Objective To evaluate the correlation between osteophytes size and lower limb alignment in the knees of patients with Kaschin-Beck disease (KBD).Methods A total of 300 clinically diagnosed patients with KBD were X-rayed on knee-joints which ranged from the distal half of femur to proximal half of tibia.Meanwhile some related parameters in the X film with the anteroposterior position (including osteophytes length,femorotibial angle,femorotibial joint space ratio of inner side to outer side) were measured by DICOM 2.0,a software of medical graphic measuring,then followed by calculating the osteophyte spur index.The association between femorotibial angle,femorotibial joint space ratio and osteophytes spur index was evaluated by Pearson correlation test.Results The average of femorotibial angle of all the tested knee-joints was (165.97 ± 4.02)°,which positively correlated with both the osteophyte spur index of the medial femoral condyle [(6.54 ± 3.12)％,correlation coefficient (r) =0.524,P＜0.01] and the osteophyte spur index of medial tibil plateau [(7.14 ± 3.40)％,r =0.578,P ＜0.01].The femorotibial joint space ratio was 0.61 ± 0.13,which positively correlated with both the osteophyte spur index of medial femoral condyle (r =0.531,P ＜0.01) and that of the medial tibil plateau (r =0.563,P ＜0.01).Conclusions The results of this study indicate that there is a positive correlation between lower limb alignment and osteophyte size of both the medial femoral condyle and the medial tibial plateau.This finding may be evidenced by the fact that the changes of lower limb biomechanics may contribute to formation and development of osteophytes in the kneejoint.

OBJECTIVE To investigate the phenotypical and genotypical characteristics of the ?-lactamase in the 302 strains of Gram-negative bacilli,and assess the characteristics of the drug resistance.METHODS The phenotypes of ?-lactamase were detected in the Gram-negative bacilli by disc diffusion screen test,which were further ascertained by disc diffusion confirmatory test,a cefoxitin three dimensional test,and metallo ?-lactamases double-disc synergy test.The ?-lactamases were detected by multiple PCR amplification,then DNA product was sequenced.Antibiotics susceptibility was detected by K-B method.RESULTS Among the clinical Gram-negative isolates,a total of 26.49%(80/302)strains′ ?-lactamases phenotypes were positive,ESBLs,ESBLs combined with AmpC enzyme,ESBLs combined with AmpC enzyme and MBL,and AmpC enzyme producing strains were found in 16.56%,6.62%,1.66% and 0.66%,respectively.A total of 24.83% strains′?-lactamases phenotypes were positive,strains produced ESBLs,ESBLs combined with AmpC enzyme,ESBLs combined with AmpC enzyme and MBL,and AmpC enzyme producing strains were found in 17.55%,6.95%,0.33%,and 0.33%,respectively.Drug-sensitivity test showed multi-resistant Gram-negative isolates were more sensitive to amikacin(18.75%),and heavier resistant to ampicillin(97.50%).CONCLUSIONS ?-Lactamase producing Gram-negative bacilli are resistant to multi-antibiotics.

Objective To investigate the antibiotic resistance and molecular epidemiology character of ?-lactamase producers among clinical isolates of Citrobacter freundii.Methods Four strains of Citrobacter freundii were detected by K-B susceptibility method and three-dimensional test.The ?-lactamase gene was identified by polymerase chain reaction(PCR) and sequencing.Results The No.29 strain of Citrobacter friundii was multiple-drug-resistant and proved to produce CMY,DHA type AmpC,TEM and SHV type of extended-spectrum ?-lactamases(ESBLs).The sequencing of corresponding DNA revealed 97% identities of the CMY-2 amino acid sequence.It was a new type of cephalosporinase.Conclusion A novel strain of Citrobacter friundii with CMY type AmpC,DHA type AmpC,TEM and SHV type ESBLs has been found in southern China and it is multiple-drug-resistant.

Objective To explore the diagnostic value of GP-/3 protein in gene detection in the patient of primary hepatic carcinoma, to discuss the joint roles of serum GP73 and AFP, and provide a novel method for the diagnosis for PHC and screening for high-risk population. Methods ELISA was used to detect the serum level of GP73 and AFP in 73 cases of PHC, 13 cases of hepatic cirrhosis, 32 cases of hepatitis and 62 cases of health people. SYBR Green real time fluorescence quantitative PCR was used to detect the relative value of GP73 mRNA in the peripheral blood cells of each group. Comparative Ct method was used to evaluate the relative expression levels. Eight cases of normal liver tissues and 8 cases of PHC tissues were detected at the same time to compare the relative expression levels. Results Kruskal-Wallis test showed that the serum levels of GP73 and AFP had significant differences between four groups(H value were 89. 6 and 52.0, P ＜ 0. 01) and the whole blood GP73 mRNA had no significant differences(H =4. 33, P ＞ 0. 05). Mann-Whitney test showed that the serum levels of GP73 had significant differences among PHC groups[166. 7 (162. 7-231.8) μg/L] and liver cirrhosis[57. 3 (46. 6-113. 6) μg/L], hepatitis[29. 6(26. 2-54. 5) μg/L], health group[25.1 (20. 8-29. 4) μg/L] (U value were 246, 297, 349, P ＜ 0. 01).The A FP levels of the four groups were 380. 9 (258.5-503.2) μg/L, 3.8 (1.3-14. 5) μg/L, 5. 1 (2. 4-7. 8)μg/L and 2. 8(2. 2-5.7) μg/L. It also showed significant differences (U value were 246,419 and 790,P ＜0. 01). The GP73 mRNA expression of PHC liver tissues(12. 64) was significant higher than normal liver tissues (1.00). The critical values for GP73 and AFP was determined to be 123. 2 μg/L and 10. 6 μg/L through the 8OC curves. Under the critical value the sensitivity of GP73 and AFP were 65.8% and 53.4% ,and the specificity of CP73 and AFP were 95.3% and 92. 5% respectively. Joint detection could increase the sensitivity up to 79. 5%, and achieve the high specificity of 90. 7%. Conclusions As a new diagnositic marker of primary hepatic carcinoma, GP73 protein has the very good sensitivity and specificity. The GP73 mRNA in the whole blood sample could not be used for the diagnosis of PHC. But it woule be a good molecular marker for diagnosis of PHC in the liver tissue sample. The joint detection of GP73 and AFP could improve PHC diagnostic performance, and provide an effective approcach to the PHC high-risk screening.

Objective To observe the condition of Keshan disease (KSD) in Gansu Province in order to provide a scientific basis for prevention and control of the disease. Methods In 2011, according to “The national Keshan Disease Monitoring Program (trial edition)”, based on searching of KSD cases, 12 villages of 12 towns in 6 counties of Gansu Province, were selected as surveillance sites. All the residents in surveillance sites were clinically examined and given 12-lead ECG tracings; suspected cases were taken anterior chest X-rays in the distance of 2 meters, while staple food and life conditions of the residents were surveyed. Diagnosis of KSD was based on“Keshan Disease Diagnostic Criteria”(WS/T 210-2011). Results Among investigated 5 484 residents, the incidence of abnormal electrocardiogram was 15.41%. Of the 196 X-ray films, 61 cases had enlarged heart(in which 22 of mild, 21 of moderate and 18 of severe). Two hundred and forty-three cases of KSD were detected, the general detection rate was 4.43%, in which 31 cases of chronic, the detection rate was 0.56%; 212 cases of potential, the detection rate was 3.87%. In all cases, 47 cases were under the age of 30, including 46 cases of potential and 1 case of chronic. The major abnormal electrocardiogram change of KSD cases was ST-T changes[22.68%(71/313)], followed by complete right bundle branch block[16.29%(51/313)], low voltage[12.46%(39/313)], and left anterior fascicular block[6.71%(21/313)]. Per-capita annual income in surveillance site was 1 763 Yuan;and the major staple food was flour, accounted for 87%, and the staple food rice accounted for 5%. Conclusion The detection rate of KSD in Gansu Province is mainly to potential, and there is a cosiderable portion of patients under the age of 30;monitoring and investigation should also be strengthened in the younger age of KSD cases detected village.

Objective To investigate the distribution of the CTX-M- extended spectrum beta-lactamase (ESBLs) producing Esche- richia coli(ECO) and the molecular mechanism of dissemination. Methods To analyze the drug resistance of the 43 isolates, Kirby-Bauer susceptibility method was used. Multiple polymeraso chain reaction (PCR) was used to amplify the gene of ESBLs, AmpC, full length of blaCTX-M-like gene, insertion sequence (IS) ISEcp1B, IS903 , IS26 and integron I. NEST-PCR was used to detect if the beta-lactamase gene lo- cated in the integron I. The product of full length of bla-CTX-M like gone amplified by PCR was sequenced. Results Susceptibility test showed the resistance from high to low in turn was Ampicillin (97.68%), Coftriaxone (67.44 % ), piperacillin(65.12 % ), Cefotaxime (62.79 % ) ,Coftasidime(58.14% ), Cofasolin(55.81% ), Cofepime (53.49%), Cefexitin(51.16%), ciprofloxacin (44. 19% ), Aztreo- nam(41.86% ), Cefoperasone/Sulbactam ( 20.93% ), Amikacin (0% ), Imipenem (0% ), respectively. ECO was susceptive to Imipenem. CTX-M-G1 was found in 25 strains of ECO , TEM, SHV, CTX-M-G1, ISEcp1B, and integron I were found in the nine isolates. IS903 were found in ECO 3 and 5, and IS26 was found in ECO 3. In ECO 3 and 5, blaCTX-M-like was flanked upstream by ISEcp1B element that provided -35 and -10 promoter sequences and a right inverted repeat (IRR) recognized by transposase, downstream by IS903 provided an inverted re- peat, ISEcp1 B and IS903 composed the complex transpeson. Conclusion ISEcplB may drive the expression and dissemination of blaCTX-M-like gene at a high level.

Objective To investigate the expression of connective tissue growth factor(CTGF) mRNA in the sclerotic skin of mice with bleomycin (BLM)-induced scleroderma. Methods Twenty-four SPF female BALB/c mice were randomly divided into the model group and the control group. The model mice were subcutaneously injected on the back with 0.1 mL of BLM (300 ?g/mL, diluted in saline) daily for 4 weeks, while the controls were injected with saline in the same manner. After the final injection the skin section in the injected area was collected for histological examination, measurement of dermis thickness, determination of hydroxyproline contents by a colorimetric method, detection of CTGF mRNA expression by in situ hybridization and measurement of CTGF and pro-collagen ?1(pro-COL1A1) mRNA expression by semiquantitative RT-PCR. Results Compared with the control mice, the model mice showed typical scleroderma histologically. The dermis was significantly thicker and the skin hydroxyproline content was significantly higher in the model group than that in the controls (both P

Objective To grasp the epidemic features of Kaschin-Beck disease in different ecotypic areas in Gansu Province,in order to provide ecological basis for Kashin-Beck disease control.Methods Totally 37 counties with Kashin-Beck disease were divided into four ecological areas,villages with historical serious condition in township and townships with historical serious condition in county were investigated.Clinical examination and Xray of right hand of all 7-12-year-old children in the villages were carried out,while investigation of prevention and control measures was performed.Results Among 27 966 children from four ecological areas,the clinical detection rate was 0.05％ (14/27 966) and the X-ray positive rate was 1.26％ (353/27 966),metaphyseal rate was 1.25％ (350/27 966),bone-side positive rate was 0.01％ (3/27 966) and no case of epiphyseal and carpal were discovered.The clinical detection rate in children in the four ecological areas was not statistically significant (x2() =7.757,P ＞0.05),the Loess Plateau-gully region of Longdong [0.09％ (10/11 604)] ＞ the Anyon area of Qinling of Longnan [0.04％ (3/7 969)] ＞ Alpine grassland meadow area of Gannan [0.02％ (1/4 021)] ＞ the Loess Plateau-hills region of Longzhong [0 (0/4 372)].The detected rate of X-ray in four ecological areas was statistically significant (x2 =18.133,P ＜ 0.05),the Anyon area of Qinling of Longnan [1.49％ (119/7 969)] ＞ the Loess Plateau-gully region of Longdong [1.41％ (164/11 604)] ＞ the Loess Plateau-hills region of Longzhong [0.89％ (39/4 372)] ＞ Alpine grassland meadow area of Gannan [0.77％ (31/4 021)].Comprehensive prevention and control measures on Kaschin-Beck disease were different in different ecotypic areas.Relocation,long-distance education and selenium supplement measures had not been implemented in the four ecological areas.Conclusion The epidemic situation of Kaschin-Beck disease is different in different ecotypic areas in Gansu Province,which maybe related to ecological environment,but is under a state of control.

Objective To study the nursing method about percutaneous biliary tract stent implantation to cure malignant obstructive jaundice.Methods Careful perioperative nursing cares and finished post-hospital direction were applied among 21 patients with malignant obstructive jaundice when by percutaneous biliary tract stent implantation.Results There were 20 patients obtained successful operation,the successful rate was 95%.The postoperative of glutamic pyruvic transaminase were(96.60?89.36) U/L,the total bilirubin was(137.96?103.95) ?mmol/L,the directed bilirubin was((85.67)?62.95) ?mmol/L and the indirected bilirubin was(56.76?37.37) ?mmol/L.All the indexes which have mentioned above were significant lower than those of before operative,P

Objective To investigate the distribution of high pathogenicity island(HPI)in multiple-drug-resistance gram-negative bacilli and analyze the protein sequence.Methods To amplify thefyuA-irp2 gene cluster of the 84 isolates by multiple polymerase chain reaction(PCR),the product was subsequently sequenced.Results The positive rate ofirpl,irp2,irp3,irp4 and fyuA was 40.48％,41,67％,5.95％,O％and 16.67％,respectively.Theamino sequence offyuA comefromEC06748,Kp7151 and PAE7 was usedto compare with AL590842,there are 100％identities.Amino sequence ofirp2 come from Kp49 and Kp51 have 99％identities with AAA27636.1,but amino sequence of irp2 come from EC04 and EC07 only have 90％identities with 1176840.The GenBank accession number is FJ211852 and FJ211851.Amino sequence ofirpl come fromKp 10,Kp49 and Kp51 have 99％identities with AL590842。and amino sequence ofirp3 come from EC03,Kp51,Kp10 and Kp49 have 97％identities with CAA73128.There are the same mutation among the same species,and different mutation among different species.Conclusion There was different extant mutant lost in thefy～t-i,v2 gene cluster in multiple-drug-resistanee gram-negative bacilli.