Objective To discuss the feasibility and accuracy of dual-source CT ( DSCT) in the evaluation of aortic stenosis ( AS) with transthoracic echocardiography ( TTE) as reference.Methods A total of 53 patients who underwent both DSCT and TTE were prospectively evaluated.All of them were assessed by TTE for aortic stenosis.Maximum aortic valve area ( AVA) in systolic phase was measured with DSCT , and was compared to that index obtained from the continuity equation on TTE.The severity of AS was graded as mild , moderate , or severe according to the AVA.Linear regression analysis and Bland-Altman plots were used to compare the AVA measured by using CT and TTE.Agreement on semi-quantitative grades of AS severity between the two methods was tested by using Kappa statistics.Results The mean AVA using DSCT was (1.45 ±0.35 ) cm2 compared to the mean AVA of ( 1.33 ±0.36 ) cm2 using TTE, with a significant correlation between them (r=0.92,P<0.01).Bland-Altman analysis demonstrated good inter-modality consistency between DSCT and TTE.However , DSCT demonstrated a slight overestimation of the AVA compared to TTE.As identified by TTE, there were 53 patients with AS, 13 with mild AS, 21 with moderate AS , and 19 with severe AS.In 3 patients DSCT showed no AS , TTE detected mild AS.In 6 cases, TTE had graded the stenosis as moderate , but the stenosis degree was graded as mild using DSCT.Kappa analysis showed a good agreement between the two methods on semi -quantitative grades of aortic stenosis severity (Kappa=0.75,P<0.01).Conclusion AVA measurements using DSCT is feasible and reasonably accurate for those patients with moderate to severe aortic stenosis.

Objective To analyze the worldwide advances on bacterial quantitative proteomics over the past fifteen years with bibliometric approach.Methods Literature retrieval was conducted throughout the databases of Pubmed,Embase and Science citation index (SCI),using bacterium and quantitative proteomics as the key words.The deadline is July 2013.We sorted and analyzed these articles with Endnote X6 from the aspects of published year,the first author,name of journal,published institution,cited frequency and publication type.Results 932 English articles were included in our research after deleting the duplicates.The first article on bacterial quantitative proteomics was reported in 1999.The maximal publications were 163 related articles in 2012.Up till July 2013,authors from more than 23 countries and regions have published articles in this field.China ranks the fourth.The main publication type is original articles.The most frequently cited article is entitled with Absolute quantification of proteins by LCMSE:a virtue of parallel MS acquisition by Silva JC,Gorenstein MV,Li GZ,et al in Mol Cell Proteomics 2006.The most productive author is Smith RD from Biological Sciences Division,Pac.Northwest National Laboratory.The top journal publishing bacterial quantitative proteomics is Proteomics.Conclusion More and more researchers pay attention to quantitative proteomics which will be widely used in bacteriology.

Objective To learn the plague's host animals and parasitic flea composition, and to investigate the natural foci of plague in Xiji county in order to provide basic information for plague prevention and control. Methods The Citellus alaschanicus density, nocturnal rodents, the body flea, the burrow track flea, the nest flea were investigated in 8 townships (town) of Xiji county from June 11 2007 to July 25 2007. Specimens of small mammalian, fleas were collected for bacteriological and serological testing. Results The average density of the main host Citellus alaschanicus was 0.85 per hectare. The nocturnal mouse capture rate was 0.80%(24/2987).The survey found 16 species of small mammals that belonging to 3 orders, 9 families and 16 species with Citellus alaschanicus the dominant species. The Citellus alaschanicus had 2.84 fleas per body. Four families and 16 species of fleas were identified in the areas. The Citellus alaschanicus and Citellophilus Tesquorum Mongolicus were the dominant species. Plague bacteriology and serology tests were negative. Conclusions The study shows that the area is suitable for the formation of natural foci of Citellus alaschanicus plague. Surveillance is an important measure for prevention and control of the plague.

Objective To assess the clinical significance of endoscopic ultrasonography (EUS) in the diagnosis and preoperative staging of gastric cancer. Methods EUS was carried out in 22 patients inclu-ding 17 gastric cancer patients and 5 patients in suspicion. Helical CT scanning was performed in all of the patients and fine needle aspiration biopsies ( FNAB) were administrated to 5 suspicious patients. Compared the results of operation and pathology with those of tumor staging by estimating the depth of tumor invasion ( T) , local lymph node metastasis ( N) and metastasis to neighboring or remote organs ( M) in order to esti-mate the accuracy of diagnosis and TNM staging. The sensitivity and specificity of tumor-node-metastasis staging of gastric cancer by EUS were compared with those of the spiral CT according to the final histopatho-logical results. Results In 5 suspicious patients specimens were successfully obtained by FNAB under the guide of EUS with the pathological diagnosis of adenocarcinoma in 4 cases and signet ring cell carcinoma, 1 case. All patients underwent radical gastrectomy except one in T1N0M0, staging was treated by endoscopic mucosal resection (EMR). The sensitivity and specificity of EUS in T, N, and M stage were 84.9% and 74. 2% , 92. 1% and 77. 1% , 63. 4% and 87. 5% respectively; whereas those of CT in T, N, and M stage were 27. 3% and 75% , 31.5% and 100% , 50% and 100% respectively. The sensitivity of EUS in T and N staging were higher than those of CT with significant statistical difference (P

OBJECTIVETo investigate the association of heptitis B virus (HBV) genotypes and precore(PreC)/basal core promoter(BCP) mutation with interruption failure of HBV vaccination in mother-to-infant transmission.

METHODSA total number of 208 serum samples were collected from infants and mothers,including 16 infants who had become HBsAg-positive despite a complete and timely course of immunization and another 88 infants successfully protected from mother-to infant HBV transmission. HBV genotypes were determined by type-specific primers PCR method. PreC/BCP mutations were detected by direct sequencing of PCR products, and Clustal W 1.8 software was applied to analyzing the sequences.

RESULTSOf 16 mothers who were having vaccine failure infants, 15 (93.8%) were HBeAg positive and infected with genotype C (15/15, 100%). Among 88 mothers of having children being protected by vaccine, 51 (58.0%) were HBeAg positive, with 45.1% (23/51) of genotype C. The proportion of genotype C in HBeAg mothers of infants with vaccine failure, was significantly higher than that of mothers with vaccine protected infants (chi2 = 14.3, P = 0.003). However, the frequencies of T1762/A1764 mutations had no significant differences between genotype C HBeAg positive mothers with vaccine failure or protected infants (33.3% and 13.3%, respectively, P = 0.4). No A1896 mutation was found in these two groups.

CONCLUSIONHBV genotype C might contribute to the immune failure of HBV vaccination in mother-to-infant transmission, while PreC/BCP mutation might not have correlation with it.

Adult ; Female ; Genes, Viral ; Genotype ; Hepatitis B ; immunology ; prevention & control ; transmission ; Hepatitis B Vaccines ; immunology ; Hepatitis B virus ; genetics ; immunology ; Humans ; Infant, Newborn ; Infectious Disease Transmission, Vertical ; prevention & control ; Mutation ; Polymerase Chain Reaction ; Pregnancy ; Pregnancy Complications, Infectious ; immunology ; virology ; Promoter Regions, Genetic

Objective To design a new type of external fixator for bone fracture and verify its rationality and feasibility. Methods The frame and screw of stainless steel achieved fracture fixation in vitro with a threaded locking structure.At the same time the increasing thickness of body frame, the inclined nail holes and the raised bottoms were designed to greatly enhance the strength and overall stability of body frame.FEM (finite element method),measuring the relative displacement and stress distribution after axial load,was used to verify the rationality of the design.An animal experiment with sheep was used to verify the feasibility of fracture treatment. Results Simulated result of FEM indicated that the biggest relative displacement between the separated bones was 0.04 mm,which was much less than the minimum value 1 mm required for fracture healing.The maximum stresses applied on the frame of the fixator,fixator screw,and bone were 35,26,and 6 MPa, respectively, which was much less than the allowable stress. In the animal experiment, fracture site was fixed firmly after operation and was well cured 3 months later.Conclusion The design of this new device is feasible and it can be used as a new method of fracture treatment.

Objective To investigate the relationship between the degree of liver fibrosis in non-alcoholic fatty liver disease(NAFLD)and the left ventricular structure and function of the heart.Methods A total of 411 patients with NAFLD admitted to the Sec-ond Affiliated Hospital of Xinjiang Medical University from June 2022 to April 2023 were collected.NAFLD patients were stratified using the FIB-4 non-invasive liver fibrosis scoring system and divided into the progressive fibrosis group(n=138)and non-progressive fi-brosis group(n=273).A total of 151 patients with normal abdominal ultrasound examination during the same period were selected as the control group,the relationship between the severity of liver fibrosis in NAFLD patients and the left ventricular structure and function of the heart were analyzed.Results Liver fibrosis was a risk factor for cardiac diastolic function limitation in NAFLD patients(P＜0.05),and the more severe the degree of liver fibrosis,the more severe the cardiac diastolic function limitation.Conclusion The degree of liver fi-brosis in NAFLD is significantly correlated with limited left ventricular diastolic function;it may be related to changes in the left ventricu-lar structure of the heart.

BACKGROUNDHealthcare-associated pneumonia (HCAP) is associated with drug-resistant pathogens and high mortality, and there is no clear evidence that this is due to inappropriate antibiotic therapy. This study was to elucidate the clinical features, pathogens, therapy, and outcomes of HCAP, and to clarify the risk factors for drug-resistant pathogens and prognosis.

METHODSRetrospective observational study among hospitalized patients with HCAP over 10 years. The primary outcome was 30-day all-cause hospital mortality after admission. Demographics (age, gender, clinical features, and comorbidities), dates of admission, discharge and/or death, hospitalization costs, microbiological results, chest imaging studies, and CURB-65 were analyzed. Antibiotics, admission to Intensive Care Unit (ICU), mechanical ventilation, and pneumonia prognosis were recorded. Patients were dichotomized based on CURB-65 (low- vs. high-risk).

RESULTSAmong 612 patients (mean age of 70.7 years), 88.4% had at least one comorbidity. Commonly detected pathogens were Acinetobacter baumannii, Pseudomonas aeruginosa, and coagulase-negative staphylococci. Initial monotherapy with β-lactam antibiotics was the most common initial therapy (50%). Mean age, length of stay, hospitalization expenses, ICU admission, mechanical ventilation use, malignancies, and detection rate for P. aeruginosa, and Staphylococcus aureus were higher in the high-risk group compared with the low-risk group. CURB-65 ≥3, malignancies, and mechanical ventilation were associated with an increased mortality. Logistic regression analysis showed that cerebrovascular diseases and being bedridden were independent risk factors for HCAP.

CONCLUSIONInitial treatment of HCAP with broad-spectrum antibiotics could be an appropriate approach. CURB-65 ≥3, malignancies, and mechanical ventilation may result in an increased mortality.

Acinetobacter baumannii ; pathogenicity ; Aged ; Anti-Bacterial Agents ; therapeutic use ; Community-Acquired Infections ; drug therapy ; microbiology ; pathology ; Female ; Hospital Mortality ; Hospitalization ; Humans ; Male ; Middle Aged ; Pneumonia ; drug therapy ; microbiology ; pathology ; Pseudomonas aeruginosa ; pathogenicity ; Retrospective Studies ; Staphylococcus aureus ; pathogenicity

OBJECTIVETo analyze epidemiological characteristics of burn inpatients in Hainan province over 8 years.

METHODSSix thousand and ninety-nine burn patients admitted to 6 hospitals of Hainan province from January 2002 to December 2009 were enrolled in the study. The clinical data of these patients were analyzed retrospectively, including age, gender, injury cause, wound position, burn area, ailment prior to admission, admission time, medical insurance, length of hospital stay, and mortality rate, relationship among inpatient distribution, admission time, and ambient temperature at the time of admission. Data were processed with SPSS 13.0 software.

RESULTSThere were more burn male patients than female, with ratio of 2.1: 1.0. Most patients were younger than 13 years (57.2%, 3488/6099). The most common burn area was smaller than or equal to 10% TBSA (67.4%, 4108/6099), and the fewest patients had burn areas of over 50% TBSA (2.0%, 121/6099). The main causative agents were hot liquid and flame, accounting for 71.5% (4358/6099), 17.9% (1092/6099), respectively. Most patients had injuries of more than two body areas (60.7%, 3705/6099), and lower extremity injury (17.1%, 1042/6099) was predominant in wound of single body area. Among 703 cases who had other ailments prior to admission (11.5%), the highest rate of prior ailments was found in patients older than 60 years (18.5%, 48/260), it was lowest in children younger than 1 year (8.0%, 32/398). The length of hospital stay was 1 to 375 day, and the admission time was 10 minutes to 90 days after burn. Total mortality rate was 0.4% (26 cases). The number of inpatients aged from 19 to 59 was obviously higher in months with high ambient temperature (from June to August), and for inpatients younger than 13 years the incidence of burn injury showed no obvious seasonal change. The inpatients who had medical insurance accounted for 10.9% (66/603) to 19.5% (121/619) from 2002 to 2005, which increased to 46.0% (372/808) in 2007 and 79.1% (869/1098) in 2009.

CONCLUSIONSFor burn inpatients in Hainan province, the main injury cause of burn injury is hot liquid, the number of burn adults aged from 19 to 59 seems to increase in months with high ambient temperature, while the incidence of burn in children showed no obvious seasonal change. The number of inpatients and those with medical insurance showed a tendency of increase from 2005 to 2009 in Hainan province.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Burns ; epidemiology ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Incidence ; Infant ; Inpatients ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

OBJECTIVETo study the changes of platelet in May-Hegglin anomaly (MHA) and the molecular pathogenesis mechanism.

METHODSPeripheral blood was drawn from the MHA proband, her father and her uncle. Platelet count and morphology were examined by automatic blood cell counter and microscopy, respectively. The platelet membrane protein was examined by flow cytometry. Membrane antibodies were determined by ELISA. PCR was used to amplify the exons 25, 31 approximately 32, 38 and 40 of the MYH 9 gene in the MHA patient and her diseased father. Furthermore, PCR products were sequenced, a specific point mutation was identified and inclusions (Dohle's body) in the neutrophil was detected by indirect immunofluorescence technique.

RESULTSIt was proved that in MHA patients, platelet count was higher by cell counter than by microscope (P < 0.01). Giant platelet was 94% but platelet membrane proteins (CD41, CD61, CD42A, CD42b) were in normal range. Membrane antibodies was undetectable. An A5521G mutation (GAG-->AAG) in the exon 38 was found in the proband and her diseased father, resulting in a characteristic change of NMMHC-A1841 (Glutamic acid-->Arginine), which was not found in other members of the family and in normal controls. Spindle-like inclusions with fluorescence were clearly displayed in neutrophil cytoplasm.

CONCLUSIONThe molecular pathogenesis mechanism of May-Hegglin anomaly is the mutation in MYH 9 gene.

Adult ; Base Sequence ; Blood Platelets ; metabolism ; pathology ; DNA Mutational Analysis ; Enzyme-Linked Immunosorbent Assay ; Female ; Flow Cytometry ; Granulocytes ; metabolism ; pathology ; Humans ; Inclusion Bodies ; metabolism ; pathology ; Male ; Molecular Motor Proteins ; genetics ; Mutation ; Myosin Heavy Chains ; genetics ; Pedigree ; Platelet Count ; Platelet Membrane Glycoproteins ; metabolism ; Thrombocytopenia ; blood ; genetics ; pathology