BACKGROUND:The infection after spinal internal fixation was its serious complications. A number of studies have shown that erythrocyte sedimentation rate and C-reactive protein are of great importance in judging infections. OBJECTIVE:To analyze the trend of change of erythrocyte sedimentation rate and C-reactive protein for patients without infection after the cervical fixation. METHODS:Total y 56 patients, who underwent cervical fixation from October 2013 to July 2014, were retrospectively analyzed, and then divided into anterior cervical group (n=29) and posterior cervical group (n=27). Patients in the anterior cervical group underwent anterior cervical decompression bone graft internal fixation. Patients in the posterior cervical group underwent posterior cervical unilateral open door decompression internal fixation. The peripheral blood was col ected before fixation and at the early morning of the 1, 3, 6, 9 days after fixation. Erythrocyte sedimentation rate and C-reactive protein values were determined. The fol ow-up of patients was more than one year. Signs of infection did not appear. RESULTS AND CONCLUSION:(1) General rule:After the cervical fixation, the erythrocyte sedimentation rate was increased significantly and reached a peak on postoperative day 6. The peak level gradual y decreased but has not returned to normal at the 9 postoperative days. The C-reactive protein increased significantly on the first postoperative day and reached a peak on postoperative day 3. The peak level rapidly decreased but has not returned to normal at the 9 postoperative days. The level of erythrocyte sedimentation rate of patients in the posterior cervical group was significantly higher than that in the anterior cervical group at 3, 6 and 9 days after internal fixation (P<0.05). There was no significant difference in the C-reactive protein between these two groups (P>0.05). (2) These results demonstrate that C-reactive protein is an important indicator of monitoring the inflammatory response of patients after cervical internal fixation, which was conductive to the judgment of early infection after internal fixation. The abnormal inflammatory indices of erythrocyte sedimentation rate and C-reactive protein do not suggest a presence of blade infection after internal fixation. C-reactive protein can reach the peak at 3 days after fixation. It is recommended to check blood at 2 and 3 days. If there is no apparent rebound, then the possibility of infection is smal . It may indicate the presence of infection if the inflammatory indices increased again or decreased slowly after the decrease.

BACKGROUND:The reasons for spinal imbalance include spinal deformity, spinal degenerative disease osteoporotic vertebral compression fractures. We believe that the power factor (back muscle) plays a key role in spinal sagittal imbalance. OBJECTIVE:To analyze the reasons for spinal sagittal imbalance by observing clinical manifestations and therapeutic outcomes in patients with osteoporotic vertebral compression fractures. METHODS:A total of 41 patients with osteoporotic compression fractures combined with spinal sagittal imbalance were retrospectively analyzed from January 2012 to May 2013. Al patients were subjected to percutaneous bal oon vertebroplasty under local anesthesia. Before treatment, they received bone density, standing ful-spine lateral X-ray, CT and MR imaging with injured vertebrae as the center. Using standing ful-spine radiographs, the height of anterior border of the injured vertebrae, Cobb angle of kyphosis and improved angle, wedging angle of the injured vertebrae and improved angle were measured. The patients underwent weight loading test and walking test. Preoperative and postoperative data were compared. RESULTS AND CONCLUSION:The patients affected spinal sagittal imbalance symptoms, so the walking distance was significantly shorter than that postoperatively (P<0.05). Moreover, the time of weight loading test was significantly shorter than that postoperatively (P<0.05). In standing ful-spine radiographs, the average difference of Cobb angle was (10.01±0.76)°. The mean difference of vertebral wedging improvement was (4.84±0.40)° (P<0.05). Al patients were fol owed up. Low back pain and sagittal imbalance symptoms were relieved. No severe complications appeared after percutaneous bal oon vertebroplasty. Results indicated that patients with osteoporosis compression fractures can affect the symptoms of spinal sagittal imbalance, which is not only induced by wedging of the injured vertebra. In addition, after percutaneous bal oon vertebroplasty, imbalance symptoms are apparently improved, suggesting that back pain after spinal fracture limits back muscle strength and is an important cause for spinal sagittal imbalance.

BACKGROUND:Pathological examination and MRI have been widely used in clinic, but their combination is rarely reported in discrimination of early spine infections.
OBJECTIVE:To determine the accuracy of pathology and MRI for discrimination between early pyogenic spondylitis and brucella spondylitis.
METHODS:Twenty-two patients with pyogenic spondylitis and 20 patients with brucella spondylitis who had CT-guided percutaneous biopsy and MRI of the spine were retrospectively reviewed. Pathological observations included structure and activity of bone lesions, tissue cells and their main components;MRI observations included signal and sign changes at lesion sites. Statistical analysis was performed with the chi-square test.
RESULTS AND CONCLUSION:The patients with pyogenic spondylitis had a significantly higher incidence of pathological and MRI findings as fol ows (P<0.05):neutrophil infiltration;intervertebral disc abnormal signal, location of vertebral body lesions anterior+posterior, obviously shape change in the vertebral body, paraspinal abnormal signal, presence of intraosseous or paraspinal abscess. Pathological and MRI examination was accurate for early differentiation of pyogenic spondylitis from brucella spondylitis.

AIDS-Related Opportunistic Infections ; diagnosis ; Humans ; Oral Medicine ; Sarcoma, Kaposi ; diagnosis

Objective To review the diagnosis and treatment of children with systemic lupus erythematosus. Methods 13 children of systemic lupus erythematosus with acute immune thrombocytopenic purpura as the first symptom were analyzed retrospectively, who were admitted from Jan 2004 to Jun 2009 in our hospital. Results Thirteen cases were diagnosed as acute immune thrombocytopenie purpura according to clinical manifestations and bone marrow examination results. Hormones and intravenous gamma globulin treatment were ineffective. The immune parameters and other clinical manifestations were monitored. According to the characteristics of blood system change and the response to hormone, other immunosuppressive agents such as cyclosporine A ,mycophenolate mofetil and cyclophosphamide were adminitrated. Thirteen children were diagnosed finally as systemic lupus erythematosus at 2 to 24 months from onset. Other immunosuppressive treatment was effective. Conclusion For children with thrombocytopenia, especially adolescent girls, we should pay attention to dynamic monitoring of anti-nuclear antibodies and other immunological parameters,for fear of the possibility of systemic lupus erythematosus.

Objective: To investigate the value of positron emission tomography/computerized tomography(PET/CT) with fluorine-18-labeled fluorodeoxyglucose(18FDG) for gastric carcinoma.Methods: Thirty-two patients(25 males,7 females,aged 31-82 years) suspected of gastric carcinoma underwent whole-body PET/CT after taking in 600 ml of water to distend the gastral cavity.The maximal standard uptake value(SUVmax) of the region of interest(ROI) in PET and the maximum width of the gastric wall in CT were analyzed.Pathological specimens were obtained from all the patients during surgery or gastroscopy.Results: 18FDG PET/CT found gastric carcinoma in 24 of the patients.The rates of positive and negative prediction and the accuracy of PET/CT in the diagnosis of the disease were 92.3%,100% and 93.8%.SUVmax was positively correlated with the maximum width of the gastric wall,but they exhibited no statistically significant differences between the patients with involved lymph nodes and those without.Based on the PET/CT findings,the 24 gastric carcinoma patients were clinically classified as follows: 9 in stage Ⅰ,1 in stage Ⅰ-Ⅱ,3 in stage Ⅱ,1 in stage Ⅲ and 10 in stage Ⅳ.Conclusion: 18FDG PET/CT is highly valuable for gastric carcinoma in its diagnosis,the evaluation of its biological behavior and determination of its treatment strategies.

Objective To investigate the distribution and antimicrobial resistance in Enterococcus species isolated from Ordos Central Hospital.Methods The Enterococcus strains were isolated from clinical specimens from January 2010 to June 2013.The identification and antimicrobial susceptibility testing were completed on VITEK 2 Compact.WHONET 5.6 software was used to analyze the data.Results A total of 271 strains of Enterococcus were collected,including E.faecium (50.6%,137/271), E.faecalis (29.5%,80/271),and other Enterococcus (19.9%,54/271).The Enterococcus isolates were mainly from urine (25.5%,69/271 ),pus (14.8%,40/271 )and wound secretion (12.5%,34/271 ).The E.faecalis strains were highly susceptible to vancomycin and linezolid.Only 1 .3% and 1 .5% of the strains were resistant to vancomycin and linezolid, respectively.No strains of E.faecalis were resistant to nitrofurantoin.The percentage of E.faecalis resistant to penicillin and ampicillin was 11.8% and 2.6%,respectively.About 31.0% and 22.9% of E.faecalis strains were resistant to gentamicin (high level)and streptomycin (high level),respectively.The E.faecium strains were more resistant to most antibiotics tested than E.faecalis.The drug-resistance rate of E.faecium strains to vancomycin was 4.4%.But no strains were found resistant to linezolid.Only 19.1% of these strains were resistant to nitrofurantoin.Also 44.8% and 26.4% of E. faecium isolates were resistant to gentamicin (high level)and streptomycin (high level),respectively.However,E.faecium was less resistant to tetracycline and quinupristin-dalfopristin than E.faecalis.The resistance rate was 58.3% and 0, respectively.Conclusions The E.faecium strains are more resistant to most drugs tested than E.faecalis.Some strains are resistant to vancomycin.The resistance of Enterococcus varies widely with region and species.Antimicrobial therapy for such enterococcal infections should be based on the results of antimicrobial susceptibility testing.

OBJECTIVETo establish fingerprints for Poecilobdella manillensis from Guangxi province using the high performance capillary electrophoresis (HPCE) method.

METHODElectrophoresis was performed on a fused silica capillary column (75 microm x 56 cm), with 25 mmol x L(-1) Na2HPO4-120 mmol x L(-1) Tris-16 mmol x L(-1) SDS (adjusted to pH 12.0 with 1 mol x L(-1) NaOH ) as the running buffer. The applied voltage was 17 kV, the temperature was 25 degrees C and the detection wavelength was 254 nm. The sample's hydrodynamic injection was 3.4 kPa x 6s and the duration was 27 min.

RESULTHPCE fingerprint was established with 13 common peaks. The similarity between fingerprints of P. manillensis in 10 batches and control fingerprints was more than 0.98.

CONCLUSIONThe method is so precise, reproducible and stable that it could be used as a new means for the quality control of P. manillensis.

Animals ; China ; Electrophoresis, Capillary ; methods ; Leeches ; chemistry ; Medicine, Chinese Traditional ; standards ; Quality Control ; Reproducibility of Results

Epithelial membrane protein 3 (EMP3) is a trans-membrane signaling molecule with important roles in the regulation of apoptosis, differentiation and invasion of cancer cells, but the detailed is largely still unknown. We analyzed the mRNA levels and methylation statuses of EMP3 in 63 primary breast carcinomas and assessed their correlations with clinicopathologic variables. The expression of EMP3 mRNA in primary breast carcinomas was significantly higher than the expression of 20 normal breast tissues (p<10(-7)). EMP3 overexpression in breast carcinomas was significantly related to histological grade III (p=3.9X10(-7)), lymph node metastasis (p= 0.003), and strong Her-2 expression (p=3.3X10(-6)). Hypermethylation frequencies of EMP3 were detected in 36.5% of breast carcinomas by methylation-specific polymerase chain reaction. However, no significant correlations were found between methylation status of EMP3 and mRNA expression levels as well as other clinical parameters. In conclusion, EMP3 may be a novel marker of tumor aggressiveness. Overexpression of EMP3 in primary breast carcinoma is not associated with DNA methylation.
Adult ; Breast Neoplasms/*genetics/pathology ; Carcinoma/*genetics/pathology ; DNA Methylation ; Epigenesis, Genetic ; Female ; Gene Expression Regulation, Neoplastic ; Humans ; Lymphatic Metastasis ; Membrane Glycoproteins/*genetics/metabolism ; Middle Aged ; Neoplasm Staging ; RNA, Messenger/metabolism ; Receptor, erbB-2/genetics/metabolism ; Severity of Illness Index

OBJECTIVETo systematically evaluate the values of 4 serum markers in the diagnosis of rheumatoid arthritis (RA).

METHODSSerum samples were obtained from 278 RA patients and 510 control subjects and the levels of rheumatoid factor (RF), anticyclic citrullinated peptide antibody (CCP), antikeratin antibody (AKA), and glucose-6-phosphate isomerase (GPI) were detected using immune turbidimetry, ELISA, indirect immunofluorescence, and ELISA, respectively. The values of these 4 serum markers and their combinations in RA diagnosis were systemically assessed.

RESULTSIn RA diagnosis using one serum marker, two markers, and three or four markers, RF, RF+CCP, RF+CCP+GPI, respectively, had the highest sensitivity; CCP, CCP+AKA, and RF+CCP+AKA+GPI, respectively, had the highest specificity; CCP, CCP+GPI, and RF+CCP+AKA+GPI, respectively, had the highest positive predictive value; GPI, RF+CCP, and RF+CCP+GPI, respectively, had the highest negative predictive value; CCP, CCP+GPI, and RF+CCP+AKA+GPI, respectively, had the highest positive likely ratio; GPI, RF+CCP, and RF+CCP+GPI, respectively, had the lowest negative likely ratio.

CONCLUSIONCCP, RF+CCP, and RF+CCP+GPI are the most ideal for RA diagnosis using one, two, and three or more markers, respectively. CCP is the essential marker for RA diagnosis, and a combined detection of the serum makers can significantly improve the diagnostic accuracy.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Arthritis, Rheumatoid ; blood ; diagnosis ; Autoantibodies ; blood ; Biomarkers ; blood ; Case-Control Studies ; Citrulline ; immunology ; Female ; Glucose-6-Phosphate Isomerase ; blood ; Humans ; Keratins ; immunology ; Male ; Middle Aged ; Rheumatoid Factor ; blood ; Young Adult