Objective To establish a method to evoke cerebral potentials by stimulating nociceptive fibers with contact heat evoked potential stimulator,evaluate the state of nociceptive system in patients with multiple sclerosis and assess the value of the potentials in multiple sclerosis(MS).Methods Thirty-six definite MS patients and 40 sex-,height-and aged-matched healthy persons underwent stimulation of contact heat delivered via a circular thermode to excite selectively nociceptors with a rapid rising time at 70℃/s to elicit pain and contact heat evoked potentiaI(CHEP).Thermal stimuli were sent at two intensity levels (47 ℃ and 51℃)to 3 body sites:volar surface of the forearm,the skin of leg 5 cm proximal to the medial malleolus and lumbar part.The CHEP were recorded from Cz.The relationship between the stimulus intensity and pain rating was observed,and the main components of the evoked potential were recorded.Then,somatosensory evoked potential(SEP)was examined in 36 patients with MS.Results CHEP were elicited reliably and stably in all control subjects.In contrast,in 4 patients there were no recordable CHEP on stimulation of the upper limb,and in some cases of lower limb(n=5).Conduction velocity of Aδ fihers was(18.1±7.3)m/s.The 21 MS cases had hypesthesia in upper limb and 29 cases in lower limb.The visual analog scale(VAS)for pain perception was higher in control subjects(upper limb:8.0±0.7;lower limb:7.9±0.7)than MS with hypesthesia(upper limb:6.1±0.9;lower limb:5.6±1.3,Z=-3.249 and -5.272,both P＜0.01).The group of patients (MS) with hypesthesia(upper limb 17 cases,lower limb 24 cases)had markedly reduced N-P amplitudes(upper limb:(30.5±12.8)μV;lower limb:(28.2±16.2)μV,t=-4.612 and -3.144,both P＜0.01)and prolonged N-wave latencies(upper limb:(387.3±34.2)ms;lower limb:(489.9±70.2)ms,t=4.790 and 4.798,both P＜0.01)compared with the control group in CHEP mediated by Aδ fibers.CHEP abnormality was observed more often in the lower(26/36,72.2%)than the upper limb(16/36,44.4%,P=0.031)and SEP(19/36,52.8%,χ~2=4.261,P=0.039).CHEP were abnormal in 3 of 15 skin areas with clinically normal nociception in upper limb,and in some cases of lower limb(2 of 7).Conclusions CHEP provides a clinically practical,non-invasive and objective measure,and can be a useful additional tool for the assessment of nocieptive system.Combined assessment of other Eps can help to document dissemination of demyelinating CNS lesions and detect subclinical lesions thus contribute to the diagnosis of multiple sclerosis.

10% at 24-hour later than the initial value.Conclusion In patients with refractory septic shock who achieved the goal of combiming CVP ≥ 8mmHg,MAP ≥ 65mmHg,SmVO2 ≥ 65% hyperlactemia was ameliorated.Lactate clearance rate can be used as a good marker to predict outcome of septic shock patients.

Objective To construct a vector carrying tyrosine hydroxylase (TH) and glial cell line-derived neurotrophic factor (GDNF) in order to establish a new gene therapy method in Parkinson's disease. Methods Human TH gene fragment from the plasmid pWAV2-TH was cloned into pIRES to construct pIRES-TH. The mouse GDNF gene, amplified by PCR was inserted into pIRES-TH to construct pIRES-TH-GDNF. Restriction analysis and nucleotide sequencing were used to confirm the structure of pIRES-TH-GDNF. Then MES23.5 cells were transfected with this eukaryon vector using Lipofectamine TM2000. The expression of TH and GDNF in mRNA and protein levels were detected by RT-PCR and immunofluorescence after G418 selection. Results The 2 objective fragments were inserted into pIRES correctly. RT-PCR and immunofluorescence results showed that TH and GDNF were highly expressed in MES23.5 cells. Conclusion The plasmid pIRES-TH-GDNF is constructed successfully and can express TH and GDNF in vitro.

Objective To evaluate the functional alternations of canine renal ischemia and reperfusion injury by using MR perfusion-weighted imaging, and to correlate the imaging with the pathologic findings. Methods Using 1. 5 T MR system, four groups of three anesthetized dogs each were studied by left renal artery ligation for 30-, 60-, 90-, and 120-min, respectively, after the removal of ligation, reperfusion injury was suffered for one hour. True-FISP, TSE, and EPI sequences were performed in five different time phases ( pre-ischemia, onset-ischemia, post-ischemia, onset-reperfusion, and post-reperfusion). Finally, IR-turbo-FLASH sequence (TR 5. 8 ms, TE 3. 2 ms, TI 400 ms, FA 12?) with a temporal resolution of 1. 16 s was performed. Signal intensity (SI) in cortex, outer medulla, and inner medulla was measured. SI was plotted as a function of time. Peak height (P) , time to peak (Tp) , and the area (A) under the time-course curves after the intravenous injection of Gd-DTPA were estimated. Blood and urine examples were collected for measuring serum creatinine level and urinary protein before and after the insult. Histologic examination was performed with light and electron microscopy in all dogs. Results After arterial ligation,there was marked and significant reduction in the SI of each layer of left kidney on true-FISP, TSE, and EPI, except for the SI of inner medulla on TSE. After the removal of ligation,there were no significant differences in the SI of cortex of both kidneys, however, significant differences in the SI of outer and inner medulla of both kidneys remained on EPI in all groups. The turbo-FLASH study clearly depicted the three-phase pattern of SI changes in each layer on right kidney. The uniphasic enhancement pattern in all groups was showed in outer and inner medulla on left kidney, with the area under the curve decreased. Conclusion This preliminary study shows that MR perfusion-weighted imaging may be useful and very promising for the evaluation of renal dysfunction following normothermic ischemia and reperfusion injury.

0.70,and the Cronbach's ? value for satisfaction of management domain was 0.44.The ICC of the SRS-22 questionnaire,0.94,0.86,0.77,0.74,0.84,showed a satisfactory reproducibility.Five public factors were obtained by factor analysis compared with the five domains of SRS-22 questionnaire.For the concurrent validity,5 domains had excellent correlation,9 had good correlation,and 26 had correlation.CONCLUSION:The adapted simplified Chinese version of the SRS-22 questionnaire has satisfactory reliability and concurrent validity,and might be suitable for post-operative clinical evaluation of Chinese adolescent scoliosis patients.

Objective To investigate the effect of miR-20b on cell proliferation and cell cycle in gastric cancer because of up-regulation of miR-20b in gastric cancer.Methods miR-20b mimics and its inhibitor were respectively transfected into MGC 803 gas-tric cancer cell and methyl thiazolyl tetrazolium ( MTT ) and fluorescence-activated cell sorting ( FACS ) were used to analyze cell growth and cell cycle.Western blot was used to explore the molecular basis of miR-20b.Results Compared with its control, cell growth was obvious elevated and the cell cycle transition was also increased from G 1 to S phase after miR-20b mimics transfection .After transfecting miR-20b inhibitor, cell growth was markedly decreased and cell cycle transition was also delayed from G 1 to S phase.Fur-thermore, miR-20b induced the expression of cyclin D1 (CCND1) and C-Myc, decreased the expressions of p21 and p15.Conclu-sions miR-20b was considered as a potential oncogene to modulate cell growth and cell cycle transition through regulating the expres -sion of cell cycle-related genes .

Objective Observe the clinical effect of the controllable airbag elastic chest strap after the breast cancer operation,studying the clinical value of the controllable airbag elastic chest strap.Methods Between May.2009 and Oct.2012,71 women having surgery for breast cancer at The Affiliated Second Hospital of Nan Hua University Oncology Center.They were to receive either a common thoracic girdle compressed binding(n =35),or the controllable airbag elastic chest strap compressed binding (n =36) at the postoperation.The following complications were evaluated:the incidence of seroma formation and duration,the incidence of skin flap swelling,and the dressing time.Results Thirty-five patients with common thoracic girdle is 14 cases of subcutaneous effusion,fluid rate was 40.0％,the effusion duration 7 to 31 days,an average of 17.6 ±7.3 days,15 cases with skin redness (disc),swelling rate is 42.9％,the average treatment time 18.7 ±3.5 minutes; With the controllable airbag elastic chest strap group of six cases of subcutaneous effusion,fluid rate was 16.7％,the duration of effusion 5-14days,an average of 10.5 ± 3.9 days,skin redness (disc),swelling rate is 13.9％,the average treatment time 12.2 ± 2.4 minutes.Conclusions The controllable airbag elastic chest strap can reduce subcutaneous effusion,reduce skin flapswelling,saving the treatment time,is worth promoting in the clinical medical supplies.

Objective To compare the short-term clinical effect of K-Rod pedicle dynamic fixation system and lumbar fusion for multi-ple segmental lumbar degeneration.Methods Between January 2010 and October 2012,56 patients with segmental lumbar degeneration who were accepted K-Rod pedicle dynamic fixation system and posterior lumbar interbody fusion were retrospectively reviewed.The 56 patients were divided into K-Rod and fusion group,28 patients with K-Rod pedicle dynamic fixation system and 28 cases with traditional lumbar fusion and internal fixation.Clinical assessments were based on comparion of Oswestry disability index score ,visual analogous scale (VAS),im-provement rate of low back pain,postoperative lumbar spine X-ray,average operation time and intraoperative blood loss of two groups.Results All of 56 cases were followed up for 12 to 24 months,the difference of Oswestry disability index score and VAS between two groups were not statistically significant(P >0.05),but the difference of average operation time,blood loss and the average length of stay(ALOS)were statis-tically significant(P <0.05),the K-Rod group was superior to the fusion group.Conclusion In the treatment of multiple segmental lumbar degeneration both K-Rod pedicle dynamic fixation system and traditional lumbar fusion can obtain satisfactory short-term clinical effect,but the K-Rod pedicle dynamic fixation system has advantages of less intraoperative blood loss,shorter operation time,postoperative small effects on lumbar spine mobility.

Objective To further explore the relationship of CEA in gastric cancer tissue expression and serum levels,and seek after the prediction effect of serum CEA in the peritoneal metastasis.Methods Retrospective analysis of 38 gastric cancer patients with peritoneal metastasis (group A) and 60 gastric cancer patients without peritoneal mnetastasis (group B),and analyze the first time in two groups of patients with preoperative serum CEA levels.The expression levels of CEA was examined by Immunohistochemistry method in primary tumors、negative margin and peritoneal metastases foci from group A and in primary tumors from group A,and the detection result of the statistical was analyzed.Results The expression of the first preoperative CEA serum levels in group A and group B was 73.68％ and 41.67％ respectively (x2 =9.604,P =0.002),and the two groups of patients with the first preoperative CEA serum levels was (74.00 + 6.00) ng/mL,(46.06 + 9.03) ng/mL,The two groups was statistically significant (t =4.715,P ＜0.01).In group A,the expression of CEA of primary tumors was higher than that of negative margins (x2 =29.587,P =0.000);the difference expression of CEA positive degree in gastric cancer primary tumors and negative margins was statistically significant(Z =-5.348,P =0.000).In peritoneal metastases foci the expression of CEA was 92.11％,that was 64.82％ in primary tumor(x2 =6.728,P =0.009);the difference expression of CEA positive degree in peritoneal metastases foci and primary tumors was statistically significant (Z =-5.397,P =0.017).In primary tumors,the expression of CEA in group A and group B was 68.42％ and 42.67％ respectively (x2 =4.450,P =0.035),the two groups of patients with the difference expression of CEA positive degree was statistically significant,the two groups was statistically significant(Z =-2.227,P =0.026).Conclusion Over expression of CEA might have a critical role in peritoneal metastases of gastric carcinoma.The differences of the expression of CEA in gastric cancer in different tissues may indicate the risk of gastric cancer peritoneal metastasis.

Bases on the changing idea and management policy,the out-patient service process rebuilding focuses on the patient,makes use of the information technology,imports the theory of operation process reforming,reconsiders and redesigns the operation process of the out-patient department,and improves the medical quality and service.The digitizing procedure in out-patient service is the important base of process rebuilding.In the paper,we try to discuss how to improve the digitizing procedure in out-patient service and rebuild the service process.