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Table of Content

    25 June 2016, Volume 37 Issue 6
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    Effects of Tirofiban on myocardial perfusion in patients with acute non-ST segment elevation myocardial infarction complicated with type 2 diabetes treated by percutaneous coronary intervention
    JIANG Yun-fa1, GU Xin-shun1, HAO Guo-zhen1, FAN Wei-ze1, LIU Ting-ting1, DING Tao2*
    2016, 37(6):  621-624.  doi:10.3969/j.issn.1007-3205.2016.06.001
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    Abstract］ ObjectiveTo evaluate the effect of platelet glycoprotein Ⅱb/Ⅲa receptor blockade on platelet function and myocardial perfusion in patients with acute nonST segment elevation myocardial infarction(NSTEMI) complicated with type 2 diabetes mellitus(T2DM) treated by percutaneous coronary intervention(PCI).  MethodsA total of 115 patients with STEMI and T2DM were randomized assigned to receive either tirofiban and PCI(n=59) or PCI alone(n=56). The maximum platelet aggregation rate(MPAR) were measured in all patients. Trombolysis in myocardial infarction grade and the myocardial perfusion grade(MPG) were studied immediately after PCI. ResultsAt different time points in the application of tirofiban, MPAR in tirofiban group were much lower than those of control group（P＜001）. The proportion of MPG in tirofiban group was significantly higher than that in the control group(P＜001). There was no significant difference in bleeding complications between 2 groups.  ConclusionTirofiban can effectively inhibit platelet aggregation in patients with NSTEMI complicated with T2DM, improve postoperative myocardial perfusion with clinical safety and feasibility.
    Relationship between C reactive protein and plaque composition in patients with unstable angina pectoris
    WU Hui-xiang1, ZHANG Shuang2, LIU Lian-yuan2, WANG Wen-guang2, TAN Qiang2*, LIU Shu-hua2
    2016, 37(6):  625-628.  doi:1007-3205(2016)06-0625-04
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    Abstract］ ObjectiveTo analyze the correlation between the concentration of serum C reactive protein(CRP) and plaque composition in patients with unstable angina pectoris. MethodsRetrospective analyzed 43 patients with unstable angina pectoris were performed. Intravascular ultrasoundvirtual histology(VHIVUS) examination in a culprit lesion was used. Patients were divided into thincap fibroatheroma(TCFA) group or stable plague group according to VHIVUS. Enzyme linked immunosorbent assay was used to detect serum CRP and to study the correlation between CRP and plaque composition. ResultsThere were no diffirence in minimal luman area, minimal luman diameter, external elastic membrane between the two groups. TCFA group had larger plague burden than stable plague group(P＜0.05). Virtual histology analysis showed TCFA group had lower fibrous ratio than stable plague group（P＜0.05）； and TCFA group had higher necrotic core ratio than stable plague group(P＜0.05）. Spearman correlation analysis showed that CRP  was positively correlated with necrotic core (rs=0.421, P=0.005) and negatively correlated with fibrous tissue(rs=-0.411, P=0.009). ConclusionThe formation of thin fibrous cap was accompanied with the increase of CRP in patients with unstable angina pectoris. serum level of CRP increased in patients with TFCA. The level of CRP was positively correlated with the ratio of necrotic core and negatively correlated with the proportion of fibrous tissue.
    The relationship between systolic blood pressure and prognosis of elder patients with heart failure when discharged from hospital
    SHAN Xiang-xiang1, ZHOU Jian-ping1, FAN Ren-gen2*, REN Xiang-dong3
    2016, 37(6):  629-631,635.  doi:10.3969/j.issn.1007-3205.2016.06.003
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    Abstract］ ObjectiveTo investigate the relationship between prognosis and systolic blood pressure(SBP) of elder patients with heart failure. MethodsClinical datas of 35 patients with heart failure from Nov.2009 to Nov.2014 were retrospectively nanlyzed. According to the mean systolic blood pressure， 34(1 patient lost) patients were divided into group A(SBP<100 mmHg), group B(SBP 100-140 mmHg), group C(SBP>140 mmHg). The clinical statistics such as the survive time， BNP， cardiac troponin(cTn) and especially the 24 hour ambulatory blood pressure statistics of the patiens died were collected in two years. ResultsSurvival rate of elderly patients among different SBP showed significant difference(P<0.05); Three groups of elderly patients within 2 years after hospital discharge showed difference between time and the point of interaction(P＞005) but no differences between groups. CTn positive rate was statistically significant difference among the 3 groups(P＜005). The cTn positive rate in group A and the group C were higher than those in group C at 3 months. The cTn positive rate in group A were higher than those in group B and the group C at 6 months. The cTn positive rate in group A were higher than those in group B and the group C at 1to 2 years, and group A were higher than those in group B(P＜005). Within 2 years of followup, 25 patients (death) in the event group and 9 patients (survival) in the non event group had significant difference in the dynamic SBP level 24 h before discharged from hospital(P＜005). The event group had lower dynamic SBP than the survival group(P＜005). ConclusionSBP can be used as an index to judge the prognosis of elderly patients discharged from hospital. Clinicians should take effective measures for patients with SBP with lower heart failure.
    The correlation analysis of serum miR-21-5p and inflammatory factor in acute cerebral infarction patients
    YU Li-na1， XI Gang-ming1, LIU Jin-xiang1, ZHAO Zhong-xin2*
    2016, 37(6):  632-635.  doi:10.3969/j.issn.1007-3205.2016.06.004
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    ［Abstract］  ObjectiveTo investigate the correlation between serum miR215p and inflammatory cytokines interleukin6(IL6), IL8 and Creactionprotein(CRP) in patients with acute cerebral infarction(ACI). MethodsBlood samples were collected from 64 inpatients with acute cerebral infarction(duration 24-48h) and from 60 healthy physical examinees with matching age and gender as control group. Realtime quantitative PCR was performed to examine the expression profiles of serum miR215p in ischemic stroke patients and in control subjects. The ELISA method was used to detect the level of serum IL6, IL8 and CRP from two groups. Correlation analysis was made between miR215p and inflammatory factors. NIH Stroke Scale(NIHSS) scores and Activities of Daily Living(ADL) scores analysis were used to analyze the clinical prognosis of cerebral infarction patients within and after admission. ResultsThe levels of serum miR215p, IL6, IL8, CRP in the cerebral infarction group were higher than those in the control group. And miR215p were positively correlated with the expression levels of IL6, IL8 and CRP in ACI patient. After discharge, the NIHSS score of miR215p in relatively low expression group was lower than that in relatively high expression group, while the ADL score of miR215p in relatively low expression group was higher than that of miR215p in relatively high expression group. ConclusionThe upregulated miR215p expression in serum of patients with acute cerebral infarction was positively correlated with the level of serum inflammatory factors IL8, IL6 and CRP. MiR215p may serve as a potential biomarker for predicting the prognosis of patients with acute cerebral infarction.
    Analysis of polysomnography of transient ischemic attack patients with intra-and extracranial largeartery stenosis
    LIU Jie-qiong1, LIU Hui1, WU Hui-jun2, ZUO Feng-tong1, DONG Ai-qin1*, YANG Li-jun1
    2016, 37(6):  636-639.  doi:10.3969/j.issn.1007-3205.2016.06.005
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    Abstract］  ObjectiveTo assess the characteristic of transient ischemic attack patients with intraand extracranial largeartery stenosis. MethodsFiftysix cases of transient ischemic attack patients were divided into two groups, twentyfive cases with intra and extracranial largeartery stenosis(group A), and thirtyone cases without intra and extracranial largeartery stenosis(group B). All the participants were examined by clinical assess, Hamilton Anxiety Scale(HAMA), Hamilton Depression Scale(HAMD), Pittsburgh Sleep Quality Index(PSQI), polysomnography(PSG), imaging examination. The data were compared between the two groups. ResultsThere was no statistical difference between the two groups in terms of the incidence rate of sleep disorder，PSQI scores and the incidence rate of obstructive sleep apnea syndrome(P＞0.05). Total sleep time, total nonrapid eye movement(NREM) time and N3/NREM in group A were shorter than that in group B, and sleep efficiency in group A were lower than that in group B, whereas wakening time and sleep time of N2/NREM in group A were longer than that in group B(P＜0.05). But there was no statistical difference between the two groups in terms of total recording time, sleep latency, rapid eye movement(REM) latency, REM time, and N1/NREM(P＞0.05). ConclusionTIA patients with intraand extracranial largeartery stenosis were more prone to shorter total sleep time, longer wakening time, lower sleep efficiency, shorter total NREM time, longer N2/NREM, shorter N3/NREM, and lower sleep quality.
    Neuralelectrophysiologicalanalysisof121patientswithdiabetes
    LV Shu-juan1, ZOU Ji-min2, SU Ying-ying2, ZHENG Jun-zhong3, YUAN Xiao-dong1, DING Huan-ran4
    2016, 37(6):  640-643.  doi:10.3969/j.issn.1007-3205.2016.06.006
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    ［Abstract］ ObjectiveTo explore the changes and clinical significances of neural electrophysiological parameters in patients with diabetes. Methods Changes of neural electrophysiological parameters were analyzed in 121 diabetic patients .  According to the course of disease(by 10 years), the electrophysiological indexes were analyzed. ResultsThere was difference in the electrophysiological indexes of 121 patients with diabetes mellitus. In more than 10 years group, thd decreased abnormal rates of conduction velocity in the median nerve, peroneal nerve and tibial nerve motor nerve were increased(P＜0.05). The abnormal rates of latency in median nerve and ulnar nerve were higher than that in <10 years group(P＜0.05). The decreased abnormal rate of amplitude in peripheral motor nerve was also increased, but the difference was not statistically significant in two groups(P＞0.05). In more than 10 years group, the conduction velocity decreased abnormal rates in sensory nerve median nerve, ulnar nerve and radial nerve were increased（P＜0.05）. The decreased and the abnormal rate of amplitude in median sensory nerve was increased(P＜0.05). ConclusionThe regular nerve electrophysiological examination in patients with diabetes will be helpful for early detection, early diagnosis and early treatment of diabetic peripheral neuropathy.
    Cerebrospinal fluid cytology analysis of infectious diseases of the central nervous system
    ZHANG Qing1, HE Hong-yan1*, MA Ai-rui1, SHAO Yan-xin2, FENG Jian-chun3, LI Jun-xia1
    2016, 37(6):  644-646,651.  doi:10.3969/j.issn.1007-3205.2016.06.007
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    Abstract］  ObjectiveTo evaluate the clinical significance of dynamic monitoring of cerebrospinal fluid cytology in the differential diagnosis and therapeutic effect of central nervous system infectious diseases. MethodsThe results of the cerebrospinal fluid cytology in 117 cases of infectious diseases of central nervous system were analyzed retrospectively. ResultsAmong the 117 patients, tuberculous meningitis(TBM) was found in 70 cases（5983%）, viral meningitis(encephalitis) was found in 30 cases(2564%), purulent meningitis(PM) was found in 10 cases(855%), cryptococcal meningitis(CM) was found in 6 cases(513%), and  cerebral cysticercosis was found in 1 case(085%). The cases in TBM group showed a mixedcell response in cerebrospinal fluid.With the improvement of the condition, neutrophils was gradually decreased, but the duration was longer. Purulent meningitis was mainly dominated by neutrophils. After antiinfection treatment, neutrophils declined sharply in a short period of time. Viral meningitis were mainly in lymphocyte reaction. Cryptococcus neoformans could be directly found in cryptococcal meningitis by cerebrospinal fluid cytology,which can achieve the etiological diagnosis. Eosinophile cells were increased in cerebrospinal fluid in patients with cerebral cysticercosis. Eosinophilia was decreased gradually after insecticide treatment. ConclusionTBM was the most common infectious disease of central nervous system in our hospital. The dynamic monitoring of cerebrospinal fluid cytology had an important role on the diagnosis and guiding the prognosis in patients with infectious diseases of central nervous system.
    The protective effects of Methylprednisolone on rats with HClinduced acute lung injury #br#
    HEN Jie1, CHEN Wei1*, ZHU Xi2, BIAN Wei-shuai1, ZHAO Lei1, SHENG Bo1
    2016, 37(6):  647-651.  doi:10.3969/j.issn.1007-3205.2016.06.008
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    ［Abstract］  ObjectiveTo investigate the protective effects of different doses of methylprednisolone(MP) on HCLinduced acute lung injury in rats. MethodsA total of 48 male SD rats were divided randomly into four groups according to the random number table method:model group, control group, smalldose MP group and highdose MP group. Each group included 12 rats. The model group were injected with hydrochloric acid(pH=18, 2 mL/kg) by the endotracheal intubation, and the control group were injected with equal volume of normal saline by the endotracheal intubation. The smalldose MP group and highdose MP group were intraperitoneally injected with 5 mg/kg and 40 mg/kg MP after duplicating model. Four hours after duplicating model, the pathological changes of lung tissue were observed under light microscope. The lung wet/dry ratio(W/D) was calculated. Protein concentration, PMN% in bronchoalveloar lavage fluid and the expression of  Na+K+ATPase α1  isoforms mRNA in lung tissues were measured.  ResultsIn the control group, the lung tissue structure was clear, the alveolar septum was uniform, and there was no fibrin exudation and neutrophil infiltration in the alveolar. Model group showed the bronchial epithelial cells, alveolar cavity, a large number of fibrin exudation and edema fluid formation. Compared with model group, there were different degrees of improvement of the lung tissue pathologic characteristics in the smalldose MP group and highdose MP group.  In model group，smalldose MP group and highdose MP group, W/D，protein concentration and PMN% in BALF were significantly increased， the Na+K+ATPase α1  isoforms mRNA expressions were significantly lower. and the protein concentrations in BALF in smalldose MP group and highdose MP group were significantly decreased, compared with control group. The difference was statistically significant (P＜001). ConclusionMP can significantly improve lung injury degree of hydrochloric acidinduced acute lung injure model of rats. Smalldose MP has more advantage on lung protection than highdose MP on acute lung injury of rats.
    The experience of reducing the use rate and infection rate of ICU central venous catheter by cluster intervention
    GUO Zhi-qiang1, DAI Kun-peng1, WANG Bin1， KONG Ji-chang1， YU Guang-yan1, LI Shuang-cheng2*
    2016, 37(6):  652-654.  doi:10.3969/j.issn.1007-3205.2016.06.009
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    ［Abstract］ ObjectiveTo determine whether implementation of the central line bundle(CLB) would reduce the usage rate and the infection rate of central venous catheters(CVCs). MethodsDuring baseline phase(from January 2011 to December 2011), active surveillance of CLABSIs was conducted. The intervention of the central venous catheter in the intervention phase(from January 2012 to December 2014) was measured and the implementation of target was monitored. The rate of central venous catheter and the infection rate of central venous catheter before and after the intervention were compared. ResultsAfter implementation of the CLB, the usage rate of central venous catheter was reduced from 730% to 588%(P＜001). Central venous catheter infection rate was decreased from 486% to 184%(P＜005). ConclusionThe utilization rate and infection rate of central venous catheter in intensive care unit were reduced by cluster intervention.
    The value of the eradication of helicobacter pylori in the treatment of dual antiplatelet therapy after percutaneous coronary stent implantation
    WANG Shao-hua1， LI Shi-jing2， WANG Jun2， WANG De-zhao3*
    2016, 37(6):  655-658.  doi:10.3969/j.issn.1007-3205.2016.06.010
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    ［Abstract］ ObjectiveTo investigate the value of the eradication of helicobacter pylori（Hpylori） in the treatment of dual antiplatelet therapy after percutaneous coronary stent implantation（PCI）. MethodsAfter PCI, 282 cases with Hpylori infection were randomly divided into group A，group B and group C. One hundred and twentyfive patients without Hpylori infection were treated as control group. All the patients in 4 groups were treated with dual antiplatelet therapy. At the same time group B was treated with pantoprazole for six months, group C was treated with Hpylori eradication and pantoprazole for six months. The symptoms of dyspepsia, upper gastrointestinal hemorrhage （UGH） and major adverse cardiovascular events（MACE）were compared. ResultsFor the incidence of dyspepsia, group A> control group> group B> group C(489% vs 298% vs 191% vs 75%,P＜005)；For UGH incidence, group A> control group, group B>group C(160% vs 65%, 74% vs 11%, P＜005), difference between the control group and Group B was not statistically significant(P＞005). For comparing MACE incidence, there were no statistical difference among 4 groups(P＞005). There was no significant difference in the incidence of UGH in patients with pylori H. eradication failure(67% vs 0%, P＞005).  ConclusionHpylori infection can increase symptoms of dyspepsia and the incidence of UGH within one year after PCI and dual antiplatelet therapy in patients. The Hpylori eradication program containing pantoprazole combined with a half year of pantoprazole therapy can effectively prevent and reduce those symptoms, and does not increase the incidence of MACE. However, whether it can reduces the incidence of MACE needs large samples and longrange observation.
    CharacteristicsofbloodglucoseandbloodlipidlevelsinpatientswithHHcy
    SU Yong-chen1， GUO Xin2*， CAO Xue-feng3
    2016, 37(6):  659-662,666.  doi:10.3969/j.issn.1007-3205.2016.06.011
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    ［Abstract］ ObjectiveTo investigate the changes of blood glucose and blood lipid levels in patients with hyperhomocysteinemia(HHcy). MethodsA retrospective study were performed in 528 cases from hospital of armed police public security fire control team of Tangshan or from Tangshan people′s hospital. On the basis of homocysteine levels, all cases were divided into normal control group(< 15.0 μmol/L), mild increase group(15~30 μmol/L), moderate increase group(＞30~100 μmol/L) and the severe increase group(>100 μmol/L), Blood glucose and blood lipid levels were measured in each group. SPSS 19.0 software were used for statistical processing. The changes of blood glucose and blood lipid levels in patients with homocysteine were compared. ResultsCompared with the normal control group, TC, LDLC level in Hcy mild increase group, in moderate increase group and in the severe increase group were increased significantly. The difference was statistically significant and two two comparison of the differences also have statistical significance(P<005). But there was no significant difference in the level of GLU and HDLC in all the groups(P>005). Linear correlation analysis showed that the change of Hcy concentration was correlated with the GLU, TG, TC, HDLC, LDLC. However, if Logistic regression analysis was performed by using GLU, TG, TC, HDLC, LDLC, Lpa as the independent variables and HHcy as the dependent variable, the results showed that the correlation between HHcy, TG, TC, HDLC, LDLC, Lpa, and GLU was not statistically significant, but was the result of a multifactor action. Independent variables had little effect on HHcy. ConclusionHigh homocysteine levels are affected by multiple factors. The blood glucose and blood lipid levels in the patients were changed, and the changes of serum TC and LDLC levels were the most significant.
    Diagnostic value of CD64 on pulmonary tuberculosis with bacterial infection
    WANG Xian-lei1, WANG Yong1, HE Cong2, CHEN Su-li1, LIU Rui1, GUO Li-ping3*
    2016, 37(6):  663-666.  doi:10.3969/j.issn.1007-3205.2016.06.012
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    ［Abstract］ ObjectiveTo investigate the diagnostic value of CD64 on pulmonary tuberculosis with bacterial infection. MethodsA total of 200 patients, hospitalizing at the departments of respiration and tuberculosis in Hebei Chest Hospital were divided into two groups:Group Ⅰ(n=100), patients with pulmonary tuberculosis; Group Ⅱ(n=100), patients suffering pulmonary tuberculosis with bacterial infection. Firstly, we detected the level of CD64, procalcitonin(PCT), and Creactive protein(CRP) invenous blood drawn within 48 h after patients were enrolled in group. Secondly, ROC curves could be plotted based on the data of CD64，PCT and CRP. Finally, it was essential to account the area under curve, the best borderline of CD64, PCT and CRP. Then the sensitivity and specificity were caculated. ResultsCompared with Group Ⅰ，CD64 index，PCT and CRP in Group Ⅱ were increased significantly(P＜005). The area under curves plotted basing on the data from two groups were 0.971（CD64）>0921（PCT）>0.825（CRP）, respectively. Compared with the standard area of 0.5, there were statistical significance（P＜005）. ConclusionCD64 is highly expressed in infectious patients with pulmonary tuberculosis, whose diagnostic value is similar to PCT, whereas better than CRP. These results indicate that CD64 might be an assistant marker in diagnosing pulmonary tuberculosis with bacterial infection.
    Comparative study of Parkinson disease rat model via unilateral injection of 6OHDA into three different brain regions
    LI Jin,SUN Jie,ZHAO Nan,WU Jun,LIU Jun*, MA Gang
    2016, 37(6):  667-671.  doi:10.3969/j.issn.1007-3205.2016.06.013
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    ［Abstract］  ObjectiveTo compare Parkinson disease(PD) rat models via unilateral injection of 6hydroxydopamine(6OHDA) into three different brain regions from the aspects of neurobehavior, histopathology and biochemistry. MethodsHealthy male SD rats were randomly divided into three groups(n=10):striatum group， substantia nigra group，substantia nigra+ midbrain ventral tegmental area group. According to the stereotaxic atlas of the brain, the trace 6OHDA unilateral injection into rat substantia nigra and striatum were performed via single point position in striatum group and in substantia nigra group, and 6OHDA injection into rat substantia nigra and midbrain ventral tegmental area were performed by double point position in substantia nigra+midbrain ventral tegmental area group.The rotation behavior induced by apomorphine was observed in rats. The tyrosine positive neurons in the rat substantia nigra were detected by immunohistochemistry. The dopamine(DA) and its metabolic products 3, 4 dihydroxy phenyl acetic acid(DOPAC) and homovanillic acid(HVA) were measured by electrochemical highperformance liquid phase chromatography in rat striatum. ResultsIn the rats with unilateral injection 6OHDA into striatum viasingle point position, stablerotation appeared at 3 weeks, and a high rate of success in animal model was obtained. In the rats with substantia nigra injection model viasingle point and in the rats with substantia nigra + midbrain ventral tegmental area via double point position injection model, stable rotation appeared after 2 weeks, but animal model success rate is low. Three types of PD rat models in different brain regions injected by 6OHDA showed that the number of tyrosinehydroxylase neurons in substantia nigra area was severely deficient, and that the contents of DA and its metabolites(DOPAC, HVA) in striatum were significantly decreased. ConclusionRat model with unilateral injection 6OHDA into striatum via single point position is  highly successful, which can be used as a stable and reliable animal model for the study on PD.
    Comparative analysis of postoperative recovery between singleport and three ports VATS surgery of lung cancer
    LI Ai-zhen1, WANG Liang2, YANG Sha3, QI Ke-lei1*, LI Hui1
    2016, 37(6):  672-675,679.  doi:10.3969/j.issn.1007-3205.2016.06.014
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    ObjectiveTo analysis the advanges of singleport video assisted thoracoscopic surgery(VATS) compared to three portVATS in the lung cancer patitens. MethodsRetrospective analysis of clinical data of 137 patients with lung cancer were performed. Among the patients，65 cases undertook  singleport VATS surgery were observation group, and 72 cases received three ports VATS were control group. The operation time，blood loss, postoperative drainage amount, chest tube drainage duration，postoperative hospital stay, the Visual Analogue Scale(VAS) score pain score of the 1st and 2nd postoperative day,shoulder disfunction,the incision discomfort in the 30th and 90th postoperative day, and the incision satisfaction degree were evaluated between the two groups. ResultsAll the patients were underwent total VATS surgery successfully and no severe complications were observed. There were no significant difference on  blood loss, postoperative drainage amount，chest tube drainage duration，postoperativep hospital day(P＞005) between the two groups．Compared to control group，renees in operation time was longer(P＜005), the VAS score of the 1st and 2nd postoperative day was lower(P＜005), the incision discomfort of 30th and 90th postoperative day was reduced and the incision satisfaetion degree was significantly improved(P＜005), shoulder disfunction  rate was lower(P＜005) in observation group. ConclusionSingleport VATS surgery had the same result cmopared with the three ports VATS, but the postoperative recovery is more better in singleport VATS surgery, which indicated singleport VATS surgery is worthy of clinical promotion.
    Short segment fixation combined with fenestration in treatment of degenerative instability in L3 degree Ⅰ spondylolisthesis with lumbar spinal stenosis
    LI Yi-peng1, TIAN Yu-liang1, DUAN Xiao-feng2, YU Hai-quan1, CAO Bin1, WANG Meng1
    2016, 37(6):  676-679.  doi:10.3969/j.issn.1007-3205.2016.06.015
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    ObjectiveTo explore the clinical effect of short segment fixation combined with fenestration in the treatment of degenerative instability L3 degree Ⅰ spondylolisthesis with lumbar spinal stenosis disease. MethodsThirtynine patients who suffered from degenerative instability L3 degree Ⅰ spondylolisthesis with lumbar spinal stenosis were treated with short segment fixation combined with fenestration. Operative bleeding volume、 operation time、 complication occurrence were observed. Japanese Orthopedic Association(JOA)score was adopted to evaluate postoperative effec. Periodic observation with radiographic imaging, postoperative internal fixation、fusion of bone and slippage of the segment after surgery were examined. ResultsObserved indicators were as follows: operative bleeding volume was(400.0±80.6) mL，operation time was(133.0±28.4) min, complication occurrence was 2/29. The symptoms were relieved obviously in the group of patients after the operation. with higher JOA scores．The position of nail stick system was good, without cage subsidence, displacement and increasement in slip. Six months after operation, lumbar fusion between L3 and L4 was good except one case. ConclusionShort segment fixation combined with Posterior limited spinal decompression in the treatment of degenerative instability L3 degree Ⅰ spondylolisthesis with lumbar spinal stenosis has advantages of minimal invasion, retains part of the spinal mobility, alleviates the economic burden of the patient, and shows good effects.
    Comparison of the forming ability of three kinds of nickeltitanium root canal preparation system#br#
    LI Zhan-jie1, YIN Pu-guang2, GAO Ming-ying2, WANG Yu-wei2
    2016, 37(6):  680-683.  doi:10.3969/j.issn.1007-3205.2016.06.016
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    ［Abstract］ ObjectiveTo compare the effects of nickel titanium Reciproc, K3, ProTaper system and stainless steel system KFile in the preparation of the root canal forming of the severe bending molar. MethodsForty first molar with severe bending of the mandibular canal were randomly divided into four groups. Reciproc, K3, ProTaper system and manual stainless steel system KFile were used for root canal preparation. The position of the tip of the instruments in the 4 groups before and after the root canal preparation were recorded. The changes of root canal curvature, the change of working length in root canal and the operation time were compared between the 4 groups. ResultsAmong 4 groups, the operation time of Reciproc group was the shortest, and the stainless steel manual KFile time was the longest. There was no significant difference in the changes of the working length of the root canal after Reciproc, K3 and ProTaper in each group. Before the root canal preparation, there was no significant difference in root canal curvature between the 4 groups. After root canal preparation, the changes in Reciproc, K3, root canal curvature ProTaper groups are less than KFile group.  ConclusionThe applications of Reciproc, K3, after ProTaper nickeltitanium instruments prepared for molar curved root tube forming were with high efficiency and strong ability.
    Ultrasonic feature analysis of cervical metastatic lymph nodes in thyroid carcinoma
    LI Jia
    2016, 37(6):  684-686.  doi:10.3969/j.issn.1007-3205.2016.06.017
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    Abstract］  ObjectiveTo observe the ultrasonographic features of cervical lymph node metastasis in thyroid carcinoma, and to investigate the value of ultrasonography in the diagnosis of cervical lymph node metastasis of thyroid carcinoma. MethodsUltrasound imaging features of 503 cases of cervical metastatic lymph nodes in 169 patients with thyroid carcinoma were analyzed. ResultsMetastatic lymph nodes in the neck of thyroid carcinoma show medium or low echo,lymph node blood mainly showed peripheral blood supply type and no blood supply type. There was no significant difference in metastatic lymph node length(L), short diameter(S), L/S and resistance index(RI) in different pathological types of thyroid carcinoma（P＞005）. L/S ratio mean value was less than 1.8 and blood flow RI mean number was more than 06. Micro calcification(calcification foci＜2 mm ) was the characteristic manifestation of metastatic lymph nodes in papillary carcinoma of the thyroid gland. ConclusionThe metastatic lymph nodes of thyroid carcinoma have typical characteristics of ultrasound image.To master the characteristics of the manifestation is helpful to improve the detection rate, wchich possess important clinical practical value.
    Contrast analysis of ultrasound images of typical breast cancer and atypical breast cancer
    YAN Hui-tong1， CAO Yun-feng1， ZHAO Jia-hui2
    2016, 37(6):  687-689.  doi:10.3969/j.issn.1007-3205.2016.06.018
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    ［Abstract］ ObjectiveTo investigate the ultrasound characteristics between the typical and atypical breast cancer and improve the understanding for the atypical breast cancer， and to reduce the misdiagnosis rate and missed diagnosis rate. MethodsRetrospective analysis of 58 cases of breast cancer patients confirmed by surgery or puncture pathology were performed. The differences are analyzed from twodimensional image including boundary, echo, shape and so on. ResultsThirtytwo typical and twentysix atypical breast cancers were enrolled in the study. Aatypical breast cancers included 13 cases of glandular structure disorder(500%), 5 cases of microcalcification type(192%), 5 cases of small nodules or cysts type(192%), 2 cases of cystic and solid type(77%), 1 case of occult type(38%). For the typical breast cancer, there was statistically significant difference between the ultrasound compared with Xray mammography and MRI（χ2=7.199，P<005）, but no statistically significant difference in the atypical breast cancer （χ2=2791，P＞005）. ConclusionMore and more atypical breast cancers were discovered. Different imaging examination have its virtues and faults. We should combined all the imaging examinations to achieve early detection, early diagnosis .
    Comparative analysis of the diagnostic value of smear negative pulmonary #br# tuberculosis in different age groups by two methods
    LI Yu-jing1, WU Hai-feng1, SUN Zhi-ping1, MA Jing-hua2, WANG Liang3, LV Cui-huan1*
    2016, 37(6):  690-692.  doi:10.3969/j.issn.1007-3205.2016.06.019
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    ［Abstract］ ObjectiveTo evaluate the diagnostic value of TSPOTTB and tuberculosis protein chip test for difference age patients with smearnegative pulmonary tuberculosis. MethodsOne hundred and ninetyone tuberculosis patients(smearnegative pulmonary tuberculosis) and 91 pneumonia patients were enrolled in our test. They were divided into three groups: the teenage group(7~40 years old), the middleaged group(＞40~65 years old) and the gerontism group(more than ＞65 years old). The three groups were examined with TSPOTTB and tuberculosis protein chip test. ResultsThe  sensitivity of TSPOTTB and tuberculosis protein chip test in teenage group and  middleaged group were significant difference between the two methods(P＜005)， but the specificity of two methods was no significant difference(P＞005). The sensitivity and  specificity in gerontism group were no significant difference(P＞005).  ConclusionTSPOTTB was important in the diagnosis for teenage  and middleaged patients with smearnegative pulmonary tuberculosis. The diagnosis of smear negative pulmonary tuberculosis in the elder patients should be selected according to the specific status.
    In vivo experimental study of bacteria combined vaccine in respiratory tract infection
    LI Shu-yi1, BAO Chen-xian2, ZHANG Jing3
    2016, 37(6):  693-696.  doi:10.3969/j.issn.1007-3205.2016.06.020
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    Abstract］ ObjectiveThe immune function of the mice was detected through the in vivo experiment in mice, which will provide theoretical basis for the development of the bacterial combined vaccine of respiratory tract infection in our country. Methods①Six common bacterias in children with respiratory tract infection in our country were isolated and cultured.  Bacterial proteins were prepared by washing, ultrasonic crushing, precipitation, dialysis and spectrophotometer, and the equivalent amount of the mixture was used as the experimental combined vaccine. ②Forty specific pathogen free mice were randomly divided into four groups, with 10 rats in each group. All mice were fed with a basal diet.After adaptive feeding for 10 days, the experimental group were fed with concentrations of 01, 02, 04 g/L combined vaccine, with daily morning irrigation of 02 mL. The mice in normal control group were orally administered daily with  physiological saline 02 mL. All groups were immuned for 10 days. Effects of combined vaccine on the phagocytic function of macrophage,the cellular immune function of mice, the changes of serum hemolysin content and the effect of thymus index and spleen index determinated. ResultsCompared with the normal control group, the macrophage phagocytic rate and phagocytic index,left and right foot weight, the absorbance value of serum hemolysin, the spleen index and thymus index of combined vaccine groups were significantly increased(P＜005). In the experimental design of vaccine concentration range, the detection values in different groups were increased with the increasement of vaccine concentration, and there were significant differences among the test groups(P＜005). ConclusionCombined vaccine can improve the immune function of organism. Combined vaccine can not only improve the cellular immune function, but also has obvious effect on humoral immune function. In the experimental concentration range, the higher the vaccine concentration, the more obvious effect on the immune function of the body.