Objective:A more effective approach to judge the fissure fracture by using image enhancement is presented.Methods:The Gradient image after 5×5 median filtering smoothing was used to mask the laplace image, and to add the original image in order to informing the sharpening image, and then the adaptive contrast histogram equalization is put in shaping image and to compare the effect of the image enhancement.Results: The algorithm to enhance the X-Ray fracture image can highlight the shape of the fissure fracture clearly. The enhanced image is more effective than the image by using one way alone.Conclusion: This method is valuable in judging the fissure fracture in clinical diagnosis.

Objective To observe the long- term result of pathological dislocation of the hip with absence of the femoral head treated with trochanteric arthroplasty in infancy. Methods Eighteen cases with absence of the femoral head and pathological dislocation of the hip treated with trochanteric arthroplasty were followed- up for 5－ 16 years, with an average of 9.25 years. The timing of the surgery was average 18.2 months(ranged from 11 to 30 months). Based on Hunka pathological classification, one case was divided as typeⅠ lesion, 2 cases as typeⅡ lesion and 15 cases as typeⅤ lesion. Results There were 8 cases in the excellent group, the morphology and function of the reconstructed femoral heads were nearly normal and the limb shortening were in an average of 0.25 cm. There were 3 cases in good group, the femoral heads were nearly ball sized and the femoral necks were absent, however, the function was good and the limb shortening averaged 1.5 cm. There were 5 cases in fair group, the plastic femoral heads were abnormal and there were acetabular dysplasia and the limb shortening averaged 2.1 cm. There were 2 cases in poor group with redislocation. Conclusion The result demonstrate that surgical treatment of the absence of the femoral head in infancy could obtain a better reconstructed hip and fair function; the shortening of the limb can also be avoided.

ObjectiveTo explore the difference on clinical features of massive cerebral infarction with different concious states.MethodsPatients diagnosed as massive cerebral infarction of middle cerebral vascular or internal carotid artery were divided into group without conscious disorder and group with conscious disorder according to concious state. Their gender, age, past disease history, conscious state, location of ischemic area, blood pressure, heart rate, temperature, complications, white blood cell, blood glucose, lipemia, and electrolyte were recorded.ResultsThere are more hyperlipemia and diabetes, more complications and fast heart rate in the group with conscious disorder.ConclusionAbnormity of blood glucose and lipemia for a long time may affect the concious state of massive cerebral infarction patients.

Objective To study the changes of ambulatory blood pressure parameters after endovascular treatment.Methods The ambulatory blood pressure of 7 patients with artery stenosis was tested before and after endovascular treatment,and the coefficient of variation(CV)was calculated.Results All patients' blood pressures decreased after endovascular treatment.The CV of blood pressure of patients with internal carotid stent decreased,but the CV of blood pressure in patients with vertebro-basilar artery stent increased.Conclusion The effects of stent on blood pressure is far from clear.

Objective To study the prevalence and genotypes of rotavirus (RV) among children,< 5 years old hospitalized with viral diarrhea in Tianjin. Methods Stool specimens were collected from hospitalized diarrhea children in Tianjin children's hospital between May 2008 and April 2009. Detection of rotavirus was employed by Colloidal Gold Device. The detected positives were inoculated to MA-104 cells. The total RNA of virus was extracted after CPE which was caused by rotavirus were observed, The VP7 serotypes were determined by using RT-PCR to amplify the VP7 gene and sequencing the RT-PCR products.The clinical data for each patient were also collected. Results Among 837 specimens, the RV antigen positive rate was 26. 3% (220/837). Among all the children with rotavirus diarrhea, 90. 5% (199/220)were < 2 years old. The prevalence of rotavirus diarrhea in children peaked during Oct. 2008 through Apr.2009. Of the 208 rotavirus positive specimens, 95 were successfully identified by RT-PCR Thirty-five positive strains of RV were sequenced, and the sequencing results showed that 32 positive strains were belonged to rotavirus G1 type, 2 positive strains were belonged to rotavirus G3 type and 1 positive strain were belonged to rotavirus C9 type. Conclusion RV was the dominant etiological agent for infantile diarrhea infection in Tianjin, and the predominant serotype was G1.

Totally 177 individuals (87 males and 90 females), who took abdominal computer tomography were enrolled. Anthropometric surrogates such as abdominal height( AH), waist circumference( WC), body mass index(BMI), and waist to height ratio(WHtR) were measured. Correlations between AH, WC, BMI, and WHtR with visceral abdominal fat were analyzed, and receiver operating characteristic curves ( ROC) were prepared for detecting abdominal adiposity at or beyond 80cm2 using lumbar vertebra 4-5 cross-section visceral fat areas as the screening cut-point within gender separately. Youden′s index was used to determine cut-off values of AH, WC, BMI, and WHtR by which to classify excess abdominal fat. 70(80. 5% ) males and 59(65. 9% ) females had abdominal obesity. Compared to other anthropometic indicators, AH presented the highest correlation with visceral adipose fat. The pearson correlation efficiencies were 0. 825 and 0. 732, the cut-off points were 20 cm and 20. 3 cm in male and female respectively. After controlling for age, receiver operating characteristic analysis showed that AH, followed by WHtR, outperformed WC and BMI in identifying central obesity participants. Optimal cut-off values of the physical anthropometric indices to indentify abdominal adiposity were 20 cm(AH), and 91 cm(WC) 25 kg/ m2 (BMI), and 0. 52(WHtR) for men, and 20. 3 cm(AH), 86. 5 cm(WC), 25 kg/ m2(BMI), and 0. 54(WHtR) for women. AH is effective for predicting visceral adiposity and might be considered the best predictor of abdominal obesity at a cut-point of 20cm in Chinese adults.

ObjectiveTo investigate the relationship between tumor-infiltrating mast cell (TIM) and the clinicopathological and prognostic factors of patients with colorectal cancer.MethodsA total of 282 cases of paraffin-embedded colorectal cancer specimens were obtained from the First Affiliated Hospital of Sun Yat-sen University from January 2002 to December 2005.The density of TIM was determined by immunohistochemical staining.According to the mean TIM density detected [ ( 8.4 + 6.5 )/HPF ],all the patients were divided into low-TIM density group (mean TIM density ＜8.4/HPF) and high-TIM density group (mean TIM density ＞8.4/HPF).The clinicopathological factors and the prognosis of patients between high-TIM density group and low-TIM density group were compared.All data were analyzed using the t test or chi-square test.The survival curve was drawn using the Kaplan-Meier method,and the survival of the patients was analyzed by the Log-rank test.The clinicopathological factors were analyzed retrospectively with the univariate and multivariate COX regression model.ResultsTIM was detected in all the patients with colorectal cancer.Significant differences were observed in the number of patients in N stage and TNM stage between patients in the high-TIM density group and those in the lowTIM density group (x2 =6.025,7.410,P ＜ 0.05 ).All patients were followed up till September 2010,the 5-year overall and tumor-free survival rates of patients were 82.9％ and 63.1％ in the low-TIM density group,79.0％ and 59.3％ in the high-TIM density group,with significant difference between the 2 groups (P ＜ 0.05 ).COX proportional hazard regression model revealed that high density of TIM was associated with short overall survival time and tumor-free survival time of colorectal cancer patients ( RR =2.119,95 ％ CI 1.326- 3.386; RR =2.084,95 ％ CI 1.357-3.199,P ＜0.05).The resuhs of multivariate analysis showed that high density of TIM was the independent factor influencing the overall survival time and tumor-free survival time (RR =1.651,95％ CI 1.009-2.702; RR =1.680,95％ CI 1.074-2.629,P ＜ 0.05 ).ConclusionHigh density of TIM is correlated with the N stage and TNM stage of colorectal cancer,and it is an independent predictor of poor survival for patients with colorectal cancer.

One hundred and eighty three women with high risk of breast cancer identified in Baoding First Central Hospital from June 2007 to June 2014,were enrolled in the study.In these 183 cases,41 received preventive therapy (22.4％),142 did not.Factors associated with acceptance of chemoprevention included older age,menopause,comorbidities,lower level education,being married,higher BMI,having high level hyperplasia of ductal epthelia and counseling to breast specialists (P ＜ O.05);whilenot informed by doctors was the main reason for failed taking preventive agents(95.1％,135/142).Thirteen of 41 women receiving chemoprevention discontinued the therapy (31.7％);no-insurance,no side-effects and higher BMI were related to the discontinuing (P ＜ 0.05).The 1-,2-,3-,and 5-year adherence rates of chemoprevention was 86.1％ (31/36),65.4％ (17/26),59.1％ (13/22),8/13 and 5/10,respectively.The results show that chemoprevention rate is low among Chinese women at high risk of breast cancer,and the long-term adherence to preventive therapy is poor.Corresponding measures should be taken to strengthen the chemoprevention of breast cancer.

Objective To explore the methods of cerebral palsy registration. Methods The operation of cerebral palsy registration in Jiamusi was introduced, including the development of the management system, and contents, steps and notices of registration. Results 51 cases with cerebral palsy in Jiamusi were registered from Januaray 1st, 2002 to December 31st, 2011. Conclusion Less children with cerebral palsy had registered, and received insufficient rehabilitation.

Objective:To analyze the incidence, biochemical and molecular characteristics, and gene mutation spectrum of neonatal methylmalonic acidemia (MMA) in Shaanxi province.Methods:This study involved 146 152 newborns undergoing neonatal screening for methylmalonic acidemia by tandem mass spectrometry in Northwest Women's and Children's Hospital from January 2014 and December 2019. Clinical manifestations and follow-up data of newborns diagnosed with MMA and their acylcarnitine profiles and gene mutations were analyzed. According to whether they had elevated homocysteine or not, these patients were divided into two groups, the complicated group and the isolated MMA group. The control neonates were those excluded from having methylmalonic acid by re-examination. Kruskal-Wallis and Mann-Whitney U test was conducted for statistical analysis. Results:(1) Twenty-one cases of MMA were confirmed with an incidence of 1/6 960, including 11 cases (52.4%) of isolated MMA (isolated MMA group) and 10 (47.6%) complicated by elevated homocysteine (complicated group). Eight patients in the isolated group had symptoms within one month after birth, mainly feeding difficulties, vomiting, drowsiness, poor response and infection, and five died. Patients in the complicated group were all diagnosed before developing typical clinical symptoms, and no developmental abnormalities were reported during follow-up. (2) Blood propionyl carnitine and its ratios to acetylcarnitine and free carnitine in the isolated MMA and complicated groups were higher than those in the control group [ M (min-max), 9.26 (3.70-37.78) μmol/L and 7.27 μmol/L (3.58-13.62 μmol/L) vs 4.51 μmol/L (1.48-8.69 μmol/L), H=23.239; 1.12 (0.32-2.43) and 0.74 (0.36-1.90) vs 0.25 (0.09-0.45), H=47.061; 0.94 (0.12-1.92) and 0.56 (0.18-1.03) vs 0.17 (0.06-0.38), H=36.868; all P<0.001]. The blood methionine level in the complicated group was significantly lower than that in the isolated MMA group [7.64 μmol/L (3.40-19.25 μmol/L) vs 24.22 μmol/L (10.73-56.55 μmol/L), U=3.000, P<0.001]. (3) All 21 patients carried complex heterozygous mutations or homozygous mutations in pathogenic genes, including 15 distinct MMUT mutations and 13 distinct MMACHC mutations. In the isolated MMA group, the most common mutation was c.323G>A (p.Arg108His) in the MMUT gene with a positive rate of 13.6%, and an unreported mutation, c.1676+11A>G, with unidentified clinical significance, was also found. The most common mutations in the complicated group were c.609G>A (p.Trp203Ter) and c.567dupT (p.Ile190fs) in the MMACHC gene, and the positive rates were both 20.0%. Moreover, two unreported variants, c.430-2A>C and c.648_650delAGA (p.216_217delSEinsS), were detected and suspected to be pathogenic. Conclusions:MMA is not uncommon in Shaanxi province. Children with isolated MMA tend to be more severe clinically. The identification of hotspot mutations, including c.609G>A (p.Trp203Ter) and c.567dupT (p.Ile190fs) in MMACHC gene and c.323G>A (p.Arg108His) in MMUT gene, provides a foundation for further genetic screening, counseling, and prenatal diagnosis, and is conducive to reduce the mortality and disability rate of neonatal MMA.