Objective:To compare the mRNA expression of IRG1in PBMCs from patients with TB, individual with latent infection and healthy controls, and investigate its diagnostic value for Mycobacterium tuberculosis infection.Methods: The mRNA expression of IRG1 from PBMCs stimulated with Mtb-specific antigens was quantitatively detected by quantitative real-time PCR ( qPCR).Receiver-operating-characteristic ( ROC) curves were used to determine the cutoff points yielding the highest specificity and sensitivity,and discriminative ability was evaluated by the area under the ROC curve.Results: The mRNA expression of IRG1 in healthy controls was significantly lower than that in patients with tuberculosis and LTBI ( P<0.05 ).The AUC for using IRG1 mRNA levels (>0.01536 ) to identify Mycobacterium tuberculosis infection was 0.91, with 76.47% sensitivity, 96.30% specificity, LR 20.65,and 85.2% of cases correctly classified.Conclusion: IRG1 may be used as a biomarker for diagnosing Mycobacterium tuberculosis infection.

Objective To estimate the diagnostic value of dual-energy CT in gouty arthritis.Methods English and Chinese litera-tures publicated before May 2014 were searched in PubMed,Embase,Cochrane and Wanfang database.Available literatures were selected according to the inclusion and exclusion criterias.Sensitivity,specificity with 95% confidence interval (95% CI)was pooled with bivariate random-effects model.Hierarchical weighted symmetric summary receiver-operating curve (HSROC)was also used in estimating.Meta-regression and sensitivity analysis were used to explore the potential sources of heterogeneity.Results Nine studies were included in the analysis.The pooled sensitivity,specificity and 95% CI were 92%(84-96%)and 88%(83-92%)respectively, area under the HSROC curve was 0.91 (0.88-0.93).There was substantial heterogeneity between studies(I 2 =85%).Conclusion Dual-energy CT is accuracy in diagnosing gouty arthritis.The sources of heterogeneity was not been explored.

Objective To observe the effect and safety of intravesical perfusion of theprubicin ( THP) on postoperative recurrence of normuscle invasive bladder cancer .Methods According to digital table , a total of 58 cases received bladder cancer surgery were randomly divided into observation group and control group .All patients were treated by TURBt surgery .Patients in observation group were treated by THP intravesical perfusion , while patients in control group were treated by intravesical perfusion of mitomycin ( MMC) .A 1-year follow-up was conduc-ted to evaluate the recurrence rate and the toxicity .Results The recurrence rate of observation group in the follow-up period was 10.3%,while the control group was 20.7%,the difference was significant (χ2 =13.880,P<0.05).The incidence rate of toxicity of the observation group was 24.1%,which was lower than 27.5%of the control group ,but the difference was not significant (χ2 =0.090,P>0.05).The incidence rate of Ⅱ-Ⅲgrade toxicity in the observation group was 6.8%,while the control group was 17.2%,the difference was significant (χ2 =16.960,P <0.05). Conclusion The THP intravesical perfusion can prevent postoperative recurrence of normuscle invasive bladder cancer,with less toxicity.THP is effective,safe and reliable.

Objective To explore the points of nursing cooperation during double pedicle of forehead flap for repair of mouth scar contracture deformity.Methods The psychological nursing,equipment and instrument preparation,cooperation of instrument nurses and circuit nurses were summarized in 15 cases of an expanded forehead flap for repair of mouth scar contracture.Results The operation process was smooth,all the flaps survived,repair effect was good,no complications occurred.Conclusions Burn plastic surgery specialist nurses in operation room giving careful preoperative visit and nursing risk assessment can alleviate the psychological pressure of the patients,reduce the defects of nursing.Close cooperation during operation and effective environmental management is critical for successful completion of operation.

Objective:To investigate the method of how to realize one stop payment service between hospitals, enrich its connotation, and expand its outreach.Methods: The establishment funds unified trading platform can realize the settlement of one stop payment service between hospital, and at the time achieve a unified account management, real-time account transactions, and perfect reconciliation.Results: Through the research, we can conclude that we can realize the one stop payment service between hospitals, and will improve the usage and satisfaction of the system, achieve better results.Conclusion: With the deepening of the one stop payment service model, it will play a greater role; achieve more satisfactory economic and social benefits.

Objective To evaluate the effect of the percutaneous nephrolithotomy ( PCNL) in the manage-ment of complicated upper ureteric calculi , compared with retroperitoneal laparoscopic ureterolithotomy ( RLU ) . Methods Seventy-one cases with complicated upper ureteric calculi were retrospectively investigated ( PCNL group 23 cases,RLU group 29 cases).Clinical data including operation time ,stone free rate and the surgical complications were statistically analyzed .Results All the operations were successful in all 52 cases.Compared with the RLU group,the PCNL group had a significant shorter operation time [(45.12 ±11.56)min vs (82.03 ±12.45)min,t=10.13,P<0.01],and significant difference were detected .A week after the operation,the PCNL group showed a stone free rate of 95.6%(22/23) while the RLU group 100.0%(29/29),and no significant difference were detec-ted.No significant complications ,such as intraoperative or postoperative bleeding and damage to surrounding organs , were detected.The patients were followed up for 6 to 12 months(mean,9 months),and no recurrent stones or ureteral stricture were developed during the period .Conclusion Both PCNL and RLU are safe and effective for complicated upper ureteral calculi.The appropriate method depends on the patients′specific conditions,the unit equipments and the experience of operator .

BACKGROUND: It is necessary to keep a good cervical curvature for improving nerve symptom in patients with cervical spondylotic myelopathy (CSM). It is verified that cervical anterior plate internal fixation implant is effective to restore the physiological curvature of cervical vertebra.OBJECTIVE: To assess the physiological lordosis of cervical vertebra in CSM patients after cervical anterior plate internal fixation implantation.DESIGN: Observational study.SETTING: First Affiliated Hospital of Nanchang University.PARTICIpANTS: Totally 72 CSM patients were enrolled at Department of Orthopaedics, First Affiliated Hospital,Nanchang University from February 2003 to January 2006, including 46 males and 26 females, aged 45-70 years,averagely 54 years, with the history of 2-6 years. Inclusive criteria included ①cervical spinal cord compression shown in MRI, and ②using autogenous iliac bone. The experiment was approved by Hospital Ethics Committee, and all patients signed the informed consent. Cervical anterior plate was Orion locking plate offered by Shufamo Company. There were single segmental discectomy group (n =32) and two-level segmental discectomy group (n =40) according to experimental requirement.METHODS: ①Anterior decompression plus autogenous iliac bone implant plus titanium plate internal fixation were utilized.The patients were in supine position; shoulder and back were blocked up; neck backward, and endotracheal tube was done under general anesthesia. Transverse or oblique incision was made at right anterior neck. Discectomy decompression was performed with Caspar vertebra ecarteur. Three-dimensional autogenous iliac bone was implanted in decompressed intervertebral space. Immediate stability was obtained after Orion locking titanium plate was fixed, with placement drainage, and then the incision was sutured. ②Postoperative daily activities were conducted with cervical gear, which was removed 8 weeks later. ③Lateral cervical vertebrae X-rays were taken before operation, immediately after operation, 6 and 12 months after operation. Lordosis of the fusion segment was measured with Cobb's angle, and lordosis of cervical vertebra was assessed with D value. These data were analysed by statistic software. ④Bone fusion of the patients was followed up for 12 months after operation. Vertebral fusion standards included no abnormity between two spinous processes of the fusion segment, no lucency between implant and vertebra, as well as bone trabecula across the interface between implant bone and vertebra. ⑤Biocompatibility between material and host was observed during follow-up.MAIN OUTCOME MEASURES: ①Changes of Cobb's angle and D value at different time points before and after operation,and ②Bone fusion and rejection were followed up.RESULTS: Totally 72 patients were involved in the result analysis. ①Cobb's angle was larger and D value was higher immediately after operation, 6 and 12 months after operation than those before operation in the single segmental discectomy group and the two-level segmental discectomy group (P＜0.05). ②Findings of 12-month follow-up showed that bone fusion appeared in all patients of the two groups. ③No significant rejection was found after titanium plate internal fixation implantation. It was found that material and host had a good biocompatibility.CONCLUSION: It is satisfactory to restore physiological lordosis of cervical spine by using cervical anterior plate internal fixation plus autogenous iliac bone for CSM.

Objective To explore the auricular application pressure added dietary intervention of perimeno-pausal syndrome (PS)the influence of women's sex hormone levels.Methods Research subjects were randomly divided into two groups.The observation group was given auricular application pressure to add dietary intervention, control group was given dietary intervention alone.Before and after six months of follow -up,sex hormone levels in the blood were monitored.Results After the intervention,the estrogen level of the observation group was (272.93 ± 15.71)pmol/L,progesterone was (3.14 ±0.47)nmol/L,which of the control group was (186.32 ±12.80)pmol/L, (2.86 ±0.34)nmol/L;After the intervention,the follicular thorn hormone content of the two groups were decreased, which of the observation group was (12.88 ±1.50)U /L,which of the control group was (21.35 ±4.70)U /L;The perimenopausal symptoms were reduced,Kuppermun score in the observation group were (9.36 ±1.41 )points, (10.43 ±1.63)points,the difference between the two groups were statistically significant (t =40.15,4.52,3.82, 4.65,all P <0.01)for the control group.Conclusion Auricular application press fit dietary intervention for patients with perimenopausal syndrome sex hormone regulation of metabolic disorders has obvious effect,can significantly improve the patients'symptoms of the menopausal transition,it is worthy of further research on intervention measures.

Objective To investigate the relationship between proliferative diabetic retinopathy and E-selectin level .Meth-ods Ninty-two patients with diabetic retinopathy were divided into two groups based on the results of fundus fluorescence angiography :basic diabetic retinopathy (BDR) group, and proliferative diabetic retinopathy (PDR) group.Body mass index (BMI), fasting blood-glucose (FPG), total cholesterol (TC), triglycerides (TG), hemoglobin A1c (HbA1c), systolic blood pressure (SBP), diastolic blood pressure ( DBP) , and E-selectin levels of two groups were determined and compared .Results Compared with normal control group, the BDR and PDR group soluble E-selectin (sE-sel), FPG, HbA1c levels were increased significantly ( P <0.05).There was no significant difference in the SBP, DBP, BMI, TC, and TG levels in BDR group compared with control group ( P >0.05).The level of E-sel was positively correlated with HbA 1c and FBG in diabetic retinopathy patients .Conclusions High levels of sE-sel, HbA1c, and FPG were the important risk factors for diabetic retinopathy , and were closely related to the severity of PDR .Detection of serum sE-sel and HbA1c will help to predict the severity and prognosis of diabetic retinopathy .

Objective To investigate the feature of Th1 cytokines induced by Mtb-specific antigen in patients with refractory pulmonary tuberculosis.Methods 28 patients with refractory pulmonary tuberculosis,67 patients with first-treated pulmonary tuberculosis,and 25 healthy controls with positive T.spot (LTBI group) were enrolled.IFN-γ,IL-2 and TNF-α in supernatants from PBMCs stimulated with ESAT-6 and CFP-10 were analyzed with Bender Flowcytomix on flow cytometry.Results The levels of the three cytokines were utmost high in patients with first-treated pulmonary tuberculosis.The lowest level of IFN-γ and IL-2 were induced in patients with refractory pulmonary tuberculosis,and were significantly lower than the LTBI group(Mann-Whitney U ＝ 105.5,162.5,P ＜ 0.01).Conclusions The immunotherapy with IFN-γ and IL-2 may play a role in treatment for refractory pulmonary tuberculosis but not for most of first-treated pulmonary tuberculosis.