OBJECTIVE To approach the effect of empirically applying ?-lactam antibiotics for treatment of hospital-acquired pneumonia on distribution and antibiotic-resistance of pathogenic bacteria.METHODS To investigate 141 patients with hospital-acqired pneumonia in intensive care unit during Jan 2001-Oct 2005,and divide into 3 groups:third generation cephalosporin group;lactamase inhibitor group;and other lactam antibiotics group according to different initial antibacterial strategy,then analyze difference in distribution and antibiotic-resistance of pathogens among each group.RESULTS We acquired 164 strains of pathogens.Comparing with other two groups,the proportion of Gram-positive cocci in lactamase inhibitor group was higher significantly(P

Objective:To investigate the necessity and measures about quality assurance (QA) and quality control (QC) in bedside photography based on digital radiography (DR). Methods: To do retrospective analysis on bedside photography in the same month of different years (2013.9 and 2014.9) by image storage and PACS system. Each has 200 cases. They were evaluated and analyzed of its causes in order to explore the QA improvement measures.Results:The application of DR and its quality control in bedside photography can improve image quality obviously, shorten the examination time greatly, reduce radiation dose, put an end to waste film.Conclusion: DR has obvious advantages in the bedside photography, can provide better image with more information for clinic work.

Objective To establish the animal model of periventricular leukomalacia (PVL) caused by lipopolysaccharide (LPS) and investigate the immune mechanisms in the pathogenesis of cerebral palsy due to intrauterine infection. Methods Twenty-six mature pregnant Wistar rats were divided into experiment(n= 15)and control groups(n =11). LPS(0. 3 mg/kg) and distilled water were injected on 15 days of gestation to two groups respectively intraperitoneally. One hundred and twenty-eight neonatal rats of experiment group and 105 in the control group were obtained till the gestation day of 21. The level of IL-2, TNF-? and histology changes in neonatal rats' brain were observed by HE staining and RIA, water content in brain tissues were compared. Results IL-2[(3. 56?0. 450) ng/g] and TNF-? concentrations [(8. 23?0. 47)ng/g] in neonatal rats' brain of the experiment group were significantly higher than those in the control group [(0. 78?0. 2)ng/g and (5. 23?0. 32)ng/g, P

Objective To observe the clinical efficacy of electroacupuncture plus nasal irrigation in treating upper airway cough syndrome (UACS).Method A total of 114 UACS patients were randomized into 3 groups, 38 cases in each group. Group A was treated with acupuncture plus electrical stimulation with sparse-dense wave, group B was intervened by nasal irrigation with Shuang Huang Lian, and group C was treated with the two methods together. The clinical efficacies of the three groups were compared.Result The total effective rates were respectively 84.2%, 73.7% and 94.7% in group A, group B and group C. The total effective rate of group C was significantly different from that of group A and group B (P<0.05).Conclusion Electroacupuncture plus nasal irrigation can produce a more significant therapeutic efficacy compared to electroacupuncture or nasal irrigation alone.

Objective To summary MRI findings and its diagnostic value of Balo's concentric sclerosis .Methods Brain MRI images of 4 cases with Balo's concentric sclerosis were studied with review of the literature in 13 cases.Results MRI showed multiple ring-like lesions within brains in 16 patients and single lesion only in 1.The deep white matters of cerebrum were involved in all patients.The cerebellum and brain stem were invaded in 2 and 4 respectively. Typical concentric sclerosis lesions demonstrated alternate middle and low signal rings on T1WI, middle and high on T2WI. The ring-like lesions were best seen on T1WI. The middle signal rings were enhanced on post-contrast images.The typical multiple sclerosis lesions were seen in 7 patients. Conclusion Balo's concentric sclerosis has characteristic findings on MRI.MRI is a very reliable diagnostic methed for this disease.

Objective To study the diagnostic value of MRCP in cholangiocarcinoma.Methods MRCP in 39 patients with cholangiocarcinoma comfirmed by surgery and pathology were performed on a GE 1.5T superconductive MR imaging unit before operations.Results MRCP imagings with diagnostic value were obtained in 39 cases,MRCP accurately showed the obstructive positions confirmed by surgery and pathology in all cases (100%).The qualitative rate of cholangiocarcinoma was 97%(38/39).Conclusion MRCP can not only accurately show the position of cholangiocarcinoma but also make accuracy diagnosis.

BACKGROUND: The characteristics of cervical anatomy and pedicle screw, operational specification, and individual screw implantation are the key factors of a successful implantation treatment.OBJECTIVE: This study was designed to investigate the cervical pedicle screw and host response as well as the recovery of spinal nerve functions during the surgery and follow-up period of cervical spine fracture-dislocation.DESIGN: A case analysis.SETTING: Department of Orthopaedics, General Hospital of Shenyang Military Area Command of Chinese PLA, Shenyang, Lianning Province, China.PARTICIPANTS: A total of 41 patients with cervical spine fracture-dislocation, who have complete follow-up data, were admitted to the Department of Orthopaedics, General Hospital of Shenyang Military Area Command of Chinese PLA between February 2002 and February 2006. Of the included patients, 18 were complicated by spinal cord injury (according to Frankel classification system, 6 were graded as A, 1 as B, 4 as C, and 7 as D.METHODS: Forty-one patients with cervical spine fracture-dislocation were treated by implanting a screw through the cervical pedicle and fixing it. Prior to surgery, all patients were subjected to X-ray, CT and MRI examinations. According to measurements, each cervical pedicle screw was individually implanted. The entire surgery was accomplished by Xiang Liang-bi, chief physician, whose qualification corresponds to the responsibilities.MAIN OUTCOME MEASURES: Material and host response during and after screw implantation as well as in the follow-up period. Recovery of spinal nerve function after screw implantation.RESULTS: All patients were followed up for 6-12 months and all incisions were healed primarily. Material and host response during the process of screw implantation: A total of 218 screws were implanted. After initial implantation, 12 screws were loosened, and such a phenomenon disappeared in 11 screws by adjusting inserting point and inserting direction or/and increasing screw diameter or length. The remaining 1 screw was stabilized by increasing the fixed segments. After drilling, poles of 10 screws bled much and treated by hemostasis. C1-2 venous plexus hemorrhage was caused in 3 patients and stopped by compression, and Apofix internal fixation was used in 1 of 3 patients due to unclear surgical visual field. Material and host response after surgery and during the follow-up: A total of 218 screws were inserted. Of the 218 screws, 196 were in correct position, and 22 were deviated to different degrees. Deviation of 1 screw caused injury to nerve root and that of another screw led to injury to blood vessel. Thirty-eight patients acquired satisfactory reduction and bone union. Three patients presented with symptoms of nerve root irritation due to incomplete reduction in the old fracture-dislocation. Among the 3 patients, 1 was subjected to anterior approach due to screw removed, and neither injury to vertebral artery, spinal cord, and nerve root nor internal fixation destroy was found in any other patients. Recovery of spinal nerve function after implantation: Among the 18 patients complicated with spinal cord injury, 6 patients, who were assessed as grade A spinal cord injury, did not exhibit improvement in spinal cord function, while the remaining 12 presented with 1 or 2 grades of improvement.CONCLUSION: There is a lower probability for biocompatibility reaction, and spinal nerve function recovers better after implantation of cervical pedicle screw. So implantation of a cervical pedicle screw system is an effective and relatively safe method for treatment of cervical spine fracture-dislocation.

Objective To compare the effect of glucosamine (Virtral-s) on the cartilage oligomeric matrix protein (COMP) secretion of chondrocytes and synoviocytes in vitro.Methods Chondrocytes and synoviocytes isolated from knee cartilage of osteoarthritic patients were cultured by phased enzymatic digestion.Sera containing Virtral-s of the experimental animals were obtained after orally administrated Virtral-s at the dosages that equal to human.Cells were cultured in the medium with Virtral-s containing sera.Super-natant COMP level was tested by enzyme-linked immunoabsorbent assays (ELISA).Results COMP conceu-tration of synoviocytes cultured in vitro was significantly higher than that of chondrocytes (P＜0.05).Virtral-s could significantly increase COMP secretion in cultured chondrocytes in vitro (P＜0.05),however,it had a weaker role on synoviocytes,ie,it could only mildly reduce COMP secretion of synoviocytes.Conclusion Glucosamine (Virtral-s)-containing serum can promote COMP secretion of chondrocytes in vitro,and it has no significant effect on synoviocytes in vitro.

Objective To examine the effectiveness of HGF in blocking TGF-β1 induced α-SMA and extracellular matrix production in fibroblasts of the flexor tendon sheath. Methods Seven adult male New Zealand white rabbits (3.75-4.00 kg) were used for this study. Both of their front feet were sterilised and the middle digit flexor digitorum profundus tendon equivalents were identified and isolated. These specimens were used to establish primary cell cultures. Sheath fibroblasts were obtained from rabbit flexor tendons. After the cells reached confluence, cells were detached with trypsin/ethylenediamine tetra-acetic acid. All experiments were performed using the cells at the third passage. At 70% confluence the medium was supplemented with 5 ng/ml of TGF-β1 along with increasing doses of HGF (10-40 ng/ml). After 72 hours incubation, the productions of α-SMA were assayed by Western-Blot. The productions of collagen Ⅰ and fibronectin in supernatants culture were examined using ELISA. Results Evaluation of protein expression revealed that TGF-β1 markedly induced α-SMA expression in cultured rabbit flexor tendon sheath fibroblasts. TGF-β1 treated fibroblasts expressed 1.8-fold more protein compared to non-treated fibroblasts (P ＜ 0.05). However, simultaneous incubation of HGF significantly abrogated TGF-β1 induced α-SMA expression in a dose-dependent manner (P＜ 0.05). Treatment with TGF-β1 significantly stimulated collagen Ⅰ and fibronectin production in flexor tendon sheath fibroblasts (P ＜ 0.01). Remarkably, the addition of HGF reduced productions of all components induced by TGF-β1 in a dose-dependent manner (P ＜ 0.05). Conclusion HGF antagonizes TGF-β1 induced α-SMA, collagen Ⅰ, and fibronectin production in flexor tendon sheath fibroblasts. The findings provide a cellular and molecular basis for HGF's acting as a therapeutic agent for adhesions in flexor tendons.