[Objective] To compare the efficacy of interbody fusion with cage versus corpectomy and fusion with plate in treating adjacent two-level cervical spondylosis.[Method] Sixty patients were included in this study.All patients were randomly assigned to anterior interbody fusion with cage (AIFC) group or anterior corpectomy and fusion with plate (ACFP) group. The average follow-up period was 28 months for AIFC group,and 25 months for ACFP group. [Result] The average loss of lordosis angle, the lost correction of segmental height and the scores on the criteria of 40-score method were not statistically significant between these 2 groups. The lordosis correction, operative estimated blood loss, and operative time were statistically better in the AIFC group significantly . [Conclusion] The short-term results of AIFC and ACFP in treating adjacent two-level cervical spondylosis were satisfactory. The advantages of AIFC are the elimination of donor site complications, increasing more segmental lordosis, and reducing blood loss and operative time.

Coal Mining ; Humans ; Occupational Diseases ; prevention & control ; Occupational Health ; Tuberculosis ; prevention & control

Background Clinical researches showed that antimicrobial-resistance of bacterium is gradually serious.It is very important to master pathogen distribution and antimicrobial susceptibility after eye surgery.Objective This study was to investigate the distribution and drug sensitivity of pathogenic bacteria from ocular operative infection in 3-year duration to provide a reference for reasonable selection of antibiotics.Methods Sixtyfive positive specimens were obtained from 65 patients due to postoperative infection in Department of Ophthalmology of Shenzhou Hospital and Shengjing Hospital from 2009 January through 2011 December.The pathogenic bacteria were isolated and then the drug sensitivity test of conventional antibiotics was performed.Results Among the 65 ophthalmic specimens,35 strains of Gram-positive bacteria were isolated with the constituent ratio 53.8％,and 15 strains of Gram-negative bacteria accounted for 23.1％.Fungus was found in 15 cases with the constituent ratio 23.1％.Staphylococcus epidermidis accounted for 42.9％ in Gram-positive bacteria,and Pseudomonas aeruginosa accounted for 33.3％ in Gram-negative bacteria.Aspergillus was the main component of fungus,which accounted for 60.0％ of the proportion 3 strains of methicillin-resistant Staphylococcus aureus (MRSA) in 8 strains of Staphylococcus aureus,but no vancomycin-resistant Enterococcus (VRE) and vancomycin-resistant Staphylococcus (VRS) were seen.The in vitro drug sensitivity test showed that the main Gram-positive bacteria,Staphylococcus epidermidis and Staphylococcus aureus,were sensitive to linezolid,vancomycin,levofloxacin and ciprofloxacin with the sensitive rates ＞50.0％,and these bacteria were lowly sensitive to penicillin and erythromycin with the sensitive rates ≤30.0％.Pseudomonas aeruginosa appeared to be the main Gram-negative bacteria,showing a sensitive rate ≥ 80.0％ to tobramycin,amikacin,ceftazidime,cefepime,cefoperazone/sulbactam,piperacillin/tazobactam,imipenem and meropenem.Conclusions Staphylococcus epidermidis,Staphylococcus aureus,Pseudomonas aeruginosa and Aspergillus are primary pathogens in ocular infection after operation.Antibiotics such as penicillin,erythromycin,levofloxacin,cefotaxime seem to be relatively high resistant to eye infection.To choose sensitive antibiotics timely and reasonably is a key to the prevention and control of ocular infection after operation.

Objective To explore the endogenesis metabolizer character of kidney-yang insufficiency syndrome model rats caused by hydrocortisoni natrii succinas with metabolomics technology. Methods Twenty four Sprague-Dawley(SD)male rats were divided randomly into a normal group, a kidney-yang insufficiency model group, and a oral administration group, eight rats in each group. After producing kidney-yang insufficiency model by injecting hydrocortisoni natrii succinas intramuscularly, oral administration group rats were administered orally with white prepared lateral root of aconite every day for two weeks. After twenty-four hour the last oral administration, the blood plasm were prepared and used for testing endogenesis metabolism with the liquid phase color spectrum-mass spectra (LC/MS) metabolomics technology. Results Apices shape change of lysophosphatidyl choline (LPC) and lysophosphatidyl ethanolamine(LPE) and 468.4m/z unbeknown chemical compound of normal rats were distinct from those of model rats. Above-mentioned chemical compound as chief material symbols of kidney-yang insufficiency syndrome might be farther studied. Conclusion Finding out differential symbol from endogenesis metabolizer with metabolomics technology was redounded to deep exploring the biology essence of traditional Chinese medicine syndrome.

Objective To evaluate the early complications of cervical spine surgery .Methods We retro-spectively analyzed 96 cervical spine surgery patients in our department ,including 56 cervical spondylotic myelopathy , 21 cervical fracture and/or dislocation ,11 cervical spine tumor ,5 atlantoaxial dislocation ,3 Chiari malformation .By analyzing causes of complications ,the countermeasures were developed .Results 27 patients had complications .The major complications were:death in 1 case,incision hematoma in 2 cases,incision infection in 4 cases,spine cord inju-ry or nerve root injury in 3 cases,cerebrospinal fluid leakage in 3 cases,superior laryngeal nerve and recurrent laryn-geal nerve injury in 4 cases,pulmonary infection in 5 cases,urinary tract infection in 4 cases.There were no esophage-al fistula and vertebral artery injury in these patients .The incidence rate in anterior ,posterior,anterior combined with posterior surgery was 24.6%(14/57),36.8%(7/19),40.0%(6/15) respectively.Conclusion Cervical spine surgery is likely to get early complications .Adequate preoperative preparation and improving operative techniques , timely and correctly handle the complications could reduce complications and improve cure rate .

Abstract: Objective　To explore the early diagnostic value of peripheral blood peroxisome proliferator-activated receptor γ (PPARγ) combined with γ-interferon (IFN-γ) release assay (IGRA) in the diagnosis of pulmonary tuberculosis in patients with end-stage renal disease (ESRD), and to provide reference for clinical diagnosis and treatment. Methods　From January 2019 to December 2021, 70 ESRD patients with suspicious symptoms of pulmonary tuberculosis were treated at Hebei Chest Hospital were selected as the research objects. According to the examination results, they were divided into ESRD group (40 cases) and ESRD complicated by pulmonary tuberculosis (40 cases, comorbidity group). In addition, 40 cases with pulmonary tuberculosis were used as the PTB group. All three groups of patients underwent IGRA test, and the peripheral blood PPARγ level was detected by enzyme-linked immunosorbent assay, and the diagnostic value of PPARγ combined with IGRA test for ESRD patients with pulmonary tuberculosis was explored. Results The expression level of PPARγ and IFN-γ content in the PTB group and the comorbidity group were obviously higher than those in the ESRD group (P<0.05), while the differences in PPARγ expression level and IFN-γ content between the PTB and comorbidity groups were not statistically significant (P>0.05). The ROC curve showed that the areas under the curve (AUC) of PPARγ and IGRA in the diagnosis of end-stage renal disease combined with tuberculosis were 0.823 (95%CI: 0.722-0.925) and 0.773 (95%CI: 0.662-0.883), respectively, and the AUC of combined detection was 0.928 (95%CI: 0.871-0.984), which was better than that of PPARγ and IGRA alone (Z/P=2.057/0.039, 2.843/0.005). The Kappa values of serum PPARγ and IGRA test compared with the clinical gold standard results in the diagnosis of ESRD complicated with pulmonary tuberculosis were 0.557 and 0.444 (P<0.05). The combined screening of ESRD with pulmonary tuberculosis was consistent with the clinical gold standard (Kappa=0.661, P<0.05). Among the 30 ESRD patients complicated with pulmonary tuberculosis, the sensitivity of PPARγ combined with IGRA test in diagnosis of ESRD complicated with pulmonary tuberculosis was 93.33% (28/30), which was higher than 70.00% (21/30) of PPARγ and 66.67% (20/30) of IGRA test alone (P<0.05). Conclusions Peripheral blood PPARγ and IGRA tests have certain diagnostic value for ESRD complicated with tuberculosis, and the combined detection of the two can improve the sensitivity and reduce the rate of missed diagnosis, which is worthy of clinical promotion.

Background The diagnosis and treatment of fungal keratitis are knotty.There is no quantitative method to identify the disease and judge the therapeutic effect of the antifungal agent.Studies have determined that serum (1,3-) β-D-glucan level can sensitively and specifically reflect the state of systemic mycotic-causing diseases.However,whether (1,3-) β-D-glucan level in tear can monitor and diagnose mycotic keratitis is unclear.Objective Purpose of this study was to investigate the change of tear (1,3-) β-D-glucan level following the administration of antifungal drug in fungal keratitis patients,and evaluate the diagnosis and monitor value of (1,3-) β-D-glucan in tears for fungal keratitis.Methods Sixty patients who were diagnosed as fungal keratitis by fungal culture were analyzed in Affiliated Hospital of Qingdao University Medical College from July 2010 to May 2012.The patients received the topical administration of antifungal drug for 28 days.Thirty healthy volunteers without eye disease served as normal controls.The tear of 50 μl was collected from each subject for the detection of (1,3)-β-D-glucan before the therapy,7,14,28 days after therapy and 7 days,14 days after the drugs were stopped,respectively.The dynamic changes of (1,3-) β-D-glucan levels in tears were evaluated and compared with the manifestation of the lesions under the laser scanning confocal microscope.The patients without hyphal by the laser scanning confocal microscopy and tear (1,3-)β-D-glucan level less than 20 ng/L were subsequently treated for another 7 days,and the following-up duration was 2 months.The informed consent was obtained before any medical examination was performed from each subject.Results (1,3-)β-D-glucan level in tears (Log value) was (6.37 ±0.48)ng/L in the patient group,and was significantly higher than (2.00±0.31) ng/L in the normal control group (t =2.89,P＜0.01).The lesion was smaller with the gradually clear border,and the number of mycelia was decreased under the laser scanning confocal microscope 7 days after treatment.(1,3-) β-D-glucan level in tears was gradually declined in a time-dependent manner after treatment.The (1,3)-β-D-glucan level in tears (Log) was (5.19 ± 0.42),(4.16 ± 0.33),(2.99 ±0.42),(2.91 ±0.39),(2.80±0.40) ng/L 7,14,28 days after treatment,and 7 days,14 days after the drugs were stopped,respectively,with a statistically significant difference in comparison with (6.37±0.48)ng/L before treatment (P＜0.01).(1,3)-β-D-gluean level in tears remained a lower level till the end of follow-up,and no recurrence of lesion was found in the patient group.Conclusions Detecting (1,3)-β-D-glucan level in tears is of good diagnosis and monitor value in the evaluation of fungal keratitis.

Objective To investigate the distribution of water-borne fluoride and the current status of water defluoridation project by improving drinking water quality in endemic fluorosis areas in Shandong province,and to provide scientific basis for making strategies in prevention and control of the disease. Methods According to "the National Technical Scheme for Endemic Disease Control in 2004, 2005 and 2006", 113 endemic fluorosis diseased counties(cities, and districts) of the province's 17 cities were screened in order to investigate the fluoride level in drinking water in fluorosis villages, recheck the fluoride level after implementing the water defluoridation project, and investigate the current status of the water defluoridation project. The fluoride level in drinking water was determined by F-ion selective electrode. Results There were a total of 5816 water defluoridation projects in the province. Most of them were carried out by drilling a deep well to get under-ground water. The wells still in good condition were accounted for 72.80% (4234/5816). Intermittent operated wells were accounted for 3.11% (181/5816). Abandoned wells were accounted for 24.09%(1401/5816). Level of water fluoride was determined in 6940samples from fluorosis villages(villages that not carry out the water defluoridation project as well as villages carried out the water defluoridation project with abandoned wells were included) and the value that lower or equal to 1.00mg/L was determined in 2987 villages which accounted for 43.04% (2987/6940). Level of water fluoride that over 1.00 mg/L was found in 3953 villages which accounted for 56.96% (3593/6940), and the highest level of water fluoride was 11.33 mg/L. Level of water fluoride were determined in 4415 samples from water defluoridation project and the value lower or equal to 1.00 mg/L was in 2983 wells which accounted for 65.53%(2983/4415). The value over 1.00 mg/L was in 1522 wells which accounted for 34.47%(1522/4415), the highest value of water fluoride was 9.71 mg/L. Conclusions Level of water fluoride in up to 1/2 of the villages and 1/3 of the projects, is still higher than the standard in Shandong province. Nearly 1/4 of the project has been abandoned. The current situation for endemic fluorosis control is still not good in the province, countermeasures for endemic fluorosis must be carried out as soon as possible and surveillance of water defluoridation project must be strengthened.

Objective To study the clinical characters,the mode of inheritance of osteogenesis Imperfecta in a Chinese Family and effect of bisphosphonate on Osteogenesis Imperfecta.Methods Clinical data of proband and their family members were collected.The family patterns were mapped.clinical features were summarized and analyzed.Results(1)Clinical features:There are sixty members of four generations in the family.20 cases including proband's mother and cousin were diagnosed as having OI type Ⅰ based on clinical manifestations.15 cases of blue sclera,16 cases of dentinogenesis imperfecta,5 cases of hearing loss and 3 cases of fracture.Thyroid cancer and Turner's syndrome was found in Proband's mother and cousin respectively.(2)The genetic map showed that the disease was autosomal dominant inheritance.(3)Treatment:The proband,her mother and her cousin were treated with alendronate for two years.Bone pain relieved and bone mineral density increased significantly,and no fracture occurred so far.Conclusion(1)This OI family was diagnosed as having OI type Ⅰ.The mode of inheritance is autosomal dominant inheritance.(2)Bisphosphonates may be an effective drug for treatment of OI.