The developing process of thermal comfort was analyzed based on physiology and psychology and the relationship between thermal comfort and human health, environment was discussed in this paper.It suggested that the thermo-stable and thermo-comfortable environment, which might decrease body's adaptability to environment, were not necessarily good for human health. It might have some impacts on human's physiological and psychological adaptabilities also to live in the environment with a great difference between the indoor and outside temperature simultaneously and alternately.

Objective To analyse the causes of shunt obstructions after ventriculoperitoneal shunting for children hydrocephalus and their therapy. Methods Ventriculoperitoneal shuntings were done in 156 children with hydrocephalus, in 26 cases of them, the shunts were obstructed. Surgical interventions were performed, and causes of obstruction were found and corrected. Results There were eight kinds of obstructive causes in the ventricular catheters, three kinds in the peritoneal catheters. All obstructions were corrected surgically, 26 patients recovered soon without complications and mortality.Conclusion If the causes of ventriculoperitoneal shunt obstructions can be found and corrected in time, the prognosis of patients is good.

We retrospectively analyzed 23 cases of histiocytic necrotizing lymphadenitis (HNL) admitted to our hospital as fever of unknown origin (FUO).Fever,lymphadenopathy and skin rash were the most common clinical manifestation.The major laboratory features included cytopenia,abnormal liver enzyme and elevated inflammatory markers.Three of the 23 cases were finally diagnosed as infectious disease,5 as autoimmune disease,while the left 15 remained as HNL during the follow-up.Four of the 15 HNL patients resolved spontaneously,while the other 11 relieved by steroid use.Two patients relapsed during the follow-up.HNL was one of the rare causes of FUO.Since it would be accompanied with infectious,autoimmune or malignant diseases,long follow-up is necessary.

Objective To investigate the thermostability of aristolochic acid Ⅰand the effect of the compatibility on aristolochic acid Ⅰ in Caulis Aristolochiae Manshuriensis decoction and to explore the detoxification mechanism of compatibility for aristolochic acid Ⅰ.Methods Analyzing the contents of aristolochic acid Ⅰ by HPLC in the single decoction of Caulis Aristolochiae Manshuriensis,the concoction of Caulis Aristolochiae Manshuriensis with Cortex Moutan,the residues of decocted Caulis Aristolochiae Manshuriensis and the residues of concocted Caulis Aristolochiae Manshuriensis with Cortex Moutan,respectively.Results Aristolochic acid Ⅰ decreased after heating in pure water,a new peak was found in HPLC spectra and supposed to be the derivate of aristolochic acid Ⅰ,which was also found in the decoction of Caulis Aristolochiae Manshuriensis.The content of aristolochic acid Ⅰ in the concoction of Cortex Moutan with Caulis Aristolochiae Manshuriensis is lower than that in the single Caulis Aristolochiae Manshuriensis decoction.Furthermore,the quantity of aristolochic acid Ⅰ in the residues of Caulis Aristolochiae Manshuriensis after concoction is lower than that in the residues of single Caulis Aristolochiae Manshuriensis decoction.Conclusion Aristolochic acid Ⅰ is unstable in decoction and a part of it was changed into another compound.The stripping of aristolochic acid Ⅰfrom Caulis Aristolochiae Manshuriensis is not inhibited when Cortex Moutan concocted with Caulis Aristolochiae Manshuriensis.It is the chemical reaction of aristolochic acid Ⅰ,which could decrease the toxicity in the decoction or concoction of Caulis Aristolochiae Manshuriensis.

To study the effects of fentanyl on the MAC of sevoflurane. Method: One hundred and sixteen patients were given continuous infusion of fentanyl with CACI-pump (computer-assisted continuous infusion)to maintain different target plasma concentrations (Ct), meanwhile inhaled sevoflurane. All patients were randomly divided into seven groups receiving sevoflurane in oxygen with fentanyl target plasma concentration of 0?g/L (n=16), 0.5?g/L(n=20), 1?g/L(n=18), 2?g/L(n=16), 3?g/L(n=18), 4?g/L(n= 14) or 6?g/L(n= 14). Plasma concentraion of fentanyl was measured with radioimmunoassay. MAC determination, in response to the stimulus of skin incision, was made using the "up-down" method and logistic regression. Result: The MAC of sevoflurane from group 1 to group 7 were 1.94%, 1.89%, 1.55%, 1.29%, 1.09%, 0.86% and 0.35% respectively. Conclusion: We verify the MAC of sevoflurane, which is reduced by increasing plasma fentanyl concentration.

Objective To have a systemic review of the association between relative ratio in proton magnetic resonance spectroscopy (1H-MRS) and Alzheimer's disease (AD). Methods A search in Medline and China National Knowledge Infrastructure (CNKI) was performed,and relevant English and Chinese-language articles about assessing AD with 1 H-MRS were identifed.The data of relative metabolic ratios (NAA/Cr,Cho/Cr,mI/Cr ) from different brain regions (hippocampus,posterior cingulate gyrus,temporal lobe,parietal lobe,frontal lobe,occipital lobe) were extracted from the articles.The quality of the articles was evaluated according to the standard recommended by Newcastle-Ottawa criteria. The Meta-analysis was done with the Review Manager 4.2 to calculate pooled weighted mean difference (WMD) with 95％ confidence interval (95％ CI ),and linear correlation analysis between NAA/Cr ratio and mI/Cr ratio was done by SPSS 17.0.Results Thirty six articles (27 English articles,9 Chinese articles) were included. After heterogeneity test was done,fixed effects model or random effects model was selected. The meta-analysis showed that the NAA/Cr ratio in patients with AD was higher than that in controls ( WMD:-0.14,95％CI:-0.17 to -0.11 ).The mI/Cr ratio in patients with AD was lower than that in controls ( WMD:0.10,95％ CI:0.07 to 0.13 ).There were greatest changes in NAA/Cr ratio and mI/Cr ratio on the hippocampus ( WMD of NAA/Cr: - 0.27,95％ CI:- 0.36 to - 0.19 ; WMD of mI/Cr:0.21,95％ CI:0.10 to 0.33). There were also no differences between patients with AD and controls with respect to the Cho/Cr ratio (WMD:0.01,95％ CI:0.00 to 0.01,P ＞0.05). The NAA/Cr and mI/Cr changes are markedly correlated with each other in different brain regions ( r =0.947,P =0.004). Conclusion The hippocampus region is the first to present neuropathological changes in AD and the changes of NAA/Cr and MI/Cr might reflect the neurodegenerative process of AD.

ObjectiveTo explore the application of peripherally inserted central venous catheter (PICC)and central venous catheter (CVC) in the surgical parenteral nutrition.MethodThe operation time,success rate,indwelling duration,abnormal biopsy,and adverse reactions of PICC and CVC were retrospectively compared.ResultsCVC had significantly shorter operation time than PICC groups [ (28.67 ±5.13) min vs.(45.20 ±6.89)min,P =0.035 ).The mean indwelling duration was significantly longer in PICC group than in CVC group [ ( 114.85 ± 10.29) d vs.(24.78 ± 8.42) d,P =0.033 ].PICC group was superior to CVC group in terms of five complication items,while only phlebitis was more frequent/severe in CVC group.ConclusionsPICC may be more suitable for long-term ( ＞4 weeks) catheter-based nutrition.CVC has short operation time and fast flow rate,and therefore is most suitable for rescue treatment for critically ill patients.

OBJECTIVE To develop a rapid method for simultaneously identifying Staphylococcus aureus(SA) and its resistance against meticillin. METHODS The target strains authenicated to Staphylococcus by traditional methods(appearance,Gram-stain,catalase) first,then using Slidex~staph.plus to authenticate SA;establishing traditional method or coagulase test and ATB-ID32STAPH system for verification.The penicillin-binding protein 2a(PBP2a) was examined by Slidex MRSA Detection,establishing resistance oxacillin sieving test and mecA gene was examined by PCR for verification. RESULTS The 135 strains were positive and 321 strains were negative for Slidex~staph.plus from 456 strains.The 127 S.aureus strains and eight others were confirmed from 135 positive strains finally,11 SA strains and 310 other strains were confirmed from 321 negative strains,there were 92.0% for sensitivity and 97.5% for specificity in this method.The 52 strains PBP2a positively confirmed to meticillin-resistant S.aureus(MRSA) using Slidex MRSA Detection and 57 MRSA strains were confirmed using resistance oxacillin sieving test or PCR from 138 strains.There were 91.2% for sensitivity and 100% for specifity in this method. CONCLUSIONS The duplex Slidex~-staph monoclonal antibody examinated to SA and confirmed to MRSA has higher sensitivity and specificity.

Objective: To explore the feasible methods for item selection of TCM syndrome scale.Methods:Elderly hypertension with syndrome of kidney qi deficiency was selected as example.The symptoms and signs of elderly hypertension patients were statistically analyzed with clinical epidemiological investigation on the basis of discussion among focus group and expert consultation.Six selection methods were used,such as correlation coefficient method,dispersion tendency method,factor analysis method,etc.Results:18 Items were selected in the end and constituted the preliminary scale of kidney qi deficiency of elderly hypertension.Conclusion:Only if combine subjective and objective selection methods,use kinds of proper statistical methods and master the scale of preserving items,can we acquire good reliability and validity of scale.