One patient with the pedicle screw threatening the aorta was treated with adjusting the position of pedicle screw by anterolateral approach. No nervous lesion was found after adjusting. Radiograph showed the position and length of screw at T11 left pedicle of vertebral arch were good. No adverse reaction was detected after 2-years of follow-up.

Objective To investigate the value of diffusion weighted imaging (DWI) in detecting acute intracerebral hemorrhage with 3.0T MR. Methods A total of 105 patients with acute strokes underwent MR examination within 3 days after on set. The detectability and reliability of intracerebral hemorrhage with the DWI b0 sequence was assessed. The results were compared with the gradient-echo (GRE) sequence. The results of the GRE sequence were used as the standard. Results DWI b0 images of 47 cases displayed clearly in 48 acute intracerebral hemorrhage patients. For the detection of acute intracerebral hemorrhage, DWI b0 images had a sensitivity of 97.92%, specificity of 100%, the positive predictive value of 100%, and the negative predictive value of 98.25%. Deoxyhemoglobin-induced hypointense rim was characteristic on DWI b0 images, the next was GRE. Conclusion In the setting of acute stroke, DWI can clearly distinct intracerebral hemorrhage and non-intracerebral hemorrhage with 3.0T MR scanner. With a more rapid and accurate MRI strategy to evaluate acute stroke including DWI, T1WI and T2WI sequences without GRE is helpful in clinical decision making.

Objective To investigate the treatment of intractable bile duct stones. Methods Of the total 149 cases of biliary stones, some are multiple bile duct stones,large stones,stones obstructed in the duodenal ampulla or residuary stones after T-tube surgery, others are associated with small papilla or papilla with neighoring diverticulum. All the stones were extracted with several endoscopic methods, such as choledochoscopy during or after operation, mechanical lithotripsy after EST(endoscopic sphincterotomy), biliary mother-baby endoscopy, ENBD(endoscopic nasobiliary drainage) or biliary-duodenum internal drainage. Results In general, extrahepatic bile duct stones were effectively removed in 94. 6% cases. In 19 out of 20 cases, stones were completely removed with choledochoscopy during operation; In 35 out of 40 cases stones were fully extracted through T-tube endoscopy, and in 72 of 76 cases stones were thoroughly removed with mechanical lithotripsy after EST. Conclusion The intractable bile duct stones can be effectively managed with combined endoscopic therapy, which is attributed to the high success rate in removing biliary stones and should be popularized in this field.

Objective To study the clinical application value of the multiple link dependency probe amplification (MLPA) technology combined with chromosomes karyotype analysis in detecting child development abnormalities .Methods 87 children of growth and development abnormality were collected .Peripheral blood samples were extracted for conducting traditional G -banded karyotype analysis .Moreover the MLPA technique was applied to conduct the chromosome microdeletion detection .The chromo-some situation in children of development abnormality was analyzed .Results Among 87 children patients ,22 cases of abnormal karyotype were detected out ,the abnormality rate was 25 .3% ,including 10 cases of small Y chromosome karyotype(46 XY) ,2 cases of Turner syndrome ,2 case of 45 ,X karyotype ,1 case of 45 ,X/46 ,XY karyotype ,1 case of46 ,XY/45 ,XX karyotype ,1 case of 47 , XXY karyotype ,etc .Among 65 cases of normal karyotype ,microdeletion/microduplication was still found in 8 cases by MLPA . Conclusion The MLPA technology combined with karyotype analysis provide an effective and accurate detection flow process for clinically diagnosing child development abnormality and is conducive to increase the detection rate and accuracy of chromosomal abnormality .

Objective To investigate the antibiotic resistance profile and ftsⅠ genotypes of Haemophilus influenzae isolates from respiratory tract in children.Methods A total of 141 consecutive nonduplicate clinical strains of H.influenzae were collected from January to March 2016.Antimicrobial susceptibility was determined using Kirby-Bauer method.Beta-lactamase production was detected by nitrocefin disk test.PCR technique was employed for ftsⅠ genotyping.Antimicrobial resistance was compared between differentfisⅠ genotypes.Results The prevalence of β-lactamases was 40.4％ (57/141) in H.influenzae isolates.More than half (53.2％,75/141) of the strains were resistant to ampicillin.Mutation offtsI gene was positive in 72.3％ (102/141) of the isolates.The dominant genotype of genomic beta-lactamase-negative ampicillin-resistant (gBLNAR) strains was type Ⅲ (72/102,70.6％).The gBLNAR strains showed higher resistance rate to ampicillin and cefuroxime than the genomic beta-lactamase-negative ampicillin susceptible (gBLNAS) strains (P＜0.05).Conclusions High prevalence offisⅠgene mutation is found in the strains ofH.influenzae isolated from respiratory tract in children.The dominant genotype of gBLNAR strains was type Ⅲ.Mutation offtsⅠ gene in H.influenzae is associated with higher resistance rate to ampicillin and cefuroxime.

OBJECTIVE： To study the chemical constituents of ethanol extract from Yao medicine Cissampelopsis spelaeicola. METHODS： The petroleum ether， ethyl acetate and n-butanol fraction from 75％ ethanol extract of C. spelaeicola were isolated and purified by silica gel， SephadexLH-20 gel column and AB-8 macroporous resin column， etc. The structures of the compounds were analyzed and identified by physicochemical properties and spectral data （mass spectrometry， hydrogen spectrum， carbon spectrum）. RESULTS & CONCLUSIONS： Twelve compounds were isolated and identified from 75％ ethanol extract of C. spelaeicola. β-sitosterol（Ⅰ） and Stigmasterol（Ⅱ） were isolated from petroleum ether fraction； p-hydroxybenzoic acid（Ⅲ）， β-daucossterol（Ⅳ）， protocatechuic acid（Ⅴ）， 6β-hydroxyeremophi-7（11）-en-12，8β-olide（Ⅵ）， 10β-hydroxyeremophil-7（11）-en-8，12-olide（Ⅶ）， 10β-hydroxyeremophi-7（11），8（9）-dien-8，12-olide（Ⅷ）， Quercetin（Ⅸ）， Hyperin（Ⅹ） and 4α-hydroxy- eudesman-11-ene（Ⅺ） were isolated from ethyl acetate fraction； quercetin-3-O-robinobioside（Ⅻ） was isolated from n-butanol fraction. Compounds Ⅰ-Ⅻ are isolated from C. spelaeicola for the first time. The study can lay material foundation for activity stady of C. spelaeicola.