[Objective]To develop a mini-pressure-sensor(MPS)for measurement of plantar pressure(PP)and to evaluate its clinical application.[Method]The MPS was installed in the shoes,and computer was used to accumulate and analyze the change of PP in whole walking stage.Pathologic changes of PP in clinical patients were also analyzed by MPS.[Result]In normal walking,the PP of forefoot was 49% of body weight(BW)and of midfoot and heel was totally 51% of BW,but at pathologic state,the equilibrium of walking was dynamically disrapted inducing a pathologic changes of foot bearing.[Conclusion]Self-developed MPS for measuring PP is help for dynamic analysis of normal PP and is valuable to recognize the pathologic distribution of PP in pathological state and to provide a guide for treatment.

In the elderly, patient who suffered from hip fracture need to stay in bed for a long time and has a higher prevalence of complications and mortality. Considering the factors of patients in the intraoperative death and postoperative re?habilitation, we take appropriate treatment measures during preoperative, intraoperative and postoperative period respective?ly based on the concept of Enhanced Recovery. Patient will benefit from rapid rehabilitation and reduction of incidence of complications and mortality. ERAS includes preoperative fasting, preventive anagelsia, intraoperative temperature control, anesthesia and surgical approach, postoperative intravenous restriction, nutritional support and painless early motion. This ar?ticle intends to review the security , reliability and clinic efficacy of ERAS.

Objective To design a quantitative criterion and grading system for injury from adverse drug reaction (ADR) in order to serve the compensation system of injury from ADR. Methods Based on the other grading system of injury cases, the independent scores and serial grades were given to the ADR injury of different organs or different levels through two turns of consultation to 27 experts from Shanghai. Results Injury from ADR was graded from stage 1 to stage 10 according to the damage degree, with 1 stand for death and 10 for slightest injury. Conclusion The grading method of ADR based on the characteristics of injury accords with the condition of China, and can provide reference for making up the compensation system of ADR injury.

Objective To compare the stress distribution of calcaneal compression articular surface and normal surface in biomechanical analysis.Methods The posterior articular facet of the normal finite element model was wedged resected from inside to outside and from front to back,to imitate the malunion model with subtalar articular surface collapse after fracture.The B(o)hler angle was 35° before wedged,and 0° after wedged.On heel and Achilles tendon attachment point,320 N and 160 N loads were applied vertically upwards respectively.Compare calcaneal Vonmises stress distribution between malunion and normal model.Results Judging from the general stress distribution of malunion of calcaneal,subtalar joint stress reduced.The main stress area of normal bone joints was in articular surface,while the main stress area of malunion model was in the lateral calcaneal close to the calcaneocuboid joint.The main stress of the outboard is high-er than that of inboard.Outboard is the main part of supporting load.Judging from the detailed comparison with bone structure,first of all,the subsidence of subtalar joint top resulted in partial backward of the main stress of the calcaneus,which shifted to the Achilles tendon attachment point.It increased from normal (1.51±0.22) MPa to (3.11±0.24) MPa.Joint top of the stress reduced from normal (6.71±0.37) MPa to (2.83± 0.49) MPa.Secondly,the calcaneus stress of the former calcaneocuboid articulation significantly increased,which increased from normal (0.46±0.15) MPa to (2.13±0.15) MPa,and sustentaculum tali stress decreased from 5.18 MPa to 1.41 MPa.Conclusion By finite element model of this subject,the study proves that subtalar joint surface collapsed in calcaneal fractures is the main causes of most pathological changes.The problem of the joint surface subsidence should be resolved firstly in a clinical treatment,and the normal height of the calcaneus should be restored.The internal stress distribution of calcaneal is essential to the pain in the related part of calcaneal.

Objective:To explore the traits of gray matter volume in general anxiety disorder (GAD)and ob-sessive compulsive disorder (OCD)by using magnetic resonance imaging (MRI)technique.Methods:Twenty-eight GAD,25 OCD and 39 normal controls were recruited.All patients were met the Diagnostic and Statistical Mannal of Mental Disorders,Fourth Edition,Text Revision (DSM-IV-TR)or the International Statistical Classifica-tion of Disease and Related Health Problems Tenth Revision (ICD-10)diagnostic criteria for GAD or OCD.All subjects underwent structural MRI scan.The severity of anxiety and OCD symptoms were rated in all patients with the Hamilton Anxiety Rating Scale (HAMA)and the Yale-Brown Obsessive Compulsive Scale (Y-BOCS).The gray matter volume (GMV)was compared between all groups by using the voxel-based morphometry (VBM)a- nalysis.The correlation analysis between GMV and total scores of HAMA and Y-BOCS was performed in GAD and OCD.Results:The GMV was increased in regions including left anterior cingulate cortex in GAD (P =0.016,small volume correction),while only decreased GMV was observed in OCD in bilateral orbitofrontal cortex (OFC)(P <0.001,uncorrected).GAD had larger GMV than OCD in several regions including bilateral OFC (P <0.001,un-corrected).The higher total score of HAMA was associated with increased GMV of right temporal cortex in GAD, and with the GMV of OFC in OCD (P <0.001,uncorrected).Conclusion:No sharing of GMV abnormalities in GAD and OCD was observed in the current study.The traits of brain structure and the potential neural substrate of anxiety symptom in GAD and OCD may be significantly different.

Objective:To discuss the curative effect of bifid triple viable capsules in the patients after laparoscopic cholecystecto-my ( LC) . Methods:Totally 100 cases of patients with LC were selected and divided into the observation group and the control group at random. The patients in the two groups underwent LC under the general anesthesia, and were given routine medical treatment after the operation. The patients in the observation group were additionally given bifid triple viable capsules, 630mg per time, twice a day for 1 week as the treatment course. The changes in the occurrence of diarrhea, alteration of intestinal flora and plasma D-lactic acid of the patients and drug adverse reactions in the two groups were observed and compared after the medical treatment. Results:One week after the operation, the occurrence of diarrhea and alteration of intestinal flora of the patients in the observation group were lower than those in the control group (P<0. 05), and compared with those before the treatment, the plasma D-lactic acid levels of the patients in the two groups were declined (P<0. 05 or P<0. 01), and the declining rate in the observation group was much higher than that in the control group (P<0. 05). Totally 3 and 5 cases of drug adverse reactions were appeared in the observation group and the control group, respectively with no significant difference (P>0. 05). Conclusion: The application of bifid triple viable capsules in the pa-tients after LC can effectively reduce the plasma D-lactic acid levels, occurrence of diarrhea and alteration of intestinal flora with prom-ising security, which is good for the postoperative recovery of the patients.

Objective To investigate the cellular viability and mitochondrial reactive oxygen species (ROS) production of the Müller cells under high glucose condition,and explore the protection role of the 5,6-dihydrocyclopenta-1,2-dithiole-3-thione (CPDT) on Müller cells.Methods Müller cells from Sprague Dawley rats were divided into 5 groups randomly,including 25 mmol/L normal glucose group (group A) and 65 mmol/L high glucose group (group B).High glucose group with 45,60,70 μmol/L CPDT and cultured them 72 hour was set as group C,D and E.Water soluble tetrazolium salt (WST)-8 was used to measure the cellular viability.Flow cytometry was used to measure the active oxygen and apoptosis index.The expression of nuclear factor erythroid 2-related factor 2 (Nrf2),hemeoxygenase-1 (HO-1),Bcl-2 and Bax protein were measured by Western blot.Results Compared with group A,the WST-8 showed that the viability of Müller cells apparently decreased in group B (t=39.59,P＜0.05).Compared with the group B,the viability of Müller cells had changes in group C (t=0.97,P＞0.05),but recovered in group D and E (t=-4.17,-7.52;P＜0.05).Compared with group A,the FCM showed that the mitochondrial ROS levels was higher in group B (t=-30.99,P＜0.05).Compared with group B,the mitochondrial ROS levels were decreased in group D (t=27.68,P＜0.05).Compared with group A,Bax,Nrf2 and HO-1 increased (t=-11.03,-63.17,-11.44;P＜0.05),while the bcl-2 decreased in group B (t=7.861,P＜0.05).Compared with the group B,Nrf2,HO-1 and Bax decreased (t=15.11,26.59,6.27;P＜0.05),while the bcl-2 increased in group D (t=-6.53,P＜0.05).Conclusions Under the high glucose,CPDT may reduce the mitochondrial ROS levels and the expression of Nrf2,HO-1 and Bax protein of Müller cells.It may inhibit apoptosis through activating the Nrf2/HO-1 pathway and balancing of level of Bcl-2 protein and mitochondrial ROS.

ObjectiveTo review the experience with surgical removal of meningiomas in the falx cerebri and sagittal sinuses.MethodsThirteen patients with meningiomas in the falx cerebri and sagittal sinuses were retrospectively analyzed.ResultsTumors in eleven patients were totally removed( Simpson Grade Ⅰ and Ⅱ ),while in two patients they were subtotally resected( Simpson Grade Ⅲ and Ⅳ ).After operations,no patient died.ConclusionAdequate surgical exposure,efficient management of operative bleeding,protection and replacement of the sagittalsinus,and avoidence of damage to the brain tissues were the key factors to improve operative effect.

Objective To determine the susceptibility of yeasts and to explore the antifungal m echanismof Lisea cubeba oil,so as to provide evidence for the development of antifungal medicinal herbs.Methods The minimuminhibitory concentrations(MIC)of Lisea cubeba oil and fluconazole were determined by broth microdilution method according to the National Com mittee on Clinical Laboratory Standards(NCCLS)reference method for broth dilution antifungal susceptibility testing of yeasts.Ultra-structur al changes of C.krusei were observed by electron microscopy before and after Lisea cubeba oil treatment.Results Five previously identified quality control(QC)strains(Candida albicans,Candida tropical is,Candida glabrata,Candida parapsilosis,Candida krusei)were susceptible to Lisea cubeba oil,their MICs were 14.14?3.64?g /mL,23.22?2.85?g /mL,31.24?2.88?g /mL,76.19?4.40?g /mL,28.30?2.54?g /mL,respectively.After treatmen t with Lisea cubeba oil the mor-phology and ultrastructure of Candida krusei showed obvious changes:their cell wall and cytoplasmic membrane ruptured;intracellar components dissolved;organellae swollen and di ssolved.There were no changes observed in the morphology and ultrastructure of C.krusei treated with fluconazole.Conclusions The data indicate that Lisea cubeba oil has antifungal effect not only on C.albican and other medically important Candida spp.,but also on fluconazole resistant isolates such as C.krusei and thus has great clinical importan ce.The antifungal mechanismof Lisea cubeba oil may be that the structure of cell w all and cell membrane of C.krusei being inhibited.

Objective To investigate antibiotic resistance of Klebsiella pneumoniae and Escherichia coli in old patients with lower respiratory tract infections. Methods Kirby Bauer agar diffusion method was used to evaluate the drug sensitivity in 240 strains of Klebsiella pneumoniae and Escherichia coli isolated from patients with lower respiratory tract infection. Phenotypic confirmatory test recommended by NCCLS1999 was used to detect extended spectrum beta lactamases(ESBLs). Results The resistant rates of Klebsiella pneumoniae and Escherichia coli to 14 antibiotics in old patients and in non old patients with lower respiratory tract infections were amoxicillin 93 2% vs 87 3%, piperacillin 57 1% and 42 9%, cefuroxime 51 4% and 33 3%, cefotaxime 40 1% and 17 5%, ceftazidime 13 6% and 3 2%, ceftriaxone 39 0% and 17 5%, cefoperazone 37 3% and 15 9%, cefepime 10 2% and 3 2%, amikacin 47 5% and 34 9%, ciprofloxacin 54 2% and 38 1%, imipenem 0, cefoperazone/sulbactam 0, piperacillin/tazobactam 1 1% vs 0, and cefmetazole 9 6% and 4 8% respectively. Out of 240 clinical strains of Klebsiella pneumoniae and Escherichia coli, 78(32 5%) were considered ESBLs producers by phenotypic confirmatory test. The prevalence of ESBLs in old patients was 38 4%, which was much higher than that in non old patients(15 9%). The resistant rate of ESBLs producing strains to imipinem, cefoperazone/sulbactam, piperacillin/tazobactam and cefmetazole was the lowest, being 0, 0, 2 6% and 12 8%. Conclusions The resistant rates of Klebsiella pneumoniae and Escherichia coli to most antibiotics and the prevalence of ESBLs in old patients with lower respiratory tract infection were higher than that in non old patients. Imipinem, cefoperazone/sulbactam, piperacillin/tazobactam and cefmetazole were the effective antibiotics to infections caused by ESBLs producing strains.