Research progress of nicorandil in prevention of contrast agent-related acute renal injury in patients with coronary intervention / 中国综合临床

With the rapid development of imaging and percutaneous coronary intervention, the application of contrast media has become more and more widespread, and contrast-associated AKI has become one of the most common causes of acute kidney injury. Contrast-associated AKI seriously threatens patients' health and brings greater economic burden to patients, so it is particularly important to prevent the contrast-associated AKI. Nicorandil is a common vasodilator drug in clinical practice, widely used in the treatment of angina pectoris, with the effects of anti-oxidative stress, anti-apoptosis, anti-inflammatory and vasodilation, and is considered to be effective in preventing contrast - associated AKI. However, there is still a lack of further research on the efficacy of nicorandil in preventing contrast-associated AKI.

Analysis of serotype distribution and antibiotic resistance of Haemophilus influenzae in hospitalized children / 中华实用儿科临床杂志

Objective:To explore the serotype, antibiotic resistance and β-lactamase gene of Haemophilus influenzae strains isolated from hospitalized children, thus providing reference for clinical diagnosis and treatment. Methods:A total of 148 Haemophilus influenzae strains collected from January 2016 to December 2018 in hospitalized children of Children′s Hospital, Capital Institute of Pediatrics were retrospectively analyzed.The serotype and genotype of Haemophilus influenzae strains were examined by slide agglutination test and PCR, respectively.The sensitivity of isolates to Ampicillin and other antimicrobials was detected by the E-test and disk diffusion methods.The β-lactamase phenotype was tested by nitrocefin disk method.The carrying of β-lactamase gene TEM-1 and ROB-1 were detected by PCR.The drug resistance rate was compared by χ2 test. Results:All the 148 strains were nontypeable Haemophilus influenzae (NTHi), and capsular gene was not amplified.The rate of resistance to Ampicillin, Ampicillin/Sulbactam, Cefuroxime, and Azithromycin were 68.9%(102/148 strains), 40.5%(60/148 strains), 53.4%(79/148 strains) and 56.1%(83/148 strains), respectively.The Haemophilus influenzae isolates showed the highest resistance rate to Trimethoprim-sulfamethoxazole, which was up to 91.9%(136/148 strains). The sensitive rate of isolates to Ceftriaxone, Meropenem and Levofloxacin were all 100.0%(148/148 strains). The prevalence of β-lactamase was 64.8%(96/148 strains) in Haemophilus influenzae and the genotype was TEM-1.The drug resistance rates of β-lactamase positive strains to Ampicillin, Ampicillin/Sulbactam and Azithromycin were significantly higher than those of other strains( χ2=123.222, 27.973, 70.273, all P<0.01). Conclusions:The most prevalent serotype of Haemophilus influenzae is NTHi in children. Haemophilus influenzae carried TEM-1 gene had a high positive rate of β-lactamase production, which was the main mechanism of drug resistance to Ampicillin.Ceftriaxone and Meropenem were the most active agents against Haemophilus influenzae.

Analysis of bacterial etiology of the outpatients with infectious diarrhea in the Children's Hospital Capital Institute of Pediatrics / 中华检验医学杂志

Objective To analyze the bacterial etiology and drug resistance of pathogens from the outpatients with acute infectious diarrhea in the Children's Hospital Capital Institute of Pediatrics.Methods The children with acute infectious diarrhea in the outpatient department of our hospital were randomly enrolled in the period of August 2017 to July 2018.Enteric pathogenic bacteria were cultured and isolated from the fresh stool specimens.The serum of Salmonella spp were identified while five types of diarrheagenic Escherichia coli were detected by PCR method.Antibiotic susceptibility of Salmonella spp and diarrheagenic Escherichia coli were tested by Kirby-Bauer disk diffusion method.Chi-square or Fisher exact test was done for statistical analysis.Results Of the 356 stool specimens,103 strains of 6 pathogenic bacterial species were detected.The positive rate was 27.8％ (99/356),and 2 strains were detected in four stool samples.The isolation rate of Salmonella spp,which was the highest in this study,was 10.7％ (38/356).The isolation rate of Staphylococcus aureus,diarrheagenic Escherichia coli and Pseudomonas aeruginosa were 8.4％ (30/356),5.6％ (20/356) and 3.7％ (13/356),respectively.No Shigella spp strain was isolated.Salmonella enteritidis and Salmonella typhimurium were the dominant serotype for 38 Salmonella spp stains with the isolation rate of 63.2％ (24 / 38).Each 10 Enteropathogenic Escherichia coli and 10 Enteroaggregative Escherichia coli isolates were detected among the diarrheagenic Escherichia coli.Enterohemorrhagic Escherichia coli,Enteroinvasive Escherichia coli and Enterotoxigenic Escherichia colistrain was not found in this study.The resistant rates of Salmonella spp to ampicillin and ceftriaxone were 52.6％ (20/38) and 13.2％ (5/38),while the diarrheagenic Escherichia coli were 11/20 and 1/20,respectively.Three diarrheagenic Escherichia coli isolates produced extended spectrum beta-lactamase.Conclusions Salmonella spp was the major bacterial pathogen among the outpatients with infectious diarrhea in the hospital.The study indicated that the infection ratios of Staphylococcus aureus,diarrheagenic Escherichia coli and Pseudomonas aeruginosa increased.Shigella spp was no long the main pathogenic agent.The resistant rates of Salmonella spp and diarrheagenic Escherichia coli to ampicillin were high,but low resistant rates to ceftriaxone were found among these two kinds of bacteria.The third-generation cephalosporins should be the first choice for the treatment of childhood bacterial diarrhea.

CTdiagnosisofthepulmonarychondroma / 实用放射学杂志

Objective ToanalyzetheCTfeaturesandthediagnosticvalueofpulmonarychondroma.Methods Tencasesofpulmonary chondromaprovenbypathologywereretrospectivelyanalysed.Thenumber,location,size,shape,margin,calcificationpatternandCT valueofthelesions wereanalysedonnonGenhancedandenhanced CTscans.Results Allthe10casesofpulmonarychondroma showedsolitary,mildlylobulated,wellGcircumscribed masses.6lesionswerelocatedintherightlung,and4lesionswereintheleft lung.Thesizeofthelesionsrangedform1.3cm×0.8cmto10.7cm×9.8cm.OnplainCTimages,9lesions(90%)showedvaried calcification,withpunctatecalcificationin8lesionsandringcalcificationin1lesion.OncontrastGenhanced CTimages,6lesions showedslighthomogeneousenhancement(enhancedvalue≤14HU).Conclusion Pulmonarychondromaisusuallylocatedintheperiphery ofthelung.Thenodulehasasmoothboundary,withsignificantcalcificationandslightlyenhancement,whichcouldbehelpfulindiagnosis ofthedisease.

Different optimizing strategies based on spot scanning carbon ion therapy for non-small cell lung cancer / 中华放射肿瘤学杂志

Objective To evaluate the dose variation of target coverage and organs at risk ( OARs) among four planning strategies using spot-scanning carbon-ion radiotherapy for non-small cell lung cancer ( NSCLC) . Methods Ten NSCLC patients utilizing gating motion control were selected to receive dose calculation over multiple acquired 4DCT images. Four optimizing strategies consisted of intensity-modulated carbon-ion therapy ( IMCT-NoAS ) , IMCT combined with internal gross tumor volume ( IGTV ) assigned muscle ( IMCT-ASM ) , single beam optimization ( SBO ) ( SBO-NoAS ) and SBO combined with IGTV assigned muscle (SBO-ASM).The initial plan was re-calculated after the 4DCT data were reviewed and then compared with the initial plan in the dosimetry. Results For re-calculation plans with two reviewing CTs,all four strategies yielded similar planning target volume ( PTV ) coverage. Merely IMCT-NoAS strategy presented with relatively significant variations in dose distribution. Dose variation for OARs between initial and re-calculated plans:for all four strategies,V20 of ipsilateral lung was increased by approximately 2. 0 Gy (relative biological effective dose,RBE),V30 of heart was increased by approximately 1. 0 Gy (RBE) for both IGTV assigned muscle strategies,whereas decreased by approximately 0. 2 Gy ( RBE) for both IGTV non-assigned muscle strategies. The maximum dose of spinal cord was changed by 2. 5 Gy ( RBE ) . Conclusions Carbon-ion radiotherapy is sensitive to the anatomic motion within the tumors along the beam path. When the tumor motion along the head-foot (H-F) direction exceeds 8 mm,SBO-ASM strategy provides better dose coverage of target. Strategies with IGTV assignment may result in dose overshoot to a position deeper than the initial planning dose distribution.

The role and significance of digital reconstruction technique in liver segments based on portal vein structure / 中华外科杂志

Objective@#To study the segment of liver according to the large amount of three-dimensional(3D) reconstructive images of normal human livers and the vascular system, and to recognize the basic functional liver unit based on the anatomic features of the intrahepatic portal veins.@*Methods@#The enhanced CT primitive DICOM files of 1 260 normal human livers from different age groups who treated from October 2013 to February 2017 provided by 16 hospitals were analyzed using the computer-aided surgery system.The 3D liver and liver vascular system were reconstructed, and the digital liver 3D model was established.The vascular morphology, anatomical features, and anatomical distributions of intrahepatic portal veins were statistically analyzed.@*Results@#The digital liver model obtained from the 3D reconstruction of CAS displayed clear intrahepatic portal vein vessels of level four.Perform a digital liver segments study based on the analysis of level four vascular distribution areas.As the less anatomical variation of left hepatic portal vein, the liver was classified into four types of liver segmentation mainly based on right hepatic portal vein.Type A was similar to Couinaud or Cho′s segmentation, containing 8 segments(537 cases, 42.62%). Type B contained 9 segments as there are three ramifications of right-anterior portal vein(464 cases, 36.82%). The main difference for Type C was the variation of right-posterior portal vein which was sector shape(102 cases, 8.10%). Type D contained the cases with special portal vein variations, which needs three-dimensional simulation to design individualized liver resection plan(157 cases, 12.46%). These results showed that there was no significant difference in liver segmental typing between genders(χ2=2.179, P=0.536) and did not reveal any significant difference in liver segmental typing among the different age groups(χ2=0.357, P=0.949).@*Conclusions@#The 3D digital liver model can demonstrate the true 3D anatomical structures, and its spatial vascular variations.The observation of anatomic features, distribution areas of intrahepatic portal veins and individualized liver segmentation achieved via digital medical 3D visualization technology is of great value for understand the complexity of liver anatomy and to guide the precise hepatectomy.

Relationship between Serum Diamine Oxidase Content and Intestinal Motility after Acute Spinal Cord Injury / 中国康复理论与实践

Objective To measure the level of diamine oxidase (DAO), and observe the intestinal motor and mucosal barrier injury after acute spinal cord injury (SCI) in rats. Methods A total of 45 Sprague-Dawley rats were randomly divided into SCI group (group A, n=15), sham group (group B, n=15) and control group (group C, n=15). SCI model was established with Allen's strike mode (10 g × 25 mm) by striking T10 spinal segment in rats. One day, three days and seven days after SCI, hind limb motor function was assessed with Basso-Beat-tie-Bresnahan (BBB) Scale in each group, the myoelectric slow wave and ileum smooth muscle contractility were measured in rats, ileum tis-sues were tested with HE staining, and the DAO content of serum was tested with ELISA kit. Results One day, three days and seven days af-ter SCI, the BBB score was significantly lower in group A than in groups B and C (P0.05). Group A showed ileal mucosal edema, lodging, inflammatory cell infiltration, and submucosal gap increase. The Chiu's score of intestinal mucosal injury was higher in group A than in groups B and C (P0.05). Conclusion Serum DAO content may respond to the intestinal motor function and mu-cosal injury after acute SCI in rats.

Comparative study of radiography,CT and MRI of benign spinal lesions associated with invasive signs / 实用放射学杂志

Objective To investigate the aggressive signs of benign spinal lesions appearing on medical imaging and their impact on diagnosis.Methods 139 cases of benign spinal lesions with aggressive signs confirmed by pathology of needle aspiration or surgery were reviewed,including 18 cases of osteoblastoma(OB),12 cases of aneurysmal bone cyst(ABC),14 cases of osteoenchondroma (OC),19 cases of Langerhans cell histiocytosis (LCH),15 cases of hemangioma (HA),34 cases of tuberculous spondylitis (TS),and 27 cases of pyogenic spondylitis (PS).All patients underwent radiography,119 cases CT plain scan,75 cases MRI scan,and 57 cases performed all the three imaging modalities.The aggressive signs,including bulging of posterior margin of the vertebral body,pathological compression fractures,ill-defined boundary,abnormal soft tissue mass,bone marrow and soft tissue edema were showed.The benign and malignant misdiagnosis rate,the consistent rate of diagnosis with pathology were statistically analysed.Results Bulging of posterior margin of the vertebral body were found in 2 cases of OB,1 case ABC,3 cases LCH,1 case OC,6 cases HA,6 cases TS,2 cases PS.Pathological compression fracture were found in 6 cases of OB,10 cases ABC,16 cases LCH,4 cases HA,21 cases TS,16 cases PS.Ill defined boundary were found in 3 cases of OB,8 cases HA,34 cases TS,27 cases PS.The abnormal soft tissue around spine were found in 6 cases of OB,2 cases ABC,15 cases LCH,10 cases TS,15 cases PS.Bone marrow and soft tissue edema were found in 5 cases of OB,4 cases ABC,10 cases LCH,4 cases HA,30 cases TS,27 cases PS.For benign and malignant misdiagnosis rate,MRI was better than CT(P＜ 0.05).For accuracy of the consistent rate with pathology,CT was better than MRI(P＜0.05).The integrated application of the three imaging methods could significantly improve diagnostic accuracy (P＜0.05).Conclusion The imaging features benign spinal lesions are various,which may be associated with aggressive signs.A comprehensive method combined with three kinds of imaging methods,is a simple and feasible way to avoid the misdiagnosis.

Imaging diagnosis of congenital absence of the internal carotid artery / 中华神经科杂志

Objective To discuss the clinical and radiological features of congenital absence of the internal carotid artery.Methods Four patients of the congenital absence of the internal carotid artery were reported and the clinical and radiological features were summarized by a review of the literature.Results Four patients were shown subarachnoid hemorrhage ( SAH) , transient ischemic attack ( TIA) , epilepsy and headache, respectively.All of the four patients presented the absence of unilateral or bilateral carotid arteries in cervical computed tomography angiography ( CTA) or magnetic resonance angiography ( MRA).Carotid canal was absent in all the patients in CT base of skull and multiple intracranial vascular dysplasia was shown in all the patients.Basilar or posterior communicating artery was presented as dolichoectasia in 3 patients.There were 2 patients who suffered aneurysm.Conclusions The onset of the congenital absence of the internal carotid artery can be presented in any age.Sudden severe headache as initial symptom caused by SAH is showed more common in children and adolescents.TIA is commonly seen in the elderly.CT shows carotid canals are absent in the base of skull.Unilateral or bilateral carotid arteries are shown absent in CTA or MRA.Multiple intracranial vascular dysplasia is shown in CTA or MRA.Carotid artery CTA has been considered as the optimal imaging method of showing the congenital absence of the internal carotid artery.

The value of pulmonary embolism detection and double energy perfusion imaging of dual source CT in diagnosing peripheral pulmonary embolism / 实用放射学杂志

Objective To explore the value of post processing technique of dual source CT in diagnosing peripheral PE.Methods One hundred and fifty patients with suspected PE were underwent dual source CT scan,and 20 of the all patients met the criterion. The raw CT data were reconstructed by the pulmonary embolism detection (PED)software,double energy perfusion imaging (DEPI)and CT pulmonary artery angiography (CTPA).The PED,DEPI and CTPA map were analyzed by 2 senior doctors in cardiovascular diagnosis profession.According to the diagnosis standard of PE,the location,number of the emboli in segmental and sub-segmental pulmonary arteries were respectively recorded on the PED and DEPI map.We calculated the detection rate,evaluated the significant difference and evaluated the diagnosis consistency between the DEPI and CTPA map.Results Emboli were found in 30 segmental and 40 sub-segmental arteries on the CTPA map with the detection rate of 7.50% and 5.00%,respectively.Emboli were found in 48 segmental and 62 sub-segmental arteries on PED map with the detection rate of 12.00% and 7.75%,respectively.There was significant difference between the CTPA and PED map (χ2 =4.60,5.06,P<0.05).The DEPI and PED map had higher consistency in diagnosing PE.The Kappa coefficient was 0.94 if the PED map was regarded as the reference standard,Among 48 cases with segmental PE detected by the PED map,there were 13 cases of complete filling defects and 35 cases of partial filling defects.Among 13 cases of complete filling defects,there were perfusion defect in 10, and perfusion thin in 3 on the DEPI map.Among 35 cases of partial filling defects,there were perfusion defect in 2,perfusion thin in 29,and perfusion normal in 4 on the DEPI map.Conclusion The PED map combined the DEPI map of dual source CT can significantly improve the diagnosis rate of peripheral PE and has a high clinical value.

CT and MRI findings of granulomatosis with polyangiitis of the nasal cavity and paranasal sinus / 实用放射学杂志

Objective To investigate the CT and MRI findings of granulomatosis with polyangiitis of the nasal cavity and paranasal sinus. Methods The CT and MRI features of eight patients of granulomatosis with polyangiitis in the nasal cavity and paranasal sinus confirmed by histo-pathology were analyzed retrospectively.CT scanning was performed in all eight patients.Routine MRI scanning was performed in seven patients.Dynamic contrast MRI was performed in three cases.SImax ,SIpeak ,Tpeak and MSI of the time-intensity Curves(TICs)were calculated.Results On CT scanning,bilateral middle turbinate,uncinate process and nasal septum were defected in 8 cases.Medial wall of bilateral maxillary sinus showed destruction and other walls of bilateral maxillary sinus showed sclerosis in 8 cases.The ethmoid labyrinth were involved in 6 cases in which the volume of maxillary sinus reduced.The collapse of nasal dorsum and flat nasal bone occured in 4 cases.Nasopharyngeal soft tissue was thicken in 2 cases.Theorbit was involved in 1 case.The mucosal thickness of all group of sinuses were showed in all 8 cases.On MRI scanning,peripheric mucosal of the lesions showed iso or long T1 and long T2 signal in 7 cases.Dynamic-enhanced MRI showed heterogeneous enhancement.TICs showed flat.But in one to four periods showed a slow rising gradient.SIpre was 1 030, SImax 2 500,SIpeak 2 353,Tpeak 100 s,and MSI 1.28%.Conclusion Granulomatosis with polyangiitis of the nasal cavity and paranasal sinus shows some typical CT and MRI features.To summarize the features is helpful to the diagnosis and therapy of the lesion.

Correlation of radiological charicteristics of Coats’disease with pathology / 实用放射学杂志

Objective To investigate the CT and MRI findings of Coats’disease in comparison with pathology.Methods CT,MRI and ultrasonic features,FFA findings of eight patients of Coats’disease with histo-pathologically confirmed were analyzed retrospectively.CT scanning,routine MRI scanning and ultrasonic examination were performed in all eight patients.Results Unilateral eyeball was involved in all eight cases.On CT scanning,the density of the vitreous body was increased homogeneously which boundary was clear(n=8).The retina was thick(n=8).The anterior chamber depth was shallow(n=5).Multiple calcified foci occured in lens and vitreous body(n=1).The volume of affected eyeball increased(n=1).The affected eyeball shrinked(n=1).The difference of volume of bilateral eyeball was not obvious(n=6). Lens were thick and dislocation(n=5).On MRI scanning,the lesions in the vitreous body showed iso T1 and iso T2 signal (n=6),short T1 and long T2 signal(n=1),long T1 and long T2 signal(n=1).The retina showed short T2 signal(n=3).The vitreous body was filled with lesions(n=5).The lesions looked like‘V’sticked to retina(n= 3).On ultrasonic examination low echo was showed in the vitreous body(n=6),the ball wall bulged(n=8),retinal detachment(n=8).The echo of the ball wall was obviously enhanced,which indica-ted ossification(n=1).Strong echo calcified plaque was showed in one case.FFA showed retinal telangiectasia(n=8),retinal capillary zone(n=2),mutiple chestnut shaped aneurysms(n= 6),retinal neovascularization(n= 1 ).Pathological examination showed retinal telangiectasia with foam macrophages and lipid deposition.Conclusion Coats’disease carries some typical CT and MRI features.To summarize the radiologic features,the findings of FFA and ultrasonic inspection are helpful to diagnosis.

Accuracy, image quality and radiation dose comparison of prospective ECG-gated sequential and high-pitch acquisition on 128-slice dual-source CT angiography in infants and children with congenital heart disease / 中华放射学杂志

Objective To compare the accuracy, image quality and radiation dose between prospective ECG?gated sequential and high?pitch acquisition on 128?slice dual?source CT (DSCT) angiography in infants and children with congenital heart disease (CHD). Methods Ninety?two children with CHD from October 2011 to February 2013 were prospectively enrolled and assigned into two groups according to random number table. Forty?six patients underwent DSCT angiography with sequential mode, and the other 46 patients were examined with high?pitch mode. With surgical and/or DSA results as the standard, the diagnostic accuracy and sensitivity of the two groups for the intracardiac structures, extracadiac and coronary artery anomalies were evaluated, and the comparison was analyzed by Fisher exact test. A 5?grade scoring system was used to interpret the image quality of intracardiac structures, great vessels and the proximal and middle segments of coronary arteries. Interobserver agreement on grades of image quality was assessed by Kappa statistics. The image quality scores were compared using the Mann?Whitney U test. The Student t test or the Mann?Whitney U test was used to analyze the differences between the two groups regarding to patients' age, weight , heat rate, CT attenuation, image noise and SNR in the ascending aorta and the pulmonary trunk as well as radiation dose. Results All 92 patients successfully underwent DSCT angiography. The diagnostic accuracies of intracardiac anomalies by high?pitch group and sequential group were 95.65%(88/92) and 99.28%(274/276), showed significant difference between the two groups (P0.05) .There was no significant difference in the diagnostic accuracy and sensitivity of extracadiac anomalies between the two groups (P>0.05). The diagnostic accuracies of coronary artery anomalies by high?pitch group and sequential group were 93.48%(43/46) and 100.00%(46/46), showed no significant difference between the two groups (P>0.05), but there was significant difference in the sensitivity of coronary artery anomalies (50.00%(3/6) , 100.00% (11/11)) (P0.05). The median image quality scores of intracardiac structures and proximal and middle segments of coronary arteries respectively by high?pitch group were 4.00 and 3.00, and 5.00 and 4.00 respectively by sequential group. The image quality of intracardiac structures (U=594.500, P<0.05) and proximal and middle segments of coronary arteries (U=397.500, P<0.05) was significantly better in the sequential group than that in the high?pitch group. There was no significant difference between the two groups in CT attenuation, noise and SNR of the ascending aorta and pulmonary trunk. The mean effective doses of the high?pitch group and the sequential group were(0.27±0.11)and(0.39±0.17)mSv, and showed significant difference between the two groups (t=4.316, P<0.05). Conclusions Both sequential and high?pitch mode of 128?slice DSCT angiography provide high accuracy for the assessment of CHD in infants and children, while the high?pitch mode, though with some image quality declined, shows further significantly lower radiation dose.

The imaging diagnosis of synovial chondromatosis of the temporomandibular joint / 实用放射学杂志

Objective To investigate X‐ray ,CT and MRI features of synovial chondromatosis of the temporomandibular joint (TMJ) .Methods X‐ray ,CT and MRI features of eight patients of synovial chondromatosis of TMJ with histo‐pathologically con‐firmed were analyzed retrospectively .X‐ray examination and CT scanning were performed in all eight patients .Routine MRI scanning was performed in six patients and contrast‐enhanced MRI scanning was performed in two patients synchronously .Results Tumors occured unilaterally in all eight cases ,which occured on the right TMJ in six cases and on the left side in two cases .On X‐ray films , widen joint space and calcificated loose bodies occured in all eight cases .On CT scanning ,cystic‐solid mixed mass around the joint and calcificated loose bodies occured in all eight cases .On MR scanning ,multiple nodular long T1 and short T2 signal occured in six cases . Arthroedema and synovial hyperplasia with iso T1 and iso or slightly long T2 signal in six cases .On contrast‐enhanced MR ,homoge‐neous enhancement occurred in svnovial tissue and the edge of loose bodies in two cases .Conclusion The synovial chondromatosis of TMJ owns typical imaging features .The imaging findings can serve as a reference to improve diagnosis of synovial chondromatosis of TMJ .

Serotype distribution and antibiotic resistance of Streptococcus pneumoniae in hospitalized children / 中华检验医学杂志

pneumococcal infections for children. S. pneumoniae was sensitive to penicillin, which was still the first choice of treatment for S. pneumoniae infections. All the isolates were resistant to erythromycin, and ermB was the dominant mechanism of macrolide-resistance.

The characteristics of bacterial biofilm formation in endotracheal tubes in ventilated patients and the relationship between the biofilm and ventilator-associated pneumonia / 中国小儿急救医学

Objective To observe the formation of the biofilm in endotracheal tubes,the characteris-tics of etiology, drug resistance and relationship between the biofilm and ventilator-associated pneumonia ( VAP) . Methods A total of 60 cases of ventilated children patients whose mechanical ventilation time were≥48 h in the ICU from September 2010 to September 2012,according to the mechanical ventilation time,all cases were divided into 2 to 6 d group,7 to 14 d group and ≥15 d group. The incidence of VAP, biofilm structure under the electron microscope,etiology culture positive rate of the lower airway secretions and bio-film,etiological characteristics and drug resistance were prospectively studied. Results ( 1 ) A total of 19 cases occurred VAP in 60 cases of mechanical ventilation,the incidence of VAP was 31. 7%. (2) Observed by electron microscope,biofilm had formed in the endotracheal tube inner wall in early period of mechanical ventilation. With prolonged mechanical ventilation,biofilm structure had improved,as well as VAP incidence rate from 9. 1%(2 to 6 d group ) increased to 44. 4%(7 to 14 d group) and 88. 9%(≥15 d group). (3) A large number of pathogenic bacteria colonized in the biofilm. Gram-negative bacilli were dominate and drug resistance was high. (4) With prolonged mechanical ventilation,the cultured pathogens from the lower airway secretions and biofilm converged. Conclusion Biofilm could form in the endotracheal tube with mechanical ventilation patients,and is associated with the occurrence of VAP and refractory infections.

Imaging diagnosis of ameloblastomas of the jaw / 实用放射学杂志

Objective The purpose of the study was to characterize the X-ray and CT findings of ameloblastomas of the jaw.Meth-ods X-ray (n=9)and CT (n=20)findings of 20 patients with pathologically proven ameloblastomas of the jaw were obtained.Image features included location,size,shape,density of the lesion,and changes of adjacent bone were assessed.Results 1 9 cases were located in the mandible,including 10 cases in the molar-ramus region,four cases in the whole half of the mandible body,two cases in the whole half of the mandible body and the opposide mantum,one case in the whole mandible body,two cases in the anterior teeth region and mantum.One case was located in the molar region of the maxilla.Three cases were uniocular and 17 cases were multiocular in shape.All lesions caused expansile changes in the adjacent bone,including expanding towards the lip and bucca(n=15),the lingua(n=3),and expanding uniformly(n=2).The interruptions of the surrounding bone cortex were demonstrated in 1 9 cases.Conclusion There are some characteristic imaging find-ings for ameloblastomas of the jaw.Correct preoperation dignosis can be made on the basis of imaging findings.

Comparison of Efficacy of Three Methods to Deal with Hydrosalpinx before in vitro Fertilization and Embryo Transfer / 天津医药

Objective To compare three different curative effects on hydrosalpinx before in vitro fertilization and embryo transfer (IVF-ET). Methods Patients receiving IVF-ET between January 2011 to December 2013 (n=731) due to tubal factor infertility (hydrosalpinx) were retrospectively analyzed. All patients were divided into four groups. Embolization group underwent fallopian tube embolization (n=257). Colostomy group underwent laparoscopic tubal umbrella end colosto?my (n=193). Excision group underwent laparoscopic tubal excision(n=198). Control group did not undergo any effusion be?fore transplantation (n=83). Results Comparing main indicators of ovarian hyperstimulation (the number of antral follicles, the dosage of gonadotropin (Gn), the number of retrieved oocytes), indicators were better in embolism group, colostomy group and control group than those in excision group. Comparing main indexes of IVF-ET (embryo implantation rate, clinical preg?nancy rate, abortion rate), indicators were better in embolism group, excision group than those in colostomy group while indi?cators in colostomy group were better than those in control group. The pregnancy rate in fallopian tube was the lowest in em?bolism group and excision group, and the highest in control group. Conclusion All three methods of processing hydrosal?pinx before transplantation ended with positive impact on IVF-ET, and fallopian tube embolization has certain advantages over the other two treatment measures.

Effect comparison of fallopian tube recanalization and hydrotubation for treating partially obstructed fallopian tubes / 重庆医学

Objective To compare the effects of fallopian tube recanalization and hydrotubation for treating partially obstructed fallopian tubes .Methods A retrospective analysis was conducted in 464 patients with partially obstructed bilateral fallopian tubes diagnosed by hysterosalpinography ,excluding other non -tubal infertility patients ,in the intervention department of our hospital Hospital from Jan .2005 to Dec .2010 .The patients were divided into 3 groups:fallopian tube recanalization group (157 cases) , hydrotubation group (155 cases) and control group(152 cases) .Results The intrauterine pregnancy rate of the fallopian tube reca-nalization group was higher than that of the hydrotubation group and control group .The ectopic pregnancy rate of the fallopian tube recanalization group was lower than that of the hydrotubation group and control group .The intrauterine pregnancy rate of the hydrotubation group was higher than that of the control group ,there was statistical difference between the two groups (P0 .05) .Conclusion Active medical intervention can make the clinical benefit in the patients with partially obstructed fallopian tubes ,moreover ,fallopian tube recanalization is better than hydrotubation in the curative effect .

The radiological manifestation of hypophosphatasia / 中华放射学杂志

ObjectiveTo explore the radiological features of hypophosphatasia.MethodsFive cases of hypophosphatasia were definitely diagnosed,which included 3 males and 2 females aged from 5 months to 23 years.The laboratory assays were analyzed,radiological appearances of bone were determined and differential diagnoses were made.ResultsThe alkaline phosphatase in blood serum of five patients decreased,which were 8,20,13,21,and 18 U/L respectively.Phosphoethanolamine increased in blood serum of the five patients,which were 16.5,13.5,21.6,18.7,and 28.9 μmol/L respectively.Phosphoethanolamine also increased in urine,which were 2350,9120,3520,5280,and 1820 μmol/L respectively.Calcium in blood serum increased,which were 4.2,5.6,4.9,6.1,and 3.5 mmol/L respectively.X-ray images displayed that the density of bone decreased in 5 cases,the metaphyses exhibited widening and cupping in 4 cases,the provisional calcification zone of the metaphysis became thinning or disappearing in 4 cases,long bone bended in 4 cases and pathologically fractured in 1 case.Conclusion Hypophosphatasia can be indicated by its relatively special radiological appearance,and it can be diagnosed and differentiated from rickets,osteomalacia and osteogenesis imperfect by the laboratory examination combined with its clinical presentation.