Purpose To evaluate the correlation between acute pulmonary embolism (APE) and right ventricular parameters by multi-slice spiral computed tomography pulmonary angiogmphy (MSCTPA),and assess the severity and mortality of patients with APE.Materials and Methods The clinical and MSCTPA image data of APE patients from January 2012 to November 2015 was analyzed retrospectively.All the patients were divided into three groups according to the pulmonary embolism type and clinical prognosis:66 cases in mixed embolism group (25 cases of death,41 cases of survival);36 cases in peripheral embolism group,2 cases in centralembolism group.The CT post-processing software was used to measure thoracic aorta and main pulmonary artery inner diameter ratio (PA/AO),right ventricular diameter to left ventricular diameter ratio (RVD/LVD);right ventricular area to left ventricular area ratio (RVA/LVA) on axial four-chamber (4-CH) sections and the largest of maximum minor axis diameters on axial sections (RV/LV-LD).The difference of CT related right ventricular parameters among the mixed embolism groups,peripheral embolism and normal groups was compared.Results Statistical difference was found in right ventricular parameters (RVD/LVD,RV-LD/LV-LD,RVA/LVA) in mixed embolism death patients compared with the patients in other three groups (P＜0.05).There was significant difference of right ventricular parameters RVD/LVD,RVA/LVA in mixed pulmonary embolism survival patients compared with patients in peripheral pulmonary embolism and normal groups (P＜0.05),but there was no significant difference between peripheral APE patients and the control group in all RV and PA/AO parameters (P＞0.05).According to the result of ROC curve in mixed type embolism death patients,RVA/LVA was the best indicator of predicting early death (AUC=0.881),with 100.0％ sensitivity and 73.2％ specificity.Conclusion The right ventricular parameters by multislice CT pulmonary angiography can assess APE patient's condition and forecast their early mortality;and the clinical diagnosis accuracy of RVA/LVA is higher.

Objective To explore the inhibition effect of glutamine on the inflammation of rats with pneumonia induced by Klebsiella pneumoniae.Methods Thirty-six SD rats were randomly divided into the normal group,model group and glutamine treatment group.The rat pneumonia model was established by intratracheal instillation of Klebsiella Bacillus pneumonia.Results Compared with the model group,the glutamine treatmernt group could reduce the ratio of W/D(5.98±0.29)vs.(4.32±0.33)(P＜ 0.05),alleviated the lung tissue edema,inflammatory cell infiltration and then improved the morphology of the lung tissue,inhibited the IL-6,IL-1 and TNF-α secretion in serum and lung homogenate(P＜0.05),and inhibited the level of NF-κB p65 and IκBα phosphorylation.Conclusion Glutamine inhibits the inflammation of rats with pneumonia induced by Klebsiella pneumoniae,which might be related to NF-κB signal pathway.

Immunocompromised hosts(ICH)is a particular population drawing more current attention with the susceptibility to infections,especially to the opportunistic pathogens.When infections occur in ICH,the mortality increases significantly.The clinical manifestations and radiological characteristics are untypical and non-specific,so the correct diagnosis in good time is arduous.But the rapid and correct diagnosis is primary and principle to lower the mortality of the infections of ICH,so this article aims to generalize the diagnosis phronesis of pulmonary infections of ICH-to elaborate the key points of the assessment and evaluation of ICH;the principle of differential diagnosis of pulmonary infections in ICH;clinical evaluation program of the pulmonary infiltration in ICH. Abstract:Summ ary:Immunocomprom ised hosts(ICH) is a particu lar popu lation draw ing more current attention w ith the susceptib il-ity to infections,espec ially to the opportun istic pathogens.W hen infections occur in ICH,the mortality increases sign ifi-cantly.The c lin icalm an ifestations and rad iological characteristics are untyp ical and non-spec ific,so the correct d iagnosis in good tim e is arduous.But the rap id and correct d iagnosis is prim ary and princ ip le to lower the mortality of the infections of ICH,so th is artic le aim s to generalize the d iagnosis phronesis of pu lmonary infections of ICH-to elaborate the key points of the assessm ent and evaluation of ICH;the princ ip le of d ifferential d iagnosis of pu lmonary infections in ICH;c lin ical e-valuation program of the pu lmonary infiltration in ICH.

Objective To investigate the etiology of the nosocomial infection and immune function changes anus and anal after operation.Methods 130 patients who needed anus and anal canal surgery were recruited in the study.The clinical data were recor-ded and postoperative nosocomial infection data were observed,including infection type,distribution,pathogenic analysis and im-mune function.Results A total of 67 cases of nosocomial infection occured,the infection rate was 51.5% (67/130),the main types of infection were perineal wound infection,abdominal infections and pelvic infections,urinary tract and vaginal infections were rare. 93 isolates were collected,of which gram-negative bacilli accounted for 67.7% (63/93 ),including bacteroides fragilis (21.5%), Escherichia coli (18.3%),Pseudomonas aeruginosa (10.8%);Gram-positive bacteria accounted for 23.7% (30/93 ),including Staphylococcus aureus(17.2%),Staphylococcus epidermidis(6.5%);5 fungi were isolated accounting for 5.4%,other strains ac-counted for 3.2%.All the immune parameters detected in patients with postoperative nosocomial infection were statistically differ-ent from those before infection(P <0.05)except for IgM(P >0.05).Conclusion The incidence of nosocomial infection was rela-tively high in patients who had anus and anal canal surgery,which could serious affect the patients'outcomes,preventive and control measures should be taken in clinical practice.

Objective: To design and prepare a field battle "Windbreaker" stretcher for fixation of spinal cord injury using macromolecular material, and to determine its application index and assess its efficacy. Methods: Using shape memory waterborne polyurethaneurea/SiO2 nano-composite, we prepared a field battle "Windbreaker" stretcher for fixation of spinal cord injury according to the physique of the Chinese. The time spent to finish the fixation procedure under different conditions (raining, cold weather, land and rivers) was recorded, and the time of solidification was also observed. Results: The weight of a complete set of the field battle "Windbreaker" stretcher was (7.5±1.4) kg. The time to complete a fixation was (2.1±0.55) min in the water, (1.9±0.35) min under dry environment. The time of solidification was(7.7±1.45) min in the water and was (6.9±1.23) min under dry environment. The maximum strength the stretcher could bear was (80±5.7) kg. Conclusion: Our self-designed "Windbreaker" stretcher can be used for rapid and simple fixation of different spinal cord injuries, and the mechanics intensity meet the requirement for fixation. The stretcher can be used for fixation of spinal cord injury under different conditions of field battle.

Objective: To design a portable real-time monitoring tool for spine surgery and to preliminarily evaluate its application,so as to reduce the iatrogenic injury during the treatment of battle field spinal cord injury. Methods: A portable spine guiding device for spinal fixation was designed and prepared. The spinal specimens were randomly divided into control group (n = 10) and experimental group (n = 10). In the control group the way was cleared for the pedicle according to the doctor's experience; in the experimental group the way was cleared using our self-designed guiding device. The operation time was recorded in the two groups. After manipulation the specimens were opened along the pedicle level; the location and the depth of the needle were compared. Results;The manipulation time of a single vertebral body was (0. 5 + 0. 2) min in the control group and (0. 6 + 0. 1) min in the experimental group (P>0. 05). The edge of the puncture to the pedicle wall in the control group was significantly shorter than that in the experimental group ([1. 1 + 0. 3] vs [1. 8 + 0. 2] mm,P = 0. 037). Conclusion:The designed portable guiding device for spinal fixation is easy to carry, simple to operate; and initial in vitro application is satisfactory and can provide reliable reference for early operation.

BACKGROUND: The exact pathogenesis of osteoarthritis is unclear. Studies have shown that macrophages in synovial tissue are involved in sliding-inflammation response and the production of cartilage matrix degradation enzyme. OBJECTIVE: Based on the important role of synovial macrophages in osteoarthritis, to review and summarize the major research achievements and important research methods in this field, laying a foundation for future research on synovial macrophages. METHODS: The first author used computer to search relevant literatures included in PubMed and VIP from 1999 to 2019. The search terms were “osteoarthritis, synovitis, synovial macrophages” in English and Chineserespectively. Manual screening was conducted according to the inclusion criteria, and irrelevant, repetitive and obsolete articles were excluded. Finally, 46 eligible articles were included.RESULTS AND CONCLUSION: There is an inflammatory response in the synovial tissue, and the severity of synovitis is closely related to osteoarthritis symptoms and progression. A large number of macrophages with different activation states are infiltrated in the synovial tissues of osteoarthritis patients at different stages. M1 macrophages are the main subgroup of macrophages involved in the production, cartilage degradation and osteophyte formation of osteoarthritis inflammatory factors, while M2 macrophages have a protective effect on osteoarthritis by secreting anti-inflammatory factors. Inhibiting the differentiation of macrophages into M1 type and promoting their M2 type differentiation can alleviate the pathological changes of osteoarthritis and delay the progression of osteoarthritis. It may be an effective method to treat osteoarthritis by regulating the polarization state of synovial macrophages.

Objective To survey the prevalence of the pulmonary function test in Liaoning province and investigate the cognition of chronic obstructive pulmonary disease（COPD）patients to the test.Methods One hundred and twenty nine comprehensive hospitals of Grade Three and Grade Two have been included to survey the prevalence of the pulmonary function test by telephone.A cross-sectional study was carried out among 206 COPD outpatients to investigate their cognition to the pulmonary function test.Results The total prevalence of the hospitals with the equipment and ability to do pulmonary function tests was only 51.2%.The prevalence of the hospitals of Grade Three（79.4%）was higher than that of the hospitals of Grade Two（24.2%）.In 206 COPD patients,100 cases（48.5%）had been provided with pulmonary function test,53 cases（25.73%）had been diagnosed as COPD in the past.The patients diagnosed as COPD accounted for 33.8% of all chronic bronchitis patients surveyed.The span during the diagnosis of chronic bronchitis and the definitive diagnosis of COPD was 11.79±10.96 years.Conclusion The prevalence of pulmonary function test in Liaoning province is relatively low,especially in the comprehensive hospitals of Grade Two.Few chronic bronchitis patients received pulmonary function test.Thus the time span from the diagnosis of chronic bronchitis to definitive diagnosis of COPD is long as well.

Radiotherapy is an important treatment on gynecological tumors,especially for brachyther- apy.~(137)Cs,~(192)Ir were usually used in the past,but the local control and survival rates were not increased obvi- ously.The machines,that was made in China,of ~(252)Cf neutrons brachytherapy were used already by many hos- pitals in our country and played a preponderant role more and more.It can increase the local control and sur- vival rates effectively on gynecological tumors.

Objective To study the effects of motor imagery therapy on functional performance of upper ex- tremity in stroke patients.Methods Sixty cases of stroke were divided into a treatment group(n=30) and a con- trol group(n=30).The control group was treated with routine rehabilitation training,while the treatment group was treated with motor imagery therapy in addition to the routine rehabilitation training.The Fugl-Meyer Assessment (FMA),upper extremity function test(UEFT)and simple test for evaluating hand function(STEF)were used to as- sess the upper extremity function before and after six months of treatment.Results After treatment,patients in both groups scored significantly better with the FMA scales,UEFT scales and STEF scales when compared to their scores obtained before the treatment(P