Objective To evaluate the clinical value of vertebral body venography in performance of percutaneous vertebroplasty(PVP). Methods 92 patients with 124 vertebraes underwent PVP. Before injecting the bone cement, venography was performed with injection of nonionic contrast material into vertebral body. 124 vertebraes were classified into four groups according to the results of vebgrophy. Group A: no draining veins displayed; group B: draining veins appeared late; group C: draining veins appeared ahead of time; group D: draining veins appeared ahead of time, then intervention such as adjusting the puncture needle's position or gelatin sponge embolization of vein was performed to delay the appearance of veins. Results 94 of 124 vertebraes displayed draining veins. According to the results of vebgrophy, there're 30 vertebraes in group A, 25 in group B, 30 in group C, 39 in group D. Thirty-seven vertebraes demonstrated cement extravasation, cement entering vein was observed in sixteen vertebraes and two patients among them had pulmonary embolism. Venograms showed all correlative venous extravasation. Bone cement extravasation rate of each groups was 20.0%, 24.0%, 56.7% and 20.5% respectively. Moreover, extravasation rate of group C was higher than any other group. Pain reduction was observed in 88 of 92 patients after 30 days of the operation, the rate of pain relief was 95.7%. Conclusion Vertebral body venography could describe the velocity of venous blood flow within vertebral body and predict the direction of bone cement leaking to veins effectively, which could provid valuable information in takeing some measures to prevent bone cement leaking into veins. Vertebral body venography has very impotant clinical value in improving the safety and preventing complication of PVP.

Adult ; Aneurysm, Dissecting ; complications ; Aortic Aneurysm ; complications ; Humans ; Lower Extremity ; physiopathology ; Male

Objective:To express Helicobacter pylori oipA gene with different fragments and determine the protein and its peptides with finest antigenicity.Methods:oipA gene was obtained from international standard Hp NCTC 11637 and cloned into vector pGEM-T then was identified by PCR and sequencing.Six different fragments of oipA gene were amplified by PCR with the template pGEM-T/oipA.The gene fragments and expressing vector pET-42a were ligated.The recombinant vector were transformed into BL-21.The correct recombinants were identified by PCR,enzyme digestion and sequencing.Recombination protein and the peptides were detected by Western Breeze chemiluminescent after induced by IPTG.Optimization of the time and IPTG concentration for induction were conducted.The expressed products were affinity purified by Ni-NTA of His?Bind.The antigenicity of the recombination protein was determined with Western blot indicated by goat anti-Hp polyclonal antibody,and the recombination protein with finest antigenicity was selected with indirect ELISA.Results:The six oipA gene fragments could all expressed and the products were recognized by goat-anti Hp polyclonal antibody.The finest peptide with antigenicity was the smallest peptide.Conclusion:OipA gene fragments could be expressed in prokaryotic system and the smallest peptide had the finest antigenicity.It may be used as the reagent to detect corresponding antibody in serum.

Objective: To investigate chronic kidney disease (CKD) and its risk factors in people receiving physical examination. Methods: hTis retrospective study included people over 20 years old who had physical examination in the Health Management Center of Third Xiangya Hospital from Janurary 2008 to June 2011. CKD and its risk factors as well as questionnaire were recorded. hTe risk factors were analyzed by multivariate logistic analysis. CKD was deifned by kidney damage (microalbuminuria≥30 mg/L) and/or hematuria and/or reduced kidney function [evaluate glomerular ifltration rate (eGFR)<60mL/(min.1.73 m2)]. We counted eGFR according to the modiifcation of diet in renal disease (MDRD). Results: A total of 5 708 physical examination reports were included. The detection rate of albuminuria, reduced renal function and hematuria was 25.0%, 1.7% and 1.1%. hTe detection rate of CKD was 25.6%, and detection rate of CKD stage 1-5 was 17.8%, 6.7%, 1.1%, 0 and 0, respectively. Multivariate logistic analysis indicated that diabetes mellitus, hypertension, hypercholesterolemia, male, age, and smoking were the risk factors for CKD. Increasing physical activity was the protective factor against CKD. Conclusion: High prevalence of CKD in people receiving physical examination is found in Changsha, especially stage 1 and 2 CKD. Physical examination is important to screen CKD. Stopping smoking, control of blood glucose, blood pressure, blood lipids and increasing physical activity may help reduce the prevalence of CKD.

Objective To investigate the status of knowledge and performance on Chinese Heart Failure Diagnosis and Treatment Guideline (2014 version) in general practitioners of Shanghai Pudong communities.Methods The survey was conducted from April to June in 2014 with a self-designed questionnaire.Total 390 general practitioners (GPs) in Pudong New Area were selected by cluster sampling method.The contents of questionnaire included:diagnosis and differential diagnosis,drug therapy,non drug therapy of chronic heart failure.Result Total 385 questionnaires were retrieved with a response rate of 98.7％ (385/390).The results showed that in aspect of diagnosis and differential diagnosis,373 (96.9％) Gps made the diagnosis based on history and physical examination,171 (44.4％)Gps never used BNP or NTPro-BNP tests,280 (72.7％)GPs did not know how to identify systolic or diastolic heart failure,86 (22.3％)Gps made the differential diagnosis according to the EF value.In aspects of drug therapy,the rate of beta blockers use was 10％-30％ in 284 (73.8％) Gps,149 (38.7％) Gps did not use beta blockers because of not knowing the contraindications,289 (75.1％) Gps used a maximum dose of betaloc for 25-50 mg,no one used 101-200 mg,242 (62.9％)Gps did not know the target dose of betaloc,the rate of ACEI/ARB use was 10％-30％ in 330 (85.7％) Gps,258 (67.0％) Gps would increase the dose but not knowing the target dose.The main reason for not using the target dose of Betaloc and ACEI/ARB was not knowing the dose.In aspect of non-drug therapy:240 (62.3％)Gps never heard of cardiac resynchronization therapy (CRT) and 271 (70.4％)Gps never heard of implantable cardioverter defibrillator (ICD).The senior rank GPs grasped the guideline much better than Gps with primary and intermediate professional ranks.Conclusion General practitioners in community health centers should further study the guideline of heart failure,particularly need to strengthen the knowledge and ability of drug therapy.

Objective To understand the status of oipA gene of Helicobacter pylori (H.pylori) and to evaluate the relationship between oipA gene and digestive disease, Methods Biopsy gastric mucosa were obtained from 360 patients with digestive disease under gastroscopy. H.pylori was isolated from urease positive and some negative samples, and then identified by microscope, urease test and 16 S rRNA PCR. oipA and cagA genes of the isolates were amplified by PCR and the status of oipA signal region was analyzed after sequencing. The relationship between functional oipA gene of H. pylori and digestive disease was investigated. Results One hundred and six isolats were obtained. Seventy-two strains were positive for cagA gene and 87 were positive for oipA gene in signal region. Eighty strains were on open status in signal region called functioal oipA gene and 1 was on off status. The status of other 6 strains were uncertain. The frequency of functional oipA in ulcer and atrophic gastritis were higher than that of cagA(100% and 78.26% vs 58.33% and 39.13%).Conclusion Functional oipA gene is closely related with ulcer and atrophic gastritis.

Objective To explore the risk factors for methicillin-resistant Staphylococcus aureus (MRSA)infection of refractory wound,and provide reference for clinical prevention and control.Methods Clinical data of patients who were isolated Staphylococcus aureus (SA)from wound at the burn ward in a hospital from January 2006 to December 2013 were analyzed,patients were divided into four groups according to whether the isolated SA were MRSA and whether SA were from refractory wound or from non-refractory wound.Risk factors for MRSA infection of refractory wound were analyzed. Results A total of 112 isolates of SA were isolated from wound,statistical differences existed in the length of hospital stay,recent invasive operation,and recent antimicrobial use between patients in refractory wound MRSA group and refrac-tory wound methicillin-sensitive SA (MSSA)group (all P <0.05);non-conditional logistic regression analysis revealed that length of hospital stay>30 days (OR 95% CI :1.14-30.69)and recent invasive operation (OR 95% CI :1.41 -17.84) were independent risk factors for refractory wound MRSA infection.There were statistically differences in previous MRSA infection,burn depth,recent operation and recent antimicrobial use between refractory wound MRSA group and non-refrac-tory wound MRSA group(all P <0.05);non-conditional logistic regression analysis revealed that recent antimicrobial use (OR 95% CI :2.080-26.800)was independent risk factor for the persistence of MRSA infection of refractory wound. Conclusion Shortening the length of hospital stay,reducing invasive operation,and using antimicrobial agents ra-tionally are helpful for the prevention and control of MRSA infection of refractory wound.

Background:Single-balloon enteroscopy(SBE)is a new method for the examination of small intestine,its clinical value in suspected small intestinal diseases need to be further studied. Aims:To evaluate the diagnostic and therapeutic value of SBE in suspected small intestinal diseases. Methods:A total of 73 suspected small intestinal diseases patients who had undergone 81 SBE examinations from July 2011 to October 2013 at Chengdu Military General Hospital were retrospectively examined,indications,diagnostic and therapeutic value of SBE in suspected small intestinal diseases were analyzed. Results:Of all the 81 examinations,33(40. 7% )were obscure gastrointestinal bleeding,29(35. 8% ) incomplete intestinal obstruction,and 19(23. 5% )chronic abdominal pain or diarrhea. The intubation depth was 230 cm for the oral approach,and 100 cm for the anal approach. The diagnostic yield of SBE was 67. 9% ,the main lesions were small intestinal ulcer,small intestinal inflammation,small intestinal tumor,small intestinal polyp. A total of 8 patients underwent endoscopic therapy,of whom 5 underwent endoscopic hemostatic therapy and 3 underwent resection of polyp. No serious complications were found. Conclusions:SBE is a safe and reliable diagnostic and therapeutic method for suspected small intestinal diseases,and its main indications are obscure gastrointestinal bleeding and incomplete intestinal obstruction.

Objective To investigate the expression of macrophage migration inhibition factor (MIF) in pulmonary tissues of the smokers with and without chronic obstructive pulmonary disease (COPD).Methods The subjects were assigned into three groups:non-smokers without COPD (control group,n =12),smokers without COPD (smoker group,n =13) and smokers with COPD (COPD group,n =16).The specimens were obtained from lung tissues as far away from cancer focus as possible (＞ 5cm).Real-time quantitative PCR and immunohistochemistry were used to investigate the expression and distribution of MIF in pulmonary tissues.The relationship between the severity of airflow obstruction and the differential expressions of MIF in lung tissues of the smokers with or without COPD was analyzed.Results (1) MIF mRNA expression in COPD group (4.87 ± 1.79) was higher than that in the smoker group (2.16 ±0.72;P＜0.01),which was higher than that in the control group (1.09 ±0.48;P ＜0.01).(2)Immunohistochemistry analysis showed that MIF protein expression in lung tissues of the COPD group (0.277±0.025) was higher than that in the smokers group (0.199 ±0.034;P ＜0.01),which was significantly higher than that in control group (0.130 ±0.021 ;P ＜0.01).(3) Correlation analysis of MIF mRNA expression in the lung tissues and pulmonary function parameters of forced expired volume in one second (FEV1) percentage of predicted (FEV1 pred) and ratio of FEV1 to forced vital capacity (FEV1/FVC) suggested that MIF mRNA expression in the lung tissues was negatively related with FEV1 pred (r=-0.578,P ＜ 0.01) and FEV1/FVC (r =-0.607,P ＜ 0.01).Conclusions MIF expression significantly increases in the smokers with COPD,and MIF level in the lung is positively correlated with airflow limitation.The results suggest that MIF may play an important role in the pathogenesis of smokinginduced COPD.

Objective To detect nucleos(t)ide-resistance mutations in hepatitis B virus (HBV) covalently closed circular DNA (cccDNA) isolated from hepatocytes of patients with chronic HBV infection and to analyze the correlation between the mutations found in cccDNA and relaxed circular DNA (rcDNA). MethodsForty patients with chronic HBV infection were investigated. Preoperation serum samples and non-tumor liver tissues were collected.Intrahepatic HBV cccDNA and rcDNA were selectively extracted by co-precipitation of sodium dodecyl sulphate-protein and QIAamp DNA Mini Kit, and further purification with plasmid-safe ATP-dependent DNase (PSAD).Thereafter,cccDNA were amplified by selective polymerase chain reaction (PCR) or nested PCR using the primers spanning both the two gaps in HBV genome and covering the common mutations associated with nucleoside analogues resistance (rt169- rt250).Intrahepatic HBV rcDNA and pre-operation serum HBV rcDNA were also extracted and then amplified by PCR.The PCR products were then purified and sequenced.Results Among the 40 patients,intrahepatic HBV cccDNA were detected in 31 patients,and HBV rcDNA were detected in liver samples of 35 patients and pre-operation serum samples of 21 patients. The PCR products amplified from these samples were all successfully sequenced.rtM204Ⅰ mutation was detected in intracellular HBV cccDNA,rcDNA and serum HBV rcDNA in 2 patients.Both rtM204Ⅰ and rtQ215H were detected in intrahepatic HBV cccDNA and rcDNA in 2 patients,while no corresponding mutation was observed in serum HBV rcDNA of these two patients.Three variants including rtM204V,rtM204V and rtV173L-rtL180M-rtM204V were detected in serum HBV rcDNA in 3 patients,while corresponding mutants were not detected in intracellular HBV cccDNA or rcDNA of these patients.Condsions The results suggest that antiviral nucleos(t) ide resistance mutations can be found in HBV cccDNA in chronic hepatitis B patients. The dominant resistant mutation found in intrahepatic HBV cccDNA/rcDNA may be different from that in serum HBV rcDNA.