Objective To assess the risk assessment of stroke associated pneumonia (SAP ) in patients with ischemic stroke using A2DS2 score.Methods A total of 1279 patients with ischemic stroke who were admitted and treated in our department from 2009 to 201 1 were retrospectively analyzed and applicated A2DS2 score.A2DS2 score was calculated as follows:Age ≥75 years=1,atrial fibrillation=1, dysphagia=2,male sex=1;stroke severity:NIHSS score 0-4=0,5-15 =3,≥16=5.The patients were divided into three groups according to A2DS2 score:620 in score 0 group,383 in score 1-9 group,276 in score ≥10 group.The three groups were comparatively analyzed.The diagnostic criteria for SAP were as follows:newly emerging lesions or progressively infiltrating lesions in post-stroke chest images combined with more than two of the following clinical symptoms of infection:(1 )fever ≥38 ℃;(2 )newly occurred cough,productive cough or exacerbation of preexisting respiratory tract symptoms with or without chest pain;(3)signs of pulmonary consolidation and/or moist rales;(4)peripheral white blood cell count≥10 ×109 L -1 or≤4 ×109 L-1 with or without nuclear shift to left,while excluding some diseases with similar clinical manifestations to pneumonia, such as tuberculosis, pulmonary tumors, non-infectious interstitial lung disease,pulmonary edema,pulmonary embolism and atelectasis.Analysis of the incidence and mortality of SAP as well as the correlation with ischemic stroke site were performed in the three groups,respectively. Mean ± standard deviation (x ±s)was used to represent measurement data with normal distribution and t test was used.Percentage was used to represent enumeration data and χ2 test was used.Results The incidence of SAP was significantly higher in A2DS2 score ≥10 group compared with those in score 1-9 and score 0 groups (7 1.7%vs..22.7%,7 1.7%vs..3.7%,respectively),whereas the mortality in score ≥10 group was significantly higher than those in score 1-9 and score 0 groups (16.7%vs.4.96%,16.7%vs.0.3%,respectively).The incidences of cerebral infarction in posterior circulation and cross-MCA, ACA distribution areas were significantly higher in SAP group compared with those in non-SAP group (35.1%vs.10.1%,11.4%vs.7.5%,respectively).The incidence of non-fermentative bacteria infection was significantly increased in score ≥10 group.Conclusions A2DS2 score provides a basis for risk stratification of SAP.The prevention of SAP needs to be strengthened in acute ischemic stroke patients having a A2DS2 score ≥10.

A measurement system based on the image processing technology and developed by LabVIEW was designed to quickly obtain the range of motion (ROM) of spine. NI-Vision module was used to pre-process the original images and calculate the angles of marked needles in order to get ROM data. Six human cadaveric thoracic spine segments T7-T10 were selected to carry out 6 kinds of loads, including left/right lateral bending, flexion, extension, cis/counterclockwise torsion. The system was used to measure the ROM of segment T8-T9 under the loads from 1 Nm to 5 Nm. The experimental results showed that the system is able to measure the ROM of the spine accurately and quickly, which provides a simple and reliable tool for spine biomechanics investigators.
Biomechanical Phenomena ; Cadaver ; Humans ; Image Processing, Computer-Assisted ; Range of Motion, Articular ; Spine ; physiology

Objective To investigate the current status and distribution characteristics of chronic constipation,sleep disturbances and olfactory disorders in Chinese elderly.Methods In 2010,the 3rd Chronic Non-communicable Disease & Risk Factor Surveillance in China was conducted in 31 provinces and Xinjiang Production & Construction Corps.42 668 Chinese aged over 60 years in 98 548 households were randomly selected from 162 National Disease Surveillance Points (DSPs) by a stratified multistage cluster sampling.All subjects received a set of standardized questionnaire and interview.After a complex weighing,the differences in the prevalence of constipation,sleep disturbances and olfactory disorders were investigated among the residents with different genders,ages,urban or rural areas and regions.Results In all subjects aged over 60 years,the general prevalence of self-reported constipation was 5.06 ％,which increased with age.The general prevalence of self-reported constipation was higher in females than in males (5.80％ vs.4.27％,x2 =21.78,P＜0.05),higher in urban areas than in the rural areas (6.04％ vs.4.58％,x2 =5.66,P＜0.05),and there were no significant differences among residents in eastern,central,and western regions.The general prevalence of self-reported sleep disturbances was 14.19％,which increased with age.The general prevalence of self-reported sleep disturbances was higher in females than in males (17.27％ vs.10.94％,x2 =165.53,P＜0.05),and there were no significant differences among residents in urban and rural areas or in different regions.The general prevalence of self-reported olfactory disorders was 8.49％,which increased with age.The general prevalence of self-reported olfactory disorders was higher in females than in males (9.36％ vs.7.58％,x2 =22.32,P＜0.05).There were significant differences in the prevalence of self-reported olfactory disorders among residents in eastern,central and western regions (6.98％,8.28％ and 11.00％,x2 =6.66,all P＜0.05 respectively),and no significant difference was found between residents in urban and rural areas.Conclusions The prevalences of self-reported constipation,sleep disturbances and olfactory disorders are increased with age and significantly more common among women in Chinese elderly residents.

Objective To investigate the status of the readiness for hospital discharge and pain degree in inpatients with thoracolumbar osteoporotic fractures, and the correlation between them.Methods A cross-sectional analysis of survey data from a sample of 252 patients with thoracolumbar osteoporotic fractures was conducted in a grade A tertiary hospital in Xi′an from January 1st, 2016 to June 30th, 2016. The status of the readiness for hospital discharge and pain level were investigated through the Readiness for Hospital Discharge Scale and Numerical Rating Scale (NRS) respectively. Pearson correlation coefficient method was used to detect the correlation between the two target factors. Results The average score of readiness for hospital discharge was 7.71±1.55. The mean NRS score decreased from 7.8 ± 0.8 at baseline to 2.7 ± 0.6 before discharge. The scores of each dimensions of readiness for hospital discharge from high to low were expected support, personal status, and coping capacity. There was a negative correlation between discharge readiness and pain degree in patients with thoracolumbar osteoporotic fractures (r =-0.537, P<0.05). Conclusions The status of the readiness for hospital discharge among the patients with thoracolumbar osteoporotic fractures is in a medium to high level before discharge. The pain degree is significantly decreased to a lower level. There is a negative correlation between the readiness for hospital discharge and the pain degree.

OBJECTIVE: To investigate the clinopathological characteristics, differential diagnosis, therapy and prognosis of sinonasal mucosal malignant melanoma. METHOD: Clinopathological data of 18 cases which were diagnosed by pathology and immmunohistochemistry were analyzed retrospectively. All cases were proved by pathology and immmunohistochemistry. All cases were performed operations. 5 underwent single surgery. 4 underwent surgery plus adjuvant radiotherapy. 4 underwent surgery plus adjuvant radiotherapy chemotherapy. 5 underwent surgery plus adjuvant chemoradiation. RESULT: All cases were followed up for a period of 1 to 7 years after operation. Twelve patients died of tumor until the last follow-up, meanwhile 6 patients stayed alive. In Six cases recurrence occurred. In five casescervical lymph node metastasis occurred, of which 3 cases received neck dissection and 2 cases received chemotherapy and radiotherapy due to no surgical indications. In three cases distant metastasis oc- curred. CONCLUSION Sinonasal mucosal malignant melanoma is rare and highly heterogenous. Current diagnosis depends on clinical characteristics and immunohistochemical examination. It still should be differentially diagnosed from other tumors. CT and MRI image examination can provide some helpful information to understand the extent and nature of lesions. The treatment of nasal endoscopic or the surgery under endoscopy has become to be a safe, viable and reasonable alternative to open resection. Appropriate indication must be carefully selected for these lesions.
Chemotherapy, Adjuvant ; Endoscopy ; Humans ; Lymphatic Metastasis ; Melanoma ; drug therapy ; pathology ; surgery ; Mucous Membrane ; Neck Dissection ; Neoplasm Recurrence, Local ; Nose Neoplasms ; Paranasal Sinus Neoplasms ; drug therapy ; pathology ; surgery ; Prognosis ; Radiotherapy, Adjuvant ; Retrospective Studies

Objective To analyze the pulse-field gel electrophoresis (PFGE) patterns and antibiotic resistance of Salmonella enteritidisstrains isolated in Longyan city in order to provide reference for effective control, clinical diagnosis and treatment of outbreaks of food-borne diseases.Methods Seventy-seven Salmonella enteritidis strains isolated from food poisoning cases, livestock and poultry meat samples collected for food safety risk monitoring and sporadic cases in 2014 and 2016 were analyzed by PFGE.Antibiotic susceptibility testing was carried out to determine the minimum inhibitory concentrations (MIC) of 16 common antibiotics to 57 strains.Results Seventeen PFGE types were identified among the 77 Salmonella strains including three predominant types (P4, P6 and P8) and were grouped into three major pulsotypes (Cluster1-3) at 90% similarity level.The predominant types causing outbreaks of Salmonella enteritidis infection were P8, P6, P4 and P14, which were responsible for five cases of food poisoning.These isolated strains were highly resistant to nalidixic acid (93%), followed by resistance towards ampicillin (74%) and streptomycin (54%).Forty-one strains were resistant to three or more antibiotics (71.93%).Conclusion The PFGE types of Salmonella enteritidis strains isolated in Longyan city exhibit polymorphism and are clustered into three major pulsotypes.PFGE molecular typing can provide early-warning of sporadic outbreaks and help to identify the sources of infections in Salmonella enteritidis-related food poisoning.Attentions should be paid to multidrug resistant Salmonella enteritidis.Surveillance for multidrug resistant strains and usage of antibiotics should be strengthened.

Objective To evaluate the influence of narrow-band ultraviolet B on lesional microvessel density (MVD),vascular endothelial growth factor (VEGF),matrix metalloproteinases 2 (MMP-2)as well as on serum VEGF in patients with psoriasis vulgaris(PV).Methods Fifteen patients with PV were recruited into this study with 10 normal human controls.All patients received NB-UVB phototherapy thrice a week for 4-5 weeks.Prior and after the treatment,psoriasis area and severity index (PASI)was calculated,tissue specimens were taken from non-photoexposed lesions,and sera samples were obtained from these patients.Then,MvD and the expression level of VEGF and MMP-2 were measured by immunohistochemical labeled dextran polymer(LDP)method in the tissue specimens.Also,the serum level of VEGF was tested by enzyme-linked immunosorbent assay(ELISA).Results PASI score remarkably decreased in patients after the photothempy(t=13.35,P＜0.01).The MVDs were 20.52±5.02,7.33±1.24 and 4.26±0.79 capillaries per high power field(400 × amplification),in psoriatic lesions before treatment,after treatment,and normal control tissues,respectively,with a significant difference among the three groups (F=97.57,P＜0.05),and a significant increase was observed in the lesions before treatment compared with those after treatment and normal controls.The serum level of VEGF was 307.55±121.65 ng/L in psoriatic lesions before treatment,significantly higher than that after treatment(163.92±95.57 ng/L),and in normal control skin (139.78±79.06 ng/L),whereas there was no significant difference between the latter two groups(P＞0.05).The positivity rate of MMP-2 was similar among the three groups without statistical difference(P＞0.05).In psoriatic patients,a positive correlation was observed among PASI score,MVD,lesional and serum VEGF levels(P＜0.05),also among the MVD,VEGF and MMP-2 levels in lesions(P＜0.05).but lesional MMP-2 was unrelated to PASI score or sgrum VEGF(both P＞0.05).Conclusions NB-UVB may regulate superficial dermal microvascular proliferation by acting on the expression of VEGF in sera and lesions of psoriatic patients.VEGF and MMP-2 may bOth participate in the proliferation process of microvessels,while MMP-2 is unlikely to be involved in the therapeutic mechanism of NB-UVB.

Objective To explore the value of color Doppler ultrasonography(CDU)as preoperative diagnosing and postoperative monitoring in patients with stenosis of subclavian or innominate artery(SIA)before and after percutaneous transluminal angioplasty and stent(PTAS).Methods A total of 45 patients with stenosis of SIA were selected.Their extracranial vertebral artery and subclavian artery were observed with CDU.In 36 patients with one-sided stenosis of SIA.blood flow direction and spectrum of extracranial vertebraI artery were analyzed.Subclavian steal grade confirmed by spectrum change of vertebral artery was compared with the stenosis grade on quantitative angiography(QA).Among 45 patients with stenosis of SIA,PTAS was performed successfully in 36 patients(36 stents implanted).After stents implanted, hemodynamie parameters such as peak systolic velocity(PSV)in stent, follow-up velocity ratio in stem(VR)were measured.Restenosis in stent were observed.Results In 36 patients with one-sided stenosis of SIA,the ultrasonographic steal grade correlated with the QA stenosis grade significantly(r=0.752,P<0.01).Among 36 patients with stent implanted,follow up 8-12 months, 4 patients with restenosis in stent were found.Compared with the patients without restenosis in stent,PSV and VR in stent increased significantly(P<0.01).Conclusions As a fast and non-invasive imaging technique,CDU could allow diagnosis of stenosis of SIA before PTAS,and detection of restenosis after PTAS.

Objective To investigate the characteristics of persisters isolated from the chronic infected patients and clarify the relationship between the infection time and persistence as well as antibiotic drugs,so as to provide scientific basis for clinical effective measures to prevent,control and treatment of persister-associated chronic infection.Methods The tolerant ability of the 41 persisters (4 strains of Escherichiacoli,23 strains of Klebsiellapneumoniae,8 strains of Pseudomonasaeruginosa and 6 strains of Staphylococcusaureus)under differet kind and concentration of antibiotics and nutritional deficiencies cindi-tions were detected.In addition,analysis of the homologous strains isolated from the same patients with different infection time was performed.Results The study found that with the increase of concentration of antibiotics,the proportion of persis-ters would gradually decrease.The tolerance ability of the same persister strain to different antibiotics was dissimilar,and different species persisters also had various tolerance ability to the same kind of antibiotics.Persisters were more able to withstand the lack of nutrition.What’s more,there is no significant difference between the resistant ability of the homolo-gous strains isolated from the same patients with different infection time (P>0.05).Conclusion Persisters have different a-bility to stand the kill of different kinds and concentration of antibiotics and they can even be completely removed when ex-posed to sufficiently high concentrations of antibiotic.

Objective To investigate the effects of PM2.5 on tear film function and corneal epithelial structure in mice.Methods Totally 24 male BALB/c mice (24 eyes) were divided into two groups:group A (with PBS eye drops,n =12),group B (5 mg · mL-1 PM2.5 eye drop group,n =12).PBS and PM2.5 eye drop were given with four times per day for 7 consecutive days in right eye.Tear secretion level was measured with phenol red thread.Break-up time (BUT) of tear film was tested,and corneal fluorescein staining (FL) was scored before therapy and 1 day,4 days and 7 days after droppings and HE staining was performed 7 days after droppings,respectively.Results There was no significant difference in the tear secretion levels,BUT,FL between the groups A and B before treatment (all P ＞ 0.05).At 4 days,7 days after treatment with PM2.5,the mean differences of the group B showed all items significantly changed compared with those before treatment (all P ＜ 0.05).For the group A,there was no statistical change in tear secretion levels,BUT,FL at 7 days after treatment (all P ＞ 0.05).There were statistical differences in all items between group A and B at each time point (all P ＜ 0.05).At 7 days after therapy,the mean layers of corneal epithelial cells in the group A (4 ± 1) was significantly lower than that in the group B (7 ±l) (P ＜0.05).The group B showed that the whole corneal fluorescein staining obviously increased,and corneal epithelial cell layer was thickened.Conclusion PM2.5 can influence tears film function and damage the corneal epithelial structure in mice.