Objective To explore the relationship between vascular lesions and benign paroxysmal positional vertigo in the elderly.Methods 74 patients aged 60 years and over with benign paroxysmal positional vertigo in Huanhu Hospital and 80 subjects without vertigo history in the medical examination center of the same hospital were randomly divided into the case group and the control group,respectively.The carotid intima-media thickness (CIMT) and plaque in the carotid artery were detected using high-resolution color duplex ultrasound for evaluating large vascular lesions.At the same time,T1WI,T2WI and diffusion weighted imaging (DWI) were performed with high-field 3.0 T MRI scanner as the detection index of small vascular lesions to compare the difference in severity of lacunar infarction,leukoaraiosis and micro hemorrhage between the two groups.Both indexes were used together to compare the overall difference in the intracranial and extracranial vascular lesions between the two groups.Results Between the case group and the control group,there were significant differences in the CIMT [(0.96±0.21) mm vs.(0.84±0.26) mm,t=3.136,P＜0.05],the detection rate of plaque (89.2％ vs.72.5％,x2 =5.803,P＜0.05),the number of lacunar infarction [(3.48± 1.67) vs.(2.34± 2.06),t=1.994,P＜0.05] and the score of white matter [(4.77±2.15) vs.(3.95±2.04),t=2.430,P＜0.05].There was no significant difference in the positive detection rate of the cerebral microbleeds in the case group and control group (22.9％ vs.17.5％,x2=0.4264,P＞0.05).Conclusions There is a relationship between the benign paroxysmal positional vertigo and intracranial or extracranial vascular lesions in the elderly.Vascular factor may play an important role in the pathogenesis of benign paroxysmal positional vertigo.Not only the atherosclerosis of large and small arteries but also the microcirculation disturbance may be partly attributed to the benign paroxysmal positional vertigo in the elderly.

Objective To evaluate the diagnostic value of quantitative analysis parameters of dynamic contrast-enhanced magnetic resonance imaging (MRI) in differential diagnosis of prostatic disease.Methods 12 patients with prostate cancer and 16 patients with benign disease underwent DCE-MRI examination.Region of interest (ROI) were drawn in areas of cancerous foci,normal prostate peripheral zone and normal prostate central gland to measure the values of Ktrans (transport constant),Kep (rate constant),Ve (extravascular extracellular volume fraction).Values of the three parameters were analyzed by ANOVA and the differences were compared between the different tissues.Results The values of Ktrans,Kep and Ve were (0.42±0.10)/min,(0.64±0.11)/min,(0.61±0.14) respectively in the area of cancerous foci,while (0.17 ±0.08)/min,(0.32 ±0.10)/min,(0.59±0.11) respectively in normal prostate peripheral zone,and (0.33±0.12)/min,(0.50± 0.16)/min,(0.62 ±0.07) respectively in normal prostate central gland.The differences in Ktrans,Kep values were statistically significant between cancerous foci,normal prostate peripheral zone and normal prostate central gland (F =31.646,27.196,respectively,all P ＜ 0.05),but no statistically significant difference was found in the Ve value between the three different tissues (F=0.533,P＞ 0.05).Conclusions Quantitative analysis of DCE-MBI can be used to differentiate benign from malignant prostatic diseases,which hasa great application prospect.

Bronchi ; abnormalities ; pathology ; Bronchial Diseases ; complications ; congenital ; diagnosis ; pathology ; Bronchoscopy ; Child, Preschool ; Diagnosis, Differential ; Female ; Humans ; Infant ; Male ; Pneumonia ; etiology ; physiopathology ; Respiratory System Abnormalities ; complications ; diagnosis ; pathology ; Trachea ; abnormalities ; pathology ; Tracheal Stenosis ; etiology ; pathology

OBJECTIVE:To improve the electronic prescription prior-review mode and increase the rate of qualified prescrip-tions. METHODS:The electronic prescription prior-review mode of our hospital was established by setting up outpatient and emer-gency electronic prescription review team,review evidence and enforcement measures. Aimed at these problems as low review effi-ciency at initial stage,non-unified standards and untimely feedback,quality control circle and internet tools WeChat were used to improve the mode and evaluate its effects. RESULTS:The electronic prescription prior-review mode of our hospital was improved by optimizing system settings,unifying review standard,one-to-one feedback and communication with WeChat public platform, etc. Average time of prescription prior-review had reduced from 50 s to 30.58 s;the rate of qualified prescriptions had increased from 86.77% to 95.30%;prescription review efficiency and the rate of qualified prescriptions had been improved significantly. CONCLUSIONS:The implementation and continuous improvement of electronic prescription prior-review mode can reduce the rate of unqualified prescriptions and promote rational drug use in outpatient and emergency department.

Objective To elucidate the biocompatibility differences of 4 dialyzers with different membranes in maintenance hemodialysis (MHD)patients. Methods A total of 60 MHD patients were enrolled in the prospective,randomized,control,cohort study.In baseline,synthetic polysulfone(PS)membrane dialyzer was used in all the patients for at least 3 months.Then the patients were randomly divided into three groups:ployethersulfone(PES)membrane group,cellulose triacetate (CTA)membrane group,and synthetic polymethylmethacrylate(PMMA)membrane group.Study duration was 6 months.No dialyzer was reused.The biocompatibility markers were detected repeatedly at different time points and compared with each other in different dialyzer groups. Results The blood levels of high sensitive C reactive protein,interleukin-1β and interleukin-13 were not significantly different among different groups on every time point.However,the blood complements levels and WBC count were significantly different among four kinds of dialyzer.When the dialyzers changed from PS to PMMA membrane,C3a levels and WBC count changed significantly(P＜0.05).Moreover,the change of C5a level was significantly different between PES group and PMMA group on month 3(P＜0.05). Conclusion There are some differences of biocompatibiliy among different dialyzer membranes.

Objective To construct drug-resistant variant recombinant human cytomegalovirus (rHCMV)and identify drug susceptibility by phenotypic and genotypic assays.Methods The UL97 fragments containing Pine I recongnition site and resistant mutation were introduced by site-directed mutagenesis using gene splicing by overlap extension polymerase chain reaction(PCR),and blended with human cytomegalo-virus(HCMV)standard strain ADl 69 genomic DNA proportionally,then the DNA mixture were transfected into MRC-5 fibroblasts by the vector of liposomes.HCMV-PP65 antigen was detected by indirect-immunofluorescent assay to verify rHCMV infection of MRC-5 fibroblasts.When the eytopathic effect(CPE)of homologous recombinant virus reached 100%,the virus was harvested.The purified target virus was screened by plague with different concentrations of ganciclovir(GCV)and the recombinant virus was identified by plague reduction test and DNA sequencing of drug-resistant genes(UL97 and UL54).Results The UL97 fragments containing intended mutations for transfection were constructed successfully.After cotransfected with AD169DNA mixture for 7 days,rHCMV formed cytopathology was obviously visible,which was verified as rHCMV infected focus by HCMV-PP65 antigen test.The UL97 genotypic analysis of recombinant virus obtained by cloning was as expected.No mutation was found by UL54 gene sequencing.The GCV susceptibility of rHCMV positive clone was 15 μmol/L (50% inhibiting concentration),which was 12-fold of standard AD169 strain and was drug-resistant phenotype.Conclusions The rHCMV containing intended mutations is constructed successfully by cotransfeetion into MRC-5 cells and the recombinant virus strain is obtained by GCV screening and plaque purifying.The establishment of this method provides technique platform for identifications of new drug-resistant mutations of HCMV during anti-viral therapy.

AIM: The role of human interleukin-2(IL-2) signal peptide sequence in the effect of human Endostatin (hEndostatin) expression and secretion was investigated in HeG2 cells. METHODS: RT-PCR and Western-blotting were conduct to observe mRNA level difference of hEndostatin gene, its protein expression and secretion level difference between with hIL-2 signal peptide sequence and without it. RESULTS: mRNA level of hEndostatin gene in HepG2 (pBlast-hIL2-hEndo) cells was higher than that in HepG2(pBlast-hEndo)( P

ObjectiveTo explore composition rules of suppress cough prescriptions.MethodsThe suppress cough prescriptions in “The New National Medicine” were collected to build a database based on Traditional Chinese medicine inheritance assist system. Themethods of association rules with apriori algorithm and complex system entropy cluster were used to achieve the frequency of medicines and association rules between drugs.ResultsThe data-mining results indicated that themostfrequentlyused drugs wereRadix Glycyrrhizae, Platycodon grandiflorum, Semen armeniacae amarae, Ephdra vulgaris, Dried tangerine or orange peel. The most frequent drug combinations were “Radix Glycyrrhizae, Platycodon grandiflorum”, “Radix Glycyrrhizae, Semen armeniacae amarae”, “Radix Glycyrrhizae, Dried tangerine or orange peel” and so on. The drugs with a high degree confidence coefficient of association rules include “Dried tangerine or orange peel, the root bark of white mulberry”, “Dried tangerine or orange peel, Snakegourd Seed”. The new prescription that we can get composited by Fructus AurantiiwasAngelica decursiva, Pericarpium Citri Reticulatae, Rhizoma Anemarrhenae, the root bark of white mulberry.ConclusionFrom the analysis above, we could conclude that the drugs insuppress cough prescriptions havemoreeffects ofrelieving superficies, clearing heat and drying dampness, ventilating the lung and resolving phlegm,nourishingYinand supplementingQi.

Objective To evaluate the effect of en bloc open-door laminectomy and pedicle screw fixation for extremely severe cervical ossification of posterior longitudinal ligament (OPLL).Methods From January 2007 to December 2011,16 cases of serious cervical OPLL were treated,in which there were 13 males and 3 females,aged from 45 to 74 years (average,56.5 years).Spinal cord functional deterioration was related to minor activities of the neck,such as sneeze,cough or hyperextension of the neck,in 15 cases.One case suffered from aggravating neurological symptoms without a definite precipitating factor.The average preoperative Japanese Orthopaedic Score (JOA) was 7.1 ±1.8.Preoperative CT scans displayed the average stenotic rate (thickness of OPLL/sagittal diameter of the spinal canal) was 83.7％.All the patients received en bloc laminectomy and pedicle screw fixation of the cervical spine.Results All the patients were followed up for 3 months to 4 years (average,24.4±10 months).The JOA scores at 2 weeks,3 months,and the last follow-up postoperatively were 13.2±1.7,13.5 ±1.6 and 14.1 ±1.5,respectively; the improvement rates were 61.6％,64.6％ and 70.7％,respectively.The operative time ranged from 80 to 150 minutes (average,130 minutes),and blood loss ranged from 150 to 600 ml (range,300 ml).One case of postoperative wound hematoma,1 case of cerebrospinal fluid leakage and 3 cases of trapezius muscle pain occurred in this group.No serious complications,such as deep infection,deterioration of neurological dysfunction,vertebral artery injury and internal fixation failure,were noticed.Conclusion Owing to the minimum interference to the cervical spinal cord,stabilization of the decompressed segments and maintenance of cervical lordosis,en bloc open-door laminectomy and pedicle screw fixation is suitable for extremely severe cervical OPLL.

Objective To explore and evaluate the clinical significance of pressure-controlled discography in diagnosis of discogenic low back pain.Methods From July 2008 to October 2009,pressurecontrolled discography under C-arm guidance was taken in 52 patients with suspected discogenic low back pain,including 83 degenerative discs and 52 good discs.Based on the pressure of discography inducing pain,the discs were divided into 4 groups:pressure ≤ 30 psi,30 psi＜pressure ≤50 psi,50 psi＜pressure≤70psi,and pressure＞70 psi.By using SPSS 11.0 statistical software,the correlation of pressure of discography and morphologic representation was analyzed.Results Among 83 degenerative discs,positive discography was detected in 46 discs.During discography,the pressure of positive degenerative discs was (36.5±15.7)psi; the pressure of negative degenerative discs was (50.5±26.2) psi,and the normal discs’ pressure was (98.6±3.7) psi.A significant difference could be found between the mentioned three groups.Among different pressure groups,the positive rate were analyzed by x2 test,and a significant difference was found as well.But no significant difference was found between the group of less than 30 psi and group of 30 to 50 psi.According to Adams’ morphological classification of discography,the pressure of disc varied from 30 to 50 psi in grade Ⅲ,while less than 30 psi in grade Ⅳ.There was a significant difference of discography pressure between discography positive grade Ⅲ and grade Ⅳ.Conclusion The pressure-controlled discography is valuable for clinical diagnosis of discogenic low back pain.The morphological classification of discs could indicate the degree of the disruption of annular fibrosus.