Objective To investigate the relationship between Ambulatory Arterial Stiffness Index (AASI)and kidney damage or carotid endarterectomy damage in hypertension patients.Methods One hundred and forty-nine patients with hypertension but without diabetes or other arteriosclerosis diseases were enrolled.Forty-eight healthy volunteers during the same period were enrolled as control group.All participants'24 h-ambulatory blood pressure monitoring(ABPM),urinary albumin/creatinine ratio(ACR)and IMT were recorded and AASI was calculated.Then the correlation between AASI and ACR or IMT were calculated.Results There were significant differences in the urinary albumin/creatinine ratio(46.34 vs.33.52)(P ＜ 0.05),microalbuminuria incidence(41％ vs.21％),Carotid intima-media thickness([0.90 ±0.21]mm vs.[0.83 ±0.20]mm),abnormal incidence(72％ vs.60％)and AAS1(0.50 ± 0.16 vs.0.42 ± 0.17)(P ＜ 0.01)between the subjects with hypertension and those without.The AASI were positively correlated with ACR and IMT in hypertension patients.Compared with healthy subjects,the AASI were significantly increased in the patients with abnormal CR and IMT(P ＜0.05 、P ＜0.01).Conclusion The AASI were correlated with kidney damage and carotid endarterectomy damage in hypertension patients.

Objective To investigate the distribution and drug resistance of bacterial pathogens isolated from peritonsillar abscess .Methods Data on bacterial pathogens isolated from peritonsillar abscess in Wenzhou Central Hospital from January 2010 to December 2014 were retrospectively analyzed .Strains were identified with Vitek 32 identification system and the drug susceptibility test was performed with K-B method.Chi-square test for linear trend was performed to reveal the changes of distribution and drug resistance of the strains .Results A total of 2 864 bacterial strains were isolated in five years , in which 1 786 strains were Gram-negative bacilli (62.4%), and 1 078 (37.6%) strains were Gram-positive cocci. The positive rate of Gram-negative bacilli was on the rise during year 2010-2014 (χ2 =84.74, P<0.01), and the top three Gram-negative bacilli were Pseudomonas aeruginosa, Acinetobacter baumannii and Haemophilus influenzae, which accounted for 72.5%(1 295/1 786) of the total Gram-negative strains, and the positive rates of first two bacilli were on the rise (χ2 =83.75 and 24.74, P<0.01).Gram-positive cocci were mainly Staphylococcus aureus and Hemolytic streptococcus, which accounted for 83.2% ( 897/1 078) of the total Gram-positive strains.Resistance rates of Pseudomonas aeruginosa to ceftazidime, cefoperazone, piperacillin/tazobactam were on the rise (χ2 =16.17, 13.48 and 11.44, P<0.05), while resistance rates to gentamicin and amikacin were on the decline (χ2 =16.54 and 16.63, P <0.05). Resistance rates of Acinetobacter baumannii to ceftazidime, cefoperazone/sulbactam and piperacillin/tazobactam were on the rise (χ2 =12.52, 10.85 and 14.14, P<0.05).Resistance rates of Haemophilus influenzae to ampicillin were on the rise (χ2 =10.21, P<0.05), and the positive rate of β-lactamase producing strains was also on the rise (χ2 =10.38, P<0.05).Resistance rates of Staphylococcus aureus to cefazolin and methicillin were on the rise (χ2 =15.44 and 12.53, P<0.05), but no vancomycin resistant strain was found .Hemolytic streptococcus were sensitive to all commonly used antibiotics .Conclusions Peritonsillar abscess in Wenzhou Central Hospital is mainly induced by Gram-negative bacilli infection . Pseudomonas aeruginosa, Acinetobacter baumannii and Staphylococcus aureus are the top three bacterial pathogens , and are highly resistant to most antibiotics .

Objective To discuss the risk factors of ventilator-associated pneumonia (VAP) in intensive care unit(ICU).Methods From January 2008 to June 2010,the clinical data of 145 patients with mechanical ventilation over 48 hours in ICU were analyzed prospectively,and the effect was observed.Results There were a total of 53 patients with VAP,and the incidence was 36.6％ (53/145).Thirty-three cases died,and the fatality rate was higher than that in non-VAP patients [62.3％ (33/53) vs.30.4％ (28/92)],and there was significant difference (P ＜0.05).Related factors analysis results showed that indwelling gastric tube,the use of antiacids,mechanical ventilation time,nutritional status,age ≥ 60 years and chronic diseases were the risk factors of VAP (P ＜ 0.05 or ＜ 0.01).Conclusion VAP has many risk factors and higher fatality rate in ICU,and comprehensive prevention measures should be adopted to prevent the occurrence of VAP.

Objective To study the relationship between the washout speed in the contrast-enhanced ultrasound (CEUS) and the differentiation grading in pathology in patients with hypervascular hepatocellular carcinoma (HCC).Methods Totally 271 patients who underwent complete resection for hypervascular HCC from April 2009 to December 2014 at Nanchong Central Hospital were included in this study.CEUS examinations were perfomred in all patients 2-3 days before liver resection.A timer on the ultrasound screen displayed the time elapsed since the saline flush was used to determine time to washout.The washout rate were categorized into four levels based on enhancement in portal venous phase and delayed phase.The differentiation grade and the washout speed were compared using Kruskal-Wallis test.Results All 271 (100％) lesions were arterially enhanced with different washout rate.Washout speed 1 was found in 19 patients (7.0％),while speed 2 in 157 patients (57.9％),speed 3 in 65 (24.0％),and speed 4 in 30,respectively.The washout speed had a significant correlation with the differentiation (x2=179.8238,P ＜ 0.001).The faster washout speed,the higher differentiated.Washout speed 1 could distinghuish well-differentiated from the poor and moderately differentiated tumor.The sensitivity and specificity of preoperative washout speed 1 to identify well histologic grade were 98.0％ and 77.8％,the positive predictive value and negative predictive value were 96.0％ and 48.8％,and the positive likelihood ratio and negative likelihood ratiowere were 1.9 and 0.01.Washout speed 4 could distinghuish poor differentiated from well and moderately differentiated tumor The sensitivity and specificity of preoperative washout speed 4 to identify poor histologic grade were 24.3％ and 97.0％,the positive predictive value and the negative predictive value were 65.3％ and 61.3％,and the positive likelihood ratio and negative likelihood ratiowere were 3.2 and 0.7.Conculsions Washout speed can reflect the degree of differentiation roughly.Washout speed can effectively diagnose the well-differentiated HCC,but it is difficult for moderate and poor differentiated HCC.

Objective To investigate the risk factors for death within 30 days of stroke associated pneumonia(SAP) in elderly patients of the intensive care unit (ICU).Methods Clinical data of 116 patients with SAP who were admitted to ICU were reviewed.The predicting factors of death within 30 days were analyzed through variable analysis method.Results The hospitalization periods of the SAP group and control group were (27±8) d and (12±5) d,the difference was statistically significant(t =1 1.30,P =0.002).The most common pathogenic bacteria in SAP were Klebsiella pneumoniae,Bauman Acinetobacter,Escherichia coli,and gram negative bacteria.There was significant difference between the two groups in term of mortality rate(37.9％(44/ 116) of SAP group,22.0％ (22/100) of control group,x2 =6.423,P =0.011).Logistic regression analysis showed that basic diseases(OR =2.778,95％ CI:1.205-6.401),high CRUB-65 score (OR =1.978,95％ CI:0.871-11.098),lower Glasgow coma score(GCS) (OR=3.601,95％CI:0.244-9.477),bucking(OR=3.020,95％CI:1.305-10.603),mechanical ventilation(OR=2.654,95％CI:1.176-5.990),shock(OR=2.636,95％ CI:1.164-5.969) and high plasma CRP level(OR=2.333,95％CI:1.046-5.206) were risk factors for SAP (all P＜0.05).In Cox regression analysis,a GCS score of ＜ 9 was an independent risk factor for 30 d mortality of patientswithSAP(HR=7.23,95％Cl:2.24-20.11,P=0.001).Conclusion SAP is one of the serious complications of the elderly hospitalized for the acute stroke in the ICU,which may affect the prognosis of the patients.

Objective To determine the power-time-ablation scope correlogram of a water-cooled single needle electrode radiofrequency (RF) ablation system and to establish a theoretical basis for its practical application.Methods RF ablations were performed using a water-cooled single needle electrode radiofrequency ablation system developed by the authors using fresh ox liver as well as liver and muscles of healthy adult New Zealand white rabbits.The temperature of the ablation area was monitored using a multichannel thermometric system.The maximum ablation scope was determined by detecting the rim at which the temperature was no less than 50 °C.The specific absorption rate (SAR) of the isolated liver tissue was calculated.Results In the treatment voltage range of 100-130V,the process was smooth and steady.No impedance variation was obvious.The maximum diameter of a single ablation was 51 cm.With the treatment voltage at 140-170 V,a larger ablation area could be reached in less time,but eventually the impedance began to increase while the ablation area was no longer expanded.When the treatment voltage reached the range of 180-200 V the impedance almost always increased rapidly out of limits,and the treatment system stopped automatically.The measured SAR value was consistent with the theoretical value.Pathology confirmed that both liver tissue and muscle tissue manifested typical coagulative necrosis.Conclusions The power amplifier,cooling,thermometric and control sections of the RF ablation system worked stably,and the practical ablation effect met the design and clinical treatment requirements.

Objective To evaluate the value of CT guided percutaneous lumbar diskectomy (CT PLD) at plateau area. Methods Sixty eight cases of lumbar disc herniation was reated with CT PLD. (1)Before operation, diseased intervertebral disc was scanned, cases were selected, and operation plan was plotted . (2)The best puncture arrangement was chosen on the current video CT picture by designing the puncture path, noting down the puncture parameter, and marking the puncture spot on patient′s body surface. (3)Puncture was performed according to fixed parameter. (4)Operation was performed after the puncture needle was put into the disc ascertained by scan.(5)CT scan was done again after operation to observe if the puncture path had bleeding and intervertebral disc recovery. Results After 3 to 18 months′ follow up, 28 cases were prominent effective and 36 cases effective. The lumbar disc backed 1 to 4 mm. The total effective rate was 94.12%. Conclusion CT PLD is an ideal therapeutic method for lumbar disc herniation at plateau area because it is safe and effective and with less complications.

Objective To investigate the effect of cluster needling at scalp points plus gavage of modified Buyang Huanwu decoction on NSC differentiation in rats with ischemic stroke of qi deficiency and blood stasis type.Methods A model of qi deficiency and blood stasis syndrome was made using healthy rats. Dil dye was given for pre-labelling after the success of model making. The rats were randomized into groups A, B, C, D, E and F. Group F consisted of 4 rats and each of the other groups, of 12 rats. A rat model of ischemic stroke of qi deficiency and blood stasis type was made by MCAO at 48 hrs after pre-labelling. After the success of model making, group A was the model group, group B was treated by cluster needling at scalp points, group C was treated by an oral gavage of Buyang Huanwu decoction, group D was treated by an oral gavage of modified Buyang Huanwu decoction, group E was treated by cluster needling at scalp points plus an oral gavage of modified Buyang Huanwu decoction and group F was the sham operation group. The rats were sacrificed at various time points respectively and the materials were taken. By nerve function assessment, double immunofluorescence staining and laser scanning confocal microscopy, a comparative study was conducted to investigate the effects of different treatments on NSC differentiation.Results There was a statistically significant difference in the nerve function score between group B, C, D, E or F and group A after one week of treatment (P<0.01), between group B or E and group A after two weeks of treatment (P<0.05,P<0.01) and between group E and group C or D after one and two weeks of treatment (P<0.01,P<0.05). After one and two weeks of treatment, there were statistically significant differences in Brdu﹢/NeuN﹢ cell count, Brdu﹢/GFAP﹢ cell count, Dil﹢/Brdu﹢NeuN﹢ cell count and Dil﹢/Brdu﹢/GFAP﹢ cell count between group B, C, D or E and group A (P<0.01), between group D or E and group B or C (P<0.01) and between groups E and D (P<0.01).Conclusions Various treatments have a promoting effect on nerve stem cell differentiation in the rats. Of various treatments, cluster needling at scalp points plus gavage of modified Buyang Huanwu decoction has the best therapeutic effect.

This paper introduces HIFU system software based on a phased-array HIFU device. Combined with the database and computer graphics technology, this HIFU system software can be used to develop the therapy planning semi-automatically, implement the pilot project efficiently and accelerate the clinical studies.
Computer Graphics ; High-Intensity Focused Ultrasound Ablation ; methods ; Software ; Software Design

Objective:To analyze the epidemiological characteristics of the first case of human infection with H7N9 avian influenza in Gansu province, and to provide scientific basis for the prevention and control of H7N9 avian influenza.Methods:The epidemiological investigation method was used to investigate the incidence and treatment, possible infection sources, transmission routes and exposure factors of the first human case of H7N9 infection in Gansu province, medical investigation was also conducted for close contacts, and external environmental samples were collected for detection. Moreover, we initiated disinfection of the epidemic area.Results:The first case of human infection with H7N9 avian influenza confirmed in Gansu province was an 82-year-old male urban resident. He went to a private clinic for cough on March 29, and went to Jiuquan City Hospital on April 3 for treatment. The patient had a history of activities near the live poultry sales store where H7N9 virus nucleic acid was tested positive, The positive test result of H7N9 avian influenza virus nucleic acid detected from pharynx swab was consistent with those of the Provincial and National Centers for Disease Control and Prevention. The case was carefully treated and cured 17 days after the onset. Nine close contacts underwent a 7 days medical health observation, which did not show any health abnormalities. A total of 357 flu-like cases and unexplained pneumonia and 2 cases who were H7N9 avian influenza virus nucleic acid positive were reported in the city. Three cases of H7N9 found in Jiuquan city had a history of exposure to the live poultry market, and one of them died due to late diagnosis.Conclusions:Exposure to the external environment of H7N9 avian influenza virus is the main risk factor of H7N9 infection in humans. The management of free-range poultry and live poultry market should be strengthened, especially the circulation management of live poultry. The monitoring of external environment for avian influenza plays an important role in the prevention and control of human infection with h7n9 avian influenza.