Objective To study the value of prealbumin(PAB) ,C reactive protein(CRP) and apolipoprotein A1(Apo A1) in e-valuating the prognosis of patients with severe pneumonia .Methods 63 cases of patients with severe pneumonia were selected ,and the fasting serum level of prealbumin ,C-reactive protein and apolipoprotein A1 were detected in 24 hours at the admission day ,and APACHE Ⅱ score was calcumulated .The patients were divided into group A (APACHEⅡscore <20) and group B(APACHEⅡscore≥20) ,with the incidence of MODS and mortality rate compared .The patients were divided into non-MODS group and MODS group .In addition ,the patients were divided into survival group and death group according to the prognosis .PAB ,CRP and Apo A1 in each group were compared .Results The incidence of MODS and mortality rate in group B (57 .9% ,47 .4% ) were higher than that in group A(24 .0% ,16 .0% )(P<0 .01 ,P<0 .05) .PAB and Apo A1 of patients in MODS group[(134 .13 ± 36 .20)mg/L , (0 .62 ± 0 .21)g/L] and death group[(129 .05 ± 52 .24)mg/L ,(0 .76 ± 0 .29)g/L] were respectively lower than that in non-MODS group[(215 .03 ± 72 .08)mg/L ,(1 .06 ± 0 .39)g/L] and survival group[(185 .52 ± 57 .63)mg/L ,(1 .15 ± 0 .36)g/L](P<0 .05) , while the CRP in MODS group(102 .37 ± 35 .65)mg/L and death group(96 .37 ± 34 .72)mg/L were higher than that in non-MODS group(69 .68 ± 32 .92)mg/L and survival group(62 .94 ± 38 .36)mg/L (P<0 .05) .Conclusion The measurement of PAB ,CRP and Apo A1 are valuable to evaluate the prognosis of the patients with severe pneumonia .

Objective To reduce unreasonable use of antibiotics in acute suppurative tonsillitis cases. Methods Retrospective analyses of 1107 acute suppurative tonsillitis cases from the pediatric outpatient department were conducted.According to course of antibiotic treatment, these cases were divided into the group of full course of treatment and the group of insufficient course of treatment.According to the types of antibiotic, the subjects were di-vided into azithromycin group and non-azithromycin group.Three months after the onset of illness, the occurrence of complications and illness relapse between full course of treatment group and insufficient course group, azithromycin group and non-azithromycin group were analyzed.Meanwhile, the cases were divided into Chinese mainland group, Macao and Taiwan group, and foreign group according to their native places and nationalities.We compared the num-ber of cases used insufficient course in these three groups and analyzed their reasons.Results The relapse rate was significantly lower in the full course treatment group compared with insufficient course treatment group ( P<0.05 ) , and significantly higher in non-azithromycin group compared with azithromycin group ( P<0.05 ) .The occurrence rate of insufficient course treatment in the Chinese mainland group was obviously higher than the Macao group, Tai-wan group and foreign group (P<0.05).The main reasons for insufficient course of treatment were the insufficient patients′obedience and some doctors′poor understanding of the disease course.Conclusion A full course treatment with antibiotics on acute suppurative tonsillitis are strongly suggested.It may be of great significant to strengthen the awareness of reasonable use of antibiotics among the inland citizens.

Objective To assess the feasibility of using bispectral index (BIS) to guidance of desflurane or sevoflurane anesthesiaMethods Forty ASA Ⅰ-Ⅱ patients were randomly assigned to four groups, After a induction of propofol 2-2?5mg?kg -1 and fentanyl 2ug?kg -1, laryngoscopy and intubation were facilitated with intravenous vecuronium 01mg?kg -1,and anesthesia was maintained with either desflurane or sevoflurane in combination with 60% nitrous oxide In control groups, the anesthesiologists were blinded to the BIS value, and the volatile anesthetics were administered according to their clinical experience In BIS-titrated groups, the volatile anesthetics were titrated to maintain the BIS value at about 60Results During the maintenance period, the SBP in BIS-titrated groups was higher than that in control groups, while SBP fluctuation was less in control groups than that in BIS-titrated groups The requirements of volatile anesthetics were lower in BIS-titrated groups than those in control groupsConclusions In spite of predicting the sedative effect of desflurane or sevoflurane, BIS can not titrate desflurane or sevoflurane anesthesia

Bioeleotrical activities of human cerebral cortex which control and regalate movements get to increase during voluntary movements, the metabolic level of the cells of motor areas change at the same time,and consequently regiond cerebrd blood flow (rCBF)changes. Different changes of rCBF indicate the range of motor areas with which the relavant movemats are involved.And studies of this take great significance in finding out the basic active regalarity and features of human brain. In this artide motheds of the determination of rCBF an introduced briefly, and changes and distribution of rCBF of rCBF of each cortical moter area during different types of volantary movements are discribed. Keywords：regional cerebral blood flow; voluntary movements; cerebral corrical motor areas

Influenced by the intensity, volume of exercise, the basic metabolic features of skeletal muscle are changed to such structural and functional adaptations as there are increases in the amount of contractile components, muscle glycogen and myoglobin, in the volume and quantity of mitochondria and in the density of capillary in skeletal muscle, which result in enhanced aerobic metabolism, contraction efficiency and prolonged time defore failure. It is also pointed out that the structural changes and decrease of function of sarcoplasmic reticula during acute exercise are important reasons for skeletal muscle fatigue , whereas, high- intensity training can improve sarcoplasmic reticulum function and its Ca2＋ -intake rate, so that to improve the physiological efficacy of excitation- contraltion coupling. So it is put forward that anti- resistance training, as a means of exercise therapy, can efficiently increase muscle strength and prevent muscle atrophy. Keywords：exercise;muscle metabolism;contractile protein;sarcoplasmic reticulum;mitochondria;oxygen restore;exercise therapy

The gene encoding the VP28 envelope protein of White spot syndrome virus (WSSV)was cloned into expression vector pET-30a and transformed into the Escherichia coli strain BL21.After induction,the recombinant VP28 (rVP28) protein was purified and then used to immunize Balb/c mice for monoclonal antibody (MAb) production.It was observed by immuno-electron microscopy the MAbs specific to rVP28 could recognize native VP28 target epitopes of WSSV and dot-blot analysis was used to detect natural WSSV infection.Competitive PCR showed that the viral level was approximately 104 copies/mg tissue in the dilution of gill homogenate of WSSV-infected crayfish at the detection limit of dot-blot assay.Our results suggest that dot-blot analysis with anti-rVP28 MAb could rapidly and sensitively detect WSSV at the early stages of WSSV infection.

Objective To study the clinical effects of Ditan Xingnao Chengqi soup for treatment of patients with sepsis brain dysfunction. Methods Sixty-two cases of sepsis brain dysfunction were divided into treatment group(32 cases)and control group(30 cases)according to random digits table. Both groups received general clinical treatment,while the treatment group additionally accepted Ditan Xingnao Chengqi soup through nasal feeding. The changes of C-reactive protein(CRP)of two groups before treatment and after treatment for 12,24,48,72 hours and 1 week were observed. Besides,the Glasgow Outcome Scale(GOS)was used to assess the curative effect of two groups, and its clinical significance was judged. Meanwhile,the hospitalization costs,the times staying in hospital and total effective rates of the two groups after treatment were observed. In addition,cost-effectiveness analysis was carried out. Results With the extension of therapeutic time,the levels of CRP(mg/L)in the two groups were reduced effectively in comparison with those before treatment,and the change was more obvious in the treatment group;after treatment for 24 hours,the difference in the level of CRP between the two groups began to be statistically significant(106.5±22.3 vs. 201.6±25.4,P<0.05). The GOS of two groups after treatment had been increased markedly in comparison to that before treatment,and the change was more obvious in treatment group(72 hours:10.34±0.76 vs. 7.34±0.48,1 week:13.16±0.86 vs. 9.56±0.64,both P<0.05). Hospitalization costs(yuan)of treatment group in intensive care unit (ICU)was lower than that in control group(43276.16±1844.23 vs. 51347.75±2011.06,P<0.05),and the duration of staying(day)in ICU of treatment group was shorter than that in control group(15.11±2.25 vs. 20.30±2.97,P<0.05). The total effective rate of treatment group was higher than that of control group,but the difference had no statistical significance(87.5%vs. 60.0%,P>0.05).The ratio of cose effectiveness analysis in treatment group was smaller than that of control group(497.42 vs. 855.80,P<0.05). Conclusions Ditan Xingnao Chengqi soup has a relatively good effect on antagonizing inflammatory factors,controlling excessive inflammatory response and improving disturbance of consciousness. The early intervention with this agent for a patient with sepsis cognitive impairment can control the disease situation,improve the patient's prognosis and reduce his or her hospitalization costs.

Objective To investigate the changes of coagulation function and blood rheology in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and effects of depside salt from salvia miltiorrhiza.Methods The patients with AECOPD were randomly divided into depside salt from salvia miltiorrhiza anticoagulation group (45 patients) and conventional treatment group (45 patients).At the same time 50 normal were choosed as control group (50 patients).On the 14th day after treatment,4 indexes of coagulation,D-dimer and of blood rheology in depside salt from salvia miltiorrhiza anticoagulation group and conventional treatment group were determine and compared with those of normal control group.Results The levels of Fbg (4.6 ± 0.7) g/L and D-dimer (1.58 ± 1.13) mg/L were significantly different between depside salt from salvia miltiorrhiza anticoagulation group and normal controls.After depside salt from salvia miltiorrhiza anticoagulation,The levels of FbgFbg (3.3 ± 1.2) g/L and D-dimer (0.48 ± 0.36)mg/L were decreased significantly (P ＜ 0.01).The 1 evels of Fbg (3.3 ± 1.2) g/L and D-dimer (0.48 ± 0.36)mg/L were decreased significantly in depside salt from salvia miltiorrhiza anticoagulation group compared with those in Conventional treatment group (P ＜ 0.01).But PT,APTT and TT level were not significantly different in three groups (P ＜0.05).After treatment,hemodynamic indexes:whole blood high shearing viscosity (4.76 ± 1.35)mPa.S,low shearing viscosity (8.69 ± 2.36) mPa.S plasma viscosity (2.32 ± 0.26) mPa.S and hematocrit (40.3 ± 2.38)％ in depside salt from salvia miltiorrhiza anticoagulation group indicated significant differences compared to those in Conventional treatment group[(5.50.3 ± 1.34) mPa.S,(12.30 ± 2.30) mPa.S,(2.32 ± 0.26) mPa.S,(47.89 ± 3.13)％)] (P ＜ 0.01).Conclusion Patients with in AECOPD have hypercoagulable state.depside salt from salvia miltiorrhiza could improved hypercoagulable state in acute exacerbation of chronic obstructive pulmonary disease and decrease blood viscosity.

Objective To investigate the clinical features of 4 cases with systemic lupus erythematosus (SLE) complicated by chylothorax and chylous ascites.Methods Clinical manifestations,laboratory examinations,treatment and prognosis of 4 patients with SLE complicated by chylothorax and chylous ascites,who were admitted to our center in recent 13 years,were retrospectively analyzed.Results Four patients were female.The average age of SLE at presentation was 38 years (ranging from 31 to 47 years of age).The average disease duration of chylothorax and chylous ascites was 6.5 months (ranging from 3 to 12 months).Of the 4 patients,3 were complicated with chylothorax and chylous ascites,and 1 with chylothorax.Three patients were treated with corticosteroid,and 2 patients were treated combined with immuno-suppressive agents (cyclophosphamide or ciclosporin A).Chylothorax and chylous ascites improved in 1 patient.Conclusion The clinical manifesta-tions of chylothorax and chylous ascites are relatively rare in patients with systemic lupus erythematosus,and more attention should be given to improve the quality of life of these patients.

Objective To study the effect of adaptive support ventilation (ASV) in treatment of severe asthma.Methods Forty-nine cases of severe asthma were divided into ASV group (25 cases) and control group (24 cases,tradition mechanical ventilation).The arterial blood gas,respiratory dynamics,mechanical ventilation time,hospital stay and thorax barotrauma was compared between two groups.Results The arterial blood gas and respiratory dynamics was improved after mechanical ventilation compared with that before mechanical ventilation in two groups,and there was significant difference (P ＜ 0.05 or ＜ 0.01).The airway peak voltage,lung dynamic compliance and platform pressure after mechanical ventilation of 2,12 and 24 h in ASV group was better than that in control group[2 h:(33 ± 12) cm H2O(1 cm H2O =0.098kPa) vs.(37 ± 11) cm H2O,(16 ± 9) ml/cm H2O vs.(17 ± 10) ml/cm H2O,(27 ± 6) cm H2O vs.(30 ±12) cm H2O; 12 h:(23 ± 12) cm H2O vs.(25 ± 11) cm H2O,(28 ± 6) ml/cm H2O vs.(23 ± 10) ml/cm H2O,(20 ±6) cm H2O vs.(25 ±4) cm H2O; 24 h:(18 ± 12) cm H2O vs.(20 ± 11) cm H2O,(32 ±9)ml/cm H2O vs.(28 ± 10) ml/cm H2O,(12 ±7) cm H2O vs.(16 ±7) cm H2O],and there was significant difference(P＜ 0.05 or ＜ 0.01).The mechanical ventilation time and hospital stay in ASV group was shorter than that in control group [(46 ± 8) h vs.(56 ± 6) h,(7 ± 2) d vs.(10 ± 3) d],and there was significant difference (P＜ 0.01).The thorax barotrauma was not observed in ASV group; 3 cases showed subcutaneous emphysema and 2 cases showed pneumothorax in control group.Conclusions ASV mode could decrease airway peak voltage and platform pressure,improve arterial blood gas and lung dynamic compliance,shorten mechanical ventilation time and hospital stay.It is safe and effective for patients with severe asthma.