, poisoning dose and SOFA score for predicting the prognosis in patients with acute PQ poisoning was 0.866, 0.857, 0.826, and 0.631 respectively (all P < 0.05). The sensitivity of urine sodium dithionite assay for predicting the prognosis was 87.6%, and the specificity was 83.7%. Conclusions Early plasma PQ concentrations can objectively reflect the body absorbed toxicant doses and actual situation after poisoning, and help to judge the early evaluation of prognosis. The accuracy of urine sodium dithionite assay in judging the prognosis of PQ poisoning is high. Because of its simplicity and availability, it was easier to be performed in the primary hospital.

The CR image system is a widely-used device to digitize X-ray images. The superiority of CR image system over a traditional X-ray camera shows that the former has a higher image quality and a less radiation dosage. Moreover, the CR image allows easier post-processes to convince the diagnoses and enables digital storage, reproduction and access on line. By analyzing the basic theory of CR image systems, the potential factors to impact the image quality are discussed. A series of strategy to improve the CR image quality are proposed.

Ethylene Dichlorides ; poisoning ; Humans ; Intracranial Pressure ; drug effects ; Occupational Exposure ; adverse effects

Objective To investigate the correlation between cystathionine β-synthase (CBS) T833C gene polymorphism and the plasma homocysteine (Hey) levels in patients with ischemic cerebral vascular disease(ICVD). Methods Three hundred and sixty patients with ICVD and 210 control subjects were enrolled. The T833C polymorphism of CBS gene was analyzed by the amplification refractory mutation system (ARMS). Plasma Hey levels were measured by high performance liquid chromatography-fluorescence detection(HPLC-FD). Results Plasma Hey levels in the ICVD group ((17.6±4.8) μmol/L) were higher than those in control group ((13.3±4.3) μmol/L, t = 10.716, P< 0.05) . There were no differences in genotype frequencies and allele frequencies between the ICVD group and contral group (χ2 = 0.785, 0.941 ,P>0.05). Plasma Hey levels in CC genotype or TC genotype were higher than those in TT genotype (F = 6.56, P< 0.05). Condusions High plasma Hey level is an independent risk factor of ICVD,but CBS T833C polymorphism may not associated with ICVD.

[Objective]To explore the surgical feasibility and clinical outcome of pedicle screw instrument for treatment of irreducible atlantoaxial dislocation and to choose an effective method of internal fixation.[Method]From June 2003 to February 2009,14 pationts with atlas dislocation followed by upper cervical cord compression were treated surgically with oral anterior soft tissue release combined with posterior reduction and pedicle screw instrument.Preoperative CT,MRI and radiographs as well as intraoperative screw placement and bone graft were administered in all pationts.Only cervical collars were used as external support for 3 months in occipitocervical fusion.[Result]All screws were successfully placed in atlas and axis.Forteen patients were followed up for an average of 18 months.Bone fusion was achieved in all cases with no complications of nerve,internal fixation failure and redislocation.Neurological recovery was significantly improved in 12 cases and took a turn for better in 2 cases.[Conclusion]Pedicle screw instrument in atlas and axis has the advantages of direct screw placement,short-segment fusion,intraoperative reduction and high fusion rate.It is a better alternative for atlantoaxial dislocation.

Objective To investigate the relationship of antishock effect of arginine vasopressin(AVP) on hemorrhagic shock and its relationship with Rho kinase.Methods Hemorrhagic shock(40 mmHg for 2 h) Wistar rats were treated respectively by AVP(0.4 U/kg),Rho kinase specific inhibitor,Y-27632(30 ?g/kg),or these 2 reagents.The pressor effect of norepinephrine(NE) on these rats and the contractility of their isolated superior mesenteric artery(SMA) were observed.Isolated SMAs from hemorrhagic shock rats were adopted to observe the effects of AVP on vascular reactivity and calcium sensitivity and its relationship to Rho kinase with an isolated organ perfusion system.Results AVP at the concentration of 0.4 U/kg significantly improved the pressor effect of NE and the contractile response of SMA.While,Y-27632(30 ?g/kg) abolished these beneficial effects of AVP.The vascular reactivity and calcium sensitivity of SMA were significantly decreased following hemorrhagic shock.AVP at the concentration of 0.5 and 5 nmol/L significantly increased the decreased vascular reactivity and calcium sensitivity.These effects of AVP were abolished by Y-27632(10 ?mol/L).Conclusion Rho kinase may take part in the action of AVP on hemorrhagic shock via improving shock induced vascular hyporeactivity and calcium desensitization.

BACKGROUND:Methicil in-resistant Staphylococcus aureus (MRSA) infection had been a global problem up to 1980s, and it has become a leading pathogen giving rise to nosocomial infections now.
OBJECTIVE:To determine the molecular types and drug susceptibilities of Staphylococcus aureus prevailed in burn ward, and to provide a basis for preventing and control ing MRSA intections.
METHODS:A total of 53 Staphylococcus aureus strains were col ected from the burn ward in the Urumqi General Hospital of Lanzhou Military Region of Chinese PLA. These MRSA strains were identified by PCR and cefoxitin disc diffusion test, and al MRSA strains were typed by spa, SCCmec and MLST typing. In the meanwhile, antibiotic susceptibilities of 17 kinds of drugs, such as oxacil in, to Staphylococcus aureus were also determined, and drug resistance of different types of Staphylococcus aureus especial y MRSA, was analyzed.
RESULTS AND CONCLUSION:Among 53 Staphylococcus aureus strains, 43 were identified as MRSA, containing determined for amplification of meoA (n=41) and positive for cefoxitin disc diffusion test (n=2). Three SCCmec types, four spa types, and three ST types were found. The major predominant clone was ST239-MRSA-III-t030 (90.7%), with highest resistant to oxacil in and other nine antibiotics. In conclusion, the higher MRSA isolation rate from the burn ward, and ST239-MRSA-III-t030, as the predominant clone, presents with an outbreak in the burn ward and stronger resistance to many different families of antibiotics.

OBJECTIVE:To compare the pharmacodynamics of active parts in crude Atractylodes lancea and A. lancea fired with bran. METHODS:170 rats were randomly divided into 17 groups,including blank control group,spleen and stomach damp obstruction model group,volatile oil of crude A. lancea and A. lancea fired with bran high-dose and low-dose(0.747,0.083 mg/ml by the concentration of crude medicinal materials,similarly hereinafter)groups,solvent control 2% polysorbate 80 group,dichlo-romethane extract of crude A. lancea and A. lancea fired with bran high-dose and low-dose groups,solvent control 1‰ polysorbate 80 group,n-butyl alcohol extract of crude A. lancea and A. lancea fired with bran high-dose and low-dose groups,solvent control stomach damp obstruction model distilled water control group. Except blank control group,other 16 groups were given Sennae foli-um decoction ig for 14 d to induce spleen and stomach damp obstruction model,and then received relevant medicine or solvent ig once a day for consecutive 7 d. Body weight of rats were determined before and after medication,and the serum levels of amylase, D-xylose,gastrin,vasoactive intestinal peptide and NO were determined after medication. RESULTS:Compared with spleen and stomach damp obstruction model group,the body weight and serum levels of gastrin,amylase and D-xylose increased significantly in rats of active part in A. lancea fired with bran groups(P<0.05),while vasoactive intestinal peptide and NO decreased signifi-cantly(P<0.05). Compared active part in crude A. lancea group,except the body weight,above indicators of active part in A. lan-cea fired with bran groups had greater change,with statistical significance (P<0.05). CONCLUSIONS:There are pharmacody-namic differences in the active parts between crude A. lancea and A. lancea fired with bran,the latter one is stronger.

Objective To discuss the clinical effect of surgical treatment for ankle osteoarthritis under arthroscopy.Methods Forty-eight cases with ankle osteoarthritis patients admitted at the Orthopaedic Hospital of Zhengzhou from January 2012 to June 2014 were selected and all of them were given the treatment of focal cleaning under arthroscopy.The clinical effect of surgical treatment were judged by modified McGuire ankle rating system,the United States after ankle surgery AOFAS ankle-full score and Mazur ankle rating system respectively.Results At the time of the last follow-up,modified McGuire ankle rating system((85.64±16.52)points vs.(52.46±10.25)points,t=-8.465),the United States after ankle surgery AOFAS ankle-full score [(85.24±11.46)points vs.(53.68±9.48)points,t=-7.548)and Mazur ankle rating system((86.45±12.57)points vs.(58.49±8.64)points,t=-6.596)all increased than that of pre-operation,the differences were statistically significant(P＜0.05).The modified McGuire ankle rating system of patients with low-grade lesion at pre-operation((62.45±7.63)points vs.(49.58±6.35)points,t=3.685)and the time of the last follow-up((93.68±11.54)points vs.(68.54±9.68)points,t=8.695)were all higher than that of patients with high-grade lesion,the differences were statistically significant(P＜0.05).The clinical effect of surgical treatment judged by modified McGuire ankle rating system,the United States after ankle surgery AOFAS ankle-full score and Mazur ankle rating system were respectively 91.67％(44/48),89.58％(43/48)and 89.58％(43/48),the differences were no statistically significant(x2=0.824,P＞0.05).Conclusion The clinical effect of surgical treatment for ankle osteoarthritis under arthroscopy is remarkable and it causes light damage to the body.It is especially suitable for patients with low-grade lesions and is worth popularization and application.

Background It is determined that riboflavin/ultraviolet A (UVA)-induced corneal collagen crosslinking is able to increase resistance of cornea against enzymatic digestion and has antimicrobial efficacy for various kinds of bacteria in vitro.However,its in vivo study is less now.Objective This study aimed to evaluate the efficacy of iontophoresis-mediated corneal collagen crosslinking combined with or without drugs for Staphylococcus aureus keratitis.Methods Bacterial keratitis models were induced by the interstromaly injection of Staphylococcus aureus suspension with concentration 2× 109/ml in the right eyes of 40 rabbits,and then the rabbits were randomly classified into the model group,gatifloxacin eye drops group,riboflavin/UVA corneal crosslinking group and drugs+ crosslinking group.The smearing of corneal surface was performed for the identification of bacteria 24 hours after injection.Iontophoresis-mediated riboflavin/UVA crosslinking was applied on the eyes of the riboflavin/UVA corneal crosslinking group and drugs+crosslinking group,and gatifloxacin eye drops was topically used 7 times per day on the eyes of the gatifloxacin eye drops group and drugs+crosslinking group.The corneal inflammation was examined and graded under the slit lamp biomicroscope before and after treatment.Ocular anterior segment optical coherence tomography(AS-OCT),corneal histopathology and ultrastructure were examined 14 days after treatment.The living environment of the experimental animals was maintained at 21 ℃ with a 12-hour light and dark cycle.Animals used in this study were treated in accordance with the Weifang Medical College Animal Experimentation Ethic Committee (AEEC) guidelines.The study protocol was approved by the AEEC.Results Corneal inflammation and ulcer were observed,but no significant difference was found in the inflammatory grade among the 4 groups 24 hours after injection (x2=0.293,P＞0.05).In the 14th day after injection,the corneal ulcer area was smaller and corneal edema was milder in the drugs+crosslinking group compared with the model group,gatifloxacin eye drops group and riboflavin/ UVA corneal crosslinking group,showing a significant difference in the inflammatory grade among them (x2 =38.710,P＜0.001).The cornea thickness values of ulcer zone were (428.1 ± 146.2) μm on the 14th postinjected day in the drugs+crosslinking group,which was evidently higher than those in the model group,gatifloxacin eye drops group and riboflavin/UVA corneal crosslinking group,with a significant difference among the 4 groups (F =8.310,P＜0.001).A lower degree of destruction of cornea collagen and less inflammatory cells were seen in the cornea tissue of the drugs+ crosslinking group by haematoxylin and eosin staining in comparison with other 3 groups,and normal keratocytes were much more in the drugs + crosslinking group than those in other treated groups.Conclusions Iontophoresismediated corneal collagen crosslinking can alleviate Staphylococcus aureus keratitis.The combination of crosslinking with drugs has a better effectiveness than the administration of gatifloxacin eye drops only or riboflavin/UVA corneal crosslinking only.