The role of the hematuria examination by urinary analyzer in forensic medicine practice was evaluated in the present study.By using the chemical analysis of urinary analyzer and urinary sediment microscopy,the erythrocytes in 418 urine samples were examined simultaneously.The results showed that the negative outcome was found in 276 cases,+ in 58,++ in 35,≥++ in 84 by urinary analyzer,while negative outcome in 274 cases, +- and + in 31, ++ in 1 ,≥++ in 37 with consistent rates of 99 26%, 53 45%, 2 86% and 44 05% respectively.There was high significant difference between the positive and negative outcome and between the trauma mild (≥++) and slight trauma outcome (≤+) as determined by these two methods ( P

Aim To investigate the roles of intracellu-lar reactive oxygen species ( ROS ) and Nrf2 pathway in shikonin-induced A549 cell apoptosis. Methods The cytotoxicity was analyzed by MTT assay. The ap-optosis of A549 cells was analyzed by both cellular morphological and biochemical methods. The relative changes of the redox marks ( ROS/GSH) were studied by fluorescence assay in the shikonin-treated A549 cells in accompany with the changes of the intracellular redox homeostasis by GSH/GSSG ratio. ROS inhibitor was also employed in the treatment to find the role of ROS in shikonin-induced A549 cell apoptosis. Real-time PCR analysis and ELISA assay were performed as well to determine the role of Nrf2 pathway in the shiko-nin-induced A549 cell apoptosis. Results The IC50 of shikonin on A549 cells was 3. 2 mg·L-1 . The cellu-lar redox homeostasis shifted toward oxidation signifi-cantly in shikonin treatment in a time-dependent man-ner. The expression of the Nrf2 pathway related genes was up-regulated by shikonin ( 3 . 2 mg · L-1 , 8 h ) . The expression of the anti-apoptotic genes was down-regulated , and proapoptotic genes were up-regulated by shikonin (3. 2 mg·L-1, 24h). Futhermore, the inhi-bition of intracellular ROS alleviated the cytotoxicity of shikonin in A549 cells. Conclusion The critical role of shikonin-induced redox imblance in A549 cell, coped with the secondary produced ROS and Nrf2 path-way antioxidants, result in A549 cell apoptosis.

Objective To develop an evidence-based community extended care model for patients with asthma.Methods Mixed research methods were applied to integrate best evidences:80 literatures were included in systemic review; 394 medical records were analyzed; 112 nurses admitted a test and a questionnaire to assess their competence on asthma care; clinical observation to both hospital and community centers were conducted; 6 multidisciplinary experts were consulted; and 100 patients admitted a questionnaire on patient needs and 17 of them were further interviewed.Results The nursing care model with the feature of hospital and community health service center collaborating to provide extended care for patients with asthma was established.Conclusions The development of a nursing care model for practice should be based on the current best evidence generating from the best research evidence,professional judgment on clinical practice requirement and patients' needs.

Objective To investigate the effects of different doses of dexmedetomidine used in SEP and MEP monitoring in patients undergoing neurosurgery. Methods Eighty patients undergoing neurosurgery receiving SEP and MEP monitoring were randomly divided into 4 groups(n = 20 each):group C,group D1,group D2 and group D3. In groups D1 ,D2 and D3 ,dexmedetomidine 0.5 μg/kg was infused over 10 minutes before anesthesia induction,and then was infused at a rate of 0.1,0.3 and 0.5μg/(kg·h)respectively toward the end of operation. Group C received the equal volume of normal saline. HR ,MAP and BIS were recorded at admission to the operating room(T1),skin incision(T2),when the muscle relaxants were stopped(T3)and 50 minutes later(T4). The current intensity and the time when first MEP was induced after muscle relaxant was stopped ,the amplitudes and latencies of SEP(N20-P25,N20)and MEP on thenar muscle at T4,the total consumption of propofol,and development of adverse affects were also recorded. Results Compared with groups C and D1,HR and MAP were decreased at T2-T4 in groups D2 and D3(P<0.05). The amount of propofol consumed were lower in groups D2 and D3 than in groups C and D1(P < 0.05). The current intensity inducing MEP was lower and the amplitude of MEP at T4 was higher in group D2 than in groups C,D1 and D3,and the situation was same in group D3 than in group C (P<0.05). No significant change was found in the other parameters in groups C ,D1 ,D2 and D3(P>0.05). Conclusion Dexmedetomidine infused at 0.3 μg/(kg · h) after infusion of a loading dose of 0.5 μg/kg could improve monitoring quality of MEP through reducing the amount of propofol consumed ,have less inhibition on MEP than other groups,have no obvious effects on SEP,andmaintain hemodynamic stability.

Objective To observe the feasibility and safety of dexmedetomidine used in motor evoked potentials(MEP)monitoring in patients undergoing neurosurgery.Methods Thirty ASA Ⅰ orⅡ patients,male 1 5 cases,female 1 5 cases,aged 20-60 years,weighing 40-80 kg undergoing neuro-surgery receiving MEP monitoring were randomly divided into 2 groups (n =1 5 each):control group (group C)and dexmedetomidine group (group D).In group D,dexmedetomidine 0.5 μg/kg was in-fused over 10 minutes before anesthesia induction,and then was infused at a rate of 0.5 μg·kg-1 · h-1 toward the end of operation.Group C received the equal volume of normal saline.HR,MAP and BIS were recorded at admission to the operating room (T0 ),skin incision (T1 ),when the muscle re-laxants were stopped (T2 )and 50 minutes later (T3 ).The current intensity and the time when first MEP was induced after muscle relaxant was stopped,the amplitudes and latencies of MEP on thenar muscle at T3 ,the total consumption of anesthetics,and development of adverse effects were also re-corded.Results Compared with T0 ,HR in group C at T1 ,T3 and MAP in group C at T1-T3 was in-creased,HR in group D was decreased at T2-T3 (P <0.05).Compared with group C,HR and MAP were decreased at T1-T3 in group D(P <0.05).The amount of propofol consumed and the current in-tensity inducing MEP were lower in group D than in group C (P <0.05).The amplitude of MEP at T3 was higher in group D than in group C (P <0.05).Compared with group C,the incidences of hy-pertension and tachycardia were decreased in group D,and the incidence of bradycardia was increased (P <0.05).Conclusion Dexmedetomidine used in MEP monitoring in patients undergoing neurosur-gery can meet the operation requirements,maintain hemodynamic stability,reduce the incidences of adverse reactions,and improve monitoring quality of MEP.It is a safe and feasible anesthesia method.

Objective To explore the application of ultrasound- guide modified Seldinger technique for upper arm PICC insertion in infant patients. Methods Use the ultrasound-guide modified Seldinger technique to inserted PICC for 27 infant patients. Results All 27 cases were inserted successfully, success rate of the one puncture reached 92.6%. Conclusions By adequate preparation for infants, effective immobilization and good cooperation of operators, and combined with techniques which prevent PICC misplacement, overcome the shortcoming of bad vessel and non-compliance of infant patients, develop the advantage of ultrasound, could improve the rate of successful catheterization of upper arm PICC insertion in infant patients, and protect the vessels.

Objective The goal of this study was to investigate the correlation between the level of serum vitamin D and bone metabolism and disease activity in ankylosing spondylitis(AS) patients,and thus to explore the role of vitamin D in bone metabolism in AS patients.Methods The serum levels of BALP,TRACP-5b,25-(OH)D3 and blood lymphocytes VDR of 80 AS patients were measured by enzyme-linked immunosorbent assay (ELISA) and compared with those of the control group.Bone mineral density (BMD)was measured by dual-energy X-ray absorptiometry (DEXA).The ESR and CRP level of AS patients were also measured.The correlation between those parameters was analyzed and evaluated.Patients were divided into normal,insufficient and deficient subgroups according to the serum 25-(OH)D3 levels for further comparison.Indepondent saimple t test,t'test andx2 test were used for statistical analysis.Results The 25-(OH)D3 of AS patients [(11.9±2.7) μg/L] was significantly lower than that of the control groups [(22.3±7.9) μg/L] (P＜0.05),while the serum levels of BALP [(3.9±2.7) μg/L] and TRACP-5b [(46±25) ng/L] of AS patients were significantly higher than those of the control group [(2.4±1.0) μg/L] (P＜0.05).According to linear correlation analysis,25-(OH)D3 was negatively correlated with CRP (r=0.324,P=0.003).The ESR,BALP,TRACP-5b in the deficient subgroup were higher than those in the normal and insufficient subgroups(P＜0.05).Conclusion The plasma 25-(OH)D3 may decrease in AS patients,and this may activate bone metabolism,results in increased morbidity of osteoporo-sis,and negatively affect disease activity.

Objective To study the adsorption and separation of licorice flavonoid with macroporous resins. Methods Eight types of macroporous resin were selected to compare their performances in absorbing and desorbing licorice flavonoid. The optimal type for licorice flavonoid was decided, meanwhile, its kinetic curve and dynamic absorbing behavior were studied. Results HPD300 resin possessed higher adsorption and desorption capacity. The appropriate adsorption and desorption conditions were as follows:concentration of sample was 2.0 mg/mL, velocity of sample solution was 1.5 BV/h, volume of sample solution was 2 BV (bed volume);velocity of 80%ethanol was taken as eluant 1.5 BV/h, and the volume was 3 BV. Flavonoid content was increased more than 2 times under above conditions. Conclusion HPD300 macroporous resin showed better comprehensive adsorption property. It can be used to purify and separate licorice flavonoid.

Objective To evaluate the effect of mind-map in health education of elderly patients with knee osteoarthritis in community.Methods 71 elderly patients with knee osteoarthropathy were randomly divided into observation group(n=35)and control group(n=36).The control group received routine oral mode health education,and the observation group applied mind map to health education.Before and after the intervention,the self-designed disease knowledge and compliance questionnaire were used to evaluate the effect of two groups of health education.Results There was no significant difference in score between the two groups(P=0.997).After intervention,the score of disease knowledge questionnaire(20.25±3.01)points in the observation group was higher than(18.17±3.12)points in the control group,the difference was statistically significant(t=2.858,P=0.006).At the 1st,3rd and 6th month,the compliance scores of the observation group were(19.35±3.14)points,(19.68±3.22)points,(20.18±3.42)points,respectively,which of the control group were(17.42±3.11)points,(17.89±3.35)points,(18.32±3.47)points,respectively,the differences between the two groups were statistically significant(t=2.602,2.294,2.274,P=0.011,0.025,0.026).The scores of the observation group questionnaire were all more than 3 points,the difference was statistically significant between the two groups(all P=0.000).Conclusion Using mind map to carry out health education to middle-aged and elderly patients with knee joint disease can help patients master disease knowledge and improve compliance,its effect is better than traditional method.

Objective To investigate the response of mesenchymal stem cells in mice to mediumdose X-ray irradiation in vitro.Methods The mouse mesenchymal stem cell line C3H10T1/2 was submitted to 3.5 Gy X-ray irradiation.Hoechst33258 staining of adherent cells and Annexin V-FITC staining and flow cytometry analysis of suspension cells were performed respectively to assess cellular apoptosis at 3,6,12,24,48,72 h and 1 week after irradiation.SA-β-gal staining was performed to analyze the cellular senescence at 24,48,72 h and 1 week after irradiation.The mRNA level of both Fas with its ligand FasL and p53 with its downstream target p21 WAF1 were measured by Real-Time PCR analysis.The expression of Fas protein was determined by immunofluorescence staining.Results An increased apoptosis was observed at 3 h after irradiation with apoptosis rate 11.72％ ± 1.61％ ( t =9.01,P ＜0.01 ),the apoptosis rate reached the peak level at 12 h 20.52％ ± 1.96％ (t =16.27,P ＜ 0.01 ),and then declined progressively to normal level at 48 h 4.93％ ±0.46％ (t =2.26,P ＞0.05).The SA-β-gal positive rate of post-radiation cells at 72 h was 53.33％ ± 5.62％,significantly higher than that of normal control 3.24％ ± 0.39％ (t =17.77,P ＜ 0.01 ).The level of Fas,FasL mRNA was found to be elevated 3 h after irradiation with a peak at 12 h,and no differences were found l week later.The level of Fas protein was observed to reach the peak at 12 h after irradiation.The occurrence of peak level of Fas/FasL mRNA and protein was consistent with that of apoptosis of C3H10T1/2 cell.A transient up-regulation of p53,p21 WAF1 mRNA expression was found at 12 h after irradiation followed by a significant increase later at 72 h after irradiation.The occurrence of the two peaks of p53,p21WAF1 mRNA expression were coincident with that of cellular apoptosis and senescence,respectively.The levels of p53,p21WAF1 mRNA in senescence group were significantly higher than those of apoptosis group ( t =17.85,13.36,P ＜ 0.01 ).Conclusions The MSC cell line C3H10T1/2 was sensitive to medium-dose X-ray irradiation.Cell apoptosis occurred immediately after irradiation and cellular senescence happened at advanced stage.Both Fas/FasL and p53/p21 WAF1 signal pathway mediate the injury of C3H10T1/2 cell to medium-dose X-ray irradiation exposure.