[Objeetive] To assess the reproducibility and accuracy of four ratios used to measure patellar height,named the Blackburne-Peel,Caton Deschamps,Insall-Salvati and modified Insall-Salvati,before and after totalknee arthroplasty.[Methods]The patellar height was measured,by means of the four ratios,on the pre-and post-operative lateral radiographs of 44 patients(45 knees)who had undergone total knee arthroplasty.Two independent observers measured the films sequentially,in identical conditions,totally 720 measurements per observer.[Results]Before operation there was greater interobserver variation using either the Insall-Salvati or modified Insall-Salvati ratios than that when using the Caton-Deschamps or Blackburne-Peel methods.This was due to difficulty in identifying the insertion of the patellar tendon.Before operation,there was a minimal difference in reliability between these methods.After operation the interobserver difference was greatly reduced using both the Caton-Deschamps and Blackburne-Peel methods,which used the prosthetic joint line,compared with the Insall-Salvati and modified Insall-Salvati,which refered to the insertion of the patellar tendon.[Conclusion]The theoretical advantage of using the Insall-Salvati and modified Insall-Salvati ratios in measuring true patellar height after total knee arthroplasty needs to be balanced against their significant interobserver variability and inferior reliability when compared with other ratios.

Objective The clinical distribution and drug resistance of isolated Acinetobacter Bauman strains were retrospectively analyzed in Xiangya Hospital Central South University in 2015,and its resistant transitions in ten years were also analyzed,to provide theoretical guidance for clinical rational use of antibiotics and control of infection.Methods 534 Acinetobacter Bauman strains were collected at Xiangya Hospital in 2015,the clinical distribution characteristics and drug resistance of Acinetobacter Bauman strains were analyzed according to specimen type,department,age and drug resistance result.Meanwhile,the drug resistance situation was compared with that in 2006 and 2011.Results The isolation rate of Acinetobacer Bauman from respiratory tract specimen was 76.78％,the tolal isolation rate from ICU,respiratory department of internal medicine,neurology department of internal medicine and neurosurgery department ward was 57.87 ％,and the infection patients over the age of 61 occupied 37.83 ％.Risperidone/Shubatan showed the best antibiotic activity with the resistance rate 3.02 ％ in ten drugs,the Acinetobacter Bauman strains were resist to other nine drugs in different level,with the percent from 50.0％ to 85.0％.The drugs of tobramycin and imipenem showed the greatest growth,with the resistance rate of 1.87％ and 11.70％ in 2006 in Xiangya hospital,increased to 69.85％ and 80.53％ in 2015,respectively.The drug of levofloxacin and cefepime also showed great growth in ten years with the increase of 58.81％ and 55.98％,respectively.Conclusion The clinical isolates of Acinetobacter Bauman strains mainly derived from respiratory tract specimen,and mainly distributed in ICU,the most infection people were from the older.The resistance rate of common drugs showed a significant increase in ten years,especially for cephalosporins and carbapenems.With the increase of multiple drug resistant strains,the monitoring of drug resistance of Acinetobacter Bauman and use of antibiotics rationally should be strengthened.

Objective To investigate the clinical characteristics of speech disorders in children with cerebral palsy (CP) and any relationship between those characteristics and cranial magnetic resonance images.Methods A sample of 138 children with CP were given the ＜ s-s ＞ language development test,a Chinese-language articulation test and oral motor scores to quantify their functional speech and articulation.The characteristics of their speech disorders,articulation and oral motor dysfunction were then related with abnormalities in their cranial magnetic resonance images (MRIs).Results Of the 138 MRIs,only 9 were normal.Three showed non-specific abnormalities (delayed myelination and/or broadening of the space outside the brain) and 122 (91％) showed specific abnormalities.Among the children with specific abnormalities,51.6％ had speech reception delay and 74.6％ had speech expression delays.The dysarthria rate was 71.3％,including 8.7％ with no speech ability at all.The main MRI abnormalities were lesions of the basal ganglia (23％),lesions of the cerebellum (11.5％),periventricular leukomalacia (PVL) (47.5％),extensive cortical or subcortical lesions (6.6％) and focal cerebral injury (11.5 ％).The corresponding oral motor scores increased successively.The children with lesions of the basal ganglia or cerebellum were most likely to manifest speech expression delay and dysarthria.The children with cortical or subcortical lesions or PVL also showed speech expression delay and dysarthria.However,the children who had a focal cerebral injury generally performed well on the speech ability assessment.Twelve children had no speaking ability at all,and in 7 of them the lesions were of the basal ganglia.Conclusions The probability and severity of speech disorders in children with cerebral palsy relate with specific abnormalities detectable with cranial MRI.Those with lesions of the basal ganglia or cerebellum will be more likely to show more severe speech disorders.

BACKGROUND:Signal transducer and activator of transcription 3 (STAT3) is an important cytokine signaling pathway, which plays an important role in inflammatory diseases. However, it is unclear whether gene polymorphism of STAT3 is associated with rheumatoid arthritis in the Chinese Han population. OBJECTIVE: To explore the association of gene polymorphism of STAT3 with rheumatoid arthritis in the Chinese Han population. METHODS:Four tag-single-nucleotide polymorphisms (tag-SNPs) in STAT3 were selected from the Chinese Han population of HapMap database. The study was performed with 228 rheumatoid arthritis cases and 228 normal controls. Four tag-SNPs (rs12601982, rs2293152, rs8078731 and rs9912773) were examined by matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry. RESULTS AND CONCLUSION:The frequency of GG genotype at rs9912773 was 18.9% and 10.5% respectively in rheumatoid arthritis and control groups, and there was a significant difference between the two groups (P < 0.05). These results indicate the possible association between the STAT3 gene polymorphism at rs9912773 and the susceptibility of rheumatoid arthritis in the Chinese Han population.

OBJECTIVE To observe the curative effect of external dacryocystorhinostomy(EDCR) and intranasal endoscopic dacryocystorhinostomy(IEDCR)for chronic dacryocystitis, and to evaluatethe postoperative satisfaction of the patients.METHODS According to randomized controlled design, 108 chronic dacryocystitis patients were divided into the intranasal endoscopic dacryocystorhinostomy group and control group, both groups underwent intranasal dacryocystorhinostomy and external dacryocystorhinostomy respectively.The changes of symptom and clinical sign, operation time, hospital day, cost of hospitalization were recorded.All patients were followed up for 1-5years, and the postoperative satisfaction of the patients were investigated by interval satisfaction scale.RESULTS ①There were no significant difference between the groups at the curative effect, operation time and hospital day, the hospitalization cost of the intranasal endoscopic dacryocystorhinostomy group was higher than that of the control group;②The recurrence rate of the intranasal endoscopic dacryocystorhinostomy group and control group were 12.82% and 15.56% respectively after 5 years, Log Rank test ?2=0.394, P=0.530;③ The postoperative satisfaction of the patients in both groups were(81.70?10.242)and(75.72?10.653) score respectively, which were similar to normal distribution, t=-2.974, P=0.004.CONCLUSION The effect of intranasal endoscopic dacryocystorhinostomy for chronic dacryocystitis is similar to external dacryocystorhinostomy.But intranasal endoscopic dacryocystorhinostomy is a more ideal method, because it is minimal invasive technique and doesn't affect the face cosmetology.

Objective To investigate the epidemiological characteristics of occupational exposure to human immunodeficiency vi-rus (HIV) in Chongqing to provide the scientific basis for avoiding and reducing the HIV occupational exposures in the future . Methods All archival data of the exposed individuals came to our hospital for seeking post-exposure consultation and treatment during 2009-2012 were performed the classification and arrangement for conducting the descriptive analysis on the distribution characteristics of the age ,gender ,occupation ,working region ,exposure mode and severity of exposure .Results During this period , there were 135 cases of occupational exposure ,which ocurred in the medical institutions outside the main urban area (74 .18% ) , dominated by the nurses (57 .04% ) and doctors(33 .33% ) .21-30 years old (51 .85% ) and 31 -40 years old(33 .33% ) were the age groups with more occurrence of occupational exposure .The exposure routes were dominated by the sharp instrument injury (92 .59% ) and the exposure degree was mainly the secondary exposure ( 69 .63% ) .Conclusion The prevalence situation of HIV occupational exposure in Chongqing is stable in the total trend .The medical and health institutions outside main urban area should perfect the management system ,strengthen training ,put the standard prophylaxis principles to practice for reducing the occurrence of occupational exposure .

Objective To explore the diagnostic value of dual syringe and dual-channel direct multi-slice computed tomography venography(MSCTV) for lower extremity deep venous obstructive disease.Methods 100 patients highly suspected deep vein thrombosis by clinic wereunderwent dual syringe and dual-channel direct MSCTV.The original data processed with technology of subtraction,and put into workstation and reconstructed with maximum intensity projection(MIP),multiplanar reformation(MPR) and volume rendering (VR).Images of deep venous obstructive lesions were analysed and graded.All patients were underwent DSA in one week.Results Direct MSCTV showed that the reconstructed images and the vascular contrast were very clear.In the evaluation of deep venous,excellent proportion was 95 ％ for the inferior vena cava,94 ％ for the common iliac vein,95 ％ for the external iliac vein,95.5 ％ for the femoral vein,96.5％ for the popliteal vein and 92 ％ for the low leg vein.Direct MSCTV displayed complete and regular vein in 8 normal patients,92 cases displayed different parts and different degrees of thrombosis.On original axial images,eccentric filling defect of vascular were showed (there were 64 multiple vein occlusion cases and 28 solitary obstruction cases).The occlusion locations in deep venous were as following:3 in the inferior vena cava,67 in the common iliac vein,28 in the external iliac vein,50 in the femoral vein,26 in the popliteal vein,89 in the anterior tibial vein,35 in the posterior tibial vein and 5 in the peroneal vein.There were 7 normal patients and 93 patients with different parts and different degrees of thrombosis.Conclusion Direct MSCTV can accurately show deep vein thrombosis,which image is clear and reliable for displaying the scope and extent of lesions of the vascular and whether the collateral circulation established.Direct MSCTV has a significant clinical value in diagnosing the thrombotic disease of deep vein obstructive lesions.

Objective To enhance understanding of the vertebral compressed fracture in old patients so as to reduce its misdiagnosis. Methods 30 aged patients with vertebral compressed fracture were treated from 1998 to 2004 in our department. Their clinic data were retrospectively analyzed. There were 27 males and 3 females, aged from 70 to 90 years (averaging 82.5 years). Results All the patients were diagnosed definitely. There were 2 cases of T11 fracture, 13 cases of T12 fracture, 11 cases of L1 fracture, 3cases of L2 fracture, and 1 case of L3 fracture. At first 1 case was overlooked, and segmental positioning was wrong in 3 cases but the mistakes were corrected later. Conclusion Meticulous review of the history and clinical manifestation in addition to supplemental imageological examination are essential to early diagnosis of the majority of vertebral compressed fractures. As for some difficult early diagnoses, fat suppression MRI and nuclide bone scanning are helpful.

In this study, 17 kinds of Dendrobium species of Fengdous including 39 individuals were collected from 4 provinces. Mitochondrial gene sequences co I, nad 5, nad 1-intron 2 and chloroplast gene sequences rbcL, matK amd psbA-trnH were amplified from these materials, as well as nrDNA ITS. Furthermore, suitable sequences for identification of Dendrobium species of Fengdous were screened by K-2-P and P-distance. The results showed that during the mentioned 7 sequences, nrDNA ITS, nad 1-intron 2 and psbA-trnH which had a high degree of variability could be used to identify Dendrobium species of Fengdous. However, single fragment could not be used to distinguish D. moniliforme and D. huoshanense. Moreover, compared to other combined fragments, new type combined fragments nrDNA ITS+nad 1-intron 2 was more effective in identifying the original plants of Dendrobium species and could be used to identify D. huoshanense and D. moniliforme. Besides, according to the UPGMA tree constructed with nrDNA ITS+nad 1-intron 2, 3 inspected Dendrobium plants were identified as D. huoshanense, D. moniliforme and D. officinale, respectively. This study identified Dendrobium species of Fengdous by combined fragments nrDNA ITS+nad 1-intron 2 for the first time, which provided a more effective basis for identification of Dendrobium species. And this study will be helpful for regulating the market of Fengdous.

Objective To evaluate the surgical results of spinal stenosis in the elderly and to investigate the indications , surgical technique and factors which may contribute to the outcome. Methods A retrospective study was held, 304 patients aged 65 and over who had different kinds of decompression laminectomy for lumbar spinal stenosis between Jan 1990 and Jun 2005 were recruited. The mean patient age at surgery was 70.4 years (65-86 years old). Results One hundred and seventy-five cases had co-existing illnesses, 62 had concomitant degenerative spondylolisthesis, 138 had spinal instrumentation. Functional results were graded as excellent, good, fair and poor: 86. 8% excellent or good, 11. 2% fair and 6 cases poor. Four patients had re-operations because of post operation hematomas. Multivariate analysis revealed that age, sex, co-morbidity score, number of levels decompressed, and degenerative spondylolisthesis did not predict bad outcomes. Conclusions The surgical results of spinal stenosis in the elderly are favourable and comparable to those reported for the general population . Carefully perioperative preparation is very important in the treatment of elderly patient with lumbar spinal stenosis.