Objective To search for the CT and MRI morphological changes in the child patients with cerebral palsy. Method The CT scranning and MRI were carried out in 150 child patients with cerebral palsy, andthe results were analysed. Results In 150 cases, 97 cases (54.6 per cent) have abnormal findings of CT scranning. Diffuse ence-phalatrophy (42 cases), encephalomalacia focus (24 cases) porencephaly (9 cases), and localized ence-phalatrophy (7 cases) ect are the common CT morphological changes in the patients with cerebral palsy.In the 53 patients with normal findings of CT scranning, MRI was carried out for 30 cases and 25 cases(83.3 per cent) were abnormal. The delayed myelinogeny of white matter of brain is the main MRI mor-phalogical abnormality. Conclusion CT scranning and MRI have important value on the etiological diagnosis for child patientswith cerebral palsy. The combination of them can improve the diagnostic accordance rate.

Objective To explore the lower limbs joints movement of patients with unilateral and primary artificial hip replacement in convalescence. Methods 100 cases of patients with unilateral and primary artificial hip replacement in convalescence were chosen as the ob-servation group,while 100 cases of matched healthy subjects were included as the control groups. The three-dimensional kinematics and mo-tion of lower extremities were monitored. Results The difference in operated knee flexion,operated ankle planter flexion and operated hip flexion of the observation group and the observation group were statistically significant(P<0. 05). The difference in the joint angle peak of hip backward extension of sagittal section,hip adduction of frontal plane,knee adduction of frontal plane,ankle adduction and outreach of frontal plane,hip internal rotation and extorsion of horizontal plane,ankle rotation and extorsion of horizontal plane in two groups were statisti-cally significant(P<0. 05). Conclusion There are abnormal prosthetic joint movement,limited range of operated movement in patients with unilateral and primary artificial hip replacement in convalescence,and coterminous kinematic chains appear compensatory changes,it should strengthen the muscle exercises of operated hip.

Objective To detection the carrying situation of Clostridium difficile toxin gene A/B in stool specimens of the pa-tients with ulcerative colitis (UC) and persons undergoing physical examination and to research the relationship between Clostridium difficile toxin gene carrying and UC.Methods The stool specimens were collected from 53 cases of UC(32 cases of active stage and 21 cases of resting stage) and 45 persons undergoing physical examination.Total DNA was extracted from stool specimens.The Clostridium difficile toxin gene cdtA and cdtB were detected by real-time PCR ,then the PCR products were amplified and performed the agarose gel electrophoresis and gene sequencing for conducting the amplification products verification.Results 7 cases of cdtA and 4 cases of cdtB were checked out in the UC group ,in which 5 cases of cdtA and 2 cases of cdtB were in the UC active stage group ,2 cases of cdtA and 2 cases of cdtB were in the UC resting stage group.In the healthy control group ,5 cases of cdtA and 2 cases of cdtB were checked out.The detection rate of cdtA and cdtB had no statistically significant difference between the UC group and healthy control group(P>0.05).There was no statistically significant difference between UC active group and inactive group (P>0.05).Conclusion There is no appearant correlation between the carrying situation of cdtA and cdtB in stool with UC onset and UC stage.

Objective To investigate the distribution and susceptibility of carbapenem resistant citrobacter freundii for rational antimicrobial therapy.Methods The C.freumdii were collected between January 2011 and December 2014 from inpatients.The minimum inhibitory concentration (MIC) were detected by an automated analyzer (VITEK 2) to analyze the characteristic of tested bacteria.Results (1) Of the 21 strains of carbapenemresistant citrobacter freundii,95％ were collected from urine,among which most of the strains were isolated from the Department of Transplantology (66.7％) and Urology (19％);(2) Antimicrobials Susceptibility test showed that Citmbacter freund were highly resistant to Cephalosporins and relevant beta-lactamase inhibitors.Even carbapenem were highly resistant.Imipenem had a resistance rate of 90％ (95％ confidence interval:70 to 99),Meropenem 85.7％ (95％ confidence interval:64 to 97),The drug resistance rate to Amikacin was only 4.8％,followed by Nitrofuran toin (10.5％) and Fosfomycin (15％).Conclusions Carbapenem resistant citrobacter freundii,which often causes urinary tract infection in our hospital,was characterized by multi-drug resistant (MDR).Monitoring of the Citrobaeter freundii should be strengthened to control the prevalence of drug resistance.

ObjectiveTo explore the role of activation and expression of absent in melanoma 2 (AIM2) in pathogenesis of hepatitis B virus (HBV) associated glomerulonephritis (HBV-GN).MethodsFifty-four patients with HBV-GN were recruited into the investigational group,and 25 patients with chronic glomerulonephritis (CGN) and 6 patients with chronic hepatitis B (CHB) were included as negative control group and positive control group,respectively.Immunohistochemistry was used to detect AIM2,Caspase-1 and interleukin (IL)-1β expressions in both kidney tissues from the investigational group and negative control group and liver tissues from positive control group.The differences between groups were compared by chi-square test,and the correlation analysis was conducted by Spearman correlation test.ResultsThe positive expression rates of AIM2 in 54 patients of HBV-GN group and 25 of CGN group were 81.4 ％ and 4.0％,respectively (x2 =38.746,P＜ 0.01).AIM2 was found to be expressed in all 6 CHB patients.In HBV-GN group,the expression of AIM2 was positively correlated with Caspase-1 (rs =0.444,P＜0.01),and the expression of IL-1β was also positively correlated with Caspase-1 (rs =0.515,P＜0.01 ).In HBV-GN group,the expression of AIM2 in patients with HBV DNA≥1 ×105 copy/mL was significantly higher than that in those with HBV DNA＜1 × 105 copy/mL (x2 =6.097,P＜0.05).ConclusionThe activation of AIM2 may play a role in the pathogenesis of HBV-GN through Caspase-1 activation and inflammatory factor IL-1β release.

BACKGROUND: Craniocerebral injury can cause a series of visceral complications, among which cardiovascular complication is paid special attention.OBJECTIVE: To investigate the effects of craniocerebral injury on changes of circulatory and local angiotensin Ⅱ (Ang Ⅱ ) and local angiotensin Ⅱ receptor 1 (AT1) in the heart.DESIGN: Randomized controlled experiment taking animals as subjects.SETTING: Beijing Tiantan Hospital, and the College of Basic Medicine,Capital University of Medical Sciences.MATERIALS: The experiment was conducted at the Central Laboratory of Capital University of Medical Sciences and the Central Laboratory of Beijing Tiantan Hospital from 2003 to 2004. Totally 40 healthy male Wistar rats were divided randomly into craniocerebral injury group and control group with 20 in each group.METHODS: Rats in craniocerebral injury group were treated with weightdrop method to establish the model of craniocerebral injury, while rats in control group received no impact. Twenty-four hours after hitting, 10 rats in each group were selected to assay their Ang Ⅱ and AT1; the other 10 in each group were selected to observe their myocardial forms.myocardium of rats assayed with light microscope after hematoxylin-eosin staining and transmission electron microscope.It was significantly higher in craniocerebral injury group than in control ity: It was obviously higher in craniocerebral injury group than in control Ⅱ and AT1: The area of positive reactant and gray value in craniocerebral toxylin-eosin staining: Strong acidophil staining was found on myocardial cellular plasma in craniocerebral injury group. The results showed that cytoplasm shrank obviously; muscle fiber broke, decreased or disappeared.Focal hydropic degeneration, lysis or necrosis was observed in myocardium.Ultrastructural pathological observation revealed pathological damage of myocardium.CONCLUSION: Craniocerebral injury in rats can cause myocardial damage, and changes of angiotensin system may be one of the factors.

Objective To analyze the correlation between the levels of urinary ptasminogen activator receptor (uPAR) and the clinicopathological characteristics of patients with cervical carcinoma and it's clinical significance. Methods SABC immunohistochemistry was employed to detect the expression of uPAR in 50 cases of cervical carcinoma tissue and 50 cases of normal cervical tissue. ELISA method was used to determine the serum uPAR levels for the patients with cervical carcinoma. Results There was no expressionfor uPAR in normal tissues, The positive expression rate of uPAR was 66 % (33/50). The uPAR level of cervix cancer tissues [(70.92±28.55) ng/100 mg protein]was significantly higher than those in normal tissues [(11.01±5.40) ng/100 mg protein], (P ＜0.001). and uPAR levels were closely related to clinical stages,lymphatic metastasis and differentiation degree (P ＜0.05), but not related to deep myometrial invasion and vascular embolization (P ＞0.05) (however, they were not related to patient's age, tumor growth type and the size of tumor. Significant difference of uPAR level was observed between the patients with cervical carcinoma [(2.38±0.29) ng/ml]and in healthy controls [(0.50±0.16) ng/ml](P ＜0.001). Single factor analysis indicated that, before the treatment, the serum uPAR levels were closely related to clinical stages, lymphatic metastasis, vascular embolization, and deep myometrial invasion (P ＜0.05-P ＜0.01). However, they were not related to differentiation degree (P ＞0.05). Multifactor regression analysis showed that the pretreatment serum uPAR levels of patients were related to clinical stages (P =0.000), cavum pelvis lymphatic metastasis (P =0.000) and deep myometrial invasion. Patients with cervical carcinoma showed a dramatic drop in serum uPAR levels after treatment, which were significantly different compared to their pretreatment uPAR levels (P ＜0.001). Linear correlation analysis showed that there was a positive correlation between serum and tissue uPAR levels, (r =0.801, P ＜0.001). Conclusion There were high expression of uPAR in serum and tissues with cervical carcinoma. Pretreatment serum uPAR levels were closely related to patients' clinical stages,cavum pelvis lymphatic metastasis and deep myometrial invasion, serum uPAR levels may be an important tmnor marker for the diagnosis, detection, prognosis of cervical carcinoma.

Objective:Aimed to investigate the value of adrenocorticotropic hormone (ACTH) stimulation in adrenal venous blood sampling (AVS).Methods:Patients who diagnosed as primary aldosteronism (PA) and completed successful bilateral cannulation judged by selection index (SI) for routine and(or) ACTH stimulation AVS were enrolled. The lateralization index(LI) was calculated to compare the effect of ACTH stimulation on AVS cannulation success rate and lateralization judgment.Results:A total of 73 patients with PA were enrolled in the study, of whom 28 were confirmed as aldosterone producing adenoma (APA) after unilateral adrenalectomy. Cortisol and aldosterone in peripheral and adrenal veins were significantly increased after ACTH stimulation. The left SI was increased from 6.5(3.0-13.6) to 26.8 (16.9-40.3) ( P<0.01) and the right SI from 20.8(4.8-34.8) to 57.6(35.7-80.9) ( P<0.01) after ACTH stimulation. There was no significant difference on LI before and after ACTH stimulation [7.7(2.3-19.6) vs 5.6(1.9-14.6), P=0.14]. The success rates of left and right adrenal cannulation were increased by 15% and 10% respectively after ACTH stimulation. For 57 patients who were determined in successful cannulation by both routine and ACTH stimulation AVS, 27 patients were determined to have lateralization by both AVS methods, 21 patients were determined to have bilateralization, and the consistency of lateralization by both AVS methods was 84%(48/57). Among the 28 patients who were confirmed to be APA after unilateral adrenalectomy, the correct rate of lateralization by both AVS methods was 89% (25/28). Conclusion:ACTH stimulation is able to improve the success rate of bilateral adrenal vein cannulation, and is helpful to judge AVS results. For patients with successful cannulation, there is no significant difference in lateralization judgment for routine and ACTH stimulation AVS.

Objective To investigate the transmission of blaNDM-1 gene in carbapenem-resistant Citrobacter freundii. Methods A total of 18 strains of NDM-1-producing C. freundii were collected from the First Affiliated Hospital of Kunming Medical University during the period from June 2012 to October 2014. The isolates were identified and subjected to antimicrobial susceptibility testing with VITEK 2 System. Conjugation experiments, pulsed-field gel electrophoresis (PFGE) and Southern blot hybridization were performed to determine the transferability of plasmids. Results The antibiotic susceptibility results showed that all the NDM-1-producing C. freundii isolates were resistant to penicillins, cephalosporins and carbapenems. All isolates exhibited different level resistance to other antibiotics. Conjugation experiments revealed that the plasmids harboring blaNDM-1 in 13 strains were transformed into E. coli 600, and exhibited carbapenem resistance. PFGE and Southern blot hybridization found that blaNDM-1 was located on a 33.3 kb plasmid in 16 isolates and on 33.3-54.7 kb plasmid in 2 isolates. Conclusions Our findings suggest that plasmids contribute to the horizontal dissemination of blaNDM-1 gene in carbapenemresistant C. freundii.

Objective To investigate the distribution of integrons and ISCR1 elements in NDM-l-producing Citrobacterfreundii isolates,and analyze the genotypes of these strains to understand their homology.Methods A total of 18 strains of NDM-1-producing Citrobacterfreundii were collected from the First Affiliated Hospital of Kunming Medical University during the period from June 2012 and October 2014.The isolates were identified and subjected to antimicrobial susceptibility testing with VITEK 2 System.Class Ⅰ,Ⅱ,and 1Ⅲ integrons and ISCR1 elements were detected by PCR.Clonal relatedness was assessed by pulsed field gel electrophoresis (PFGE).Results Most (77.8％,14/18) strains were positive for class Ⅰ integron conserved region,27.8％ (5/18) isolates were positive for ISCR1 conserved region.No class Ⅱ or Ⅲ integron was detected.Most (72.2％,13/18) isolates were positive for class Ⅰ integron variable region.None of the strains harbored class Ⅱ integron or ISCR1 variable region.Integron variable regions included gene cassette encoding resistance to aminoglycosides (aadA1,aadA5,aac(6')-Ib-cr) and trimethoprim-sulfamethoxazole (dfrA,dfrA15,dfrA17).PFGE revealed 17 clusters among 18 NDM-l-producing Citrobacter freundii isolates.Conclusions The clonal dissemination of NDM-l-producing Citrobacterfreundii isolates is not significant.Class I integron is prevalent in NDM-l-producing Citrobacter freundii.The presence of ISCR1 is relatively rare.The two mobile elements are not related to the spread of NDM-1 gene in this hospital.