Objective To assess the clinical value of MSCT in diagnosing the overcrowding of osteal posterior cranial fossa (PCF) in adults.Methods MSCT images of a cohort of 52 adult patients with foramen magnum osteal malformation confirmed by surgery (diseased group), and 100 healthy adults (control group) were retrospectively reviewed.Images post-processing techniques included multi-planer reformation (MPR) and volume rendering (VR).The posterior cranial fossa volume (PCFV), posterior cranial fossa height (PCFH), clivus length (CL), clivus gradient (CG), supraocciput length (SL), and anteroposterior diameter of the foramen magnum (FMD) were measured on sagittal images in 52 patients and 100 normal adults.Independent-sample student's t test was used to compare the differences between patients and normal adults.Results The results of PCFV, PCFH, CL, SL,FMD and CG, male of control group were (168.2 ±12.3) cm~3, (38.2 ±1.2), (47.1 ±2.8), (41.1 ±1.8), (36.6 ±4.9) mm, (51.5±3.6)°, female of control group were (157.5 ±10.2) cm~3, (36.5 ±1.4), (46.2 ±2.2), (39.7 ±1.3), (35.2 ±3.8), (49.6±3.1)° ;diseased group were (128.7 ±11.7) cm~3, (30.6 ±1.9), (36.2 ±1.4), (37.3 ±0.9), (33.9 ±3.5)mm, (44.5 ±2.8)° .There was significant sex difference in PCFV, PCFH, CL, SL and CG in control group (t =4.70, 6.44, 4.84, 4.43 and 2.81 respectively, P<0.01), but FMD was not significant(t=1.97,P>0.05); the results of PCFV, PCFH, CL, CG and SL were significant different between diseased group and male of control group (t=16.62, 24.04, 25.01, 14.17 and 10.99 respectively,P<0.01) ; the results of PCFV, PCFH, CL, CG and SL were significant different between diseased group and female of control group (t=13.23, 17.80, 27.50, 11.67 and 8.73 respectively,P<0.01) ;but there were no significant differences of FMD between diseased group and control group, both male and female (t=2.96,2.07, P> 0.05).Conclusions The overcrowding of PCF can be accurately measured by MCST.As a routine preoperative examination, MSCT is helpful in the therapeutic selection and the anatomic and pathologic study of PCF.

Objective To discuss the effect of the quality control circle(QCC)activities in reducing the incidence of cold in reflux-enema of children.Methods The QCC team was built,reducing the incidence of cold in reflux-enema of children was named as the theme,to grasp the present situation,set the goal,fix the methods and carry out countermeasures.Results Through the development of QCC,making the standards of reflux-enema,the incidence rate of cold reduced from 25.0％(7/28) down to 3.6％(1/28),the nurses' abilities of technical operation and communication improved significantly.Conclusions Application of QCC in reflux-enema of children is practical.It can effectively improve the nurses' awareness of participating in the implementation management and nursing management system.By making the standardization of reflux-enema,nurses can improve the quality and effect of the reflux-enema and ensure the quality and safety of nursing.

ObjectiveTo evaluate the clinical effect of MSCT measurements in the pre- and postoperational osteal posterior cranial fossa for the adult patients of basilar invagination.Methods We reviewed the images of a cohort of 31 adult patients with basilar invagination,which were treated by surgical operation.According to the presence of atlantoaxial dislocation,the patients were divided into groups A and B.The basion-dens interval (BDI),atlanto-dental interval (ADI),space available of the spinal cord ( SAC),clivus-canal angle( CCA),Highly index( HI),and Chamberlian line(CBL) of the posterior cranial fossa were obtained in all the patients.Independent-sample Student's t test was used to compare the differences between groups A and groups B.Spearman correlations were analyzed between CT measurement data and effects of operations.ResultsIn Group A,the BDI,ADI,SAC,CCA,HI,CBL before and after surgery were 12.6 mm,8.3 mm,4.5 mm,3.3 mm;18.2 mm,20.8 mm,138.3°,150.4°,28.7 mm,43.4 mm,6.3 mm,3.3 mm respectively.There were significant differences ( t = 5.603,2.323,3.124,5.531,4.278 and 2.375,respectively,P ＜0.05 ).Preoperative JOA score in groups A was 10 points,and was 14 points after surgery.There was significant difference between the JOA scores before and after surgery ( t = 3.526,P ＜ 0.05 ).There were 7 effective cases and 4 stable cases after surgery in group A.Before and after surgery,JOA score and BDI,ADI,SAC,CCA,HI,CBL were significantly correlated( r = -0.667,- 0.673 ; - 0.571,- 0.619 ; 0.642,0.513 ; 0.525,0.558 ; 0.587,0.511 ; - 0.532,- 0.596,respectively,P＜0.05).The SAC,CCA,and CBL before and after surgery in group B were 18.3 mm,19.6 mm,146.8°,150.2°,2.7 mm,1.8 mm.The difference was statistically significant after operation ( t = 5.359,4.126,0.769,P ＜0.05).The BDI,ADI,and HI before and after surgery in group B were 7.2 mm,6.6 mm,2.4 mm,2.1 mm,39.3 mm,41.5 mm.And there were no significant differences (t = 1.482,2.374,0.153,P＞0.05).The preoperative JOA score in groups B was 11 points,and the postoperative score was 16 points.JOA scores before and after surgery were significantly different (t =2.874,P ＜0.05).There were 14 effective cases and 6 stable cases after operation in group B.The JOA score before and after surgery and BDI,ADI,and HI had no correlation (r =0.341,0.387;0.154,0.182; 0.192,0.167,P ＞0.05),and CBL,SAC and CCA were correlated (r = -0.756,-0.728;0.651,0.672; 0.726,0.695,P ＜0.05).ConclusionMSCT measurements for basilar invagination before and after surgery are helpful for understanding changes of osteal posterior fossa anatomy and comprehensive evaluation of surgical treatment.

Adult ; Arthritis ; diagnosis ; diagnostic imaging ; Female ; Humans ; Radiography ; Tuberculosis, Lymph Node ; diagnosis ; diagnostic imaging ; Tuberculosis, Osteoarticular ; diagnosis ; diagnostic imaging ; Ultrasonography

The bacteriophage T7 RNAP gene was amplified via PCR from -lysogen DE3, and the gene was cloned into pBABEpuro retrovial vector, a recombinant plasmid named as pT7BABEpuro was constructed and sequenced. Then the pT7BABEpuro and pVSV-G plasmids were cotransfected into GP2-293 packaging cells by liposomese, some pseudotype viruses were ingathered and transfected into IBRS-2 cell under polybrene. The IBRS-2 cell was propagated in DMEM with puromycin. The genome extraction from the cells transfected different times, the T7 RNAP gene was amplified from the genome by PCR, the mRNA of T7 RNAP protein expressed in IBRST7 cells was analyzed by RT-PCR, respectively, the results showed the T7 RNAP gene had been integrated into the chromosome of IBRS-2 cell and expressed stably at high level. To study whether T7 RNAP is of transcriptional activity in the established IBRST7 cell line, a plasmid pIERS-EGFP-ET with a reporter gene (EGFP) under control of the T7 promoter was constructed. IRES element from FMDV (for CAP-independent translation) was cloned into plasmid pET-43.1a-c(+) downstream of the T7 promoter sequence, then EGFP gene was cloned in frame downstream of the AUG codon of the FMDV IRES, resulting in the plasmid. IBRST7 cells were transfected with plasmid pIERS-EGFP-ET using lipfection, EGFP was expressed, the results showed the T7 RNAP in IBRST7 cells has transcriptional activity. IBRST7 cell line was directly transfected with linearized full-length cDNA of swine vesicular disease virus (SVDV) HK/70, infectious SVDV was efficiently recovered from the cDNA. The reverse genetic procedure is simplified to a faster, one step protocol to recover RNA virus and will be useful to understand the mechanisms of molecular pathology of RNA virus and develop effective vaccines.

Objective To determine the plasma and intracellular concentration of Ara-C by the RPHPLC method and analyse the influence factors and the relationship between the concentration and drug dose.Methods Mononuclear cells and serum of 75 patients with acute leukemia were extracted after the first intravenous infusion of different administration dosage of Ara-C (0.5, 1.0, 2.0 g/m2), and analysed with different chromatographic conditions by RP-HPLC. Results The linear range of Ara-CTP was 0.28-18.96 μg/ml (r =0.998), and the detection limit was 0.28 μg/ml. The detection limit of Ara-C and Ara-U in plasma was 0.0157 μg/ml and 1.034 μg/mnl respectively. In 27 samples preserved for more than 1.5 years, 11 (40.7 %)cases of the plasma concentration of Ara-C were below the detection limit. In 36 samples of mononuclear cell count below 1.5×106/ml, 15 cases (41.7 %) of intracellular concentration of Ara-CTP were below the detection limit. The plasma concentration of Ara-U and intracellular concentration of Ara-CTP were increased with administration dosage of Ara-C increased, and the plasma concentration of Ara-C was not increased. The intracellular concentration of Ara-CTP in old patients over 40 years was tend to in crease with age.Conclusion The RP-HPLC method is simple, rapid, stable, reproducible and applicable for the monitoring of the plasma concentration of Ara-C and intracellular concentration of Ara-CTP. In 0.5-2.0 g/m2 dose range of Ara-C, the plasma concentration of Ara-U and intracellular concentration of Ara-CTP was increased with administration dosage of Ara-C increased.

Objective The aim of this retrospective study was to analyze the role of surgery in the management of limited-stage-Ⅱ small cell lung cancer.Methods A retrospective review of 82 patients with limited-stage Ⅱ small cell lung cancer between January 2001 and December 2009 was performed.The prognostic impact of different therapy and the clinicopathologic factors were analyzed.Using SPSS 16.0 statistical software for data analysis.Log-rank test for the difference of survivale rate.Using the Cox model for muliti-factor survival analysis.Chi-square test for local recurrence and distant metastasis rate.Results The overall median survival time and the 1-,3-,and 5-year overall survival rates were 27.0 months,62.1％,35.9％,and 21.0％,respectively.Median survival was 34.0 months in surgical patients vs 16.0 months in nonsurgical patients (P =0.000).Median survival after lobectomy or pneumonectomy was significantly longer than after wedge resection (P =0.048).However,survival after wedge resection was still significantly longer than survival in nonsurgical patients(P =0.024).Survival analysis confirmed that the operation,chemotherapy and radiotherapy were showed to be independent prognostic factors.The local-regional recurrencer rates of lobectomy or pneumonectomy group was lower than wedge resection group(P =0.030).The distant metastasis rates of lobectomy or pneumonectomy group was lower than nonsurgical grou (P =0.021).Conclusion This study suggests that lobectomy or pneumonectomy combined with adjuvant radio-chemotherapy should be recommended for patients with limited-stage Ⅱ small cell lung cancer.

Objective To analyze the papers published by domestic scientific research workers in order to improve the academic level of their papers. Methods The papers published by over 3000 domestic scientific research workers were investigated with questionnaires. Their motives to publish papers and the relation between the number of pub-lished papers and the assessment of their performance were analyzed. Results The number of papers published by domestic scientific research workers was increased. However, their academic level was to be further improved. Over quantization of the assessment mechanisms for scientific research increased the external motives to publish papers, thus leading to the insufficient internal motives of them to engage in scientific research. Conclusion A loose and comfortable academic environment should be created for the scientific research workers in order to initiate their in-ternal motives to publish papers. Over quantization of the assessment mechanisms for scientific research should be changed in order to reduce the external motives of domestic scientific research workers to publish papers. Innovative and cultural environment should be created in order to improve the soft power of scientific research in our country.

Objective To analysis the immunological characteristics of patients with severe H1N1 influenza A, and to provide theoretical basis for predicting the prognosis of the disease. Methods A retrospective analysis was conducted. The clinical data of 15 patients diagnosed with severe H1N1 influenza A and admitted to Shanghai General Hospital of Nanjing Medical University from October 2015 to December 2016 were collected. All the patients were divided into survival and death groups according to 28-day survival. Clinical characteristics, treatment algorithm, organ function, inflammatory reaction and immune cell status were compared, and Cox regression was used to decide the risk factors of 28-day death in patients with severe H1N1 infection A. Results All 15 patients with severe H1N1 infection A were enrolled, most of who presented with cough (93.3%), fever (86.7%), sputum production (80.0%), shortness of breath (73.3%), myalgia (40.0%) and fatigue (40.0%). All had been received anti-virus, antibiotics, mechanical ventilation and anti-coagulation therapy; some were treated with prone position, neuromuscular blocker and extracorporeal membrane oxygenation (ECMO). The incidences of acute myocardial and kidney injury were high, and the acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score (14.1±6.1) and sequential organ failure assessment (SOFA) score (9.6±4.1) implicated the critical condition. Of 15 patients, 4 patients died in 28 days, while 11 were cured and discharged. Compared with survival group, the patients in death group had higher levels of APACHE Ⅱscore (22.7±3.8 vs. 11.8±3.8), troponin [cTn (μg/L): 0.52 (0.07, 2.02) vs. 0.15 (0.10, 0.45)] and blood urea nitrogen [BUN (mmol/L): 11.9 (6.7, 29.1) vs. 3.9 (2.7, 6.8)] and a lower level of blood platelets count [PLT (×109/L): 76±33 vs. 146±49, all P < 0.05]. The levels of C-reactive protein (CRP) and interleukin-6 (IL-6) within 24 hours of admission in death group were significantly higher than those of survival group [CRP (mg/L): 172.2±88.5 vs. 74.8±33.1, IL-6 (ng/L):283.3 (140.1, 711.0) vs. 18.5 (12.7, 71.4), both P < 0.01]. Compared with survival group, the expressions of CD3+, CD4+, CD8+ T cells and natural killer cell (NK cell) in death group were significantly decreased (CD3+ T cell: 0.348±0.119 vs. 0.573±0.106, CD4+ T cell: 0.135±0.046 vs. 0.344±0.098, CD8+ T cell: 0.089±0.057 vs. 0.208±0.054, NK cell: 0.124±0.057 vs. 0.252±0.182, all P < 0.05), but there were no significant differences in CD4+/CD8+ ratio and human leucocyte antigen-DR positive (HLA-DR+) T cell between death group and survival group (CD4+/CD8+ ratio:1.57±0.26 vs. 1.83±0.54, HLA-DR+ T cell: 0.035±0.022 vs. 0.062±0.036, both P > 0.05). B lymphocyte in death group was significantly higher than that of survival group (0.477±0.136 vs. 0.229±0.121, P < 0.01). Cox regression analysis revealed that APACHE Ⅱ score [risk ratio (RR) = 20.4, 95% confidence interval (95%CI) = 5.3-31.2, P = 0.017], CD4+ T cell (RR = 11.1, 95%CI = 5.1-20.0, P = 0.048) and CD8+ T cell (RR = 9.1, 95%CI = 4.3-16.7, P = 0.049) were independently risk factors of 28-day survival of patients with severe H1N1 influenza A. Conclusion Immunological paralysis and severe inflammatory response were early complicated with severe H1N1 influenza A, and these were significantly associated with prognosis.

Objective: To investigate the resistance to rifampicin and isoniazid and the changing trends among patients with pulmonary tuberculosis in Luohu District, Shenzhen City, Guangdong Province from 2012 to 2022, so as to provide insights into improving drug-resistant pulmonary tuberculosis control and prevention strategies. Methods: Basic information, treatment classification and drug resistance data of patients with pulmonary tuberculosis and positive pathogenic detection in Luohu District from 2012 to 2022 were collected through the Tuberculosis Surveillance System of Chinese Disease Prevention and Control Information System, and resistance rates of rifampicin and isoniazid and the changing trends were analyzed. Results: A total of 2 126 patients with pulmonary tuberculosis were collected and had a median age of 34 (interquartile range, 25) years, including 1 334 males (62.75%) and 792 females (37.25%). There were 302 patients with drug-resistance in Luohu District from 2012 to 2022, with a resistance rate of 14.21%. Among them, 60 patients were monoresistant to rifampicin (2.82%), 113 patients were monoresistant to isoniazid (5.32%), and 129 patients were multidrug resistant (6.07%). The rate of rifampicin monoresistance showed a downward trend from 2012 to 2022, while the rate of multidrug resistance showed an upward trend (both P<0.05). There was no significant tendency in the rate of isoniazid monoresistance (P>0.05). The rate of multidrug resistance among patients without Shenzhen residence was higher than that among patients with Shenzhen residence; the rates of rifampicin resistance and multidrug resistance among retreated patients were higher than those among treatment-naïve patients (all P<0.05). Conclusions The rate of rifampicin monoresistance appeared a downward trend and the rate of multidrug resistance appeared an upward trend among patients with pulmonary tuberculosis in Luohu District from 2012 to 2022. Attention should be given to non-Shenzhen residence and retreated patients.