Objective To analyze the recent changes in features of joint injury caused by the fast running railroad train. Methods 1279 joint injuries o f the 10214 cases of train injury after the speeding up of the railway services from 1997 to 2003 were analyzed to find out their particular causal conditions, the severity of the injury, and the classification of the injuries, the correlat ion between which and recovery was also tested by AIS-ISS grading. Results Afte r the speeding up of the railway services, the incidence of joint injuries rose from 33.54% to 34.12%,the mortality rose from 22.88% to 30.33%,the multipl e joint severances rose from 19.84% to 34.19%,the open joint injury rose from 31.71% to 63.15%,and the mortality caused by multiple joint severances rose from 21.19% to 49.07%. Conclusions The incidence of multiple traumas resulted from the train is much higher than those resulted from other causes. Multiple t raumas caused by train are very difficult to deal with. The multiple organ dysfu nction syndrome (MODS) is a main factor to cause the death.

ObjectiveTo develop the manipulation and scoring system of Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) into a Chinese software.MethodsThe manual manipulation and scoring system of LOTCA was developed into a technological procedure and changed into primary product of software through conforming computer programs such as Basic, C, C++ and Flash Maker. The primary product was tested in clinic and feedback suggestions were collected. The questions found during assessment and items with reliability and validity not satisfied were optimized.ResultsThe Chinese software of LOTCA, including mandarin and Cantonese, composed manipulation system, scoring system, administer system and affiliated system. It could run on systems of Windows 2000 and Windows XP.ConclusionThe Chinese software of LOTCA is objective, standard and convenient for clinic.

Objective To investigate the clinical manifestations and MR imaging features of olivopontocerebellar atrophy(OPCA).Methods The clinical data and MR findings of 8 patients with OPCA (OPCA group) were retrospectively analyzed,and 75 cases of healthy physical examination people were chosen as control group (they were divided into 21-30 years group,31-40 years group,41-50 years group,51-60 years group,61-70 years group,and 15 cases in each group),all subjects under went pons measurement.Results All 8 patients with OPCA were sporadic cases.The cerebellar symptom,autonomic symptoms and extrapyramidal symptoms were common manifestations.The head MR imaging of OPCA presented with cerebellum and brain stem atrophy,cross sign was the characteristic appearance.Vertical diameter and anteroposterior diameter of the pons in OPCA group patients was (20.63 ± 2.16) and (16.74 ±4.37) mm,compared with control group [(27.14 ±1.73) and (22.28 ± 1.49) mm],there was significant difference (P ＜ 0.01).In control group,vertical diameter and anteroposterior diameter of the pons maximum in 21-30 years group and 31-40 years group,increased with age,the value had been reduced,but there was no significant difference (P ＞ 0.05).Conclusion MR is the first choice for the diagnosis of OPCA,combine with clinical manifestations may improve the diagnostic accuracy.

BACKGROUND:Tantalum rod implant technology is a new method of early osteonecrosis treatment. Current research on stress distribution before and after tantalum rod implant in different sizes of femoral head necrosis area is few. OBJECTIVE:To analyze the stress distribution before and after tantalum rod implantation in different sizes of necrotic femoral head area using three-dimensional finite element method. METHODS:Three-dimensional finite element models of normal femoral head and necrotic femoral head of 15, 20 and 30 mm diameterwere constructed. Eight measuring points were chosen on two tiers of each necrotic model to detect the stress distribution and its alteration before and after tantalum rod implantation. RESULTS AND CONCLUSION:(1) Stress concentration werefound on every necrotic femoral head, most pronounced on the one with 30 mm lesion. (2) Tantalum implant appeared to reduce the stress concentration generaly. Comparison of the peak points of these models indicated most significant benefit in 15 mm lesion, next in 30 mm lesion, last in 20 mm lesion. (3) Results indicate that larger lesion entails more concentrated stress distribution and more likely to colapse. Tantalum rod implantation can delay the development of necrosis of the femoral head, andismost effective in smal lesion.

Adolescent ; Adult ; Female ; Humans ; Male ; Meridians ; Middle Aged ; Moxibustion ; Spondylitis, Ankylosing ; therapy ; Young Adult

Acupuncture Therapy ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Periarthritis ; physiopathology ; therapy ; Shoulder Joint ; injuries ; physiopathology ; Young Adult

Objective To studythe cephalocaudal relationship ofabdominal aortic bifurcation relative toumbilicus and iliac crest vertex and their correlations with abdominal adipose tissue thickness and age. Methods The vertical distances,cephalocaudal relationship and other related anatomic parameters of aortic bifurcation relative to umbilicus and iliac crest vertex in 108 patientswere measured by consecutive abdominal CT scanning. The correlations of the acquired data with abdominal adipose tissue thickness and age were analyzed using Pearson correlation coefficient. Results Umbilicus was located at cephalad to aortic bifurcation in 67 patients(62.0%), caudal in 34(31.4%)andthe same level in 7(6.5%),with the vertical distance of(4.53 ± 17.51)mm to the aortic bifurcation. No statistically significant relationship was found between abdominal adipose tissue thickness(P>0.05) or age(P>0.05). Iliac crest vertex relative to aortic bifurcationwas located at cephalad,caudal and the same level in 31,71 and 6 patients,taking up 28.7%,65.7%and 5.6%,respectively. Its vertical distance to the bifurcation was(-6.34 ± 14.49)mm,nonrelated with abdominal adipose tissue thickness(P>0.05),but positively correlated with age(P<0.01). The difference in the cephalocaudal relationship of aortic bifurcation relative to umbilicus and iliac crest vertex was statistically significant(P<0.01). Conclusion Compared with iliac crest vertex,umbilicus is an important landmark of locating abdominal aortic terminal occlusion position in vitro because it mostly lies cephalad to aortic bifurcation in the front of the body,not easy to vary with abdominal adipose tissue thickness and age.

Objective CD8 +T cells increased in the airway of patients with chronic obstructive pulmonary disease and exis -ted constantly .The aim was to investigate the role of CD 8 +T-cells in rats with chronic bronchitis ( CB) which was induced by cigarette smoking and intratracheal injection with lipopolysaccharide ( LPS) . Methods 18 health Wistar rats were radomly divided into sham smoking group(group A), CB group(group B) and N-acetylcysteine prevention group (group C).The rats in group B and group C re-ceived intratracheal injection with LPS twice and exposed to cigarette smoking for 4 weeks to induce CB model .The rats in Group C re-ceiving intragastric administration with N-acetylcysteine (NAC)(200mg/kg) before received LPS and smoking.Group A was the sham smoking group.The lung tissue of all rats were stained by HE then evaluated about pathological scores .The expression of nuclear fac-tor-κB (NF-κB), major histocompatibility complex class I (MHCI), CD8 +T cell and Vascular endothelial growth factor (VEGF) in airway were detected by immunohistochemisty which was stained by labeled streptavidin biotin method . Results The pathological scores of airway ( 10 .83 ±3 .31 ) in group B were higher than (1.17 ±2.40) in group A(P <0.05).The pathological scores of airway(4.66 ±2.25) in group C were less than (10.83 ±3.31) in group B(P <0.05).The expression of NF-κB(4.84), MHC I (2.48),CD8 +T cell(5.35)and VEGF(5.02) in airway increased in group B when compared with (1.18, 1.25, 1.33) and (1.18) in group A respectively(P <0.05).The expression of NF-κB (2.18), MHC I(1.46),CD8 +(2.35)and VEGF(2.02) in airway decreased in group C when compared with (4.84), MHC I(2.48),CD8 +T cell(5.35)and VEGF(5.02) in group B respectively (P<0.05 ). There were positive correlations between the expression of NF-κB, MHC I and CD8 +T cells in airways(r=0.670, r=0.701, respec-tively, all P<0.01).There were positive correlations between the expression of CD 8 +T cells and VEGF the pathological scores of air-ways(r=0.689, r=0.782, respectively, all P<0.01). Conclusion NAC can inhibit airway inflammation which is regulated by CD8 +T-cells and VEGF through suppressing the expression of NF -κB and MHC I.

Objective To evaluate the effects of serum procalcitonin (PCT)-guided antibiotic therapy in elderly patients with early-onset stroke-associated pneumonia (EOP).Methods Totally 179 eligible elderly patients with EOP were randomly devided into 2 groups:standard therapy group (standard group,n=88) and PCT-guided group (PCT group,n=91).Patients in standard group received antibiotics according to antibiotics guidelines in China by the treating physicians.Patients in PCT group were treated with antibiotics for 5 days,then the antibiotic treatment was based on serum PCT levels as follows:discouraged if PCT＜0.25 μg/L and encouraged if PCT≥0.25 μg/L.Length of hospitalization,duration of antibiotics,costs of hospitalization and antibiotics,clinical efficacy,andmortality,National Institutes of Health Stroke Scale (NIHSS) score and Barthel index (BI) on the 28th day were observed.Results There were no significant differences in clinical efficacy,mortality,NIHSS score and BI between the two groups on the 28th day [(85.7％ vs.86.3％),(8.8％ vs.7.9％),10.1 (7.8,16.2) vs.9.8 (6.0,15.5),60.1(42.5,82.3) vs.57.9 (39.2,84.8),respectively,all P＞ 0.05].The length of hospitalization,antibiotic duration,costs of hospitalization and antibiotics were lower in PCT group than in standard group [19 (10,38) d vs.26(17,42) d,10 (7,14) dvs.15 (6,21) d,3350 (2052,6163) yuanvs.10355 (6877,15421) yuan,7532 (4810,12116) yuan vs.5358 (3089,8144) yuan,respectively,all P＜0.05].Conclusions PCT guidance of antibiotic therapy is effective and safe for the treatment of early-onset stroke associated pneumonia in elderly patients.It can reduce the antibiotic duration and costs of hospitalization.

Objective To detect the expression of VIP1R and VIP2R mRNA in gallbladder tissues of patients with gallbladder diseases. Methods The expression of VIP1R and VIP2R mRNA in gallbladder tissues were detected in 25 patients with gallstone, 8 patients with gallbladder polyps and 7 control liver transplantation donors by RT-PCR. Results The VIP2R mRNA level of the control group (1. 09 ?0. 58 ) was lower than that of the gallbladder polyps group (1.64?0.56 ),P