The clinical value of 5.0 T ultra-high field MRI in assessing intracranial arteries and branches / 中华放射学杂志

Objective:To evaluate the clinical value of 5.0 T ultra-high filed MRI system in assessing intracranial arteries segments and vessel branchers.Methods:This study was a prospective study. Totally 40 consecutive healthy volunteers were recruited from Zhongshan Hospital, Fudan University from September 1, 2021 to November 30, and all participants who underwent either 3.0 T or 5.0 T time-of-flight MR angiography (TOF-MRA) in random order were divided into 3.0 T MR group and 5.0 T MR group with 20 volunteers for each group. Image quality was assessed by Likert 5 scoring systems and signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR),and score in visualization of intracranial arteries [middle cerebral artery (MCA) and its segments, anterior cerebral artery (ACA) and its segments, posterior cerebral artery (PCA) and its segments, lenticulostriate arteries (LA) and pontine artery (PA)] were assessed from 0 to 3 (≥2: good depiction of vessel segment). Quantitative indicators were compared between 2 groups using independent t test or Mann-Whitney U test. Results:Among the 40 subjects, there were 29 males and 11 females, aged 20-69 (50±12) years. SNR and CNR were both significantly higher in 5.0 T MR group than those in 3.0 T MR group (SNR: 187±9 vs 91±4, t=31.59, P<0.001; CNR: 156±7 vs 70±4, t=31.45, P<0.001), but there was no significant difference in subjective scores of image quality between the 5.0 T MR and 3.0 T MR groups [5.0 (4.0, 5.0), 5.0 (5.0, 5.0) points, respectively, Z=-1.23, P=0.218]. In the evaluation of cerebral arteries, the visualizations of the proximal and middle segments of MCA, ACA and PCA was better than those in the 3.0 T MR group, and there was no significant difference in the scores ( P>0.05), while the visualizations of proximal arteries in the 5.0 T MR group were significantly better than those in the 3.0 T MR group ( P<0.05). Furthermore, small vessel branches such as LA and PA in 5.0 T MR group were visualized better than those in 3.0 T MR group ( P<0.001). Conclusion:TOF-MRA by ultra-high filed 5.0-T provides an optimal choice in visualization of distal large arteries and small vessel branches, which could be useful for the diagnosis on cerebral vascular disease.

Influence of flood disaster on Oncomelania snail distribution in Wuhu section of Yangtze River in 2020 / 中国热带医学

@#Abstract: Objective　To analyze the impact of the flood disaster on the distribution of Oncomelania snails in 2020 in Wuhu City, to provide scientific basis for formulating the "14th Five-Year Plan" for schistosomiasis control and precise prevention and control measures in Wuhu City. Methods　Systematic sampling combined with environmental spot check was used to investigate the distribution of snails in the historical snail's environment, existing snail's environment and suspected snail's environment in Wuhu City. The collected snails were crushed and examined by microscope to understand the death and life of snails and the infection of Schistosoma japonicum, and the density of live snails and other indicators were counted. Results　The historical area of snails was 14 475.24 hm2 in Wuhu City, and the existing area of snails was 4 588.72 hm2, including 4 210.32 hm2 for lake type and 378.40 hm2 for hill type snails. The average occurrence rate of live snails was 14.59%, and the average density of live snails was 0.50 snails/0.1 m2 in Wuhu City. There were 2 745 snail breeding environments, of which 491 were lake type and 2 254 are hill type, accounting for 17.89% and 82.11% respectively. The existing snail area was mainly distributed in the beaches and ditches, accounting for 92.51% and 6.29% of the existing snail area respectively. Some snails were distributed in ponds, paddy fields and other environments. Among all the historical snail habitats, the majority were class Ⅱ and class Ⅲ environments (which still have the basic conditions for snail breeding at present), with a total of 1 739 sites (blocks), accounting for 63.35% of the total environment. No schistosomiasis infected snails have been found, and the newly discovered and recovered snails cover an area of 268.21 hm2 in Wuhu City. Conclusions　The distribution of snails is extensive in Wuhu City, and snails are mostly distributed in beaches, which are vulnerable to the impact of flood disasters. The spread of Oncomelania snails is found in 30 marshlands in 3 counties in this survey. It is necessary to continue to strengthen snail monitoring after disasters, and take class Ⅱ and class Ⅲ environments as key areas for snail monitoring, so as to find, identify and evaluate the risk of schistosomiasis transmission as soon as possible, to avoid or reduce the impact of flood disasters on the process of schistosomiasis control, and promote the process of schistosomiasis elimination.

Caries-inhibiting effect of topical fluorides for 5 to 6-years old children in two urban districts of Xi’an / 中国学校卫生

Objective@#To explore the effect of a preschool-based fluoride application on early childhood caries (ECC) prevention among 5 to 6-years old children in two urban districts of Xi’an.@*Methods@#This cross-sectional study was conducted by using a two-stage cluster method. A total of 564 children aged 5 to 6-years old from eight preschools were recruited for this study. Each participant was assessed dental caries and debris index. Time and materical for topical fluorine application was recorded. Parents/guardians completed a structured self-administered questionnaire, which included demographic, family and social factors (educational level of parents,household monthly income, etc). Children’s oral health related behaviors (age to start brushing, brushing tooth frequency, parents supports in child’s teeth brushing, and whether use fluoride toothpaste); dietary habit (frequency of dessert, desert before sleep, dental discomfort within 12 months, visits to dentist within 12 months). The status of dental caries was shown in the form of the mean dmft and the prevalence of ECC.@*Results@#The prevalence of ECC and mean dmft of children was 63.8% and (3.00±3.33) respectively. Among the 294 children aged 5-6 years old, the average intervention time was (4.83±1.00), 33.7% of the children only applied fluorine vanish, 66.3% of the children applied fluorine vanish and fluorine foam. The prevalence of ECC was 53.5%, 63.1% and 68.1% in the children who applied fluorine vanish, fluorine vanish and fluorinated foam, no fluoride, respectively. The mean dmft was (2.45±3.42)(2.83±3.04) and (3.32±3.47), respectively, with statistically significant differences(χ2/F=6.77, 7.08, P<0.05). According to binary Logistic regression equation analysis, the application of fluorine vanish was negatively associated with the prevealence of ECC(OR<1.00). High frequency of dessert intake, low degree of oral hygiene and late start of brushing teeth was positively associated with deciduous teeth caries(OR>1.00). Negative binomial regression analysis of dmft was independent of local fluoride intervention(P>0.05).@*Conclusion@#The effect of preschool-based fluoride intervention to prevent ECC was limited. It is necessary to improve the effect of intervention for children, carry out targeted health education，encourage parents to intervene eating and brushing behavior of children as early as possible.

Evaluate the follow-up effect of drug treatment for middle cerebral artery atherosclerotic plaques using high resolution MRI / 中华放射学杂志

Objective:To explore the value of 3.0 T high resolution MRI (HR-MRI) in the follow-up of drug treatment in acute and non-acute ischemic stroke caused by middle cerebral artery (MCA) plaque.Methods:The perspective study enrolled patients with ischemic stroke caused by MCA stenosis from October 2012 to October 2015 in the department of Neurology and Neurosurgery of Changhai Hospital Affiliated to Naval Medical University. All the patients underwent HR-MRI and then were divided into acute and non-acute stroke groups according to the intervels of the last symptom onset to the time of HR-MRI examination. All patients were informed consent to receive antiplatelet drug and intensive lipid therapy and followed up with HR-MRI. The HR-MRI sequence including T 2WI, T 1WI and contrast-enhanced T 1WI of vessel wall, and T 2WI and DWI of brain were routinely performed. T-test of paired samples was used to evaluate the changes of stenosis rate of vascular lumen, plaque enhancement degree, plaque volume and plaque burden on HR-MRI, and the NIHSS score of nervous system and blood biochemical indicators of the patients before and after treatment. Chi square test was used to compare the difference in ischemic event recurrcence between the acute and the non-acute stroke group. Results:A total of 31 acute stroke patients and 20 non-acute stroke patients were enrolled in the study. The mean follow-up time of acute stroke group was (671.71±522.86) days. Compare with the baseline, the stenosis rate of vascular lumen ( P=0.039), plaque enhancement degree ( P<0.001), plaque volume ( P=0.024) and plaque burden ( P=0.031) were all improved after the drug treatment, the NIHSS score of nervous system was also significantly improved, and the levels of total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) in 12 patients were significantly decreased. The mean follow-up time of patients with non-acute stroke was (695.35±555.90) days. The stenosis rate of vascular lumen, plaque enhancement degree, plaque volume and plaque burden were slightly improved, but without statistical significance ( P>0.05). There were no significant changes in NIHSS score of nervous system, TC, triglyceride (TG) and LDL-C ( P>0.05), however the high density lipoprotein cholesterol (HDL-C) was significantly increased than that in the baseline ( P=0.02). During the follow-up period, no new cerebral infarction was found in the DWI images of the two groups. Six patients had transient ischemic attack (TIA) recurrence in the acute stroke group and 5 patients in the non-acute stroke group, there was no significant difference between both groups(χ 2=0.229, P= 0.632). Conclusion:HR-MRI can be used as an important evaluation method for the follow-up of MCA atherosclerotic plaque therapy. After antiplatelet therapy and intensive lipid-lowering therapy, the plaque volume and burden of MCA offending plaque, and plaque enhancement decreased in acute stroke patients but there was no significant change in non-acute patients.

Identification of culprit plaques characteristics of intracranial atherosclerosis: a radiomic study / 国际脑血管病杂志

Objective To investigate the ability of quantitative radiomic method based on highresolution magnetic resonance imaging (HR-MRI) to distinguish between culprit plaques and non-culprit plaques of intracranial atherosclerosis.Methods Patients with middle cerebral artery and basilar artery stenosis underwent HR-MRI in Changhai Hospital Affiliated to the Naval Medical University from September 2013 to October 2016 were analyzed retrospectively.The minimum lumen area,plaque burden,severity of luminal stenosis,intraplaque hemorrhage (IPH),enhancement rate,and 109quantitative radiomic characteristics of the culprit and non-culprit plaques were measured.For clinical features and traditional plaque morphology,multivariate logistic regression models were used to determine independent risk factors for culprit plaque.A random forest-supervised machine learning method was used to determine the radiomic characteristics of distinguishing between symptomatic plaques and asymptomatic plaques.The receiver operating characteristic (ROC) curve was constructed,and the diagnostic efficacy was described by the area under the curve (AUC).Results During the study,158 subjects were enrolled,and they aged (59.42± 11.62) years.The plaques of 75 patients were located in middle cerebral artery,and the plaques of 83 patients were located in basilar artery.There were 111 symptomatic patients and 47 asymptomatic patients.Multivariate logistic regression analysis showed that smoking (odds ratio [OR] 2.724,95％ confidence interval [CI] 1.200-6.183),IPH (OR 11.340,95％ CI 1.441-89.221),and enhancement rate (OR 6.865,95％ CI 1.052-44.802) were the independent risk factors for culprit plaques.The AUC of these three characteristics for predicting symptomatic plaques were 0.605,0.584,and 0.590,respectively.The combination of the three cloud improve the test efficacy for the intracranial atherosclerotic culprit plaques,AUC could reached 0.714.Radiomic analysis showed that 22 radiomic characteristics extracted from T-2 weighted imaging,T1 weighted imaging,and contrast-enhanced T1 weighted imaging were associated with the culprit plaques.Their AUCs were 0.801,0.835,and 0.846,respectively.After the combination of all morphological and radiomic characteristics,AUC could reach 0.976,the accuracy rate was 87.4％.However,the difference was not statistically significant compared to the combined AUC of all radiomic characteristics (0.953) (P=0.275).Conclusion Radiomic analysis could accurately distinguish between the culprit plaques and non-culprit plaques of intracranial atherosclerosis,and is superior to the traditional morphological methods.

Study Progress of Radiomics in Precision Medicine for Lung Cancer / 中国肺癌杂志

Precision medicine, imaging first. Radiomics, a method of machine learning in artificial intelligence, provides valuable diagnostic, prognostic or predictive information through quantitative analysis on the tumor's region of interest to support personalized clinical decisions and improve individualized treatment, which could lay a solid foundation for achieving the precision medicine. This review provides a latest advance of the radiomic application of the precision medicine for lung cancer.

Assessment of mild chronic pancreatitis：the utility of diffusion weighted imaging before and after secretin stimulation / 中华放射学杂志

Objective To explore the diagnostic value of DWI after secretin stimulation for the diagnosis of mild chronic pancreatitis (CP). Methods This was a prospective study. Ninety-nine consecutive individuals including 23 healthy volunteers, 11 risk volunteers, 15 mild CP patients, 14 moderate CP patients and 36 severe CP patients underwent secretin DWI and faecal elastase 1(FE-1) testing. The subjects were grouped by Cambridge classification about endoscopic retrograde cholangiography (ERCP), CT and ultrasonography. Secretin stimulated diffusion weighted imaging(S-DWI), the ADCs, time to peak ADCs and FE-1 were performed on all subjects. The changes of pancreatic ADC values were observed before and after the injection of secretin. All ADCs and FE-1 were compared between groups with single factor analysis of variance, and the correlation between ADCs and FE-1 was determined with Pearson analysis. ROC curves were performed to identify the diagnostic efficacy of DWI related measures. Results Eight patients with severe CP were excluded because the significant atrophy of the pancreatic parenchyma prohibited the evaluation of ADC measurement. Ninety-one individuals were divided into five groups including 23 healthy volunteers, 11 risk volunteers, 15 mild CP patients, 14 moderate CP patients and 28 severe CP patients. The mean baseline and peak ADCs were higher in the healthy volunteers than in other groups, with significant differences (P<0.05). There was no ADC peak in severe CP patients. There were significant differences between the mean baseline ADCs and the peak ADCs in the other groups (P<0.05). The mild and moderate CP groups showed a delayed peak. The area under curve (AUC) of the mean baseline and peak ADCs, time to peak ADCs for differentiating mild CP was 0.818, 0.912 and 0.965, respectively. Using 4.67 min as the cutoff value, time to peak ADCs were most accurate for differentiating healthy from risk patients and those with evident pancreatitis, yielding a sensitivity of 80.0%and a specificity of 100.0%. Good correlations between baseline and peak ADCs, time to peak ADCs, and FE-1 were shown(r=0.57, 0.72 and-0.84, P<0.01). Conclusions Using the peak and time to peak ADCs may improve the detection of risk and mild CP. Secretin-enhanced DWI is a noninvasive, convenient and accurate method.

Value of reduced field of view DWI in differentiating solid pancreatic focal lesions / 中华胰腺病杂志

Objective To study the value of reduced field-of-view (rFOV DWI) in differentiating patients with solid pancreatic focal lesions.Methods 139 patients with solid pancreatic mass were enrolled,including 105 patients with pancreatic ductal acinar carcinoma (PDAC),16 patients with neuroendocrine neoplasms,7 patients with mass forming chronic pancreatitis (MFCP) and 11 patients with solid papillary tumor (SPT).38 healthy adult volunteers served as controls,and underwent single stimulated echo planar imaging (ss-EPI) DWI and rFOV DWI(b value =0 and 600 s/mm2) MRI examination.Quartation method was used to evaluate the image quality of ss-EPI) DWI and rFOV DWI in the three terms of the visibility of anatomical structure,contrast of pancreatic lesions,motion and the susceptibility artifacts during MRI.Work station self-carried software was used to measure the ADC value of the region of interest (ROI).The image quality and ADC values of different pancreatic diseases and normal pancreas were compared.ROC curve for ADC value was drawn to evaluate the difference among PDAC,other benign pancreatic masses and normal pancreas.Results At b value of 0 and 600 s/mm2,rFOV DWI was superior to ss-EPI DWI in terms of showing pancreatic anatomic structure,the contrast of the lesion and the score evaluation for susceptibility artifacts(b =0 s/mm22.99 ±0.51 vs 2.79 ±0.64,2.37±0.48 vs 1.81 ±0.63,3.17 ±0.56 vs 2.91 ±0.60;b =600 s/mm23.63 ±0.50 vs 3.32 ±0.56,3.45 ±0.50 vs 3.01 ±0.49,3.74 ±0.44 vs 3.12 ±0.37),and the differences were statistically significant (P＜0.001).ADC values of PDAC,NET,MFCP,SPT and normal pancreas were (1.38 ± 0.17) × 10-3,(1.22 ± 0.35) × 10-3,(1.29 ± 0.13) × 10-3,(1.04 ± 0.38) ×10-3and(1.86±0.15) ×10-3mm2/sforrFOV DWI,and (1.73 ± 0.24) ×10-3,(1.63±0.39) ×10-3,(1.58±0.19) × 10-3,(1.25±0.26) × 10-3 and(2.04±0.20) × 10-3mm2/s for ss-EPI DWI.The difference on ADC values among different groups and within one group were all statistically significant (P ＜0.001).There were no statistical significant differences on ADC values between MFCP and PDAC,between MFCP and SPT as well as on ss-EPI DWI ADC values between PDAC and NET,but statistical differences were found between other two groups (P ＜ 0.05).The area under the ROC curve of rFOV and ssEPI DWI was 0.983 (95％ CI 0.944-0.998) and 0.889 (95％ CI 0.822-0.936),respectively,and the difference was statistically significant (P =0.0004),but rFOV DWI and ss-EPI DWI ADC values for PDAC and all benign solid diseases were 0.799 (95％ CI 0.719-0.864) and 0.755 (95％ CI 0.672-0.827),and the difference was not statistically significant.Conclusions rFOV DWI could significantly enhance the quality of DWI images,and its diagnostic efficacy was much better than ss-EPI DWI.

The application of 3D printing-assisted microcatheter shaping in the embolization of intracranial aneurysms / 介入放射学杂志

Objective To discuss the feasibility of using 3D printing-assisted precise microcatheter shaping technology in the embolization of intracranial aneurysms.Methods From November 2015 to April 2016,a total of 13 patients with intracranial aneurysm were treated with interventional embolization therapy.During the performance of the procedure,3D printing-assisted precise microcatheter shaping technology was employed.The accuracy of microcatheter position and the stability of the microcatheter were used to evaluate the shaping effect.Results During the performance of interventional embolization,the microcatheter was precisely placed to the right site in all 13 patients with intracranial aneurysm,the catheter tip position remained stable and the aneurysm was densely obstructed.In ten patients,no complications such as rupture of aneurysm occurred,and postoperative recovery was fine.One patient,whose Hunt-Hess classification was grade V,died after the treatment.One patient developed rupture of aneurysm during the procedure,which was considered to occur probably during the anesthesia induction process.One patient developed bleeding due to re-rupture of the aneurysm before the procedure.Conclusion With the help of 3D printing-assisted precise microcatheter shaping technology,the precisely shaped microcatheter can be smoothly inserted to,and can keep stable in,the right site,which is helpful for successfully accomplishing the operation and effectively reducing the occurrence of procedure-related complications.

MR-fluorescent dual-modality molecular probes anchored with LyP-1 for pancreatic cancer / 中国医学影像技术

Objective To construct the LyP-1 targeted MR fluorescence dual-modality molecular probe for pancreatic cancer,and to observe its features and MRI charicteristics.Methods The 50 nm MR-fluorescent dual-modality molecular probe with surface modified with cyclic nine-amino acid peptide LyP-1 (Cys-Gly-Asn-Lys-Arg-Thr-Arg-Gly Cys) was rationally designed.Whether the molecular probe could specifically recognize the pancreatic cancer cells were validated by the combination of fluorescent imaging and MR T2WI.Results The new MR-fluorescent dual-modality molecular probe anchored with LyP-1 could be used for the fluorescent imaging and MR T2WI of pancreatic cancer in mouse.And the molecular probe was demonstrated to be effective in conjugating with pancreatic cancer cells on fluorescent images and caused obvious MR signal reduction under T2 relaxometry in vitro.In vivo experiment,the molecular probe could be used for fluorescent labeling tumor tissue and detecting orthotopic pancreatic cancer in C57BL/6 mouse as MR contrast agent.Conclusion The LyP1 immobilized MR-fluorescent dual-modality molecular probe can actively target to mouse orthotopic xenograft of pancreatic cancer,which is hopeful to the application in early probing and diagnosis of pancreatic cancer by multimodal imaging.

MR-fluorescent dual-modality molecular probes anchored with LyP-1 for pancreatic cancer / 中国医学影像技术

Objective To construct the LyP-1 targeted MR fluorescence dual-modality molecular probe for pancreatic cancer,and to observe its features and MRI charicteristics.Methods The 50 nm MR-fluorescent dual-modality molecular probe with surface modified with cyclic nine-amino acid peptide LyP-1 (Cys-Gly-Asn-Lys-Arg-Thr-Arg-Gly Cys) was rationally designed.Whether the molecular probe could specifically recognize the pancreatic cancer cells were validated by the combination of fluorescent imaging and MR T2WI.Results The new MR-fluorescent dual-modality molecular probe anchored with LyP-1 could be used for the fluorescent imaging and MR T2WI of pancreatic cancer in mouse.And the molecular probe was demonstrated to be effective in conjugating with pancreatic cancer cells on fluorescent images and caused obvious MR signal reduction under T2 relaxometry in vitro.In vivo experiment,the molecular probe could be used for fluorescent labeling tumor tissue and detecting orthotopic pancreatic cancer in C57BL/6 mouse as MR contrast agent.Conclusion The LyP1 immobilized MR-fluorescent dual-modality molecular probe can actively target to mouse orthotopic xenograft of pancreatic cancer,which is hopeful to the application in early probing and diagnosis of pancreatic cancer by multimodal imaging.

Application of perfusion magnetic resonance imaging with arterial Spin labeling in craniocerebral diseases / 第二军医大学学报

Arterial spin labeling (ASL) in perfusion magnetic resonance imaging is based on endogenous contrast (hydrogen proton in arterial blood), and it has drawn widespread clinical attention and application due to its advantages, including noninvasiveness, convenient operation, low cost, quantitative measurement of cerebral blood flow(CBF), and good repeatability. Recently, the craniocerebral disease has become one of the diseases with highest incidence, which has drawn great attention from scientists and clinicians in and outside China; ASL could be helpful in the clinical examination and diagnosis of craniocerebral diseases. This review summarized recent reports on the clinical application of ASL in the cerebrovascular diseases, brain tumors and mental diseases, so as to provide references for future ASL research in craniocerebral diseases.

Molecular characterization of multidrug-resistant Klebsiella pneumoniae isolates

Klebsiella pneumoniae is an important cause of healthcare-associated infections worldwide. Selective pressure, the extensive use of antibiotics, and the conjugational transmission of antibiotic resistance genes across bacterial species and genera facilitate the emergence of multidrug-resistant (MDR) K. pneumoniae. Here, we examined the occurrence, phenotypes and genetic features of MDR K. pneumoniae isolated from patients in intensive care units (ICUs) at the First Affiliated Hospital of Xiamen University in Xiamen, China, from January to December 2011. Thirty-eight MDR K. pneumoniae strains were collected. These MDR K. pneumoniae isolates possessed at least seven antibiotic resistance determinants, which contribute to the high-level resistance of these bacteria to aminoglycosides, macrolides, quinolones and β-lactams. Among these isolates, 24 strains were extended-spectrum β-lactamase (ESBL) producers, 2 strains were AmpC producers, and 12 strains were both ESBL and AmpC producers. The 38 MDR isolates also contained class I (28/38) and class II integrons (10/38). All 28 class I-positive isolates contained aacC1, aacC4, orfX, orfX’ and aadA1 genes. β-lactam resistance was conferred through blaSHV (22/38), blaTEM (10/38), and blaCTX-M (7/38). The highly conserved blaKPC-2 (37/38) and blaOXA-23(1/38) alleles were responsible for carbapenem resistance, and a gyrAsite mutation (27/38) and the plasmid-mediated qnrB gene (13/38) were responsible for quinolone resistance. Repetitive-sequence-based PCR (REP-PCR) fingerprinting of these MDR strains revealed the presence of five groups and sixteen patterns. ...

Molecular characterization of multidrug-resistant Klebsiella pneumoniae isolates

Klebsiella pneumoniae is an important cause of healthcare-associated infections worldwide. Selective pressure, the extensive use of antibiotics, and the conjugational transmission of antibiotic resistance genes across bacterial species and genera facilitate the emergence of multidrug-resistant (MDR) K. pneumoniae. Here, we examined the occurrence, phenotypes and genetic features of MDR K. pneumoniae isolated from patients in intensive care units (ICUs) at the First Affiliated Hospital of Xiamen University in Xiamen, China, from January to December 2011. Thirty-eight MDR K. pneumoniae strains were collected. These MDR K. pneumoniae isolates possessed at least seven antibiotic resistance determinants, which contribute to the high-level resistance of these bacteria to aminoglycosides, macrolides, quinolones and β-lactams. Among these isolates, 24 strains were extended-spectrum β-lactamase (ESBL) producers, 2 strains were AmpC producers, and 12 strains were both ESBL and AmpC producers. The 38 MDR isolates also contained class I (28/38) and class II integrons (10/38). All 28 class I-positive isolates contained aacC1, aacC4, orfX, orfX’ and aadA1 genes. β-lactam resistance was conferred through bla_SHV (22/38), bla_TEM (10/38), and bla_CTX-M (7/38). The highly conserved bla_KPC-2 (37/38) and bla_OXA-23(1/38) alleles were responsible for carbapenem resistance, and a gyrAsite mutation (27/38) and the plasmid-mediated qnrB gene (13/38) were responsible for quinolone resistance. Repetitive-sequence-based PCR (REP-PCR) fingerprinting of these MDR strains revealed the presence of five groups and sixteen patterns. ...

Knowledge map of artemisinin research in SCI and Medline database.

Background & objectives: Artemisinin was first extracted from the herb Artemisia annua which has been used for many centuries in Chinese traditional medicine as a treatment for fever and malaria. It has been given the 2011 Lasker-DeBakey clinical medical research award. In this paper, knowledge map of artemisinin research was drawn to provide some information for global researchers interested in artemisinin and its relevant references. Methods: In this work, bibliometric analysis and knowledge visualization technology were applied to evaluate global scientific production and developing trend of artemisinin research through Science Citation Index (SCI) papers and Medline papers with online version published as following aspects: publication outputs, subject categories, journals, countries, international collaboration, citations, authorship and co-authorship, author key words and co-words analysis. The Thomson Data Analyzer (TDA), Netdraw and Aureka software were employed to analyze the SCI as well as Medline papers data for knowledge mapping. Results: Global literature of artemisinin research has increased rapidly over the past 30 years and has boosted in recent years. Seen from the statistical study in many aspects, Pharmacology & Pharmacy, and Chemistry are still the main subjects of artemisinin research with parasitology and tropical medicine increasing quickly. Malaria Journal and American Journal of Tropical Medicine are top productive journals both in SCI and Medline databases. Quantity and quality of papers in US are in a leading position, although papers quantity and active degree in developing countries such as P.R. China, Thailand and India are relatively high, the quality of papers from these countries needs to be improved. New emerging key words and co-words remind us that mechanism of action, pharmacokinetics, artemisinin-based alternatives, etc. are the future trends of artemisinin research. Conclusion: Through bibliometric analysis the development trends of artemisinin research are predicted. With further development of artemisinin research, it is presumed that scientists might concentrate mainly on the synthesis of new compounds with activity, action mechanism, new artemisinin-based combination therapy regimens, etc.

Tratamento das fraturas femorais subtrocantéricas com placas de bloqueio lateral da parte proximal do fêmur / The treatment of femoral subtrochanteric fractures with the proximal lateral femur locking plates

OBJETIVO: Estudar o desfecho de fraturas subtrocantéricas de quadril tratadas com placa de bloqueio lateral da parte proximal do fêmur. MÉTODO: Revisamos retrospectivamente os resultados clínicos de 48 casos de fraturas subtrocantéricas tratadas com placas de bloqueio lateral da parte proximal do fêmur de janeiro de 2008 a maio de 2010. Registrou-se o progresso da consolidação da fratura, assim como a ocorrência de complicações. A função da articulação do quadril foi avaliada pelo índice social de Harris e o escore de mobilidade de Parker-Palmer, um ano após a cirurgia. RESULTADO: Quarenta e cinco pacientes foram acompanhados até a união da fratura ou a revisão da cirurgia. Entre os 45 pacientes, 43 atingiram a união da fratura sem outra intervenção. Trinta e oito fraturas consolidaram sem perda da posição no acompanhamento de um ano. Não houve casos de perfuração da cabeça do fêmur pelo parafuso. O escore médio do índice social de Harris foi 86,5 ± 9,8 (73 ~95). A média do escore de mobilidade de Parker e Palmer foi 7,4 ± 2,1 (3~ 9). CONCLUSÃO: A placa de bloqueio lateral da parte proximal do fêmur é o tipo de fixação interna estável e efetiva para tratar as fraturas subtrocantéricas de quadril e tem a vantagem de fixação estável, em especial em fratura da parede lateral do fêmur. Nível de evidência IV, Série de Casos.

OBJECTIVE: To study the outcome of subtrochanteric hip fractures treated by using a proximal lateral femur locking plate. METHOD: We retrospectively reviewed the clinical results of 48 cases of femoral subtrochanteric fractures treated with proximal lateral femur locking plates from Jan 2008 to May 2010. The progress of fracture healing, as well as the occurrence of complications, was recorded. The function of the hip joint was evaluated by Harris social index and the Parker and Palmer mobility score at 1 year after the operation. RESULT: 45 patients were followed up until fracture union or a revision surgery. Among the 45 patients, 43 patients obtained fracture union without further intervention. 38 fractures healed with no loss of position at the 1-year follow-up. There were no cases of hip screw cutting through the femoral head. The mean score of Harris social index was 86.5±9.8 (73~95). The mean Parker and Palmer mobility score was 7.4±2.1 (3~9). CONCLUSION: The proximal lateral femur locking plate is the kind of stable and effective internal fixation of treating subtrochanteric hip fractures which has the advantage of stable fixation especially for the lateral femoral wall fracture. Level of Evidence IV, Case Series.

Characterization of 13 microsatellite loci developed from Meconopsis horridula

Meconopsis horridula is one of the eight most famous flowers in Chinese province of Yunnan. In this study, a modified biotin-streptavidin capture method was used to detect 13 microsatellite markers in the genome of M. horridula. The polymorphism of each locus was assessed in 24 samples collected from four populations. The number of alleles per locus ranged from 2 to 7 (mean: 3.2). The observed and expected heterozygosities ranged from 0.0833 to 0.9167 and 0.0816 to 0.8050, respectively. Additionally, nine of the 13 microsatellite markers were successfully amplified in three other congeneric species. These polymorphic SSR markers could be useful for studying the population genetics of M. horridula and for assessing genetic variation in this and congenerc species in conservation programs.

Segmental resection of the liver by Glissonean pedicle transection for primary liver cancer / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the clinical effect of segmental resection of the liver using Glissonean pedicle transection for primary liver cancer.</p><p><b>METHODS</b>The clinical data of 55 primary liver cancer patients admitted from January 2006 to October 2008 were analyzed retrospectively. Twenty-five of the patients underwent segmental resection of the liver by Glissonean pedicle transection (group A), and 30 underwent routine hepatectomy (group B). The positivity rate of the resection margin, micrometastasis in the hepatic parenchyma surrounding the lesions and postoperative recurrence rates were investigated.</p><p><b>RESULTS</b>The positivity rate of the resection margin was 4.0% in group A, significantly lower than that of group B. The number of histological micrometastasis was significantly higher in group A than in group B (16 vs 8). The median distance of histological micrometastasis was 6.8 mm (2.7-25.6 mm) in group A and 4.2 mm (2.4-9.0 mm) in group B. The one-year recurrence rate was significantly lower in group A than in group B (16% vs 26.7%).</p><p><b>CONCLUSION</b>Glissonean pedicle transection for segmental liver resection is a simpler procedure than routine hepatectomy for primary liver cancer and can reduce the number of histological micrometastasis and recurrence rate.</p>

Epidemiological and etiological characteristics of typhoid and paratyphoid fever in Ningbo during 1988-2007 / 中华流行病学杂志

Objective To study the epidemiological and etiological characteristics of typhoid and paratyphoid fever in high epidemic areas. Methods Reported data on typhoid and paratyphoid fever during 1988- 2007 in Ningbo were analyzed epidemiologically. Shellfish from the market was collected for laboratory testing and ,Salmonella typhi strains collected from the patients were also studied. Results Number of reported cases on both typhoid and paratyphoid fever was 19 404 with 7 deaths, from 1988 to 2007. The annual mean incidence was 17.68 per one hundred thousand with the fatality rate as 0.36 per thousand. Most cases were among adults aged 20-50 years and an obvious regional distribution was observed with high incidence seen in winter and spring. Since 1990s, the advantage strain had changed from Salmonella typhi to Salmonella paratyphi A. Etiologic studies showed that raw Anadara subcrenata and oyster were the main risk factors. One Salmonella paratyphi A strain was detected in both Anadara subcrenata and oysters collected from the market, which contained TEM-1 drug resistance gene. PFGE genotyping showed that PFGE-X2 was the strain which causing pandemic in Ningbo. Conclusion Eating contaminated raw shellfish like oysters and hairy clams was the primary risk factor, responsible for the outbreaks. Salmonella paratyphi A was the advantages pandemic strain in Ningbo. Strategies as supervision on personal hygiene and health education should be strengthened.