Objective To improve spiral CT diagnosis and differential diagnosis of small amounts of traumatic subarachnoid hemorrhage(TSAH).Methods SCT features of 105 cases with small amounts of TSAH , which were demonstrated by SCT reexaminations , were retrospectively analyzed. Results The distributions of small amounts of TSAH included cerebral longitudinal fissure cistern in 47 cases, cerebral lateral fissure cistern in 30 cases , cerebral surface sulcus in 22 cases, tentorium of cerebellum in 6 cases. There were 12 cases of small amounts of TSAH with contusion and laceration of brain , Subdural hematoma or bone fracture of skull.Conclusions Spiral CT scan has important value in qualitation and level diagnosisa of small amounts of TSAH.

Background and purpose:Bladder carcinoma is the most common tumor in the urogenital system in China. For patients with non-invasive bladder cancer, intravesical therapy is an important part of treatment after complete transurethral resection (TURBt). Bacillus Calmette-Guerin (BCG) remains the most effectively used immune agent, and epirubicin (EPI) has been reported to have an improved antitumor activity and high remission rate. However, the results differed significantly from study to study. To compare the efficacy and treatment-induced side effects of intravesical epirubicin versus BCG on postoperative recurrence of non-invasive bladder carcinoma, we completed a meta-analysis of the published literature. Methods:According to the criteria in the paper, we retrieved published comparative studies on intravesical epirubicin versus BCG for non-invasive bladder carcinoma. Data were extracted from each identified paper and Revman4.2 software was used for statistical analysis.Results:6 trials including 1 288 patients were eligible according to the eligibility criteria. Of 657 cases that were treated with epirubicin and 631 with BCG, recurrence occurred in 253 and 184 respectively. Pooling data of a meta-analysis indicated that BCG statistically reduced the incidence of tumor recurrence (Peto OR=1.60, 95%CI=[1.26, 2.03], P=0.000 1). With regard to tumor progression, BCG was also statistically superior to epirubicin (Peto OR=1.70, 95%CI=[1.16, 2.49], P=0.006). 5 studies reported the comparison on main local side effects in terms of hematuria, cystitis or irritative symptoms. Combined results showed that the incidence of hematuria (Peto OR=0.47, 95%CI=[0.35, 0.62], P

The cytolytic effect of perforin is a mechanism of anti-virus,killing microbial-infected cells and tumor cells.Perforin is a very important non-specific immune factors in fish.In order to understand the function of perforin,the cDNA of grass carp perforin C-terminal peptide was amplified from grass carp liver and kidney cDNA library.It contains a protein kinase C conserved region 2(C2).The cDNA was connected with pET32a,and transformed to expression bacteria DE3.PFP-C was expressed by a prokaryotic expression system and then purified by affinity chromatography.It showed a significant haemolytic activity when tested with rabbit red cells,the optimal pH for haemolytic activity was 7.5,and its haemolytic function dependents on Ca2+ apparently.

Long-term treatment with an agonist of peroxisome proliferator-activated receptor (PPAR)-γ is associated with bone fractures in the clinical practice. However, the mechanisms underlying the fractures are not fully understood. This study was aimed to examine the effect of rosiglitazone (an agonist of PPAR-γ) of different doses on the proliferation, differentiation, and transforming growth factor beta 1 (TGF-β1)-induced expression of connective tissue growth factor (CTGF) in primary rat osteoblasts in vitro. Osteoblasts were isolated from newly born SD rats and treated with different doses of rosiglitazone (0-20 μmol/L). The proliferation and differentiation of osteoblasts were measured by MTT assay and NPP assay, respectively. The expression of CTGF was determined by RT-PCR and Western blotting. The results showed that most isolated osteoblasts displayed strong alkaline phosphatase (ALP) activity and treatment with different doses of rosiglitazone did not affect their proliferation, but significantly inhibited the differentiation of osteoblasts in a dose-dependent manner. Moreover, treatment with different doses of rosiglitazone significantly reduced the TGF-β1-induced CTGF mRNA transcription and protein expression in a dose-dependent manner in rat osteoblasts. It was concluded that the activation of PPAR-γ may inhibit the differentiation of osteoblasts by reducing the TGF-β1-induced CTGF expression in vitro.

Objective To evaluate the diagnostic value and misdiagnosis cause of echocardiography (UCG) and CT in aorto-left ventricular tunnel (ALVT). Methods UCG and CT of 5 patients who were diagnosed as ALVT by surgical operation during August 2010 to October 2014 in Wuhan Asia Heart Hospital were reviewed and analyzed. Results By UCG, 4 cases were diagnosed as ALVT. The abnormal tunnel between aortic root and left ventricle could be clearly displayed with two dimensional echocardiography. On color Doppler flow image (CDFI), it could be clearly demonstrated that the blood flow went into aorta from left ventricle in systolic period via aortic valves and ALVT, and back to left ventricle in diastolic period via ALVT. Bicuspid aortic valve (BAV) was found in 2 patients, and aortic valve reflux in 1 patient. According to Hovaquimian classification, 2/4 patients were diagnosed as ALVT of typeⅠ, and other 2 patients as ALVT of typeⅡ. One case was misdiagnosed as left coronary artery-left ventricle fistula. By CT, 2 cases were diagnosed as ALVT and 1 case was misdiagnosed as left coronary artery-left ventricle fistula. Conclusion The combination of UCG and CT is a reliable technique in the diagnosis of ALVT, which has significance in therapeutic strategy making and prognosis prediction.

Objective:Toprepare poly-DL-lactide-poly (PELA) microspheres encapsulating recombinant tissue inhibitors of metalloproteinase-1 (TIMP-1) adenovirus, and to investigate their effects on the proliferation of hepatocellular carcinoma HepG2 cells. Methods: The microsphere was constructed by encapsulating recombinant adenovirus containing TIMP-1 in biodegradable PELA. The diameter of the microsphere, quantity of virus encapsulated, loading rate, and releasing kinetics were measured. HepG2 cells were infected with the microspheres; the infection efficiency was examined by fluorescent microscope; and the ultrastructure was observed by TEM. The expression of TIMP-1 mRNA in HepG2 cells was examined by semi-quantitative RT-PCR, and the proliferation of HepG2 cells was detected by MTT assay. Results: The microsphere encapsulating recombinant TIMP-1 adenovirus was successfully constructed, with its diameter, entrapment efficiency, and virus loading rate being 1.965, 60.0%, and 10.5×10~8/mg, respectively. About 60% of the viruses were released within 120 h, and the total releasing time was longer than 240 h. Infection with rAdTIMP-1 PELA microsphere efficiently induced TIMP-1 expression in HepG2 cells, and significantly inhibited the proliferation of HepG2 cells, with the inhibitory rate being 47%. Conclusion: PELA microsphere encapsulating recombinant TIMP-1 adenovirus can markedly inhibit the proliferation of HepG2 cells, which provides an experimental basis for the combining macromolecular chemistry and gene therapy for treatment of hepatocellular carcinoma.

To explore the model of the standardized training for health management talents by referring to the standardized training for resident-doctors.This article analyzed the necessities of the model of the standardized training for health management talents from two aspects.After that,it elaborated on the significance of standardized training.At last,it proposed some ideas about constructing the standardized training for health management talents.

Objective To compare the internal fixation methods for treatment of intertrochanteric fractures in elderly patients.Methods One hundred and sixty four elderly patients with intertrochanteric fractures were treated from June 2006 to September 2011.The fractures were fixed with dynamic hip screws (DHS,n =42),locking proximal femur plate (LPFP,n =40),Gamma nails (n =36) or proximal femoral nail anti-rotation (PFNA,n =46),respectively.The clinical data were collected and the operative time,blood loss,time of clinical healing,postoperative complications and Harris hip scores of 6 months after surgery were compared among groups.Results All patients were followed-up for 6 to 36 months.The operative times of DHS,LPFP,Gamma nails and PFNA groups were (103 ± 15),(90 ± 13),(79 ± 11)and (65 ±9)min,respectively(F =2.87,P ＜0.05).The blood loss of 4 groups was (202 ±23),(181 ±23),(98 ± 13) and (87 ± 11) ml,respectively (F =3.21,P ＜ 0.05).The times of clinical fracture healing were (16.1±1.9),(14.6±1.8),(12.9±1.7) and (11.5±1.4) weeks,respectively(F=2.66,P＜0.05).The postoperative complications of 4 groups were 4/42,3/40,2/36 and 1/46,respectively (x2 =5.67,P ＜0.05).The Harris hip scores of 6 months after surgery of 4 groups were 81％ (34/42),85％ (34/40),89％ (32/36)and 93％ (43/46),respectively(H =20.03,P ＜0.05).Conclusions In treatment for intertrochanteric fractures in elderly patients,the efficacy of intramedullary fixation (Gamma nails and PFNA) is better than extramedullary fixation DHS and LPFP).PFNA is more effective than other 3 methods and should be preferentially chosen.

Objective Aortic dissection is accute in occurrence along with fast change , which is inclined to to induce psy-chotic symptoms and affect the lives of patients .The study was to investigate the effects of healthcare cooperative intervention on pa-tients with psychiatric symptoms secondary to aortic dissection . Methods We established medical cooperation organization structure to clarify the division of responsibility along with a quick assessment form , a process chart and a green channel for emergencey treat-ment.The above method was applied to intervene 32 patients with psychiatric symptoms secondary to aortic dissection and observe the diagnosis time , the time from diagnosis to surgery , the remission time of psychiatric symptoms , the incidence of adverse events and the length of stay. Results 32 patients were diagnosed within 30min followed by emergency surgery within 30min after diagnosis, which was 1-2 hours shorter than the previous diagnosis and surgery preparation time .5-21 d after surgery , psychiatric symptoms have been effectively controlled.Extubation, falling out of bed, self-injury or injury and other adverse events did not occur .No patient died, and the average length of stay was 13.5d, which was 1.75d shorter than the length of stay of previous similar patients . Conclusion The healthcare cooperation method can quickly identify patients with psychiatric symptoms secondary to aortic dissection , prevent adverse events and shorten the length of stay .

Objective To investigate the diagnostic values of vaginitis five of the joint inspection kit combined with microscopic examination for common vaginal disease.Methods The vaginal secretions samples from 4 114 outpatients were tested with LTS-V400 vaginitis five of the joint inspection kit and microscopic examination.The examination results of age groups were analyzed and compared.Results In all 4 114 cases of samples,the positive rate of trichomonad(1.95%)was significantly lower than that of fun-gi(4.74%),P <0.05.The positive rates of N-acetyl-beta-galactosamine glycosides enzyme(NAG),sialidase(SNA),and leukocyte esterase(LE)were the highest in >40-50-age group,which were 1.95%,6.10%,14.15%,10.24% and 46.34%,respectively. The positive rates of H2 O2 ,pH >4.5 and pH < 3.8 were the highest in > 50 age group,which were 85.43%,86.09%,and 0.66%,respectively.The positive rates of trichomonad,SNA,LE,H2 O2 ,pH>4.5 and pH<3.8 were statistically different a-mong the age groups(P <0.05 ).Conclusion Vaginitis five of the joint inspection kit combined with microscopic examination is suitable for the diagnosis of trichomonas vaginitis,mouldsex vaginitis,and bacterial vaginal disease .