Ventilator-associated pneumonia (VAP) is a common hospital acquired infection in neonatal intensive care unit with high incidence in China. There is no diagnostic gold standard of VAP. The risk factors include premature birth, low birth weight, dura-tion of mechanical ventilation, episodes of intubation, blood stream infections. The recommended precautions include rising head of bed, closed tracheal suction, sucralfate, selective decontamination in digestive tract, improvement of mechanical ventilation, oral and skin care, hand hygiene. However, it is controversial that sucralfate, selective decontamination in digestive tract, passive humidifiers, oral and skin care can reduce the incidence of VAP.

Fractalkine has been recognized as the first member of the fourth chemokine family recently and its receptor, CX3CR1, was identified afterwards. This pair of ligand/receptor play important roles in the migration and adhesion of peripheral leukocyte through different ways. They are also likely to be related to the embryogenesis and regeneration of several organs and may possess some functions in the central nervous system.

Fractalkine has been recognized as the first member of the fourth chemokine family recently and its receptor, CX3CR1, was identified afterwards. This pair of ligand/receptor play important roles in the migration and adhesion of peripheral leukocyte through different ways. They are also likely to be related to the embryogenesis and regeneration of several organs and may possess some functions in the central nervous system.

Objective To investigate the liver protective effects of Siphonostegia chinensis decoction in rats with liver fibrosis induced by carbon tetrachloride(CCl4).Methods A total of 120 male SD rats were randomly divided into six groups: a blank control group, a model group, a Siphonostegia chinensis decoction group, a Salvia miltiorrhiza decoction group, a Rhizoma polygoni cuspidati decoction group and a polyene phosphatidylcholine capsules group, with 20 rats in each group. The model of liver fibrosis in rats was induced by subcutaneous injection with CCl4, except the blank group. Except rats in the blank control group and the model group, the rats in the other four groups were treated with Siphonostegia chinensis decoction, Salvia miltiorrhiza decoction, Rhizoma polygoni cuspidati decoction and polyene phosphatidylcholine capsules(10 ml/kg). The serum level of tumor necrosis factor-α(TNF-α)was determined with enzyme-linked immunosorbent assay, the fibrosis stage assessment were determined by histopathological examination.Results Compared with the model group, Siphonostegia chinensis decoction group significantly reduced the stage of liver fibrosis(P<0.01)and there were no obvious difference in liver fibrosis stage among the Salvia miltiorrhiza decoction group, Rhizoma polygoni cuspidati decoction group and polyene phosphatidylcholine capsules group, and the Siphonostegia chinensis decoction group(allP>0.05).Compared with liver fibrosis model group(368.06±24.90)U/L, the serum level of TNF-α in the Siphonostegia chinensis decoction group(336.61± 20.20)U/L significantly reduced(P<0.01), and there were no obvious difference among the Siphonostegia chinensis decoction group, the Salvia miltiorrhiza decoction group(337.81±21.04)U/L, the Rhizoma polygoni cuspidati decoction group(338.95±24.43)U/L and the polyene phosphatidylcholine capsules group(337.11± 23.64) U/L(allP>0.05).Conclusion Siphonostegia chinensis decoction has certain liver protective effect in rats with liver fibrosis induced by CCl4.

Objective To study the real?time dose verification with 2D array ion chamber array in volumetric modulated arc therapy ( VMAT) with a 2D array ion chamber array. Methods The 2D ion chamber array was fixed on the panel of electronic portal imaging device (EPID). Source?detector distance (SDD) was 140 cm. 8 mm RW3 solid water was added to the 2D array to improve the signal noise ratio. Patient plans for esophageal, prostate and liver cancers were selected to be delivered on the cylindrical Cheese phantom 5 times in order to validate the reproducibility of doses. Real?time patient transit dose measurements were performed at each fraction. Dose distributions were evaluated using gamma index criteria of 3 mm DTA and 3% dose difference referred to the first time result. Results The gamma index pass rate in the Cheese phantom were about 98%;the gamma index pass rate for esophageal, prostate and liver cancer patient were about 92%, 92% and 94%, respectively. Gamma pass rate for all single fraction were more than 90%. Conclusions The 2D array is capable of monitoring the real time transit doses during VMAT delivery. It is helpful to improve the treatment accuracy.

Objective To explore the value of diffused optical tomography(DOT)with ultrasonography (US)in differential diagnosis of breast benign from malignant neoplasms.Methods One hundred ard twenty-three breast neoplasms from 113 patients were checked use the optical tomography image ultrasonography(OPTIMUS).The diagnosis results of the system were compared with pathological study.Two-dimensional ultrasound features in breast neoplasms were digitalizated,and HBT and SO_2 were detected by DOT.At last,synthesis diagnostic index(SDI)was obtained by both US and DOT.Statistic process was carried out in sensitivity,specificity,and the rate of accuracy respectively by US,DOT and OPTIMUS system.Results Among breast neoplasms of 123 mass studied pathologically,78 of them were benign and the rest were malignant.HBT in benign lesions(153.02±105.78)was significantly less than malignant lesions(232.95±78.22),SO_2 in benign lesions(1.0332±0.1641)was significantly elevated compared with malignant lesions(0.8794±0.1814),SDI in benign lesions(147.26±53.76)was significantly less than malignant lesions(243.98±57.27),significant differences were found between the two groups(P＜0.05).The sensitivity of differential diagnosis of breast neoplasms by the OPTIMUS system was 93.33%,the specificity was 83.33%,and the rate of accuracy was 86.99%.Conclusions OPTIMUS can improve the specificity and the rate of early diagnosis.

Objective To describe epidemiological characteristics of scalp psoriasis in China,and to determine its influencing factors through a hospital-based,multicenter and large-scale survey.Methods An epidemiological survey was conducted on patients with scalp psoriasis in 42 hospitals in 11 provinces and 4 municipalities.A questionnaire was designed to collect general and clinical information of patients,including clinical type,lesion distribution,psoriasis scalp severity index (PSSI),aggravating factors,influence on quality of life,treatment course,degree of satisfaction with treatment,etc.Participants were asked to fill out the questionnaire with the help of well-trained dermatologists.Data were processed with the EpiData software.The WPS system and Epi Info 5.0 statistics software were used for descriptive analysis of the data.Results Totally,3 901 patients participated this study,and 3 586 valid questionaires were obtained.The mean age at onset of scalp lesions was (27.40 ± 13.34) years,and the male to female ratio was 1.6∶1 with a mean PSSI score of 13.61 ± 12.31.The hairline of the forehead was the most frequently affected area with the constituent ratio of forehead psoriasis being 74.3％ (2 663/3 586).The duration of scalp psoriasis reached 3 to 6 months every year in 1 136 (31.7％) patients,and the area affected by scalp psoriasis was less than 25％ of the total surface area of the scalp in 1 649 (46％) patients.The most frequent clinical presentation was scaling (92.1％),followed by erythema (80.6％),itching(76.7％),bunchy hairs (39.9％) and hair loss(18.0％).Disease aggravation was most frequently associated with seasons (76.7％),emotions (47.4％),stress (47.1％) and fatigue (46.6％).The quality of life (especially social,outdoor and entertainment activities) was reported to be negatively influenced by this entity to different degrees in 2 529 (70.5％) patients.Of these patients,583 (17.8％) received combination therapy (topical and systemic),with glucocorticoid ointment (27.5％),calcipotriol scalp solution (22.7％) and glucocorticoid-containing solution (11.9％) being the most commonly used topical drugs; only 38.6％ complied with medication requirements and doctors' advice for 3 to 5 weeks,and 35.2％ believed that the primary reason for poor compliance was unsatisfactory response to drugs.It was considered that an ideal drug for the treatment of scalp psoriasis should be highly effective (50.3％),safe (17.8％) and easy to apply (11％) with a rapid onset of action(11.9％).Conclusions Scalp psoriasis has a predilection for the hairline of the forehead with scaling as the main clinical presentation.Winter and spring seasons appear to be the most common aggravating factor of scalp psoriasis.The quality of life is negatively influenced to different degrees in many patients with scalp psoriasis.Topical corticosteroids plus non-hormonal drugs should be the first choice for the treatment of scalp psoriasis.Patients consider that the ideal drugs for the treatment of scalp psoriasis should be effective,safe,and easy to apply.

A ganglion is a benign cystic mass, commonly found around a joint or tendon sheath. It frequently occurs at the wrist, foot, ankle, and knee. Intratendinous ganglion has been rarely reported, and intratendinous ganglion of the long head of biceps brachii is extremely rare. According to our literature review, this is the third case of intratendinous ganglion of the long head of biceps brachii, and the first case of arthroscopic treatment. Therefore we report a case of an arthroscopic treatement for an intratendinous ganglion of the long head of biceps brachii.
Ankle ; Arthroscopy ; Foot ; Ganglion Cysts* ; Head* ; Joints ; Knee ; Shoulder ; Tendons ; Wrist

AIM: To explore correlation,consistency and comfort between traditional tear film examination methods and Oculus Keratograph.METHODS: A retrospective study.Totally 101 cases (101 eyes) were diagnosed myopia and then accepted LASEK (laser epithelial keratomileusis).Non-invasive tear film break-up time(NIBUT),lower tear meniscus height(LTMH) were measured with Oculus Keratograph,fluorescein tear film break-up time(fl-BUT) and Schimer Ⅰ test (SⅠt) were performed on all cases.The correlations analysis between NIBUT and fl-BUT,LTMH and SⅠt were performed by Spearman rank correlation,consistency check between NIBUT and fl-BUT by Bland-Altman analysis.Visual analogue scale(VAS) was applied on evaluating the comfort of two kinds of examination methods.RESULTS: LTMH and SⅠt showed positive correlation (rs=0.346,P=0.001).NIBUT and fl-BUT showed positive correlation (rs=0.393,P=0.001),95% consistency limits range-9.62 to 14.18 in Bland-Altman Figure.There was significant difference between VAS of NIBUT and VAS of fl-BUT(z=-2.324,P=0.020).There was significant difference between VAS of LTMH and VAS of SⅠt (z=-8.845,P=0.001).CONCLUSION: Oculus Keratograph can objectively measure NIBUT and LTMH,and was more comfortable than traditional tear film examination methods.It can effectively assess tear film function before corneal refractive surgery.

Objective To explore the sensitivity and specificity of near-infrared spectroscopy ( NIRS) in the diagnosis of depression. Methods From March 2013 to August 2013,62 patients with de-pression and 70 normal controls were collected from Peking University Sixth Hospital. Optical Tomography System (52 channels) was used to collect the NIRS data during the Verbal Fluency Test (VFT),and the number of words produced during VFT task was recorded. The wave analysis was performed by a professional psychiatrist. Results There was statistical difference in the number of words produced during VFT task be-tween the patients with depression (8.65±0.49)and control group(10.19±0.43) ( t=2.385, P<0.05). Through the wave analysis of NIRS to test patients with depression,the results demonstrated that the sensitivi-ty was 66.1% and the specificity was 91.4%. Conclusion The results of NIRS test display high specificity in the diagnosis of depression,which can be used as an objective index for clinical auxiliary diagnosis.