Among 109 patienta with basilar fracture of skull, 24 with special complications were analysed retrospectively, The complications included: delayed severe intracranial infection or brain abscess (7 cases), intracranial artery damage (9 cases), multiple cranial nerve injury (5 cases), and acute massive rhinorrhea and pneumocephalus (3 cases). Thirteen patients were operated on with various methods according to the clinical diagnosis. The relations between the biophysiological nature of the base of the skull and the mechanism of the complications were discussed. Forehead injury may cause "craniofacial cleavage fracture", and unilateral or bilateral temporal crush may caues "hinge fracture". All the basilar fractures mentioned above may damage the internal carotid artery and cranial nerves.

30 cases of tumors on the base of the skull were reported. The symptoms and signs, the pathological types and the relationship between the location. and the histological findings of these tumors were analysed. 40 operations were carried out on 26 patients. 2/26 patients died postoperatively, the operative mortality was 7.7%.The choice of the operative procedure depended upon the tumor's location, size, nature and consistency, we suggested that the operative procedure of choice should be transcranial resection for the tumors located at the anterior or lateral region of the base of the skull, or at the cerebellepontine angle, because it would offer a wider operative field without any important structures there.The dumbbell tumors involving both intracranially and extracranially were difficult to remove. In such a case it was necessary for the neurosurgeon to cel-laberate with the otolaryngologist. The operative procedure in two stages was successful with no complication.

Objective To develop a double antibody sandwich ELISA method with neutralizing antibody for the determination of content of functional antigen diphtheria toxoid(DTd), and to verify and preliminarily apply it to the quality analysis in the DTd production.Methods The concentration of anti-diphtheria toxin(DTx) coating antibody and enzyme-labeled antibody in double antibody sandwich ELISA was determined by square titration, and a linear standard curve was established.The method was verified according to the requirements of Chinese Pharmacopoeia(Volume Ⅳ, 2020 edition), and was preliminarily applied to the detection of DTd stock solution.Results The optimal concentration of coating antibody was 5 μg/mL,the working dilution of enzyme-labeled antibody was 1∶5 000 and the best linearity of dose-response curve was in a range of 0. 000 781-0. 012 5 Lf/mL(r > 0. 99). This method showed no cross reaction with pertussis toxoid(PTd), filamentous haemagglutinin(FHA), pertactin(PRN), tetanus toxoid(TTd) and Sabin-strain inactivated poliomyelitis vaccine(sIPV) Ⅰ,Ⅱ,Ⅲ. For the DTd standard in the linear range, the coefficients of variation(CVs) of precision verification were 4. 23%, 2. 98%,1. 81%, 6. 61% and 1. 82%, and the recoveries of accuracy verification were 90. 67%, 105. 39%, 102. 11%, 97. 76% and 81. 31%, respectively. The Pearson r was 0. 638 0(P < 0. 05) for the determination of toxoid content in 12 batches of DTd stock solution by this method and flocculation test. For the concentration of diphtheria toxoid less than 1 800 Lf/mL, the Pearson r was 0. 899 2(P < 0. 001).Conclusion A double antibody sandwich ELISA method for quantification of DTd antigen based on neutralizing antibody was successfully developed with good specificity, accuracy and precision, which provides an effective verification means for the production of DTd stock solution.

Objective To investigate the clinical effect of ulinastatin treating systemic inflammatory response in the patients with serious blood infection .Methods The patients with serious blood infection in our hospital were selected and divided into the control group and observation group .The control group was treated with the conventional treatment ,while on this basis the observation group was added with ulinastatin .The body temperature ,heart rate ,respiratory rate ,WBC ,Scr ,CRP ,PCT ,TNF-α,APACHE Ⅱscore and mortality rate were compared between the two groups .Results The body temperature ,heart rate ,respiratory rate and A-PACHE Ⅱ score in the observation group were lower than those in the control group ,moreover ,the levels of WBC ,CRP ,PCT , TNF-αand Scr ,and mortality rate in the observation group were lower than those in the control group ,the differences were statisti-cally significant (P<0 .05) .Conclusion Uinastatin has good effect for treating systemic inflammatory response in the patients with serious blood infection ,which can decrease the mortality and is worth clinical promotion .

The long-year program for medical education is the major way to train the high level medical professionals.This paper colleeted the research papers on this topic published in Chinese journals in recent years,extracted their key words and counted the high frequent key words According to the co-occurrence of a pair of key words in one paper.these high frequent keywords were clustered into groups.The research structure and main directions of the long-year program were outlined as the study of macro-planning of long-year program,the study of teaching models and teaching system,study of teaching practice.These results could be a useful reference for the medical educational researchers and managers.

Attention deficit hyperactivity disorder(ADHD) is one of the most common psychiatric disorders among school-age children.The diagnosis and treatment of ADHD rely on a comprehensive evaluation of symptom,functional impairment and comorbidity.Therefore the standardized rating scales is widely used clinically.The standardized rating scales can be categorized into: Broad-band scales,evaluating the general misbehavior and sociopsychological functions andNarrow-band scales,evaluating ADHD specific symptoms,and also functional impairment rating scales.Useful comorbidity and functional impairment rating scales are in need domestically.This paper reviewed the published literature about the clinical application and progression of frequently-used rating scales for school-age ADHD evaluation,at home and abroad.

Objective To explore the application effect of strengthened pulmonary rehabilitation exercise in lung cancer patients with severe pulmonary ventilation dysfunction during perioperative period. Methods A total of 96 patients receiving lung cancer radical treatment under thoracoscope in our hospital during March 2013 to April 2015 were collected, and for all these patients, pulmonary function test before treatment showed that there was severe pulmonary ventilation dysfunction. The patients were divided into the routine group and the intervention group by random digital table method, with 48 patients in each group;patients in the routine group received routine perioperative nursing, and those in the intervention group received the strengthened pulmonary rehabilitation intervention plan; change in pulmonary function before treatment, duration of mechanical ventilation, time of oxygen therapy, retaining time of chest tube, length of hospital stay and occurrence of complications after treatment were compared between the two groups. Results After strengthened pulmonary rehabilitation intervention in the intervention group, the FVC was (2.63±0.47) L, the MVV was(53.14±9.40) L, the DLCO was(19.26±2.63) ml·min-1·mmHg-1, the VO2 was (23.15±4.36) ml/kg and the O2Pulse was(10.98±2.52) ml·min-1·times-1, Which were significantly improved compared with those before treatment, (2.41±0.40) L,(46.98±8.91) L,(17.56±2.83) ml·min -1·mmHg -1, (20.17±4.35)ml/kg and(9.82±2.07) ml·min-1·times-1, t=2.521, 3.512, 3.112, 3.421, 2.515, P<0.01 or 0.05. While there was no obvious change in the above- mentioned indexes of those in the routine group. After treatment of patients in the intervention group the duration of mechanical ventilation was (9.42±3.17) hours, time of oxygen therapy was (76.23±21.18) hours, retaining time of chest tube was (3.58±1.44) days and length of hospital stay was (6.62±2.14) days, which were significantly shorter than those in the routine group, (17.29±4.79) hours,(92.14±24.29) hours, (4.73±2.15) days and(8.68±2.96) days. The occurrence rates of complications such as pulmonary infection, pulmonary atelectasis and respiratory failure were 12.50%(6/48),10.42%(5/48) and 4.17%(2/48)in the intervention group, significantly lower than those in the routine group, 41.67%(20/48),29.17%(14/48) and 18.75%(9/48), χ2=10.338, 5.315, 5.031, P <0.01 or 0.05. Conclusions Strengthened pulmonary rehabilitation intervention can improve pulmonary function of lung cancer patients with severe pulmonary ventilation dysfunction before treatment, reduce the occurrence rate of post- operative complications and enhance safety during the perioperative period; it is worth of being further promoted clinically.

Objective: To explore the changes of the graph theory metrics and the functional connectivity (FC) of adolescent depression with attempted suicide. Methods: Resting-state functional MRI (rs-fMRI) data of 33 patients of adolescent depression with attempted suicide (attempted suicide group), 40 patients of adolescent depression without attempted suicide (no suicide group) and 52 normal adolescents (NC group) were collected, and a binary network was constructed. The brain regions changed in the graph theory attribute were selected as the seeds, and FC between seed and all the other voxels within the whole brain was computed and compared among groups. Results: There were small world attributes in all subjects. Compared with NC group, the degree of centrality significantly decreased in adolescent depression patients (P<0.01), and there were negative correlations between the decreased degree of centrality and Hamilton Depression Scale scores (r=-0.31, P<0.01). Compared with NC group, FC of the somatomotor networks and the salience network decreased in adolescent depression patients, while FC of the attention network in attempted suicide group increased than in no suicide group (all TFCE correction, P<0.05). Conclusion: Decrease of visual network information transmission ability in patients of adolescent depression is related to the severity of depression. The abnormal attention space ability caused by the attention network lesions may be the pathological mechanism of suicidal attempt in patients of adolescent depression.

Objective:To seek the best part and optimal culture medium for the tissue culture of Bletilla striata. Methods: The effects of hormone concentration and proportion on the induced differentiation, propagation and rootage of Bletilla striata were investiga-ted. Results:The radicle of Bletilla striata was the best part to induce the clustered shoots with the optimal culture medium of 1/2MS+1. 0 mg·L-1 6-BA+2. 0 mg·L-1 NAA. The best hormone concentration for inducing the clustered shoots was MS+1. 0 mg·-1 L 6-BA+0. 05 mg·L-1 NAA, and the optimal rooting medium was 1/2MS+0. 5 mg·L-1 NAA. Conclusion: The tissue culture system for Bletilla striata is established.