Objective To examine the morphological changes in the cervical intervertebral foramen during axial rotation of cervical spine and explore its clinical significance for the diagnosis and treatment of cervical degenerative disease. Methods Ten healthy volunteers (5 male, 5 female) were subjected to transectional scan by multislice spiral computed tomography of cervical spine from the upper edge of C 3 vertebra to the lower edge of C 7 vertebra. On the 45 degree oblique reconstructions of C 3～4, C 4～5, C 5～6 and C 6～7 intervertebral foramina, four parameters were measured, including foraminal height, foraminal width (both superior and inferior), and cross-sectional area of the foramen. Statistic analyses were performed to examine the morphological changes in the cervical intervertebral foramen. Results It was found that the foraminal cross-sectional area was decreased on the side of rotation,and increased on the opposite side of rotation. Significant correlation was revealed between the variation rate of the C 3～4 intervertebral foramen cross-sectional area and the rotational degree between C 3 and C 4. Conclusion Morphologic changes were found in the cervical intervertebral foramen due to axial rotation. The correlation between the cross-sectional foraminal areas with the degrees of rotation of the vertebrae was statistically significant. The results of the test have the clinical significance on the prevention, diagnosis and treatment of the cervical degenerative diseases, especially of the radiculopathy.

BACKGROUND: In the early stage following spinal cord injury, a series of changes in metabolism and secretion take place, such as accelerated bone resorption and decreased bone formation. Determination of the biochemical markers of bone metabolism early after spinal cord injury may help understand the metabolic changes and facilitate risk evaluation for osteoporosis on such occasion.OBJECTIVE: To study the earlychanges of bone mass and bone metabolism indices in guinea pigs with spinal cord injury and evaluate the impact of spinal cord injury on bone metabolism.DESIGN: Randomly controlled animal experiment. SETTING: Department of Rehabilitation Medicine, Zhongshan Hospital of Fudan UniversityMATERIALS: The experiment was conducted in the Institute of Rehabilitation Medicine, Zhongshan Hospital of Fudan University in March 2004. Twenty-three male guinea pigs with body weight of 427-710 g (averaging 570 g) were provided by the Experimental Animal Center,Zhongshan Hospital of Fudan University and divided into experimental group (n=10) and normal control group (n=13). All the guinea pigs were kept under the same environment and fed with standard food for two weeks.METHODS: Small microsurgery scissors was used to induce a 1.5-mm transverse incision of the spinal cord, with the bleeding carefully managed and the wound closed. Thirty minutes after surgery, the guinea pigs recovered consciousness with bilateral lower limb paralysis (hypertonic paraplegia) and loss of superficial and deep sensations, but without urinary and fecal incontinence. The animals in the control group had sham operation. After housing in the same environment with standard food for 2 weeks, urine,serum and shinbone samples were collected from the animals for measurement of serum bone alkaline phosphatase (BALP), urinary pyridinoline (Pyd)/creatinine (Cr) and Ca/Cr. t test and H test were used for comparison of the samples between the two groups.parison of biochemical markers for bone formation between the two groups.RESULTS: Ten animals were analyzed in each group. No significant difference was observed in the BMD and bone dry weight between the two groups (P ＞ 0.05), but the bone ash weight of experimental group was remarkably lower than that of the control group [(0.284±0.050) vs (0.361±0.064) mg, t=3.254, P ＜ 0.05). The experimental group had significantly lower serum BALP than the control group [(0.640±0.240)vs (1.328±0.606) U/L, H=9.499, P ＜ 0.05), but higher urinary Pyd/Cr [(0.206±0.080) vs (0.117±0.037), P ＜ 0.01) and Ca/Cr [(0.003±0.003)vs (0.002±0.002), P ＜ 0.05] than the control group (H=9.676, 4.124,P ＜ 0.05).CONCLUSION: After the spinal cord injury, bone resorption remarkably increases and the function of the osteoblasts is inhibited. Bone metabolic abnormalities can occur in the early stage of spinal cord injury, and the biochemical indices for bone metabolism are sensitive in evaluating the risks for osteoporosis after spinal cord injury.

BACKGROUND: With the development of China, quality of life (QOL) is getting more and more attention, however, there are few studies on QOL, especially in Mainland China.OBJECTIVE: To observe the situation of combinative application of Functional Independence Measure (FIM) and QOL assessment in rehabilitation clinical practice.DESIGN: Case analysis.SETTING: Zhongshan Hospital of Fudan University.PARTICIPANTS: Totally 83 rehabilitation patients selected from Shanghai Zhongshan Hospital from January to December 2003,consenting to take part in the study, were divided into 4 groups: bone & joint rehabilitation(n=42), stroke rehabilitation (n=17), internal medicine (n=15), and cancer rehabilitation (n=9).METHODS: Every patient carried out functional independence assessment and quality of life measurement within 24 hours of admission. FIM was adopted for functional independence assessment which included 13 items of motor (ranged from 13 to 91 points) and 5 items of cognition (ranged from 5to 35 points), and FAQ for quality of life included making telephone call,self-care economy, shopping, using vehicle, housework, jobs, entertainment,etc. with 100 in total. The author performed all the assessment.MAIN OUTCOME MEASURES: Every patient carried out FIM and FAQ assessment after admission and discharge.RESULTS: All data of totally 83 patients entered the final analysis. [1]The average age and length of hospital stay in stroke group were higher than those in other groups (P ＜ 0.01). [2] FIM motor and cognitive scores in stroke group were higher at discharge than those at admission (5.276,3.624;6.200,5.941,P ＜ 0.01), but scores of functional activity were lower at discharge than those at admission (1.253, 1.547, P ＜ 0.01). [3]In bone joint group, the FIM cognitive scores were coincidence in general, while motor scores were higher at discharge than those at admission (6.220,5.388, P ＜ 0.01), but scores of functional activity were lower at discharge than those at admission (0.610, 0.912, P ＜ 0.01). [4] Only scores of functional activity in tumor group were lower at discharge than those at admission (0.722, 0.989, P ＜ 0.05). [5] All items in internal medicine group were coincidence in general (P ＞ 0.05).CONCLUSION: FAQ is more sensitive than FIM in rehabilitation practice, but cannot replace FIM, and should be used with FIM.

AIM: To investigate the effects of poly (I:C) as virus mimics on iodine excess-induced chronic lymphocytic thyroiditis in NOD mouse. METHODS: Female, 32 NOD mice were randomly divided into 4 groups: (1) control;(2) high iodine;(3) poly (I:C);(4) high iodine+poly (I:C). Nine weeks after administration, mice were sacrificed. The following parameters were determined: body weight, thyroid weight and anatomic form. Thyroid hormone (T_4) in serum was measured by radioimmunoassay, the thyroid morphology was observed through HE staining, apoptosis was detected by TUNEL, the mRNA expression levels of TRAIL, TRAIL-sR1, ICAM-1 and CXCL10 were determined by the method of real time RT-PCR. RESULTS: Compared to control group and poly (I:C) group, the thyroid absolute weight and relative weight in high iodine group were increased (P<0.01), the level of total T_4 in serum was decreased (P<0.05), inflammation and apoptosis were obviously observed, the mRNA expressions of TRAIL, TRAIL-sR1, CXCL10 and ICAM-1 were upregulated (P<0.05). Compared to high iodine group, thyroid absolute weight and relative weight in high iodine+poly (I:C) group were further increased, the level of total T_4 in serum was further decreased (P<0.05), the ratio of inflammatory degree Ⅳ increased to 50.0%, the numbers of apoptosis cells were further enhanced, the mRNA expressions of TRAIL, TRAIL-sR1, ICAM-1 and CXCL10 were further upregulated (P<0.05). Otherwise, the tendency of all parameters in poly (I:C) group was similar to that in control group (P>0.05). CONCLUSION: Poly (I:C) aggravates chronic lymphocytic thyroiditis induced by excess of iodine associated with increase in infiltration of lymphocytes and induction of apoptosis.

Objective To evaluate the serum level of antimicrobial peptide human cationic antimicrobial protein 18 ( hCAP18 ) in non-small cell lung cancer ( NSCLC ) patients and its auxiliary diagnosis and prognosis value.Methods Case-control study was used.The serum level of hCAP18 was measured by enzyme linked immunosorbent assay ( ELISA) in 50 cases with NSCLC patients of department of thoracic surgery and 50 cases healthy people of department of physical examination from January 2011 to January 2012 in Tongji Hospital of Tongji University.The concentrations of hCAP18 in serum of NSCLC patients before and after surgery were analyzed.The sensitivity and specificity of serum hCAP18 for the diagnosis of NSCLC were evaluated using the receiver operating characteristic ( ROC ) curves.Data was analyzed by using the t-test and Log-rank test.Results Serum hCAP18 concentration in NSCLC patients (6 733 ±771.8) μg/L was significantly higher than in healthy controls (253 ±6.9) μg/L (t=8.396, P<0.05) .However, the concentration of hCAP18 showed no significant difference between squamous cell carcinoma and adenocarcinoma[(6 300.0 ±1 221.0) μg/L and (7 074.0 ±1 005.0) μg/L, respectively;t=0.494 2, P <0.05 ] .hCAP18 levels had significantly decreased in serum of NSCLC patients after 30 d surgery compared to preoperative results[from (6 733.0 ±771.8) μg/L to (433.6 ±38.2)μg/L;t=8.512, P<0.05].ROC analysis of serum hCAP18 yielded an AUC (Area under the ROC curve) of 0.931 ( 95% CI =0.884 -0.978 ) with 95% sensitivity and 96.3% specificity, which was higher than the CYFRA21-1[0.873 (95%CI=0.758-0.917)].The relapse rate of NSCLC patients with serum hCAP18≤390.0 μg/L was 12.5%(4/32), while 44.4%(8/18) in NSCLC patients with serum hCAP18>390.0μg/L (χ2 =22.64,P<0.05).Conclusions Detection of serum hCAP18 shows a good sensitivity and specificity for the auxiliary diagnosis of NSCLC. It is possible to be a potential detection index for noninvasive diagnosis and monitoring progression of lung cancer.

Objective Through detecting the expression of chemokine CCL21 and its receptor CCR7 in thyroiditis of NOD mice induced by excessive iodine and thyroglobulin (Tg) immunization,to explore the mechanism of lymphocytic infiltration.Methods Seven to eight weeks old female NOD (non-obese diabetic) mice were used,the mice were divided into four groups by random number table,7 mice for each group.Control group:intoke distilled water;,Tg group:intoke'distilled water,use pig Tg emulsified in Freund's complete adjuvant subcutaneous injection to immunization,0.10 mg Tg for each mouse at 8 weeks old,strengthened immunity at 11 and 15 weeks old (0.05 mg Tg for each mouse,and emulsified by Freund's incomplete adjuvant); iodine excess (HI) group:intoke 0.05％ NaI water; iodine excess combined with Tg (HI + Tg) group:intoke 0.05％ NaI water,Tg immunization method was same to Tg group; all mice were raised in specific pathogen free (SPF) environment.All mice were executed at 16 weeks old,and removed the thyroid tissue.Morphologic change in thyroid was observed by HE staining.Immunofluorescence (IF) staining was used to observe CD3,CD22,CCL21 and CCR7 expression in thyroid.Real-time PCR was used to detect CCL21 mRNA expression in thyroid.Results The morphologic change of thyroid was observed under the light microscope,in HI group,thyroid follicle distended,colloid accumulation,lymphocytes accumulate together and disorganization was seen; Tg group thyroid had scatted lymphocytes; HI + Tg group enhanced inflammation response and disorganization.IF staining showed that lymphocytes infiltrated in thyroid were almost CD3+ T cells,only few scatted CD22+ B cells; CCL21 and CCR7 were negative in control group,CCR7 positive cells were scatted in Tg group but no CCL21 expression,in HI and HI + Tg groups,we could see CCL21 strong positive expression in inflammation area and also had CCR7 positive cells there.CCL21 mRNA relative expression in thyroid:Tg group (3.20 ± 0.18),HI group (1.72 ± 0.31),and HI ± Tg group (9.94 ± 0.32) increased compared to control group (1.00 ± 0.17,all P ＜ 0.01).Conclusion CCL21 and its receptor CCR7 have improved lymphocytic infiltration in autoimmune thyroiditis

AIM:To investigate the effects of poly (I:C) as virus mimics on iodine excess-induced chronic lymphocytic thyroiditis in NOD mouse. METHODS:Female,32 NOD mice were randomly divided into 4 groups:(1) control; (2) high iodine; (3) poly (I:C); (4) high iodine+poly (I:C). Nine weeks after administration,mice were sacrificed. The following parameters were determined:body weight,thyroid weight and anatomic form. Thyroid hormone (T4) in serum was measured by radioimmunoassay,the thyroid morphology was observed through HE staining,apoptosis was detected by TUNEL,the mRNA expression levels of TRAIL,TRAIL-sR1,ICAM-1 and CXCL10 were determined by the method of real time RT-PCR. RESULTS:Compared to control group and poly (I:C) group,the thyroid absolute weight and relative weight in high iodine group were increased (P0.05). CONCLUSION:Poly (I:C) aggravates chronic lymphocytic thyroiditis induced by excess of iodine associated with increase in infiltration of lymphocytes and induction of apoptosis.

Objective To investigate the effects of schistosomiasis on malignant bio-behaviors including histological types,differentiation grade,inasie depth,lymphnode metastasis and prognosis of colorectal carcinoma among elderly people in the district of petrochemical industry,Shanghai.Methods A total of 184 cases (aged 60 years and over) with specimens of colorectal cancer were collected from January 2004 to December 2010.These specimens were divided into colorectal carcinoma with schistosomiasis (CRCS) group (102 cases) and simple colorectal carcinoma (CRC) as control group (82 cases).The prognostic data of 40 elderly cases with colorectal carcinoma from January 2004 to December 2006 were simultaneously selected and analysed Results Totally 55.4％ (102/184) cases exhibited coexistent schistosomiasis with colorectal carcinoma.lesion site(x2=16.53),growth pattern(x2 =10.81 ),differentiation degree(x2 =10.46),infiltration degree(x2 =6.71),lymph node metastasis(x2 =3.90),and TNM staging(x2=5.73) in CRCS group were closely related to schistosomiasis compared with CRC group (P＜0.05).Survival curve analysis showed that there was no significant effect of schistosomiasis on the survival time of elderly patients with colorectal carcinoma (x2 =0.14,P＞0.05).Conclusions The coexistent schistosomiasis may be associated with the malignant bio-behaviors of colorectal carcinoma among the elderly,but have no significant influence on the survival time after operation.

Objective To understand the distribution and antimicrobial resistance of pathogenic bacteria isolated from patients in the department of infectious diseases in Xiangya Hospital.Methods The distribution and antimicrobial susceptibility testing results of pathogenic bacteria isolated from patients in this department in 2011 -2015 were analyzed retrospectively.Results A total of 560 strains were isolated during 5 years,of which gram-posi-tive bacteria and gram-negative bacteria accounted for 44.1 % (n =247)and 55.9%(n =313)respectively.69.8%(81/116)of coagulase-negative staphylococcus and 24.3%(9/37)of Staphylococcus aureus were methicillin-resistant (MRCNS,MRSA)respectively.Enterococcus was highly susceptible to vancomycin,linezolid,and phosphonomy-cin (>81 %).Enterobacteriaceae remained highly susceptible to carbapenems (88.9%-100.0%),and was suscep-tible to amikacin,cefoperazone/sulbactam,and piperacillin/tazobactam (>84%).Acinetobacter baumannii was the major isolated multidrug-resistant organism (MDRO),isolation rate of imipenem-resistant Acinetobacter baumannii increased from 50.0% in 2011 to 77.8% in 2015,its resistance rate to imipenem was 64.9%.Conclusion The majority of clinically isolated pathogenic bacteria from this department is gram-negative bacilli,and detection rate of MDROs showed an upward trend;antimicrobial agents should be chosen according to distribution and antimicrobial resistance of pathogenic bacteria.

ObjectiveTo compare the clinical effects of extracorporeal shock wave lithotripsy (ESWL) and ureteroscope holmium laser lithotripey(URL) in emergency patients with ureteral calculi.MethodsTwo hundred and forty emergency patients with ureteral calculi were retrospectively analyzed,including 110 patients undergoing ESWL (ESWL group) and 130 patients undergoing URL (URL group).Results The success rate of fragmentation and calculi-free rate were 90.0％ (117/130) and 80.8％(105/130) in URL group,of which were 88.2％(97/110) and 75.5％(83/110) in ESWL group with no significant difference between two groups (P ＞ 0.05 ).The success rate of fragmentation and calculi-free rate of upper ureter in ESWL group were much better than those in URL group[93.1％(54/58) vs.84.3％(59/70),77.6％ (45/58) vs.70.0％ (49/70),P ＜ 0.05 ],those of middle-lower ureter in URL group were much better than those in ESWL group[96.7％(58/60) vs.82.7％(43/52),93.3％(56/60) vs.73.1％(38/52),P＜0.05].ConclusionESWL and URL both have good curative effects in emergency patients with ureteral calculi,and ESWL has better effects for upper ureter while URL for middle-lower ureter.