Objective By contrasting and analyzing the clinic manifestations, radiological features and pathological results of patients with bone invasion from skin of the lower limbs that were associated with malignancy, authors advanced X-ray diagnostic evidence to promote its diagnostic accuracy. Methods The radiological appearances of squamous cell carcinoma arising in chronic ulcers, sinus and scars of the lower limbs in 16 patients from February 1968 to April 2002 confirmed by pathology, were analyzed retrospectively. All cases were taken posterior-anterior and lateral radiograph before operation. There were 15 males and 1 females aging from 15 to 67 years (mean, 50.4 years). The lesion was located at the front of tibia in 15, and the middle inferior part of femur. The medical history of primary diseases varied from 1 to over 50 years with an average of 20 years and 3 months. Of 16 cases, the duration of 8 cases from a sudden change of state of an illness to the final diagnosis was 4 to 6 months, 4 cases above 1 year, and 4 cases were found with no any change of state of an illness. Results There were 14 cases observed as typical chronic osteomyelitis, which demonstrated peripheral osteolytic defect, 13 cases with osteolytic destruction spreading outwards from front of tibia, and 1 case with widespread osteolytic destruction in the middle and inferior part of femur. Floating-ice-like rudimental bone in the defect was found in 11 cases, and 4 case were observed with old fracture. 2 cases without obvious history of typical chronic osteomyelitis, 1 case with soft tissue trauma and 1 case of burn, showed small Saucer-like erosion of the cortex and huge lobar soft tissue masses. Moreover, patchy shadow and Codman's triangle were found in 1 case of burn. Furthermore, lobar soft tissue masses and huge ulcer accord with osteolytic destruction was observed in all cases, and soft tissue masses were larger than the area of bony destruction in 6 cases. Conclusion Roentgenogram could display shape, location and extension of bone invasion from skin of the lower limbs that were associated with malignancy, which contribute to diagnose the lesion and provide useful evidence for surgical plan.

Objective To study on chromosome-and plasmid-mediated fluoroquinolones-resistant in Escherichia coli isolated from fecal samples of chicken,swine and people around the farm.Methods Anti-microbial susceptibility testing was carried out by disk diffusion testing and bmth microdilution testing.gyrA,gyrB,parC,pareE,qnr and aac(6')-I b-cr were examined by PCR,and the products were sequenced.Ex-presion of aac(6')-I b-cr by conjunction was tested too.Results The resistance to antimicmbial agents was much higher in strains isolated from chicken than that from swine and human.Among the E coli strains examined by PCR,most resistant strains carried two mutations in gyrA and/or two mutations in parC.In ad-dition,some resistant strains had mutations in parE with MIC of ciprofloxacin>16μg/ml.No(resistance) mutation was found in gyrB.Seven strains(25.O%)and one strain(11.1%)had aac(6)-I b-cr,variant isolated from chicken and swine,respectively.The strains harboring cr variant enzyme reduced the suscepti-bility to ciprofloxacin and norfloxacin by N-acetylation of the drugs. Conclusion There is a close relation-ship between high level quinolone resistance and the numbers of amino acid exchange in DNA gyrase and to-poisomeraae IV,and aac(6)-I b-cr may play some role for fluoroquinolone resistance.

Objective To characterized the Salmonella enterica serotype typhimurium isolates recovered during 2002 to 2005 from outpatients in Tongji Hospital, Wuhan China. Methods The 36 isolates from Tongji Hospital were characterized by antimicrobial-susceptibility testing and screened for class Ⅰ integrons, beta-lactamase genes, qnr, aac(6')-Ib-cr and mutations in the quinolone resistance determining regions (QRDRs) by PCR and DNA sequence analysis. All isolates were also characterized by pulsed-fieldgel electrophoresis (PFGE) to determine the genetic relateness among these isolates. Results All isolates displayed multidrug resistance and most of them harbored class Ⅰ integrons. Ciprofloxacin-resistant isolates showed significant difference compared with ciprofloxacin-susceptible isolates after PFGE analysis. All 31 ciprofloxacin resistant isolates carried at least three mutations in the QRDR of GyrA and ParC. Three ciprofloxacin resistant isolates had accumulated additional mutation in ParE. Five isolates harboring the OXA-30. Enzyme showed intermediate resistant to eefepime. Conclusions Fluoroquinolone-resistant Salmonella typhimurium isolates were widely distributed among the outpatients in Wuhan and the resistant isolates accumulated multiple antimicrobial resistant mechanisms and showed unique genetic profiles. The state and local health authority must remain vigilant for the emergence of Salmonella typhimurium resistant to both third generation cephalosporins and fluoroquinolonos.

Objective To study on plasmid-mediated quinolone-resistant in Escherichia coli strains isolated from fecal samples of chicken and swine from the nine farms around our country.Methods Antimi-crobial susceptibility testing was carried out by broth microdilution testing,gyrA,gyrB,parC,qnr and aac (6')- Ⅰ b-cr were examined by PCR,and the products were sequenced.Conjugation experiment was carried out to proved that the plasmid-mediated quinolone resistance was transferable.Results In the total 818 animal isolates,qnr and aac genes were detected in 38 (4.6%) and 75 (9.2%) strains.The qnrA,qnrB,and qnrS genes were detected in 1 (0.1%),9 (1.1%) and 28 (3.4%) of the isolates.All isolates were negative for qnrC,qnrD genes.Conclusion There is a close relationship between high level quinolone resistance and plasmid-mediated quinolone resistance.The results of the current study highlight food-producing animals as a potential reservoir of antimicrobial-resistant bacteria and clinically important resistance genes.More attention should be paid to the surveillance of such strains.

Objective To characterize the roles of different quinolone resistance mechanisms in quinolone-resistant Escherichia coli isolates,including different topoisomerase point mutations,efflux pumps and outer membrane proteins.Methotis Through homologous gene recombination methods,different quinolone-resistant mechanisms of E. coli mutants were constructed and the susceptibility changes of these mutants to different antimicrobials were measured.Resuits Efflux pumps AcrAB and outer membrane protein TolC played different roles in different E. coli isolates.Compared with other mechanisms,the mutations in topoisomerases played a dominant role in quinolone resistance.Only the mutations jn parC had no effect on quinolone resistance,which further confirmed parC was the secondary target of quinolones in E.coli.Fluoroquinolone susceptible E.coli would automatically become highly resistant to quinolones after acquiring the point mutations in both gyrA(S83L,D87N)and parC(S80I,A108V),but not requiring the over-expres-sion of efflux.Conclusion The mutations in topoisomerases play a dominant role in E.coli quinolone resistance,and the mutations in both gyrA and parC are required.

Objective To investigate the changes and clinical significance of the frequency of circulating CD4+ CD25+ regulatory T cells (Treg) in nonalcoholic fatty liver (NAFL) patients.Methods CD4+ CD25+ Treg in the peripheral blood from 50 NAFL patients and 50 healthy subjects were quantitatively analyzed using flow cytometry. Group t test or Mann-Whitney U test and Spearman's rank correlation test were used for statistical analysis.Results The proportion of circulating CD4+CD25+ Treg in NAFL patients was (5.39 ± 1.94)％,which was significantly higher than that in healthy controls [(4.21±1.52)％](t=3.385,P＜0.01).Further analysis revealed that the frequency of Treg was positively correlated with triglyceride (TG) level and body mass index (r=0.307 and 0.251,respectively; P=0.002 and 0.012,respectively),and negatively correlated with high density lipoproteincholesterol (HDL-C) (r=-0.306,P=0.002).Meanwhile,Treg in patients with high body mass index,high TG,low HDL-C,hypertension and metabolic syndrome (MS) were all higher than those in controls (t=2.294,2.533,3.154,2.010 and 4.454,respectively; all P＜0.05).But there was no significant difference between patients with high fasting blood glucose and controls (U=1143.500,P=0.471).Conclusion The increased frequency of peripheral Treg in NAFL patients may have some relations with the imbalance of proinflammation and anti-inflammation in NAFL patients who coexisting with MS.

Objective:To explore the clinical effect of Bobath manipulation combined with traditional Chinese medicine fumigation and intradermal acupuncture on shoulder hand syndrome(SHS) after stroke.Methods:From April 2017 to August 2019, 80 patients with SHS after stroke admitted to the People's Hospital of Deqing County were selected, and they were divided into control group and observation group according to the random digital table method, with 40 cases in each group.The control group was treated by Bobath therapy, and the observation group was treated by Bobath therapy combined with acupuncture(intradermal acupuncture) and traditional Chinese medicine fumigation.After 8 weeks of treatment, the ROM scale, FMA scale, BI scale and VAS scores were used to evaluate the improvement in the mobility of the shoulder and wrist joints, motor function of the upper limbs, quality of life and pain, and the clinical efficacy of the two groups was compared.Results:Compared with before treatment, the ROM scale score of all dimensions of shoulder and wrist mobility, FMA scale score and BI scale score of all patients after treatment increased significantly, and the VAS score decreased significantly, the differences were statistically significant(all P<0.05). Compared with the control group after treatment, the improvement of the indicators mentioned above of the observation group were better[shoulder joint flexion ROM score: (154.83±25.63)points vs.(133.82±22.03)points; shoulder joint abduction ROM score: (152.36±25.68)points vs.(133.35±19.96 )points; shoulder joint external rotation ROM score: (75.87±14.69)points vs.(60.82±16.57 )points; wrist joint palm flexion ROM score: (73.94±14.37)points vs.(57.37±9.47)points; wrist joint back extension ROM score: (60.83±7.61)points vs.(42.27±6.37 )points; FMA scale score: (45.74±6.82)points vs.(34.19±4.07)points; BI scale score: (70.36±12.09)points vs.(58.70±12.53)points; VAS score: (1.05±0.49)points vs.(3.37±1.14)points, t=3.703, 3.715, 3.257, 5.576, 7.964, 3.037, 8.746, 3.153, all P<0.05]. The total effective rate of the observation group was significantly higher than that of the control group[97.5%(39/40) vs.62.5%(25/40), χ 2=15.313, P<0.05)]. Conclusion:The combination of Bobath therapy with traditional Chinese medicine fumigation and intradermal acupuncture can improve the pain degree, joint mobility disorder, upper limb motor function and quality of life of SHS patients, the efficacy is better than single Bobath therapy.The clinical effect is accurate, and it is worthy of further promotion and application.

The purpose of this investigation was to evaluate the effect of transforming growth factor-beta (TGF-beta) on the efficacy of Schwann cell (SC) and on the repair of peripheral nerve defect. 50 ng x ml(-1) TGF-beta was shown to promote the proliferation of SC by MTT and flow cytometry (FCM) assay, and NGF synthesis in SC culture media was noted to be of significantly higher concentration by ELISA method (P<0.05). SCs mixed with bovine acellular matrix (BAM), fetal bovine serum and media based on definite ratio were injected into polylactideco-glycolide acid (PLGA)guide. 30 SD rats, each had a man-made sciatic nerve defect 15 mm long, were randomly divided into 3 groups: experiment group (PLGA conduit+SC+TGF-beta), control group(PLGA conduit+SC), and autograft group. After 16 weeks, it was demonstrated that the effect of the test group was not significantly different from that of the autograft group, but it was better than that of the control group by means of electrophysiological test and sciatic nerve function index (SFI). TGF-beta can promote not only the proliferation, but also the NGF synthesis of SC obviously. The use of exogenous TGF-beta in the repair of peripheral nerve defect may produce better curative effect.
Animals ; Cell Proliferation ; drug effects ; Cells, Cultured ; Culture Media ; Female ; Guided Tissue Regeneration ; Lactic Acid ; chemistry ; Nerve Growth Factor ; biosynthesis ; Nerve Regeneration ; drug effects ; Polyglycolic Acid ; chemistry ; Rats ; Rats, Sprague-Dawley ; Schwann Cells ; cytology ; Sciatic Nerve ; injuries ; physiology ; Tissue Engineering ; Transforming Growth Factor beta ; pharmacology

Objective To investigate the effect of different radiation doses on the accuracy of iodine quantification and CT value of virtual monochromatic image with a muti-spectral CT iodine phantom using second-generation dual-layer detector spectral CT(DLCT).Methods The second-generation DLCT scan abdominal phantom was used,which consisted of six different concentrations of iodine rods at 4,8 and 12 g/L.The scan parameters were set at 100,120 and 140 kVp tube voltages,and six radiation exposure sequences were scanned at each tube voltage:5,10,15,20,25 and 30 mGy.Measure the iodine concentration value and the CT value at the single level of 50,70 and 100 keV,and calculate the absolute error value of iodine concentration and CT value under different radiation exposure.SPSS 22.0 software single factor analysis of variance was used to compare the difference between the io-dine concentration and the absolute error of CT value under different Radiation exposure,and LSD method was used to compare the two groups.Results The absolute error of CT value of 4 g/L iodine rod with 10～30 mGy scanning at 100 keV energy level was significantly higher than that of 12 g/L and 8 g/L(P＜0.05),and the absolute error of iodine concentration measurement of other iodine rods with different concentrations at different Radiation exposure had no statistical difference.Conclusions The second-generation double-layer detector spectral CT has high meas-urement stability for iodine concentration quantification and CT value accuracy under conditions of radiation dose greater than 5 mGy.

Objective:To investigate the feasibility of coronary CT angiography(CCTA)-feature tracking(FT) for assessing global and regional myocardial strain in patients with heart failure(HF).Methods:From July 2019 to December 2020, twenty-five patients diagnosed with HF from Peking Union Medical College Hospital were prospectively enrolled into the study. All patients underwent retrospective electrocardiogram-gated CCTA and cardiac MR (CMR) imaging within 7 days. CCTA-FT and CMR-FT were undertaken using cvi 42 dedicated commercial software to measure global and regional strain parameters, including global peak radial strain (GPRS), global peak circumferential strain (GPCS) and global peak longitudinal strain (GPLS), as well as peak radial strain (PRS), peak circumferential strain (PCS) and peak longitudinal strain (PLS) of left ventricular basal segment, middle segment and apical segment. Conventional left ventricular functional parameters were also calculated, including left ventricular ejection fraction (LVEF), left ventricular stroke volume (LVSV) and left ventricular mass index (LVMI). Paired t test or Wilcoxon signed-rank test was used to compare the differences of measurements between CCTA group and CMR group. Pearson or Spearman correlation analysis was used to analyze the correlation between the two groups. Inter-and intra-observer consistence in CCTA group was evaluated by intraclass correlation coefficient (ICC) analysis. Results:The effective radiation dose of CCTA examination was 6.00 (4.86,7.63) mSv. Inter-and intra-observer consistence in CCTA group was excellent, and the ICC value was 0.85-0.98. In the overall strain parameters, GPCS in CCTA group[-8.10%(-10.32%, -5.20%)] was significantly lower than that of CMR group[-8.49%(-13.79%, -5.95%)] ( Z=-2.15, P=0.031). There was no significant difference in GPRS and GPRS between the two measurement methods ( P>0.05). Strong correlations were observed between GPRS, GPCS and GPLS ( r=0.65, 0.63, 0.71,all P<0.001). For local strain parameters, PCS in the middle segment and apical segment of CCTA group were lower than those of CMR group ( Z=-2.17, -2.62, all P<0.05). There were no significant differences in PCS of basal segment, PRS and PLS of all segments between groups (all P>0.05). The PCS and PLS of basal segment, PRS of middle segment and PRS of apical segment were moderately correlated ( r=0.46, 0.52, 0.58, 0.53, P<0.05); The other local strain parameters were strongly correlated, the range of r value was from 0.64 to 0.70 (all P<0.001). For left ventricular functional parameters, LVEF, LVSV and LVMI showed no significant differences between groups ( P>0.05), and the correlation was extremely strong ( r=0.90, 0.89, 0.96, all P<0.001). Conclusions:The repeatability of CCTA-FT technique in measuring myocardial strain was good, and the correlation of parameters measured by CCTA-FT technique and CMR-FT technique was excellent. Therefore, CCTA-FT technique can be used as a new noninvasive and simple method to evaluate myocardial motor function.