Objective To assess the behavior of rat by suction traumatic brain injury model. Methods Suction traumatic brain injury (TBI) models were created in SD rats. Twenty-four rats were divided into two groups: suction TBI group (n=12) and sham operation group (n=12). Modified neurological severity score (mNSS) test and Morris water maze test were employed to assess the animal behavior in both groups. Results One rat was died of suction trauma. Success rate of modeling for those survivors was one hundred per cent. Cortical and subcortical contusion, hemorrhage and tissue loss were seen in paraffin section by HE staining one week after suction impact. Abnormal mNSS persisted no more than twenty-five days. Morris water maze test suggested that abnormal mean escape latency period last no more than three days. Conclusion Rat suction traumatic brain injury model is suitable for the research about neurological sensory-motor function which last relatively short period.

Objective To investigate the diagnostic value of thyroglobulin measurement in fine-needle aspiration biopsy(FNA-Tg).Methods This study included 63 patients with thyroid cancer or with enlarged lymph nodes during the follow-up from Aug.2010 to Jun.2012.Ultrasound-guided fine-needle aspiration was done in the 63 patients with 79 suspicious enlarged lymph nodes.Then thyroglobulin(Tg) in FNA washout fluid and serum Tg were assayed with electrochemiluminescenceimmunoassay(ECLIA).Diagnostic sensitivity,specificity and area under the ROC curve were evaluated according to 5 predetermined threshold levels:FNA-Tg/serum-Tg ＞ 1,mean + 2SD of node-negative patients,10 ng/ml,optimal operating point of ROC curve and 1000 ng/ml.Results The sensitivity value was 90.70％,90.70％,95.35％,90.70％ and 65.12％ respectively on the 5 threshold level,significantly lower than those on the threshold level of 1000 ng/ml(P ＜0.05).The specificity value was 97.22％,91.67％,72.22％,97.22％ and 100％ (P ＞0.05) on those threshold levels,significantly lower than those on the threshold level of 10 ng/ml (P ＜0.05).The area under the ROC curve was 0.940,0.912,0.838,0.940 and 0.826 respectively.There was no statistical difference(P ＞0.05).Conclusion Selecting FNA-Tg/serum-Tg ＞ 1 as a positive threshold value can be a secondary diagnosis of lymph nodes metastasis in patients with papillary thyroid cancer.

Objective To define the expression of Shh/Gli1,the key elements of Hedgehog signaling pathway in papillary thyroid carcinoma(PTC) and to explore the relationship between the expression of Shh/Gli1 and clinical significance.Methods The expression of Shh and Gli1 was examined in 142 cases of PTC tissues and adjacent tumor thyroid tissues as control by immunohistochemistry.The relationship between the expression of Shh/Gli1 and clinical characteristics of PTC patients was analyzed.Results The positive rate of the cytoplasm Shh expression and the nuclear Gli1 expression was 64.1% and 47.9% ,respectively.Significant difference was found between normal thyroid tissues and PTC.The research showed that the expression of Shh/Gli1 was related to the tumor size,clinical stages and lymph node metastasis,Shh was more significantly related to the tumor size(P ＜0.01) and Gli1 was more significantly related to the lymph node metastasis (P ＜ 0.01).Conclusions Varying expression of the main ligand Shh and transcription factor Gli1 in Hedgehog signaling pathway was found in PTC.The expression of Shh/Gli1 was related to the tumor size,clinical stage and lymph node metastasis,indicating that the aberrant activation of Shh signaling pathway plays some roles in PTC.Shh/Gli1 may be indicators for prognosis and ideal targets for therapy against PTC.

Objective To improve treatment success rate and prognosis for patients with bifrontal contusions by intracranial pressure monitoring.Methods A retrospective analysis was conducted on 79 cases of bifrontal contusions admitted between October 2004 and April 2012.The patients were divided into intracranial pressure monitoring group (n =40) and group without intracranial pressure monitoring (n =39),according to the treatments.Significance of high coronary craniotomy timing,surgical strategy and intracranial pressure monitoring in the diagnosis,treatment and prognosis was analyzed.Results The intracranial pressure monitoring group showed a significantly shorter period concerning osmotic dehydration [(14.24 ± 7.93) days vs (21.61 ± 11.97)days,P＜0.01],ICU stay [(14.38 ±7.56)days vs (24.71-± 17.94)days,P＜0.01] and total hospital stay [(17.20 ±8.09)days vs (33.92 ± 21.70)days,P＜0.01] as well as a better GOS [(4.15 ± 1.22) points vs (3.69 ± 1.56) points,P ＜ 0.05],as compared with group without intracranial pressure monitoring.Conclusions Craniotomy,especially decompressive craniectomy,is one of the most important treatment means to control cranial pressure and ensure cerebral perfusion pressure in patients with bifrontal contusions (in particular the moderate and severe ones).Besides,intracranial pressure monitoring is conducive to selection of surgery timing and is instructive to combined treatment,such as osmotherapy,intracranial pressure controlling and assurance of cerebral perfusion pressure.

Objective To evaluate the left ventricular rotation and twist in the cardiac allograft by speckle tracking echocardiography.Methods Twenty-six heart transplant recipients underwent echocardiographic studies at 1st,3rd,6th and 12th month after heart transplantation.Twenty-six healthy subjects served as controls.Parasternal basal and apical short-axis images of left ventricle were recorded and then were analyzed using EchoPAC software.The curves of basal and apical rotation and left ventricular twist were obtained,Peak values of basal and apical rotation and left ventricular twist were measured and then statistically analyzed.Results There were no significant differences in left ventricular ejection fraction (LVEF) and fractional shortening (LVFS) between heart transplant recipients and controls (P ＞0.05).The left ventricular twist,apical rotation were significantly lower in heart transplant recipients at 1 st,3rd,6th and 12th month after surgery than those in controls (P ＜0.05) ;while basal rotation in heart transplant recipients had no significant difference when compared with controls (P ＞0.05).The left ventricular twist,apical and basal rotation in heart transplant recipients among 1 st,3rd,6th and 12th month after surgery had no significant difference (P ＞ 0.05).Conclusions Although the LVEF and LVFS of cardiac allograft seemed normal,the left ventricular twist,apical rotation were still significantly lower in heart transplant recipients than those in controls.Speckle tracking echocardiography can be used for accurate assessment of left ventricular twist in heart transplant recipients.

Objective To survey the resistance profile of clinical isolates to antibiotics across the hospitals in Dongguan,Guangdong Province during 2015.Methods Kirby-Bauer method or automated system was used to test the susceptibility of clinical isolates to selected antimicrobial agents.Results were analyzed according to CLSI 2015 breakpoints.The susceptibility data were analyzed using WHONET 5.6 software.Results A total of 29 665 strains of microorganisms were isolated,of which gram positive cocci accounted for 32.1％ (9 509/29 665) and gram negative bacilli accounted for 67.9％ (20 156/29 665),respectively.The prevalence of methicillinresistant Staphylococcus was 23.3％ (705/3 024) in S.aureus and 43.6％ (1 054/2 419) in coagulase-negative Staphylococcus.No vancomycin-resistant staphylococcal strain was found.ESBLs-producing strains accounted for 36.4％ (2 554/7 020) in E.coli and 24.5％(792/3 227) in Klebsiella isolates.The prevalence of carbapenem-resistant Enterobacteriaceae was 0.2％ (30/13 077).The prevalence of carbapenem-resistant Pseudomonas aeruginosa (CRPA) and carbapenem-resistant Acinetobacter baumannii (CRAB) was 16.0％ (500/3 116) and 53.9％ (827/1 533),respectively.The prevalence of penicillin-resistant S.pneumoniae (PRSP) strains was 10.1％ (142/1 404).Beta-lactamase was produced in 30.6％ (276/902) of the H.influenzae strains.The prevalence of vancomycin-resistant Enterococcus (VRE) strains was 0.7％ (10/1 441).Conclusions Periodic surveillance of antimicrobial resistance is valuable for rational antimicrobial therapy,formulation of treatment guidelines and infection control and prevention measures,as well as preventing the spread of drug-resistant strains.

Objective To explore the extensively drug resistant mechanism and clinical treatment strategy of Klebsiella pneu-moniae .Methods The isolate was identified by Vitek2 Compact System.Antimicrobial susceptibility testing was conducted by Kirby-Bauer method.KPC-2 carbapenemase was detected by modified Hodge test.The gene encoding KPC-2 carbapenemase was amplified by polymerase chain reaction (PCR)and then sequenced.Results The strain was resistant to all antibiotics used in routine antimicrobial susceptibility testing except amikacin.Modified Hodge test showed positive result.KPC-2 gene was detected by PCR.The sequence was consistent with that of 11844849 in GenBank.After treatment for one month,no exten-sively drug resistant K.pneumoniae strain was detected from the patient.Conclusions It is necessary to strengthen the monito-ring and improve the awareness of extensively drug resistant K.pneumoniae for better control of such infections.

ObjectiveTo explore the predictive effect of serum TC/HDL-C ratio on ischemic and hemorrhagic stroke incidence in middle aged Chinese population.MethodsA prospective study was conducted based on the PRC-USA Collaborative Study on Cardiovascular and Cardiopulmonary Epidemiology. A total of 10 121 individuals (4921 men and 5200 women), aged 35—59 years were selected from 4 cohorts, in Beijing and Guangzhou, urban and rural. The average following up time was 15.9 years. During the follow-up period, 277 ischemic and 125 hemorrhagic stroke cases were diagnosed.ResultsThe age adjusted incidence rate of ischemic stroke was 144.1,169.4,166.7,226.9 and 282.2 in the group of TC/HDL-C ratio

Objective To summarize the practical experiences of Clinical Research Unit (CRU) platform established by Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine,provide reference for domestic institutions that have prepared or to prepare to establish CRU platform.Methods Oriented by demand,this platform has set up six modules including project management module,methodology support module,data management module,quality risk management module,project transformation module and training and international exchange module.Besides,it also establishes and improves the corresponding module system,quality assurance,technical support and information data platform system.Results With this platform,the enthusiasm of departments to carry out clinical research has been continuously enhanced,the talent pool of clinical research has been expanded;the awareness of clinical research cooperation has been improved and the international cooperation fields have been further extended;the number of clinical research projects and funding have increased rapidly.Conclusions CRU Platform in Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine provides all-dimensional technical support and whole-process informatization management to improve clinical research quality and efficiency.While learning from the advanced international concepts,we still need to explore and improve the platform construction and management mode in line with general research-oriented hospitals in China,further to enhance the academic research internationally.

Objective To explore and understand limitations and needs of support for conducting clinical research among clinicians in China.Methods The in-service clinician in our hospital were enrolled in as survey participants,survey questionnaires were designed and filled up by target audience in the questionnaire star platform.Results Main problems identified as restrictions for conducting clinical studies including lack of data platform,have ideas but not protocols,lack of research funding and project management.On the other hand,identified needs for support including research-related technical support,project management facilitation,training,external communication and exchange,as well as quality risk management.Conclusions Hospital should establish Clinical Research Unit to help clinicians to improve research quality by training,providing technical support and administrative service of clinical research.