Objective To explore the correlation of CT perfusion imaging with microvessel density (MVD) and vascular endothelial growth factor (VEGF) in hepatic alveolar echinococcosis (HAE).Methods Multi-slice spiral CT perfusion imaging was performed in 27 patients with HAE.Time-density curves(TDC) of the HAE peripheral area was drawn from the region of interest (ROI) with perfusion functional software.CT perfusion parameters including blood flow ( BF ),blood volume ( BV ),mean transit time(MTT) and permeability surface area product (PS) were calculated.MVD and VEGF expression of pathological specimens were examined by immunohistochemical staining with anti-CD34,anti-VEGF monoclonal antibody.The CT perfusion parameters,MVD and VEGF were compared in different types of TDC with t test.The correlation of CT perfusion parameters with MVD and VEGF were analyzed with Spearman test.Results In this group,21 cases which TDC lower than that of the liver were classified as type Ⅰ,the others 6 cases TDC higher than the liver were of type Ⅱ TDC.TDC perfusion parameters of the two types were as follows,BF:( 111.7 + 27.6),( 158.9 + 39.5 ) ml · 100 g- 1 · min - 1,BV:( 15.1 + 6.2),(26.8+8.4) ml/100 g,MTT:(7.0+4.4),(7.7+3.1) s,PS:(51.7 +17.3),(51.0+20.5) ml·100 g-1 · min-1.The significant differences of BF,BV and MVD[ (20.5 +5.4)/HP,(37.2 ±7.5)/HP,respectively ] were found between two types ( t =- 7.897,- 18.783,- 5.223,P ＜ 0.05,respectively).There were no significant differences in MTT,PS and VEGF expression(2.1 ± 1.0,3.2 ± 1.0,respectively)between two types of TDC(P ＞0.05).The correlation was found between the MVD and BF and BV in the type Ⅱ TDC group( r =0.789 and 0.878,respectively) and no correlation was found between MVD and each CT perfusion parameters in the type Ⅰ TDC group ( P ＞ 0.05 ).There was no correlation between the VEGF expression and CT perfusion parameters in two types of TDC ( P ＞ 0.05 ).Conclusion CT perfusion imaging with different type of TDC reflected different situation of angiogenesis in HAE peripheral area,which could be a potential technique to illustrate the microcirculation of this disease.

Objective To investigate the incidence of infection and the effect of anti-infection prophylaxis in renal transplanted patients after Basiliximab induction therapy. Methods A total of 204patients who have received renal transplantation and Basiliximab induction therapy from January 1,2001 to December 31, 2010 in our hospital have been retrospective analysed in this study. These patients were divided into a prophylaxis group (118 cases) with Ganciclovir + Sulfadiazine +Trimethoprim therapy and a control group (86 cases) without any anti-infection prophylaxis.Furthermore, 440 transplanted patients in the same peroid without any induction therapy were also analysed. They were also devided into two groups: an anti-infection prophylaxis group (206 cases)and a control group (234 cases) without any anti-infection prophylaxis. Results In the prophylaxis group with Basiliximab induction therapy, there were 23 patients (19. 5 %, 23/118)experienced hospitalization due to infection, 3 cases (13. 0 %,3/23) among them were severe infection, and 3patients (13.0 %, 3/23) died from vital infection. In the non-prophylaxis control group with Basiliximab induction therapy, 27 patients (31.4 %, 27/86) had infection complication, 7 patients (25.9 % ,7/27) among them were severe infection, and 4 patients(14. 8 % ,4/27)died. The incidence of infection between the above two groups is significantly different (P＜0. 05). In the prophylaxis group without induction therapy, the incidence of infection was 15.0 % (31/206), there were no severe infection cases but 7 patients (22. 6 %, 7/31) died from infection. In the non-prophylaxis control group without induction therapy, the incidence of infection was 12. 8 % (30/234), 3 cases among them were severe infection(10. 0 %,3/30)and 5 patients died from infection (16. 7 %, 5/30).The incidence of infection in Basiliximab induced patients without anti-infection prophylaxis is significantly higher than that in patients without induction therapy and anti-infection prophylaxis (31.4 % vs. 12.8 %,P＜0.01). Conclusion Basiliximab induction therapy increased the risk of infection, but not the rate of mortality. It is necessary to give anti-infection prophylaxis in renal transplanted patients with Basiliximab induction therapy.

objective To evaluate the influence of HLA matching and new immunosuppressants on pre-venting acute rejection of renal allograft in sensitized recipients. Methods 751 recipients underwent renal transplantation were enrolled in this study including 46 sensitized recipients (study group) with PRA be-tween 10%-90% and 705 non-sensitized recipients (control group) with PRA less than 10% pretransplant. All patients in the study group received induction course (ATG 100 mg/d, 5-7 d) plus triple-immunosup-pressive therapy including FK506 + MMF + steroid. The rate of acute rejection and delayed graft function after renal transplantation was analyzed. The influence of HLA matching on preventing acute rejection was al-so evaluated. Results The acute rejection rate in the study group and control group was 30.43% and 19. 57%, respectively, (P < 0.05). The rate of delayed graft function was 60.86% in the study group, signifi-cantly higher than that of the control group (11.87%). There was no statistically difference of one-year pa-tient / graft survival rotes between the two groups. The average serum creatinin levels at one-year posttrans-plantation were similar between the two groups (130 mmol/dl in the study group and 125 mmol/di in the control group). The average loci of HLA matching in the study group (4.2) was significantly higher than that in the control group (2.8). The acute rejection rate in the study group was significantly higher when lo-ci of HLA mismatch ranging from 2-4 compared with loci of HLA mismatch less than 2. The acute rejection rate was significantly higher in the highly sensitized recipients (PRA ranging from 50% -90% pretmnsplant) than that in the less sensitized (PRA ranging from 10% to 20% pretransplant) in the study group. Patients with higher PRA level posttransplantation were prone to developing acute rejection. Conclusion HLA matching and new immunosuppressants can reduce the incidence of acute rejection in sensitized recipi-ents and increase the survival rate of patients and allografts.

Objective To investigate the infection following the lymphocytes deleted agent (ATG) and IL-2 receptor antagonists (Basilixinab and Daclizumab)-based induction therapy after renal trausplantation.Methods A retrospective analysis was carried out on 701 kidney transplant recipients between Jan. 1,2005 to Dec.31,2010.According to exclusive and inclusive criteria,finally 549 patients were evaluated,including 429 patients treated with ATG (ATG group) and 120 patients with anti-CD25 monoclonal antibodies (monoclonal antibodies group; 86 patients with Basiliximab,and 34 patients with Daclizumab).The incidence of acute rejection,infection rate,infection time,hospital stay,severe infection rate and mortality were analyzed.After operation,the patients received an immunosuppression therapy including Tacrolimus (cyclosporine A),Mycophenolate-Mofetil and prednisone to present rejection. Part of the patients were treated with ganciclovir and sulfamethoxazole sulfadiazine and trimethoprim for infection prevention.Results The acute rejection rate in ATG group and monoclonal antibodies group was 15.9％ (68/429) and 10.0％ (12/120),and there was no statistically significant difference (P＞0.05).The infection rate in ATG group was 11.9％ (51/429),including 13.7％ (7/51) with severe infection,and mortality was 7.8％(4/51).The infection rate was 15.0％ (18/120) in monoclonal antibodies group,including 11.1％ (2/18) with severe infection,and mortality was 5.6％ (1/18).There was no statistically significnat difference in infection rate,severe infection rate and mortality between two groups (P＞0.05).The hospital stay in ATG group and monoclonal antibodies group was 25.8 days and 19.1 days respectively (P＜0.05).Dead cases had not received regular anti-infection treatment,and the patients age was over 50 years.Conclusion The infection risk and mortality between these two induction therapies are identical,but hn comparison to the patients using ATG,the infection of patients using anti-CD25 monoclonal antibodies is easier to control.Anti-infection prophylaxis is important to reduce infection rate and decrease infectious mortality.

Objective To evaluate the postoperative quality of life of donors in living donor renal transplantation patients.Methods One hundred and seventeen donors were involved in present study from 2006-2008.A crosssectional survey was performed with questionnaire research to all the donors who received living donor nephrectomy during this period.The questionnaire included sociodemographic characteristics,surgical complications,economic status,donors awareness status,family support,the health care,social welfare and daily exercise after surgery.The Chinese version of SF-36 was used as the measurement of quality of life.The statistic analyze include T test,analysis of variance and stepwise regression analysis.Results The donors' mental health status was better than the healthy population (P ＜ 0.05).The difference of quality of life and scores of other dimensions compared with the healthy population was not statistically significant (P ＞ 0.05).In univariate analysis,four kinds of fields such as age,education level,economic status and physical exercise were associated with quality of life.In further multivariate analysis,with exclusion of the interaction between various factors,the main factors for postoperative quality of life are the cultural,economic status and physical activity (P ＜ 0.05).Conclusions Social and psychological factor should be concerned in donor's preoperative screening.Good social psychological background,the necessary psychological intervention and postoperative follow-up maybe play an important role to improve the postoperative quality of life in living donor renal transplantation.

Objective To observe the clinical changes in resin and porcelain veneer in restoring dental fluorosis in order to provide a basis for the repair of dental fluorosis. Methods Fifty six severe dental fluorosis patients were divided into porcelain and resin teeth group in the department of Prosthetics, school of Stomatology, Harbin Medical University during 2005 to 2008. All 162 teeth of 25 patients in porcelain group were veneered with porcelain. 201 teeth of 31 patients in resin group were repaired with resin. To evaluat the clinic effect, the veneer surface color was detected by the Easyshade computer-aided colorimeter when the repair was completed and 18 months afterward. The edge of veneer adaptation, retention, secondary caries and abutment were examined after 18 months, and classified by color, shape, function and feeling. Results The color difference between the porcelain and resin teeth group was 0.27±0.20 and 0.21±0.15 when it was completed, and it was 0.28±0.21 and 0.77± 0.68 respectively after 18 months. The color difference value of the porcelain teeth group was lower when it was completed than 18 months later(t=-13.55, P<0.01). The color difference value of the resin teeth group was lower than the porcelain teeth group after 18 months(t=-12.60, P<0.01). The percentage of level A of veneer adaptation in the porcelain group[100%(162/162)] was higher than the resin group[91.04% (183/201), χ2=15.26, P< 0.01) after 18 months. The clinical effect was divided into three degrees of excellent, moderate or failed, into which the number of the teeth catergorized was 158, 4 and 0 in porcelain group, 148, 56 and 4 in resin group respectively. The clinical effect of the porcelain group was superior to the resin group(χ2=44.24, P<0.01). Conclusions The surface color of porcelain veneer last 16nger than the resin veneer, the adaptation and clinical effect is also superior to the resin veneer. But the long-term efficacy of two methods needs further study, especially of the resin veneer.

Abstract: To report a case of Aspergillus salwaensis-induced spinal infection and its laboratory detection. The inflammatory granulation and necrotic tissue samples of a patient with spinal infection were collected from, the Affiliated Hospital of Chengde Medical College on June 17, 2020 for direct smear microscopy and culture, and the isolated strain was identified by microscopy by smear staining, matrix-assisted laser desorption ionization-time-of-flight mass spectrometry (MALDI-TOF-MS), molecular identification and in vitro antifungal susceptibility test. The patient was 62 years old female and presented with recurrent chest and back pain with no obvious cause. The initial diagnosis was spinal infection, after 7 days of treatment with levofloxacin, the effect was not good. Surgery was then performed remove the lesion via posterior thoracic debridement, and fungal hypha was observed under microscope in tissue specimens. The isolated strains had no typical structure, MALDI-TOF-MS was used for identification for many times, but there was no identification result. After 7 days of fluconazole treatment, the patient's condition improved, and her chest and back pain were alleviated compared to before surgery. The patient was discharged and followed up in the outpatient department, the fungus was later identified as Aspergillus salwaensis by sequence analysis of the internal transcribed spacer (ITS) gene sequencing, and the patient's antifungal medication was changed to voriconazole after with the attending physician. The patient consciously recovered well with no pain in the operative area and normal spinal activity at 1 year follow-up. The possibility of spinal fungal infection should be considered in patients with back pain without a clear cause and poor response to routine antibiotic treatment. Direct smear report of microscopic results are very important for guiding clinical antibiotic selection for rare filament fungi with atypical colony and microscopic morphology and unsuccessful MALDI-TOF-MS identification, molecular biological methods such as ITS sequence analysis can be helpful for early identification of the fungal species, improving identification speed.

Objective To assess the income status of primary care providers and to explore the determinants of income in a county of Dali. Methods In August 2016, the questionnaire was employed to collect the data of income status of 191 rural health workers and 217 village doctors in the county. Results Through the study, we found that the income of rural health workers in the county was 34, 000 (26, 000, 46,000) yuan with a satisfaction rate of 62.3% (95% CI 55.4%～69.2%) and no change (74.7%) was seen in the income among majorities after implementing the Zero Mark-up Policy for essential medicines. For the village doctors, the income was 20,000 (15,000, 24,000) yuan with a satisfaction rate of 40.6% (95% CI 34.0%～47.1%) and a fall of the income was found in more than half of the doctors after the implement of the policy. Conclusion Health care workers in towns are quite satisfied with their income whereas those in health stations of villages are not content, compared with the average income at the national level. We should increase government's investments on grass-root healthcare team, improve the incentive pay plans and promote the integrated management of health facilities in towns and villages.

This paper reports an in vivo study on the biophysics characteristics of reticulocytes. Anemia was induced by injection of phenylhydrazine in rabbits. The measurements, including electrophoresis rate, hematolytic rate, fluorescent polarization and the changing anisotropic value, were performed in vivo for 72 hours in the process of reticulocytes growing into erythrocytes. It was shown that there were obvious changes in the biophysics characteristics of reticulocytes in this course. Therefore, the findings are of significance to basic, theoretical and clinical studies.
Anemia, Hemolytic ; blood ; chemically induced ; Animals ; Biophysical Phenomena ; Biophysics ; Erythrocyte Deformability ; Erythrocyte Membrane ; physiology ; Phenylhydrazines ; Rabbits ; Reticulocytes ; metabolism ; physiology

Objective To develop and validate a mortality risk prediction model for patients infected with avian influenza A H 7N9 virus.Methods A stratified and random sampling method was adopted for selection of subjects .A total of 102 patients infected with avian influenza A H7N9 virus, who were admitted to the designated hospitals in Zhejiang Province during March 2013 and March 2015, were enrolled.Standard questionnaires were used to collect data about demographic , epidemiologic and clinical characteristics , and the data were retrospectively reviewed . Univariate analysis and stepwise logistic regression analysis were used to identify the mortality risk factors of patients infected with avian influenza A H7N9 virus, and nomogram was applied to develop the risk prediction model .The accuracy of the prediction model was assessed using Concordance index (C-index) and receiver operating characteristic (ROC) curve. Results Stepwise multiple logistic regression analysis showed that age ≥60 years (χ2 =3.98, OR=2.99, 95%CI:1.05-9.21, P<0.05), increased initial neutrophil count (χ2 =6.66,OR=5.06, 95%CI:1.56-18.83, P<0.05), C-reactive protein≥120mg/L (χ2 =8.63, OR=5.15, 95%CI:1.79-16.31, P<0. 01), poor hand hygiene (χ2 =6.83, OR =10.29, 95%CI:2.18-81.49, P <0.01) and 5 days of incubation period or shorter (χ2 =7.23, OR=4.75, 95%CI:1.59-15.80, P<0.01) were independent risk factors for mortality of patients .Based on the above study , a risk prediction model of nomogram was developed.Poor hand hygiene (grade A, 100.0 points) ranked on the top of all risk factors, followed by C-reactive protein≥120 mg/L (grade B, 76.5 points), increased initial neutrophil count (grade C, 70.5 points), 5 days of incubation period or shorter (grade D, 62.0 points) and age ≥60 years (grade E, 51.0 points).The C-index and the area under the curve were 0.833 and 0.817 for the nomogram model , respectively;and the nomogram model fitted well .Conclusion Nomogram model can effectively predict and estimate the risk of death for patients infected with avian influenza A H 7N9 virus.