Objective To evaluate the performance of parallel test in detecting malaria infection for returned person from malaria endemic area.Methods The blood samples of 484 returnees from malaria endemic area were analyzed and detected by thick blood smear,rapid diagnostic test (RDT) and nest PCR in four companies involving the African labor dispatching.Results The sensitivi ty of thick blood smear and RDT was 0.628 and 0.744 respectively,which of the parallel test was 0.930.On the other hand,the area under the curve (AUC) of parallel test was 0.930 (95％CI:0.895-0.986),which was higher than thick blood smear[0.814 (95％CI:0.724-0.904)]and RDT[0.847 (95％CI:0.769-0.926)].Conclusion Thick blood smear and RDT,which consist of parallel test,could improve the detection sensitivity and accuracy for returnees from malaria epidemical area effectively.This approach is worthy of popularization and application.

OBJECTIVETo analyze the data of angle variation on traction based on a finite element model of complete cervical spine with straight physiological curvature, and try to give experimental reference and suggestion in treating cervical spondylosis.

METHODSA 43-year-old female patient with straight cervical spine was chosen and the CT scan data were collected. By using specially designed modeling system, a high quality finite element model of complete cervical spine with straight physiological curvature is generated,which included ligament and muscle according to anatomy. After the model was confirmed, traction was loaded with angle 0 degree, anterior 5 degrees, 10 degrees, 15 degrees, 20 degrees, 25 degrees, to observe the data of distance change on between adjacent intervertebral foramen, processus articularis, uncovertedral joint, intervertebral discs, and stress of anulus fibrosus and nucleus pulposus.

RESULTSWhen the angle was 0 degrees-15 degrees, the distance between intervertebral foramen, Luschka joint and processus articularis posterioris was enlarged, the tensile stress was adequate and compressive stress was small. It met the clinical requests.

CONCLUSION0 degree-15 degrees anterior position is suggested for the treatment of cervical spondylosis.

Adult ; Biomechanical Phenomena ; Cervical Vertebrae ; anatomy & histology ; surgery ; Female ; Finite Element Analysis ; Humans ; Spondylosis ; surgery ; Traction ; methods

Objective To summarize the experience of the diagnosis and therapy of chronic pancreatitis (CP).Methods 189 patients with chronic pancreatitis confirmed surgically from 1983 to Aug 1999 admitted in our hospital were retrospectively studied. Results Of all 189 patients, the average age was forty-eight yearsold. The ratio of male to female is 2.1:1. The proportion of confirmed diagnosis to CP is 51.3% within one year and 80.4% within the first five years. The positive rate for diagnosis was 71.9% by CT and 76.9% by ERCP respectively. The positive rate of PABA was 69.7%. While 136(72%) patients received operations, the rate of complication was low. One patient died of infection after pancreatic fistula at the seventh day after surgery, and 97.8% of patients suffered less pain. Conclusions The early diagnosis of CP is difficult. As a delicate operation program set at appropriate time is of vital importance formodifying the course of the disease and improving patients' life quality.

Objective To investigate the influence of tumor necrosis factor-?(TNF-?) on ATP binding cassette transporter A1(ABCA1)in THP-1 macrophage foam cells, and the intervention effect of nuclear factor-?B(NF-?B) inhibitor TPCK on the TNF-?, so as to determine the role of TNF-?/ NF-?B in cellular cholesterol efflux. Methods Foam cells were transformed from THP1 cells. The correlation of cellular cholesterol efflux from foam cells with different concentrations and time stimulated by TNF-? were estimated. Subsequently foam cells were treated with TNF-? at satulated concentration(10.0 ng/ml ), TPCK(10?mol/L),or TPCK(10?mol/L) pretreated for 60 min before TNF-? stimulation. ABCA1 gene expression was analyzed by RT-PCR. ABCA1 protein level was detected by Western blot. Results TNF-? decreased cellular cholesterol efflux of foam cells in concentration-and time-dependent manner. 10 ng/ml of TNF-? down-regulated the levels of both ABCA1 mRNA and protein expressions in time-dependent manner. TPCK was observed to efficiently block the suppressive effect of TNF-? on ABCA1. Conclusions TNF-? decreases cellular cholesterol efflux mainly through the down-regulation of ABCA1. TPCK, an inhibitor of NF-?B activation, is observed to partly block the suppressive effect of TNF-? on ABCA1, suggesting a mechanism involving NF-?B signal transduction. TNF-?/NF-?B might play a critical role in the progression of atherosclerosis by decreasing cellular cholesterol efflux from foam cells.

Objective To investigate the association between the single nucleotide polymorphism (SNP) of leukotriene C4 synthase(LTC4S) rs730012 in the childhood asthma.Methods Sequence specific primers-polymerase chain reaction was used to assess the genetic polymorphism of LTC4S rs730012 in 105 asthma children with different order of severity and 128 non-asthma children in our hospital in the northeast of China to analyse the association between the SNP of LTC4S rs730012 and susceptibility,clinical phenotype in asthma children.Results (1) In case group,genotype frequencies of A/C,A/A and C/C were 71.4％ 、25.7％ 、2.9％,allele frequencies for A,C were 84.3％,15.7％.In control group,the genotype frequencies of A/A,A/C,C/C,were 70.3％,28.9％,0.8％,allele frequencies for A,C were 84.8％,15.2％.No significant difference was found in AA genotype and C allele frequencies between case and control grouP(x2 =0.035、0.020,P both ＞0.05).(2) C/C genotype or C allele frequencies in moderate-severe asthma group were significantly higher than the mild asthma group(x2 =5.859、5.641,P both ＜ 0.05);(3) SaO2 of A/A group was significantly higher than A/C and C/C group (t =2.976,Pboth ＜ 0.05),and FeNO and obstructive ventilatory disorder incidence rate in A/C,C/C group were higher than A/A group,the differences were statistically significant (t =2.946、x2 =5.564,P both ＜ 0.05).Conclusion The SNP of LTC4S rs730012 is associated with the order of severity,SaO2,FeNO,pulmonary function in asthma children of northeast China.However,the rs730012 is not associated with the susceptibility for asthma.

OBJECTIVETo assess the efficacy and experience of gracilis muscle transposition for complex rectovaginal fistula (RVF) and rectourethral fistula (RUF).

METHODSNineteen patients underwent gracilis muscle transposition for complex RVF and RUF from May 2009 to November 2011 in the Beijing Shijitan Hospital and the clinical data were prospectively collected. The success rate and complications were recorded. SF-36 quality of life score, Wexner fecal incontinence score, and female sexual function score before surgery and 6 months after surgery were recorded.

RESULTSIn 19 patients, there were 8 males (RUF) and 11 females (RUF). The times of failed attempt repair preoperatively ranged from 0-3 (mean, 1.0). The diameter of the fistula ranged from 0.5-3.0 cm (mean, 1.6), and all fistulas located above the sphincter. The operative time ranged from 145-400 minutes (median, 240). The postoperative hospital stay ranged from 10-39 days (median 21). Early postoperative complications included thigh pain and numbness in 2 cases, leg numbness in 2 cases. No long-term complications were noticed. The follow-up period ranged from 6-35 months (median, 18). The gracilis muscle transposition had a healing rate of 94.7% (18/19). As compared with the preoperative level, Wexner score decreased from 10.0±8.8 to 2.9±5.8, and the continence function improved significantly (P=0.002). Sexual function score of 11 female patients increased from 1.0±1.8 to 4.0±4.0, and the sexual function had a significant improvement after surgery (P=0.022). SF-36 quality of life scores improved significantly (P<0.001).

CONCLUSIONSGracilis muscle transposition for complex rectovaginal fistula and rectourethral fistula has high success rate with mild and rare complications.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Muscle, Skeletal ; surgery ; Prospective Studies ; Rectal Fistula ; surgery ; Rectovaginal Fistula ; surgery ; Surgical Flaps ; Thigh ; surgery ; Treatment Outcome ; Urethra ; surgery ; Urinary Fistula ; surgery ; Young Adult

OBJECTIVETo compare results of the growth and development of the upper dental arch and the velopharyngeal closure of the cleft patients treated by two methods.

METHODSThe dental cast of patient and X-ray films were measured and the statistical medical records were analyzed.

RESULTSThe transverse distance of upper dental arch was found to be wider in group A than in group B. The anterior-posterior distance of the dental arch in bilateral cleft group was shorter in group A than in group B. The difference of the two groups were gradually lessened as age increases. Bony bridge in alveolar gap was 63% and 83.3% in unilateral and bilateral cleft group respectively. 15% of cases in group A and 35.2% in group B needed pharyngeal flap.

CONCLUSIONSThe stable upper dental arch in group A can opposes the pressure from the lip muscles, this maintains the width of the arch. But A-P distance of upper dental arch in BCLP in group A should be followed up after the age of 9 years. Pharyngeal flap is needed less in group A than in group B.

Alveolar Process ; growth & development ; Child ; Child, Preschool ; Cleft Lip ; surgery ; Cleft Palate ; surgery ; Humans ; Infant ; Orthodontics, Corrective ; Palate, Soft ; surgery

OBJECTIVETo determine the difference of post-operative mortality between ORIF (open reduction internal fixation) and hip replacement for the treatment of intertrochanteric fracture in elderly by using survival analysis.

METHODSThe clinical data of 110 patients above 60 years old who underwent surgical treatment (ORIF or hip replacement) for the intertrochanteric fracture between April 2003 and May 2013 were retrospectively analyzed. Among the patients, 83 cases were treated with ORIF (ORIF group), there were 32 males and 51 females, aged from 61.44 to 98.75 years old with an average of (78.52 ± 7.98) years old; and 27 cases were treated with hip replacement (arthroplasty group), there were 8 males and 19 females, aged from 71.82 to 96.54 years old with an average of (79.99 ± 6.11) years old. A survival analysis was performed on the clinical data by using SPSS 110 software. The survival rate of 1-year,2-year, 5-year and the mean survival time for the total patients, the mortality rate of 1-year, 2-year in each group, the survival rate of 1-year, 2-year and mean survival time and survival curve in each group were included.

RESULTSAll wounds achieved primary healing and no deaths were found in stay hospital. All patients were followed up from 1 to 125 months with an average of (46.93 ± 29.53) months. Among all 110 cases, 31 were dead and 79 survived. The survival rate of 1-year, 2-year and 5-year was (90.7 ± 2.8)%, (82.5 ± 3.9)% and (57.6 ± 6.5)%, respectively,while the ensemble mean survival time was (84.137 ± 5.902) months. The mortality rate of 1-year, 2-year in ORIF group was 7.2% and 12.0%, respectively; and in arthroplasty group, there was 14.8% and 25.9%, respectively. There was no significant difference in mortality rate of 1-year and 2-year between two groups. According to the survival analysis of the ORIF group, the survival rate of 1-year, 2-year was (92.6 ± 2.9)%, and (85.8 ± 4.3)%, respectively, and the mean survival time was (87.508 ± 6.063) months. In arthroplasty group, the survival rate of 1-year, 2-year was (85.2 ± 6.8)% and (73.9 ± 8.5)%,and the mean survival time was (67.294 ± 11.180) months. There was significant difference in mean survival time between two groups (P < 0.05).

CONCLUSIONORIF can achieve a better postoperative survival compare with hip replacement in treating intertrochanteric fracture in elderly.

Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip ; Female ; Fracture Fixation, Internal ; Hip Fractures ; mortality ; surgery ; Humans ; Male ; Middle Aged ; Prognosis ; Retrospective Studies

OBJECTIVETo investigate the effect of polycaprolactone-ascobic acid (PCL-AA) scaffolds in promoting repair of articular cartilage defects in a rabbit model.

METHODSThe cartilage defects (3.5 mm in diameter and 3.0 mm in depth) were created in the trochlear groove of the bilateral knees of eight 6-month-old male New Zealand white rabbits. The rabbit models were then randomized into 3 groups to receive implantation of PCL-AA scaffolds (group A, n=8), implantation of PCL scaffolds without AA (group B, n=5), or no treatment (group C, n=3). In groups A and B, the mixture of fibrin gel (10 µg) and thrombinogen (10 µg) was injected into the defects to fix the scaffolds during the surgery. Histological analyses and quantitative assessments of defect repair were conducted at 6 and 12 weeks after implantation of the scaffold.

RESULTSAt 6 weeks after scaffold implantation, macroscopic observation showed better filling of the cartilage defects in group A than in group B, while no obvious defect repair was observed in group C. The rabbits in group A showed a significant improvement of the Wakitani score than those in group B (4.05∓1.11 vs 7.05∓0.98, P<0.05). HE staining revealed the presence of newly generated cells in and around the PCL-AA scaffolds without inflammatory cells. Safranin O staining showed a significantly greater ECM of the newly regenerated tissue in groups A and B than in group C (P<0.05), and the volume of the regenerated cartilage and cells was significantly greater in group A than in group B (P<0.05). Samples harvested at 12 weeks showed more hyalione-like cartilage formation than that at 6 weeks in group A.

CONCLUSIONPCL-AA scaffolds have a good biocompatibility and promotes the healing of articular cartilage defects. Adding ascorbic acid into PCL scaffolds better promotes cartilage formation in terms of both quantity and quality of the regenerated tissues. PCL-AA scaffolds can serve as a promising biomaterial to promote the regeneration of articular cartilage using tissue engineering techniques.

Objective To investigate antimicrobial resistance among gram-positive cocci in China in 2008.Methods From June 2008 to December 2008,1171 consecutive and non-repetitive gram-positive cocci were collected from 12 teaching hospitals.The MICs of antibacterial agents was determined by agar dilution method.Results The prevalence of MRSA and methicillin-resistant coagulase-negative Staphylococci(MRSCoN) was 49.9%(232/465) and 74.0%(179/242),respectively.The MRSA prevalence ranged from 33.3% to 65% in different regions.About 71.1%(108/152) of Staphylococcus aureus from respiratory tract specimens,48.3%(28/58) of Staphylococcus aureus from blood samples,and 36%(68/189) of Staphylococcus aureus from the pus,wound and sterile body fluid samples were resistant to methicillin.The susceptible rates of MRSA to trimethoprim/sulfamethoxazole(SXT) and chloramphenicol were 81.5%(183/232) and 89.7%(208/232).Susceptibility to gentamicin, erythromycin, clindamycin, tetracyclines,rifampicin,and quinolones were from 3.9% to 35.0%.All Staphylococci isolates were susceptible to vancomycin,teicoplanin,and linezolid.Three vacomycin-resistant Enterococcus faecium strains were found in this study.About 96.2%(101/105) of Enterococcus faecalis and 97%(130/134) of Enterococcus faecium were susceptible to linezoild.Fifty-one out of 105 of Enterococcus faecalis(48.6%)and 101 out of 134 Enterococcus faecium(75.4%)were resistant to high concentration gentaroicin.The susceptibility of Enterococcus faecalis to all the antibiotics except for chloramphenicol and tetracycline was higher than that of Enterococcus faecium.Enterococcus faecium isolates showed a high resistant prevalence to most of antibiotics except glycopeptides and linezolid.The prevalence of PISP among 225 isolates was was 36.6%(15/41),and the prevalence of PNSSP from the other patients ranged from 15.4% to 26.6%.The susceptible rates of PSSP to cefprozil,cefuroxime and cefaclor were 67.5%(114/169),66.3%(112/169) and 61.5%(104/169),respectively.All the PISP isolates were resistant to the above three antibiotics.Teicoplanin,vancomycin and linezolid were the most active agents against Staphylococcus pneumoniae(susceptible rate,100%).About 96.9%,97.8% and 98.2% Staphylococcus pneumoniae isolates were susceptible to gatifloxacin,levofloxacin,and moxifloxacin,respectively.The susceptible rates of Staphylococcus pneumoniae to ceftriaxone,chloramphenicol and amoxicillin/clavulanic acid were 81.3%,77.3%,and 68.0%,respectively.The susceptibility of Staphylococci pneumoniae to macrolides,SXT and tetracycline ranged from 11.6% to 23.6%.Conclusions The prevalence of VRE is low in China.However,methicillin-resistance among Staphylococci isolates was high.The prevalence of PNNSP isolated from (≤)3 years children is higher than in the other age population.Teicoplanin,vancomycin,and linezolid remain high activity against Staphylococci,Enterococcus faecalis,Enterococcus faecium,and Staphylococcus pneumoniae.