Objective To evaluate the efficacy of early rehabilitation for severely burned patients in intensive care unit (ICU).Methods One hundred and eighty two severely burned patients were enrolled in the study,including 97 patients receiving early rehabilitation in ICU (rehabilitation group) and 85 patients without early rehabilitation (control group).There were no significant differences in burned surface area,depth and locations between two groups.After one year's treatment,patients were evaluated by the Vancouver Scar Scale (VSS).Results The mean VSS score of rehabilitation group was significantly lower than that of control group (3.1 ± 1.2 vs.5.2 ± 1.3,P ＜ 0.05).Conclusion Early rehabilitation therapy is beneficial for severely burned patients in ICU.

Objective To study clinical efficacy of ulinastatin combined with naloxone in patients with cardiogenic shock(CS) after acute myocardial infarction (AMI).Methods Eighty patients with CS after AMI were randomly divided into routine treatment group (n =19),ulinastatin group (n =20),naloxone group (n =21) and ulinastatin combined with naloxone group (n =20).The levels of serum cardiac troponin I (cTnI),brain natriuretic peptide(BNP),tumor necrosis factor-α(TNF-α) and interleukin-6 (IL-6)were measured before and a week after treatment.In the meantime,recovery time of shock,the average hospitalization days and 28-day mortality rate were recorded.Results After the treatment,the levels of serum cTnI,BNP,TNF-α and IL-6decreased in all groups(P ＜ 0.01),and there was significant difference on the decreasing degree of cTnI,BNP,TNF-α and IL-6 in ulinastatin combined with naloxone group when compared with those in routine treatment group,ulinastatin group and naloxone group(cTnI:(1.04 ± 0.17) ng/L vs.(2.06 ± 0.15) ng/L,(1.59 ± 0.16)ng/L,(1.97 ± 0.14) ng/L; BNP:(143.21-56.94) ng/L vs.(261.07 ± 71.43) ng/L,(203.46 ± 65.73) ng/L,(252.96 ± 68.85) ng/L; TNF-α:(13.42 ± 8.93) ng/L vs.(31.21 ± 12.32) ng/L,(20.39 ± 11.08) ng/L,(28.98 ± 11.76) ng/L ; IL-6:(37.58 ± 11.14) ng/L vs.(80.46 ± 27.15) ng/L,(59.84 ± 20.72) ng/L,(76.15 ±26.45) ng/L; P ＜ 0.01).The recovery time of shock,the average hospitalization days and 28-day mortality rate in ulinastatin combined with naloxone group were significantly lower than those in routine treatment group,ulinastatin group and naloxone group(recovery time of shock:(7.16 ± 1.52) d vs.(11.43 ± 2.40) d,(8.05 ±1.81)d,(8.74 ± 1.98)d;the average hospitalization days:(15.03 ±3.23)d vs.(22.64 ±4.18)d,(18.93 ±3.97)d,(19.21 ±3.94)d ;28-day mortality rate:(41.62％ vs.61.20％,50.74％,52.31％ ; P ＜0.01)).Conclusion The application of ulinastatin combined with naloxone can effectively inhibit the cardiac injury and inflammatory response,promote the recovery of circulation function and improve prognosis in patients with CS after AMI.

Objective To assess the health risk of soil-mouth exposure of soil heavy metal pollution by in vitro method. Methods Collected the soil sampling from the heavy metals contaminated field and roadside. Digested the soil sample by in vitro device and determined the content of Cd, Pb, Zn in the solution in the simulated stomach phase and intestine phase respectively with ICP-MS after centrifuging. Calculated the exposure and assess health risk. Results Bioaccessibility of Cd, Pb and Zn at the stomach phase was 21%-33%, 2%-28%, 33%-43% respectively in the polluted areas, and 27%, 23%, 95% in the control area; At the intestine phase was 16%-19%, 3.4%-4.9%, 8%-14% in polluted areas and 11%,2.6%,18% in control area respectively. The amount of available Cd, Pb and Zn in the stomach phase was 0.04-1.46 ?g/d, 3.09-5.53 ?g/d, 3.86-9.39 ?g/d in polluted areas and 0.01 ?g/d, 0.74 ?g/d ,5.64 ?g/d in control area for children, and 0.01-0.36 ?g/d, 0.77-3.88 ?g/d, 0.97-9.85 ?g/d in polluted areas and 0.00 ?g/d. 0.19 ?g/d, 1.41 ?g/d in the control area for adult ; at intestine phase the amount of available Cd, Pb and Zn was 0.03-0.71 ?g/d, 0.50-9.92 ?g/d, 1.26-9.55 ?g/d in polluted areas and 0.00 ?g/d, 0.08 ?g/d, 1.07 ?g/d in the control area respectively for children, 0.01-0.18 ?g/d, 0.11-2.48 ?g/d, 0.31-2.39 ?g/d in the polluted areas and 0.00 ?g/d,0.02?g/d,0.27 ?g/d in the control area respectively for adult. Conclusion Heavy metals exposure through soil-mouth pathway will increase the total health risk of heavy metal to exposed population.

Objective To analyze the incidence,clinical feature and the risk factors of invasive fungal infection in pediatric intensive care unit (PICU). Methods We retrospectively summaried the invasive fungal infection in our PICU from Jan 2007 to Dec 2009 in order to analyze the incidence, clinical feature and the risk factors of invasive fungal infection in PICU. Multiple clinical data were collected such as pediatric critical illness score, mechanical ventilation, urinary drainage tube, indwelling gastric canal and continuous blood purification. Results ( 1 ) The incidence rate of invasive fungal infection was 1.65 % ( 35/2 116 ). The morbidity was 20. 00% ( 7/35 ). ( 2 ) Mean infected day was ( 10. 4 ±- 8. 3 ) d after admission. The clinical manifestations included fungal pneumonia( 60. 0% ), peritonitis ( 14. 3% ), urinary tract infection ( 11.4% ),intestinal tract infection(8. 6% ) ,sepsis(2. 9% ) and meningitis(2. 9% ). All of the patients had used broad spectrum antibiotic. (3) The risk factors of invasive fungal infection included lower pediatric critical illness score, mechanical ventilation, indwelling gastric tube, urinary drainage tube and continuous blood purification.(4) Candia albicans was the predominant pathogen in invasive fungal infection. Conclusion Invasive fungal infection has become one of the main nosocomial infection in PICU. Lung is most commonly involved and candida albicans is the major pathogen. Using antibiotics appropriately, decreasing unnecessary invasive performance,and rationally using antifungal agent mi.ght be effective strategy for invasive fungal infection in PICU.

BACKGROUND: Human apolipoprotein H which characterizes by polymorphism is related to metabolism of triacylglycerol (TG) and function of platelet; therefore, it is suspected that it is possibly related to coronary atherosclerotic heart disease (CAHD).OBJECTIVE: To investigate the correlation among apolipoprotein H(ApoH) exon-8 polymorphism with CAHD and its effect on lipometabolism.DESIGN: Case-controlled observation.SETTING: Department of Cardiology, Haici Medical Group, Qingdao,Shangdong. PARTICIPANTS: 110 CAHD patients selected from Qingdao Haici Medical Group were regarded as CAHD group, and other 100 healthy subjects were regarded as control group.METHODS: 2 mL blood was collected from peripheral vein of all cases. Polymerase chain reaction and technique of restriction fragment length polymorphism were used to determine the genotype of ApoH exon-8; meanwhile, lipids were measured with oxidase technique.MAIN OUTCOME MEASURES: ① polymorphism of ApoH exon-8 genotype; ② gene frequency of ApoH exon-8 (Try316Ser); ③ comparisons of lipid level of cases with various genetypes.RESULTS: All 210 cases were involved in the final analysis. ① G1025C (Try316Ser) existed in ApoH exon-8, including types of GG and GC, butnot CC type. ② The frequency of GC in the CAHD group was 25.5％, and the frequency of C allele was 0.13; they were significantly higher than those in control group (10％, 0.05, P ＜0.05). ③ TG level in genotype GC of CAHD group was significantly higher than that both in GG genotype and in any genotype of control group [(1.38±0.24), (1.16±0.10),(1.09±0.78), (1.12±0.76) mmol/L, P ＜ 0.05]. Level of low-density lipoprotein cholesterol (C-LDL) was higher in CAHD group than that in control group (P＜0.05).CONCLUSION: The polymorphism of ApoH exon-8 is closely related to CAHD and TG level.

objective To analyze the correlation between the level of serum uric acid and the clinical and pathological features of IgA nephropathy.Methods Totally 148 patients diagnosed as IgA nephropathy by renal biopsy in our hospital from January 2007 to December 2010 were divided into hyperuricaemic group(41 cases)and non-hyperuricaemic group(107 cases)according to the level of serum uric acid.The clinical parameters and renal pathology grade were compared.Results There were significant differences between hyperuricaemic group and non-hyperuricaemic group in the incidences of hypertension(63.4%vs 38.3%),disease duration[(18.90±10.12)months vs(9.46±3.91)months]and body mass index[(22.81±3.60)kg/m2vs(15.32±2.54)kg/m2](all P<0.05),while no differences in age and sex(both P>0.05).The blood urea nitrogen(BUN)[(8.93±4.28)mmol/L vs (5.21±2.18)mmol/L],creatinine(Cr)[(155.96±107.72)μmol/L vs(79.52±40.01)μmol/L],serum triglycerides[(2.11±1.06)mmoVL vs(1.86±1.20)mmol/L]and 24-hour urine protein amount [(4328.16±1434.25)mg/24 h vs(2885.10±1388.15)mg/24 h]were significantly different between the two groups(all P<0.05).The percentage of Lee's grade I+Ⅱin hyperuricaemic group was 12.2%,and IV+V grade was 39.0%,while percentage of Lee's grade I+Ⅱin non-hyperuricaemic group was 25.2%,and IV+V grade was 16.9%(P<0.05).Tubulointerstitial lesions(TIL)gradeⅢ+IV was more in hyperuricaemic group,which was 68.3%,while TIL grade II was more in non-hyperuricaemic group,which was 76.6%.Renal artery damage grade II+Ⅲ was more in hyperuricaemic group.which was 73.2%,while renal artery damage grade 0+1 was more in non-hyperuricaemic group,which was 69.2%.Conclusion The level of serum uric acid was related with 24-hour urine protein amount,blood pressure and kidney function in IgA nephropathy,and Lee's grade,TIL grade and renal artery damage grade were severe in hyperuricaemic group.

Objective To investigate the diagnostic significance of the difference values between Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA)in elderly patients with dementia.Methods 331 elderly patients with dementia were collected from outpatients in our hospital.There were 148 people with Alzheimer's disease (AD),87 cases with vascular dementia (VaD),44 cases with mixed dementia (MD),41 cases with frontotemporal dementia (FTD) and 11 cases with dementia with Lewy bodies (DLB).MMSE and MoCA were applied to test the cognitive impairment separately.Results The difference values between MMSE and MoCA was (3.3±1.7) points,(6.6±2.1) points,(6.6±2.1) points,(5.4±2.3) points,(6.1 ± 1.9) points in AD,VaD,MD,FTD and DLB group respectively,and there were statistical differences among the five groups (F=46.420,P=0.000).Statistical differences were found in the difference values between MMSE and MoCA between dementia patients with AD and non-AD (t=-13.429,P=0.000).According to receiver operating characteristic curve (ROC curve),the optimal cut off point of the difference values between MMSE and MoCA for differential diagnosis between AD and non-AD dementia was 5 points,with 79.8％ sensitivity and 78.4％ specificity,and area under the curve was 0.848 (95％CI:0.807-0.890).Conclusions The difference values between MMSE and MoCA may be one of parameters for differential diagnosis between AD and non-AD dementia.

Objective To explore the effect and application value of percutaneous transhepatic various interventional technique for treatment of common bile duct stones.Methods 46 patients with common bile duct stones were treated.All patients were treated by percutaneous transhepatic cholangiopancreatography in order to confirm the number and location and size of the stones.Place me-chanical lithotripsy net according to the size of stones.Then percutaneous transhepatic balloon dilation.Postoperatively biliary tract was drained for 2 weeks.Results 45 operations were successful,The successful rate was 97.83%.Complete stone removal was obtained with one session in 41 patients and two sessions in 4 cases,respectively.There was no serious complications occurred during the operation. There was no perforation and bleeding,but hyperamylasemia occurred in 3 patients and acute pancreatitis occurred in 1 patient and bile perito-nitis occurred in 2 patients.Conclusion Percutaneous transhepatic various interventional technique can keep the function of papillary sphincter and is a valuable methed for patients suffering from common bile duct stones with a high successful rate and safety.

Objective: To observe the short-term effects of electroacupuncture at different acupoints on patients with hemiplegia after cerebral infarction. Methods: Patients with cerebral infarction were randomly allocated into a group of electroacupuncture nerve trunk and a group nerve trunk or routine acupoints, respectively, once a day, for 14 d. Results: Electroacupuncture at nerve trunk had better effects than at routine acupoints. The short-term improvement of electroencephalogram had significant differences (P＜0.05). Conclusion: Electroacupuncture at the nerve trunk could improve the neurologic impairment and brain function, and it has a better result than routine electroacupuncture.

All elements and refinements had been built in ontology with protégé 4.1, which can be used to record over 20 classic Chinese medicine books in related author, publisher, storage site, edition, form and arrangement of lines in calligraphy, and etc. It also realized the graphical display based on ontology. It gave brief analysis on elements which had been used or without using. Studies showed that Web Ontology Language (OWL) can express all elements of TCM literatures clearly. This study indicated that element refinements should be considered to add in the amendment of ISO International Standards application for further improvement.