Objective To investigate the effect of patient positioning on the Duplex ultrasound evaluation of great saphenous vein reflux elicited by the pneumatic cuff method. Methods FFifty great saphenous veins (GSV) with relfux (relfux group) and iffteen with no prior history of venous disease (healthy group) were examined by duplex scanning in the supine, 20 degrees reverse-trendelenburg (RT-20), 40 degrees reverse-trendelenburg (RT-40) and standing position. Each GSV was assessed for relfux at three venous sites:two centimeter below the sapheno-femoral junction (SFJ), the greater saphenous vein in the mid thigh (MGV) and the greater saphenous vein in the upper calf (CGV). Pneumatic cuff compression pressure of conifned 100 mmHg (1 mmHg=0.133 kPa) was used onto the calf to elicit relfux. The incidence of positive venous relfux was calculated. The statistical differences of the peak relfux velocity and duration of relfux in four positions were analyzed. Results TThe relfux elicited in the standing position was set as the gold standard. In healthy group, there was no false positive results of relfux in supine, RT-20 and RT-40 positions. In relfux group, false negative results were found at all venous sites when limbs were examined in supine position [false negative rate:59%(19/32), 22%(11/50), 24%(12/50)]. At RT-20 and RT-40 positions, the incidence of venous relfux reached 100% at MGV and CGV, and false negative cases were only detected at SFJ [false negative rate:12%(4/32), 12%(4/32)]. The relfux time in standing, supine, RT-20 and RT-40 positions were (7.75±3.23) s, (5.27±3.66) s, (8.67±3.72) s, (8.55±3.93) s respectively. There were signiifcant differences among different positions in reflux time (F=56.9, P<0.01). In detail, no significant differences were identified between standing position and RT-20 or RT-40 position (q=1.51, 1.33 respectively, both P > 0.05), except for supine position (q=4.11, P<0.01). Peak relfux velocity in standing, supine, RT-20 and RT-40 positions were (55.26±22.24) cm/s, (22.87±12.03) cm/s, (38.46±16.30) cm/s, (45.13±19.21) cm/s respectively. There were also signiifcant differences among different positions in peak relfux velocity (F=13.7, P<0.01). Comparing the supine, RT-20 and RT-40 positions with standing position, differences of the peak relfux velocity between them were all statistically signiifcant (q=12.71, 6.59, 3.98 respectively, all P<0.01). Conclusions When GSV reflux was examined by pneumatic cuff compression, false negative rate was higher in the supine position. RT-20 and RT-40 position were effective to detect GSV relfux, espically for GSV at mid-thigh and upper calf.

Objective To investigate the influence of abaI expression on acinetobacter baumannii biofilm formation.Methods Acinetobacter baumannii strain S isolated from bums patients was collected for the study,while the standard strain ATCC19606 was served as the control.At 6,24 and 48 hours,the gene expressions of abaI,pgaA,pgaB and pgaC were detected by real-time fluorescent quantitative PT-PCR,secretion of N-acyl-homoserine lactones (AHLs) by biological sensor and biofilm formation by MTT method.Results (1) Gene expressions of abaI,pgaA,pgaB and pgaC at 6 hours were 8.63 ±5.93,1.98 ± 1.93,1.01 ± 1.32 and 2.67 ± 3.46 respectively,which showed a quick increase at 24 hours (22.81 ± 17.60,5.13 ± 4.32,5.66 ± 3.97,11.97 ± 7.75 respectively),followed by a rapid decline in 48 hours (3.43 ± 0.88,1.30 ± 0.24,3.01 ± 3.00,3.02 ± 3.29 respectively).Gene expressions of pgaB and pgaC at 6 hours and that of pgaA and pgaC at 48 hours revealed statistically significant differences from those at 24 hours (P ＜ 0.05).(2) AHLs showed a level of 18.49 ± 11.03 at 6 hours,reached a peak of 52.23 ± 15.95 at 24 hours,then descended to 5.53 ± 0.94 at 48 hours.AHLs level at 24 hours showed statistically significant difference from that at 6 hours and 48 hours (P ＜ 0.05).(3)Biofilm formation at 24 hours and 48 hours was 2.83 ±0.44 and 2.71 ±0.15 respectively,far higher than that at 6 hours (0.49 ± 0.11,P ＜ 0.05).(4) In the correlation analysis among AHLs,biofilm formation and gene abaI,pgaA,pgaB and pgaC expressions,significant positive correlation was found between abaI and pgaA and between AHLs and pgaC expression (P ＜ 0.05).Conclusion Acinetobacter baumannii may regulate gene expressions of pgaA and pgaC responsible for biofilm formation to adjust to the external environment by means of changing abaI gene expression and AHLs secretion.

Fatty Acids ; metabolism ; Humans ; Myocardial Ischemia ; diagnostic imaging ; metabolism ; Tomography, Emission-Computed, Single-Photon

Humans ; Infant ; Male ; Mandibulofacial Dysostosis

Acute Coronary Syndrome ; complications ; drug therapy ; Adrenergic beta-Antagonists ; therapeutic use ; Aged ; Heart Failure ; complications ; drug therapy ; Humans ; Male ; Middle Aged ; Treatment Outcome

Objective To explore the operation indication of fracture of rib with fracture internal-fixation.Methods The clinical data of 103 cases with Fracture of rib,treated by fracture internal-fixation(n =49)and conservative treatment (n =54) respectively,were retrospectively analyzed.Results The hospital stay time,VAS scores and the healing time of surgical group were lower than that of non-surgical group.Fracture internal-fixation could significantly reduce the incidence of lung infection,deformities of chest and delayed hemathorax.Conclusions Internal fixation of fracture is much better than other routine therapies for fracture of ribs.The patients with indication of operation should operate actively.

Objective To evaluate the diagnostic value of ultrasound-guided pleural biopsy combined with thoracic biochemical detections in malignant and tuberculous pleural effusions. Methods Sixty-four patients with moderate or large pleural effusions and pleural thickening received the ultrasound-guided diagnostic pleural biopsy. All patients had chest CT enhancement scans to find out the suspicious pleural thickening preoperatively, facilitating the selection of puncture sites by ultrasound. Pleural tissue samples were sent for pathological examinations immediately. After successful achievements of pleural biopsy, ultrasound-guided aspiration or drainage was performed to alleviate symptoms, more importantly, to get pleural effusions for biochemical analysis. Biological results including carcinoembryonic antigen(CEA), CA125, CYFRA21 and lactate dehydrogenase(LDH) in malignant and tuberculous effusions were analyzed by group design t tests. The positive rates of CEA, CA125, CYFRA21, LDH in malignant and tuberculous effusions were compared by chi square tests. Results Pleural tissues in all cases were got by one pleural biopsy procedure. The strategy of pleural biopsy we used in this study had a successful rate reaching 100%(64/64), and 73% (46/64) patients had a definitive diagnosis as malignant or tuberculous effusion. Twenty-seven cases were diagnosed as malignant effusions and thirty-seven cases as tuberculous effusions based on the deifnitive clinical diagnosis. The positive rates of CEA, CA125, CYFRA21, LDH in malignant effusions were 100%(27/27), 100%(27/27), 100%(27/27), 89%(24/27) respectively, and 0%(0/37), 84%(31/37), 78%(29/37), 76%(28/37) respectively in tuberculous effusions. The positive rate of CEA between malignant and tuberculous effusions differed signiifcantly (χ2=64.0, P < 0.01), so did CA125 (χ2=3.1, P < 0.01) and CYFRA21(χ2=4.8, P<0.01). The average levels of CEA, CA125, CYFRA21, LDH in pleural effusion were (727.1±658.8)μg/L, (795.2±1249.6)×103 U/L, (296.2±320.7)μg/L, (1077.9±1058.5) U/L respectively, and (1.7±1.1)μg/L, (336.3±208.6)×103 U/L, (20.7±14.9)μg/L, (309.2±182.7) U/L in tuberculous effusions.There were signiifcant differences in CEA, CYFRA21 and LDH concentrations among malignant and tuberculous effusions (t=45.1, 27.4, 18.8 respectively, all P<0.01). Conclusion Ultrasound-guided pleural biopsy combined with CEA, CYFRA21 and LDH in pleural effusions had an important value in the etiological diagnosis of pleural effusions, while CA125 showed little value in the differential diagnosis.

Objective To retrospectively analyze the efficacy and toxicity of intensity?modulated radiotherapy ( IMRT) alone and IMRT with concurrent chemotherapy ( CRT) in the treatment of early?stage nasopharyngeal carcinoma ( NPC) using pairwise group comparison. Methods A total of 98 patients with stage T1?2N1M0 NPC were treated with IMRT alone or CRT from 2009 to 2010, and 39 pairs out of them were selected for comparison of efficacy and toxicity. The survival rates were calculated using the Kaplan?Meier method and analyzed using the log?rank test. Results The 3?year follow?up rate was 95%. There were no significant differences in the 3?year overall survival ( OS ) , progression?free survival ( PFS ) , local recurrence?free survival ( LRFS ) , and distant metastasis?free survival ( DMFS ) rates between the IMRT alone group and the CRT group ( 97% vs. 95%, P=0?411;97% vs. 92%, P=0?301;97% vs. 97%, P=0?606;100% vs. 92%, P=0?082) . The incidence rates of leucopenia, anemia, and thrombocytopenia were significantly higher in the CRT group than in the IMRT alone group ( P=0?000;P=0?000;P=0?000 ) . There were no significant differences in the incidence rates of grade 3 oral mucositis and hearing loss between the IMRT alone group and the CRT group ( 26% vs. 23%, P= 0?093;41% vs. 62%, P= 0?100 ) . Conclusions CRT fails to increase the OS, PFS, and LRFS rates and reduce the DMFS rate in patients with stage T1?2 N1 NPC. Moreover, CRT results in higher incidence rates of hematotoxicity, grade 3 mucositis, and hearing loss than IMRT alone.

Objective To evaluate the efficacy of ~(125)I radioactive seeds implantation and ~(125)I plaque brachytherapy for oral carcinoma. Methods Eighteen patients with oral carcinoma confirmed by cytology or histopathology were included in this study, Twelve patients with tongue cancer and six patients with gingival carcinoma, there were 20 ulcerative lesions and 10 metastatic cervical lymph nodes. The mean diameter is (2.3±0.7)cm and(2.8±1.7)cm respectively. The patients were treated with both interstitial implantation of ~(125)I seeds and ~(125)I plaque brachytherapy or with ~(125)I plaque brachytherapy only according to patient's individual conditions.The metastatic cervical lymph nodes were treated with CT-guided interstitial implantation of ~(125)I seeds.The sizes of ulcerative lesions and lymph nodes were observed at 1,3,6 months following treatment,and statistical analysis of the sizes of ulcerative lesions were evaluated by paired t-test.Results After 1,3,6 months follow-up,The mean diameters of ulcerative lesions were(2.1±0.6)cm(t=3.559,P＜0.01),(1.7±0.5)cm(t=7.609,P＜0.01),(0.7±0.6)cm(t=11.508,P＜0.01),the cervical lymph nodes showed reduced size. Furthermore, PET-CT images showed a significant decrease in the metabolic activity of treated tumor. After six months, the focus of infection were healing in 8 patients, the cervical lymph nodes of one patient relapsed after ~(125)I implantation again. Patients were followed for 7 to 28 months, all patients were still alive. Conclusion Interstitial ~(125)I radioactive seeds implantation and ~(125)I plaque brachytherapy provide an effective, safe treatment for oral cancer.