To explore the associations between the presence of bacteria and virus in the nasopharyngeal secretions, and wheezing, condition and hospitalization period in infants with community acquired pneumonia. Methods Clinical data, inclu-ding detection of bacteria and viruses, conditions and hospitalization period, of 1106 hospitalized infants with community ac-quired pneumonia from March 2009 to February 2010 were retrospectively analyzed. The infants were classiifed into wheezing (697 cases) and non-wheezing (409 cases) groups. Results Viruses were detected in 540 infants (48.8%), and the total detection rate of viruses and detection rate of respiratory syncytial virus in wheezing group were signiifcantly higher than those of non-wheezing group (P=0.000). Bacteria were detected in 590 cases (53.3%) and no signiifcance was found between two groups (P=0.821). The detection rate of Streptococcus pneumonia was higher in wheezing group than that of non-wheezing group (P=0.038). Comparing to the infants detected with both viruses and bacteria, no signiifcances were found in the occurrence of severe pneumonia and hos-pitalization period in those infants detected with viruses only (P>0.05), as well as in the wheezing time of period (P>0.05). Con-clusions Wheezing in infants with community acquired pneumonia is related to the infection of viruses, especially to respiratory syncytial viruses. Virus infection accompanying bacterial infection has no impact on duration of hospitalization and wheezing. The infection of Streptococcus pneumonia may relate to wheezing in infants.

Objective To analyze the ability of rheumatologistto read the magnetic resonance imag of sacroiliac joint of spondyloarthritis patients.Methods The questionnaire survey were conducted among rheumatologists and the answers of the questionnaires were analyzed by quantitative analysis.Results 66.9％ (75/112) rheumatologist did not known how to choose the sequence of magnetic resonance imaging,and 55.4％(62/112) rheumatologist thought that bone marrow edema was very important for the diagnosis of spondyloarthritis,but only less than 10％ rheumatologists thought that erosion and fat infiltration could also h elp to make the diagnosis of spondy-loarthritis.Conclusion It is very important for rheumatologists to receive training on the reading of magnetic resonance images of sacroiliac joint of spondyloarthritis patients.

Objective To investigate spinemagnetic resonance imaging(MRI) findings in patients with axial spondyloarthritis (SpA) and to analyze the correlation between imaging and clinical manifestation.Methods The clinical data of patients with axial SpA were recorded.All patients underwent whole spine MRI scanning.The MRI findings of spinal involvement were explored.Moreover,the correlation between lesions in spinal MRI and Bath Ankylosing Spondylitis Disease Activity Index(BASDAI),Bath Ankylosing Spondylitis Functional Index (BASFI),Bath Ankylosing Spondylitis Metrology Index (BASMI),nocturnal pain visual analogue scale (VAS) score,back pain VAS score,global disease activity VAS score,Ankylosing Spondylitis Disease Activity score (ASDAS),erythrocyte sedimentation rate,C-reactive protein was analyzed.Results Thirty-three patients with axial SpA were included in this study.The image abnormalities of the spine were confirmed in 29 axial SpA patients by MRI,including Romanus lesion,Andersson lesion,the inflammation of facet joints and syndesmophyte.In correlation study,BASMI was positively correlated to the numbers of acute Romanus lesions,chronic Romanus lesions,chronic Andersson lesions and whole spinal lesions(r =0.440,P＜0.05; r =0.483,P＜0.05; r=0.421,P＜0.05; r=0.589,P ＜ 0.05 respectively).There was a statistically significant correlation between chronic Andersson lesions and BASFI(r =0.392,P ＜0.05).But no significant associations were found between MRI lesions and other clinical findings.Conclusions MRI lesions in axial SpA were associated with findings reflecting the spinal function,which can better guide the clinical treatment.

Objective To explore the relationship between the endemic arsenism and the liver,renal damage.Methods Some permanent residents were selected as investigated subjects who lived at 3 villages in Datong in Shanxi Province,an arseniasis-endemic areas,These objects were divided into arsenic poisoning and control group on the basis of Diagnosis Standard for Endemic Arsenism(WS/T 211-2001).Then blood and urine samples were collected in the surveyed people.Serum glutamate pyruvic transaminase(ALT)were detected by Enzyme-linked immunosorbent assay as the indicator of the impaired hepatic function.The microdosis albumen (mAlb)and acetylglucosaminidase(NAG)in urine were detected by end-point method and alkaline picric acid as the renal damage indicators.Results A total of 661 people investigated,of which 144 cases were arsenic poisoning patients.The rates of abnormal liver function were significant hisher in arsenic poisoning group[10.42% (15/144)]than that in control[5.22%(27/517)],and both wag significant[X2=5.107,P＜0.05;OR=2.11,95%CI (1.09-4.08)].The geometric mean of mAlb/Ucr was 2.16 mg/g Cr in control,and 2.31 mg/g Cr in arsenic poisoning group,and both was not significant(t=-1.71,P＞0.05).The geometric mean of NAG waft higher in arsenic poisoning group(2.43 U/g Cr)than that in the control(2.22 U/g Cr),and both was significant(t=-3.55, P＜0.05).Conclusions The damage of the liver and renal function were related with endemic arsenism,and NAG is the early indicators suggesting impaired renal function due to endemic arsenism.

Objective To explore the feasibility,safety and efficacy of laparoscopy assisted ultrasound guided radiofrequency ablation (RFA) in the treatment of hepatocellular carcinoma (HCC) beneath the diaphragm.Methods Twentythree consecutive patients with solitary HCC beneath the diaphragm were treated by laparoscopy assisted ultrasound guided RFA in the Chinese PLA General Hospital from January 2013 to March 2016.We observed the p erioperative complications and followedup long-term effect.Results All the 23 patients successfully underwent laparoscopy assisted ultrasound guided radiofrequency ablation.No serious complications such as massive hemorrhage,biliary fistula and severe pleural effusion,hemopneumothorax occurred in the patients during perioperative period.CT examination 2-3 days after the operation revealed that the tumor was completely covered by the ablation area.Besides,the survival condition was satisfactory during follow-up period of 9-38 months.Conclusion Laparoscopy-assisted ultrasound-guided radiofrequency ablation is effective and safe for HCC beneath the diaphragm.

OBJECTIVETo compare postoperative blood loss under different negative pressures of drainage after total hip arthroplasty for the treatment of femoral neck fractures.

METHODSFrom January 1st to December 30th 2013, 74 patients with femoral neck fractures treated with total hip arthroplasty were randomly divided into two groups: high negative pressure drainage group and low negative pressure drainage group. In high negative pressure drainage group, there were 34 cases including 10 males and 24 females, with a mean age of (75.94 ± 9.02) years old, and the patients were treated with 60 kPa negative pressure of drainage. In the low negative pressure drainage group, there were 40 cases including 13 males and 27 females, with an average age of (74.93 ± 8.90) years old, and the patients were treated with 30 kPa negative pressure of drainage. The amount of total drainage, total blood loss, and hemoglobin change were compared between these two groups.

RESULTSAll the patients got primary healing without infections. In high negative pressure drainage group,the change of hemoglobin was (41.74 ± 15.69) g/L, total blood loss was (1,217.73 ± 459.50) ml and the drainage volume was (312.94 ± 103.44) ml; while in low negative pressure drainage group,the results were (34.90 ± 12.90) g/L, (904.01 ± 381.58) ml and (129.25 ± 44.25) ml separately. All the results in high negative pressure drainage group were higher than those in the other group. Three days after operation, the change of hemoglobin was (46.00 ± 13.29) g/L and total blood loss was (1,304.72 ± 421.75) ml; while in low negative pressure drainage group, the changes of hemoglobin was (43.87 ± 11.39) g/L and total blood loss was (1,196.78 ± 344.20) ml; there were no statistically significant differences between two groups.

CONCLUSIONWhen placing drainage devices after total hip arthroplasty for the treatment of femoral neck fractures, the level of negative pressure should be chosen according to preoperative level of hemoglobin and HCT in patients. For old patients with femoral neck fracture, low negative pressure is more suitable.

Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip ; methods ; Case-Control Studies ; Female ; Femoral Neck Fractures ; surgery ; Humans ; Male ; Middle Aged ; Negative-Pressure Wound Therapy ; Postoperative Hemorrhage ; prevention & control

Objective To investigate the difference of the expression of hypoxia reaction genes of vascular endothelial growth factor(VEGF),erythropoietin (EPO) and hypoxia-inducible factor-1 alpha (HIF-1α)) at different times of rats that were induced epilepsy by kainic acid (KA),and analyze their correlation.Methods The epileptic rat model was established by intraperitoneal injection of kanic acid.The expression of VEGF,EPO and HIF-1α gene were detected by real-time fluorescent quantitative PCR assay with TaqMan probe in different times after intraperitoneal injection of KA.Results Compared with normal sodium (NS) group,the expression VEGF was higher at 12 h((8.38±1.27) ×10-3 ng/μl,P＜0.05)) and 24 h((8.30±5.08) ×10-3 ng/μl,P＜0.05)),EPO was higher at 12 h((8.42±0.90) × 10-5 ng/μl,P＜0.05)) and 48 h ((1.50±3.25) × 10-2 ng/μl,P＜0.01)) while the HIF-1α was higher at 24 h((2.11±0.21) × 10-2 ng/μl,P＜0.01)),48 h((1.50±0.33) × 10-2 ng/μl,P＜0.05))and 72 h((1.64±0.16) × 10-2 ng/μl,P＜0.01)).Furthermore,the expression of EPO showed significant correlations with HIF-1α and VEGF (r=0.573,0.471,P＜0.05),VEGF and HIF-1α had eminent correlations (r=0.803,P＜0.01).Conclusions The expression of VEGF,EPO and HIF-1α participate in the seizure procedure and there is certain correlation between the three genes.

Objective To investigate the biomechanicai characteristics of flexor profundus tendons repaired after decimeter wave therapy, and to observe the effect of decimeter wave therapy on early active mobilization. Methods A total of 56 Leghorn chickens were randomly divided into a therapy group and a control group with 28 chickens in each. The 3rd and 4th toes of their left feet were employed for the establishment of a tendon injury model. The flexor profundus tendons were cut and repaired. Gypsum support was applied and fixed with an adhesive plaster after the operation. The operated sites on toes Ⅲ and Ⅳ were exposed. The external fixation was removed 3 weeks later and the chickens were left free to move. Decimeter wave therapy ( frequency 915 MHz, power 8 Watts) was ap-plied for 10 minutes once daily on the left foot of each chicken in the therapy group from day 1 until 3 weeks after the operation. Sham decimeter wave therapy was applied to chickens in the control group. Four chickens from each group were randomly selected at the 1st, 7th, 10th, 14th, 18th, 21st and 28th days for biomechanical analysis. Biome-chanical parameters including tensile strength of rupture (Pmax), elongation ratio at rupture (δimax) and the tensile adhesion strength of the rupture zone (W0>) were observed at each time point. Results At the 7th, 10th, 14th, 18th, 21st and 28th day after the operation, the differences in Pmax, δmax and W0 between the therapy and control groups were statistically significant. The results of the therapy group were better than those of the control group. Conclusions Local decimeter wave therapy after flexor tendon repair can promote intrinsic healing and reduce ex-trinsic healing. The speed and quality of healing are improved. The elasticity and tenacity of the injured tendons are enhanced. Therefore decimeter wave therapy is helpful for early active mobilization training.

Objective To investigate the influence of murine cytomegalovirus(MCMV) infection on differentiation and differentiation gene expression of neural stem cells (NSCs) in vitro for studying the mechanisms of brain abnormalities calmed by congenital cytomegalovirns infection. Methods NSCs were separated from fetal BALB/c mouse and cultured and identified in vitro. The differentiation potency of NSCs was observed by immunnfluorescence. The NSCs infected by MCMV at dosage of multiplicity of infection (MOI) equaled to 5, I and 0. 1, respectively, were cultured in differentiation medium. The morphological changes of the cells were observed by inverted microscope. The ratios of NSCs and its differentiated cells were detected by flow cytometry. The expression changes of nestin, GFAP and NSE, markers of NSCs and its differentiated cells, were studied by immunofluorescence ( MOI = 1 ). The expression of early antigen (EA) of MCMV was detected to observe the infection process. Real-time RT-PCR method was employed to measure the expression levels of the key differentiation genes Wnt-3 and Wnt-7a in Wnt signal pathway of NSCs at early phage of differentiation culture. Results NSCs isolated from embryonic mouse brains could proliferate to form neurnspheres and strongly express Nestin and differentiate into NF-200 positive neurons or GFAP positive astrocytes. The NSCs of the infected groups couldn't adhere to the wall and appear differentia-tion growth, but showed swollen gradually after differentiation culture. The nostin expression of the infected groups downregulated slowly and was higher than that of the control groups ( P < 0.05 ). The GFAP and NSE expression of the infected groups were lower than that of the control groups (P <0.05). The EA of MCMV could be always detected in the cells of the infected groups. The ratios of nestin positive cells of the infected groups were higher than that of the control groups, but the ratios of GFAP and NSE positive cells of the for-mer were lower than that of the latter from 3rd to 9th day after differentiation culture ( P < 0.05 ). The levels of Wnt-3 mRNA and Wnt-7a mRNA of the infected groups were markedly lower than that of the control groups from 1st to 2nd clay and from 12th hour to 2nd day after differentiation culture respectively ( P < 0.05 ) . These changes of the infected groups became more obvious as MCMV MOI increased . Conclusion MCMV could inhibit significantly NSCs differentiate to neurons and astrocytes and lead to the decrease of dif-ferentiated cells. MCMV could inhibit or interfere with the gene expression of Wnt-3 and Wnt-7a in Wnt sig-nal pathway of NSCs. The effect that MCMV inhibited the differentiation and the differentiation gene expres-sion of NSCs showed dose-dependent with MCMV MOI. The inhibitory effect of MCMV on the differentiation of NSCs might be induced by interfering the differentiation gene expression of NSCs, which is possibly the one of primary causes of brain development disorders caused by congenital CMV infection.

AIMTo study the relationship between changes of learning, memory and orphanin FQ (OFQ) in hippocampus of rats in acute hypobaric hypoxia at two different altitude levels of 4 500 m(moderate) and 7 500 m(serious).

METHODSHypobaric chamber, Morris water maze training method and RT-PCR technique were used in the experiment.

RESULTS(1) Compared with the control, the OFQ mRNA expression of hippocampus increased significantly after exposure to acute serious hypobaric hypoxia (8 h/d for 6 d in succession), but obviously decreased after Morris water maze training (6 times/d for 6 d in succession, the latency of place navigation was shortened). (2) After exposure to acute hypobaric hypoxia, the latency of place navigation was markedly elongated, but the OFQ mRNA of hippocampus was significantly higher than that of learning and memory group.

CONCLUSIONThe hippocampal OFQ was involved in the mechanism of decrease in spatial learning and memory induced by acute hypobaric hypoxia.

Altitude ; Animals ; Hippocampus ; metabolism ; Hypoxia ; Maze Learning ; Memory ; Opioid Peptides ; physiology ; RNA, Messenger ; genetics ; Rats ; Rats, Wistar