Objective To explore the influencing factors and preventive measures of vascular crisis after digital replantation.Methods The clinical data of 726 patients with digital replantation from Jan 2006 to Jun 2008 were retrospectively investigated.Among which,120 cases suffered from vascular crisis after digital replantation.The possible influencing factors of vascular crisis were analyzed by Logistic regression analysis.Results Logistic regression analysis showed that sex,age,smoking history,causes of injury,ischemia duration,and surface of division were the predictors of vascular crisis after digital replantation.Conclusion Appropriate preventive measures aimed at the influencing factors should be taken to prevent and reduce vascular crisis after digital replantation,and thereby to increase the survive rate of replanted digits.

Objective To analyze the clinical application value of the critical value reporting system.Methods The data record-ings of the critical values reported by the clinical laboratory department from Nov.2013 to May.2014 were inquired through the clinical laboratory information management system(LIS).The incidence rate of the critical values,receipt time of the critical values, items and department distribution were analyzed.Results A total of 1856 items of critical value were reported.The occurrence rate of the critical values was 0.31%.The top 5 of critical value numbers according to the item distribution were white blood cells (46.28%),total bilirubin (16.92%),D-dimer (9.81%),hemoglobin(8.51%)and platelets (8.03%).According to the depart-ments distribution,the top 3 departments with maximal reported critical values were the neonatal department (37.12%),followed by the department of gynecological oncology(23.33%)and the obstetrical department (21.17%).Conclusion The critical value reporting system plays an important role in the obstetrics and gynecology hospital.It should be evaluated and analyzed regularly.

The paper reported two methods. a genetic probe and the solid phase radio-immunological assay, for the detection of the thermolabile toxin produced by Escherichia coli. The former is the application of a 32P-IabelIed probe of B subunit DNA prepared from Hind Ⅲ restriction fragment of LT-encoding DNA. and the latter is by using CNBr-activated paper as carrier and 125I-SPA to substitute the secondary antibody. Applying the methods to 160 strains of E. coli isolated from patients suffering from infantile diarrhea, the results showed that 42 out of 160 strains belong to the strain which produces the thormolabile toxin. These two methods not only have the advantages of being sensitive and specific, but also are beneficial favourable to the epidemiological survey and clinical diagnosis, because the testing bacteria are decomposed on the nitrocellulose membrane, so that hundreds of samples can be examined in one test.

Objective To detect the percentage of cultured neuron apoptosis after the neurons were treated with anoxia and specific inhibitors of protein kinase A (PKA) and protein kinase C (PKC). Methods After establishment of the model of neurons cultured under hypoxic condition, the neurons were cocultured with different concentrations of Rp-cAMP and Calphostin C, specific inhibitors of protein kinase A and C, respectively. Then neurons were cultured under an ischemic condition until the number of survived neurons, the activity of mPKA,and mPKC, and the apoptotic neurons stained by TUNEL in each group were observed. Results The activity of mPKA and mPKC significantly increased after the onset of hypoxia. With the increases in concentrations of Rp-cAMP or Calphostin C, the percentage of apoptotic neurons obviously decreased or increased, respectively. Conclusion The pathways of PKA and PKC signal transduction may participate in the hypoxic neuron injury. The functions of these two kinases are opposite for apoptotic regulation. It suggests that the signal transduction of PKA and PKC in hypoxic neurons belongs to a monophasic controlling system and the ratio of PKA to PKC in cells may determine the survival of hypoxic neurons.

Objective Summarize the clinical nursing keys and experiences for tranplantation of leg island flap. Methods Follow- up 111 patients with transplantation of leg island flap. Results There were 109 patients had accepted survival of island flap, their function of wounded limb were recoveried satisfactory by one- year follow up. There were 2 amputation patients because of disturbance of blood circulation of distal wounded limb. Conclusions Careful perioperative nursing and observation are the keys of survival for tranplantation of leg island flap. Proper rehabilitaiton education can guarantee the satisfactory prognosis.

Objective To explore the value of real‐time three‐dimensional speckle tracking imaging (RT‐3D‐STI) in the early detection of globle and regional left ventricular myocardial systolic function in patients of coronary stenosis without regional wall motion abnormality. Methods 64 coronary stenosis patients without regional wall motion abnormality were divided into 2 groups according to angiography (CAG):without coronary stenosis group( n = 20) and coronary stenosis group ( n = 44), and all the myocardial segments of the patients were divided into 5 groups:without coronary stenosis group normal myocardial segments ( n = 340 ), coronary stenosis group normal myocardial segments ( n = 235 ), mild coronary stenosis myocardial segments( n = 126), moderate coronary stenosis myocardial segments( n =213) and severe coronary stenosis myocardial segments( n =174). Real‐time three‐dimensional full volume of left ventricle was obtained, left ventricular global area strain (GAS)and regional area strain(AS) of 17 myocardial segments, etc, were measured by RT‐3D‐STI respectively. The parameters between the two groups and among the five sub groups were compared, the correlation between GAS and coronary artery Gensini score was also analyzed. Results GAS in coronary stenosis group significantly reduced compared with without coronary stenosis group( P <0 0.5) S.egmental AS gradually reduced with the increasing of the degree of the coronary stenosis. There was no statistically difference of segmental AS among without coronary artery group normal myocardial segments, coronary stenosis group normal myocardial segments and mild coronary stenosis myocardial segments( P >0 0.5) S.egmental AS in moderate and severe coronary stenosis myocardial segments significantly reduced ( P < 0.05 ), and that in severe coronary stenosis myocardial segments was lower than that in moderate coronary stenosis myocardial segments, the differences were statistically significant ( P < 0.05 ). In addition, GAS was significantly correlated with coronary artery Gensini score( r =0.828, P <0.01). Conclusions RT‐3D‐STI can quantitatively assess the early changes of left ventricular globle and regional myocardial systolic function in patients with coronary stenosis.

Objective: To investigate the value of enhanced 3D SPACE sequence in displaying brachial plexus. Methods:35 healthy volunteers with no history of brachial plexus injury of brachial plexus MRI examinations by DWIBS scan, and SPACE scanned. Analysis and comparison of DWIBS sequences, sequences of SPACE provides a clear display of the brachial plexus, and two sets of image sequence average signal-to-noise ratio (SNR) and the contrast to noise ratio (CNR). Results:A total of 35 cases 70 lateral brachial plexus after coronary DWIBS is clearly displayed on the sequence;the partial medial cord of brachial plexus, beams and lateral beams can also be displayed in the SPACE sequence. SPACE sequence of image signal-to-noise ratio and contrast noise ratio than the DWIBS sequence, and the difference is statistically significant. Conclusion:SPACE sequence can clearly show the brachial plexus, and DWIBS sequences compared to the normal image has a higher resolution of the brachial plexus.

Recent important applications of inductively coupled plasma mass spectrometry in biological samples analysis are reviewed.The sample preparation,sample introduction techniques,interference correction and typical applications are introduced in detail with 154 references.

Objective To explore a modality of ambulatory nursing care applied to the elderly patients with severe trigeminal neuralgia treated by radiofrequency thermocoagulation.Methods42 patients were equally assigned into 2 groups: group A(n=21) aged from 40～60, and group B(n=21) aged from 80～92. Pertinent nursing measures were assessed for risks of ambulatory surgery, including psychological care before surgery and intensive observation during surgery. The pain was assessed with Visual Analogue Scale (VAS) between the groups and before and after surgery, as well as complications.ResultsNo significant difference of the VAS scores was found between the groups before and 2 weeks after surgery (P>0.05), while the score of VAS decreased in two groups 2 weeks after surgery(P<0.01). No severe complication occured in the groups after surgery.ConclusionIt is safe and effective to apply the modality of ambulatory nursing care for the elderly patients with severe trigeminal neuralgia treated by radiofrequency thermocoagulation.

Objective To investigate the related index of early diagnosis of acute-on-chronic liver failure caused by chronic hepatitis B.Methods 13 cases of the acute-on-chronic liver failure caused by chronic hepatitis B were collected in our department,39 cases of chronic hepatitis B were randomly paired to analyze the difference index.ROC curve analysis was conducted for the different data,then to choose the data whose AUC (area under the curve)is >0.8 to accumulate points,while the cutoff value in the light of Youden index was indentified.Each accu-mulating points data would score 1 point if it is≥cutoff value,otherwise,it would score 0 points.ROC curve analysis was conducted for the total accumulating points,the cutoff value of the total accumulating points according to Youden index was indentified,the sensitivity and specificity were calculated.Results The data of which AUC are >0.8 include glutamic-pyruvic transaminase (ALT)/Upper Limit Of Normal (ULN),neutrophil count (N),alkaline phosphatase (AKP)/ULN,glutamic-oxalacetic transaminease(AST)/ULN,direct bilirubin/total bilirubin(Dbil/Tbil),total bile acid(TBA),whose AUC were respectively 0.869,0.874,0.897,0.917,0.919 and 0.978,while their cutoff value were respectively 18.57,3.1 ×109/L,0.99,22.21,44.41%and 140.20μmol/L.The cutoff value of total accumula-ting points of the six data was 4 points,AUC was 0.987,Youden index was 0.949,and their sensitivity for ealier diag-nosis for the acute -on -chronic liver failure caused by chronic hepatitis B was 100%,specificity was 94.87%. Conclusion The accumulating points of the six data aboved (ALT/ULN,N,AKP/ULN,AST/ULN,Dbil/Tbil,TBA) will help the early diagnosis of acute-on-chronic liver failure caused by chronic hepatitis B.