Objective To observe clinical effect of treating arthralgia syndrome by syndrome differentiation and treatment of TCM.Methods 42 patients with arthralgia syndrome were randomly recruited into a control group and a treatment group.The control group was treated with routine western medicine,and the treatment group was treated with syndrome difierentiation and treatment of TCM.The clinical effect was observed in both groups after the treatment.Results The total effective rate of the treatment group and the control group was 85.7%and 66.7%respectively.The clinical effect in the treatment group was significantly higher than that of the control group(χ~2=3.126,P＜0.05).Conclusion The treatment of syndrome differentiation and treatment of TCM on arthralgia syndrome is better than routine western medicine.

Objective To investigate the association of plasma metallothionein 3 (MT3) and its polymorphisms with childhood autism,in order to provide the objective evidence for autistic etiology and molecular diagnosis.Methods A total of 132 autistic children were recruited from several special autism training schools in Wuhan and the Hubei Maternal and Child Health Hospital between January 2011 and November 2014.Three hundred and sixteen healthy children from the out-patients of Zhongnan Hospital of Wuhan University during the same period were enrolled as healthy controls.Enzyme linked immunosorbent assay was utilized to measure plasma MT3 protein levels in a dataset of 81 cases and 80 controls,while eight single nucleotide polymorphisms (SNP) located in MT3 gene were genotyped in another greater dataset that included 132 cases and 236 controls by the matrix-assisted laser desorption/ionization time of flight mass spectrometry within the Sequenom platform.Results Plasma MT3 protein level was significantly lower in autistic group compared to healthy controls [(740.0 ± 327.4) ng/L vs (1 007.1 ± 554.3) ng/L,P ＜ 0.001],particularly for boys when stratified by gender (P =0.005).No difference existed in any allele or genotype frequencies between the 2 groups (all P ＞ 0.05).Conclusions The selected autistic children harbored abnormal expression profiles of plasma MT3 protein,which may have no connection with its gene polymorphisms.

Objective To further compare the effect of intravitreal injection of bevacizumab (IVB) and photodynamic therapy (PDT) for the treatment of choroidal neovascularization (CNV) secondary to pathologic myopia by meta-analysis.Methods Pertinent publications were identified through systemic searches of PubMed,EMBASE and the Cochrance Controlled Trials Register.All clinical comparative studies of IVB or PDT as initial treatment for CNV secondary to pathologic myopia were included.Meta analysis of these clinical trials was performed to analyze the effect of IVB and PDT for CNV secondary to pathologic myopia.Measurements included best corrected visual acuity (BCVA) and central foveal thickness (CFT).Results A total of 6 comparative studies involving 351 eyes were included.There were 196 eyes in IVB group and 215 eyes in PDT group.Funnel plots,Egger linear regression and Begg method did not show publication bias.Compared with PDT group,at 3,6 and 12 months after IVB treatment,BCVA significantly increased [3 months:weighted mean difference (WMD) =-0.14,95 ％ confidence interval (CI)=-0.26 to-0.01,P=0.04; 6 months:WMD=-0.18,95％ CI=-0.33 to-0.03,P=0.02; 12 months:WMD=-0.26,95％ CI=-0.35 to-0.18,P＜0.001].However,change of CFT at 3,6 and 12 months did not vary significantly between IVB group and PDT group (3 months:WMD=-22.49,95％ CI=-93.49 to 48.52,P=0.53; 6 months:WMD=-17.34,95％ CI=-56.00 to 21.31,P=0.38; 12 months:WMD=-5.32,95％ CI=-56.37 to 45.74,P=0.84).Conclusion Patients with CNV secondary to pathologic myopia experienced a significant benefit of visual improvement after IVB,but reduction in CFT after the IVB or PDT did not vary significantly.

Objective To study the impact of changes in the pharynx on the vocal functions and resonance functions to evaluate the effects of UPPP on voice and in order to provide a reference for the selection of UPPP sur‐gery population .Methods The 30 male adult patients who underwent UPPP surgery were recorded pre-surgery ,1-week post-surgery and 3-month post-surgery speech .Then the multi-dimensional voice program (MDVP) , linear prediction coding (LPC) ,the Nasometer Ⅱ(model 6450) were used to evaluate the vocal functions ,the oral resonance functions and the nasal resonance function .Results F0 ,jitter ,shimmer ,and NHR were unchanged from the pre-surgery to the post-surgery condition .One week after the surgery ,F1 ,F2 of /a/,/i/and /u/were un‐changed (P>0 .05) .Three months after surgery ,F1 ,F2 of the vowel /a/and F1 of the vowel /u/were remained essentially unchanged (P>0 .05);while the frequency of F1 ,F2 of the vowel /a/and of F2 of the vowel /u/were significantly higher compared to pre-surgery values (P<0 .05) .One week after the surgery ,the nasalance scores of the oral sentence ,the oranasal sentence ,and the nasal sentence were unchanged (P>0 .05) .Three months after surgery ,the nasalance scores of the oral sentence and the oranasal sentence were unchanged (P>0 .05);while the nasalance scores of the nasal sentence were significantly higher compared to pre-surgery values (P<0 .05) .Conclu‐sion UPPP doses not affect the vocal function .But it might have a certain effect on resonance function ,demonstra‐ted by the change of several formant frequency and nasalance .UPPP in all professional voice users should be cau‐tious .Such patients who want to undergo UPPP must be informed of this potential modification of the voice after sursery .

Objective To evaluate the effect of ulinastatin on brain injury induced by lipopolysaccharide (LPS) in mice.Methods Ninety adult male C57 mice,aged 3-4 months,weighing 200-300 g,were randomly divided into 3 groups (n =30 each) using a random number table:control group (C group),LPS group and ulinastatin group (U group).Group U received intraperitoneal injection of ulinastatin 10 000 U/kg,while group L received the equal volume of normal saline,and 10 min later brain injury was produced with LPS 1 μg/g injected into the cerebral ventricle.Ten animals were chosen and blood samples were taken for determination of plasma concentrations of S100β protein and neuron-specific enolase (NSE) at 1,3 and 7 days after LPS injection.Then the animals were sacrificed and hippocampal tissues were obtained for determination of interleukin-1β (IL-1 β) and tumor necrosis factor-α (TNF-α) contents and IL-1β mRNA and TNF-α mRNA expression.Results Compared with C group,the plasma concentrations of S100β protein and NSE and contents of IL-1β and TNF-α were significantly increased at 1,3 and 7 days after LPS injection,and IL-1β mRNA and TNF-α mRNA expression was up-regulated at 1 and 3 days after LPS injection in LPS and U groups.Compared with group LPS,the plasma concentrations of S100β protein and NSE and contents of IL-1β and TNF-α were significantly increased,and IL-1β mRNA and TNF-α mRNA expression was down-regulated at 1 and 3 days after LPS injection in group U.Conclusion Ulinastatin can attenuate brain injury induced by LPS in mice,and the mechanism is related to inhibited inflammatory responses.

Objective:To explore the directed forgetting ability of elder people to disease/death-related words under the conditions of the neutral and negative emotion.Methods:Thirty-six elder people and thirty-seven young people were included in this study.The directed forgetting effects to disease/death-related words were compared by using item-method directed forgetting paradigm under the neutral and negative emotional conditions.Results:Under the neutral and negative emotion conditions,higher recognition of to-be-remembered (TBR) than to-be-forgotten (TBF) words in elder group and younger group (Ps ＜ 0.05).The elder group showed the weaker effect of directed forgetting than younger group[neutral emotion:(0.4 ± 0.1) vs.(0.6 ± 0.1);negative emotion:(0.3 ± 0.1) vs.(0.7 ± 0.04),Ps ＜ 0.05].Under the negative emotion condition,elder people showed stronger effect of directed forgetting for sensitive words compared with control words[(0.4 ± 0.1) vs.(0.1 ± 0.1),P ＜ 0.001].Conclusion:The results suggest that the directed forgetting ability of elderly is weaker than that of young individuals,the ability of non-sensitive words than that with sensitive words,and the directed forgetting effect of elder people tonon-sensitive words in negative emotion is weaker than that in neutral emotion.

Objective To evaluate the clinical effect of different temperature of fluids and blood infusion on postoperative recovery quality in elderly patients undergoing total knee arthroplasty (TKA).Methods One hundred and fifty-six cases of elderly patients (male 42,female 1 14,aged 65-85 years,ASA Ⅰ or Ⅱ)scheduled for selective single TKA were recruited and divided into three groups randomly(n =52 each),normal temperature group (group NT),constant temperature group (group CT)and warming temperature group (group WT).Patients of group NT were infused with blood or fluids of room temperature (22-24 ℃)and surgical area were flushed with fluid of room tem-perature too.Patients of group CT were infused with blood or fluids of 37 ℃ by heating apparatus and temperature of fluids used to flushing was 37 ℃ too.Otherwise,in group WT,the tempreture of blood and fluids for infusion were kept at 37 ℃ and the surgical area were flushed with fluid of 39 ℃. The nasopharyngeal temperature were recorded on time points of before anesthesia (T0 ),30 min (T1 )and 1 h (T2 )after surgery beginning,30 min (T3 )and 1 h (T4 )after surgery.Time of sponta-neous breathing,time of eye opening on call,time of fully conscious,extubation time and Steward scores of patients were recorded too.And the cognitive function were evaluated by Postoperative Quality Recovery Scale (PQRS)on time points of 1 5 min and 40 min after extubation and the 1,3, 30 d after surgery.Results Compared with T0 ,the nasopharyngeal temperature of three groups were significantly decreased at T1-T4 (P <0.05 or P < 0.01 ).The nasopharyngeal temperature of group CT and group WT were significantly higher than in group NT at T1-T4 (P <0.01).And the nasopha-ryngeal temperature of group WT was significantly higher than in group CT at T4 (P <0.05).Com-pared with group NT,time of eye opening on call and spontaneous breathing in groups CT and WT were significantly shorter (P < 0.01 ).Time of fully conscious in group WT was obviously shorter than in group NT (P <0.01),and the Steward score in group WT was significantly higher than in group NT (P <0.05).Compared with before extubation,the cognitive function scores in all patients at 1 5,40 min after extubation and 1,3,30 d after surgery were increased significantly (P <0.01).The cognitive function scores in group CT and group WT at all time points were significantly higher than that in group NT (P <0.05).And the cognitive function scores in group WT was significantly higher than that in group CT at 30 d after surgery (P <0.05).Conclusion The elderly patients undergoing TKA receiving blood transfusion and infusion at 37 ℃ and flushing the area with fluid at 39 ℃ can prevent the occurrence of hypothermia and improve the postoperative recovery quality and cognitive function recovery.

Objective To observe the expression of vascular endothelial growth factor receptor-1 (VEGFR-1) and VEGFR-2 in hypoxic chorioretinal endothelial cells of monkeys (RF/6A),and to evaluate the effect of minocycline.Methods RF/6A was cultured and divided into four groups:control group,hypoxia group,hypoxia and low dose of minocycline group (0.5 μmol/L),hypoxia and medium dose of minocycline group (5 μmol/L),and hypoxia and high dose of minocycline group (50 μmol/L).Real-time reverse transcription-polymerase chain reaction (RT-PCR) and immunohistopathological staining were used to measure the mRNA and protein expression of VEGFR-1 and VEGFR-2,respectively.Results RT-PCR showed that the expression of VEGFR-1 mRNA did not vary significantly between groups (F24 h =0.17,F48 h =1.53,F72 h =2.04; P＞0.05).Compared with hypoxia group,the expression of VEGFR-2 mRNA in all minocycline treated groups were significantly down-regulated (low minocycline,medium minocycline,high minocycline:t=4.69,20.16,17.12; P＜0.001).The immunohistopathological study showed the cells with positive staining of VEGFR-1 can be observed in all groups,and the staining was relatively weak and mainly located in cell membrane and cytoplasm.The optical density value analysis showed that the protein expression of VEGFR-1 did not vary significantly between groups at all time points(F24 h =0.251,F48 h=0.340,F72 h =0.589; P＞0.05).The VEGFR-2 positive staining cells were also observed in all groups,and the staining was relatively high.Brown staining particles of VEGFR-2 were observed in the cell membrane with minor staining particles in cytoplasm.The staining density of VEGFR-2 was significantly higher in hypoxia group than control group.Compared with the hypoxia group,the protein expression of VEGFR 2 in minocycline treated groups was significantly lower (F24 h =19.147,F48 h =14.893,F72 h =11.984; P＜0.05).Conclusion The expression of VEGFR-2 is up-regulated in RF/6A,and minocycline somewhat shows an inhibition effect.

Objective To investigate the clinical significance of building core competencies evaluation system among emergency nurses. Methods 170 nursing staff in emergency department were chosen and were investigated about the general situation and previous training and training needs.Before and after training 170 nursing staff were tested for relevant knowledge,and the survival rate of critically ill patients and satisfaction degree of patients were taking for statistics. Results Training needs of core competencies of professional nurses in emergency department were as followed from high to low in sequence:first-aid equipment and facilities,first-aid skills,organization and coordination of emergency response and education and training.For nurses with different nursing work experience,the knowledge level about core competencies was also different,work experience ＞ 5 years was significantly higher than those ≤ 5years,emergency equipment and facilities and knowledge level of first-aid skills showed significant differences.After training,the level of related nursing skills of 170 nurses was better than before,in the rescue of patients,the survival rate and satisfaction degree of patients was significantly higher than before the training. Conclusions Building core competencies evaluation system for emergency nurses and applying it in clinic is feasible and has a positive meaning.

To evaluate CT in the diagnosis of tuber culosis of the brain． CT findings in 95 cases with tuberculosis of t he bran confirmed clinically were analyzed retrospectively． Results: The CT detectability fate was 80%． The direct CT si ngs included exudation in basal system, meningitis, enhancement and intracranial tuberculosi s． The indirect signs had hydrocephalus infarction, atrophy calcification, periventricular hypo densith and subdural fluid accumulation etc． The most usual appearance was hydrocephalus． Conclusions: (1) It was helpful to diagnose when very two kinds of direct sings or a kind of dir ect sings and more than two kinds of indirect sings appeared． (2)The plain and contrast canning s hould be routinely used in tuberculosis of the brain．