Abstract: Objective　To investigate the diagnostic value of joint detection of Mycobacterium tuberculosis rifampicin resistance gene (Xpert MTB/RIF), Mycobacterium tuberculosis ribonucleic acid (TB-RNA) and Mycobacterium tuberculosis deoxyribonucleic acid (TB-DNA) in bronchoalveolar lavage fluid for smear-negative pulmonary tuberculosis. Methods A total of 806 patients with suspected smear-negative pulmonary tuberculosis admitted to our hospital from May 2020 to July 2022 were selected, 506 patients diagnosed as bacterial negative pulmonary tuberculosis by clinical, X-ray and sputum samples were classified as bacterial negative pulmonary tuberculosis group, and the other 300 patients with non-tuberculous pulmonary disease were classified as non-tuberculous pulmonary disease group. XpertMTB/RIF, TB-RNA and TB-DNA in bronchoalveolar lavage fluid of all patients were detected. With clinical, X-ray and sputum specimen examination of mycobacterium tuberculosis as the gold standard, the diagnostic efficacy of alveolar lavage solution Xpert MTB/RIF, TB-RNA and TB-DNA alone and in combination was analyzed. Results The positive detection rates of Xpert MTB/RIF, TB-RNA and TB-DNA in bronchoalveolar lavage fluid of the smear-negative pulmonary tuberculosis group and the non-tuberculosis pulmonary disease group were 69.96% (354/506) and 2.67% (8/300), 61.46% (311/506) and 5.00% (15/300), and 63.64% (322/506) and 8.00% (24/300), respectively. The rates in the smear-negative pulmonary tuberculosis group were higher than those in the non-tuberculosis lung disease group, and the differences were statistically significant (χ2=342.005, 246.930, 235.687, P<0.01). Compared with the gold standard, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of Xpert MTB/RIF in the diagnosis of smear-negative pulmonary tuberculosis were 69.96%, 97.33%, 80.15%, 97.79% and 65.77%, respectively; those values of TB-RNA were 61.46%, 95.00%, 73.95%, 95.40% and 59.38%, respectively; those values of TB-DNA were 63.64%, 92.00%, 74.19%, 93.06% and 60.00%, respectively; those values of combined diagnosis with Xpert MTB/RIF, TB-RNA and TB-DNA were 61.26%, 100.00%, 75.68%, 100.00% and 60.48%, respectively; the specificity and positive predictive value of combined detection were higher than those of single detection (P<0.05). Conclusions The joint detection of Xpert MTB/RIF, TB-RNA and TB-DNA in bronchoalveolar lavage fluid can improve the diagnostic efficacy of smear-negative pulmonary tuberculosis and is worthy of clinical promotion and application.

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 quality control and quality assurance of the SPECT/CT system.Methods The energy peak,energy resolution capacity and the intrinsic uniformity of the device's detector were regularly examined, and the quality control was performed. Results The daily hardware maintain could reduce the rate of system's trouble. The device's energy peak,energy resolution capacity were consistent during half year's observation period. The two detector's intrinsic uniformity were better after calibration than before. [ detector Ⅰ: ( 2.71 ± 0.28 ) vs (2.37±0.11)(t=2.489,P<0. 05);detector Ⅱ:(2.68 ±0.12)vs(2.38 ±0. 19)(t =6.421,P <0.01) ] .Conclusion Regular quality control and maintain could keep the function stabilization,enhance the availability rate of the SPECT/CT system.

OBJECTIVED: To explore the prevalence and risk factors of type 2 diabetes mellitus (T2DM) and impaired glucose regulation (IGR) in Zhangzi Island of Dalian, additionally to provide a better understanding of further intervention. METHODS: A cross-sectional study was performed in 907 residents aged over 18 years from Zhangzi Island of Dalian. The questionnaire, physical measurement, food intake frequency and previously dietary investigation were used in the analysis. Simultaneously, a series of biochemistrical and immune index was measured, including blood uric acid, blood sugar, total cholesterol, triacylglycerol, as well as serum insulin.RESULTS: The recovery rate of questionnaire was 95.9%, which demonstrated that the prevalence rates of T2DM and IGR in Zhangzi Island were 11.36% and 37.38%, there was no significant differences between males and females (P > 0.05). Only 29.13% of the people with T2DM were aware of the condition. The prevalence of DM and IGR were increased significantly with age (P < 0.01). The results of the logistic regression showed that age, education, alcohol drinking and hypercholesteremia were the risk factors of IGR. In addition, age, education, hypercholesteremia, hypertriglyceridemia, body mass index and hypertension were the important risk factors for the development of DM. CONCLUSION: The prevalence rates of T2DM and IGR in Zhangzi Island of Dalian are high with a low awareness. Health promotion on lifestyle changes may help to increase the public awareness and reduce the prevalence.

For the purpose of exploring the teaching reform model and method, also promoting the quality of talents in acupuncture and tuina field, the research-based teaching model is applied into the course of Theory of Meridians and Acupoints. This method includes two parts of teaching and learning. For teachers, they bring modern research focus and trend into teaching through questionnaire survey among students, aiming to integrate the education inside and outside class. For students, they are guided to resolve the opening, enlightening and scalable issues through consulting abundant resources of literature and database to achieve autonomous participation in the course of learning. By this teaching method, it is expected to train the student's ability of expanding their thinking, as well as discovering, analyzing and solving the problem.
Acupuncture ; education ; methods ; Acupuncture Points ; Acupuncture Therapy ; methods ; psychology ; Humans ; Learning ; Meridians ; Musculoskeletal Manipulations ; education ; methods ; psychology ; Students, Medical ; psychology

Objective To investigate the contribution of single nucleotide polymorphisms (SNP)variation in folate metabolism pathway genes and its interaction with environmental risk factors to the etiology of NTD. Methods In 275 families from central China, a total of 278 aborted fetal tissues or blood samples were collected from NTD individuals, 478 maternal and/or paternal blood samples were also obtained as controls. Folate supplementation, maternal diabetes mellitus and medication before pregnancy and during the first trimester of pregnancy were investigated. SNP analyses of all samples were performed by CEQ 8800. Case-parent control study and transmission/disequilibrium tests (TDT) were performed according to environmental cofactors stratification to evaluated 28 SNP in 12 folate pathway genes associated with human NTD. Results Only gene MTHFR rs1801133 was significantly associated with NTD, and synergistic effects of environmental risk factors (no folate supplementation and maternal diabetes) were shown on the occurrence of NTD. Linkage disequilibrium between BHMT rs3733890 and NTD existed in case of no folate supplementation,whereas the genotype alone did not contribute to the etiology of NTD. Other SNP were not significantly associated with NTD. Conclusions MTHFR rs1801133 is a risk factor of NTD, but BHMT rs3733890 is not an independent risk factor. Further investigations in folate and methionine cycle genes are requird in larger scale to enclose the interactions between gene and gene, or gene and environmental factors.

Objective To explore the follow-up value of phonocardiogram D/S ratio in CHF patients with treatment.Methods Forty-eight CHF patients who had never under-went regular treatment were collected in our hospital,given the regular anti-heart failure treatment for 3 months.NYHA heart failure classification,resting heart rate(RHR),and D/S ratio of phonocardiogram were recorded,six-minutes walk distance(6MWD),Left ventricular end diastolic diameter(LVEDd),the left ventricular ejection(LVEF) were tested before and after treatment.After 3-month treatment,the resting heart rate 65 times as the watershed,the patients were classified into two groups:one was up to standard,and the other was not up to standard.D/S ratio,RHR,6MWD,LVEDD,LVEF and the improvement of the heart function were compared between the two group.Results Exception the resting heart rate,the in-dicators had no significant improvement in the group of not up to standard compared with the before treatment,and D/S ratio, 6MWD,LVEF was improved significantly after three months treatment(P <0.05).In the group of up to standard,the D/S ratio was improved significantly after one months treatment(P <0.05),while after three months treatment all indicators were improved significantly(P <0.05).Comparison between the two groups,the RHR,D/S ratio were significantly improved(P <0.05 ),LVEF was significantly improved after three months treatment(P <0.05).At the same time,the D/S ratio,6MWD and NYHA classifica-tion of cardiac function was significant negatively correlated(P <0.05).Conclusion The D/S ratio could reflect heart functional im-provements in patients with CHF after anti-heart failure treatment,and it could reflect the heart functional improvement earlier and more significant in the group up to standard,it has a good clinic follow-up value in CHF patients with anti-heart failure treatment.

Objective To observe the clinical effects of hyaluronidase iontophoresis in the treatment of in- fants with congenital muscular torticollis(CMT).Methods Fifty infants with congenital muscular torticollis were divided randomly into a treatment group and a control group.Manual stretching was performed with both groups,while hyaluronidase iontophoresis was also administered to those in the treatment group.The range of side-flexion and rota- tion of the neck was examined at the beginning of and after 1 and 2 months of treatment.At the end of the treatment, the overall outcome was assessed according to a scoring system.Results There was no significant difference be- tween the two groups at admission.Compared with the control group,the range of side-flexion and rotation of the neck,and the overall treatment outcome were all significantly better in the treatment group after treatment.Conclu- sion Hyaluronidase iontophoresis can effectively improve function in infants with CMT and alleviate their symptoms.

In order to establish the stable andreliable ISSR-PCR System of Lysimachia christinae, L16 (4(5)) orthogonal design, which based on 7 levels of single factor experiment, were used in this study. The variance analysis was carried out by SPSS 19.0, and 5 main factors affecting the reaction system were optimized in 4 levels. The best annealing temperature was selected by the optimized reaction system. And the stability and reliability of this system was tested by 23 samples from different origins. The results showed that the five factors (DNA template, primer, dNTP, Mg2+ and Taq enzyme) were the most impacts on the amplified results of ISSR-PCR of L. christinae. The order of the influence was: primer > Taq enzyme > DNA template > Mg2+ > dNTP. The optimal system, which was determined by multiple comparison on different levels of each factor, was total volume of 25 microL, including DNA template 60 ng, primer 0.3 micromol x L(-1), dNTP 0.2 mmol x L(-1), Mg2+ 1.8 mmol x L(-1), Taq enzyme 1.25 U. The optimal system was stable and reliable tested by 23 samples from different origins. This study lays the foundation for genetic diversity analysis, fine varieties selection and molecular identification of L. christinae, and provides reference for optimization on ISSR-PCR system of other speciesin future.
DNA Primers ; genetics ; DNA, Plant ; genetics ; Drugs, Chinese Herbal ; chemistry ; classification ; Microsatellite Repeats ; Polymerase Chain Reaction ; methods ; Primulaceae ; classification ; genetics ; Quality Control

Objective To explore the clinical outcome of improved technique of Gamma nail in the treatment of intertrochanteric hip fracture of the elderly patients. Methods From March 2002 to October 2006.39 patients with intertrochanteric hip fracture were operated by improved technique of Gam-ma nail.There were 18 males and 21 females at average age of75.7 years(67_98 years).There were 6 patients with type A1 fracture,24 with type A2 fracture and 9 with type A3 fracture according to AO/ASIF classification.Of all.36 patients(92.3%)had osteoporosis.The operation improvements included the following points:(1)The patients were placed at the lateral decubitus position with the fractured limb on the uppermost,with flexion of knee and hip of 60°.The normal hip and knee were flexed as possible.(2)One-off indirect traction reduction was used after general anesthesia. no requirement of continuous mechanical traction.(3)C-arm image intensifier was employed to obtain normal and lateral projections.Results Of all,35 patients were followed up for a mean period of3 years and 2 months, ranging from 6 months to 5 years and 2 months.Operation data showed incision length of(4.3±1.2)cm,mean opera-tion time of(46±10)minutes,intraoperative bleeding volume of(65±26)ml and intraoperative X-ray exposure of(3.0±2.1)times.Postoperative recovery data showed survival in one-year follow up,with ambulation time of(10.5±3.6)days and fracture union time of(10.9±2.1)weeks.Mean Parker's score wag(6.9±3.2)points 6 months after operation. Conclusions Improved technique of Gamma nail can shorten operation duration,reduce operative trauma and bleeding,reduce X-ray exposure and im-prove success rate of surgery.as facilitates early pest-operative recovery and reduces the perioperative mortality rate of the elderly.