Objective To discuss the clinical characteristics of patients withclinical features of patients with neuromyelytis opica and spectrum of neuromyelytis opica(NMOSD) and neuromyelitis optica (NMO).Methods With a retrospective study,From February 2013 to September 2016,a total of 72 NMO patients in Navy General Hospital for diagnosis and treatment were selected as the NMO the NMO group and the other 72 patients of NMOSD patients were selected as the NMOSD group.The results of two groups of patients with general demographic data,ocular symptoms,spinal cord and brain MRI,influence NMO-IgG were recorded.Results There were no significant differences in gender and age compared between the two groups (P ＞ 0.05).The clinical characteristics,frequency and duration in the NMOSD group compared to the NMO group were significantly different (P ＜ 0.05).In the NMOSD group,there were 8 patients who were decreased vision,4 patients were visual field defect,3 patients were discoloration,5 patients were diplopia.While in the NMO group,32 patients were decreased visual acuity,14 patients were visual field defect,12 patients were color vision,21 patients were diplopia.There were statistically significant difference between the two groups (P ＜ 0.05).In the NMOSD group,there were 8 patients were MRI of the spinal cord were normal,64 patients were abnormal and 32 patients of brain lesions in the head MRI.In the NMO group,MRI of the spinal cord were all abnormal,and there were 28 patients were brain lesions in the head MRI.The serum positive rate of NMO group was 41.7％,and the serum positive rate of NMOSD group was 59.7％.The sensitivity of AQP4-Ab antibody to NMO was 44.4％,the specificity was 75％,the sensitivity of AQP4-Ab was 61.1％,and the specificity of NMOSD was 75％.Conclusion The NMOSD is more with female patients,the first symptom is more with the spinal cord that the gray matter involvement in the spinal cord,and the performance of complex,NMO-IgG antibody can be used as a support for NMOSD diagnosis.

Objective To explore the treatment effect and application value of proximal humeral locking plate combined with injectable bone graft in the treatment of proximal humeral fractures.Methods 86 patients with proximal humeral fractures were selected,using the random number table method they were randomly divided into the observation group and control group,each group had 43 cases.The control group was treated with locking plate method,and the observation group was treated by the combination of artificial bone and locking plate.The therapeutic effect of the two groups was observed.Results The excellent and good rate of the observation group was 93.03％,that of the control group was 74.42％,the difference was statistically significant between the two groups(x2 =5.460 3,P ＜0.05).In observation group,the fracture healing time was (11.78 ± 3.64) weeks,the shoulder joint function score was (96.87 ± 4.23) ; those of the control group were (19.65 ± 6.27) weeks,(78.73 ± 8.28),the differences were statistically significant between the two groups (t =7.118 2,12.793 4,all P ＜ 0.05).The incidence rate of complications of the observation group was 6.98％,which was significantly lower than 30.23％ of the control group (x2 =7.678 6,P ＜ 0.05).Conclusion Proximal humeral locking plate combined with injectable bone graft in the treatment of proximal humeral fracture has reliable curative effect,short fracture healing time and mild surgical complications,which is worth popularizing in clinical.

Objectives To evaluate plain radiographs and computed tomography (CT) scans in respect of assessment of articular fragment displacements (step and gap) in displaced acetabular fractures. Methods A retrospective evaluation was done to analyze the CT scans and plain radiographs of 64 patients who had been treated for displaced acetabular fractures in our hospital from January 1998 to May 2003. Of them, 20 met the inclusion criteria. In a blind method, 3 independent reviewers measured step and gap deformities on plain radiographs and CT scans utilizing a standardized measurement technique. The sensitivity and specificity of plain radiographs in detecting step and gap displacements (2 mm and 4 mm) in comparison of those of CT scans were determined. Moreover, intraclass correlation coefficient and intraobserver reliability were also calculated. Results Compared with CT, plain radiographs showed poor sensitivity in detecting step deformity (sensitivity = 44.3%). As far as fracture type was concerned, plain radiographs were particularly poor at detecting step deformity in fractures involving a single column of the acetabulum (sensitivity = 0%). Excellent intraobserver and intraclass reliability existed among the 3 reviewers. Conclusions Compared with CT scans, plain radiographs are poorly sensitive in detection of step and gap deformities in patients with acetabular fractures, and particularly poor at detecting step deformities. Therefore, in treatment of displaced acetabular fractures, CT scans are essential and should not only be used together with plain radiographs in the preoperative evaluation but also be considered in the postoperative assessment of fracture reduction and predicting future outcomes.

Objective To analyse CT diagnosis of unusual closed retroperitoneal trauma so that to improve its diagnostic accuracy.Methods CT features of unusual closed retroperitoneal trauma confirmed by clinical data and surgery in 13 cases were analyzed.Results There were adrenal hematomas in 11 cases,among them,2 cases accompanied with renal arterial occlusion,appeared as renal arterial ruptured suddenly and "interface sign".The hematomas appeared as round,similar round or mass hyperdense shadows and in combination with periadrenal tissue injury;pancreatic rupture in 2 cases,appeared as linear area of low attenuation inside pancreas.Conclusion CT scan is an effective modality for diagnosing the unusual closed retroperitoneal trauma.Correct CT diagnosis is very important for the effective surgical treatment as well as reduction of severe complications and mortality of unusual closed retroperitoneal trauma.

With the method of bibliometric analysis, we analyzed the scientific papers on health pol-icy research embodied by CBMdisc from 1978 to 2007. It was found that the status quo of studies on health policy research in China developed rapidly. And the core journals has preliminarily formed , there were a number of highly productivity authors, besides the Ministry of Health and universities were the main units of output of health policy research papers although core authors not yet appeared.

OBJECTIVE:To study on the effect of iodine (I2) on the acid content titration in the preparations,and establish a method of eliminating I2 for accurate determination of total acid content. METHODS:Taking an example of Onychomycosis paint,I2 was reduced by sodium sulfide(Na2S)before titration analysis and compared with the standard method of traditional titration. Ac-cording to the two methods of consumption of different sodium hydrate(NaOH)volume,the effect of I2 on the determination of to-tal acid content in preparation was explored. RESULTS:Reduction method of Na2S can eliminate the effect of I2,the color of indica-tor changed acutely. The determined total acid and theoretical values were the same;the linear range of the concentration of total ac-id in onychomycosis paint was 3.926-7.290 mol/ml(r=0.9999);RSDs of precision,stability and reproducibility tests were no more than 0.04%;average recovery was 99.91%-100.10%(RSD=0.036%,n=6). CONCLUSIONS:I2 has effect on the determina-tion of total acid content,the disproportion reaction of I2 can generate hydriodic acid that can interfere acid-base titration's results, and the generated hydriodic acid can oxidize indicator to make the end point is not sensitive or even invariant color. Using Na2S can eliminate the effect of iodine on the preparation of acid titration,which has improved precision and reproducibility with accurate and reliable determination results.

Dengue is the most wide-spread arthropod-borne viral disease of humans in the tropic and sub-tropic regions.In this study,genomic sequences of more than 3 000 dengue viruses available in the GenBank were aligned and analyzed by sero type.According to phylogenetic trees generated by the minimum evolution method of MEGA5.0,dengue viruses were divided into 4-6 genotypes within the four serotypes,respectively.Meanwhile,it was indicated that the distribution of most genotypes was associated with geographic origins of dengue viruses.Probable origins for most of the 39 strains from China with genomic sequences were deduced from relevant ancestral strains in the context of ME trees.These results revealed that the genotype distribution of dengue viruses was geographic origin-specific at genomic level,and that diverse introduction sources were attributed to dengue outbreaks in China.

OBJECTIVE To investigate the resistant mechanisms of Candida albicans to azoles at molecular level.METHODS NCCLS M-27 protocols were used to test the in vitro susceptibilities of 102 C.albicans strains isolated from the patients with recurrent vulvovaginal candidiasis(RVVC) against fluconazole(FLC) and itraconazole(ITC) to screen the FLC-and ITC-resistant C.albicans isolates;six pairs of primers,A1-A2,B1-B2,C1-C2,D1-D2,E1-E2 and F1-F2 were respectively to amplify gene CYP51 of 4 strains with FLC-and ITC-resistance.The PCR products were sequenced and analyzed to identify the mutation sites by compared with the sequence of gene CYP51 of referenced C.albicans strain in NCBI site of Internet.RESULTS The analysis of full length sequence of CYP51 from 4 FLC-and ITC-resistant strains showed that from total 32 mutation sites there were 4 significant site mutations,where the mutation of GAT to GAC at 116 caused the substitution of D by E(E266D in two strains);GCC to GGT at 117 caused the substitution of A by G(A117G in 1 strain);GAA to GAC at 266 caused the substitution of E by D(E266D in 2 strains);and GTT to ATT at 488 caused the substitution of I by V(V488I in 1 strain).The site mutations of 266 and 488 were tested in 1 strain of 4 strains.CONCLUSIONS The CYP51 total gene of 4 strains has been checked out.Of FLC and ITC-resistant C.albicans alignment in this time,find out 4 significant bp mutations.Causing its amino acide change,among them,A117G has not be interrelated report still now.The details of mechanism need to be further studied.

OBJECTIVE:To intensify the scientific inner management of drugs in hospitals,lower the operation cost on drug management and guarantee patients' medication safety.METHODS:The problems occurred in hospital drug management were analyzed,and the method of management by objective and PDCA cyclical method in scientific management were employed to make a target plan in conformity with the three-level drug management model of our hospital and then the management proposal was carried out.RESULTS & CONCLUSIONS:The application of scientific management enhanced hospital drug management level as well as working efficiency,and the quantity of the overdue drugs was lowered by 90.5% in 2008 than in the same period of 2007.

Objective To assess the correlation of the characteristics of coronary lesion and the risk factors to the coronary heart diseases using angiography techniques. Methods Coronary heart disease (CHD) patients were divided into two groups according to the ages of patients: elderly group (67 cases, 60 88 years); non elderly group(61 cases, 25 59 yeas). Angiography was performed in all CHD patients and their risk factors were analyzed by Logistic regression. Results The coronary changes were characterized in most patients by multi vessels lesion(76 1%) in elderly group, while by single vessel lesion (54 1%) in non elderly group. Stenosis of the coronary artery in the elderly group was severer than that in the non elderly. Logistic regression showed that ageing, sex, hyperlipemia were the risk factors for CHD( P