Objective To design fast cluster indicators (FCIs) and compare it with the acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) scoring to judge the value and prognosis of sepsis patients.Methods Based on 33 cases of severe infected patients as samples for this study from September 2013 to July 2014 in Intensive Care Unit (ICU) in the Second People's Hospital of YiYang,and with the Procalcitonin (PCT),lactic acid (LAC),D-Dimer (DD) and base excess (BE) as the indicators,as well as drawing on the APACHE Ⅱ scoring system ideological,as is to design the FCIs to evaluate the prognosis of patients with severe infection.Results After treatment,the survivals were 17 cases,16 patients were died out of 33,and the mortality rate was 48.5％.The sensitivity and specificity of fast cluster indicator that predict patient mortality rates were 75％ and 71％,respectively.The area under the receiver operating characteristic curve (ROC) of FCIs assessing the prognosis of patients with severe infections was 0.895,which was higher than the value 0.721 of APACHE Ⅱ scoring.Conclusions FCIs scoring has a certain significance and guiding role in clinical practice.

Finite element analysis can analyze the stress and strain change of object with complex shape,structure,constitution and load condition,and is widely applied to spinal biomechanical studies due to its controllability,reproducibility and versatility in mechanics tests.The article briefly introduced several finite element analysis software,summarized the mechanical characteristics of vertebral body,intervertebral disc,accessories and the ligament and muscle around the spine,and summarized research achievements of finite element analysis in lumbar fusion,concerning the biomechanics of Cage,its influence on lumbar fusion and related surgery choice,dynamic fusion,artificial intervertebral disc and the biomechanical variation of different fusion style after spinal tumor vertebrectomy.Finite element analysis can help understand the spine biomechanics and provide biomechanical reference for lumbar fusion choice.

Objective To explore the effect of treadmill running at different intensities on three-dimensional structure of rat subchondral bones.Methods A total of 24 female Wistar rats were randomly assigned into a sedentary (SED) group,a low-intensity running (LIR) group,a medium-intensity running (MIR) group,or a high-intensity running (HIR) group,each of 6.Rats in LIR,MIR and HIR groups underwent treadmill running exercises with respective protocol,while rats in SED group serve as controls.Eight weeks later,all animals were sacrificed and their proximal end of tibia was examined using Micro-CT.Results Compared with SED group,in HIR group the subchondral plate became thicker with higher BMD and lower porosity,while trabecular bone became more and denser with higher BMD and a more plate-like architecture.LIR and MIR failed to result in considerable changes in the microstructure.Conclusion Treadmill running has an intensity-dependent effect on the three-dimensional structures of subchondral bones.High-intensity running can evoke significant structural changes in subchondral bones.

Objective To discuss the selection of indication for using uterine artery perfusion and embolization in tubal pregnancy. Methods Fifty one cases of tubal pregnancy were treated by superselective trans-uterine artery (TUA) catheterization with perfusing Methorexate (MTX) and then embolized the uterine arteries by gelfoam. The comparisons among serum P-HCG concentration, abdominal bleeding and the size of the ectopic mass could state the importance of the indication selection preprocedurally. Results Forty eight of the 51 cases were cured by this method, when the ectopic mass size≥5 cm, the cure rate was low, 33.33% (P

Objective To find out the difference in expression of glial fibrillary acidic protein and neuron-specific enolase in hippocampi and olfactory bulb of Alzheimer's disease rats,and the relationship between olfactory and Alzheimer's disease.Methods Adult rats,the expression of GFAP and NSE in hippocampi and olfactory bulb was measured by immuhistochemical after a single intracerebroventricular injection of ?-amyloid peptide,and change of these protein in olfactory.Results Comparing the hippocampi and olfactory of model and control,the expression of GFAP in model group increased evidently,the expression of NSE descended animals.Conclusion There is significant difference in olfactory system between Alzheimer's disease model and control group rats.

To assess the roles of glutamate and its ionotropic receptor in processing noxious sensory input from dental pulp,glutamate NMDA receptor subtype antagonist,MK-801 and non-NMDA receptor subtype antagonist,CNQX were administrated separately into left lateral cerebral ventricle prior to exposing pulp cavity of left maxillary first molar tooth.The number of Fos-positive neurons in medulla oblongata was measured and compared with that of the group with simple exposure of dental after same survival time pulp.Fos protein expression was reduced dose-dependently by an administration of MK-801,but CNQX had little effect.The results showed that glutamate may be an excitatory transmitter of noxious dental pulp sensory input to neurons in medulla oblongata.In pain nodel of mechanical exposing dental pulp,NMDA receptor subtype has an important role in this process.

Objective To provide references for epidemiology teaching reform by investigating scores of epidemiological exam and applications of epidemiologic course content in practice.Methods The epidemiological exam scores of students majoring in preventive medicine from 2004 to 2007 grade were statistically analyzed and questionnaire survey was carried out among students of 2006 and 2007 grade.Results The skewness of epidemiological scores from four garades were negative skew,and the kurtosis of 2007 grade was positive,the others were negative;there were statistical differences among the average scores of different grades(F=2.70,P＜0.05);there were statistical differences between 2004 grade and other grades in passing rate(x2=7.94,P＜0.008).Most of the contents applied in survey were prevention and control of infectious deseases(16.0％),prevention and control of chronic diseases(13.9％),surveillance of diseases(11.8％).Conclusions Epidemiology teaching reform should be enhanced and should integrate theory with practice.

Objective To compare the changes of blood coagulation system and the clinical interventional effect of low molecular weight heparin (LMWH) in elderly patients who had received thoracic surgery. Methods Ninety-six thoracic surgery patients (age≥70 years) were divided into control group ( 54 cases ) and experimental group ( 42 cases ) ( postoperative 1-7 days, subcutaneous injection with LMWH ) from September 2007 to December 2009 by random digits table. Observed perioperative changes in prothrombin time (PT),activated partial thromboplastin time (APTT),platelet (Plt),D-dimer (D-D),fibrinogen (Fib), anti- X a activity, and clinical performances. Also observed the influence of diabetes mellitus of surgery coagulation function. Results The preoperative indexes of coagulation function were no significant (P ＞ 0.05 ). In control group PT prolonged, Fib and D-D increased, the differences between preoperative and postoperative each time were significant (P ＜ 0.05 ). Fib and D-D in control group increased than those in experimental group postoperative each time (P ＜ 0.05 ). In experimental group anti- X a activity increased postoperative each time (P ＜ 0.05 ),compared with control group was also significant (P ＜ 0.05 ). Diabetes mellitus had no significant influence on coagulation function. One patient appeared pulmonary thromboembolism in control group,and no one appeared venous thromboembelism and bleeding adverse reactions in experimental group. Conclusion Thoracic surgery in elderly patients have high blood coagulation state, prone to venous thromboembolism, LMWH given early postoperative prophylactic treatment is beneficial to improve the hypercoagulable state and have better security.

Objective To evaluate the efficacy of Shikani laryngoscope-guided nasotracheal intubation in patients undergoing maxillofacial surgery. Methods One hundred ASA Ⅰ or Ⅱ patients with body mass index ＜25 kg/m2 , aged 18-64 yr, undergoing maxillofacial surgery under general anesthesia requiring nasotracheal intubation were included in this study. Fifty patients without anticipated difficult airway in preoperative assessment were randomly divided into 2 groups ( n = 25 each): Macintosh luyngoscope group ( group M ) and Shikani Optical Stylet (SOS) group (group S1 ). The other 50 patients with mouth opening ＜ 3 cm but without difficult ventilation by mask were randomly divided into 2 groups ( n = 25 each): fiberoptic bronchoscope group (group F) and SOS group (group S2 ). Tracheal intubation was performed under the guidance of laryngoscopes after induction of anesthesia, and then the patients were mechanically ventilated. The degree of glottis exposure and epistaxis was evaluated. The rate of successful intubation, rate of successful intubation at first attempt, intubation time and complications were recorded. Results Compared with group M, the rate of successful intubation, rate of successful intubation at first attempt, and degree of glottis exposure were significantly increased, the intubation time was significantly shortened, and the degree of epistaxis was significantly decreased ( P ＜ 0.05), but no significant change was found in the complications in group S1 ( P ＞ 0.05). Compared with group F, the intubation time was significantly shortened ( P ＜ 0.05), but no significant change was found in the rate of successful intubation, rate of successful intubation at first attempt and complications in group S2 ( P ＞ 0.05). Conclusion Shikani laryngoscope can expose glottis better and the rate of successful intubation at first attempt is higher, thus it is more suitable for nasotracheal intubation in patients undergoing maxillofacial surgery.

Objective:To investigate the expressions and their clinical significance of vascular endothelial growth factor (VEGF) and extracellular matrix (ECM) components in non-small cell lung cancer (NSCLC). Methods:Expressions of VEGF and ECM components (fibronectin, FN and collagen Ⅳ, cⅣ) in 50 cases of NSCLC tissues and 20 cases of normal lung tissues were detected by immunohistological analysis. Their relationship with clinical features of NSCLC and the correlation of expression of VEGF and Fn and cⅣ were analyzed.Results:The positive expression rates of VEGF, Fn, and cⅣ were 96%, 78%, and 50% in NSCLC tissues. The expressions of VEGF and Fn were significantly higher than those in normal lung tissues (P<0.05). The expression of Fn and over-expression of VEGF were associated with lymph node metastasis (r=1.00, P<0.001). The survival rate of patients with over-expression of VEGF was greatly lower than that with weak expression of VEGF (P=0.022). The survival rate of Fn-negative patients was markedly higher than that of Fn-positive patients (P=0.046). Conclusion:VEGF and ECM component Fn were highly expressed in NSCLC, which correlated with lymph node metastasis and survival rate. Expression of ECM and VEGF had positive correlations, suggesting that ECM might be one of the anti-angiogenesis targets for tumor therapy.