[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 resistance phenotype of acinetobacter baumannii and the expression of ade efflux pump gene. METHODS: Non-repetitive 51 strains of Acinetobacter baumannii were collected in Peking Union Medical Hospital between Feb. 2004 and Feb. 2005. The active efflux system adeB structural gene and sequence were identified by PCR. RESULTS: The tested strains were not susceptible to common broad-spectrum antibiotics. Multidrug resistant Acinetobacter baumannii carried adeB active efflux pump gene. CONCLUSION: The multiple-drug resistance of Acinetobacter baumannii is independent of ?-lactamase. It maybe related to other drug resistance mechanism. The effect of active efflux system is possibly one of the major mechanisms of multidrug resistance of acinetobacter baumannii.

BACKGROUND: Incidence rate of cervical osteoarthritis in the middleaged and elderly is high. Some researches on risk factor causing cervical osteoarthritis have been performed abroad, but most of the factors are being discussed.OBJECTIVE: To investigate the occurring cervical osteoarthritis risk factors in the middle-aged and elderly from different regions of China and provide evidences for prevention and intervention of cervical osteoarthritis in community.DESIGN: Cross-sectional study.SETTING: Beijing Hospital, Ministry of Health, together with Second Hospital of Xi'an Jiantong University, Institute of Integrated Traditional and Western Medicine of Hebei Medical University, Shanghai Huadong Hospital, Nanfang Hospital, Second Affiliated Hospital of Harbin Medical University, West China Hospital of Sichuan University.PARTICIPANTS: The investigation was conducted from July to August2005. On the basis of stratified multi-stage cluster sampling method, 6 218formal registered permanent residents of over 40 years old from Xi'an,Shijiazhuang, Shanghai, Guangzhou, Harbin and Chengdu were enrolled.They all agreed to join the investigation voluntarily. There were 2 916males of 40-94 years and 3 302 females of 40-86 years.METHODS: Questionnaire investigation of epidemiology of cervical osteoarthritis was performed in the testees, and radiograph was used in the persons with clinical symptom. The basic sample unit was neighborhood committee (city) and village committee (countryside). Sampling method:Taking each city as a whole, composed of two levels, namely city and countryside, in the first phase the persons were extracted from district (county),in the second phase from sub-district (countryside), in the third phase from neighborhood committee (village eommittee). Diagnosis standard of cervical osteoarthritis was positive clinical symptom and 2 grade or above of radiograph Kellgren & Lawrence grading. The content of questionnaire contained 6 aspects: general condition, history of present illness, history of past illness, physical check-up, radiographs and disease diagnosis, totally94 questions and 141 variation indexes. Influential factors of prevalence rate of cervical osteoarthritis were analyzed using multifactor non-conditional Logistic regression analysis. Odds ratio (OR) was used for expressing index of strength of relationship between disease and exposures. If OR ＞ 1,it was indicated that there was positive correlation between disease occurrence and exposures. If OR ＜ 1, it was suggested that there was negative correlation between disease occurrence and exposures.MAIN OUTCOME MEASURES: Prevalence rate of cervical osteoarthritis in each city and OR.RESULTS: Totally 6 218 investigational subjects were included in the result analysis, without drop out. ①Total prevalence rate of cervical osteoarthritis in population of 40 years or above from 6 domestic cities was23.6%. There was significnat difference of prevalence rate in each city (P＜0.01). ②Result of Logistic regression analysis: Age (OR=1.010-1.058),defecation with squat ting pot (OR =1.024-1.997) and history of hypertension (OR =1.815-3.078) were common risk factor in most areas. In northern area the common risk factor compos ed of daily stair climbing or grade climbing (OR =1.018-1.020), while drinking colored wine (OR=3.451, Xi'an), history of osteoarthri tis of father (OR =2.491, Xi'an), history of diabetes (OR =5.013, Shijiazhuang), history of osteoarthritis of mother (OR =2.045, Shanghai), smoking (OR =6.857, Guangzhou), age of starting drinking (OR =3.044, Guangzhou) and full-time athletic sports (OR=9.020, Harbin), etc. emerged in different areas.CONCLUSION: The onset of cervical osteoarthritis has the same risk factor in 6 domestic areas, and main risk factor in different areas has certain differences, which can provide reference data for the prevention and cure of cervical osteoarthritis for the future and reduce waster of medical resources.