Objective To investigate the relationship between the MR findings of lumbar elements and chronic low back pain(CLBP).Methods The patients underwent lumbar MRI examinations and sent for a questionnaires of low back pain (LBP).Among them,139 patients whose questionnaires illustrated with CLBP were enrolled.The enrolled patients included 68 patients with nerve roots compression and 71 patients without.Meanwhile,198 hospital staffs underwent lumbar MRI examinations and were sentfor a LBP questionnaire.Among them,62 patients without LBP and nerve roots compression were enrolled.Categorical regression was used to analyze the relationship between MR findings and CLBP.The MR findings iucluded nerve roots compression,average disk degeneration scores(ADD),high-intensity zones (HIZ),Schmorlnodes,Modic Ⅰ change,average facet joints degeneration scores(AZZ),facet joint effusion,high T2 signal in interspinous ligament and subcutaneousparaspinal muscles edema.The regression model was used to analyze the MR imaging and CLBP.Results The regression model was statistically significant (F=9.478,P＜0.01).All predictors yielded an adjusted value was 0.446.Among all predictors,nerve roots compression,ADD,AZZ,subcutaneous or paraspinal muscles edema were statistically associated with the VAS degree (P＜0.05).The sum of the importance of the four predictors above was 0.983.The quantification of predicted VAS degree increased as ADD level increased.The quantification of predicted VAS degree increased to the top at the 2 AZZ level and then decreased.Nerve roots compression and Subcutaneous or paraspinal muscles edema yielded higher quantification of predicted VAS degree level.Conclusion ADD,AZZ,subcutaneousparaspinal muscles edema were probably associated with CLBP degree after adjusting for nerve roots compression.

Objective To present our experience of dealing with complete penile amputation.Methods Two cases of penile complete amputation were reported.The first case was a 34-year-old man,suffered amputation of the penis approximately 2.5 cm distal from the pubic area with a sharp knife.3.5hours later,the patient was transferred to our hospital.The urethra mucosa and corpus spongiosum were anastomosed.The cavernous body of the penis was reattached by suturing the tunics albuginea of each corpus cavernosum to the corresponding proximal segment.One dorssl artery,two dorsal veins,and dorsal nerve were anastomosed under a 10 × microscope with interrupted 9-0 nylon nonabsorbable sutures.The second case was a 25-year-old man,presented to the emergency room 15 hours after distal penile amputation,which had 2 wounds as a result of self-mutilation caused by psychiatric problems.The urethra mucosa and corpus spongiosum were anastomosed.The cavernous body of the penis was reattached by suturing the tunics albuginea of each corpus cavemosum to the corresponding proximal segment using 4-0 polyglactic acid sutures.Results In the first case,the tourniquet was released after replantation,and the distal penis appeared to revascularize,as noted by the gradual increase in redness and size.An arterial pulse was detected,and the superficial penile veins displayed normal turgor,and no bleeding was found.On postoperative day 3,the penile skin started to necrotize.On day 12,the necrotic skin was superficially debrided,and a fistula was observed in the corresponding urethral segment.Two weeks later,the fistula was sutured with 4-0 interrupted synthetic absorbable suture,and a transposition flap to embed the whole injured penis shaft was created from the proximal scrotal skin.The glans was exposed.Two months after the second operation,the embedded penis was released from the scrotum.After follow-up of two years,the patient had glans re-epithelialization with normal voiding,sensation,and erections.In the second case,the glans was still pink,but the penile skin started to necrotize on postoperative day 3.On day 14,serious infections were noted,the necrotic skin was superficially debrided,and the amputated penis was relieved.Conclusions Prompt diagnosis and early treatment are essential to avoid the potential complications of ischemic necrosis and autoamputation.Venous outflow is a critical factor for success of replantation.Microsurgical reanastomosing of the dorsal penile vein,penile arteries,and dorsal nerves can be identified as the standard method for penile replantation.The bipedicled scrotal flap can provide adequate skin cover for penis defects.

To improve the efficiency of halophilic actinobacteria screening and carry out the rapid selection of targeted strains, we tested 34 strains of Streptomonospora by PCR-single strand conformation polymorphism analysis (PCR-SSCP) based on genus-specific primers for the PCR identification. This approach employs PCR with two pairs of primers located in the 16S rRNA sequence flanking two variable region, then build clustering tree according as SSCP data. Synchronously, we sequenced all the 16S rRNA partial sequences for these strains to verify them. The results showed that the PCR-SSCP analysis was an efficient, easy-to-handle and economic method for rapid selection of halophilic actinobacteria resources.

Penile amputation and successful replantation is very uncommon, and there is no routine standardized procedures for dealing with this medical condition. Here we report two cases of penile amputation and replantation involving different degrees of vascular insult leading to different pathogenesis, clinical presentation, surgical approach and prognosis. This report described the microsurgical procedure and postoperative care using bipedicled scrotal flap to achieve successful engraftment and function. A review of the published data and future methods to increase success of such surgical procedures is provided.
Adult ; Amputation, Traumatic ; surgery ; Humans ; Male ; Microsurgery ; Penis ; blood supply ; injuries ; surgery ; Replantation ; methods

BACKGROUND: Benzalkonium chloride has been used in dental restorative materials to enhance the long-lasting antibacterial properties of materials. OBJECTIVE: To evaluate the antibacterial activity of benzalkonium chloride on oral common pathogenic bacteria in vitro. METHODS: The agar diffusion method was used to determine the inhibitory effects of antibacterial agents, 0.1% benzalkonium chloride, 3% H2O2and 5.25% sodium hypochlorite, on five kind of oral pathogens, Porphyromonas gingivalis (P.g), Prevotella intermedia (P.i), Actinobacillus actionmycemcomitans (A.a), Streptococcus mutans (S.m) and Enterococcus faecalis (E.f). The tube dilution method was used to detect the minimal inhibitory concentration of benzalkonium chloride against the five bacteria mentioned above. RESULTS AND CONCLUSION: The antibacterial effect of 0.1% benzalkonium chloride on P.g was not significantly different from that of 3% hydrogen peroxide (P＞0.05), while 0.1% benzalkonium chloride showed better effect on P.i than 3% hydrogen peroxide (P＜0.05). On P.g and P.i, the antibacterial effect of 0.1% benzalkonium chloride was worse than that of 5.25% sodium hypochloritethe ( P＜0.05). The antibacterial effect of 0.1% benzalkonium chloride on A.a and S.m was better than that of 3% hydrogen peroxide (P＜0.05), and similar to that of 5.25% sodium hypochlorite (P＞0.05). The antibacterial effect of 0.1% benzalkonium chloride on E.f was better than that of 3% hydrogen peroxide (P ＜ 0.05), but worse than that of 5.25% sodium hypochlorite (P ＜ 0.05). The minimal inhibitory concentration of benzalkonium chloride to P.g, P.i, A.a, S.m, E.f was 16, 2, 4, 2, 4 mg/L, respectively. To conclude, 0.1% benzalkonium chloride has strong antibacterial effects on P.g, P.i, A.a, S.m and E.f.

To discuss the anti-infection treatment for extensively drug resistant( XDR) Pseudomonas aeruginosa bloodstream infection.Methods This article expounded the pharmaceutical care provided by clinical pharmacists in the treatment of the bacteremia caused by XDR Pseudo-monas aeruginosa.The clinical pharmacist put forward to a feasible plan referring to the solution to other bacterium.Results and conclusion When the minimum inhibitory concentration ( MIC) was not more than 8 mg · L-1 , carbapenems with the combination of amikacin may be an effective method for the XDR Pseudomonas aeruginosa bacteremia.

Background:Leukocyte telomere has been shown to be related to insulin resistance-related diseases,such as type 2 diabetes mellitus (T2DM) and non-alcoholic fatty liver disease (NAFLD).This cross-sectional study investigated the association of leukocyte telomere length (LTL) with NAFLD in T2DM patients.Methods:Clinical features were collected and LTL was measured by Southern blot-based terminal restriction fragment length analysis in 120 T2DM patients without NAFLD and 120 age-matched T2DM patients with NAFLD.NAFLD was clinically defined by manifestations of ultrasonography.The correlation between LTL and clinical and biochemical parameters were analyzed by Pearson correlation or Spearman correlation analysis.Factors for NAFLD in T2DM patients were identified using multiple logistic regressions.Results:LTL in T2DM patients with NAFLD were significantly longer than those without NAFLD (6400.2 ± 71.8 base pairs [bp] vs.6023.7 ± 49.5 bp,P ＜ 0.001),especially when diabetes duration was less than 2 years.Meanwhile,the trend of shorter LTL was associated with the increased diabetes duration in T2DM patient with NAFLD,but not in T2DM patients without NAFLD.Finally,LTL (odds ratio [OR]:1.001,95％ confidence interval [CI]:1.000-1.002,P =0.001),as well as body mass index (OR:1.314,95％ CI:1.169-1.477,P ＜ 0.001) and triglycerides (OR:1.984,95％ CI:1.432-2.747,P ＜ 0.001),had a significant association with NAFLD status in T2DM patients.Conclusions:T2DM patients with NAFLD had a significantly longer LTL than those without NAFLD.The longer LTL was especially evident in the early stage of T2DM,indicating that longer LTL may be used as a biomarker for NAFLD in T2DM patients.

Objective:To explore the effect of the hospital discharge readiness plan based on deep integration of medical nursing and rehabilitation in children with cerebral palsy.Methods:From January 2020 to September 2021, 60 children with cerebral palsy and their 60 parents admitted to the Children's Rehabilitation Department of Anhui Children's Hospital were selected as the research object. The children and parents were divided into the observation group and the control group by random number table, with 30 children and 30 parents in each group. The control group was given routine nursing, and the observation group was given the hospital discharge readiness plan based on the deep integration of medical nursing and rehabilitation. On the first day of admission and the day before discharge, the effects were evaluated using the Chinese version of the Chinese version of the Readiness for Hospital Discharge Scale (RHDS) -Parent Form, the Chinese version of the Quality of Discharge Teaching Scale (QDTS) -Parent Form, the Activities of Daily Living (ADL) Rehabilitation Nursing Rating Scale for Children with Cerebral Palsy.Results:After the intervention, the scores of the observation group were higher than those of the control group in terms of readiness for hospital discharge, quality of discharge teaching, and the differences were statistically significant ( P<0.05) . Conclusions:The hospital discharge readiness plan based on deep integration of medical nursing and rehabilitation in children with cerebral palsy can effectively improve their discharge readiness, the quality of discharge teaching and the ADL of children with cerebral palsy.

OBJECTIVETo study the related risk factors of anemia of rural elderly women in Huangling county, Shanxi, northwest of China.

METHODSElderly women aged 50-75 years in Huangling (northwest of China) were selected as study objects. Finger hemoglobin (Hb) was measured and basic health survey was face-to-face questioned. Two-hundred anemia elderly women were entered into the case group; and by age-matching, 200 with normal Hb concentration were entered into the control group. Dietary survey, health and lifestyle questionnaire were undertaken, and related blood indexes were tested.

RESULTSIn case and control group, annual income was (446.1 +/- 107.9) vs (903.8 +/- 179.1) yuan (t = 3.06, P < 0.01), daily average physical active time was (9.6 +/- 3.2) vs (10.3 +/- 3.1) hours (t = 1.94, P < 0.05), proportion of experiencing food scarce period was 31.8% vs 22.6% (chi2 = 4.14, P < 0.05), waist circumference was (76.2 +/- 7.3) vs (79.5 +/- 8.9) cm (t = 4.08, P < 0.01), respectively; the total protein was (78.0 +/- 5.8) vs (81.9 +/- 6.0) g/L(t = 5.94, P < 0.01), serum iron was (13.9 +/- 5.7) vs (16.1 +/- 5.0) micromol/L (t = 4.19, P < 0.01), serum ferritin was (94.9 +/- 76.4) vs (116.6 +/- 85.2) microg/L (t = 2.58, P < 0.01), saturation of transferrin was 22.9% +/- 10.0% vs 25.6% +/- 8.7% (t = 3.16, P < 0.01), respectively. Multifactor conditioned logistic regression analysis showed that the odd ratio (OR) for anemia with annual income, whether experiencing food scarce period, daily average physical active time, staple food, soybean products, energy was 0.57, 4.74, 0.06, 0.59, 0.55, 0.65, respectively; their confidence interval (CI) was 0.45 - 0.71, 0.73 - 30.56, 0.01 - 0.52, 0.38 - 0.91, 0.34 - 0.87, 0.44 - 0.98, respectively.

CONCLUSIONThe quality of diet, health status and related blood indexes in anemia elderly women were lower than those in control group; lower income, less active time, less staple food, soybean products and energy intake should be risk factors of anemia.

Aged ; Anemia ; epidemiology ; Case-Control Studies ; China ; epidemiology ; Diet Surveys ; Female ; Hemoglobins ; analysis ; Humans ; Middle Aged ; Nutritional Status ; Risk Factors ; Rural Population ; Surveys and Questionnaires

Acquired Immunodeficiency Syndrome ; Biopsy, Fine-Needle ; China ; HIV ; Humans ; Sarcoma, Kaposi