Objective To assess the disc injury in neurologically intact thoracolumbar bust fractures and to evaluate the correlation between the severity of disc injury and the parameters of vertebral body damage as as to formulate radiologic index for further MRI examination.Methods A retrospective case series review was made on 22 patients (44 discs) with thoracolumbar burst fractures without neurologic deficit treated from January 2015 to December 2015.Vertebral level involved was from T11-L2.There were 12 males and 10 females,with the mean age of 47.9 years (range,43-60 years).MRI were used to evaluate the severity of disc injury.Among the 44 discs,18 were Grade 0,11 were Grade 1,12 were Grade 2,and three were Grade 3.Then patients with Grade 0 and 1 were taken as disc intact group and other 12 patients disc rupture group.Vertebral wedge angle,local kyphosis angle,anterior and posterior vertebral body height and canal compromise were measured on CT to determine the damage of fracture.Spearman correlation coefficient was used to analyze the correlation between the severity of disc injury and the parameters of vertebral body damage,and receiver operative curve (ROC) was used to assess the effectiveness of these indexes in predicting disc injury.Results Vertebral wedge angle and anterior/posterior vertebral body height ratio were correlated with the severity of superadjacent disc injury (P ＜ 0.05 or 0.01).Canal compromise,vertebral wedge angle and anterior/posterior vertebral body height ratio were significantly different between the two groups (P ＜ 0.05 or 0.01).ROC results showed the area under curve of canal compromise,vertebral wedge angle and anterior/posterior vertebral body height ratio were 0.758,0.762,and 0.867 respectively,indicating no significant difference (P ＞ 0.05).Threshold of canal compromise,vertebral wedge angle and anterior/posterior vertebral body height ratio were 21％,15.4°,and 0.69 respectively.Conclusions Vertebral wedge angle and anterior/posterior vertebral body hight ratio are correlated with the severity of superadjacent disc injury.Canal compromise ＞21％,VWA ＞ 15°and anterior/posterior vertebral body height ratio ＞ 0.69 may be the practice preferences of indications for ordering a MRI in patients with neurologically intact thoracolumbar bust fractures.

Objective To analyze the dynamic trends of physical development,constitutional fitness,and prevalence of obesity among Han children and adolescents in Ningxia aged 7-18 years from 1985 to 2010.Methods Data were collected from the National Survey on Students Constitution and Health in 1985,1991,1995,2000,2005 and 2010,respectively.Height,weight and chest circumference were used to evaluate physical development,vital capacity,50-meter running and vital capacity versus weight ratio for the evaluation of constitutional fitness.Results 1.Weight and chest circumference increased faster than height.The average annual increase of weight among the urban girls was significantly faster than those in rural areas.2.The tempo per year of vital capacity in both boys and girls decreased during 25 years,especially after 2005.The rural students had a faster tempo than those in the urban students,and the rate in boys was higher than those in girls.Vital capacity to weight ratio in boys decreased from 2005 much more than before,and had a decreasing trend in each age group except for a few groups in girls.There was a decrease in the mean time of 50-meter running in both boys and girls from 1985 to 2005,whereas the decrease became slow during 1995-2005.The prolonged trend in 50-meter-run time existed during 2005-2010.The average prolonged speeds per decade in boys and urban students was higher than that in girls and rural areas.3.From 1985 to 2010 year,the increasing prevalence of overweight and obesity among boys and girls was 15.0％,25.0％ and 28.1％,12.4％,respectively.The average increasing rate was much higher in the obese than in the over-weighted children,and there were more in boys than in girls.There was a similar positive trend of increasing prevalence of overweight and obesity with the increased gross domestic product.Conclusions The physical growth and development among students in Ningxia increased rapidly,along with the descending trend of average annual rate of physical fitness as well as the rising trend of prevalence obesity.Some measures should be taken by the government to tackle with the situation,and the healthy intervention should be applied to the high risk population.

Objective To investigate the current situation of clinical practice mode of intensive care unit specialist nurses in Chongqing city, and to provide reference for the construction of standardized clinical practice mode of intensive care unit specialist nurses. Methods A self-designed questionnaire was used to investigate and analyze the 509 students who participated in the training of intensive care unit nurses in Chongqing city. Results Clinical practice time was 2 months, the practice base could meet the clinical practice needs of clinical nurses, clinical practice and assessment methods were varied, but the time arrangement was not reasonable (6.67%, 29/435), the practice content lacked the pertinence (5.52%, 24/435), the teaching method was not reasonable (2.76%, 12/435), the teacher capital was not qualified (1.38%, 6/435) and so on. Conclusions The clinical practice base and teaching staff needs to be improved, and the clinical practice pattern of intensive care unit specialist nurses is good, but the ability to recognize it is not in place. Should be guided by the needs of nurses, under the supervision of the health department, construction of training bases, training in line with the requirements of clinical teachers, strengthen the ability of students to understand, to help study the clinical application of knowledge and skills.

Objective To Establish an evaluation index system of critical care nurses training in Chongqing. Methods A panel of experts was formed with 20 experts from related fields. By the use of Del-phi method, we designed a questionnaire survey and took two rounds of expert consultation and revision, screening the intensive care nurse training evaluation index. SPSS 17.0 statistical software was used to assess the experts involved in the study and to determine the weight of indicators at all levels. Results In the course of the investigation, the experts participating in the initiative was very high, and the authority coeffi-cient (Cr) was 0.896. The training evaluation system of critical care nurses in Chongqing was initially iden-tified, including 3 first-level indicators, 7 second-level indicators 7, 21 third-level indicators. Conclusion The preliminary construction of critical care nurse training evaluation system in Chongqing can promote the ICU specialist nurse training effect and guarantee the training quality, and at the same time it provides some reference for the training and evaluation of the health administrative department.

Objective To evaluate the practicability of CHROMagar orientation medium combined with simple biochemical tests for identification of common oxidase-negtive gram-negative bacilli.Methods The CHROMagar orientation medium was used together with biochemical tests including indole test , ornithine decarboxylase test and lysine decarboxylase test for identification of common oxidase -negtive gram-negative bacilli.The sensitivity, specificity, likelihood ratio, Youden index and Kappa value of the diagnostic assays were evaluated .McNemar test was performed to evaluate facticity, accuracy and cost of the method in com-parison with the Vitek-2 system as reference method .Results The identification of oxidase-negtive gram-negative bacilli from 318 bacterial strains showed that the sensitivities and specificities of CHROMagar orien-tation mediumm in combination with simple biochemical tests to Serratia marcescens, Stenotrophomonas mal-tophilia and Acinetobacter baumannii reached 100%, and for Escherichia coli, Enterobacter aerogenes and Klebsiella pneumoiae were above 90%.The specificities for identification of Enterobacter cloacae, Klebsiella oxytoca, Citrobacter freundii and Proteus mirabilis were all above 90%, but the sensitivities were around 75%-90%.Kappa values of the assays were above 0.85, howerer, which was only 0.5947 for Citrobacter freundii.McNemar test showed that all P values were above 0.05, and cost of the assays was reduced by 90%.Conclusion CHROMagar orientation medium in combination with simple biochemical tests is a cost-effective assay for identification of common oxidase-negtive gram-negative bacilli .

Objective To explore the relationship between obesity phenotypes and adipocytokines in children.Methods Based on the Beijing child and adolescent metabolic syndrome (BCAMS) study,3 508 children (1 788 boys and 1 720 girls) aged 6-18 were recruited.In this study,participants were categorized into four groups:226 cases in general obese group,192 cases in abdominal obese group,1 004 cases in combined obese group and 2 086 cases in non-obese group,according to the sex,age,specific body mass index(BMI),and waist circumference (WC) equal to or greater than the 90th percentile for age and gender of school children in Beijing in 2004.The levels of plasma insulin,serum leptin,resistin and adiponectin were measured by sensitive,specific double-antibody sandwich enzyme-linked immunosorbent assays (ELISA).Analysis of covariance,multivariate linear regression and binary logistic regression analysis were performed.Results There were highest plasma insulin and serum leptin,and lowest adiponectin levels in combined obese group than those in other obese groups and non-obese group and resistin level in abdominal obese group was highest than those in other obese groups or non-obese group.Among subjects with general obesity and conbined obesity,WC was more important factor than BMI for plasma insulin[?(WC)=0.158 P0.05].With covariates adjusted,the odds ratios(OR)and 95% confidence intervals of general obesity,abdominal obesity and combined obesity were 3.46(2.44-4.91),5.41(3.87-7.57) and 10.10(8.26-12.35) for predicting hyperinsulinemia,respectively,5.83(4.02-8.45),7.07(4.97-10.05)and 20.82(16.49-26.28) for hyperleptinaemia,respectively,1.47(1.05-2.07),2.0(1.42-2.80) and 2.66(2.23-3.18) for hypoadiponectinaemia,respectively.Serum resistin was highest in abdominal obesity.Conclusion The levels of adipocytokines in children were correlated with the phenotypes of obesity,especially for abdominal obesity.

Objective To investigate the relationship between serum adiponectin and metabolic syndrome(MS) in children and adolescents with obesity and nonalcoholic fatty liver disease(NAFLD).Methods Four elementary schools and 4 middle schools were selected from Haidian district in Beijing with representative cluster sampling.Two hundred and eighty obese children(obese group),65 obese children with NAFLD(NAFLD group) and 264 normal weight children(healthy control group) aged 7 to 18 years were recruited from the 8 schools with uncompletely randomized sampling.Data including questionnaire,anthropometric measurements,B type ultrasonographic examination for liver were collected and fasting blood laboratory assay were determined.Variables including triglyceride(TG),adiponectin,alanine aminotransferase(ALT) and aspartate aminotransferase(AST) were skewed distribution and natural logarithmical transformations were performed.Chi-square test for category and multiple binary Logistic regression analysis were used to statistical analysis.Results Body mass index(BMI) and waist circumference(WC) in obese group and NAFLD group were higher than those in healthy control group.All the chi-square tests for trend among the 3 groups were statistically significant(P

Objective To investigate the effect of pretreatment with electroacupuncture at point Neiguan(PC6) on CK and myocardial cell activity in rabbit myocardial ischemia-reperfusion injury and provide an experimental basis for a relatively specific relationship between pericardium meridian points and the heart. Methods Forty New Zealand big ear rabbits were randomly allocated to groups A, B, C, D and E, eight rabbits each. Group A was a sham operation group. Group B was an ischemia-reperfusion model group, in which the left anterior descending coronary artery was occlude for 30 min and reperfused for 60 min. In groups C, D and E, points Neiguan(PC6), Lieque(LU7) and Hegu(LI4) were separately given electroacupuncture stimulation, 20 min every day, at seven days before model making. Creatine kinase (CK) and myocardial formazan contents were compared between the groups. Results There were statistically significant differences in serum CK and myocardial formazan contents between group B, C, D or E and group A (P＜0.01, P＜0.05). There was a statistically significant differences in serum CK content between group C, D or E and group B (P＜0.01). There was a statistically significant differences in myocardial formazan content between groups C and B (P＜0.05). There were statistically significant differences in serum CK and myocardial formazan contents between group D or E and group C (P＜0.01, P＜0.05). Conclusion Electroacupuncture at point Neiguan(PC6) can reduce myocardial ischemia-reperfusion induced injury to myocardial cells to produce a protective effect on the heart.

OBJECTIVETo investigate the genotype of blaADC which was a kind of AmpC produced by Acinetobacter baumannii (AB), isolated through the detection of 28 similar strains among children.

METHODS28 strains of AB were collected and isolated from the Pediatrics clinic during 2006, and were identified through bacteria and susceptibility test using Vitex-32 automicroscan GNI and GNS cards. The genotype of blaADC was confirmed by polymerase chain reaction (PCR) and them sequenced.

RESULTS3 of the 28 strains of AB showed multi-drugs resistance, with a positive rate of 10.71%. blaADC was discovered in 17 of the 28 strains and the positive rate was 60.71%. All the 28 strains of AB were resistant to Cefoxitin. blaADC positive strains were all sensitive to Ampicil/Sulbactam, and only one of them was resistant to Piperacillin/Tazobactan. There were no blaADC genes discovered in the strains that were resistant to Ampicil/Sulbactam or Piperacillin/Tazobactan. There were changes of amino acids on the site 4, 242, 342 and 376 in the sequence of blaADC of No.2 strain, comparing to gi /7258342/ emb /CAB77444. 1/ in GenBank.

CONCLUSIONAbove 60% of the AB isolated in children were carrying blaADC while a strain was collected from them at random. When they were undertaken nucleotide sequence analysis, significant difference was found from the others that landed in GenBank, which identified itself as new subtype.

Acinetobacter Infections ; microbiology ; Acinetobacter baumannii ; classification ; drug effects ; genetics ; isolation & purification ; Amino Acid Sequence ; Anti-Bacterial Agents ; pharmacology ; Bacterial Typing Techniques ; Child ; DNA, Bacterial ; genetics ; Drug Resistance, Multiple, Bacterial ; genetics ; Genotype ; Humans ; Microbial Sensitivity Tests ; Molecular Sequence Data ; Sequence Alignment ; Sequence Analysis, DNA ; beta-Lactamases ; genetics

Objective To observe the prevalence of hyperuricemia(HUA)among obese children,and to ex-plore the association between uric acid(UA)levels and cardiometabolic risk factors,acanthosis nigricans and non - al-cohol fatty liver disease(NAFLD). Methods By using representative sampling method,1 753 obese children aged 6 -17 years old from 18 schools in 3 districts of Beijing(Xicheng,Haidian,Miyun)were selected to participate in the clini-cal examinations,including anthropometric measurements(height,weight)and blood pressure. Serum biochemical pa-rameters were assessed,including fasting plasma glucose(FPG),total cholesterol(TC),triglyceride(TG),high - densi-ty lipoprotein cholesterol(HDL - C),low - density lipoprotein cholesterol(LDL - C)and UA. Acanthosis nigricans and B - model ultrasonography of the liver were conducted. Results The prevalence of hypertension,impaired fasting glu-cose,dyslipidemia,acanthosis nigricans,and NAFLD among these 1 753 obese children was 33. 6%(589 cases), 66. 5%(1 156 cases),54. 3%(943 cases),23. 3%(408 cases),and 17. 0%(298 cases),respectively. The preva-lence of HUA was 40. 70%(714 / 1 753 cases),with 50. 17%(581 / 1 158 cases)in boys and 22. 34%(133 / 595 ca-ses)in girls. There was a significant increase in body mass index,systolic blood pressure,diastolic blood pressure, FPG,TG and LDL - C with the increase of UA,but there was a decrease in HLD - C with the increase of UA(all P ﹤0. 05). In boys,the adjusted odds ratios( OR)and 95% CI of the highest quartile of UA for hypertension,impaired fasting glucose,dyslipidemia,acanthosis nigricans,and NAFLD were 1. 16(0. 77 - 1. 74),1. 34(0. 90 - 1. 99),1. 29 (0. 89 - 1. 87),1. 89(1. 17 - 3. 04),and 1. 71(1. 03 - 2. 84),respectively;in girls,the adjusted OR and 95% CI of the highest quartile of UA for hypertension,impaired fas-ting glucose,dyslipidemia,acanthosis nigricans,and NAFLD was 0. 70(0. 40 - 1. 24),0. 60(0. 40 - 1. 00),1. 69(1. 04 - 2. 70),1. 67(0. 80 - 3. 49),and 1. 33(0. 48 - 3. 66),re-spectively. Conclusions The prevalence of HUA is relatively high in obese children and there is a strong association between UA and some car-diovascular metabolic disorders,acanthosis nigricans and NAFLD.