Objective To investigate the clinical value of spiral CT in diagnosis of fracture of tibia plateau, to provide a reference for clinical treatment.Methods 50 cases of tibial plateau fracture were selected,they were diagnosed with X -ray and diagnostic multislice spiral CT three dimensional reconstruction scan respectively.The fracture type and so on of the two groups were compared.Results 50 patients were diagnosed as 14 cases of type Ⅰ, type Ⅱ 10 cases,Ⅲ type 6 cases,Ⅳ type 7 cases,Ⅴ type 5 cases,Ⅵ 8 cases,CT three -dimensional reconstruction diagnosis accuracy rate was 100.00%.X -ray diagnosis was accurate in 41 cases,diagnostic accuracy rate was 82.00%,the difference of two diagnostic ways was statistically significant (χ2 =8.657,P =0.000).All patients were not detected with significant artifacts,the line was good,the fracture line was blurred and visible fracture callus formation surgical outcome was good.Conclusion Spiral CT diagnosis in tibial plateau fracture has high accuracy,through clear and intuitive display morphological characteristics of the patients improves anatomical repair treatment,it is worthy of clinical application.

The method for ultrasonic detection of air bubble in race track is studied in this paper. A automatic detection system is established, which mainly consists of the ultrasound emitter and receiver, high-speed A/D acquisition card and PC.

A real-time tele-monitoring system for physiological multi-parameter based on Internet is introduced,and physiological signals are transmitted by P2P network technology.The experiment results show that the speed of data transfer has been improved greatly using P2P technology,and physiological signals,such as ECG,can be monitored in real-time.

The Internet -based multiple physiological parameters tele -monitoring system is composed of an information collector for multiple physiological parameters, a personal computer and a central server. A P2P structure mixed with a C/S structure is adopted in the software design. To make tele-monitoring and tele-diagnosis available, the system is applied to real-time measuring, analyzing, monitoring and tele-transmitting of multiple physiological parameters. The system is suitable to be used in community hospital and family.

CCAAT/enhancer binding protein β (C/EBPβ) is a critical member of C/EBP family.C/EBPβ,based on the leucine zipper located in C terminal of the protein,can regulate transcriptional activities of downstream target genes involved in diverse cellular processes,such as proliferation and differentiation.Recently published studies have identified that C/EBPβ is essential in the decidualization of endometrial stromal cells.This review summarizes the roles and mechanisms of C/EBPβ during the courses of decidualization,which is aimed at providing novel insights for dysfunctional decidualization.

Objective To summarize and analyze data of solid pseudopapillary tumor of pancreas (SPTP) in China,and investigate its epidemiology,clinical features,diagnosis and treatment.Methods Retrieval of Chinese Medical Current Contents and China Biology Medicine disc by the key words of solid pseudopapillary tumor of the pancreas,papillary cystic tumor of the pancreas,pancreatic papillary epithelial tumor,cystic solid tumor of pancreas and Frantz tumor were performed,and relevant literatures were included.Results A total of 1180 SPTP patients from 117 articles were involved.There were 1054 women and 126 men and the ratio of male to female was 1:8.37.The average age was 29 years old (range 9 ～83 years).Detailed clinical information was available for 1172 cases,and the main clinical manifestations included abdominal discomfort (n=526,44.88％),medical check-up (n=464,39.59％),abdominal mass (n=131,11.18％).Laboratory and imaging tests were non-specific.The tumors size was 1.3～ 30 cm with a mean value of 7.84 cm.Four handreds and seven (36.8％) cases were located in pancreatic head,96 (8.7％)were in pancreas neck and 587 (53.1％) were in the body and tail of pancreas.Eleven handreds and sixteen patients received treatment,and the resection rate was 99.2％ (n =1107).Pathological examination showed that 628(57.0％) cases were benign and 306 (27.8％) were presented as malignant behavior,mainly as infiltrative growth and invasion of the surrounding organs,vessels.Nine handreds and seventy-seven cases were followed up (ranging from 1 month to 13 years),and re-occurrence or metastasis were detected in 42 cases (4.3％) and 24 patients died.Conclusions Solid pseudopapillary tumor of pancreas is a rare pancreatic tumor with low-grade malignant potential,and part of this tumor may present as malignant behavior and it primarily affects young females.No characteristics in clinical manifestations,laboratory and imaging tests are found.Pathological examination can confirm the diagnosis.Surgical resection is the therapy of choice and the prognosis is good.

Objective:To investigate the effect of O-6-methylguananine-DNA methyltransferase (MGMT) gene promoter methylation status on the treatment and prognosis of elderly patients newly-diagnosed with glioblastoma (GBM).Methods:Clinical data of 65 newly-diagnosed GBM patients admitted to Tianjin Huanhu Hospital from January 2012 to December 2018 were retrospectively analyzed. All patients received intensity-modulated radiotherapy after surgery and 49 patients received temozolomide (TMZ) monotherapy. All patients were divided into the MGMT(+ ) group and MGMT(-) group according to the methylation status of MGMT promoter. Kaplan- Meier method and log-rank test were used for univariate survival analysis, and Cox regression model was used for multivariate prognostic analysis. Results:The median overall survival (OS) for all patients was 18.0 months. The median OS was 27.0 months and 15.3 months in the MGMT(+ ) group and MGMT(-) group, respectively. Univariate analysis revealed that tumor number, MGMT promoter methylation, postoperative concurrent chemoradiotherapy were significantly related to clinical prognosis ( P=0.029, P=0.001 and P<0.001). In multivariate analysis, tumor number and postoperative concurrent chemoradiotherapy were identified as significant prognostic factors for OS ( P=0.037, P=0.004). In the MGMT(+ ) group, the median OS was 27.0 months for patients receiving concurrent chemoradiotherapy and 12.0 months for radiotherapy alone ( P=0.040). In the MGMT(-) group, the median OS was 17.0 months for concurrent chemoradiotherapy patients and 10.0 months for radiotherapy alone ( P=0.122). Conclusions:MGMT promoter methylation status is significantly associated with longer OS in elderly GBM patients. Conventional fractional radiotherapy combined with concurrent and sequential TMZ chemotherapy probably yields better survival benefits.

Objective To compare the cost-effectiveness of closed-loop versus open-loop infusion of propofol guided by bispectral index (BIS) in elderly patients undergoing abdominal surgery.Methods Sixty American Society of Anesthesiologists physical status Ⅱ patients of either sex,aged 65-75 yr,with body mass index of 18 25 kg/m2,undergoing elective open gastrointestinal tumor resection with general anesthesia,were allocated into closed-loop target-controlled infusion (TCI) group (group C) and open-loop TCI group (group O) using a random number table.Propofol was given using closed-loop TCI,and the target BIS value was set at 45-55 in group C.In group O,the target plasma concentration (2.0-3.5 μg/ml)of propofol was adjusted to maintain the BIS value at 45-55.Remifentanil was given by TCI with the target plasma concentration of 2-8 ng/ml in both groups.The total consumption of propofol and remifentanil,time rate of maintaining BIS value within the target range,development of intraoperative hypertension and hypotension,emergence time,tracheal extubation time,time for recovery of orientation,first ambulation time,time to first flatus and length of postoperative hospital stay were recorded.The development of nausea and vomiting and delirium within 3 days after operation and intraoperative awareness was recorded.The cost of anesthetics and total cost of anesthesia were calculated.Results Compared with group O,the total consumption of propofol was significantly decreased,the total consumption of remifentanil was increased,the time rate of maintaining BIS value within the target range was increased,the emergence time,tracheal extubation time and time for recovery of orientation were shortened,the cost of propofol and total cost of anesthesia were decreased (P＜0.05),and no significant change was found in the cost of remifentanil,incidence of postoperative delirium and nausea and vomiting,first ambulation time,time to first flatus or length of postoperative hospital stay in group C (P＞0.05).Intraoperative awareness was not found in two groups.Conclusion Compared with open-loop infusion of propofol guided by BIS,closed-loop infusion of propofol guided by BIS is a cost-effective method of anesthesia in elderly patients undergoing abdominal surgery.

Objective To examine the 5-year incidence of tuberculosis in different populations with strongly positive tuberculin skin test (TST) receiving preventive administration of isoniazide.Methods A total of 12 598 subjects including 8 896 college students,2 496 migrant workers and 1 206 close contacts with active pulmonary were selected from January to December 2003.Subjects with strongly positive TST but without abnormal lung findings were divided into isoniazide group (given isoniazide for 10 months) and control group (not given any drugs).The incidence of tuberculosis in year 2-5 were observed and compared usingx2 test.Results Among 12 598 subjects,897(7.12％) had strongly positive TST,including 316 college students,388 migrant workers and 193 close contacts,and the TST strongly positive rates were 3.55％ (316/8 896),15.54％ (388/2 496) and 16.00％ (193/1 206),respectively.Migrant workers and close contacts had higher TST positive rates than college students (x2 =483.51 and 344.11,P ＜ 0.01).Among 897 TST-positive individuals,37 were diagnosed as tuberculosis,including 11 college students,12 migrant workers and 14 close contacts,and the tuberculosis rates in three populations were 0.12％ (11/8 896),0.48％ (12/2 496) and 1.16％ (14/1 206),respectively.Migrant workers and close contacts also had higher tuberculosis rates than college students (x2 =12.34 and 42.18,P ＜0.01).In the second follow-up year,9 out of 429 subjects in isoniazide group quit the study due to adverse reactions,and in the rest 420 subjects,9 (2.14％) were diagnosed as tuberculosis.The incidence of tuberculosis in three populations were 1.34％ (2/149),1.60％ (3/188) and 4.82％ (4/83),and no significant difference was found (x2 =2.92,P ＞ 0.05).While in the control group,31 out of 429 (7.23％) individuals were diagnosed as tuberculosis,and the incidence was higher than that in isoniazide group (x2 =12.69,P ＜ 0.01).During the next three follow-up years,23 individuals in isoniazide group drop out of the study,and in the rest 388 subjects,8 (2.06％) were diagnosed as tuberculosis.The incidence of tuberculosis in three populations were 1.41％ (2/142),2.35％ (4/170) and 2.63％ (2/76),and no significant difference was found (x2 =3.11,P ＞ 0.05).While in the control group,17 out of 398 (4.27％) subjects were diagnosed as tuberculosis,and the incidence was not of significant difference compared with that in isoniazide group (x2 =2.47,P ＞ 0.05).Conclusion Migrant workers and close contacts are high risk populations of tuberculosis,and preventive administration of isoniazid for 10 months may reduce the incidence of tuberculosis in the following 2 years.

Objective To investigate the incidence and risk factors of the complications in perioperative intra-aortic balloon pump (IABP) supported cardiac surgical patients. Methods The clinical data of adult cardiac surgery patients undergoing IABP in Fuwai Hospital from January 2005 to January 2017 were enrolled. The patients were divided into complications group and no complications group. Demographic characteristics, diagnosis, perioperative clinical parameters, IABP related data, and IABP complications (including ischemia, bleeding, vascular injury and mechanical problems) were collected. The incremental risk factors of complications related IABP were analyzed by logistic regression. Results During the 12-year period, 522 patients received IABP support, with 388 male and 134 female; the mean age was (61.79±9.35) years; the complications related to IABP occurred in 25 patients, and overall complication rate was 4.79%; 87 IABP patients were dead in-hospital, the overall mortality was 16.67%, no patient died due to complications. The complications rate was higher in the female patients (40.00% vs. 24.95%), and was more in patients with age ≥ 65 years old (80.00% vs. 38.03%), more with higher body mass index [BMI (kg/m2): 25.45±13.71 vs. 22.95±3.45], diabetes mellitus (44.00% vs. 26.76%), combination treatment with extra-corporeal membranous oxygenation (ECMO: 20.00% vs. 5.03%) and prolonged IABP support time (hours: 134.4±90.3 vs. 109.8±89.1, all P < 0.05). There was no significant difference in the incidence of complications among preoperative IABP support, intra-operative IABP support and post-operative IABP support [3.30% (3/91), 5.46% (10/183), 4.84% (12/248), χ 2 =0.629, P = 0.730]. Bleeding from puncture site occurred in 14 cases (2.68%) without severe bleeding. Limb ischemia occurred in 9 cases (1.72%). One patient (0.19%) was under another surgery because of retroperitoneal hemorrhage caused by vascular injury. One patient (0.19%) was unsuccessful due to a balloon leak. It was shown by logistic regression analysis that presence of age ≥ 65 years [odds ratio (OR) = 2.320, 95% confidence interval (95%CI) = 1.011-1.806, P = 0.047], diabetes mellitus (OR = 2.281, 95%CI = 1.016-5.120, P = 0.026) and combination treatment with ECMO (OR = 4.341, 95%CI = 1.240-15.196, P = 0.040) were found to be the risk factors of complications related to IABP. Conclusions IABP complication rates are generally low. The frequent complications during IABP support is bleeding from site of catheterization and limb ischemia. When patients were treated with IABP, those with older age, diabetes mellitus and combination with ECMO should be monitored closely in order to reduce complications.