Objective Based on active monitoring MRSA carriage for hospitalized patients, the relationship between colonization pressure and MRSA cross transmission in wards without rigorous contactisolation measures was analyzed, and the role of colonization pressure in predicting MRSA cross transmission was further evaluated. Methods From March to December 2009, active MRSA colonization screening was performed for 240 hospitalized patients in emergency ward and 94 cases in RICU in our hospital. rep-PCR method was employed to do homology analysis on MRSA strains obtained in this study. MRSA weekly colonization pressure, threshold colonization pressure ,cross transmission rate were calculated respectively. RR of MRSA cross transmission under higher level of colonization pressure and lower level of colonization pressure was analyzed. Results MRSA carriage rates on admission for patients in emergency wards and RICU were 6. 25% (15/2A0) and 13. 83 % (13/94) ,and MRSA cross transmission occurred in 13 weeks and 14 weeks in above two units, respectively. Threshold colonization pressures for above two units were 6. 49%and 17. 66%, respectively. For emergency ward, the MRSA cross transmission rate under higher level of colonization pressure was significantly higher than that under lower level of colonization pressure (x2 = 7. 10,P＜0. 01), the RR of MRSA transmission was 9. 61 (95% CI:1. 25-74.00). For RICU, the MRSA cross transmission rate under higher level of colonization pressure was significantly higher than that under lower level of colonization pressure(x2 = 12. 60, P＜0. 01 ), the RR of MRSA transmission was 15.87 (95% CI:2. 06-122. 10). Conclusions Higher level of colonization pressure is an important risk factor for MRSA transmission, and average colonization pressure can be used as a prediction index for MRSA transmission and strengthening prevention and control measures.

OBJECTIVETo observe clinical efficacy of renovation stem revision femoral head arthroplasty for the treatment of unstable intertrochanteric fracture in the elderly.

METHODSTotally 32 elderly patients with unstable intertrochanteric fracture were treated with renovation stem revision femoral head arthroplasty from September 2007 to January 2011. There were 11 males and 21 females with an average age of 83.8 (ranged, 80 to 98) years old,the time from injury to hospital ranged from 4 h to 14 days. According to Evans-Jensen classification, 6 cases were type II a, 20 cases were type II b, and 6 cases were type III. Postoperative mortality, complication rates and Harris hip function score were compared and analyzed to evaluate curative effect.

RESULTSAll patients were followed up and no dislocation occurred. Six patients were died during 15 months and 4.5 years; 24 cases recoved to independent wakling at 6 months after operation, and 8 cases walked with stick and walker. The average Harris hip joint function score were (91.56 +/- 2.96), 28 cases got excellent results and 4 cases good. Nine cases occurred complications and healed after treatment.

CONCLUSIONRenovation stem revision femoral head arthroplasty is a active and reliable method in treating unstable intertrochanteric fracture in the elderly.

Aged, 80 and over ; Arthroplasty, Replacement, Hip ; methods ; Female ; Femoral Neck Fractures ; surgery ; Hip Fractures ; surgery ; Humans ; Male

Objective To study the anti-tumor effects of pEgr-1-endostatin-TNF-α generadiotherapy on mice bearing Lewis lung carcinoma, and to explore the mechanism involved. Methods 240 mice with Lewis lung carcinoma were randomly divided into four groups, including control group,irradiation group, liposome group, and liposome combined irradiation group. The plasmids packed by liposome were injected locally into the tumors of the mice, and the tumors of liposome combined irradiation group were irradiated with 10 Gy γ-rays 24 h later. The expression levels of TNF-α and endostatin in mouse serum were measured by ELISA. Then the tumor growth rates at different time were observed. Tumor angiogenesis density were estimated on frozen sections stained with CD31 by using the Chalkley counting method to vessel hot-spots. The tumor inhibition rates were also calculated. Results Radiation induced the expression of pEgr-1-endostatin-TNFα. The endostatin and TNF-α were expressed steadily for about 4 weeks. The highest levels of expression of the endostatin and TNF-α were (52. 64 ±4. 19)and( 12. 01 ±0. 87 ) ng/ml at 2 week. The expression levels of TNF-α and endostatin were higher in combined therapy group than those in other groups( F = 29. 726,P ＜ 0.05 ). Compared with the control group, the density of tumor angiogenesis were depressed [ (4.7 ± 0. 8 ) vs ( 10.0 ± 1. 2)/field, t = 14. 063, P ＜ 0.05 ] and tumor growth were significantly inhibited compared to the control group and irradiation group [ (5907. 2 ±78.6), (4653.4±32.8) and (763.5 ± 12.3) mm3, F= 16.415,P ＜0.05)]. Conclusions The expression of pEgr-1-endostatin-TNFα could be induced by irradiation in dose- and time-dependent manner. The effect of antitumor and angiogenesis inhibition may be more significant than irradition.

Objective To investigate the value of contrast-enhanced ultrasound(CEUS) to diagnose thyroid nodules with different calcifications,and analyze its correlation with age and gender.Methods The image characteristics of high frequency ultrasound and pathological results of 522 patients with calcified thyroid nodules were analyzed retrospectively.CEUS enhancement patterns of different age and gender were observed and compared.Results There were no malignant nodules in patients under the age of 10.In the group of male and female,malignant nodules patients constituted the highest proportion between 40-49years old and a minimal proportion between 10-19 years old.The CEUS for weak enhancement with micro calcifications were mostly malignant nodules;the high or equal enhancement with macrocalcifications were mostly benign nodules.But a part of micro calcifications in young women patients (20 to 29 years old) with high or equal enhancement were mostly malignant nodules.Conclusions The CEUS for weak enhancement with microcalcifications are mostly malignant nodules,but a part of microcalcifications in young women patients (20 to 29 years old) with high or equal enhancement are mostly malignant nodules.

BACKGROUND:Although the nickel-titanium occluder in the treatment of congenital heart disease has a better clinical effect, arrhythmia wil be more likely to develop in late stage. OBJECTIVE:To investigate the effect of nickel-titanium wire on expression of sarcoplasmic reticulum Ca~(2+)-ATPase and ryanodine receptor of rat myocardial cels. METHODS:Thirty Sprague-Dawley rats were obtained and randomly divided into two groups: experimental and control groups. The nickel-titanium wire was implanted to the apex of heart of rats in the experimental group. Rats in the control group received no special treatment. Rat mycardial cels were harvested at the 1th, 3rdand 6th months after operation. The gene and protein expressions of sarcoplasmic reticulum Ca~(2+)-ATPase and ryanodine receptor of rat myocardial cels were detected using RT-PCR and immunohistochemistry, respectively. The inflammatory reactions were detected using hematoxylin-eosin staining. RESULTS AND CONCLUSION:After the nickel-titanium wire was implanted into the rat myocardium, inflammatory reaction was induced by inflammatory cel infiltration in the experimental group, with hyperplasia of fibrous tissue. The inflammatory reaction gradualy disappeared as the implanted time extended. No inflammatory cel infiltration was visible in the control group. There was no significant difference in the gene and protein expressions of sarcoplasmic reticulum Ca~(2+)-ATPase and ryanodine receptor of rat myocardial cels at different time points after operation between these two groups. It showed that nickel-titanium wire had no influence on the expressions of sarcoplasmic reticulum Ca~(2+)-ATPase and ryanodine receptor of rat myocardial cels. These results suggest that nickel-titanium occluder-related arrhythmia may have little relationship with abnormal protein expression of sarcoplasmic reticulum Ca~(2+)-ATPase and ryanodine receptor.

OBJECTIVETo identify the mutations of iduronate-2-sulfatase (IDS) gene in mucopolysaccharidosis type II patients.

METHODSPCR-SSCP analysis was applied to detect the common mutations in the exons 2, 3, 5, 7, 8, 9 in IDS-gene of the patient. DNA sequencing and PCR-RFLP were applied to analyze the mutation detected by PCR-SSCP.

RESULTSA new mutation(1253G-->T) of exon 7 of the IDS gene was found by PCR-SSCP and DNA sequencing in the patient, The PCR-restriction enzyme digestion showed that enzyme digestion location appeared in the patient and his mother, which verified the results of sequencing analysis.

CONCLUSIONThe mutation of patient with MPSII could be detected effectively and quickly by the applications of PCR-SSCP, DNA sequencing and PCR-restriction enzyme digestion analysis, and the new mutation thus detected is necessary for the prenatal diagnosis of the pedigree.

Child ; Humans ; Iduronate Sulfatase ; genetics ; Male ; Mucopolysaccharidosis II ; genetics ; Mutation ; Polymorphism, Single-Stranded Conformational

Objective Dual-source CT(DSCT) energy imaging was used to analyze the difference of energy spectrum pa-rameters and energy spectrum curves between mediastinal metastatic lymph nodes and non-metastatic lymph nodes in non-small cell lung cancer(NSCLC). The relationship between DSCT standardized iodine concentration and energy spectrum curve with medias-tinal lymph node metastasis was discussed. Methods A total of 113 patients with NSCLC underwent DSCT energy imaging scans. Io-dine images were obtained at the processing workstation. The normalized iodine concentrations of all mediastinal lymph nodes and en-ergy spectrum curves at different energy levels were measured. According to the pathological results,the patients were divided into lymph node metastasis group and non-lymph node metastasis group. The normalized iodine concentration and energy spectrum curve slope of the two groups were analyzed by t-test. The best threshold of standardized working iodine concentration was calculated by re-ceiver operating characteristic curve(ROC)to diagnose the mediastinal lymph node metastasis of NSCLC. Results There was a sig-nificant difference in the normalized iodine concentration between the two groups of mediastinal lymph nodes in NSCLC(P<0. 05);The ROC curve was used to calculate the standardized iodine concentration for the diagnosis of NSCLC. The optimal threshold for lymph node metastasis was 52. 45% ;The energy spectrum curve of mediastinal lymph nodes in NSCLC was gradually decreasing. There was a significant difference between the two groups in the range of 40~110 keV interval(P<0. 05). Conclusion The quanti-tative analysis of DSCT energy imaging parameters is of great significance in the diagnosis of mediastinal lymph node metastasis in NSCLC. It can be used as an important index for preoperative judgment of lymph node metastasis in NSCLC.

Objective:To detect the changes of liver stiffness before and after chemotherapy in postoperative breast cancer patients using the two-dimensional shear wave elastography (2D-SWE) technique, and analyze its correlation with liver serum indexs, then discuss the application value of 2D-SWE technique in the quantitative diagnosis for chemotherapeutic liver injury.Methods:Sixty breast cancer patients underwent postoperative chemotherapy in Qilu Hospital of Shandong University from January 2021 to November 2021 were included. Conventional two-dimensional ultrasound, 2D-SWE and the serum tests including alanine aminotransferase(ALT), aspartate aminotransferase(AST), γ-glutamyltransferase(γ-GT), alkaline phosphatase(AKP) were performed before and after chemotherapy, respectively. The medians of ElastQ Imaging stiffness (EQI meds) of the whole liver and different liver segments (S4, S5/S6, S7/S8) before and after chemotherapy were measured and compared. The EQI meds of different liver segments (S4, S5/S6, S7/S8) after chemotherapy were compared. The correlation between EQI med of the whole liver and serum indexes after chemotherapy was analyzed. Results:①Compared with before chemotherapy, the EQI meds of the whole liver and different liver segments after chemotherapy were significantly decreased ( P<0.001, respectively). ②The EQI meds among different liver segments were different after chemotherapy ( F=7.489, P=0.001). Moreover, the EQI meds of S5/S6 and S7/S8 were significantly lower than those of S4 after chemotherapy ( P=0.002, 0.001). ③The EQI med of the whole liver was negatively correlated with ALT, AST, and γ-GT ( r=-0.776, P<0.001; r=-0.656, P<0.001; r=-0.428, P=0.010), while there was no correlation between the EQI med of the whole liver and AKP ( r=-0.146, P=0.267). Conclusions:2D-SWE is expected to be a new, real-time, noninvasive and quantitative method to evaluate the changes of liver stiffness before and after chemotherapy in postoperative patients, thus provides a promising method for the early clinical diagnosis of chemotherapy-induced liver injury in breast cancer patients.

2019 novel coronavirus(2019-nCoV) outbreak is one of the public health emergency of international concern.Since the 2019-nCoV outbreak, China has been adopting strict prevention and control measures, and has achieved remarkable results in the initial stage of prevention and control.However, some imported cases and sporadic regional cases have been found, and even short-term regional epidemics have occurred, indicating that the preventing and control against the epidemic remains grim.With the change of the incidence proportion and the number of cases in children under 18 years old, some new special symptoms and complications have appeared in children patients.In addition, with the occurrence of virus mutation, it has not only attracted attention from all parties, but also proposed a new topic for the prevention and treatment of 2019-nCoV infection in children of China.Based on the second edition, the present consensus further summarizes the clinical characteristics and experience of children′s cases, and puts forward recommendations on the diagnostic criteria, laboratory examination, treatment, prevention and control of children′s cases for providing reference for further guidance of treatment of 2019-nCoV infection in children.

OBJECTIVETo evaluate the association between vasectomy and prostate cancer.

METHODSWe searched comprehensively the databases, CBMDisc, CMCC, CMAC, CNKI (from 1978 to January 6, 2009), and PubMed (from 1965 to January 6, 2009) using the key words "vasectomy" and "prostate cancer", screened the retrieved literature according to the inclusion and exclusion criteria, performed a Meta-analysis with the software RevMan 4.2 after identification of the relevant data, and calculated the overall pooled OR (95% CI) as well as that of the association of prostate cancer with <20 and > or =20 yr vasectomy.

RESULTSA total of 20 088 cases and 232 506 controls in 27 reports (7 cohort and 20 case-control studies) were included in this investigation. The overall pooled OR (95% CI) was 1.10 (0.97-1.24), and those of <20 and > or =20 yr vasectomy were 0.94 (0.83-1.06) and 1.05 (0.90-1.23), respectively.

CONCLUSIONNo existing literature show any positive association between vasectomy and prostate cancer.

Humans ; Male ; Prostatic Neoplasms ; epidemiology ; etiology ; Risk Factors ; Vasectomy ; adverse effects