[Objective]To analysis the clinical manifestation and treatment of tendious sheath tubercular,probe the influencing factor of misdiagnosis and effect of treatment,in order to offer evident base for diagnosis and treatment.[Method]The material of 86 cases(from January 1994 to Jun 2005)were reviewed and statistically analyzed including sex,age,nidus region,clinical manifestation,method and effect of treatment,etc.[Result]65% of the cases were 30~49 years old.Sexual difference was not significant.Nidus region in right side was apparently higher than that in left(67%:30%).Major manifestation was edema,tenderness and mal-motion.The misdiagnosis rate and recurrent rate were 88% and 1.2%.[Conclusion]Untypical clinical symptoms and sign,non-special laboratory examinations lead to misdiagnosis.The effective treatment includes integrity excision,local and general chemotherapy,which made recurrent rate low.

The complement system, the chief component of innate immunity, is not only required for host defense against pathogens and homeostasis, but also related to the pathogenesis and development of various kidney diseases. Recent study has shown that tissue-derived complement and immune cell-derived complement can each mediate local inlfammation. The comple-ment system acts as a bridge between innate and adaptive immunity. Furthermore it’s also a functional bridge between pathogenic humoral and cellular immune responses in an array of kidney diseases. Increasing evidence links inappropriate complement acti-vation and deifciencies of complement proteins to the pathogenesis of kidney autoimmune disease, ischemia-reperfusion injury, transplant rejection and complications in hemodialysis. The development of pharmacologic agents that target complement in pa-tients with this assortment of immune and/or inlfammatory kidney diseases has the potential to abrogate disease progression and improve patient health.

Objective To analyze the constitute and antifungal susceptibility of Candida spp . causing bloodstream infection in a hospital,so as to provide evidence for the prevention and treatment of bloodstream infection caused by Candida spp .Methods Candida spp . isolated from blood specimens of clinical patients in a hospital between 2009 and 2013 were analyzed retrospectively,the high risk factors for Candida bloodstream infection were analyzed. Results A total of 42 isolates of Candida spp . were isolated from blood specimens of 42 patients between 2009 and 2013,the major was Candida parapsilosis (C.parapsilosis ,n =20,47.62%),followed by C.albicans (n =16, 38.10%),C.tropicalis (n=4,9.52%),and C.glabrata(n=2,4.76%).Candida spp .were mainly distributed in emergency intensive care unit(n=11),departments of urologic surgery (n=9)and cardiothoracic surgery(n=8). The venous catheters of 37 patients(88.10%)were isolated the same Candida spp . as blood culture,the average time from indwelling venous catheters to positive culture of blood and catheters were 31 .47 and 33.18 days respec-tively;the percentage of positive culture for blood and catheters both increased with the prolongation of catheteriza-tion (both P < 0.001 ).Susceptibility rates of Candida spp . to fluconazole and voriconazole were 75.00% -100.00%,to amphotericin B were all 100.00%,to itraconazole varied significantly with different species (0 -87.50%).Conclusion The major Candida strains causing bloodstream infection in this hospital is C.parapsilosis , and is related to the use of intravenous catheters,susceptibility rates to fluconazole,amphotericin B,and voricon-azole are all high.

Objective To analyze the distribution and change of antimicrobial resistance of common pathogenic bacteria from geriatric ward,and provide reference for rational use of antimicrobial agents.Methods Specimens from hospitalized patients in a geriatric ward from 2009 to 2013 were analyzed,the isolated pathogenic bacteria and antimicrobial resistance of bacteria were analyzed statistically.Results From 2009 to 2013,a total of 7 426 patho-genic bacteria were isolated,the percentage of gram-negative bacilli,gram-positive cocci,and fungi were 90.96%(n=6 755),7.23%(n =537),and 1 .81 % (n = 134),respectively.The top 5 detected bacteria were Pseudomonas aeruginosa (39.16%),Escherichia coli (16.47%),Stenotrophomonas maltophilia (10.65%),Klebsiella pneu-moniae (7.22%),and Acinetobacter baumannii (6.21 %),these strains were mainly isolated from sputum (94.15%,n =5 573 ).Resistance rates of Acinetobacter baumannii to all detected antimicrobial agents,Pseudo-monas aeruginosa to 8 kinds of common antimicrobial agents (piperacillin / tazobactam,ceftazidime,aztreonam, imipenem,et al),Escherichia coli to 5 kinds of common antimicrobial agents (piperacillin/ tazobactam,cefopera-zone/sulbactam,aztreonam,levofloxacin,and ciprofloxacin),and Stenotrophomonas maltophilia to ceftazidime and levofloxacin all showed an increased tendency (all P <0.01 );there was no obvious change in resistance rates of Klebsiella pneumoniae to all detected antimicrobial agents (all P >0.05).Conclusion The major pathogenic bacteria isolated from geriatric ward is Pseudomonas aeruginosa ,which is highly resistant to multiple antimicrobial agents, antimicrobial agents should be chosen based on antimicrobial susceptibility testing results.

Child ; Congresses as Topic ; Humans ; Kidney Diseases ; Nephrology ; Pediatrics

In order to meet the requirements of ultrasound bone density measurement, we designed a sofware based on Visual Studio C+ + 2008. The software includes interface design, acquisition and control, data processing and parameter extraction, data storage and printing. Excellent human-computer interface (HCI) will give users a convenient experience. Auto gain control (AGC) and digital filter can improve the precision effectively. In addition, we can observe waveform clearly in real time. By using USB communication, we can send control commands to the acquisition and get data effectively, which can shorten the measuring time. Then we calculated the speed of sound (SOS) and broadband ultrasound attenuation (BUA). Patients' information can be accessed by using XML document. Finally, the software offers printing function.
Absorptiometry, Photon ; instrumentation ; Bone Density ; Humans ; Information Storage and Retrieval ; Software ; Sound ; Ultrasonics ; methods ; User-Computer Interface

Objective To evaluate the clinical outcome of hip arthroplasty following femoral neck fracture.Methods Sixty-one cases of femoral neck fracture were treated by hip arthmplasty from January 2000 to April 2008,and their complete data were available,whose age ranged from 36 to 90 years old,mean age(71.5±14.7)years old.The group comprised 21 men and 40 women.Results Clinical follow-up ranged from 3 months to 8 years.The Harris hip score improved from(17.5±8.4)scores pre-operatively to(78.1±8.5)scores post-operatively,and the average leg-length discrepancy decreased from(2.52±1.09)cm pre-operatively to(0.81±0.73)cm post-operatively.The differences between pre-operative data and post-operative data were significant (P＜0.05).Conclusion Hip arthroplasty is an ideal procedure for old femoral neck fracture in elderly patients or those who followed failed previous treatment.

BACKGROUND: Adhesion molecules are closely associated with inflammation. Inflammation due to white blood cell (WBC) infiltration and free radical injury following brain ischemia are believed to be important factors contributing to the pathogenesis of multi-infarct dementia.OBJECTIVE: To determine the level of serum adhesion molecules and free radicals in patients with multi-infarct dementia to explore the relationship between their levels and multi-infarct dementia.DESIGN: A case-control trial.SETTING: Department of Neurology, Second Affiliated Hospital of Jilin University.PARTICIPANTS: Totally 82 patients with multi-infarct dementia were hospitalized in the Department of Neurology, Second Affiliated Hospital of Jilin University between January 2000 and December 2004. These patients included 32 cases of mild dementia, 21 of moderate dementia, and 29 of severer dementia. The normal controls were 23 concomitant healthy volunteers who came for routine physical examination.METHODS: Enzyme-linked immunosorbent assay (ELISA) and electron spin resonance were used to determine the level of serum soluble intercellular adhesion molecules (ICAM) and vascular cell adhesion molecules (VCAM), as well as oxygen free radical concentration in the normal controls and patients with multi-infarct dementia, and the association between the severity of the illness and the levels of adhesion molecules and oxygen free radicals was analyzed.MAIN OUTCOME MEASURES: Serum levels of ICAM-1 and VCAM-1 and oxygen free radical concentration in the two groups.RESULTS: Totally 82 patients with multi-infarct dementia and 23 healthy controls were included in this study and all enter the result analysis. In multi-infarct dementia patients, the serum levels of soluble ICAM-1 and VCAM-1 and oxygen free radical concentration [(469.00±76.33), (196.00± 45.91) and (1 103.30±98.96) μg/L, respectively] were significantly higher than those of the control group [(601.00±76.30), (4.018±1.656), and (1.295±0.718) μg/g, respectively, t=5.517-6.754, P ＜ 0.01], and the 3 indices were positively correlated with the severity of dementia (r=0.659 4,r=0.697 2, r=0.649 4, respectively, P ＜ 0.05); serum ICAM-1 and VCAM-1 levels were positively correlated with the concentration of oxygen free radicals (r=0.714 7, r=0.732 4, respectively, P ＜ 0.01).CONCLUSION: Serum ICAM-1, VCAM-1 and oxygen free radicals might be implicated in the pathophysiological development of multi-infarct dementia, and their levels increase in parallel with the severity of dementia.

Objective To explore the early diagnostic value of Golgi membrane protein 73 (GP73),alpha-fetoprotein (AFP) and alpha-fetoprotein-L3 (AFP-L3) in patients with high risk of primary hepatic carcinoma (PHC).Methods Sixty-four cases of PHC were selected as the PHC group,60 cases of liver cirrhosis(LC) as the LC group,53 cases of hepatitis as the hepatitis group and 51 healthy checked-up people as the control group.Enzyme-linked immunosorbent assay (ELISA) was used to detect the serum level of GP73 in all the cases.AFP-L3 was isolated by using affinity micro centrifugal column,AFP and AFP-L3 were detected with chemiluminescent immunoassay and then the proportion of AFP-L3 was calculated.Results The positive rate of serum GP73,AFP and AFP-L3 in PHC group was significantly higher than that in LC group and hepatitis group [78.1％ (50/64)vs.25.0％ (15/60),17.0％ (9/53);48.4％ (31/64) vs.31.7％ (19/60),22.6％(12/53) ;53.1％(34/64) vs.30.0％(18/60),20.8％(11/53)] (P ＜ 0.05),In control group,GP73,AFP,AFP-L3 was no positive.The levels of GP73,AFP and AFP-L3 in PHC group were significantly higher than those in LC group,hepatitis group and control group [(245.69 ± 89.18)μ g/L vs.(116.37 ±38.52),(97.29 ± 24.58),(23.48 ±9.12) μ g/L; (403.27 ± 128.46) μg/L vs.(75.62 ± 19.35),(66.49 ± 15.14),(3.46 ± 1.02) μg/L; (15.64 ±3.19)％ vs.(5.24 ± 1.15),(4.21 ± 0.96),(2.95 ±0.73)％] (P ＜0.05).The levels of GP73,AFP in LC group and hepatitis group were significantly higher than those in control group (P ＜ 0.05).The levels of GP73,AFP and AFP-L3 had no statistically significant difference between LC group and hepatitis group (P ＞ 0.05).Sensitivity and accuracy of three combined detection for PHC was 96.9％(62/64),91.7％(209/228),significantly higher than that of AFP,AFP-L3 single detection (P ＜ 0.05).GP73 single detection and any two combined detection was no significant difference in sensitivity and accuracy,compared with three combined detection (P ＞ 0.05).The levels of GP73 in PHC patients with different age,gender,serum level of AFP,TNM stage and tumor diameter had no statistically significant difference (P ＞ 0.05).The levels of GP73 in PHC patients with positive HBsAg,extrahepatic metastases and LC had significant difference (P ＜ 0.05).Conclusions The diagnosis value of GP73 is evidently higher than AFP and AFP-L3 for PHC,and combined determination is superior to single marker.Combined determination enhances the degree of precision in populations with high risk of PHC diagnosis.

Objective To investigate the effect of preoperative oral midazolam on emergence agitation after sevoflurane anesthesia in children.Methods Sixty children,34 males,26 females, aged 2-7 years,ASA grade Ⅰ or Ⅱ,receiving sevoflurane for tonsillectomy/adenoidectomy were ran-domly divided into low dose midazolam group (group M1),high dose midazolam group (group M2) and control group (group C)(n=20 each).The 5 ml mixture of midazolam 0.5 mg/kg,0.75 mg/kg and 10% glucose was taken orally 30 min before anesthesia in group M1 and group M2,respectively. While 5 ml of 10% glucose was given in group C.Anesthesia was induced with inhalation of 8%sevoflurane and maintained with intravenous infusion of remifentanil and inhalation of sevoflurane. Scores of parental separation anxiety scale(PSAS),pediatric anesthesia emergence delirium scale (PAED scale),FLACC scale were compared.Times to extubation and discharge from PACU were al-so recorded.Results Group C showed significantly higher incidence of separation anxiety(P <0.05). The incidence of emergence agitation,peak PAED scores,FLACC scores,time to extubation were similar among three groups.Discharge time from PACU was longer in group M2 (P < 0.05). Conclusion Preoperative oral midazolam 0.5 mg/kg or 0.75 mg/kg can effectively reduce parental separation anxiety.This,however,dose not result in a reduced incidence of emergence agitation after sevoflurane anesthesia.Midazolam 0.75 mg/kg can extend the discharge time from PACU.