OBJECTIVETo detect the clinical value of the ECT bone scan in evaluating of the situation of infection control after hip knee arthroplasty.

METHODSThe clinical data were retrospectively analyzed in 62 patients, including 34 males and 28 females with an average age of 68.8 years old ranging from 65 to 74 years. The results of ECT bone scan, erythrocyte sedimentation rate, C-reactive protein were used to assess periprosthetic infection. The patients with positive ECT and ESR on CRP were considered to have periprosthetic infection; however, the patients with two or more negative, indexes were considered to have no infection.

RESULTSThe sensitivity, specificity, accurate rate of ECT were 75.0%, 88.9%, 87.1% respectively; ESR 50.0%, 72.2%, 69.4%; CRP 62.5%, 81.4%, 79.0%. The combination of the three methods were 87.5%, 96.3% and 95.2%,

CONCLUSIONCompared with ESR and CRP, ECT is a more effective way in the diagnosis of periprosthetic infection, which has great value and is worth popularizing.

Aged ; Arthroplasty, Replacement ; adverse effects ; Blood Sedimentation ; Bone and Bones ; diagnostic imaging ; C-Reactive Protein ; analysis ; Female ; Humans ; Male ; Prosthesis-Related Infections ; diagnostic imaging ; Retrospective Studies ; Tomography, Emission-Computed ; methods

Objective To analyze the potential risk factors of infantile spasms (IS) relapse through following up the respondents with IS after different treatment protocols.Methods Sixty-nine cases were collected in the Department of Pediatric Neurology,Jiangxi Children's Hospital from May 2011 to September 2013,who had complete cessation of spasms for at least 28 days or more after the different treatment protocols.The follow-up was performed on these patients until spasms seizure relapse or at least 1 year for those without recurrence.According to the literature review,8 possible risk factors of IS recurrence (gender,age of onset,course of diseases,etiology,high irregular types of electroencephalogram,development quotient,onset time,treatment protocols) were selected,and then Logistic multiple regression was used to analyze the relationship of various potential risk factors with the relapse of spasms.Results (1) The recurrence rate at 6 months and 12 months were 40.6％ (28/69 cases)and 43.5 ％ (30/69 cases),respectively.(2) Among the various potential factors,the age at onset and the time to response were closely related to the IS recurrence.Namely,the non-classic onset(early-onset and late-onset) of IS were more likely to relapse than the classic onset[66.7％ (14/21 cases) vs 33.3％ (16/48 cases),x2 =6.605,P =0.010];the responders beyond 1 week were more likely to relapse than those within 1 week[63.6％ (14/22 cases) vs 34.0％ (16/47 cases),x2 =5.341,P =0.021].There were significant differences between the 2 groups (all P ＜ 0.05).(3) Logistic multiple regression analysis demonstrated that age at onset (Wald =3.603) was most closely related to the relapse of spasms.Conclusions (1) The relapse rate of IS in children was high,and the majority of them relapsed within 6 months.So a long-term,rational and effective clinical management solution should be explored.(2) The age at onset and the time to response are very important risk factors of the IS recurrence,and the former was more significant.So,early diagnosis and early treatment are more likely to improve the efficacy of IS,and reduce the risks of recurrence and improve the prognosis.

@@

OBJECTIVETo explore the diagnostic value of the radiologic characteristics of osteoporotic Kummell's disease.

METHODSTotal 16 patients with pathologically confirmed osteoporotic Kummell's diseases were reviewed from May 2010 to May 2012, including 4 males and 12 females with the mean age of 73.4 years (ranged, 67 to 83 years old). Radiologic imagings of all patients, including X-ray, CT and MRI, were analyzed retrospectively.

RESULTSIntravertebral linear clefts could be seen on the AP and lateral X-ray films of vertebrae. Sagittal and axial CT scans demonstrated the vacuum cleft phenomenon with liquid and air was identified within the vertebral body. Sagittal MRI showed the callapsed vertebral segment and the area of fluid signal with clear and intact border within the vertebral body. The fluid signal was low on T1-weighted images and high on T2-weighted images and stir images, which was corresponding to an intravertebral vacuum cleft.

CONCLUSIONThe radiologic characteristics of Kurmmell's diseases can provide valuable evidences for the early diagnosis.

Aged ; Aged, 80 and over ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Osteonecrosis ; diagnosis ; diagnostic imaging ; pathology ; Retrospective Studies ; Spinal Fractures ; diagnosis ; diagnostic imaging ; pathology ; Tomography, X-Ray Computed

Objective To study the human brucellosis infection status and its epidemic feature during 2003-2006.Methods A total of 485 blood samples of serum underwent rose bengal plate test(RBPT)and serum agglutination test(SAT),which include 422 cases having a history of contacting with sheep/goats or cattle,22 suspected eases,and 41 cases having contacted with infected persons.All cases were diagnosed according serology test and epidemiologic survey.Results The positive rates of Serum antibodies(SAT titer)were 8.8%(12/137),12.7%(8/63),13.1%(22/171)and 16.2%(19/114),respectively,during 2003 to 2006 in Tangshan,in an increasing Rend and peaked in the second and the third seasons 77.0%(47/61).The mostly infected population were those who contacted with sheep/goats or cattle,accounting for 98.4%(60/61).Livestock farmers 86.9%(53/61),and veterinarians 8.2%(5/61)were mostly likely to be infected.Assay of serum antibodies is negative in the persons contacting with infected cases.Conclusions The prevalence of human brucellsis had presented a rising tendency in highly dangerous crowd of Tangshan.Contacting with infected livestock(such as sheep/goats or cattle),especially their aborted materials and placenta were mainly transmitted modes of human brucellsis.However,cases of person-to-person transmission has not been discovered in this study.

Shanghai University of TCM was the first Chinese medicine university that established field-grade experimental teaching center in China.And both of the Chinese medicine and Chinese herbs experimental teaching centers became national experimental teaching demonstration centers.There is general improvement in laboratories conditions,so the experimental teaching team building is the critical factor of improving experimental teaching quality.The experimental teaching team of Shanghai University of TCM consists of excellent teachers as its backbone,and lecturers and technicians from fields in traditional Chinese medicine Chinese herbs and clinical practices.The team members cooperate with each other by setting up experimental teaching research groups to improve teaching quality,which plays an important role in building experimental teaching demonstration center.

Objective To observe the concentration changes of plasma cortisol ( Cor ) and adrenocorticotropic hormone( ACTH) in preterm infants with respiratory failure receiving ventilation treatment. Methods The 30 preterm in-fants with respiratory failure requiring mechanical ventilation were selected as the preterm group with respiratory failure, and 32 full term infants with respiratory failure in need of mechanical ventilation were selected as the term infant group with respiratory failure, and 52 preterm infants( preterm control group) and 17 full term infants( term control group) were selected as controls. All the cases were chosen from Neonatal Intensive Care Unit of Anhui Province Children′s Hospital during January to December 2014. The levels of plasma Cor and ACTH were measured and analyzed. Results (1) Cor level:on the 3rd day, the level of plasma Cor in the preterm group with respiratory failure was lower than that in the term group with respiratory failure[262. 50(162. 00-332. 50) nmol/L vs 531. 00(244. 75-644. 00) nmol/L], and higher than those in the preterm control group[199. 50(49. 05-388. 95) nmol/L] and term control group[120. 00(43. 90-191. 00) nmol/L], the differences were statistically significant(all P<0. 05). On the 7th day, the level of plasma Cor in the preterm group with respiratory failure was lower than that in the term group with respiratory failure[128. 00(65. 85-244. 00) nmol/L vs 222. 00 (131. 50-377. 85) nmol/L], the difference was statistically significant(P<0. 05). (2) ACTH level:on the 3rd day, the level of ACTH in the preterm group with respiratory failure was higher than those in the other groups[38. 20(25. 18-76. 65) pmol/L vs 24. 60(19. 03-38. 20) pmol/L vs 22. 30(14. 40-40. 60) pmol/L vs 24. 20(13. 90-45. 65) pmol/L], the differences were statistically significant(P<0. 05). On the 7th day, the concentration of ACTH in the preterm group with respiratory failure was lower than those in the term group with respiratory failure[16. 55(12. 78-31. 80) pmol/L vs 29. 85(18. 23-54. 65) pmol/L], and there were statistical differences(P<0. 05). Conclusions The newborns with respiratory failure were in criti-cal stress, the level of plasma Cor in the preterm infants with respiratory failure was lower than that of the term infants with respiratory failure, while the level of ACTH in the former was higher than that in the latter. And when the stress disap-peared, both of the plasma Cor and ACTH recovered to the normal level.

Objective To evaluate left ventricular diastolic and systolic function of the dogs during different status of acute myocardial ischemia with velocity vector imaging (VVI). Methods Six healthy mongrel dogs were enrolled. Home-made artery constrictor was placed in the proximal coronary artery after opening the chest of dogs to produced different grades of coronary artery stenosis. Mean of peak diastolic velocity (Em), peak strain rate of diastole (Esr), mean of peak systolic velocity (Sm), peak strain rate of systole (Ssr), ejection fraction (EF) and left ventricular pressure were measured. Results There was good linear correlation between Em and Esr by VVI and left ventricular end diastolic pressure (LVEDP) (r=-0.834, P＜0.001 and r=-0.703, P＜0.001, respectively). Em and LVEDP had better correlation than that between Esr and LVEDP (P=0.032). Sm, Ssr or EF had significant correlation with +dp/dt_(max) (r=0.883, P＜0.001, r=0.772, P＜0.001 and r=0.647, P＜0.001, respectively). Significant difference was observed for correlation coefficient between Em and Esr and EF (P＜0.001). Conclusion Em and Sm are sensitive echocardiography indexes to evaluate left ventricular diastolic and systolic function, and are better than EF, Esr and Ssr.

OBJECTIVETo explore the correlations between diagnostic information and therapeutic efficacy in rheumatoid arthritis (RA) with decision tree model analysis.

METHODSThree hundred and ninety seven patients came from 9 clinical centers were randomly divided into the Western medicine (WM) group (n=194) treated with non-steroidal anti-inflammatory drugs and slow-acting antirheumatic drug and the Chinese medicine (CM) group (n=203) with basic therapy and syndrome-differentiation dependant TCM treatment. TCM and WM diagnostic information were collected. The ACR 20 was used for efficacy evaluation and the information of patients before treatment was analyzed by SAS 8.2 statistical package. Through single-factor exploratory analysis, odds ratio of efficacy and variable was calculated taken P < 0.2 as the including criteria for data mining analysis with decision tree model. All data were classified into the training set (75%) and verifying set (25%) with efficacy as the variable for layering to make further verification of the data-mining analysis.

RESULTSTwenty variables were included in the CM group and 26 in the WM group in the data-mining model. In the former, 9 variables were positively correlated to the efficacy, including degree of arthralgia, tenderness and morning stiffness, number of swollen joint, and joint with tenderness, levels of IgM, rheumatoid factor (RF), C-reactive protein (CRP), and total assessment from doctor; and disease duration and degree of nocturnal polyuria were negatively correlated to that. While in the latter, 8 were positively correlated to the efficacy, including erythrocyte sedimentation rate (ESR), sour and weak waist and knees, white fur in tongue, joint ache and stiffness, swollen joint, and total assessment from doctor and patient, and red tongue with yellow fur and leucocyte count negatively correlated to it. Data mining with decision tree analysis revealed that different combinations of morning stiffness, slight red tongue, joint tenderness and nocturnal polyuria in the CM group, and those of white fur in tongue, CRP level, leucocyte count and morning stiffness in the WM group showed different efficacy, which were also verified in the randomly chosen verifying set.

CONCLUSIONTo analyze the correlations between diagnostic information and therapeutic efficacy with decision tree analysis is conformed to the theory of TCM in applying treatment according to syndrome differentiation individually, thus it would contribute to elevate the accuracy of therapy.

Adolescent ; Adult ; Aged ; Anti-Inflammatory Agents, Non-Steroidal ; therapeutic use ; Arthritis, Rheumatoid ; diagnosis ; drug therapy ; Decision Trees ; Diterpenes ; therapeutic use ; Drugs, Chinese Herbal ; therapeutic use ; Epoxy Compounds ; therapeutic use ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Phenanthrenes ; therapeutic use ; Phytotherapy ; Treatment Outcome

BACKGROUND:Correlation between subchondral bone and articular cartilage in the process of osteoarthritis has not been fuly elucidated. Degeneration of cartilage is the focus of attention, and the subchondral bone also plays an important role in the process of osteoarthritis. OBJECTIVE: To observe the differences between experimental osteoarthritis models in rabbit knees established by two kinds of surgical methods and two kinds of proteases inducing methods, and to explore the correlation between subchondral bone mass and degeneration of cartilage. METHODS:Thirty-two New Zealand rabbits were randomly and averagely divided into four groups: Hulth group (group A), anterior cruciate ligament transaction group (group B), colagenase type II group (group C) and papain group (group D). The right knees of rabbits were established as osteoarthritis models, and the left knees served as controls. Bone mineral density of the knee joint was evaluated by dual-energy X-ray absorptiometry scanning at 0, 4 and 8 weeks after modeling. The rabbits were sacrificed at 8 weeks after MRI scanning, bilateral knee joints were harvested for general and histological observation. Quantitative analysis was done according to Mankin scores. RESULTS AND CONCLUSION: Bone mineral density of the right knees decreased at 0, 4 and 8 weeks after modeling, and the rank was as folows: group A > group B > group C > group D. MRI scanning showed that the articular cartilage thickness of the medial and lateral femoral condyle on the right knees became thinner compared with the left side, and the rank was as folows: group A < group B < group C < group D. Observation by specimens and pathological slices showed that the articular cartilage degeneration of the surgery groups worsened, group A was the most serious one, and group 1D was the lightest. Both surgery and proteases inducing methods can successfuly establish osteoarthritis models in rabbit knees. Surgery inducing models resemble the advanced or intermediate stage of osteoarthritis, while the proteases inducing models resemble the early stage of osteoarthritis. Degeneration of the articular cartilage and changes of subchondral bone are related in progressive development.