OBJECTIVE:To compare the clinical effect of different materials for cranioplasty. METHODS:The incidence rate of complication and the degree of moulding satisfaction of patients with skull defect which were repaired using net-added silica gel,auto-cranial bone,three-dimensional Ti frame and digital three-dimensional reconstructed Ti frame were retrospectively analyzed in the Department of Neurosurgery of Xixiang People's Hospital from January 2000 to December 2007. RESULTS:The incidence rate of complication and the degree of moulding satisfaction were 50% and 27.8% in the net-added silica gel group,12.1% and 90.9% in the auto-cranial bone group,27.3% and 45.5% in the three-dimensional Ti frame group,5.6% and 100% in the digital three-dimensional reconstructed Ti frame group,respectively. The incidence rate of complication in the digital three-dimensional reconstructed Ti frame and auto-cranial bone groups was significantly lower than other two groups,while the degree of moulding satisfaction was also significantly different from other two groups (P

Abstract: Objective To explore the effect of optimal intervention on occupational stress in front-line workers of electronic manufacturing industry. Methods A total of 257 front-line workers in an electronic manufacturing industry were selected as the research subjects using the judgment sampling method. On the basis of the previous three-level prevention intervention model on occupational stress in labor-intensive enterprise workers，a two-year optimized "333" model of three-level prevention intervention on occupational stress was implemented in the research subjects. The pre-intervention and post-intervention occupational stress levels of job demand-control（JDC）and effort-reward imbalance（ERI）model in workers at this enterprise were evaluated using the Simple Job Stress Questionnaire and the ERI Questionnaire. Results Compared with those before intervention，the scores of job requirements dimension of JDC model，giving and intrinsic input dimensions of ERI model decreased after intervention（all P<0.01）；the scores of social support dimension of JDC model and that of return dimension of ERI model increased（all P<0.05），and the detection rates of occupational stress of both JDC and ERI models decreased （26.1% vs 10.1%，21.0% vs 8.9 % ，all P<0.01）. Conclusion Optimizing the "333" intervention mode for three-level prevention intervention of occupational stress can effectively alleviate the occupational stress levels of front-line workers in electronic manufacturing enterprises.

Objective To explore the effect of early intervention on patients with severe illness deterioration induced multiple organ dysfunction syndrome(MODS). Methods 184 severe patients were randomly divided into conventional treatment and intervention groups(each,92 cases). Active treatment of primary disease and symptomatic treatment were given to the patients in the control group,and based on the treatment of the above group, low dose heparin was additionally given to the observation group for anticoagulation to change hemorheology. Before and after treatment for 1 week,life signs,blood routine test,blood biochemistry,blood coagulation index,D-dimer, hemorheology,blood gas analysis and acute physiology and chronic health evaluation Ⅱ(APACHEⅡ)score were observed in two groups to judge the overall changes of disease situation. The length of stay in intensive care unit(ICU), the incidence of MODS and mortality after 1 week treatment were compared between the two groups. Results The levels of platelet count(PLT),fibrinogen(Fib),D-dimer,whole blood high shear viscosity,whole blood low shear viscosity,plasma viscosity,white blood cell count(WBC),arterial blood lactate(Lac),alanine aminotransferase (ALT),serum creatinine(SCr),APACHE Ⅱ score in two groups after the treatment were decreased significantly, while oxygenation index(PaO2/FiO2),mean arterial pressure(MAP)were increased significantly,and the observation group improvement was better than that of the control group〔PLT(×109/L):180.74±85.59 vs. 214.33±78.68,Fib (g/L):3.15±0.83 vs. 3.22±1.89,D-dimer(g/L):0.35±0.17 vs. 0.72±0.25,whole blood high shear viscosity (mPa · s):5.54±2.26 vs. 6.73±2.48,whole blood low shear viscosity(mPa · s):8.56±2.12 vs . 11.76±3.45,plasma viscosity(mPa · s):1.35±0.24 vs. 1.82±0.50,WBC(×109/L):10.75±5.53 vs. 14.34±8.66,PaO2/FiO2(mmHg, 1 mmHg=0.133 kPa):288.52±85.34 vs. 216.34±97.72, MAP(mmHg):99.52±20.85 vs. 90.73±21.86, Lac (mmol/L):2.72±1.08 vs. 4.46±2.87, ALT (U/L):89.73±22.45 vs. 125.23±77.48, SCr (μmol/L):110.19±35.26 vs. 140.23±68.96,APACHEⅡscore:13.29±3.74 vs. 18.45±3.52,all P<0.05〕;in the control group,the activated partial thromboplastin time(APTT)after treatment was decreased significantly(s:40.76±9.89 vs. 42.39±12.47),while in the observation group,increased(57.50±7.12 vs. 41.74±13.62). Compared with the control group,the length of stay in ICU was shortered(days:4.1±1.5 vs. 4.6±2.3,P<0.05),the incidence of MODS (22.8% vs. 46.7%,P<0.05)and mortality(6.5% vs. 14.1%,P<0.05)were reduced significantly in observation group. No serious complications occurred in two groups. Conclusion Anti-coagulant used for early intervention can control the disease progress and prevent the patients with severe disease from further deterioration,thus it may reduce the incidence of secondary MODS and mortality,shorten the duration of hospitalization in ICU and save the cost.

A 51-year-old man presented with multiple, disseminated dark erythematous maculopapules and nodules over the body surface for more than 1 year. Initially, the patient presented with dark erythematous macules on the trunk without discomfort. Then, lesions gradually spread over the whole body surface with the development of tenderness. Physical examination revealed multiple disseminated dark erythematous, well-demarcated maculopapules, infiltrative plaques and subcutaneous nodules on the face, neck, trunk, upper and lower limbs. Some lesions were tender on palpation. An enlarged cherry-like lymph node was detected on the right inguina. Bone marrow inspiration showed that lymphocytes amounted to 32.5%, and naive lymphocytes accounted for 10%. These lymphocytes varied in size with irregular shape, moderate amount of basophilic cytoplasm, irregular nuclei and granular chromatin. Histopathological examination revealed diffuse infiltrate of numerous medium-sized atypical blastic cells with irregular nuclei in superficial dermis and subcutaneous fat tissue. The blastic cells showed sparse fine-granular chromatin, obscure nucleoli and obvious karyokinesis. Immunophenotype examination showed that tumor cells were strongly positive for CD4, CD56 and CD43, weakly positive for CD68 and terminal deoxynucleotidyl transferase, but negative for L26, CD3, CD38, granzyme B and myeloperoxidase. The diagnosis of BPDCN is confirmed based on typical clinical features, histopathology and immunohistology findings.

We developed a novel method for the rapid determination of lysozyme using a new fluorogenic substrate that consists of a cationic aluminum phthalocyanine ( tetra ( trimethylammonio ) aluminum phthalocyanine, TTMAAlPc ) , and an anionic mucopolysaccharide ( heparin, HP ) . We found that fluorescence from the cationic aluminum phthalocyanine, a red-region fluorescence probe, was quenched significantly in acidic media in the presence of low concentrations of anionic mucopolysaccharide heparin ( HP) bearing anionic sulfonic acid groups, because of induced aggregation. The practically non-fluorescent substrate degraded into small molecular fragments upon the hydrolysis of lysozyme, and thus the phthalocyanine molecules aggregated in HP were released, resulting in significant fluorescence recovery in the reaction system. This phenomenon forms the foundation of the proposed method. The reaction mechanism was determined using fluorescence spectroscopy and fluorescence anisotropy techniques. Factors that affected the determination were investigated. Under optimal conditions, the linear range was 0. 2-2 mg/L, and the detection limit was 0. 015 mg/L. The developed method is easy to operate and has good selectivity and sensitivity. This method was used in the analysis of practical samples of lysozyme, and the results were in agreement with those determined by a conventional turbidimetric method.

Objective To explore the clinical characteristics and the prognosis of benin convulsions as-sociated with mild gastroenteritis( BICE) in children. Methods To study clinical features of 248 children with BCIE,they followed up for 12 months,and their prognosis were observe. Results Age between 3 months and 3 years,twice or more seizures were occurred on 124 patients. 64 patients suffered the seizures more than 30 mi-nutes. Cranial CT/MRI showed no abnormality. Laboratory examinations were normal, including plasma glu-cose,serum electrolytes and cerebrospinal fluid. Followed up for 12 months,14 patients (5. 6%) suffered from recurrence of BICE,12 patients (4. 8%) suffered from simple febrile seizures,and 8 patients (3. 2%) devel-oped epilepsy. Conclusion The prognosis is good in majority of cases,but some cases may transform febrile seizure or epilepsy. It is more likely to transform epilepsy,when the children suffer from febrile seizure.

Objective To explore the effect of Rhodiola kirilowii Regel combined with calcium dobesilate in the treatment of early diabetic nephropathy.Methods 80 patients with early diabetic nephropathy were selected,and they were divided into treatment group and control group according to the digital table,40 cases in each group.The two groups were given diet control and appropriate exercise and positive controlled blood sugar,blood fat,blood pressure.The control group was given calcium dobesilate,based on this,the treatment group was given Rhodiola kirilowii Regel 10mL into 5％ glucose injection 250mL and 3 unit insulin to intravenous drip.The period of treatment was fifteen days.The UAER,Scr and BUN were compared between two groups before treatment and fifteen days after treatment.Results Before treatment,the Scr,BUN and UAER in the control group were (88.00 ± 18.19) μmol/L,(5.98 ± 1.92) mmol/L,(123.31 ± 60.01) μg/min respectively,which in the treatment group were (85.80 ± 18.31) μmol/L,(5.96 ± 1.94) mmol/L,(140.21 ± 62.92) μg/min respectively,there were no statistically significant differences between the two groups(t =-1.191,-0.016,0.432,all P ＞0.05).After treatment,the Scr,BUN and UAER in the control group were (84.61 ± 11.71) μmol/L,(6.30 ± 1.37) mmol/L,(97.81 ± 49.16) μg/min respectively,which in the treatment group were (75.60 ± 11.44) μmol/L,(5.25 ± 1.24) mmol/L,(39.81 ± 23.43) μg/min.There were no statistically significant differences in Scr and BUN of the two groups compared with before treatment (the control group:t =0.767,-0.657;the treatment group:t =1.947,1.219,all P ＞ 0.05).There was statistically significant difference in UAER of the two groups compared with before treatnent (t =2.850,5.402;P =0.046,0.006),but UAER of the treatment group after treatment decreased significantly.After treatment,there were no statistically significant differences in Scr and BUN between the two groups (t =-1.229,-1.236,all P ＞ 0.05),while there was statistically significant difference in UAER between the two groups (t =-2.394,P =0.044).The effective rate in the treatment group was 87.5 ％,which was higher than 57.5 ％ of the control group (x2 =9.028,P ＜ 0.05).Conclusion Rhodiola kirilowii Regel combined with calcium dobesilate can ameliorate protenuria and improve renal function of the patients with early diabetic nephropathy.

Purpose To explore the findings and diagnostic values of apparent diffusion coefficient (ADC) and diffusion weighted image (DWI) of the portal venous tumor thrombus (PVTT) caused by hepatic carcinoma.Materials and Methods Thirty-one patients with hepatic carcinoma (43 lesions) with 63 PVTT in the main branches and trunks diagnosed by clinical and MRI were enrolled. All patients underwent conventional MRI (cMRI) imaging, DWI and ADC imaging, the features of cMRI, DWI and ADC were observed, the relevance of ADC values between the hepatic carcinoma lesion and PVTT were analyzed.Results Among the total 43 lesions, DWI image showed low signal, iso-signal and high signal in 1, 4 and 38 lesions, respectively; and ADC image showed low signal, iso-signal and high signal in 36, 5 and 2 lesions, respectively. In the total 63 PVTT, DWI showed low signal, iso-signal and high signal in 4, 7 and 52 lesions, respectively;while their ADC images showed low signal, iso-signal and high signal in 54, 6 and 3 branches, respectively. There was good consistency for the results of two observers on the findings of ADC of tumor lesions (Kappa=0.8334,P<0.05), and a moderate consistency on that of PVTT (Kappa=0.5215,P<0.05). The average ADC value of tumor lesion and PVTT was (1.127±0.268)×10-3 mm2/s and (1.021±0.363)×10-3 mm2/s, respectively; there was a correlation of the mean values of ADC between tumor lesion and PVTT (r=0.246,P<0.05). Conclusion The features such as low signal and low value on ADC image and high signal on DWI obtain a certain clinical application value for qualitative diagnoses of PVTT.

Objective:To observe the effects of AFP gene silencing by siRNA on the Survivin mRNA of hepatocellular carcino-ma cell line HepG2. Methods:AFP gene expression was downregulated in HepG2 cell by RNAi, and the AFP content in the superna-tant was detected by ELISA. Survivin mRNA level was tested by RT-PCR. MTT was applied to evaluate cell proliferation. Flow cytom-etry was employed to observe cell apoptosis. Results:At 48 h after transfection, AFP expression was almost completely inhibited, cell proliferation activity was decreased by 43.1%, cell apoptosis rate was increased by 24.3%, and the Survivin mRNA expression was re-duced to 22.0%in the experimental group. No evident changes were observed in negative control and blank groups. Conclusion:AFP gene silenced by RNAi induces growth inhibition and apoptosis promotion of hepatocellular carcinoma cell line HepG2. This gene may be associated with the suppression of Survivin mRNA.

Objective To investigate the status of treatment institution selection and its influencing factors in elderly patients with chronic diseases in a community in Changsha.Methods By using systematic sampling,400 elderly patients with chronic diseases from June to August 2012 were included in the investigation by questionnaires.The influencing factors were analyzed by binary logistic regression model or multinomial logistic regression model on the basis of the numbers of response variables.Results In mild conditions in self-consciousness,more than half of the elderly patients with chronic diseases (206 cases,51.5％) preferred community health service centers including private clinics (67 cases,16.8％),municipal hospitals (92 cases,23.0％),third-grade class-A hospitals (35 cases,8.8％).In serious conditions in self-consciousness,patients preferred third-grade class-A hospital (238 cases,59.5％) and municipal hospitals (162 cases,40.5％),no one selected the private clinics or community health service center (x2=443.240,P＜0.001).The analysis of impact factors for the first treatment institution selection in patients with serious conditions in self-consciousness showed that,compared with patients selecting the municipal hospital,the following personnel preferred to choose third-grade class-A hospital:patients in the staff remaining in positions (OR=32.38) and retirees (OR=15.17),patients with monthly income more than 5,000 yuan (OR=134.28),rural cooperative medical patients (OR=661.42),patients with highly trusting in community health service centers (OR=4.23),patients with BP and serum glucose determination at a frequency of once a month to every three months (OR=83.93),patients unknowing the telephone numbers of community health service centers(OR=3.02)and patients living far away from community health service centers (OR=15.70),patients with little information about community health service centers (OR=1.62).The analysis of impact factors for the first treatment institution selection in patients with mild conditions in self-consciousness showed that,compared with patients selecting the private hospitals,the following personnel preferred to choose community health service centers:patients with primary education level (OR=0.15),retired persons (OR=0.14),patients with higher health attention (OR=0.26),while persons with less health attention (OR-10.65) and patients living far away from community health service center (OR =5.22) were more willing to choose the private hospitals.Conclusions Patient selection for treatment agencies is affected mainly by the perceived severity,in addition,age,education level,employment status,income,health insurance type,trust and understanding on community health services centers,and the emphasis on health and the distance from community health services centers.