Objective 7 cases of thoracic spinal cord injury without radiographic abnormality (SCIWORA) were analyzed to elevate the level of diagnosis and treatment.Methods The type of spinal cord injury were classified into complete injury in 2 and incomplete injury in 5 according to Frankel. 5 cases had MRI examination. Conservative therapy was adopted in 5, and operation was programmed in 2.Results 4 cases recovered completely , 2 cases recovered partly , and 1 case had no recovery.Conclusion MRI provides reliable foundation for diagnosis and treatment to thoracic SCIWORA. The result is satisfactory in those incomplete injury.

Objective To investigate the distribution and antibiotic resistance of the pathogens isolated from blood culture . Methods Identification and antimicrobial susceptibility testing were performed with MicroScan WalkAway 96 PLUS or VITEK 2 compact .WHONET 5 .6 software was used for analysis of the susceptibility data according to CLSI 2013 breakpoints .IBM SPSS 20 .0 was employed to compare the resistance rates between groups . Results Gram-positive bacteria , gram-negative bacteria and fungi accounted for 57 .8% ,36 .0% and 6 .2% of the 503 nonduplicate isolates ,respectively .The most common isolates included coagulase-negative Staphylococcus , Escherichia coli , Enterococcus spp ., Staphylococcus aureus and K lebsiella pneumoniae . The prevalence of methicillin-resistant S . aureus (MRSA ) and coagulase-negative Staphylococcus (MRSCN) was 32 .3% and 71 .7% respectively .The coagulase-negative Staphylococcus isolates from ICU patients showed higher resistance rates to many antibiotics than those non-ICU strains (P<0 .05) .E .coli and K .pneumoniae strains showed high percentage of resistance to cephalosporins , but relatively low resistance to piperacillin-tazobactam , imipenem and amikacin .A .baumannii isolates were highly resistant to most antimicrobial agents . Candida species were less resistant to antifungal agents .Conclusions The pathogens isolated from blood culture are diverse .The resistance profile is quite different among various pathogens .The distribution and antibiotic resistance should be actively monitored for the pathogens isolated from blood culture in order to facilitate the rational use of antimicrobial agents .

Objective To compare the difference of entrance dose between CR and amorphous silocon DR system in chest imaging, and to discuss their optimum exposure dose. Methods For CR and DR, different entrance dose was measured by dosimeter in chest phantom. The value of IQFinv was analyzed by CDRAD2. 0 software. Image quality difference between CR and DR was assessed by group t-test. The relationship between image quality and entrance dose was tested by using Pearson correlation analysis. The best IQFinv values in CR and DR system were achieved via ROC curve analysis, and the exposure dose was then calculated. Results There were direct correlation values between entrance dose and the value of IQFinv in CR and DR system, respectively( r =0. 893 ,0. 848 ,P < 0. 01 ) . The linear regression equation for DR was IQFinv =0. 0050 +3. 359, and for CR was IQFinv =0. 005D + I. 651 , where D was entrance dose. The difference of IQFinv value between CR and DR was significant(t = 5. 455 ,P < 0. 05). The best IQFinv value of the two groups from ROC analysis was 3.55. Conclusions With the entrance dose increased, the detection ability of contrast-detail was elevated in the two digital radiography systems. With equal entrance dose, the detection ability of DR in contrast-detail was superior to CR. With equal image quality, DR obviously decreased the radiation dose to the patients.

Objective To analyze the imaging features of hepatic angiomyolipoma (HAML) on computed tomography (CT) and magnetic resonance imaging (MRI).Methods The imaging fingdings of 18 tumors which were pathologically diagnosed as HAML after surgery were analyzed retrospectively.Before operation,twelve and ten patients underwent CT and MRI non-contrast and dynamic enhanced scans,respectively,and 4 patients received both examinations.The imaging characteristics including the number,diameter,location,appearance of the lesions,plain and dynamic enhancement mode were analyzed.Results Eighteen HAML lesions were found in 18 patients with a diameter ranging from 1.5 cm to 17.2 cm (mean 5.3 cm).Five lesions manifested fatty content,and one showed hemorrhage and necrosis.Five HAMLs enhanced in a fast-in and fast-out mode,eleven in a fast-in and slow-out mode and two other lesions in an irregularly discrete mode.The arterial supply was found in 11 HAMLs in the hepatic arterial phase,all coming from intrahepatic arteries.Intratumoral vessels were observed in 12 HAMLs.Early draining veins to the hepatic vein (n =3) and portal vein (n =1) were detected in 4 HAMLs.One lesion demonstrated delayed enhancement in the pseudocapsule.Conclusion The detection of arterial supply and intratumoral vessels in a hypervascular hepatic tumor on contrast CT and MRI in a patient with a non-cirrhotic liver and normal AFP helps to make a diagnosis of HAML.

Objective To evaluate the clinical value of 320-detector CT in interventional treatment of bronchial artery hemoptysis. Methods CTA and DSA images of 30 patients with bronchial artery hemoptysis were retrospectively analyzed.Spatial anatomical characters of the bronchial arteries,such as the type of branches,origin and opening positions of the bronchial arteries were observed and recorded.Results In 30 patients,6 bronchial arteries distribution patterns were found,and the most common type was R1 L1 (43.3%).83 bronchial arteries were identified using CTA,including 38 on the right and 45 on the left.The right bronchial arteries mainly originated from the intercostal artery (52.6%),while the left bronchial arteries mainly from the descending aorta and aortic arch (82.2%).The opening positions of right and left bronchial arteries were mainly located at the right wall of the descending aorta (78.9%),and anterior wall of the descending aorta (62.2%),respectively.When the cacarina of trachea was used as the reference position,the left and right bronchial arteries were mainly located in the range of above 2 cm to below 1 cm from tracheal bifurcation, accounting for 80% and 89.5%,respectively.Compared with DSA,the sensitivity and specificity of CTA were 97.5% and 100%, respectively.Conclusion 320-detector CT can be used to clearly display the distribution patterns,origin and opening positions of bronchial arteries,and especially to find bronchial arteries with ectopic origin.It is possible to apply 320-detector CT in preoperative routine examination and postoperative evaluation of massive hemoptysis.

Objective To evaluate the feasibility of optimized scan protocol in whole-brain perfusion imaging with 320-MDCT scanner.Methods Twenty healthy volunteers were randomly divided into control group (13 patients) and test group (7 patients).The standard perfusion scan protocol (collecting 19 volumes)was applied in control group.The optimized perfusion CT scan protocol(collecting ll volumes)formulated by reducing scanning phases reasonably and changing the collection intervals was applied in test group.The regions of interest(ROI) with area of(20 ± 2)mm2 were located in the bilateral frontal white matter,parietal white matter,centrum semiovate,basal ganglia,occipital lobe and cerebellum.Bilateral perfusion values from ROI were measured,including cerebral blood volume(CBV),mean transit time (TTP),cerebral blood flow (CBF),mean transit time (MTT) and delay time (DT).Results Dose length product (DLP)and effective dose (ED)in optimized protocol were decreased 42.02％ as compared to control group.Every relative perfusion value of both sides from both groups were not statistically significant (P ＞ 0.05).Every relative perfusion parameters from individual territory in both groups showed no significant differences (P ＞ 0.05).Conclusions Using the optimized scan protocol,we could obtain the same whole-brain perfusion values could be obtained with the default standard protocol and less radiation dose.

Objective To investigate the distribution and drug resistance of pathogens isolated from urinary tract infections.Methods A total of 6 262 midstream urine samples were collected from patients in the First Alfiliated Hospital of Anhui Medical University during April 2012 and March 2013.MicroScan WalkAway 96 Plus or Vitek 2 Compact system was applied in bacteria identification and drug sensitivity test.WHONET 5.6 was adopted to analyze drug resistance,and IBM SPSS 20.0 was applied to compare resistance rates between isolates from outpatients and hospitalized patients.Results A total of 1 426 strains were isolated,in which 370 strains were gram-positive coccus (25.9％),942 strains were gram-negative bacilli (66.1％) and 114 strains were fungi (8.0％).Escherichia coli and Klebsiella pneumoniae,Enterococcus faecium and Enterococcus faecalis were the top two among gram-negative bacilli and grampositive coccus,respectively.The prevalence of extended-spectrum β-lactamases (ESBLs)-producing Escherichia coli,Klebsiella pneumoniae and Proteus mirabilis were 60.5％,51.0％ and 30.3％,respectively; About 73.3％ of Staphylococcus aureus strains and 86.7％ of coagulase-negative Staphylococcus strains were methicillin-resistant.Candida albicans and Candida glabrata were the two most prevalent fungi in urinary tract infections,and they were sensitive to most antifungal agents.Conclusion Gram-negative bacilli,especially Escherichia coli are the most prevalent pathogen in urinary tract infections,and strains are highly resistant to most antibacterial agents,suggesting that antimicrobial resistance monitoring system is needed.

OBJECTIVE To investigate the ESBLs-producing isolates and their resistance and genotypes in Escherichia coli and Klebsiella in three hospitals of Wannan area.METHODS The MIC of 13 antimicrobials against 79 strains of E.coli and Klebsiella were determined by 2-fold agar dilution method.The confirmation test was used to detect ESBLs-producing strains according to CLSI 2005.PCR method was used to amplify beta-lactamases of ESBLs-producing isolates by 8 premiers,PCR products were purified and then sequencing was performed.RESULTS The ESBLs-producing rates in E.coli and Klebsiella in three hospitals of Wannan area were 61.5% and 45.0%,respectively.The resistance rates to CRO,CTX,CAZ,CIP and LEV of ESBLs-producing strains were 81.0%,81.0%,47.6%,71.4% and 50.0%,respectively,all isolates were susceptible to meropenem and imipenem.PCR indicated that CTX-M1,CTX-M13,TEM and OXA1 types of beta-lactamases were the four major genotypes of the three hospitals in Wannan area.CONCLUSIONS The isolation rates of ESBLs-producing E.coli and Klebsiella as well as their resistance rates to cephalosporins and quinolones in the three hospitals in Wannan area are quite high.Monitoring ESBLs-producing isolates should be strengthened in clinic and laboratory.

OBJECTIVE To investigate beta-lactamases production in multi-resistant Citrobacter strains isolated from the First Affiliated Hospital of Anhui Medical University.METHODS Standard agar dilution method was used to determine the minimal inhibitory concentration(MIC) of 52 clinically isolated Citrobacter strains,improved three-dimensional tests were performed to detect the ESBLs-producing,AmpC-producing and MBL-producing strains in 31 Citrobacter isolates,then beta-lactamases-encoding genes were amplified by polymerase chain reaction(PCR).RESULTS Thirty one Citrobacter strains were resistant to many beta-lactams antibiotics.Twenty four strains ESBLs-producing,3 AmpC-producing and 2 ESBLs-producing plus AmpC-producing strains have been detected by improved three-dimensional tests,and not found MBL-producing ones.Twenty strains had blaTEM gene and 1 strain had blaSHV gene,8 strains had blaCTX-M-1 gene,15 strains had blaCTX-M-13 gene and 5 strains had blaCIT gene by PCR.CONCLUSIONS Multi-resistant Citrobacter strains produce one or more types of ESBLs and AmpC beta-lactamase,it may be an important reason of resistance to beta-lactams antibiotics.

Objective To investigate the clinical features and prognostic factors of nosocomially acquired candidemia.Methods A retrospective analysis was conducted for hospitalized patients with nosocomial candidemia between January 2012 and December 2014 at the First Affiliated Hospital of Anhui Medical University.The univariate and multivariate Logistic regression analyses were used to determine the prognostic factors of candidemia.Results A total of 92 patients were diagnosed with nosocomially acquired candidemia.The most common pathogen was Candida glabrata (C.glabrata,39/92,42.4％),followed by Candida albicans (C.albicans,30/92,32.6％),then Candida krusei (C.krusei,7/92,7.6％),Candida tropicalis (C.tropicalis,5/92,5.4％),Candida parapsilosis (C.parapsilosis,4/92,4.4％) and other Candida spp.(7/92,7.6％).The sensitivity rates of Candida spp.strains against flucytosine,amphotericin B,voriconazole,fluconazole and itraconazol were 100.0％,98.9％,92.4％,82.6％oo and 77.2％,respectively.The 30-day attributable case fatality rate was 13.0％(12/92).Multivariate Logistic regression analyses indicated that presence of central venous catheter (OR=4.833,95％CI:1.010-23.125,P=0.049),invasive mechanical ventilation (OR=6.075,95％CI:1.144-32.257,P=0.034),and receiving hemodialysis (OR =8.367,95 ％ CI:1.390-50.364,P =0.020)were factors independently correlated with increased mortality.Conclusions The pathogens causing nosocomially acquired candidemia are mainly C.glabrata,C.albicans and C.krusei.The drug susceptibility of Candida spp.varies among fluconazole,itraconazol voriconazole.The resistant rates of Candida spp.against voriconazole,fluconazole and itraconazol are different.The presence of central venous catheter,invasive mechanical ventilation and receiving hemodialysis are factors independently correlated with increased mortality.