ObjectiveTo analyze the effects of three different display devices on the interpretation of imaging data in medieal imaging system.MethodsThe luminance-meter L100 and the test patterns provided by the American Association of Physicists in Medicine(AAPM)were used to assess the performance of three display devices(the spherical,flat panel and liquid crystal display devices).The corresponding luminance response was compared with the reference criteria provided by AAPM Task Group 18(AAPM TG18).DR chest photography was taken on CDRAD2.0 contrast-detail phantom using the following experimental parameters:100 mA,80 kVp,and the exposure times for 6,10,12,and 16 ms.After each exposure,the surface dose of phantom was recorded and the image quality factor(IQF)was calculated.Statistical analysis of IQF was performed using ANOVA. ResultsThe maximum luminance values in the spherical,flat panel and liquid crystal display devices were 170,59 and 231 cd/m2 and the luminance ratio was 257, 99 and 350 respectively.There was a significant difference in the IQF bewteen the liquid crystal display device and other two display devices.Conclusion The liquid crystal display device has the better image quality.

Objecive To investigate the prevalence of NDM-type carbapenemases in the carbapenem-resistant Escherichia coli strains collected from Ruijin Hospital, Shanghai Jiaotong University School of Medicine. The epidemiological characteristics of NDM-type carbapenemase-producing isolates were analyzed.Methods Eighteen strains were collected from November 2013 to January 2015 in the clinical microbiology laboratory of Ruijin Hospital. All of them were resistant to imipenem or meropenem (inhibition zone diameter≤19 mm). The blaNDM gene was detected by PCR. The amplified products were subjected to sequencing analysis. Conjugation experiment was carried out to verify the transferability of plasmids. Multilocus sequence typing (MLST) and pulsed field gel electrophoresis (PFGE) were performed to analyze the molecular epidemiology.Results The blaNDM gene was identified in 6 strains, 4 of which had blaNDM-1-type and 2 had blaNDM-5-type carbapenemase gene. Three strains were positive in the conjugation experiment. MLST analysis showed that 6 NDM carbapenemase-producing isolates belonged to ifve sequence types, corresponding to five PFGE-DNA patterns (A-E). Two of these isolates shared the identical sequence type (ST5018) and nearly the same PFGE-DNA patterns (A1, A2).Conclusions NDM-type carbapenemase-producing E. coli is identified in this study. Most blaNDM-positive cases were sporadic. Plasmid might play an important role in the spread of blaNDM inE. coli. The blaNDM-5 type carbapenemase gene was first identified in Shanghai, to which more attention should be paid.

Objective To investigate radio-sensitivity and expression of GRP78 protein in the survival subclones of nasopharyngeal carcinoma (NPC) C666-1 cells.Methods NPC C666-1 cells were first irradiated with X-ray at a large dose of 8Gy.Three survival subclones were selected and named as C666-1-R1, C666-1-R2, and C666-1-R3.The radio-sensitivity was analyzed for the radiated survival subclones and their parent control C666-1 cells with Methyl Thiazolyl Tetrazolium assay(MTT) and Trypan blue dye methods.The expression of GRP78 was analyzed for three survival subclones and control C666-1 with Western blot.Results After 6 Gy irradiation, the cell survival rate of three subclones was higher than that of the control cells, especially a significant difference for C666-1-R2 cells (P ＜ 0.05), which suggested a radioresistance in C666-1-R2 cells.Moreover, GRP78 expression in each subclone was significantly higher than that of parent C666-1 cells (P ＜ 0.05).Conclusions The irradiated-survival subclone C666-1-R2 was radio-resistant.GRP78 was overexpressed in the irradiated-survival subclones.GRP78 might be an ideal target for treatment of a nasopharyngeal carcinoma.

Objective To identify the clinical profile and neuro-imaging findings of the right temporal lobe variant of semantic dementia (RTLV),and to understand the relationship between anatomic and function by comparison to the left temporal lobe atrophy.Methods Of 70 patients with diagnosis of frontotemporal dementia in our memory clinic,three patients with right temporal lobe atrophy were identified based on the MRI scans.We obtained the profile of cognitive function,behavior and personality changes in these 3 patients and compared them with those in 5 semantic dementia (SD) patients with predominant leftsided temporal lobe atrophy.We also underwent 18F-fluoro-2-deoxy-D-glucose positron emission tomography (18F-FDG-PET) with statistical parametric mapping analysis in these 3 patients.Results In RTLV patients,the most prominent cognitive deficits were impairment of prosopagnosia,and getting lost.Variety behavioral symptoms including apathy,social disinhibition,stereotypy,compulsive behaviors were more prevalent in early course for patients with RTLV,which were different from SD patients with semantic loss began with anomia or single-word comprehension.18F-FDG-PET scan showed decreased metabolism mainly in right temporal lobe and in other brain regions with varying degrees.Conclusions The RTLV is clinical heterogeneous.Prosopagnosia,behavioral changes and getting lost are the main features in the early course.It therefore,might be proposed a separate clinical entity.

Objective To investigate the therapeutic effects of recombinant human erythropoietin(rhEPO)on brain mitochondrial energy metabolism and mitachondrial respiratory functionin after brain injury in rats.Method A total of 63 Sprague-Dawley rats were divided randomly into three groups:the rhEPO treated group(n =28),the control group(n=28),the shanl group(n=7).The models of contusion of brain caused by freefalling were set up in rhEPO treated group(n=28).The recombinant human erythropoietin was intraperitoneally injected in dose of 10 U/g immediately after brain injury and it was repeated every 10 hours in rhEPO group treated.The same models of contused brain were made without rhEPO treatment as control group(n=28).In control group,the same volume of normal saline was used in replacemem of rhEPO.Aburr hole was made on the skull of the sham group(n=7),but the brain tissue was not wounded.The mitochondria were isolated at 6 h,12 h,24h,48 h after trealment,respectively.The activity of ATPase and SOD,the content MDA and brain mitochondrial respiratory function were measured by biochemical technique.The data were analyzed with the F-test and t-test.Results The activity of ATPase(P＜0.05),SOD(P＜0.01)and brain mitochondrial respiratory function(P ＜0.05)were increased.and the levd of MDA in brain mitochondria was reduced markedly in rats treated with rhEPO.Conclusions Treatment with rhEPO can alleviates the secondary brain injury by affecting mitochondrial function.

Objective To evaluate the effects of exercise therapy for patients with difficult weaning using mechanical ventilation.Methods A total of 63 patients with difficult weaning using mechanical ventilation were randomly divided into the experimental group(33 cases) and the control group(30 cases).The patients in the control group received routine respiratory care,however,the patients in the experimental group received gradual and individualized exercise therapy according to patients' condition and physical strength.The items such as the tidal volume,respiratory rate,PaO2/FiO2 were compared between two groups.Results Compared with the control group,the tidal volume,respiratory rate,PaO2/FiO2 and the score of APACHE Ⅱ were better in the experimental group on the 21th and 28th day after mechanical ventilation,the heart rate was better in the experimental group on the 28th day after mechanical ventilation.In addition,the duration of mechanical ventilation and ICU hospitalization was shorter in the experimental group.But the rate of complications showed no significant difference.Conclusions Exercise therapy has a positive effect on patients with difficult weaning using mechanical ventilation.

Objective To evaluate Left ventricular(LV) diastolic function in essential hypertension by conventional pulse-wave Doppler echocardiography (cPWD) and Doppler tissue imaging (DTI) and compare the two modalities. Methods Two hundred patients with essential hypertension were classified as NLVH subgroup (n = 160) and LVH subgroup (n =40) based on left ventricular mass index (LVMI) with one hundred and sixty health subjects as control group. The mitral valve flow pattern (MVFP) was obtained.Early diastolic (E) and late velocities (A) were measured and E/A was calculated. DTI was used to obtain the left ventricular lateral wall early diastolic mitral annulus velocity (Em) and E/Em was calculated.Results Essential hypertension patients had LV diastolic dysfunction both by cPWD (higher E and lower E/A ratio) and DTI (lower Em and higher E/Em ratio) compared with healthy subjects [E:(0. 88 ±0. 18)cm/s vs (0. 76 ±0. 19) cm/s;E/A ratio:0. 86 ±0. 28 vs 1.02 ±0. 38;Em: (9. 4 ±2. 8)cm/s vs (11. 9 ±3. 8)cm/s;E/Em ratio;7. 9 ± 2. 7 vs 6. 0 ± 1. 8: with all P value ＜0.01]. Em was significantly reduced and E/Em was significantly elevated in LVH subgroup than NLVH subgroup [Em; (7.7 ±2. 6) cm/s vs (9. 9 ± 2. 8) cm/s, E/Em: 9. 6 ± 3. 6 vs 7. 4 ± 2. 4, P ＜ 0. 05]. No significant difference was found in A and E/A between these two subgroups [(0. 90 ± 0. 22) cm/s vs (0. 87 ± 0. 17) cm/s; 0. 80 ± 0. 34 vs 0.88 ±0.28, P ＞ 0.05]. Conclusions cPWD and DTI both had implications to detect diastolic dysfunction in non-hypertrophic stage hypertension. Em、E/Em could be more sensitive and precise to reflect the impairment of diastolic function in the progress of hypertension.

Objective To explore the relativity between clinical learning organization culture and core competency among registered nurses,to offer theoretic basis and practical advices for improving core competency among registered nurses.Methods 680 registered nurses in three tertiary hospitals in Ji'nan city were investigated with the general information questionnaire,Competency Inventory for Registered Nurses and the Dimensions of The Learning Organization Questionnaire.Results The total score and all the four subscales of learning organization were positively correlated with the core competency among registered nurses(P＜0.01),the dimension of overall situation senses and strategic leadership were the main influencing factors.Conclusions The cultivation of nurses' overall situation senses should be strengthened,providing strategic leadership for learning,strengthening cooperation and innovation,and promoting inquiry and communication.These will help increase core competency among registered nurses and improve their general competence.

Objective:To construct a fusion protein of extracellular domain peptide fragment of muscle specific kinase ( MuSK) and fluorescent protein mCherry ,and used as antigen in the detection of antibodies against MuSK ( MuSKAb ) in the sera of patients with myasthenia gravis ( MG).Methods:The mCherry gene was amplified by PCR from vector pRSET-B and cloned into pGEM-T Easy Vector,and furthermore, cloned into Eukaryotic expression vector pMT /BiP/V5-His ( MuSK), which contains MuSK extracellular domain 22-452 amino acid peptide fragment gene to construct the fluorescent fusion protein gene MuSK -mCherry.The recombinant vector was subsequently transfected into drosophila S 2 cells for expression.The expressed fusion proteins were verified in confocal mi-croscope ,and used as antigen in the detection of MuSKAb in sera of MG patents in fluorescence immunoprecipitation test .Results:The fluorescent fusion protein MuSK-mCherry was successfully constructed and expressed.The MuSKAb in sera of patents with MG could be detected in fluorescence immunoprecipitation test using the constructed MuSK-mCherry fusion protein as antigen.Conclusion: It is available to use the constructed fluorescent fusion protein MuSK-mCherry as antigen in fluorescence immunoprecipitation test for the detection of MuSKAb in sera of patents with MG.

Objective To investigate changes of coagulation function in patients with high altitude polycythemia (HAPC) .Meth‐ods Activated partial thromboplastin time (APTT) ,prothrombin time (PT) ,thrombin time (TT) and fibrinogen (Fbg) were de‐tected and compared between 69 patients with HAPC and 60 healthy subjects (controls) .Results Fbg ,APTT and TT levels in pa‐tients with HAPC were higher than controls (P<0 .05) ,while the difference of PT was not significant (P>0 .05) .Dynamic obser‐vation indicated that comprehensive therapy could these recover coagulation function .Conclusion Hemorrhage and coagulation process in patients with HAPC could be very complicated ,including physiological adaptation and the process of physiology evolving into pathology .