Objective To investigate the value of MR imaging in detecting occult fractures. Methods Sixteen cases with acute trauma were studied using radiography and MR imaging, three cases also underwent CT examinations. Three fractures occurred in the femur condyle, 8 in the proximal tibia and 5 in the thoracolumbar spine. Results All sixteen cases had normal radiographic results. In 11 cases with femur condyle and tibia occult fracture, MR imaging demonstrated linear low signal in the subcortical region in 3 cases and irregular low signal from articular faces to shaft in 8 cases on both T 1WI and T 2WI, and high signal changes around low signal were seen on T 2WI, and the width of low signal was less than 4 mm on both T 1WI and T 2WI. The high signal in T 1 weighted-Fat saturated sequence was more remarkable and wider than that on T 2WI. 3 cases with CT scanning showed no fracture signs. In five cases with thoracolumbar vertebral occlut fractures, MR imaging demonstrated horizontal linear low signal in the center of vertebra on both T 1WI and T 2WI, and high signal changes around low signal were seen on T 2WI. Conclusions MR imaging could early determine the diagnosis of occult fractures. MRI should be the next examination of choice when plain films fail to reveal suspected fractures in the setting of suggestive symptoms and positive physical examination.

Objective To establish a method for the determination of aristolochic acid A inPaishi granule.Methods The HPLC system consisted of the Phenomenex Luna C18(4.6 mm×250 mm, 5μm)column, the mobile phase consisted of acetonitrile and 0.01% HAc, gradient elution flow rate was 1.0 ml/min, the column temperature was 35℃, The UV detector was set at 250 nm.Results The linear response range was 0.029-0.580μg/ml (r=0.999 9). The detection limit and quantitation limit of aristolochic acid A inPaishi granule were 0.9 and 3.0 ng/ml. The average recovery of aristolochic acid A was 96.4%.Conclusion The method is high sensitivity, accurate, repeatable and high specificity,and can be used as an inspection method for safe use of Paishi granule.

Objective To explore the relationship of MDR1 and its encoded product P-gp expressions with clinical efficacy of transcatheter arterial chemoembolization (TACE)in primary liver cancer and their clinical significance.Methods We selected 108 patients with primary liver cancer who came to our hospital between June 2010 and June 2013 as observation subjects.Meanwhile 50 healthy people in our hospital for liver biopsy were selected as controls.MDR1 mRNA level in observation group and control group was determined by real-time quantitative PCR.P-gp protein level was analyzed by immunohistochemistry.According to P-gp level,the 108 patients were divided into drug-resistance groups and non-resistance group;the relationship between P-gp expression level and clinical efficacy was analyzed.Results MDR1 mRNA level in liver tissues significantly enhanced in observation group compared with that in control group (P <0.05).In observation group 32 patients had the ratio of MDR1 mRNA level-normal level of more than 2 and 76 patients had the ratio of MDR1 mRNA level-normal level of less than 2. Immunohistochemistry revealed that MDR1 encoded product P-gp was brownish yellow, mainly expressed in the cell surface of liver cancer cells.There were 35 P-gp protein-negative patients (non-resistance group)and 73 positive patients (resistance group).Clinical efficacy was significantly higher in non-resistance group (74.28%)than in resistance group (43.28%)(P <0.05).The 1 year and 2-year cumulative survival rates were 54. 12% and 27.40% in resistance group and 77.14% and 42.86%% in non-resistance group.They were significantly higher in the latter group (P <0.05 ).Conclusion The overexpressed MDR1 encoded product P-gp in primary liver cancer is associated with multidrug resistance in tumor chemotherapy,suggesting that P-gp can be used as one of the guiding clinical markers of chemotherapy.

OBJECTIVE:To compare Paliperidone sustained-release tablet and Paliperidone palmitate injection in the treatment of schizophrenia in respects of medium-term and long-term efficacy,safety,insight,medication compliance and social function of patients,so ad to provide reference for drug selection in the clinic.METHODS:Eighty-four schizophrenia patients selected from our center during Mar.2015-Jun.2016 were divided into Paliperidone sustained-release tablet group (group H,44 cases) and Paliperidone palmitate injection group (group Z,40 cases).Group H was given Paliperidone sustained-release tablet orally with initial dose of 3 mg/d,gradually increasing to 9 mg/d 2 weeks later according to disease condition;the drug dose was adjusted and ranged 3-12 mg/d according to disease condition.Group Z was given Paliperidone palmitate injection intramuscularly,150 mg on 1st day,100 mg on 8th day,and then given injection once a month,drug dose was adjusted according to disease condition (75,100,150 mg).Treatment course of 2 groups lasted for 12 months.Before treatment,1,2,3,6,9,12 months after treatment,Positive and Negative Syndrome Scale (PANSS) was used to evaluate therapeutic efficacy;Scale to Assess Unawareness of Mental Disorder (SAUMD) was used to evaluate the cognition of patients to disease;Medication Adherence Rating Scale (MARS) was used to evaluate medication compliance;Personal and Social Performance Scale (PSP) was used to evaluate patient's social function.The occurrence of ADR was observed during treatment.RESULTS:3,2 patients withdrew from group H,Z during treatment.Before treatment,there was no statistical significance in PANSS,SAUMD,MARS,PSP scores between 2 groups (P＞0.05).1,2,3,6,9,12 months after treatment,PANSS and SAUMD scores of 2 groups were decreased significantly,while MARS and PSP scores were increased significantly,compared to before treatment,with statistical significance (P＜0.05).9,12 months after treatment,PANSS and SAUMD scores of group Z were decreased significantly,while MARS and PSP scores were increased significantly,compared to group H,with statistical significance (P＜0.05).There was no statistical significance in the occurrence of ADR between 2 groups (P＞0.05).CONCLUSIONS:For schizophrenia,Paliperidone palmitate injection is better than Paliperi done sustained-release tablet in respects of medium-term and long-term efficacy,patient's insight,medication compliance,social function recovery;the longer the time,the more prominent the superiority.There is no significant difference in safety between them.

Objective To explore the risk factors of antidepressant treatment emergent suicidal ideas or attempted suicide among patients with bipolar depression. Methods Out of 623 patients with bipolar disorder visiting between June 2006 and June 2009,68 who was initially diagnosed as unipolar disorder and treated with antidepressants were retrospectively surveyed. Suicide and activation symptoms during the process of antidepressant treatment were estimated based on the cases record and semi-structural interviews. Unconditional bivariate logistic regression was conducted to analyze the potential risk factors. Results Of 68 patients,7 ( 10. 3% ) experienced antidepressant treatment emergent suicidal ideas and 4 ( 5.9% ) attempted suicide after 2 to 63 ( 17.45 ± 5.90 )days following the treatment. The antidepressant treatment emergent suicidal ideas or attempted suicide were related to the suicidal level before treatment (P= 0. 012, OR = 2. 072 ) and the combined use of benzodiazepine (P =0. 043, OR = 0.236). Clinical subtypes, gender, age, symptoms feature, types of antidepressant and antidepressanttreatment emergent activation symptoms had little impact on the antidepressant treatment emergent suicidal ideas orattempted suicide (P ＞ 0.05 ). Conclusion The antidepressant treatment emergent suicidal ideas or attempted suicide among patients with bipolar depression are positively related to the suicidal level before treatment while negatively associated with the combined use of benzodiazepine.

OBJECTIVE: To analyze the histopathological and imaging features for soft tissue liposarcoma of extremities and to provide guide for clinical diagnosis.
 METHODS: Nine patients with soft tissue liposarcoma of extremities received treatment in Qinghai University Affiliated Hospital from October 2012 to October 2014. The imaging features of CT and MRI as well as the histopathological features were retrospectively analyzed. The pattern, size and border of tumor were observed, and the correlation between the pathological features and the imaging features was analyzed.
 RESULTS: Lower limb lesion was found in 8 patients, including the left lower leg, left and right thigh, respectively. One patient had right upper arm lesion, 1 case had bleeding, and 1 case displayed with calcification and liquefaction performance. The CT examination showed low density shadow and linear separated shadow. The ultrasound examination displayed different intensity fat-like echo. There was short signal intensity on T1 weighted imaging and long signal intensity on T2 weighted imaging in MRI.
 CONCLUSION MRI and other imaging examinations show good performance in detecting the features of soft tissue liposarcoma of extremities, which possess diagnostic value.
Humans ; Liposarcoma ; diagnosis ; pathology ; Magnetic Resonance Imaging ; Retrospective Studies ; Soft Tissue Neoplasms ; diagnosis ; pathology ; Tomography, X-Ray Computed

Objective To explore the value of abnormal imaging findings on susceptibility weighted imaging (SWI) in delayed graft function (DGF). Methods The conventional MRI and SWI images of 26 cases with DGF and 20 cases with normal renal function of transplanted kidneys were retrospectively analyzed. Patients with cysts and angiomyolipomas were excluded. Normal structures of transplanted kidney were identified. If lesions of abnormal signal intensity were found in the transplanted kidney, the location, border and signal intensity compared to renal cortex would be analyzed. The differences in signal intensity between the abnormal signal lesions and normal renal cortex in the same SWI layer of DGF were compared by using independent-sample t test. The differences in positive detection rate of discovering the abnormal signal lesions in DGF between conventional MRI and SWI were compared by using McNemar test. Results Of the 26 cases with DGF, one case was found to exhibit abnormally low signal lesions with fuzzy boundary located at junctional zone between cortex and medulla on both conventional MRI and SWI images. Ten cases were found to exhibit abnormally low signal lesions with fuzzy boundary located at junctional zone between cortex and medulla on SWI images only. Fifteen cases exhibited no abnormal signal lesions on both conventional MRI and SWI images. Twenty cases with normal renal function of transplanted kidney, no abnormal signal lesions were found on both conventional MRI and SWI images. The differences in signal intensity between the abnormally low signal lesions (130±20) and normal renal cortex (177±25) in the same SWI layer of 11 cases with DGF were statistically significant (t=-4.582,P<0.01). The differences in positive detection rate of discovering the abnormally low signal lesions in DGF between conventional MRI [3.8%(1/26)] and SWI [42.3% (11/26)] were statistically significant (χ2=8.100,P=0.002). Conclusions Abnormally low signal lesions with fuzzy boundary located at junctional zone between cortex and medulla on SWI images suggest the presence of DGF. Compared with conventional MRI, SWI appears to be superior in detecting the abnormally low signal lesions.

Objective To analyze the popular characteristic and drug resistance of Pseudomonas aeruginosa in a hospital of Guiy-ang from January 201 1 to December 2013.Methods The distribution characteristic and drug resistance of Pseudomonas aeruginosa isolated from clinical samples from January 201 1 to December 2013 were analyzed retrospectively.Results A total of 642 strains of Pseudomonas aeruginosa were isolated for three years in our hospital from January 201 1 to December 2013,there was 57.0% isola-ted from sputum specimens,and 27.9% isolated from excreta of wound.The infected endemic area distribution was made up of Or-thopedic Surgery,ICU,Geriatrics Department and Respiratory Department accounting for 22.9%,20.1%,18.8% and 1 5.9% re-spectively.Pseudomonas aeruginosa was most sensitive to polymyxin bacillosporin.The drug resistance rates to Trimethoprim,Am-picillin and Cefazolin were all 100.0%.The drug resistance rates to Ampicillin/sulbactam and Ceftriaxone were 90.0%. Conclusion Pseudomonas aeruginosa is the main cause of lower respiratory tract infections in patients and wound infection and show serious multi-drug resistant,so it is necessary to use drugs reasonably according to the drug susceptibility results.

Chronic kidney disease (CKD) is becoming a global social problem. It is important to slow down the progression of CKD for economic and social concerns. In recent years, it has been found that colon is one of the vital organs which produce uremic toxins. And enterogenous uremic toxins are closely related to the prognosis of CKD. Theory of gut-kidney axis for the slowdown of CKD progression was raised by foreign scholars and became the research hot spot. Colon therapy with traditional Chinese medicine (TCM) has been widely used in clinical practice and is believed to slow down the progression of CKD by numerous clinical reports. However, low re-search quality and ambiguous results limited its further application. Under the guidance of senior TCM Professor Huang Chunlin, who emphasized the method of draining turbidity through bowels in the management of CKD, from the Nephrology Center, Guangdong Provincial Hospital of Chinese Medicine, as well as the modern theory of gut-kidney axis, we had carried out a series of exploratory researches which will provide data and methodology support for further confirmatory studies and improve its effectiveness.

Objective To explore the skills and summarize the experience in the establishment of orthotopic liver transplantation rat models from donation after cardiac death (DCD). Methods According to the time of warm ischemia, 120 rats were divided into 3 groups: group A (warm ischemia for 0 min, n=40 pairs), group B (warm ischemia for 10 min, n=40 pairs) and group C (warm ischemia for 20 min, n=40 pairs). Orthotopic liver transplantation was performed by the modified two-cuff technique in 3 groups. The time of each stage of surgery was recorded in 3 groups. The survival rate at the end of surgery, 24 h, 72 h and 7 d after surgery was recorded in 3 groups. The dead rats were immediately subject to anatomical examination to identify the cause of death. Results The cold ischemia time of donor liver, anhepatic phase and operation time of the recipients did not significantly differ among three groups (all P>0.05). In groups A, B and C, the survival rate at the end of surgery was 97%, 97%, and 100% respectively. The survival rate at postoperative 24 h was 92%, 90% and 92% respectively. The survival rate at postoperative 72 h was 90%, 80% and 77% respectively. The survival rate at postoperative 7 d was 85%, 70% and 57% respectively. The survival rate at the end of surgery, postoperative 24 h and 72 h did not significantly differ among 3 groups (all P>0.05). At postoperative 7 d, the survival rate in group C was significantly lower than that in group A (P<0.05). Surgical operation was the major cause of intraoperative and postoperative 24 h death. Bile leakage and ischemic hepatic failure were the causes of death at postoperative 72 h. Biliary duct complications were the main causes of death at postoperative 7 d. The quantity of rats developing with biliary duct complications was increased along with the prolongation of warm ischemic time. Conclusions The success of stable establishment of rat models with orthotopic liver transplantation from DCD depends upon the protection of the liver and biliary function. The difficulty lies in the anastomosis of the suprahepatic inferior vena cava and the shortening of anhepatic phase.