Objective To evaluate clinical features, therapeutic regimen and prognosis of unexplained rhabdomyolysis. Method Clinical manifestations, therapeutic regimen and prognosis were recorded in 23 patients,who were admitted to The First Affiliated Hospital of Nanjing Medical University 13 to 27 August,2010.The 23 patients were diagnozed as unexplained rhabdomyolysis. Results The patients all presented myalgia of upper body,like neck,waist and back,maybe with asthenia, nausea,dyspnea,abdominal pain, red urine or changed color of urine. Laboratory examination: obviously step-up of creatine kinase [CK: (4655 ± 2556) U/L( normal: 25 ～ 190U/L) AST:(141 ±78) U/L(normal:10～45 U/L),LDH:(348± 127) U/L(normal: 110～ 250 U/L)]and myoglobin[( Mb ＞ 1000 μg/L (normal: 0 ～ 50 μg/L)]. Therapeutic regimen included treatment of the underlying diseases, volume repletion, alkalization and dealing with the complications. No patients developed acute renal failure.All the patients recovered. Conclusions Rhabdomyolysis is a syndrome with different clinical manifestations.However, early diagnosis, proper treatment could prevent serious complications,and prognosis is good.

Objective To evaluate the ability of matrix-assisted laser desorption/ionization time-offlight mass spectrometry (MALDI-TOF MS) in identifying species of Acinetobacter calcoaceticus-Acinetobacter baumannii complex,and investigate the species distribution of Acinetobacter calcoaceticus-Acinetobacter baumannii complex isolated in our hospital.Methods A total of 502 nonduplicate clinical isolates of Acinetobacter calcoaceticus-Acinetobacter baumannii complex were retrospectively collected from the second affiliated hospital of Zhejiang University between January 2012 and July 2012.All strains were re-identified by MALDI-TOF MS and were also verified by sequence analysis of 16S-23S rRNA gene spacer region.Results Among all the 502 strains of Acinetobacter calcoaceticus-Acinetobacter baumannii complex,identificaion results provided by MALDI-TOF MS were A.baumannii (431,85.9％),A.pittii (68,13.5％),A.calcoaceticus (3,0.6％).Sequence analysis of 16S-23S rRNA gene spacer region was used to identify all the 502 strains:403 (80.3％) were identified as A.baumannii,68 (13.5％) as A.pittii,28 (5.6％) as A.nosocomialis and 3 (0.6％) as A.calcoaceticus.MALDI-TOF MS correctly identified all the strains but erroneously identified all 28 strains of A.nosocomialis as A.baumannii,compared with sequence analysis of 16S-23S rRNA gene spacer region.Conclusions MALDI-TOF MS can be used as a fast,simple,reliable and excellently reproducible method to identify members of Acinetobacter calcoaceticus-Acinetobacter baumannii complex at low costs.MALDI-TOF MS is expected to be an ideal technique for routine clinical microbiology testing in the future.

Objective To investigate the relationship between serum levels of PCT and neutrophil CD64 contents with the effect of hormone therapy and complications in the patients with primary nephrotic syndrome.Methods Sixty-five patients with primary nephrotic syndrome in our hospital from September 2015 to September 2016 were selected as the research subjects,all cases were treated with hormonal therapy,the serum levels of PCT and neutrophil CD64 were detected and their relationship with the curative effect and complications of nephrotic syndrome was analyzed.Results According to the PCT and neutrophil CD64 median levels,the cases were divided into the high level group and low level group,the results found that serum creatinine,serum protein,urine protein and pathological types had no statistical difference between the high level group and low level group.The hormone sensitivity had 15 cases in the patients with high PCT level,which was significantly lower than 21 cases in the patients with low PCT level;the hormone sensitivity had 14 cases in the patients with high neutrophil CD64 level,acute renal failure,infection and thrombus in the patients with high PCT level had 8,10,6 cases,which were significantly lower than those in the patients with low PCT level;acute renal failure,infection and thrombus in the patients with high neutrophil CD64 level had 7,11,6 cases,which were significantly higher than those in the patients with low neutrophil CD64 level (P<0.05).Conclusion The levels of serum PCT and neutrophil CD64 are significantly correlated with the therapeutic effect and clinical prognosis in the patients with nephrotic syndrome.

BACKGROUND:We built Sprague-Dawley rat models with mild, moderate, and severe spinal cord injuries to accord with the spinal cord injury types for basic empirical study, and consequently to further understand the microenvironmental change in Sprague-Dawley rats with spinal cord injury, and to provide help for clinical treatment. OBJECTIVE:To observe the changes in nerve function, pathological manifestation and motor sensory evoked potential in Alen’s models and Sprague-Dawley rats with complete spinal cord transection at different time points after spinal cord injury by simulating the microenviroment in Sprague-Dawley rats. METHODS: A total of 125 healthy adult female Sprague-Dawley rats were selected and randomly divided into group sham operation group, 100 gcf hit potential group (20 g×5 cm), 200 gcf hit potential (20 g×10 cm), 300 gcf hit potential group (20 g×15 cm), and spinal cord complete transection group with 25 rats in each group. At 1, 5, 7, 14 and 28 days after model establishment, the degree of spinal cord injury was identified by the BBB scores of motion function, motor evoked potential, and pathological section. RESULTS AND CONCLUSION:(1) Totaly 24 Sprague-Dawley rats died in the experiment. The death rate and the rate of complications were highest in the spinal cord complete transection group. The BBB score of each group was decreased. The BBB scores in every group increased as time went on. There were significant differences between each surgery group and the sham operation group at corresponding time points (P < 0.05). No significant difference was found between the 300 gcf hit potential group and the spinal cord complete transection group at corresponding time points (P > 0.05). (2) In each surgery group, the infiltration of inflammatory cels and obvious sweling of neurons were visible at 1 day after injury. Neural cels reduced with time prolonged. At 28 days after injury, a large number of astrocytes proliferated, scar and spinal cord cavity formed. Above symptoms were worse in the 300 gcf hit potential group and spinal cord complete transection group than in the 100 gcf and 200 gcf hit potential groups. (3) Significant differences in amplitude and latency were detectable between each surgery group and the sham operation group (P < 0.05). No significant difference in amplitude and latency was detected between the 300 gcf hit potential group and the spinal cord complete transection group at corresponding time points (P > 0.05). Results confirmed that hit potential of 20 g×5 cm, 20 g×10 cm and 20 g×15 cm can simulate the microenvironment of Sprague-Dawley rats with mild, moderate and severe spinal cord injury. The rate of complication was lower in modified Alen’s model of different hit potentials than in models of spinal cord complete transection, and was more accorded with basic research.

Objective To summarize and evaluate the clinical features,therapeutic methods and prognosis of 197 cases with eating crayfish caused rhabdomyolysis in our hospital within July,2016 to August,2016.Methods Using retrospective method,197 rhabdomyolysis cases induced by eating crayfish were admitted into study.Data of epidemiological character,clinical features,therapy protocol and prognosis were collected and analyzed.Results All the patients had the experience of eating crayfish within 12h before the onset.Patients in this cohort had the common symptoms but varying degrees of myalgia,fatigue of the whole body muscles,and urine color change.Laboratory tests revealed:On day 1 of onset,serum myoglobin level had raised up to the peak with average level at (2 135 ± 1 547) μg/L (0-46 μg/L).Creatine kinase with average level at (4 657 ± 2 178) U/L (25-190 U/L);Aspartate transaminase with average level at 264 ± 83 U/L (10-45 U/L);Lactate dehydrogenase with average level at (1 457 ± 673) U/L (313-618 U/L),all these three markers reached peak on day 2,then gradually declined.All the patients recovered and discharged after relaxation,fluid infusion,alkalization of urine and dealing with the complications.Conclusion Timely diagnosis and treatment of the rhabdomyolysis syndrome induced by eating crayfish could indicate favorable prognosis in these patients from July,2016 to August,2016.

OBJECTIVE:To establish a method for the simultaneous determination of paeoniflorin,cinnamaldehyde,psoralen and isopsoralen in Yaotong capsules.METHODS:HPLC method was adopted.The determination was performed on Agilent-C18 column with mobile phase consisted of acetonitrile-water (gradient elution) at the flow rate of 1.0 mL/min.The detection wavelengths were set at 240 nm (paeoniflorin,psoralen,isopsoralen) and 290 nm (cinnamaldehyde).The column temperature was 35 ℃,and sample size was 10 μL.RESULTS:The linear ranges of paeoniflorin,cinnamaldehyde,psoralen and isopsoralen were 0.004 02-0.100 6 mg/mL(r=0.999 8),0.024 50-0.612 7 mg/mL(r=0.999 8),0.005 24-0.131 0 mg/mL(r=0.999 9),0.005 11-0.127 8 mg/mL(r=0.999 9),respectively.LOQ were 37.17,1.47,21.76,25.57 ng,respectively;LOD were 11.15,0.44,6.53,7.67 ng,respectively.RSDs of precision,stability and reproducibility tests were all lower than 2.0％.The recoveries were 99.02％-100.83％ (RSD=0.68％,n=6),98.58％-100.99％ (RSD=0.83％,n=6),99.78％-101.69％ (RSD=0.89％,n=6),100.06％-102.46％ (RSD=0.92％,n=6),respectively.CONCLUSIONS:The method is simple,accurate and suitable for simultaneous determination of paeoniflorin,cinnamaldehyde,psoralen and isopsoralen in Yaotong capsules.

Brain aging refers to the gradual decline of brain tissue structure,function and morphology with age.The cognitive dysfunction is an important marker of brain aging.Degenerative brain white matter changes may be an important factor in brain aging.DTI and its image processing techniques can noninvasively display the microstructure of human brain in vivo.Additionally,it is beneficial to analyze aging process of brain and related diseases of brain aging.The current status and progresses of diffusion tensor imaging in normal brain aging were reviewed in this article.

Objective To evaluate the efficacy and accuracy of hammering reverse guide wire technique for safe placement of anterior column retrograde intramedullary screw in pelvic and acetabular surgery.Methods From September 2015 to March 2018,46 patients with pelvic or/and acetabular fracture involving the anterior column were treated with hammering reverse guide wire technique for safe placement of anterior column retrograde intramedullary screw at Department of Orthopaedics,Lishui Municipal Central Hospital.They were 28 men and 18 women,aged from 21 to 85 years (mean,55.6 years).There were 34 pelvic ring fractures,9 acetabular fractures and 3 combined pelvic ring and acetabular fractures.After the anterior lateral spine of pubic tuberosity was drilled by a guide pin and drill bit as the entry point,a reverse guide wire was knocked into the bone lightly by a hammer.For each retrograde intramedullary screwing into the acetabular anterior column,we recorded operation time,fluoroscopic frequency,and attempts to establish an acceptable screw pathway by the guide pin.The accuracy of screwing and the quality of fracture reduction were evaluated by imaging examination.For each patient,we recorded fracture union time and complications.Functional recovery of the pelvis and acetabulum was assessed by postoperative physical examination at the last follow-ups.Results The operation time of retrograde intramedullary screwing for the 46 patients averaged 28.9 minutes (from 16 to 55 minutes);the fluoroscopy frequency averaged 16.3 times (from 9 to 35 times);an acceptable screw pathway was established by the first attempt in 43 of the 46 patients (93.5％) and re-established after adjustment of the guide pin in the other 3.Forty patients were followed up for an average of 15.2 months(from 6 to 36 months).Postoperative CT scan and three-dimensional reconstruction showed that all the screws had been placed safely and accurately in the acetabular anterior column.Implant loosening and fracture displacement occurred in one case and lower limb thrombosis in another.No nail breakage,fracture nonunion,incision necrosis or infection,neurovascular injury or femoral head necrosis was observed.All fractures united after an average of 14.7 weeks (from 12 to 18 weeks).According to the Majeed scoring at the last follow-ups,the pelvic and acetabular function was evaluated as excellent in 29 cases,as good in 9,and as fair in 2,giving an excellent and good rate of 95.0％.Conclusion Hammering reverse guide wire technique is an effective method for safe placement of anterior column retrograde intramedullary screw in pelvic and acetabular surgery,because it can increase accuracy of screwing and reduce intraoperative radiation,operation time and incidence of complications though it is simple.

Objective To observe the effect of simulated microgravity on the photopic negative response (PhNR) of full-field flash ERG in adult mice.Methods In an experimental study,forty-eight adult male C57BL/6J mice (48 eyes) were randomly divided into model and control groups.Model mice were further divided into three subgroups of 8 each:tail-suspended for 15 days (subgroup A),tail-suspended for 30 days (subgroup B),and tail-suspended for 30 days followed by returning to normal position for 30 days (subgroup C).The three control subgroups were similarly fixed with a harness but kept in the normal position for corresponding periods of 15,30,and 60 days.The mice were immediately examined using ERG-PhNR,flash VEP,OCT and visually-guided behavior in vivo,and subsequently sacrificed to analyze the retinal histology in vitro.PhNR amplitude was measured from baseline to PhNR trough.N1 peak-time and N1-P1 amplitude of VEP was analyzed.The escape duration was used to quantitatively evaluate the visual function of mice.In addition,inner retinal thickness was analyzed by OCT imaging.Data were compared by the independent sample t-test.Results PhNR amplitude in the model subgroup A was obviously lower than the corresponding control subgroup,the difference was statistically significant (t=-3.196,P＜0.01).There was no significant difference in PhNR amplitude between the model subgroup B or C and the corresponding control subgroup (t=-1.976,0.285;P＞0.05).There was no significant difference in FVEP N1 peak-time or N1-P1 amplitude between any of the three model subgroups and the corresponding control subgroup (P＞0.05).There was no significant difference in OCT-measured inner retinal thickness between any of the three model subgroups and the corresponding control subgroup (t=-0.461,2.073,-0.402;P＞0.05).The three model subgroups showed almost normal retinal structure,including the retinal ganglion cell,inner pexiform layer,inner nuclear layer,outer plexiform layer,outer nuclear layer,ellipsoid zone and RPE.There was no significant difference in visually-guided escape time between any of the three model subgroups and the corresponding control subgroup (t=-0.637,-0.955,1.297;P＞0.05).Conclusion Via tail-suspension,short-term simulated microgravity can affect the PhNR of flash ERG;however,the change is reversible and does not affect visual function of mice.

Objective Sporadic cases occurring in mall geographic unit could lead to extreme value of incidence due to the small population bases,which would influence the analysis of actual incidence.Methods This study introduced a method of hierarchy clustering and partitioning regionalization,which integrates areas with small population into larger areas with enough population by using Geographic Information System (GIS) based on the principles of spatial continuity and geographical similarity (homogeneity test).This method was applied in spatial epidemiology by using a data set of thyroid cancer incidence in Yiwu,Zhejiang province,between 2010 and 2013.Results Thyroid cancer incidence data were more reliable and stable in the new regionalized areas.Hotspot analysis (Getis-Ord) on the incidence in new areas indicated that there was obvious case clustering in the central area of Yiwu.Conclusion This method can effectively solve the problem of small population base in small geographic units in spatial epidemiological analysis of thyroid cancer incidence and can be used for other diseases and in other areas.