0.05), in the sheets, quilt covers, bedsides, coats and underwear, the difference was significant (P

Objective To evaluate the use of keyhole dynamic magnetic resonance (MR) imaging in evaluation of pituitary microadenomas. Methods Fifty three patients with pituitary microadenomas proved by operation or clinical findings such as headache, amenorrhea, lactating, fat or acromegaly were retrospectively studied on dynamic MR, conventional contrast enhanced MR, and unenhanced MR. Then the image data were analyzed by two experienced doctors who didn′t know the details and three degrees were made as follows: grade 0, no evidence of the tumor; gradeⅠ, asymmetry signals in the pituitary; and gradeⅡ, nodulated or sheets signals in the pituitary. The grading data were compared with statistical methods. Results In dynamic MR grading system: grade 0 was revealed in 1 patient, gradeⅠ in 29 patients and gradeⅡ in 23 patients. In conventional enhanced MR: grade 0 in 26 patients, grade Ⅰ in 17 patients and gradeⅡin 10 patients. In conventional unenhanced MR: grade 0 in 39 patients, grade Ⅰin 10 patients and grade Ⅱ in 4 patients. The diagnostic rate of dynamic MR, conventional enhanced MR, and unenhanced MR was 98.1%, 51.9%, and 26.4%, respectively. ( P

Objective To investigate the recent effect and safety of magnetic resonance guided focused ultrasound (MRgFUS) for treating uterine fibroids with a Meta analysis. Methods Such databases as Cochrane Library,PubMed,EMbase, CBM,CNKI,CQVIP and Wanfang were searched from their establishment. After thestudy selected, assessment and data extraction conducted by two reviewers independently, Meta-analysis were performed by using the Comprehensive Meta-analysis V2 software. The volume of non-perfusion ratio (NPVR), fibroid shrinkage, clinical symptom severity (SSS score) and adverse reactions were analyzed.Results Nighteen retrieved articles were included, with a total of 1 549 patients. The results of Meta-analysis showed that:(1)nonperfused volume ratio (NPVR),Mean=57.1%(95%CI 45.0% —69.2%).(2)Percentage of FBs shrinkage:mean=31.4% (95% CI 29.2% —33.6%).(3)Symptom severity score (SSS):baseline mean=51.00(95%CI 41.61—60.40),3 months mean=32.50 (95%CI 25.90—39.10),6 months mean=28.62(95%CI(23.57—33.66),12 months mean=24.46(95%CI 15.44—33.49), the average of the severity score of the patient symptoms had a tendency to reduce.(4)The degree of adverse reactions were mild and could relieve itself, there was fewer serious adverse reactions. Conclusions The current evidence indicates that MRgFUS in treatment of uterine fibroidsis reliable and safe. MRgFUS can significantly reduce the volume and the symptom severity score ofthe patients.

Objective To compare the accuracy of placement of ventricular shunt tube,the efficacy and complications of the neuronavigation-assisted ventriculoperitoneal shunt (group A) and traditional ventriculoperitoneal shunt (group B).Methods A retrospective study was made on 40 cases of hydrocephalus managed with neuronavigation-assisted ventriculoperitoneal shunt or ventriculoperitoneal shunt from January 2012 to June 2016.There were 18 cases [12 males,6 females;(47.5 ±8.5) years of age] in group A and 22 cases [14 males,8 females;(44.5 ± 7.5) years of age] in group B.Therapeutic effect and complications were analyzed postoperatively.The accuracy rate in ventricular end shunt placement that was free from the frontal horn of lateral ventricle and flush the Moro hole had also been studied.Results The position of ventricular shunt of all the patients were postoperative timely review of the CT view,and hospital outpatient follow-up periodical for 3-24 months after discharge from hospital.Patients with postoperative timely review of head CT and found that group A of ventricular end of the shunt tube position reach a set position in 16 cases,2 cases had not reached the set position,the accuracy rate was 88.89％.There were 8 cases in group B reach to the set position and 14 cases did not and the accuracy rate was 36.36％.After the statistical analysis there were significant differences (P ＜ 0.05).The total efficiency of A and B groups (excellent + effective) were 94.4％ and 86.4％ (P ＞ 0.05).Postoperative complications included bleeding,infection,obstruction of the shunt,excessive shunt,shunt insufficiency and so on.During follow-up,group A appeared excessive shunt in 1 case;group B incision infection in 1 case,4 cases of shunt obstruction,excessive shunt in 1 case,2 cases of deficiency of shunt.Two groups of patients were recovery well through the drainage tube pressure adjustment or set it once again.The incidence of complications in group A was 5.56％,group B was 36.36％.There was no significant difference between group A and group B (P ＞ 0.05).In group A,there was no obstruction of shunt tube,ventricular end of the shunt tube blockage occurred in 4 cases in group B,the incidence rate was 18.18％ (P ＞ 0.05).Conclusion Neuronavigation guided ventriculoperitoneal shunt placement to the accuracy of position setting has significant advantages over traditional ventriculoperitoneal shunt in the ventricular end of the shunt tube and it has some advantages in reducing postoperative complications.

OBJECTIVE:To analyze the effect of daptomycin on methicillin resistant Staphylococcus aureus(MRSA)infection patients with diabetic foot (DF). METHODS:179 patients with type 2 DF complicating with MRSA were randomly divided into daptomycin group (90 cases) and vancomycin group (89 cases),and both groups were included infection group. 80 DF patients without MRSA infection were included in non-infection group. All of them received DF routine treatment ;daptomycin group was additionally given intravenous injection of daptomycin 4 mg/kg,once a day,for 2 weeks;vancomycin group was additionally giv-en intravenous injection of vancomycin 4 mg/kg,once a day,for 2 weeks. RESULTS:After treatment,IL-6,IL-8,MMP-2 and MMP-9 of infection group were significantly decreased,while TIMP-1 levels increased significantly,with statistical significance, compared to before treatment (P<0.05). The effective rate of daptomycin group was 94.4%,which was significantly higher than that of vancomycin group(71.9%),with statistical significance(P<0.05). CONCLUSIONS:Daptomycin can effectively improve the inflammatory status in patients with DF complicated with MRSA infection,to restore the MMPs/TIMPs balance.

Objective To compare the difference of ELISA and LABScreen in detecting HLA antibodies and evaluate their effects on allograft rejection.Methods Consecutive patients undergoing kidney transplantion from November,2008 to December,2009 in the First Affiliated Hospital and the following up patients during the same period,with abnormal Scr who had completed kidney biopsies,were included in this study.Patients' HLA antibodies were detected by ELISA (Lambda antigen tray,LATTM) and LABScreen Mix Beads (LABScreen MIX,One Lambda,Canoga Park,CA,USA) or LABScreen Single antigen beads (LABScreenTM single antigen beads,One Lambda,Canoga Park,CA,USA).Patients' Scr were also detected at different time potints.Results There were 277 patietns included.Among them 145 (52.3％) cases were HLA antibody positive detected by LABScreen,which including 118 cases ELISA negative but LABScreen positive,and 27 cases both ELISA and LABScreen positive.No case was ELISA positive but LABScreen negative.Among 118 cases which were LABScreen positive but ELISA negative,41 (34.7％) cases happened acute or chronic rejection.However,only 24 cases happened rejection in 132 double negative cases (18.2％,P =0.003).There were 31％ patients in rejection group while only 12.8％ patients (P=0.01) in non-rejection group whose HLA antibody fluorescence intensity detected by LABScreen single antigen beads still increased two weeks after transplantation.Conclusion LABScreen is more sensitive than ELISA in detecting HLA antibodies,and its result highly correlates with the incidence of allograft rejection.

Objective To compare and analyze the surgical and non-surgical treatment results of hypertensive cerebrat hemorrhage.Methods 29 vases of hypertensive cerebral hemorrhage patients are randomly divided into two groups:13 cases were treated by surgical treatment,and 16 cases were treated by medicine treatment.Results In surgical group,dead 3 cases,plant survival 5 eases,death disablity rate is 62%;and in non-surgical group:dead 1 case,plant survival 5 eases,death disablity rate is 44%.Conclusion There is no significant difierence between surgical and non-surgical treatment of hypertensive cerebral hemorrhage.It should be thought more to use surgical treatment on hypertensive cerebral hemorrhage.

Objective To prospectively investigate the value of urinary neutrophil gelatinase-associated lipocalin (NGAL) in the diagnosis of acute kidney injury (AKI) following adult cardiac surgery. Methods Twenty-nine hospitalization patients undergone cardiac surgery were enrolled in the study. Serial blood and urinary samples were collected immediately before incision and at various time intervals after surgery. The primary outcome measure was acute kidney injury, defined as a 50% increase in the level of serum creatinine (Scr) from baseline. Results Fourteen of 29 developed acute kidney injury. The diagnosis time point with Ser was at 24 (10, 48) h after cardiac surgery. By contrast, the concentration of urinary NGAL rose from a median of 3.42(1.60, 9.92) μg/L at baseline to 20.51(13.42, 50.02) μg/L at admission to ICU (P=0.006),and the median concentration of urinary NGAL in patients who developed AKI was significantly higher at admission to ICU compared with patients who did not develop AKI [20.51 (13.42, 50.02) μg/L vs 2.91 (0.72,8.61) μg/L, P=0.002]. As to urinary NGAL at admission to ICU, the area under the receiver-operating characteristic (ROC) curve was 0.824, the sensitivity was 85.7% and the specificity was 80.0% with a cutoff value of 10.95 μg/L. Significant correlation was found between urinary NGAL at admission and the levd of Scr at 24 h in ICU (r=0.545, P=0.002), as well as estimated GFR (r=-0.546,P=0.002). Conclusion Urinary NGAL concentration is significantly higher in patients developing postoperative AKI at the early time of admission to ICU, which may be a useful early biomarker of AKI after adult cardiac surgery.

Objective To examine the relationship between quetiapine serum concentration,dose,therapeu-tic efficacy and side effects in male patients with schizophrenia.Methods Sixty-three male patients with schizo-phrenia were collected.They were treated openly for 8 weeks with quetiapine,the dose was adjusted according to clini-cal improvement and tolerance.The plasma quetiapine concentrations,therapeutic efficacy and adverse drug reactions were observed after the 4 -week treatment period,and at the end of the 8 weeks of the treatment.Results After 4 weeks,the serum concentration had significant correlation with age,the disease duration and education level.After 8 weeks,there was significant correlation between serum concentration and age.We found a correlation between dose and serum concentration of quetiapine,and no relationship between serum concentration and PANSS scores.Side effects were correlated with 4 weeks′serum concentrations.Conclusion Quetiapine is effective for male patients with schizophrenia.Age,quetiapine dose and side effects have significant correlations with the serum concentration.It appears that plasma quetiapine concentration has no effects on therapeutic efficacy.

Objective To investigate the markers in early diagnosis of acute kidney injury (AKI) in patients undergoing heart surgery.Methods Markers included serum cystatin C (CyC),and urinary neutrophil gelatinase-associated lipocalin(NGAL),interleukin 18(IL-18),retinol binding protein(RBP)and N-acetyl-β-D-glucosaminidase(NAG).Twenty-nine cardiac surgical patients hospitalized were enrolled in the study.Serial blood and urine samples were collected immediately before incision and at various time intervals after surgery.The primary outcome measure was AKI.defined as a 50%increase in Scr from baseline. Results The cohort consisted of 29 patients aged(62.9±13.7)years,and baseline Scr was(73.2±11.9)μmol/L.There were no significant differences in demographics between cases and controls,while the aortic clamp time was predictably longer in AKI cases as compared to controls[(60.63±13.92)vs(43.00±9.20)rain,P<0.05].Each biomarker difiered significantly between cases and controls at least one timepoint.Optimal AUCs were for CyC at 10 houm with sensitivity (ST)0.71,specificity(SP)0.92,AUC=0.83(0.67-1.00),cut-off(CO)1.31 mg/L;NGAL at 0 hour with ST 0.84,SP 0.80,Auc=0.85(0.70-1.00),CO 49.15 μg/g Ucr;IL-18 at 2 hours with ST 0.85,SP 0.73,AUC=0.81(0.64-0.97),CO 285.65 ng/g Ucr;RBP at 0 hour with ST 0.75,SP 0.67,AUC=0.77(0.60-0.95),CO 2934.65μg/g Ucr and NAG at 4 hours with ST 0.86,SP 0.67,AUC=0.72(0.53-O.92),CO 37.05 U/mg Ucr.Using a combination of all the 5 biomarkers analyzed at the optimal time-point as above,an AUC of 0.98(0.93-1.02)(P<0.01)in this limited sample was able to obtain. Conclusions Application of serum and urinary biomarkers for the prediction of AKI in patients undergoing cardiac surgery is highly dependent on the sampling time.Of the evaluated markers,uNGAL has the best predictive profile.uRBP also shows similar predictive power.Combining all the five above biomarkers is able to predict significantly more cases,suggesting that the use of more than one marker may be beneficial clinically.