Objective To explore the risk factors in the prognosis of patients with severe multiple trauma related factors.Methods Ninety-three patients with severe multiple trauma(ISS score≥16 points) were selected as our subjects,who all hospitalized in the second hospital affiliated to Dalian medical University.Among of which,38 cases' ISS score was 16-25,and 55 cases' ISS score was higher and equal to 25.Clinical data and general information were recorded.ISS score,APACHE Ⅱ score and 6 h lactate clearance rate score were measured.Results Twenty-seven dead among these 93 cases and the mortality was 29.03％.There were significant differences in terms of ISS score,APACHE Ⅱ score,lactate level when entering ICU,6 h lactate level and 6 h lactate clearance rate between death patients (27 cases) and survival patients (66 cases) (t =9.846,9.812,7.112,7.012,9.831 ; P ＜ 0.001).In multiple organ dysfunction syndrome (MODS) patients,the mortality of ISS score:16-25 group was different from that of ISS score≥25 (15.78％ (6/38) vs.35.18％ (21/93),x2 =21.52,P ＜0.001).Among the 93 cases of severe multiple trauma,35 cases with MODS(37.6％ (35/93)),and 20 cases of which were dead(57.1％ (20/35)).There was statistic difference between MODS group(35 cases) and non-MODS(58 cases) in term of mortality(37.6％ (35/93) vs.12.1％ (7/58) ;x2 =21.52,P ＜ 0.001).Multivariate logistic regression analysis showed that the ISS score,APACHE Ⅱ score,6 h lactate clearance rate and MODS were independently prognostic correlation factors (P ＜ 0.05).Operating characteristic curve (ROC) showed that AUC of ISS score was 0.735 (95 ％ CI 0.629-0.842),of APACHE Ⅱ score was 0.888 (95％ CI 0.821 =0.956),of 6 h lactate clearance rate score was 0.951 (95％ CI 0.906 -0.997).Conclusion The factors of ISS score,APPCHE Ⅱ assessment,6 h lactate clearance rate,the occurrence of MODS are independent prognostic factors.

Objective To study the effects of traditional Chinese medicine (TCM) five-tone therapy on nursing care of patients with irritable bowel syndrome (IBS).Methods By convenience sampling,a study was conducted among 100 patients with IBS.The patients were randomly divided into the control group and the intervention group,each group consisted of 50 patients.Patients in two groups were both treated with conventional drug and routine nursing care,but patients in the intervention group were intervened by TCM five-tone therapy for 3 months.Clinical efficiency of patients in two groups were assessed by Symptoms Check List-90 (SCL-90),Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD)before treatment and after 12-week treatment.Results The clinical efficiency in the control group and intervention group were 60％ (30/50) and 84％ (42/50) after intervention (P＜0.05).The scores of HAMA and HAMD after TCM five-tone therapy intervened were (5.24±1.15)points and (5.21±1.63) points,which were lower than the control group (8.32±1.42)points and (7.64±1.96) points (P＜0.05).The intervention group was scored lower than the control group in SCL-90 (P＜0.05).Conclusions TCM five-tone therapy may be more effective in decreasing the depression and anxiety of patients with IBS and alleviating their abdominal symptoms.

BACKGROUND:When peri-implantitis occurs, the levels of interleukin-17 in the peri-implant sulcular fluid and soft tissues are significantly increased, and there is a positive correlation with the depth of the peri-implant probing. However, because of the dual effects of bone absorption and protection, the function of interleukin-17 in peri-implantitis remains controversial, which should be further studied. OBJECTIVE:To retrospectively analyze the correlation between peri-implantitis and interleukin-17. METHODS: The first author searched Wanfang, CNKI and Medline databases from 1991 to 2014 by using key words of “dental implants, peri-implantitis, periodontitis, Th17 cels, interleukin-17, cytokines” in Chinese or English. The functions of bone destruction and protection of interleukin-17 in peri-implantitis were reviewed, and interleukin-17 expression and correlation with the peri-implantitis were detected. RESULTS AND CONCLUSION:According to the inclusion and exclusion criteria, 46 articles from 241 articles are selected. The results show that, noninvasive detection of the variation of interleukin-17 levels in peri-implant sulcular fluid or blood is conducive to the monitoring of early diagnosis and treatment of peri-implantitis. At present, most researches show the relationship between interleukin-17 and peri-implantitis, and there is a positive correlation between interleukin-17 and peri-implant probing depth. But other researches suggest that interleukin-17 acts as protector for bones, and there is no statistic significance in the level of interleukin-17 receptor gene in chronic peri-odontitis and healthy subjects. Therefore, the correlation between peri-implantitis and interleukin-17 remains to be further studied.

Objective To explore the effects of traditional Chinese medicine (TCM) five-tone therapy in combination with constitutional types of Chinese medicine based dietary intervention on patients with irritable bowel syndrome (IBS). Methods By convenience sampling, a study was conducted among 68 patients with IBS. The patients were divided into the control group and the intervention group by random digital table method, and each group consisted of 34 patients. Patients in two groups were both treated with conventional drug and routine nursing care, but patients in the intervention group were provided TCM five-tone therapy in combination with constitutional types of Chinese medicine based dietary intervention for 3 months. Patients in two groups were assessed by Chinese Medicine Constitution Questionnaire (CMCQ), Symptom Check List-90 (SCL-90), Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) before treatment and after 12-week treatment. Results After TCM five-tone therapy in combination with constitutional types of Chinese medicine based dietary intervention, the number of IBS patients with pathological constitution types decreased in two groups, the number of patients with gentleness constitution increased to 8 and 25 separately in the control group and intervention group (P<0.05). After intervention, the scores of SAS and SDS in the intervention group were (40.73±8.27)points and (41.16±8.75)points respectively, which were lower than(48.36±7.53)points and(50.03±9.23)points of the control group, and the difference was statistically significant (P< 0.05). The intervention group scored lower than the control group in SCL-90, and the scores had significant differences between two groups (P<0.05). Conclusions TCM five-tone therapy in combination with constitutional types of Chinese medicine based dietary intervention may be more effective in adjusting pathological constitution to gentleness constitution of patients with IBS, alleviating their depression and anxiety and improving their physiological symptoms.

OBJECTIVE: To evaluate the applicative value of multimodal navigation combined with intraoperative magnetic resonance imaging system in the treatment of complex lesions of middle skull base. METHOD: Nineteen consecutive patients undergoing complex lesions resection using multimodal microscopic navigation combined with iMRI were included. Preoperative radiological images were imported into navigation planning system, based on which approach and microsurgical window were designed. Transcranial approach and extracranial approach(include trans-oral-nasal-sphenoidal approach and transsphenoidal approach) were performed in our series. After presumptively total resection were finished, intraoperative magnetic resonance (iMRI)were performed, followed by navigation images updating, and continuing resection if necessary. RESULT: iMRI scan were performed from 1 time to 2 times. In 5 cases with residual seen on iMRI scan, continued resection were carried on in 2 of them. There was no iMRI-associated complications. CONCLUSION Microscopic-based neuronavigation, in combination with intraoperative magnetic resonance, could provide objective basis for resection, and improve the safety level of tumor resection.
Adult ; Aged ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Microsurgery ; methods ; Middle Aged ; Neurosurgical Procedures ; Skull Base ; surgery

The data of 30 patients simulated before surgery were analyzed using Dextroscope operation planning system in Department of Neuresurgery,General Hospital of Chinese PLA between August 2004 and September 2005,including 2 patients with basilar artery aneurysm,1 with posterior cerebral artery aneurysm,3 with ophthalmic aneurysm,2 with middle cerebral artery aneurysms,1 with anterior cerebral artery aneurysm,7 atlas-occipital malformation,4 meningioma,5 schwannomas,and 5 deep gliomas. The primary CT and MRI data of 30 patients were input to the workstation of Dextroscope system for 3D reconstruction,reunion,segmentation and simulation the entire process of the operation. The relationship of the cranial nerves,vessels and skull base bone with lesions during operations were similar with that of the preoperative simulation on the workstation. The time of clipping aneurysms was reduced from (37.60±13.43) minutes to (23.51±7.62) minutes following application of Dextroscope system,and time of resections of odontoid processes was shortened from 81 minutes to 50 minutes. The ratios of complications were decreased and the patients' Karnofsky scales were 88.7 scores 3 months after operation. Dextroscope operation planning system can help doctors to analyze the patients' image data on a 3-D view and video outlook. The system can raise a precise and detailed operation plan before operation based on the simulation of the operation process,to well know the difficulty and shorten operation duration.

Autophagy dysregulation, mitochondrial dynamic abnormality and cell cycle re-entry are implicated in the vulnerable neurons of patients with Alzheimer's disease. This study was designed to testify the association among autophagy, mitochondrial dynamics and cell cycle in dividing neuroblastoma (N2a) cells. The N2a cells were cultured in vitro and treated with different concentrations of 3-methyladenine (3-MA). The cell viability was detected by methyl thiazolyl tetrazolium (MTT) assay. They were randomly divided into control group (cells cultured in normal culture medium) and 3-MA group (cells treated with 10 mmol/L 3-MA). The cell cycle was analyzed in the two groups 3, 6, 12, and 24 h after treatment by flow cytometry. Western blotting was used to evaluate the expression levels of mitofission 1 (Fis1), mitofusin 2 (Mfn2), microtubule-associated protein 1 light chain 3 (LC3), cell cycle-dependent kinase 4 (CDK4) and cdc2. The flow cytometry revealed that the proportion of cells in G(2)/M was significantly increased, and that in G0/G1 was significantly reduced in the 3-MA group as compared with the control group. Western blotting showed that the expression levels of Fis1, LC3, and CDK4 were significantly up-regulated in the 3-MA group at the four indicated time points as compared with the control group. Mfn2 was initially decreased in the 3-MA group, and then significantly increased at 6 h or 12 h. Cdc2 was significantly increased in the 3-MA group at 3 h and 6 h, and then dropped significantly at 12 h and 24 h. Our data indicated that 3-MA-induced suppressed autophagy may interfere with the cell cycle progression and mitochondrial dynamics, and cause cell death. There are interactions among cell cycle, mitochondrial dynamics and autophagy in neurons.

Objecive To explore the medicine packaging improvement based on PAP shelter hospital requirements to fulfill emergency medicine support,Methods The medicine support during rescue was discussed from the aspects of considerations in medicine plan,requirement for emergency medicine,special medicine purchasing and medicine support,and some countermeasures were put forward for improving medicine packaging.Results Its suggested that the optimization of medicine packaging be performed with considerations on medicine property,package capacity,convenience,transport and environmental suitability.Conclusion Emergency medicine support is of importance for disaster medical rescue,and medicine packaging improvement based on PAP shelter hospital requirements contributes to enhancing the efficiency during disaster rescue.

Objective To evaluate the reliability and accuracy of three-dimensional digital fusion anatomy in the preoperative evaluation and therapeutic strategy choice of intracranial tumors.Methods MRI scan,including regular MRI,MRA,MRV and DTI,were performed in 87 case.Then tumor themselves as well as tumor-associated structures were reconstructed and fused through iPlan 2.6 software.Based on the reconstructed images,therapeutic strategy were established,preoperative and intraoperative imags were compared.Results The digital reconstruction were successfully finished in all cases.Meanwhile,digital images,originally radiological images and actual images matched well.No approach-associated complication were met in our series.Among tumors in the convexity,the relationship of the reflux veins and the tumors were divided into three types:anterior(12 cases),posterior(19 cases) and overriding(3 cases).All of the relationships were seen in the preoperative fusion image,and the veins were all effectively protected during operation.The tumor-associated arteries could be pushed or wraped by the tumors,and the three-dimensional fusion image could provided their virtually aberrant pathway as well as their relationship with tumor.During microsurgical managment of tumors in the deep brain parenchyma,safe approach were found with the help of comprehensive understanding of the tumors and their adjacent structures.Conclusion Three-dimensional digital fusion anatomy can vividly and accurately display full rang of information about the tumor,and facilitate tumor treatment safely.

Investigation of the effects of rhizome atractylodis macrocephalae on yeast prion [PSI+ ]was conducted in this study .Liquid culture containing rhizome atractylodis macrocephalae aqueous extracts was applied to evaluate its therapeutic effects preliminarily .Then yeast replica plating together with Semi Denaturing Detergent Agarose Gel Electrophoresis com-bined with western blot were used to further confirm the results .It's showed that the cure rate of aqueous extracts of rhizome atractylodis macrocephalae on yease prion [PSI+ ]could reach 6% .