OBJECTIVE:To discuss the drug resistance situation and influential factors of sputum culture positive tuberculosis patients in a specialized subject hospital. METHODS:The information of sputum culture positive tuberculosis inpatients were col-lected from Heze infectious disease hospital during Jan. 1st 2014 to Apr. 30th 2015;the results of drug sensitive test were analyzed retrospectively by using absolute concentration method. RESULTS:Among 259 patients,137 cases were drug-resistant(52.90%), among including 69(26.64%) mono-drug resistant cases,52(20.08%) poly-drug resistant cases,15(5.79%)multi-drug resistant cases and 1(0.39%)extensively drug resistant case;streptomycin (31.66%) and amikacin (15.44%) were drugs with the highest drug-resistant rate;there was no statistical significance in resistant rate between different genders and ages(P>0.05),the rate of drug resistance in first-treatment patients was 47.21%,and that of the re-treatment patients was 70.97%,the difference was statisti-cal significant(P<0.05). In addition to ethambutol and kanamycin,other all had mono-drug resistance,there were 27 combinations of poly-drug resistance and 9 combinations of multi-drug resistance. Logistic regression analysis showed that treatment history was a risk factor for drug-resistance,the risk of re-treatment patient was 2.734 times of first-treatment patients. CONCLUSIONS:Sputum culture positive tuberculosis inpatients patients have high drug resistance and complex spectrum in the hospital;we should pay great attention to the risk of drug resistance in senile patients and re-treatment patients,and rational use of streptomycin,amikacin,isoni-azid and capreomycin.

Objective To assess the efficacy and safety of 800 nm diode laser for removing unwanted hair of Ⅲ-Ⅴ skin type.Methods A total of 114 patients were treated with 800 nm diode laser on 234 sites.Four sessions were performed at an interval of 6-8 weeks.Percentage of hair reduction was evaluated 3 months after each session by comparing the terminal hair count to the baseline values.Follow-up was performed 6-8 months after the last session.In addition,subjective satisfaction of physicians and patients was evaluated according to a four-grade scale and the satisfaction rates were calculated.Results After fouth session,97.01％ of patients had more than 40 ％ hair reduction,and 83.33 ％ patients had more than 60 ％ hair reduction.Hyperpigmentation was observed on 15 (6.41％) sites,and disappeared after 6-8 months follow-up.The satisfactory rates of the physicians and the patients were 98.25 ％ and 96.12 ％,respectively,with no statistical difference (x2 =3.33,P＞0.05).Conclusions 800 nm diode laser for removing unwanted hair of Ⅲ-Ⅴ skin type is a safe and effective treatment option for hair removal,with relatively less side effect.

Objective To analyze the clinical,radiological and pathological features of primary leiomyosarcoma of bone and to im-prove the diagnostic level.Methods Totally 6 cases of PLB proved by pathology were collected in our study.The clinical,radiologi-cal and pathological findings were retrospectively analyzed,and combined with the relevant literature to have a comprehensive analy-sis.Results The lesions of 6 patients were solitary,located in femoral (1 case),distal femur (1 case),proximal tibia (2 cases),is-chium (1 case)and humerus (1 case).There was no periosteal reaction in all 6 cases but they all had soft tissue mass,sometimes there may have some mineralization within the tumor.Ill-defined osteolytic bone destruction was detected in 5 patients,while expan-sion of cystic bone destruction was found in the other 1 patients.3 cases had hardened edge,2 cases with adjacent bone cortical thickening.The MR imaging in 5 patients showed iso-intensity signal on T1 WI,a slightly inhomogeneously higher signal on T2 WI and a significant heterogeneously enhancement after injected of Gd-DTPA.Another 1 patient showed a double ring sign,the central area onT1 WI and T2 WI expressed heterogeneous slightly higher signal,the peripheral annular zone was iso-intensity on T1 WI and slightly higher on T2 WI,after injected contrast medium,it was inhomogeneous enhancement.In immunohistochemically,all tumors reacted positively with SMA,3 patients with Desmin and Vimentin positive,2 patients with Ki-67 positive,and there had some scat-tered cells with CD68 positive,but the S-100 were all negative.Conclusion The clinical,radiological and conventional histological manifestations of PLB are not specific.Immunohistochemical and/or ultrastructural analysis who displayed smooth muscle differenti-ation can confirm the diagnosis.

Objective To study the relationship of three-dimensional power Doppler ultrasonographic parameters and endocrine profile in different symptoms of patients with polycystic ovary syndrome(PCOS).Methods One hundred and forty nine women with PCOS were divided into two groups,which included obese PCOS(OB-PCOS) group and non-obese PCOS (NOB-PCOS) group.The ultrasonic parameters such as follicle number,ovarian average diameter,ovarian volume,stromal volume,follicle volume,vascularization index(Ⅵ),flow index(FI),vascularization flow index(VFI) were measured and compared.Serum levels of luteinizing hormone (LH),follicle stimulating hormone (FSH),progesterone (P),estradiol (E2),testosterone(T),prolactin (PRL),sex hormone binding globulin (SHBG),free androgen index (FAI),fasting plasma glucose (FPG),fasting insulin (FINS),homeostasis model assessment-IR(HOMA-IR) were also measured and compared.The correlation of the ultrasonic parameters and hormonal factors were analyzed.Results The follicle number,ovarian average diameter,ovarian volume,stromal volume,follicle volume,FI and VFI,FINS,HOMA-IR,FAI of OB-PCOS were significantly higher than those of NOB-PCOS (P ＜0.01 or 0.05),the FSH,SHBG were significantly lower than those of NOB-PCOS (P ＜0.05 or 0.01).In OB-PCOS group,the follicle number was significantly associated with FSH(r =0.771,P ＜0.01).The ovarian volume,stromal volume,FI and VFI were significantly associated with HOMA-IR(r =0.412,0.842,0.389,0.415,P ＜0.05 or 0.01),FI was significantly associated with FAI (r =0.812,P ＜0.01).In NOB-PCOS group,the follicle number,ovarian volume were significantly associated with FAI(r =0.472,0.552,P ＜0.05)..Conclusions There are some different characters in ultrasonography and endocrine parameters between obese and non-obese PCOS patients.

Objective To evaluate the accuracy of preoperative MRI in the diagnosis of malformations associated with MRKH syndrome and identification of uterine endometrium to optimize the clinical management.Methods 1 8 females with primary amenor-rhea were studied with MRI performed with a 1.5T or 3.0T imager.All patients were examined in the supine position using a phased-array coil and underwent pelvic MRI.Two experienced radiologists evaluated all the examinations in consensus to assess the pres-ence,position and morphology of vagina,uterus,ovaries and any pelvic abnormalities.Results One or two rudimentary uteri were identified in 17 patients (94.4%).A total of 16 patients (88.9%)had bilateral rudimentary uteri,1 (5.6%)had unilateral rudimentary uteri(it was left sided).1 (5.6%)had no uterine remnants.4 (12.1%)of 33 uterine buds in 4 patients showed differentiation of the center of the uterus into three layer.Bilateral ovaries were present in 1 7 patients,and their shapes,sizes and signals are normal.The vagina and cervix were absent in all cases.Conclusion MRI is a useful diagnostic tool in the preoperative evaluation of MRKH syndrome and the endometrium to further optimize the treatment plan.

Objective To assess the clinical significance of fetal pyelectasis and its changing in utero. Methods One hundred and ninty-seven isolated pyelectasis cases were retrospective reviewed from Jan 2012 to Jul 2014.Isolated pyelectasis was defined as a renal pelvis anteroposterior diameter (RPAPD)of ≥5 mm without other fetal anomaly in second trimester.Persistent or progressive pyelectasis was defined as a RPAPD of ≥10 mm before delivery.They were divided into two groups according to the size of renal pelvis in second trimester:group A (RPAPD 5 - 10 mm)and group B (RPAPD ≥ 10 mm).As the same,there were two groups after 32 weeks of gestation:group C (RPAPD < 10 mm)and group D (RPAPD ≥ 10 mm).Results Totally 1 54 cases were followed up.There were 1 88 cases (95.4%)in group A,with 41 cases lost,141 cases (95.9%)RPAPD <10 mm,6 cases (4.1 %)RPAPD ≥10 mm before delivery.There were 9 cases (4.6%)in group B,with 2 cases lost,remained 7 cases RPAPD ≥ 10 mm before delivery. Conclusions Although most of the fetuses with RPAPD 5 - 10 mm in second trimester will remain the same or resolved before delivery,those with RPAPD ≥ 10 mm may persistent or progress.Prenatal assessment of fetal renal pelvis may provide properly consultation.

Objective To explore the value of DWI and 1 H-MRS in evaluation of malignant degree of primary osteosarcoma.Methods A retrospective analysis was performed in 41 patients with osteosarcoma confirmed pathologically and examined with DWI and 1 H-MRS.The b values were 0,400,800,1 000 and 1 500 s/ mm2 in DWI,respectively.ADC map was obtained,and ROIs were selected to measure ADC values.Eighteen cases which had stable spectral lines in MRS were selected and analyzed.The spectral lines,Choline (Cho),Creatine (Cr) and Cho/Cr ratio were obtained.Analysis of ADC values of high and low grade osteosarcoma were performed with Kruskal-Wallis H test,and Cho/Cr values were analyzed with Mann-Whitney U test.Results When b values were 400,800,1 000 s/mm2,ADC values of high and low grade osteosarcoma were significantly different (x2=6.26,4.37,4.87,P=0.01,0.04,0.03).When b value was 1 500 s/mm2,ADC value of high and low grade osteosarcoma had no statistical difference (x2 =2.39,P=0.12).Moreover,when 400 s/mm2 was taken as the optimal b value,the specificity and sensitivity of ADC value for identifying high grade osteosarcoma was 73.30 ％ and 72.70 ％,respectively.Cho/Cr values between high and low grade osteosarcoma were significantly different (Z=-2.45,P＜0.05).As a diagnostic parameter,the best threshold value of Cho/Cr was 2.21.And the specificity and sensitivity for diagnosing high grade osteosarcoma was 75.00 ％ and 92.90 ％,respectively.Conclusion ADC (b=400 s/mm2) and Cho/Cr values may be helpful to identifying malignant degree in osteosarcoma.

Objective To assess MR characteristics of supratentorial intraparenchymal ependymomas(SIEs)in different age groups.Methods 40 patients with SIEs confirmed by surgery and pathology were analyzed retrospectively.All patients were examined by head MRI without or with contrast.Patients were divided into two groups according to age:child and adult group.T test was used to analyze the difference of tumor volume of two groups.Mann-Whitney U test was used to compare cystic,edema and pathological types of two groups.χ2test was used to distinguish sexual distinction.Results 39 cases of SIEs were located in cerebral surface,1 case located in inside cerebral essence.SIEs of child group(n=13)were male dominance(n=11),5 cases were located in the frontal lobe,all lesions were cystic solid masses.In the adult group(n=27),13 cases were male,9 cases were located in the frontal lobe,solid tumors were seen in 3 cases.There were significant difference among two groups in sexual distinction(χ2=3.921,P=0.048)and cystic change(U=98.50,P=0.02).There were no significant difference in the volume of tumor(t=1.828,P=0.087),edema(U=219.00,P=0.49)and pathological types(U=258.00,P=0.10).Conclusion There are MR characteristics differences in the SIEs in different age groups.Child has a superiority of male,tumors are mainly as cystic-solid mass,edema of the tumor is mild and has a high incidence cystic necrosis,the border is clear.In adult group,tumors are mainly as cystic-solid mass,and can also be solid mass, the solid portion of the lesion is easy to bleed,edema of the tumor is serious.

Objective:Improve the quality of clinical research at different stages for better protection of human subject.Methods:Introduce the operational and the administrative experiences of establishing the human research protection program in our hospital.Results:Establish human research protection program can promote the direct communication and cooperation among relevant departments of clinical research, strengthen the whole process management of clinical research.Conclusions:Developing comprehensive human research protection program and related policies play a positive role in promoting the high-quality development of clinical research in hospitals.

Objective The aim of the study was to evaluate the hearing performance of a new transcutaneous bone conduction hearing aid.Methods One hundred and nine patients with conductive or mix hearing loss and eleven patients with single sided sensorineural hearing loss from four tertiary referral centers were tested under unaided and aided conditions with the sound processors on testbands.Free field test was performed to obtain the hearing thresholds and speech recognition thresholds in quiet.Adverse events were also documented by a self-reported questionnaire.Results ①Conductive or mixed hearing loss patients:for aged≥6 yrs subgroup,the bone conduction PTA average of aided sides was 18.55±8.99 dB HL.For aged<6 yrs subgroup, the bone conduction ABR hearing threshold average was 18.33±8.36 dB HL.②Statistically significant improvements in free field hearing thresholds were seen when compared aided hearing with unaided outcomes.The average PTA (pure tone average in free field) was measured at 32.21±10.00, 37.33±14.15, and 34.38±10.76 dB HL respectively in conductive or mixed hearing loss aged≥6 yrs subgroup;aged<6 yrs subgroup and SSD subgroup.③In aided situations;speech recognition thresholds in quiet were significantly better compared to unaided situation in patients aged≥6yrs.④None of patients presented adverse events related to the devices.Conclusion The Sophono bone conduction hearing aid has satisfactory hearing performance and can be considered an alternative device for patients with conductive or mix hearing loss or with SSD.