[Abstract] Objective To evaluate the effect of Mycobacterium tuberculosis Direct Assay (MTD) for rapid detecting Mycobacterium tuberculosis rRNA and Multi-locus PCR for M.bovis BCG strain typing in patients with suspected extra-pulmonary tuberculosis.Methods From June 2010 to December 2011,47 children and 75 adult patients with suspected extra-pulmonary tuberculosis in Shanghai public health clinical center were recruited.Also 48 non-tuberculosis patients were taken as a negative control.Clinical specimens from these patients were collected.Acid fast stain,solid culture,liquid culture,and MTD were used to detect all clinical specimens simultaneously.Screen tuberculosis strains of the culture isolates by MPT64 antigen assay and use Multi-locus PCR for the BCG strain genotyping of the isolates without MPT64 antigen.SPSS16.0 was used to analyse the results.Results The sensitivity for acid fast stain,solid culture,liquid culture and MTD test was 10.7％ (13/122),11.5％ (14/122),16.4％ (20/122) and 37.7％ (46/122),respectively.And the specificity of MTD was 100.0％.Six clinical isolates from children were identified as BCG by Multi-locus PCR typing,the same with chemical tests.Conclusions The MTD assay and the MGIT960 liquid culture are effective and reliable method for diagnosing extra-pulmonary tuberculosis.And Multi-locus PCR can be assisted for the early diagnosis of extra-pulmonary tuberculosis patients with suspected BCG infection.

Child, Preschool ; Humans ; Male ; Myiasis ; diagnosis

Anti-Bacterial Agents ; therapeutic use ; Chronic Disease ; Diagnosis, Differential ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Male ; Medicine, Chinese Traditional ; Phytotherapy ; Prostatitis ; diagnosis ; drug therapy

Child, Preschool ; Chronic Disease ; Humans ; Male ; Tuberculosis, Miliary

Objective To establish the rapid pathogen identification method for HIV and Mycobac-terium tuberculosis (Mtb)co-infection and the assay for the drug susceptibility. Methods Geneprobe and 16S rDNA sequencing were used to differentiate mycobacterium species and modified microscopic observation drug susceptibility (MODS) was used for the drug susceptibility test. The above assays were compared with acid-fast smear, L-J culture and proportional drug susceptibility tests. Results (1) Thirty-four mycobacte-rial isolates were obtained from 112 samples collected from 68 HIV patients. Among these isolates, the strain species were determined by Geneprobe and 16S rDNA sequencing as the followings: 21 Mtb complex, 10 NTM including 5 M.avium complex, 2 M.gordonae, 2 M.kansasii, 1 M.colombiense, and 3 co-infection. (2) The sensitivity of Mtb to rifampicin, ethambutol, isoniazid and streptomycin were 100%, 100%, 76.2%, 90.5% respectively, while the sensitivity of NTM to rifampicin, ethambutol, isoniazid and strepto-mycin were 40%, 60%, 0%, 30% respectively. There is no significant statistic difference between the two methods, MODS and the reference standard, for the drug susceptibility test. (3) Six to eight weeks are nee-ded for the identification of the species of mycobacteria and the drug susceptibility test by using traditional method. In this study, 5-14 d, 6-15 d and 10-14 d are needed for Geneprobe, 16S rDNA sequencing, and MODS respectively. The time for the testing has been dramatically shortened. Conclusion The identifica-tion of mycobacterial species and the drug susceptibility test using clinical samples could be completed within 15 days by using combined Geneprobe, 16S rDNA sequencing and modified MODS. This combined method can be used for the pathogen identification and drug resistant test in HIV patients who are co-infected by my-cobacteria.

BACKGROUND: Studies showed that both anterior cervical disc replacement and anterior cervical decompression and fusion can achieve good clinical result in cervical spondylosis. However, it is not conclusive about which kind of surgical method has an advantage in avoiding the adjacent segment degeneration. OBJECTIVE: To compare the effect on adjacent segment degeneration of single segment cervical disc herniation treated with anterior cervical decompression and fusion and anterior cervical disc replacement. METHODS: We col ected clinical data of 178 patients with cervical disc herniation and receiving anterior cervical disc replacement or anterior cervical decompression and fusion from January 2009 to December 2012. A retrospective analysis was performed. There were 116 cases in the anterior cervical decompression and fusion group and 62 cases in the anterior cervical disc replacement group. RESULTS AND CONCLUSION: (1) Evaluation: visual analogue scale score, Japanese Orthopaedic Association Scores and neck disability index were improved significantly in both groups during final fol ow-up compared with that pre-treatment (P < 0.05). (2) No significant difference in range of motion of operation segment, adjacent upper segment and adjacent lower segment was detected between final fol ow-up and pre-operation in the anterior cervical disc replacement group (P > 0.05). At 3 months after surgery, in the anterior cervical decompression and fusion group, surgical segment was confluent, and range of motion lost. During final fol ow-up, range of motion of adjacent upper segment and adjacent lower segment was significantly increased, and the increased range of motion in the upper segment was bigger than that of the lower segment (P < 0.05). (3) During final fol ow-up, X-ray films and MRI images revealed the number of degenerated adjacent segment was more in the anterior cervical decompression and fusion group than in the anterior cervical disc replacement group (P <0.05). The number of degenerated middle and upper segments was more than that of the lower segment in both groups (P < 0.05). (4) The findings confirmed that anterior cervical disc replacement or anterior cervical decompression and fusion for treating cervical disc herniation could effectively relieve nerve symptoms of patients. However, compared with the anterior cervical disc replacement, adjacent segment degeneration occurs more commonly after anterior cervical decompression and fusion.

Objective To analyse the correlation between hepatitis B virus infection in mother and immune effect of hepatitis B vaccine in infant so as to explore ways to prevent mother-to-infant transmission.Methods 8 022 aged from 7 months to 2 years old children and their mothers were selected.The children's HepB immunization were investigated.The serological investigation of mother and children were tested by the colloidal gold tripes and ELISA methods.The HBV genotype were detected among HBsAg positive mother.Results The mother's carry rate of HBsAg was 2.43% while the children's was 0.45%.The protect rate of HepB was 81.48%.127 genotype C were detected among 146 HBsAg positive mothers.There were 26 pair of mothers and their children whose's HBsAg were both positive.Nine of the mother's HBeAg and HBcAb were positive.While five of the mother's HBeAb and HBcAb were positive,and ten of the mother's HBcAb were positive.The differences of the three were statistically significant (?2=6.03,P

Educational reform of pathophysiology oriented to clinical application is to pass the physician qualifica -tion examination .One of essential approach is to implement pathophysiology teaching with the translational medical philosophy and promote the harmonious development of physician -patient relationship with the utilization of the de-velopment and changes of disease in the teaching process .In that way, the pathophysiology in basic and clinical medicine is worthy of the name of “bridge”, and ultimately achieves the goal of “the transformation and develop-ment of the cultivation of clinical application talents”.

BACKGROUND:Mimics software is a three-dimensional (3D) image processing and editing tool based on CT scan data. Mimics software can rebuild the data and images gotten in CT, MRI and ultrasound scans into 3D images and display on the computer screen so as to help clinicians understand the type of fracture and the relationship of the 3D structure of the surrounding tissue and to provide a great help in the development of orthopedics operation. OBJECTIVE:To explore the application effect of Mimics software 3D reconstruction on perioperative period of Pilon fracture. METHODS:This study selected 61 cases of Pilon fracture, who received the surgery in the Zhongshan City Xiaolan People’s Hospital from September 2008 to September 2013, as research objects. They were randomly divided into 3D group and control group in accordance with the time of admission. Al patients underwent anterioposterior and lateral X-ray film examination and multi-slice spiral CT scan. Patients in the control group received internal fixation according to above examination results. Patients of the 3D group, on the base of those of the control group, were subjected to internal fixation after three-dimensional entity reconstruction by using Mimics V 10.0 software. Operation time and functional curative effect in the postoperative folow-up were compared between the two groups. RESULTS AND CONCLUSION:The operation time was significantly less in the 3D group than in the control group (P < 0.05). The number of patients with excelent 6-month functional curative effect was more, and the number of patients with poor effect was less in the 3D group than in the control group. The 6-month functional curative effect was better in the 3D group than in the control group (P < 0.05). These results showed that the application of Mimics software 3D reconstruction to the perioperative period of Pilon fractures can give comprehensive assessment of the situation of fracture, optimize and improve the preoperative plan and reduce the risk of surgery, and promote the successful completion of internal fixation.

Objective To investigate the characteristics and risk factors of the injured children Under the age of 14 in Dongguan area and provide the basis for making the specific protective measures.Methods A retrospective analysis of 1707 clinical cases of the injured children in the emergency department of our hospital from 2006 to 2010.Results The incidence rate of child injury in Dongguan area is high,accounting for 3.25％ of the emergency people at the same period.Fall-wound is at the first place of the causes of injury,accounting for 30.52％ ; traffic accident injury and bums are in the second place,accounting for 19.22％ and 11.42％ ; the incidence rate of 7-10 years-old child injury is the highest,38.25％ ; the incidence rate of boys injury is higher than girls; the incidence rate of the child injury of the children in these family such as their parents are separated,their mother are just senior high school graduates or the per capita monthly income for the whole family is less than RMB 3000 yuan is higher.There are 7 different degree of disability cases caused by injury and 10 death cases resulted from injury.Conclusions To carry out the pointed health education,average up the level of safety protection of parents and teachers,to strengthen the management of child injury surveillance and damage hazards,so as to minimize the occurrence of child injury.