Acute Disease ; Angioplasty, Balloon, Coronary ; adverse effects ; Compartment Syndromes ; etiology ; Female ; Humans ; Middle Aged

Objective To analyse the changes of a district general hospital before and after management by Shanghai Renji Medical Group through current situation survey,and explore the conditions for the development of district general hospitals.Methods The Zhujiajiao People's Hospital of Qingpu District in Shanghai was selected,and patients(n=50)and hospital staff(n=100) were conducted current situation survey with questionnaires which included the knowledge and evaluation of the hospital's current situation as well as the changes before and after management by Shanghai Renji Medical Group.Results Half year after management by Shanghai Renji Medical Group,great progress in medical work was achieved,with a favourable development trend.The rate of satisfaction on medical service evaluated by inpatients reached 89.60%,and 81.91% hospital staff had confidence in the sustainable development of the hospital. Conclusion Management by Shanghai Renji Medical Group has brought prospects for the Zhujiajiao People's Hospital.Under current environment,only certain conditions are met can a district general hospital achieve sustainable development.

Objective To develop a computer-aided diagnosis(CAD)system with automatic contouring and morphologic and tex-tural analysis to aid on the classification of breast nodules on ultrasound images .Methods A modified Level Set method was pro-posed to automatically segment the breast nodules(46 malignant and 60 benign nodules) .Following ,16 morphologic features and 17 texture features from the extracted contour were calculated and principal component analysis(PCA)was applied to find the optimal feature vector dimensions .Fuzzy C-means classifier was utilized to identify the breast nodule as benign or malignant with selected principal vectors .Results The performance of morphologic features was 78 .30% for accuracy ,67 .39% for sensitivity and 86 .67%for specificity ,while the latter was 72 .64% ,58 .70% and 83 .33% ,respectively .After the combination of the two features ,the re-sult was exactly the same with the morphologic performance .Conclusion This system performs well in classifying the malignant breast nodule from the benign breast nodule .

Objective To expore the difference between magnetic resonance image ( MRI) expression of spinal tuberculosis and brku-cellare spondylitis. Methods Retrospectively analyzed the clinical data of 10 patients with tuberculous spondylitis and 12 patients with bru-cellar spondylitis from Jan. 2012 to Oct. 2013. All the patients were scanned by MRI, and the expression difference of MRI were compared. Results The vertebral body of spinal tuberculosis was destroyed severely, and it often accompanied by the kyphosis and multiple-level para-vertebral abscess, and even adjacent organs tuberculosis. The vertebral body of brucellar spondylitis was destroyed lightly,and the abscess is often limited. Conclusion We can distinguish spinal tuberculosis and brucellar spondylitis by the typical difference of the expression of MRI.

Objective To evaluate the clinical and radiological outcomes of skip-level anterior cervical discectomy and fusion(ACDF) for the treatment of two-level noncontiguous cervical spondylotic myelopathy(CSM).Methods There were 34 patients with two-level noncontiguous CSM underwent skip-level ACDF in our department from January 2014 to December 2016.The clinical outcome including surgery time, intraoperative blood loss,Japanese Orthopaedic Association(JOA) scores,Neck dysfunction index(NDI),the improvement rate of JOA,segment lordosis,fusion rate and Odom's criteria were evaluted.Results The surgery time was from 92 minutes to 125 minutes,mean operative time 103.28 minutes;the intraoperative blood loss was 50 to 150 mL,with average blood loss of 90 mL.The cervical spine lateral radiographs showed that the cervical physiological curvature had restored.The patients were followed up for average 6 months.The fusion rate of was 94.1％ at the lastest follow-up.No cages subside,implant failure or migration and infection occured.The JOA and NDI scores at the latest follow-up were(14.21±0.732) and (3.26±1.14),respectively,the JOA scores improvement rates was 58.62％.The segmental lordosis before surgery was(10.75±1.132)°,the one after surgery was(15.61±1.312)°,the difference was significant(P<0.05).The Odom's criteria at the lastest follow-up showed that excellent in 21 patients,good in 9 patients and fair in 4 patients,with excellent and good rate of 88.2％.Conclusion Skip-level ACDF can achieve good clinical and radiological outcomes including a high fusion rate and well maintainence of spinal curvature and intervertebral height for patients with two-level noncontiguous CSM.

Single clones of Leptospirillum ferrooxidans were obtained on bilayer solid medium plate by incorporating Het-erotroph Acidiphilium SJH into the underlayer broth medium. The morphologies of the bacteria were investigated using electronic microscope.

Four screening methods, colorimetric assay, blood-plate hemolysis method, surface tension activ- ity and oil spreading technique were introduced to isolate strains producing bio-demulsifiers from 6 different bacteria source samples. The results of various screening methods were evaluated in this paper. Seventeen demulsifying strains were obtained, which are qualified in demulsification test of kerosene model emulsions. Among them, 5 strains showed high demulsifying ability, achieving 70% plus demulsifying ratio within 24 hours. Petroleum-contaminated soil, excess sludge from biological process treating oilfield produced water and sludge from municipal wastewater treatment plant were the best among all tested sources. Due to the determination limit, the colorimetric assay and blood-plate hemolysis method are not competent to screen bio-demulsifiers strains. The measurement of surface tension and oil spreading method were easy but accu- rate methods to isolate bio-demulsifiers strains. Although demulsification test of model emulsion is an effec- tive technique to target strains with the capability of breaking emulsions, it is sophisticated and time-con- suming. Thus it is recommended to use surface tension and oil spreading methods in pre-screening and vali- date the results in demulsification test with kerosene model emulsions.

Objective To observe the long term effects of arthroscopic knee debridement and reconstructing operation for treating osteoarthritis in patients with Kaschin-Beck disease. Methods Thirty-one cases of patients with Kaschin-Beck disease were followed for 6 years after operation of articular clearing by arthroscope. Index of pain, symptoms of self-evaluation, range of motion, walking distance, standing test by affected leg when bending at 30° or 60° were recorded and compared with the preoperative results. Results Twenty-four cases were followed up for 6 years. Six years after operation the pain index(3.38 ± 2.87) was dramatically decreased compared to that before operation (6.88 ± 1.45, t = 5.30, P ＜ 0.05). Patients symptoms markedly improved by subjective self-evaluation was 70.83% (17/24), the effective rate was 100% (24/24). The number of cases that could stand up when leg bending at 30° or 60° were 21,18 cases, respectively, compared with that of preoperative of 14, 11 cases, respectively, the difference was statistically significant(x2 = 5.17,4.27, all P ＜ 0.05). Six years after operation the walking distance(3 cases ＜ 1 km, 11 cases 1 - 5 km and 10 cases ＞ 5 km) were greatly improved compared to the results before operation (12 cases ＜ 1 km, 9 cases 1 - 5 km and 3 cases ＞ 5 km, U = 2.88, P ＜0.05). Six years after operation the knee activity[(132.25 ± 14.52)°] remained at the same level, compared with that of preoperative [(131 .58 ± 14.68) °], the difference was not statistically significant (t = 0.16, P ＞ 0.05) .Conclusions The method of arthroscopic joint debridement to cure Kaschin-Beck disease knee osteoarthritis can significantly reduce pain, improve function and walking distance, with more stable long-term satisfactory outcome.

Objective To explore the effect of chromosomal abnormality and polygenic inheritance factor in female children with short stature.Methods 1.Chromosome analysis:peripheral blood was drawn for 1 mL and cultured 72 h to analyze chromosome karyotype (Giemsa Banding ) of peripheral lymphocytes.2.Polygenic factor analysis:the children′s final height were estimated based on their parents average height,and analyzed the distribution characteristics of children′s final height and compared the estimate final height with the actual height.Results Eighty-three cases out of the 364 female children with short stature were chromosomal abnormality(22.80%).Among the 83 cases,the 45,XO and 46,X,i(Xq) occupied 70%.The distribution of children target height shifted left,and the target height of 76 cases was lower than 2 standard deviation (-2 s)and the consistency of target height and actual height reached 20.88%.The target height of 7 cases was lower than 2 standard deviation in those whose chromosome turned out to be abnormal,and the consistency of target height and actual height was 8.43%.Conclusions Chromosomal abnormality is one of the most important etiologic agents causing short stature in female children, and polygenic inheritance is another important etiologic agent.

Objective To investigate the effects of intervertebral bridging ossifications in patients of osteoporotic vertebral compression fracture (OVCF) on bone fracture healing.Methods A total of 170 patients of thoracolumbar vertebral endplate fracture who were admitted into our hospital were selected.Divided these patients into the observation group,namely 60 patients with nonunion of vertebral endplate after 3 months of conservative treatment,and the control group, including 110 patients with well healed vertebra after 3 months of conservative treatment.Compared the distribution of intervertebral bridging ossifications of the two groups 3 weeks after injury.Results The incidence of bridging ossification at levels of T9 to T10,T10to T11,T11to T12 in the observation group were significantly higher than that in the control group.And it showed a significantly higher incidence of bridging ossification at the second proximal intervertebral segment in the observation group than that of the control group.There was a significantly greater sagittal wedge angle in the observation group compared with the control group.Conclusion Conservative treatment may increase the risk of nonunion of osteoporotic vertebral compression fractures when there is a bridging ossification at the second proximal intervertebral level or the sagittal wedge angle was greater than 14.2°in a fresh osteoporotic vertebral compression fracture.It should be a careful choose whether to take conservative treatment or surgical intervention.