Objective　To study the scan technique that can completely demonstrate the structures of middle-inner ear.Methods　Ninety volunteers underwent 30° axial and 105° coronal HRCT scan.The manifestations of the ministructures of middle-inner ear were observed and their demonstration rate was calculated.The demonstration of different structures of middle-inner ear was evaluated and compared on HRCT.Results　(1)The scan planes of 30° axial and 105° coronal were correspondent to some structures of middle-inner ear and could completely demonstrate them.(2)30° axial and 105° coronal HRCT scan had their own advantages respectively in demonstrating the structures of middle-inner ear.Conclusion　The technique of 30° axial and 105° coronal HRCT scan of middle-inner ear is useful in demonstrating the structures,including the nerve,joint,ligament etc and the relationship among them.

Objective To investigate the clinical effect of proximal femoral nail antirotation (PFNA) and dynamic hip screw (DHS) in treating senile intertrochanteric fractures.Methods From February 2006 to December 2014,111 cases of senile intertrochanteric fractures treated with PFNA and DHS at our institution were retrospectively analyzed.Fifty-nine cases were treated with PFNA (average age 77.4 years);and fifty-two cases were treated with DHS (average age 76.1 years).The outcome measures collected for statistical analysis on following aspect:surgical time,blood loss in operation,blood transfused,rate of patients transfused,time to partial weight beating,hospital stay,healing time of fracture,orthopedic complications,reoperation rate and post-operation hip function.The Harris Hip Score was used for functional evaluation.Results One hundred and eleven patients were followed up for 10 to 24 months (average 17.2 months).There were no significant differences between two groups with regard to the functional outcome at 1 year,hospital stay,orthopedic complications and reoperation rate (P ＞ 0.05).There were significant differences between the PFNA group and DHS group with regard to the surgical time [(60.7 ±9.9)min vs (97.5 ± 20.5) min],the blood loss in operation [(169.2 ± 82.1) ml vs (428.8 ± 126.O) ml],per patient concentrated red blood cells transfused [(0.7 ± 0.9) U vs (1.2 ± 1.3) U],blood transfusion rate (35.6％ vs 55.8％) and time to partial weight bearing [(12.9 ± 10.3)d vs (47.0 ± 15.5)d] (P ＜0.01).Conclusions PFNA is an effective method for the treatment of senile intertrochanteric fracture with the advantages of simple operative procedure,minimally invasion,stable fixation and fewer complications.

A bacterial strain having 3-deoxyglucosone-metabolizing enzyme was selected from 31 marine bacterial stains. The conditions for enzyme production of the strain was examined. The optimal tempreture, initial pH. and cultivate time for enzyme formation were 28℃, pH7.8~8.0, and 96 hours respectively. Composition of the suitable medium was as following (%): Fish peptone 1.0, Sucrose 0.3, Yeast extract 0.2, NaCI 5.0.3-deoxyglucosone can induce formation of enzyme.

Objective To investigate the trend in incidence, causative drugs, clinical types and treatment of drug eruption. Methods Clinical data were collected from 922 inpatients with drug eruption in Huashan Hospital, Fudan University from January 2009 to December 2013, and analyzed retrospectively. Results From 2009 to 2013, the percentage of inpatients with drug eruption among all inpatients in the Department of Dermatology in a given year varied from 9.45% to 10.01%, and the percentage of inpatients with severe drug eruption among inpatients with drug eruption from 17.45% to 28.24%. Of the 922 cases, 371 (40.2%)were caused by single drugs, and 551 (59.8%)by multiple drugs. Among the 371 cases of drug eruption caused by single drugs, the top five causative drugs were traditional Chinese medicine(72 cases), cephalosporins(38 cases), amoxicillin(27 cases), antipyretic analgesics(26 cases)and tetanus antitoxin (24 cases)in 278 cases of non-severe drug eruption, antiepileptic agents (33 cases), allopurinol (28 cases), antipyretic analgesics (7 cases), cephalosporins (6 cases)and traditional Chinese medicine (6 cases)in 93 cases of severe drug eruption. Of the 922 patients, 422 (45.8%)presented with maculopapular eruption, 259 (28.1%)with urticaria, 135(14.6%)with Stevens-Johnson syndrome, 49(5.3%)with toxic epidermal necrolysis, 33(3.6%)with drug reaction with eosinophilia and systemic symptoms (DRESS), and 7 (0.8%)with acute generalized exanthematous pustulosis (AGEP). A total of 791 (85.8%)patients with drug eruption received glucocorticoid treatment. The dose of glucocorticoids was(47.61 ± 12.07)mg prednisone equivalent per day in 550 patients with non-severe drug eruption, and (73.10 ± 18.23)mg prednisone equivalent per day in 221 patients with severe drug eruption. Totally, 110 (11.0%) patients with drug eruption were treated with combined intravenous immunoglobulin (IVIG)because of poor response to glucocorticoids alone. Of 224 patients with severe drug eruption, only 2 (0.9%)died. Conclusions Carbamazepine and allopurinol are the main causative drugs for severe drug eruption, while traditional Chinese medicine is the first causative drug for non-severe drug eruption. From 2009 to 2013, the annual mortality of severe drug eruption decreased considerably.

OBJECTIVE To study the expression of Toll-like recptor2(TLR2)and Toll-like receptor4(TLR4) in the fungal rhinosinusitis tissues,and to explore the role of TLR2 and TLR4 in the pathogenesis of fungal rhinosinusitis.METHODS The mRNA and protein expression of TLR2 and TLR4 were detected by reverse transcription polymerase chain reaction(RT- PCR)and immunohistochemistry(IHC)in 24 fungal rhinosinusitis tissues,24 chronic rhinosinusitis tissues,and 15 normal mucosa of inferior turbinate. RESULTS The mRNA expression of TLR2 and TLR4 in fungal rhinosinusitis tissues(0.208?0.063,0.159?0.059)was significantly decreased compared with that in chronic rhinosinusitis(0.505?0.097,0.406?0.102)and normal inferior turbinate tissues(0.327?0.047;0.232?0.088).The protein expression rates of TLR2 and TLR4 in fungal rhinosinusitis tissues (3/24,4/24)were significantly lower than that in chronic rhinosinusitis(20/24,21/24)and normal inferior turbinate tissues(7/15,8/15)by IHC study. CONCLUSION The lower expression of TLR2 and TLR4 in fungal rhinosinusitis tissues indicates that the declined role of TLR-mediated innate immune responses in the defensive reaction of anti-fungal in sinonasal mucosa,which may be one of the reasons for dropped clearance rate and increased susceptibility to fungi.

Objective To evaluate the diagnostic efficiency of Q?SPECT, CTPA, Q?SPECT/CT, and Q?SPECT/CTPA for pulmonary embolism (PE) in rabbit models. Methods (1) The PE models were constructed by injecting Gelfoam into the femoral vein of New Zealand rabbits ( n=30) . Q?SPECT, CTPA, Q?SPECT/CT and Q?SPECT/CTPA fusion images were obtained by integrated SPECT/CT. (2) All images were interpreted by two experienced nuclear radiologists who were blind to pathologic findings. The locations and numbers of lung lobes with PE were recorded respectively. ( 3) Serial sectioning of the lungs was per?formed and pathologically determined. (4) Se, Sp and Ac of different methods were compared using McNemar test;PPV and NPV were compared usingχ2 test. Kappa test was used to analyze the consistency between two nuclear radiologists. Kappa values<0.40 were interpreted as poor consistency, 0.40 to 0.75 as moderate con?sistency, >0.75 as good consistency. Results (1) Histologically confirmed emboli were present in a total of 26 pulmonary lobes and absent in 79 lobes. (2)The Se, Sp, Ac, PPV, and NPV of 4 imaging methods were:53.8%(14/26), 93.7%(74/79), 83.8%(88/105), 14/19, 86.0%(74/86) for Q?SPECT;73.1%(19/26), 96.2%(76/79), 90.5%(95/105), 86.4%(19/22), 91.6%(76/83) for CTPA;76.9%(20/26), 93.7%(74/79), 89.5%(94/105), 80.0%(20/25), 92.5%(74/80)for Q?SPECT/CT;88.5%(23/26), 91.1%(72/79), 90.5%(95/105), 76.7%(23/30), 96.0%(72/75) for Q?SPECT/CTPA. (3) McNemar test showed Q?SPECT/CT and Q?SPECT/CTPA had higher diagnostic Se for the detection of PE than Q?SPECT (χ2=4.167, 7.111, both P<0.05) , but without any significant difference with CTPA in diagnostic efficiency (χ2=0-2.250, all P>0.05) . Q?SPECT/CT had higher diagnostic Ac than Q?SPECT (χ2=4.167, P<0.05) . There was no significant difference between Q?SPECT/CT and Q?SPECT/CTPA in diagnostic effi?ciency (χ2=0.001-1.333, all P>0.05). (4)Kappa values of 4 imaging methods for radiologist 1 and 2 were 0.902, 0.915, 0.973, and 0.884. Conclusions Q?SPECT/CT imaging provides good Se and Sp. The diag?nostic efficiency of Q?SPECT/CT is better than that of Q?SPECT and is corresponded roughly to the efficien?cy of CTPA, Q?SPECT/CTPA. The diagnosis of two radiologists on Q?SPECT/CT images has the best con?sistency.

The authors introduced,against the backdrop of the new round of accreditation,organization and practice of the hospital.In accordance with the five management elements of planning,organization,leadership,coordination and control,and the level management theory,the hospital divided,based on a top-down design and step-by-step implementation,the process into four stages of mobilization and deployment,study and training,self-assessment and rectification,supervised self-assessment and constant improvement.These efforts aim at exploring the key points and methodology of hospital accreditation,proposing such key points as the combination of the accreditation with building a long-term mechanism,that of theory with practice,that leadership with full staff involvement,that of top-down design with step-by-step implementation,that of training and rectification,that of self-assessment and supervision,and that of system management with implementation of provisions.This way the hospital accreditation may upgrade the hospital as a whole.

Purpose: The aim of this paper is to develop a scale for measuring the perinatal bereavement care competence of midwives and assess its psychometric properties. Methods: The Perinatal Bereavement Care Competence Scale was developed in four phases. (1) Item generation: 75 items were formulated based on a literature review and interviews with midwives. (2) Delphi expert consultation: 15 experts evaluated whether the items were clear/appropriate/relevant to the questionnaire dimensions, and the items were optimized. (3) Pilot test: The comprehensibility, acceptability, and time required to complete the questionnaire by midwives were assessed. (4) Evaluation of reliability and validity: The scale was validated by initial item analysis, exploratory and confirmatory factor analyses, and internal consistency reliability and testeretest reliability. Results: The final scale consisted of six dimensions and 25 items: maintaining belief (three items), knowing (four items), being with (six items), preserving dignity (four items), enabling (five items), and self-adjustment (three items). Exploratory factor analysis yielded a six-factor structure that was consistent with the theoretical framework and explained 70.8% of the total variance. Confirmatory factor analysis indicated a good fit for the six-factor model. Cronbach's a for the scale was 0.931, and the test eretest reliability coefficient was 0.968. Conclusion The Perinatal Bereavement Care Competence Scale is a valid and reliable instrument for measuring the competence of midwives in caring for bereaved parents who have experienced perinatal loss.

OBJECTIVETo observe the herbal effects on hyperthyroidism patients with syndrome of hyperactivity of liver-Yang by method for calming the liver and suppressing Yang and investigate its effects on the lymphocyte protein expression. This approach may lay a foundation for the further investigation of the curative mechanisms of calming the liver and suppressing Yang treatment.

METHODA total of 48 hyperthyroidism patients with syndrome of hyperactivity of liver-Yang were randomly divided into treatment group and control group. The treatment group was treated by method for calming the liver and suppressing Yang in accordance with traditional Chinese medicine (TCM) and the control group with thiamazole tablets for three periods of treatment The therapeutic effects, the score of TCM symptom, electrocardiogram (P wave), thyroid hormones and ultrasound were observed in both groups before and after the treatment. The side effects in the treatment course were observed in both groups. The level of differential protein expression was analyzed by two-dimensional electrphoresis and matrix assisted laser desorption/ionizaton time-of-flight mass spectrometry.

RESULTThe treatment group has the effect on stepping down the heart rate, cutting down the P wave amplitude changes, regulating the level of thyroid hormones and decreasing the volume of thyromegaly. There are not statistically significant between the treatment group and control group. However, the treatment group has obviously better effect on regulating TCM symptom and decreasing the side reaction than the control group (P<0.05). There are not statistically significant on the total effective between the treatment group and control group. The average spots in lymphocyte for normal people, before and after treating hyperthyroidism patients with syndrome of hyperactivity of liver-Yang were (429 +/- 31), (452 +/- 28) and (437 +/- 36) spots respectively. Eight down-regulated protein expressions and 11 up-regulated protein expressions were obtained in the hyperthyroidism patients with syndrome of hyperactivity of liver-Yang and normal people. Five strengthened expressions of protein were also obtained in 8 down-regulated expressions of protein and 8 lower expressions of protein in 11 up-regulated expressions of protein before and after treating the migraine patients with syndrome of hyperactivity of liver-Yang. Ten of the total 8 differential protein spots were successfully identified by MALDI-TOF-MS. The functions of these proteins were involved in metabolism associated, transportation, antioxidation, sigal transduction and immume associated protein, etc. according to information provided by NCBI and MSDB database.

CONCLUSIONIn this study, the TCM complex prescription with herbs for calming the liver and suppressing Yang can regulate the thyroid hormones, improves TCM symptoms, and decrease the adverse reaction. It can possibly regulate lymphocyte protein expression.

Adult ; Aged ; Databases, Protein ; Drugs, Chinese Herbal ; adverse effects ; pharmacology ; therapeutic use ; Electrocardiography ; Female ; Gene Expression Regulation ; drug effects ; Humans ; Hyperthyroidism ; drug therapy ; metabolism ; pathology ; physiopathology ; Liver ; drug effects ; pathology ; physiopathology ; Lymphocytes ; drug effects ; metabolism ; Male ; Middle Aged ; Proteins ; metabolism ; Thyroid Hormones ; metabolism ; Treatment Outcome ; Yin-Yang ; Young Adult

The present study was aimed to investigate the function of diffusion weight imaging (DWI) combining with magnetic resonance spectroscopy (MRS) in the grading of brain gliomas. 12 cases low grade and 17 cases high grade of brain gliomas patients were examined with DWI and MRS, with all tumors confirmed by pathology in advance. The apparent diffusion coefficient (ADC) values, their corresponding metabolite ratios of Cho/Cr, Cho/NAA and tumor cellularities of tumor solid enhanced parts were measured. The ratios of Cho/Cr and Cho/NAA and their corresponding ADC values had significant differences between their high and low grade gliomas values, respectively. The ADC values demonstrated a negative correlation with Cho/Cr, Cho/NAA, and a significant negative correlated with Cho/Cr. And the ADC values demonstrated strong negative correlations with tumor cellularities. DWI combining with MRS could provide more valuable information in evaluating gliomas grading.
Adolescent ; Adult ; Aged ; Brain Neoplasms ; diagnosis ; pathology ; Child ; Diffusion Magnetic Resonance Imaging ; methods ; Female ; Glioma ; diagnosis ; pathology ; Humans ; Hydrogen ; Magnetic Resonance Spectroscopy ; methods ; Male ; Middle Aged ; Neoplasm Grading ; Young Adult