Objective To explore the clinical features,risk factors and the sensitivity to antibiotics of lower respiratory tract acinetobacterial infection.Methods The clinical data,results of sputum bacterial culture and drug sensitivity of the 72 cases with lower respiratory tract acinetobacterial infection were netrospectively reviewed.Results 53 cases(73.6%)were elder than 60 years old,69 cases(95.8%)had basic diseases,and 59 cases(81.9%)were nosocomial infection.Risk factors included basic diseases,lower immune function,all kinds of invasive operations,aerosol inhalation,unreasonable usage of antibiotics.Drug sensitivity test showed that the drugs which sensitive to acinetobacter was upper than 50% included Imipenen,Levofloxacin,Cefooerazone/sulbactum and Amikacin.Conclusion The patients who sufferred from lower respiratory tract acinetobacterial infection usually are elder than 60 years old,and have basic diseases.Most of this kind of infection is nosocomial infection.Because of severe clinical symptom and high drug resistant rate,the prognosis is poor.Reasonable selection of sensitive antibiotics is important.

Objective To discuss the clinical characteristics of thalamic hemorrhage,the correlative risk factor and the factors influencing prognosis.Method The clinical datas of 74 cases of thalamic hemorrhage and CT examination results were analyzed to find out the relationship between the clinical characteristics and the prognosis.Results The old age and hypertension were the main causes of thalamic hemorrhage.The mortality of thalamic hemorrhage that rupturing into ventricle was higher than that not rupturing into ventricle.Conclusions The old age and hypertension are the main causes of thalamic hemorrhage.The clinical manifestation of thalamic hemorrhage is variety.The prognosis is related weith age,blood pressure and the present of rupturing into ventricle.

Objective In order to probe the possible biomechanical mechanism of lumbar vertebral injuries, we studied the nonlinear stress distribution on lumbar vertebrae at 1500N axial compression force and 15Nm bending moments during hambar flexion, extension, lateral bending and axial torsion using an available nonlinear finite element (FE) model of functional spine unit. Methods Three-dimensional nonlinear FE model was created based on CT data of L3-L4 motion segment. The segment mechanical responses to different loadings were evaluated by the range of disc bulging, the stress level of fibrousrings, facet loadings and equivalent stress distribution of posterior structure. Results Compression and flexion induced disc bulging in anterior region, whereas extension and lateral bending induced disc bulging posteriorly and posterolaterally. Axial torsion caused not only higher unilateral facet stress but also the concentrated stress on posteroleteral fibrousrings stress. The loadings in extension and axial compression were lower than in torsion but higher than in lateral bending and anterior flexion. Higher equivalent stress was found when compression and extension loadings were applied to the pedicle of vertebral arch and interarticularis. Conclusion Intervertebral disc beared higher compressive than tensile. The posterolateral regions of lumbar vertebrae were prone to be deformity and at higher risk of fibrousring failure. Stress failure could be occured when facets were overloaded with axial torsion,extension and extension force due to the importance of facets during lumbar movement.

ObjectiveTo observe the healing effect of deep partial thickness burns by the injecting of breviscapine and discuss the possible mechanisms. Methods A rat model of deep partial thickness burns was designed,and was injected with breviscapine.The control group was injected with normal saline.The healing time of burn wound of the two groups was recorded,respectively.Seven days later,the tissues of bum wound of each group were extracted and the contents of hydroxyproline,collagenase-1,nitrogen monoxidum,erythrocuprein,and malonaldehyde that were contained in each extracts were measured.The results of each group were statistically analyzed.ResultsThe healing time of burn wound of the experimental group was [ ( 12 ± 1.428 ) days ],which was significantly shorter than the control group [ ( 14.75 ±1.291 )days] ( P ＜0.05).The contents of hydroxyproline[ (3.17 ± 1.136) mg/g],collagenase-1 [ ( 1.28± 0.651 ) mg/g ],nitrogen monoxidum [ ( 2.62 ± 0.30 ) μmol/gprot ],and erythrocuprein [ ( 221.25 ±25.94) U/mgprot ] in the experimental group were all higher than the control group [ (7.32 ± 2.173 )mg/g,(5.38 ±0.363) mg/g,(7.28 ± 0.40) μmol/gprot,(296.36 ± 29.29) U/mgprot ] ( P ＜ 0.05 or P ＜0.01 ).However,the content of malonaldehyde [ (6.36 ± 0.93 ) nmol/mgprot ] was lower than the control group [ ( 1.25 ± 0.59) nmoL/mgprot ] ( P ＜ 0.05 ).ConclusionsThe breviscapine injection can decurtate the healing time of deep partial thickness bums and it may be related to the extension of blood vessel,improvement of microcirculation,elimination of oxygen free radical,and degradation of lipid peroxidation.

Objective To explore the etiology of pulmonary atelectasis and explore the value of fiberoptic bronchoscope in the diagnosis and treatment of pulmonary atelectasis.Methods 192 cases of pulmonary atelectasis confirmed by thoracic X-ray and CT were examined and treated under fiberoptic bronchoscope.Results The final cause of 192 cases pulmonary atelectasis was lung cancer in 122 cases,chronic inflammation in 35 cases,tuberculosis in 24 cases,foreign body in 3 cases,blood clot obstruction in 3 cases,no clear causes in 5 cases;97.4% of pulmonary atelectasis were diagnosed.The treatment of pulmonary atelectasis caused by tumor obstruction was ineffective under fiberoptic bronchoscope;Then for others,atelectasis of patients was re-expanded completely in 65.7% after treatment one week under fiberoptic bronchoscope,re-expanded partially in 27.1% and the effective rate was 92.8%.Conclusion The rate of etiologic diagnosis of pulmonary atelectasis under fiberoptic bronchoscope is high;The main causes of pulmonary atelectasis are lung cancer,chronic inflammation and tuberculosis.The pulmonary atelectasis with no clear cause should be examined with fiberoptic bronchoscope.The treatment under fiberoptic bronchscope is effective for non-tumor atelectasis.

Objective To investigate the effect of sustentaculum tali screw placement on outcomes following open reduction and internal fixation (ORIF) of intraarticular calcaneal fractures.Methods A retrospective analysis was made on 139 patients with intraarticular calcaneal fractures treated by ORIF from April 2008 to January 2012.According to Sanders classification,there were 9 patients with type Ⅱ fractures,87 with type Ⅲ fractures and 43 with type Ⅳ fractures.Fracture reduction followed by placement of calcaneal anatomic plate or anatomic locking plate was performed via calcaneal lateral L-shape incision.All the patients received X-rays and CT scans within postoperative 2 weeks.Placement of screws in sustentaculum tail was detected by CT volume rendering to visualize implants combined with multiplanar reconstruction imaging (MPR).Patients were divided into accurate fixation group (Group A,n =28),marginal fixation group (Group B,n =58),and non-fixation group (Group C,n =53) based on radiological results.Intra-and peri-operative parameters,time to partial weight-bearing,time to full weight-bearing,fracture healing time,and clinical outcome were compared among groups.Functional outcome was assessed using American Orthopedic Foot and Ankle Society (AOFAS) Ankle Hindfoot Scale.Results Postoperative X-rays indicated accurate fixation of sustentaculum tail in 64 patients,marginal fixation in 22,and non-fixation in 53,but CT images manifested accurate fixation in 28 patients,marginal fixation in 58,and non-fixation in 53.Group A had operation duration of (93 ±11) min and intraoperative blood loss of (252 ± 27) ml,longer or higher than those in Group B [(85 ±8) min,(194±16) ml] and Group C [(57±6) min,(136 ±13) ml] (P＜O.05).There was no significant difference in mean hospital stay among the three groups (P ＞ 0.05).Ninety-two patients were followed-up for 12-38 months (mean 18.5 months) and 85 patients completed foot and ankle exercise as planned.Moreover,no significant differences were observed among groups concerning time to partial and full weight-bearing,fracture healing time and AOFAS score at the final follow-up (P ＞ 0.05).Conclusion Sustentaculum tali screw placement has no apparent effect on the short-term outcome of surgical treatment for calcaneal fractures.

Objective To analyze and research the Chinese medicine of tonifying kidney recipe on the mechanism of recurrent spontaneous abortion IL-4, IFN-gamma cytokine.Methods60 patients in accordance with the inclusion criteria with recurrent miscarriage from January 2013 to December 2015 were selected, according to the random number table method, the patients were randomly divided into Chinese medicine group, Western medicine group,Combine traditional Chinese and western medicine group, Chinese medicine group treated with traditional Chinese medicine of tonifying kidney recipe, Western Medicine group were given intramuscular injection of progesterone injection,combining traditional Chinese and Western medicine group was treated with acupuncture combined with progesterone Chinese medicine.The course of treatment was 15 days, before and after treatment in patients with pregnancy outcome and IL-4, IFN-gamma levels.ResultsThere was no significant difference between the three groups before treatment with IL-4 and IFN-.After treatment,compared with the traditional Chinese and Western medicine group, western medicine group, Chinese medicine group of IL-4, IFN-, respectively, showed a rise and fall, the difference was statistically significant(P<0.05).After treatment, compared with the traditional Chinese medicine group, the IL-4 and IFN-of the western medicine group were increased and decreased, respectively, and the difference was statistically significant (P<0.05).Combination of traditional Chinese and Western medicine to obtain a higher clinical cure rate.ConclusionThe combination of TCM and Western medicine for improving the efficacy of pregnancy outcome of recurrent spontaneous abortion and exact expression may obviously improve the IL-4 and IFN-gamma, help to improve the IL-4, reduce the expression of IFN-gamma, improve the outcome of pregnancy.

Objective:To transfect the tongue squamous cell carcinoma Tca8113 cells with NICD, and to investigate the effects of Notch 1 on Tca8113 cells and the expression of epidermal growth factor receptor (EGFR) in tongue squamous cell carcinoma.Methods: The Notch plasmid pRAMIC-IRES2-EGFP encoding exogenous and control plasmid pIRES2-EGFP were transiently transfected into the Tca8113 cells by LipofectamineTM 2000. In the experiment, target plasmid pRAMIC-IRES2-EGFP transfection group, control plasmid pIRES2-EGFP transfection group and non-transfection group were set up.RT-PCR, Western blotting and immunocytochemical method were used to observe the mRNA and protein expression levels of Notch 1 and EGFR.The proliferation activities of Tca8113 cells were detected by MTT assay,and the survival rates were calculated.Results:Compared with non-transfection group and control plasmid pIRES2-EGFP transfection group, the mRNA and protein expression levels of Notch 1 in Tca8113 cells in pRAMIC-IRES2-EGFP group was significantly increased(P<0.05), the mRNA and protein expression levels of EGFR in Tca8113 cells were significantly decreased (P<0.05),and the proliferation rate of Tca8113 cells was significantly decreased(P<0.05) after transfection.There were no significant differences in the expression levels of Notch 1 and EGFR mRNA and protein and the proliferation rates in Tca8113 cells between non-transfection group and pRAMIC-IRES2-EGFP group (P>0.05).Conclusion:The effect of Notch 1 on the proliferation of Tca8113 cells may be related to down-ragulatoin of expression level of EGFR.

Objective To establish a way to measure the injury severity of articular surface due to posterior malleolus fracture and investigate its clinical significance based on three-dimensional reconstruction technique.Methods Between May 2009 and March 2014,138 cases of peri-ankle injury combined with posterior malleolus fracture were treated.Lateral radiographs were reviewed to measure the ratio of posterior fragment area to distal tibial plafond area using the common method.Three-dimensional CT images were examined to measure ratio of the area of injury using the three-dimensional measuring method.Statistical comparison was made using the t-test and intraclass correlation coefficient (ICC).Results Measurement failed on 33 lateral radiographs and 13 three-dimensional CT images.Six cases cannot be measured by both imaging technology,so results of 98 cases were compared.Ratio of posterior fragment area to tibial plafond area was (16.2 ± 7.2) ％ measured by radiographs and was (29.6 ±10.1) ％ by three-dimensional CT scans (P ＜ 0.05).Three-dimensional CT measurements showed higher intra and inter-observer agreement (ICC of 0.973 to 0.942) than that in radiographic measurements (ICC of 0.875 to 0.860).Conclusion Three-dimension CT assessment of the extent of injury to articular surface because of posterior malleolus fracture is reliable and reproducible,but radiographic assessment may underestimate the injury and influence the choice of surgical indications.

Objective To investigate the safety and clinical efficacy of catheter-directed thrombolysis(CDT) with prolonged infusion of low dose urokinasefor treatment of acute iliac-femoral vein thrombosis.Methods From January 2005 to March 2011,63 patients of unilateral acute iliac-femoral vein thrombosis were treated by CDT and followed up for more than 12 months.The complications during CDT,thrombus clearance ratio,time for CDT,dose of urokinase,degree of limb swelling and clinical follow-up data were retrospectively reviewed.The Fisher exact test was used for enumeration of data.The measurements of data were tested with the one-way analysis of variance and two-two comparison LSD test.Thrombus clearance ratio in different time frame was tested by repeated measurement of data and analysis of variance.Results During the CDT,no symptomatic pulmonary embolism (PE) and significant bleeding happened.Ten (15.9％) patients had complications of minor bleeding,including 3 patients with blood oozing along the edge of vascular sheath,3 patients with subcutaneous ecchymosis or hematoma around the puncture site,3 patients with hematuria and 1 patient with gums bleeding.In four (6.3％) patients,complications were caused by catheter placement,including 3 patients with soft tissue inflammation around puncture site and 1 patient with secondary thrombosis surrounding the vascular sheath.Fifty three patients (84.1％) achieved thrombolytic degree Ⅲ and Ⅱ at 4th to 8th day during CDT.Thrombus clearance ratio was higher in CDT with urokinase 500 000 U/d and 750 000 U/d than 250 000 U/d[(91.2 ± 10.1)％ vs (75.9±20.1)％,(91.3 ± 12.2)％ vs (75.9±20.1)％,all P ＜0.05].Thrombus clearance ratio showed no significant difference between CDT with urokinase 500 000 U/d and 750 000 U/d [(91.2 ±10.1) ％ vs (91.3 ± 12.2) ％,P ＞0.05].There was no significant difference between CDT with urokinase 500 000 U/d and 750 000 U/d in perfusion thrombolytic time to reach thrombolytic degree Ⅲ [(7.1 ± 1.0)vs (6.2±1.3)d,P＞0.05]and Ⅱ[(6.4±1.0) vs (6.0±0.8)d,P＞0.05].Thrombus clearance ratio increased along with an increase in thrombolytic time for CDT (P ＜ 0.05).After 24 hours of CDT,58 (92.1％) patients showed reduction of soft tissues tension.After 48 hours of CDT,affected limb circumference decreased significantly compared with the preoperative measurement [thigh (54.25 ±5.79) cm vs (56.46±5.91) cm; leg(44.05 ±5.18) cm vs (45.68 ±5.16) cm,all P＜0.05].At the time of discharge,there was no significant difference between affected limb circumference and normal side [thigh (49.00±4.67) cmvs (48.38 ±4.68) cm; leg(38.41 ±4.15) cm vs (37.73 ±3.92)cm,all P ＜ 0.05].The patency rate of iliac venous stent was 91.1％ (41/45) after 6 months.Doppler ultrasound showed regurgitation of femoral venous valve in 11 patients after 12 months.Conclusions CDT with prolonged infusion of low dose urokinase is a safe,highly effective method for the treatment of acute iliacfemoral venous thrombosis.