Objective To explore the value of dual energy CT imaging in the diagnosis of gouty tophus deposition.Methods Sixty-five cases of patients with gout treated in this hospital between December 2012 to December 2015 were selected.Another 65 cases of patients(rheumatoid arthritis,degenerative osteoarthritis and unexplained leg pain) were selected as control group.The re sults of dual energy CT imaging between two group were compared.Three experienced clinicians who didn't understand the imaging results were selected.They had a medical history and physical examination in patients with gout.The differences between clinical evaluation and imaging results were compared.Results Dual energy CT imaging showed that there were no tophi deposition in con trol group;the topi deposition in wrist joint,knee joint and ankle joint were 6.06％oo (33/34),100.00％ (22/22) and 96.49％ (55/57) in gout group.Dual energy CT imaging detected a total of 545 parts of tophus deposition.It was 4.36 times of the result of clinical evaluation(125 parts).Conclusion Dual energy CT imaging shows the advantages of simple noninvasive,high accuracy and low rate of misdiagnosis in diagnosing gout nodules.

Objective_To evaluate the clinical profile of ANI-guided remifentanil administration during posterior lumbar spinal surgery.Methods_Sixty patients undergoing selective posterior lumbar decompression laminectomy and internal fixation were randomized into two groups, ANI-guided analgesia group ( ANI group) and another group which was blinded to ANI ( control group) .In both groups, combined propofol-remifentanil target control infusion ( TCI) was performed, In ANI group, the concentration of remifentanil was adjusted to maintain ANI values be-tween 50 and 70, however, in the control group, remifentanil target concentration was adapted corresponding to HR or BP values.Anesthetics consumption, incidence of unwanted events, interventions, time of open-eyes and extu-bation, VAS0h and VAS1/2h, complementary analgesics, intraoperative awareness, PONV and other symptoms were recorded.Results_Remifentanil consumption was lower in ANI group than that in control group ( P<0.05) . The number of unwanted events( hypotension, bradycardia and total unwanted events) were also less in ANI group than that in control group (P<0.05).Compared with control group, the usage of urapidil was more and the usage of volume expansion was less in ANI group( P<0.05) .There was no significant statistic differences in other index
between two groups.Conclusions_ANI-guided remifentanil infusion resulted in application of lower remifentanil administered dose with more stable hemodynamics in posterior lumbar spinal surgery.

Objective To investigate the species of Acaroid mites breeding in the stored traditional Chinese animal medici?nal materials and the relationship between its community and habitats. Methods A total of 30 samples of traditional Chinese animal medicinal herbs were collected from Wuhu City,Anhui Province,China. The mites were isolated by the directly micro?scopic and floatation microscopic examinations,and then identified and counted under a light microscope. Results Acaroid mites was represented in 28 of the 30 samples,and the breeding rate accounted for as high as 93.3%(28/30). Totally,13 spe?cies of Acaroid mites were identified,which belonged to 4 families and 9 genera. The densities of Acaroid mites were top in 6 Chinese herbal medicines,such as corium erinacei,aspongopus,hirudo,pheretima aspergillum,Apostichopus and huechys. The diversity parameters of these six traditional Chinese animal medicinal herbs were calculated. The highest richness indexes were in aspongopus and hirudo,the highest diversity index was in hirudo,and the highest evenness index was in Apostichopus. Conclusions There are Acaroid mites breeding in parts of the traditional Chinese animal medicinal herbs stored in Wuhu. In the storage and processing of Chinese herbal medicines,we should pay attention to the prevention and control of mites.

Background Chondrocytes' phenotype and biosynthesis of matrix are dependent on having an intact cytoskeletal structure.Microfilaments,microtubules,and intermediate filaments are three important components of the cytoskeletal structure of chondrocytes.The aims of this study were to determine and compare the effects of the disruption of these three cytoskeletal elements on the apoptosis and matrix synthesis by rabbit knee chondrocytes in vitro.Methods Chondrocytes were isolated from full-thickness knee cartilage of two-month-old rabbits using enzymatic methods (n=24).The isolated cells were stabilized for three days and then exposed to low,medium,and high doses of chemical agents that disrupt the three principal cytoskeletal elements of interest:colchicine for microtubules,acrylamide for intermediate filaments,and cytochalasin D for actin microfilaments.A group of control cells were treated with carrier.Early apoptosis was assessed using the Annexin-FITC binding assay by flow cytometry on days 1 and 2 after exposure to the disrupting chemical agents.The components and distribution of the cytoskeleton within the cells were analyzed by laser scanning confocal microscopy (LSCM) with immunofluorescence staining on day 3.The mRNA levels of aggrecan (AGG) and type Ⅱ collagen (Col-2) and their levels in culture medium were analyzed using real-time PCR and enzymelinked immunosorbent serologic assay (ELISA) on days 3,6,and 9.Results In the initial drug-dose-response study,there was no significant difference in the vitality of cells treated with 0.1 μmol/L colchicine,2.5 mmol/L acrylamide,and 10 μg/L cytochalasin D for two days when compared with the control group of cells.The concentrations of colchicine and acrylamide treatment selected above significantly decreased the number of viable cells over the nine-day culture and disrupted significantly more cell nuclei.Real-time PCR and ELISA results showed that the mRNA levels and medium concentrations of AGG and Col-2 were significantly decreased for cultures treated with colchicine and acrylamide when compared with untreated cells at three,six,and nine days,and this inhibition was correlated with higher matrix metalloprotease-13 expression in these cells.Cellular proliferation,monolayer morphology,and matrix metabolism were unaffected in cytochalasin D-treated cells when compared with control cells over the nine-day culture period.Conclusions The disruption of the microtubulin and intermediate filaments induced chondrocyte apoptosis,increased matrix metalloprotease expression,and decreased AGG and Col-2 expression in rabbit knee chondrocyte cultures.Our findings suggest that microtubulin and intermediate filaments play a critical role in the synthesis of cartilage matrix by rabbit knee chondrocytes.

Objective:To evaluate the relationship between the mechanism of promoting wound healing by modified autologous blood transfusion and metastasis-associated lung adenocarcinoma transcript 1 ( MALAT1) in diabetic mice. Methods:Twenty SPF ICR mice, weighing 21-25 g, in which the diabetic model was successfully established, were divided into 2 groups ( n=10 each) using a random number table method: modified preservation group (group I) and ordinary preservation group (group O). Peripheral venous blood samples were collected and stored in the corresponding preservation solution for 7 days.The platelet aggregation rate, blood glucose, serum glycosylated hemoglobin (GHB) and phosphodiesterase (DPG) concentrations and WBC were measured.Autologous blood was transfused back immediately after the wound model was established.The percentage of wound healing area was calculated at 7, 10 and 14 days after autologous blood transfusion.The expression of hypoxia-inducible factor-1α, vascular endothelial growth factor, matrix metalloproteinase-9, β-actin, type Ⅰ collagen (Col Ⅰ), Col Ⅲ protein and mRNA and MALAT1 was determined by Western blot, immunohistochemistry and quantitative real-time polymerase chain reaction respectively, at 14 days after transfusion. Results:Compared with group O, the blood glucose, serum concentrations of GHB and DPG, and WBC were significantly decreased, platelet aggregation rate was increased, the percentage of wound healing area was increased, the positive staining rate of Col Ⅰ and Col Ⅲ was increased, and the expression of hypoxia-inducible factor-1α, vascular endothelial growth factor, matrix metalloproteinase-9, ColⅠ, Col Ⅲ and β-actin protein and mRNA and MALAT1 was up-regulated in group I ( P<0.05). Conclusion:The mechanism by which modified autologous blood transfusion promotes wound healing may be related to up-regulating MALAT1 expression in diabetic mice.

Objective To investigate the protection effect of inferior vena cava filter on pulmonary embolism in patients with deep venous thrombosis(DVT) of lower extremities. Methods Inferior vena cava filters were placed in 55 patients with DVT. Simon Nitiol filter(SNF) was used in 25 cases,Trap Ease filter(TEF) in 13 cases and Antheor Temporal filter(ATF) in 17 cases.10 patients with DVT were treated by non operation therapy,45 patients by operation and transluminal angioplasties.Whether patients occurred pulmonary embolism was observed clinically,and the form and site of SNF and TEF were monitored by periodic fluoroscopy . Results Inferior vena cava filter was placed successfully in all patients.Symptoms and signs of DVT disappeared in all the patients after treatment . None of the putients occurred pulmonary embolism in this series. One case occurred inferior vena cava thrombolism in 16 months after SNF placement. Thrombus attached to ATF after the ATF taking off from inferior vena cava was found in 17 cases.Conclusions Inferior vena cava filter placement is a simple, safe and efficient method to prevent pulmonary embolism in a short period.But its long term complications should be considered and investigated.

Objective To detect and analyze the mutation of fibroblast growth factor receptor 3(FGFR3) gene among a family with congenital achondroplasia(ACH).Methods Six blood samples of family member in this pedigree were cellected according to the informed consent process for genetic research,and 2 unralted healthy human blood sample were taken as controls.The mutation at nucleotide position 1 138 on FGFR3 gene was detected by using Polymerase chain reaction and single-strand conformation polymorphism(PCR-SSCP)and polyme-rase chain reaction and restriction endonuclease technology(PCR-RFLP) methods.Results Using PCR-SSCP method firstly,only the proband with ACH and his father in this family had the same abnormal band.The amplified products including 1 138 loci on FGFR3 gene further was analyzed by Sfe Ⅰ digestion,3 fragments including 164 bp,109 bp and 55 bp were detected in the proband and his father again,and the other members in the family and 2 controls just showed 164 bp band.It indicated that just 2 patients (proband and his father) showed heterozygous G→A transition mutation at nucleotide position 1 138 on the FGFR3 gene.The amplified products at 1 138 loci was also detected by MspⅠ digestion,just 1 band was observed in all members in this family and 2 controls.It showed that there was no G→C substitution at nucleotide position 1 138.Conclusions The G→A transition mutation at nucleotide position 1 138 in transmembrane domain of FGFR3 gene may be the main cause of achondroplasia in this family.In this pedigree,the proband showed's father a de novo mutation which was transferred to his child again.

Objective To summarize the clinical features,neuroimaging findings and pathological characteristics of demyelinating pseudotumors(DPT)of the brain,and to differentiate it from glioma. Methods The clinical features,neuroimaging findings and pathological characteristics of 35 patients with demyelinating pseudotumors of the brain were summarized,and the diagnosis for 18 of them was confirmed by bioscopy.Results Demyelinating pseudotumors affected adults of both sexes.The onset age of patients ranged from 9 to 69 years old.There was no definite antecedent,and the clinical syndromes were atypical. Neuroimaging scans showed multiple lesions in cerebral hemisphere,while the lesion in brain stem and spinal cord was single.The symptom and neuroimaging were not parallel.While with many or large lesions, the symptoms and signs were less.The lesions were not enhanced on CT scan,but appeared round or patch enhancement on MRI scan.Nine patients with DWI all appeared high density.The myelin basic protein was useful for diagnosis.The typical pathological changes were demyelination,perivascular inflammatory infiltration and reactive gliosis.The Creutzfeuldt cells were also found in these patients.The lesions might become small or disappear after treatment,but could not serve as the criterion to exclude brain neoplasm. Conclusions DPT is a distinct demyelination disease entity,which is confusable with brain neoplasm.It is difficult to distinguish DPT from brain neoplasm with the clinical features and conventional neuroimaging scan.But DWI scan is useful.The pathological changes accord with demyelination,and Creutzfeuldt cells are also found.It is important to apply corticosteroid treatment or biopsy rather than being anxious to excise the lesions.

Objective:To summarize experience of 8 lower limb deep venous thrombosis(DVT) patients who used OptEase recyclable vesa cava filter(VCF) during in operations.Methods:Through collecting the clinical data of 8 patients who used OptEase recyclable vena cava filter(VCF) ,analyzing the method of recycling and releted complications.Results:No pulmonary embolism happened during and after operations,when recycle VCF implanted,vena cava graphy shows:inperfection thrombous near the filter in 1 case and vena iliaca thromb of uninjure side in 1 case too,reclaiming successfully in 5 cases,3 cases turn to permanent placement.FolIowing-up observation for 3-8 months,recurrence of limbs vena thrombosis never happened.Conclusion:The recyclable vena cava lilter could prevent plamonary embolism effectively in lower limb deep venous thrombosis patients.

Objective:To express and purify hemoglobin receptor(HgbA) and its partial fragment(HgbAF) from Haemophilus ducreyi and to develop a sandwich ELISA for the detection of H.ducreyi infection.Methods:The HgbA,a hemoglobin-binding outer membrane protein of H.ducreyi and its partial fragment(HgbAF) were expressed by cloning the genes of hgbA and its 705bp fragment into pET30a and pET28a respectively,and the expressing products were purified from E.coli BL21 with Ni-NTA-His affinity chromatography.The polyclonal antibodies were developed by immunizing rabbits with the rHgbA and rHgbAF.The anti-rHgbA IgG and anti-rHgbAF IgG were purified respectively by saturated amine sulphate precipitation,and their immunoactivity with rHgbA and rHgbAF was tested by Westen blot and ELISA analysis.A Sandwich ELISA was developed for the detection of chinical infection of H.ducreyi using the specific polyclonal antibodies.Results:The HgbA and its partial fragment,HgbAF of H.ducreyi,were expressed and purified successfully by cloning their genes respectively.The results obtained by Western blot analysis showed that each of the antibodies could react with both antigens,rHgbA and rHgbAF.The results of the ELISA analysis showed that H.ducreyi strain was strongly positive,and all other bacteria,including H.influenzae and the bacteria known to relate to genital ulcers were negative.The results of the ELISA analysis showed that the minimum amount of rHgbA detected was 1.56 ng/ml and the minimum number of CFU of H.ducreyi detected was 2?105 cfu/ml in buffer and 1?106 cfu/ml in pus.Conclusion:HgbA and its partial fragment,HgbAF of H.ducreyi are expressed and purified successfully.The polyclonal antibodies developed by immunizing rabbits using rHgbA and rHgbAF could react not only with rHgbA and rHgbAF,but also with H.ducreyi specifically.They do not react with other bacteria,including H.influenzae and the bacteria known to relate to genital ulcers.So the ELISA based on the polyclonal antibodies was specific for the detection of H.ducreyi.Although the level of sensitivity of the ELISA may not be sufficient to detect H.ducreyi in all clinical specimens,further work to increase the sensitivity could potentially make this assay a valuable tool in areas where chancroid is endemic.