Objective To study the image features and clinical significance of 3-dimensional (3-D)and multiplanar reconstruction with spiral CT(SCT) in cervical spinal fractures.MethodPlain film radiography and spiral CT scanning were taken for 26 cases of cervical spinal fractures.The type of fractures, diagnositic successful rate, parameter of scanning and late stage managing methods were investigated retrospectively to find out the effective difference between the diagnosis of plain X-ray and SCT. The imagin location of fractures,sequence of cenrum, heighth of centrum, fracture line, auxillary structure and rotation/dislocation of the fractures were emphasized to evaluate the advantages of 3-D imaging.ResultIn the 26 cases, there were 4 Jefferson fractures, (in which 1 combined with articular dislocations), 17 C2 spinous process fractures, (in which 1 had failure of plain X-ray diagnostic), 1 Hangman fracture, 2 C1～2 imbalance, (in which 1 had failure of plain X-ray diagnostic).There were 2 cases of axoid longitudinal fractures without obvious dislocation. The diagnositic successful rate were 100% in SCT group, while 65% in X-ray group in which 6 cases had diagnostic failure and 3 cases had fracture mis-diagnozing as dislocation.The anatomical structure of upper cervical spine was complicated and was significantly different from other cervical spine constructions. Spiral CT could reveal high resolution images of the upper cervical spine, morphosis of vertibral canal, dislocation information of fracture mass and its relation with neighbouring tissues. Especially in C1 burst fracture,C2 dens fracture and C1～2 dislocation, SCT could provide clear 3-D information of the size of collateral mass and the dislocation degree, furthermore, images could be rotated freely to observe the fracture in any proper section. That provides important information for the decision of operation, selection of operation types and evaluation of operation dager.ConclusionThe spiral CT scan and 3D reconstruction can reveal fracture better.The advantages of SCT are suggested that this diagnostic modality may be the standard method for the initial evaluation of the upper cervical spine injury.

Objective To study the influencing factors of raised D-dimer levels in elderly people.Methods 592 elderly people underwent physical examination in our hospital were selected.They were divided into observation group and control group according to the level of D-dimer.The clinical data,liver and kidney function and blood lipid levels between both groups were compared.Re-sults There were no significant difference on gender,BMI,FBG,ALT,AST and Cr between both groups (P >0.05),but the age of patients in the observation group were significantly higher than that of the control group(P <0.05).The PT,CRP,bacterial pneu-monia and (or)of acute exacerbations of chronic bronchitis,cancer,diabetes patients in the observation group were significantly higher than those in control group,while LDL-C,TC were significantly lower than that of the control group,there were significant differences (P <0.05).The plasma D-dimer level in patients showed positive correlation with CRP and age (r =0.27,0.25,P <0.05).Conclusion Malignant tumor,type 2 diabetes,bacterial pneumonia,acute exacerbation of chronic bronchitis are the risk fac-tors of raised plasma D-dimer levels in the elderly.

Objective To study in patients with stable chronic obstructive pulmonary disease treatment, the use of Tiotropium Bromide Powder for Inhalation treatment combined with psychological intervention effect.Methods In 40 cases of patients with stable chronic obstructive pulmonary disease treatment using tiotropium bromide powder for inhalation, and classified as the control group, the other 40 patients in the control group based on the use of psychological intervention combined with treatment the treatment, and classified as the observation group, two groups of patients were in our hospital from January 2016 to January 2017.Results There was no significant difference in anxiety and depression of patients in the two groups before intervention, after the intervention group patients in the observation group improved significantly better;two groups of patients before intervention PaCO2, there was no significant difference in PaO2 index, after group intervention of patients in the observation group improved significantly better;compared two groups of patients with the treatment efficiency, the obvious observation group were higher, there were significant differences (P<0.05).Conclusion Tiotropium Bromide Powder for Inhalation combined psychological intervention treatment of patients with stable chronic pulmonary disease blocking was observed, which can improve the patient's condition, and improve the treatment effect, the patient's mental state adjustment also has a positive effect, it is worthy of reference.

Objective To study the changes in tumor necrosis alpha(TNF ?), interleukin 6(IL 6), procalcitonin(PCT) and C reactive protein (CRP) levels and their values in the prediction and assisting diagnosis of infection complications in severe multiple trauma patients. Methods TNF ?, IL 6 and CRP were measured by enzyme linked immunosorbant assay(ELISA) and PCT was determined by immunoluminometric assay(ILMA) in serial samples of plasma from 34 patients with severe multiple trauma(ISS≥16) and compared with those of 11 normal control volunteers. Patients were divided into 2 groups(infection and non infection groups). The differences of the above parameters between groups were compared. In addition, all data were managed by receiver operating characteristic(ROC), and sensitivity, specificity, negative and positive predictive values for the diagnosis of infection complications were calculated. Results Plasma levels of TNF ?, IL 6, PCT and CRP in multiple trauma patients without infection complications were increased differently in the early posttrauma period. TNF ? and CRP levels in the early posttrauma period before infection were not significantly different from those in patients without infection complications, but they increased significantly following infection. However, during the whole observing period, plasma levels of PCT and IL 6 in the patients with infection complications were higher than those in patients without. The value of those parameters in assisting diagnosis of infection was evaluated. PCT was of the highest specificity and higher negative and positive predictive values. Conclusion All the parameters are of clinical value in infection diagnosis after severe multiple trauma. PCT is the best index for the prediction and assisting diagnosis of infection after multiple trauma.

Objective To report the clinical results of minimally invasive percutaneous plate osteosynthesis (MIPPO) in treatment of type C fractures of distal femur.Methods A retrospective study was conducted to an- alyze 14 consecutive cases of distal femoral fractures who had been treated with MIPPO in our department from April 2002 to February 2005.According to AO/ASIF classification,there were three cases of type C1,six cases of type C2,and five cases of type C3.At first,the fractures of articular surface were directly reduced and fixed with spongy screws.Next,the condylar fractures were indirectly reduced and fixed with buttress or LISS (less invasive stabi- lization system) plates through transarticular approach.Results Follow-ups,ranging from 10 to 32 months for 12 cases,revealed that they all reached union.The time for their bony union was 10 weeks to 12 months (mean,4.6 months).Their functional recovery was evaluated according to criteria by Kolmert and Wulff.Four cases were rated as excellent,five as good,two as fair and one as poor.The total satisfactory rate was 75%.Conclusion MIPPO is a safe and effective procedure for the type C fractures of the distal femur with the benefits of limited invasion to soft tissues and a high rate of bone union.

Objective To improve the quality of antibiotics prescriptions in outpatient and emergency departments, to reduce the irrational use of antimicrobial drugs and to improve the quality of pharmacy service through system of rational drug administration.MethodsAnalyzing and evaluating the data of irrational administration of antimicrobial drugs between 2014 and 2015.The data was collected by the system of rational drug administration.ResultsFrom 2014 to 2015, the qualified rate of antibiotics prescriptions increased from 95.40% to 98.71%.Different types of irrational use of antimicrobial agents significantly reduced.ConclusionThe application of system of rational drug administration can improve the qualified rate of antibiotics prescriptions in outpatient and emergency departments and can promote pharmacy service.

OBJECTIVETo investigate the technological parameters of the purification process of total flavones from Smilax china with macroporous absorption resin.

METHODThe technical process for purification of total flavones with the optimum macroporous absorption resin was screened by yield of total flavones product.

RESULTThe D140 macroporous absorption resin had the best separating efficiency when the flavones content in the liquid was 0.5 g x mL(-1) equivalent to raw material, the volume of drug 18 BV (resin bad volume) with the adsorption-power 2 BV x h(-1), and the volume of 60% (mL x mL(-1)) ethanol as eluant 5-10 BV (resin bad volume) with desorption-power 1 BV x h(-1). The obtained flavones product has total flavones recovery rate of 84.72%.

CONCLUSIONThe treatment of regenerated resin is easy, this method is advisable.

Absorption ; Flavones ; chemistry ; isolation & purification ; Plants, Medicinal ; chemistry ; Resins, Synthetic ; chemistry ; Rhizome ; chemistry ; Smilax ; chemistry ; Technology, Pharmaceutical ; methods

AIM:To observe related biological parameters of 3 minutes dark-room provocative test in patients with laser peripheral iridectomy(LPI) in the fellow eyes of acute primary angle-closure (APAC) by ultrasound biomicroscopy (UBM).To explore the risk factors in primary angle closure suspect(PACS) patients with progressive angle closure after LPI.METHODS: Seventy-eight eyes of APAC patients without peripheral anterior synechia were selected.Each eye underwent 3 minutes dark-room provocative test after LPI.Anterior segment parameters, including anterior chamber depth (ACD), anterior chamber angle open distance500 (AOD500), peripheral iris thickness (PIT), iris convex (IC), the position of iris insertion and trabecular-ciliary process distance (TCPD), and the number of positional angle closure(NPAC) were observed and analyzed by statistic methods.RESULTS:Patients with APAC were examined by UBM after LPI and 26 eyes(33%) occurs at least one positional angle closure,19 eyes(24%)were positive in 3 minutes dark-room provocative test among them.It occurs a positive relationship between the elevation intraocular pressure and the number of positional angle closure in dark-room provocative test(r=0.84, P<0.01).AOD500, IT and IC were significantly changed from normal light to darkroom between positional angle closure positive group and positional angle closure negative group(all P<0.01).In single factor analysis, AOD500(P=0.003), IT(P=0.012), IC(P=0.043), TPCD(P=0.015), the position of iris insertion(P=0.024) were correlative factors of positive results.In multiple-factor analysis, only IT(P=0.011), TPCD(P=0.009), iris root attachment points(P=0.02) were independent risk factors of positive results.CONCLUSION:A certain proportion of patients with PACS after LPI appeared positional angle closure in a dark room.Peripheral iris hypertrophy, anterior displacement of the ciliary body and iris root attachment points are vital risk factors.Long-term follow-up study and intervention treatment are required in these patients after LPI.

Objective:To observe the effects of Etifoxine on proliferation and migration of RSC96 (Schwann cells of rat) and its potential molecular mechanisms.Methods:From March, 2020 to October, 2020, cultured RSC96 were treated with 20 μmol/L Etifoxine and saline respectively for 48 h. Cell proliferation was tested by EdU assay using Cell-Light EdU DNA Cell Proliferation Kit and the capability of migration was determined by wound healing assay and a transwell system. To investigate the effects of Etifoxine on CELSR2 protein expression, after treated with different concentrations of Etifoxine at 0-20 μmol/L for 48 hours, cells were subject to Western blot analysis to verify the expression of CELSR2 protein. To explore whether CELSR2 would be a potential target of Etifoxine, siRNA targeting CELSR2 and control siRNA groups were transfected into 20 μmol/L Etifoxine-treated RSC96 using Lipo3000. Again, the cell proliferation and migration of were investigated after 48 hours with the same procedures. The two-tailed Mann-Whitney U test was employed in statistical assessment.Results:EdU results showed a significant higher percentage of Edu-positive (proliferating) cells in the 20 μmol/L Etifoxine-treated group than the control group[(36.30±3.09)% vs (19.40±2.50)%, P<0.05]. Transwell migration assay demonstrated that the number of 20 μmol/L Etifoxine-treated RSC96 which migrated through the transwell membrane was higher than saline group, with significant statistical difference [(132.30±6.77) vs(65.33±7.37), P<0.05]. The percentage of reduction of wound area measured at 24 hours and 36 hours after the scratch also showed the similar results [(30.67±2.16)% vs (23.00±2.61)%; (86.00±2.19)% vs (49.67±2.81)%, respectively, P<0.05]. Besides, with increase of the concentration of etifoxine, the expression of CELSR2 showed an trend of increase in RSC96 ( P<0.05), but no significant statistical difference was found between 10 μmol/L and 20 μmol/L groups ( P>0.05). Interestingly, the rate of cell proliferation, the number of migrating cells and the percentage of wound area reduction of RSC96 in which were treated by Etifoxine and transfected with CELSR2 siRNA were significantly decreased compared with the control siRNA treatment ( P<0.05). Conclusion:Etifoxine could promote proliferation and migration of RSC96. Upregulation of CELSR2 protein expression in RSC96 is associated with the Etifoxine-induced enhancement of cell proliferation and migration.

ObjectiveTo study the characteristic findings on MRI in children surviving premature delivery with cerebral palsy.MethodsThe clinical data and MR imaging in 16 cases surviving premature delivery with cerebral palsy was retrospectively analyzed, compared with 16 healthy and age-matched controls.Results16 cases were final diagnosed as cerebral palsy with spstic diplegia. MRI features of children surviving premature delivery with cerebral palsy included abnormally high signal intensity in the periventricula white matter on T2WI, marked loss of periventricular deep white matter, ventriculomegaly with or without irregular ventricular outline and atrophy of the corpus callossum. These features were consistent with periventricular leukomalacia(PVL).ConclusionPVL was the characteristic findings on MRI in children surviving premature delivery with cerebral palsy. The characteristic findings of PVL was useful in determining the etiology and type of cerebral palsy in children.