Objective To investigate the effect of three-level network of vaccination on immunization rates of planned immunization vaccine,and provide science basis for planned immunization work.Methods Immunization rates of children in 131 villages under administration of Xiaolan People's Hospital of Zhongshan were investigated according to PPS from 2007 to 2010,and were compared before and after the establishment of three-level network of vaccination.Results After the establishment of three-level network of vaccination,rates of certification,and vaccination rates of OPV,DPT,and HBV were all increased significantly,vaccination rates of BCG were not raised obviously.Conclusions The establishment of three-level network of vaccination can increase immunization rates of planned immunization vaccine.

Objective To evaluate the role of fetal brainstem-vermis (BV) and brainstem-tentorium (BT) angles in differential diagnosis of fetal cereballar vermis anomalies by three-dimensional ultrasonography. Methods A total of 335 normally developed fetuses at 18-34 gestational weeks were examined prospectively in Prenatal Ultrasound Center of Suzhou Municipal Hospital from July 2013 to July 2014 by three-dimensional ultrasonography scanning. The BV angles and BT angles were measured at the mid-sagittal sections of fetal heads which were obtained by three-dimensional ultrasonography. Sixteen fetuses with abnormal cerebellar vermis were selected. The BV angles and BT angles were measured and compared with the measurements of normal group. Results In normal fetuses, the mean of BV angles was (3.3±1.7)° , ranging from1.0 to 10.0°;the mean BT angle was (31.5±6.9)° , and ranging from 16.6 to 57.8° . In 16 cases of abnormal cerebellar vermis, 4 cases of Dandy-Walker Malformation (DWM) showed significantly upward rotated cerebellar vermises, the BV angles increased significantly (88.9±18.1)° , the cerebellar tentoriums were superior displaced, the BT angles increased remarkably (89.0±12.8) ° ;6 cases of Dandy-Walker variant (DWV) showed upward rotated cerebellar vermises, with increased BV angles (23.7±5.2) ° , and slightly increased BT angles (54.5±12.0)°;6 cases of Blake′s pouch cyst (BPC) showed upward rotated cerebellar vermises were, mildly increased BV angles (16.7±1.8)° , and slightly increased BT angles (50.3±8.2)° . The comparison results showed:BV angles increased with increasing severity of the condition in BPC, DWV and DWM;BT angles increased significantly in DWM. Conclusions The measurements of BV angles and BT angles are valuable in the differential diagnosis of fetal cereballar vermis anomalies. From 19 gestational weeks, a BV angle>60° is strongly suggestive of a Dandy-Walker malformation, while a measurement>10.0° and<20° favors the diagnosis of Blake′s pouch cyst.

Objective To investigate the effect of pre-treatment of ginkgo biloba extract from portal vein on oxidative stress in liver surgery.Methods Sixty cases of hepatic portal occlusion for hepatectomy surgery in patients (38 males, 22 females, ASA grade Ⅰ or Ⅱ, cardiac function Ⅰ or Ⅱ, Child-Pugh class A), were randomly divided into three groups (n=20 each): portal vein injection group (group P), jugular vein injection group (group J) and control group (group C).Patients in group P were injected with ginkgo biloba extract injection 5 ml slowly from portal vein after freeing the portal vein, patients in group J were injected with ginkgo biloba extract injection 5 ml slowly from the jugular vein after freeing the portal vein, while patients in group C were injected with normal saline 5 ml slowly from the jugular vein after freeing the portal vein.Venous blood samples were drawn from jugular vein at the following time points: pre-occlusion ten minutes (T0), 1 h (T1), 6 h (T2), 24 h (T3) after reperfusion respectively, and then detected the levels of ALT, AST, tumor necrosis factor(TNF-α), manlondialdehyde (MDA) and the activity of superoxide dismutase (SOD).Results Compared with T0, the serum levels of ALT, AST, TNF-α and MDA at T1-T3 were significantly increased,the activity of SOD was significantly decreased in all groups (P＜0.05).Compared with group C, serum levels of ALT, AST, TNF-α and MDA at T1-T3 were significantly decreased, the activity of SOD was significantly increased in groups J and P (P＜0.05).Compared with group J, serum levels of ALT, AST, TNF-α and MDA at T1-T3 were significantly decreased, the activity of SOD was significantly increased in group P (P＜0.05).Conclusion The pre-treatment of ginkgo biloba extract from portal vein can increase the SOD activity, inhibit the activation of Kupffer cells, reduce the release of TNF-α, enhance the ability of anti-oxidative stress and produce significant protective effect on liver ischemia-reperfusion injury.

Objective To explore whether the PDA patients in the early stage of Eisenmenger syndrome can accept interventional surgery. Methods Three patients were choose from the “National Multicenter Prospective Registration Study on Pulmonary Artery Hypertension”, Clinical assessment, as well as examinations and registrations associated with PAH, was conducted in accordance with relevant provisions of the registration study within 1 wk prior to surgery. The way of the interventional treatment were right heart catheterization and pulmonary vasodilator testing (a capsule of iloprost solution for inhalation), and measurement of the pulmonary arterial pressure, descending aortic pressure, ratio of pulmonary to systemic blood flow, ratio of pulmonary to systemic blood pressure, pulmonary capillary wedge pressure [mean≤15 mmHg(1 mmHg=0.133 kPa)], before and after testing. After clear the results of pulmonary vasodilator test all patients underwent transcatheter closure testing, if it was positive,the amplatzer was released if her family members’ approved;Conversely, the amplatzer was quickly withdrawn with negative results, and symptomatic treatment was conducted based on the patient’s clinical symptoms. Results The first cases pulmonary vasodilator test was negative, but positive in transcatheter closure testing. Satisfaction immediate effect of surgery, and the occluder was released with her family members’ approval. patients of Example 2 and Example 3 were negative in pulmonary vasodilator testing and transcatheter closure testing, can not released the occluder. Conclusions Some Patents Ductus Arteriosus (PDA) patients in early stage of Eisenmenger syndrome is feasible to accept interventional therapy , try plugging test is may be an important indicator of prognostic assessment.

ObjectiveTo investigate the postoperative 3D MRI appearances and their evolvement patterns of ACL grafts and bone tunnels at follow-up.Methods There were 26 double bundles ACL reconstructions and 16 single bundle ACL reconstructions,and a total of 56 follow-up 3D MR Imaging.MR images were reconstructed with MPR technique to evaluate grafts,bone tunnels,fixers and associated.complications.Proportions of grafts with hypointensity or hyperintensity and occurrence rates of marrow edema around bone tunnels were calculated respectively among groups of different periods after operation.ResultsThere were 24 grafts of hypointensity and 32 grafts of hyperintensity.Grafts of 2 cases were suspended with cross pins within femoral tunnels,graft of 1 case was suspended with an endobutton within the femoral tunnel,and grafts of other sites were fixed with interference screws.In the three periods as 3 months,6 to 9 months and over 12 months after cruciate ligament reconstruction,proportions of hypointensive grafts were 20/25,0/14 and 4/10 respectively,while proportions of hyperintensive grafts were 5/25,14/14 and 6/10 respectively,occurrence proportions of marrow edema around bone tunnels were 54/54,10/32 and 4/26 respectively.There was 1 tear graft,4 tibial tunnels placed anteriorly with ACL graft impingement on the intercondylar roof,3 femoral tunnels placed anteriorly,and 2 bone tunnels with mismatching interference screws.Conclusion3D MRI can accurately demonstrate the state of ACL grafts,bone tunnels,fixers and associated complications.Intensity of grafts presented a rise and reduce pattern after operation.

Objective To study the characteristics of patients with low body mass index (BMI) chronic obstructive pulmonary disease(COPD). Methods A total of 38 clinically stable patients with moderate-to-severe COPD were enrolled. They were divided into two groups: underweight (UW) group (n=16,BMI<20);normal weight(NW) group(n=22, 20≤BMI<26). Body height and weight, smoking indexs, and six minutes walk distance (6MWD) were assayed. The British Medical Research Council (MRC) dyspnea scale was used to assess the degree of dyspnea. St. George's Respiratory Questionnaire (SGRQ) and Short Form 36 item Questionnaire (SF-36) were used for health-related quality of life (HRQoL) evaluation. The serum concentrations of leptin and ghrelin were detected by enzyme-linked immunosorbent assay (ELISA). Results Compared with the NW group, the inspiratory eapacity(IC), forced expiratory volume in one second (FEV), vital capacity (VC) ,most ventilate volume (MVV) and peak expiratory flow(PEF) were lower(P<0. 05) in the UW group. Residual volume-to-total lung capacity ratio (RV/TLC), smoking indexs and MRC score were higher (all P<0. 05) and 6MWD was significantly lower (P<0. 05) in the UW group than in NW group. Activity scores,impact scores and total scores of SGRQ showed significant deterioration in the UW group (P<0. 05). SF-36 also showed significantly worse scores for the parameters of the emotional and social functioning (P < 0. 05 ). Serum leptin was significantly lower ( P< 0.01 ) and ghrelin was higher in UW group than in NW group (P<0. 05). Stepwise multiple regression analyse showed that lC,mental health(MH) and physical function (PF) of SF-36, leptin,6MWD and smoking indexs were independently correlated with BMI. Conchtsions The pulmonary function, nutritional status, PF and life quality of COPD patients with low BMI were more deteriorative. The most significant influencing factor for BMI in COPD patients was IC. M H,exercise capacity,leptin level and smoking indexs were independently correlated with BMI in COPD patients. It is important to retrieve low BMI in the management of COPD patients.

Objective To discuss the value of MR T2 mapping in the research of the biomechanics and function of cartilage of knee joint.Methods Knees of 20 healthy adults before and after jogging and 19 osteoarthritis patients were examined with sagittal 8-echo SE sequence.The T2 value of cartilage was selected and calculated.The T2 values in the superficial and deep cartilage of femoral and tibial joint before and after jogging were compared,so did between the osteoarthritis patients and healthy adults.The source images were sent to the workstation to get T2 mappings.The T2 value of cartilage between before and after jogging was compared with paired-samples t test.The T2 value between superficial and deep cartilage before jogging was compared with independent-samples t test,so did between the osteoarthritis patients and healthy adults.Results The T2 values in the superficial and the deep tibial cartilage were(48.8±6.3)ms,(44.3±5.7)ms before jogging and(43.4±5.0)ms,(40.3±6.1)ms after jogging.The T2 values were significantly different between before and after jogging(t=6.004 and t=5.037,P＜0.05).There was a significant difference between superficial and deep tibial cartilage before jogging(t=3.148,P＜0.01).The T2 Values in the superficial and deep femoral cartilage were(52.1±5.7)ms,(47.7±5.3)ms before jogging and(47.2±4.5)ms,(43.6±4.1)ms after jogging.The T2 values were significantly different between before and after jogging(t=6.169 and t=5.957,P＜0.05).There was a significant difference between superficial and deep femoral cartilage before jogging(t=3.384,P＜0.01).The T2 mapping showed those changes.The mean T2 value in the tibial cartilage of osteoarthritis patients was(56.0±9.1)ms and was higher than that of healthy adults.There was a significent difference between osteoarthritis patients and healthy adults(t=-3.446,P＜0.01).Conclusion T2 mapping can be used in the research of biomechanics and function of cartilage and has a prelimilary value in the diagnosis of cartilage degeneration.

Objective To investigate the effect of slice orientation on the popliteomeniscal fasciculi (PMF) MR imaging and its normal MRI appearances. Methods Volumetric MRI data of 40 knees of healthy volunteers were acquired using an isotropic 3D turbo spin echo (TSE) MR sequence. The posterior tangential line to both femoral condyles was used as the reference line, and the long axis sectional images of the popliteal hiatus region were reformatted at 0°, 15°, 30°, 45°, 60°, 75° and 90° to the reference line. The MRI appearances of the PMF were scored respectively and classified. The final scores of the PMF at each slice angle were statistically analyzed by a repeated measure ANOVA. Results At 0°, 15°, 30°, 45°, 60°, 75° and 90° slice angles: scores of the anteroinferior fasciculi were (1.7±0.7), (1.8±0.6), (1.9±0.6), (2.0±0.7), (1.9±0.7), (1.8±0.8) and (1.0±0.5),respectively. Scores of the posterosuperior fasciculi were (1.5±0.7), (1.9±0.7), (2.1±0.6), (2.2±0.6),(2.2±0.6), (2.0±0.8) and (1.7±0.8), respectively. There were statistically significant differences in the average scores at each slice angle for both anteroinferior fasciculi (F = 29.744, P = 0.000) and posterosuperior fasciculi (F = 19.770,P =0.000). The anteroinferior fasciculi and the posterosuperior fasciculi had highest average scores at the angle of 45°. The percentage of type A, B and C of anteroinferior fascicali were 20.0% (8/40), 75.0% (30/40) and 5.0% (2/40), respectively. The percentage of type A, B and C of posterosuperior fasciculi were 37.5% (15/40) ,62.5% (25/40) and 0% (0/40) ,respectively. Conclusion The anteroinferior fasciculi and the posterosuperior fasciculi can be well depicted at the angle of 45° slice orientation.

Objective To understand the molecular epidemiology of penicillin resistance Streptococcus pneumonia (PNSP) isolated from children in Guangzhou area to provide the experimental basis for clinical prevention and control of Streptococcus pneumonia infectious diseases.Methods Specific primers were designed according to Genebank,penicillin binding protein(PBP) genes PBP1A,PBP1B,PBP2A,PBP2B,PBP2X,PBP3 were amplified by PCR.The sequencing analysis was performed.The PCR products were digested by Hinf I,and the restriction fragment length polymorphism (RFLP) was analyzed.Results DNA of PNSP was successfully extracted,the PCR results showed that in 50 strains of PNSP,the positive rates of bacterial strains containing PBP1A,PBP1B,PBP2A,PBP2B,PBP2X and PBP3 were 48.9%,64.4%,71.1%,31.1%,40.0% and 31.1% respectively.The sequencing showed that their homologies with known sequences in GenBank were 99%,98%,100%,97%,95% and 100% respectively.Using RFLP in Hinf I showed that PBP1A,PBP1B,PBP2A and PBP3 only had one kind of genotype,PBP2B and PBP2X had two kinds of genotypes,the positive rates were 71.4%,28.6%,66.7% and 33.3% respectively.Conclusion The gene distribution of PNSP strains among children in Guangzhou is dominated by PBP2A,PBP1B and PBP1A,there are two subtypes in PBP2B,PBP2X when digested by Hinf I,in which the predominant subtype >65%.

Diskectomy, Percutaneous ; Endoscopy ; Intervertebral Disc Displacement ; Lumbar Vertebrae ; Minimally Invasive Surgical Procedures ; Spine ; surgery ; Treatment Outcome