In this study a grey model GM(1,1) was developed on the basis of malaria cases reported for the period of 1986-1990 in China. In order to further enhance the predicting power of the model,residual correction is performed and the residual correcting GM(1,1)model was established. The result showed that the predicting performance of the latter model was much improved. The number of predicted cases for 1991(101 770) was conformed to the number of actual malaria cases reported (101 636).

Objective To investigate the effects of moderate hypothermia on the permeability of alveolar capillary membrane in acute lung injury (ALI) induced by lipopolysaccharide (LPS) .Methods Thirty-four adult male SD rats weighing 300-350g were randomly divided into 4 groups: control group (n = 8) ; LPS group (n = 10); hypothermia group (n = 8) and LPS + hypothermia group (n = 8) . The animals were anesthetized with intraperitoneal (i.p.) 1% pentobarbital 30 mg?kg-1, intubated and mechanically ventilated (RR 80 bpm, VT 20 ml?kg-1, I: E 1:2) . Right external jugular vein and left carotid artery were cannulated for BP and CVP monitoring and blood sampling. ALI was induced by LPS 1.0 mg?kg-1 i.p. and 16h later, intratracheal instillation of LPS 1.5 mg?kg-1. ALI was considered established when PaO2/FiO2 ≤300. Hypothermia was induced by surface cooling. Body T0 was reduced to 32.5-33.0℃. In control and hypothermia groups normal saline was given instead of LPS. Arterial blood samples were taken for blood gas analysis and MAP and CVP were recorded before (T0, baseline) and 1, 2, 3, 4 h after ALI (T1-4) . At the end of experiment (4h after ALI was established) the animals were killed by exsanguination. The lungs were removed. Lung lavage was performed and the concentration of albumin in bronchoalveolar lavage fluid (BALF), the left lung wet/dry weight ratio, myeloperoxidase (MPO) activity of lung tissue were measured. Lung tissue was also taken for histologic examination by transmission electron microscopy.Results There was no significant difference in hemodynamics among the 4 groups. PaO2/FiO2 and PaCO2 remained unchanged in the control group and hypothermia group. PaO2 /FiO2 was significantly decreased and PaCO2 was significantly increased as compared to the baseline values (T0) in LPS group (P

Objective To evaluate the effect of atorvastatin on patients with hepatolithiasis and obstructive jaundice after partial hepatectomy.Methods We retrospectively analyzed the data of 51 patients with hepatolithiasis and obstructive jaundice who were treated with partial hepatectomy from July 2006 to August 2015 at Xishan People's Hospital of Wuxi.Based on whether atorvastatin was used or not,the patients were divided into the treatment group (25 patients) and the control group (26 patients).Liver function tests were determined regularly after operation.The serum liver function on postoperative day 3 (P3d) and postoperative day 5 (P5d),complications (incisional infection,abdominal infection,pleural effusion,peritoneal effusion and bile leakage) and duration of hospital stay in the two groups of patients were compared.Results There was no perioperative death in the two groups.When compared with the control group,liver function data suggested an improvement in the treatment group,as ALT and AST in the treatment group were significantly lower than in the control group on P3d and P5d [ALT (252.6 ± 87.0) U/L vs (385.0 ± 152.9)U/L,(89.9 ±28.2) U/L vs (116.9 ±29.3) U/L;AST(130.7 ±66.9) U/L vs (212.7 ±80.0) U/L,(47.5 ± 16.1) vs (69.2 ± 12.2) U/L,all P ＜ 0.05].When compared with the control group,the serum cholesterol level was lower on P3d and P5d [TC:(6.7 ± 0.3) mmol/L vs (6.2 ± 0.3) mmol/L;(6.1 ± 0.4) mmol/L vs (7.0 ± 0.4) mmol/L,P ＜ 0.05],the serum CRP level was also lower in the treatment group [(56.8 ± 15.7) mg/L vs (98.9 ± 40.3) rg/L,P ＜ 0.05];the duration of hospital stay was (10 ± 1) days in the treatment group,which was significantly different from the control group (12 ± 1) days.Conclusion The use of atorvastatin in patients with hepatolithiasis and obstructive jaundice who were treated with partial hepatectomy improved postoperative liver function and shortened postoperative hospital stay.

Objective To investigate the outcome of microsurgical treatment and its influencing factors in patients with aneurysmal subarachnoid hemorrhage.Methods The consecutive patients with aneurysmal subarachnoid hemorrhage treated with the early or ultra-early microsurgery were enrolled retrospectively.The Glasgow outcome scale (GOS) was used to assess the outcomes of patients at discharge.GOS 4-5 was defined as good outcome,and GOS 1-3 was defined as poor outcome.Results A total of 147 patients with aneurysmal subaraclnoid hemorrhage were enrolled.One hundred and twelve patients (76.2％) had good outcomes.There were significant differences in the proportions of preoperative Glasgow Coma Scale (GCS) scores (12.8 ± 2.8 vs.7.5 ± 3.8;t =7.525,P ＜0.001),low Hunt-Hess grade (83.0％ vs.31.4％;x2 =34.318,P ＜ 0.001),size of aneurysm (x2 =9.531,P =0.009),preoperative rebleeding (6.3％ vs.25.7％;x2 =8.506,P =0.003),preoperative brain herniation (4.5％ vs.40.0％;x2 =26.846,P ＜ 0.001),initial CT scan showing intracerebral hemorrhage (19.6％ vs.48.6％;x2 =11.449,P =0.002),and intraventricular hemorrhage (8.9％ vs.40.0％;x2 =18.846,P ＜0.001) between the good outcome group and the poor outcome group.Multivariate logistic regression analysis showed that the larger aneurysm (odds ratio [OR] 3.194,95％ confidence interval [CI] 1.458-6.999;P =0.004),older age (OR 1.054,95％ CI 1.013-1.097;P=0.010),lower preoperative GCS score (OR 0.539,95％ CI 0.410-0.724;P ＜ 0.001),and preoperative brain herniation (OR 3.633,95％ CI 1.039-12.700;P =0.043) were the independent risk factors for poor outcomes.Conclusions After active surgical treatment,most of the patients with aneurysmal subarachnoid hemorrhage have good outcomes,however,patients with older age,larger aneurysms,lower preoperative GCS scores,and preoperative brain herniation usually have poor outcomes.

Objective To assess the efficacy of NaClO irrigation of root canal at different temperatures.(Methods Thirty) human teeth with single root-canal mandible premolar were instrumented using standard technique,then were divided into 3 groups,carrying on root-canal irrigation.group A: 5.25% NaClO+System B,group B:5.25% NaClO+15% EDTA,group C:5.25% NaClO+System B+15% EDTA.After the teeth root were split,the scanning electron microscope was used to observe the coronal third,middle third and apical third parts.(Results The) amount of remaining debris on root canal wall in group C decreased significantly,compared with group A and B.The differences of coronal third and middle third between group A and B,group B and C,group A and C were significant(P0.05),but there were significant differences between group A,B and C(P

AIM: To study the effect of mild hypothermia on energy metabolism and hydroxyl radical production as well as delayed neuronal death (DND) in hippocampus during cerebral ischemia/reperfusion in gerbils. METHODS: Forebrain ischemia was induced by occluding bilateral common carotid arteries with aneurysm clamps for 10 min in gerbils. The DND in hippocampal CA1 sector was assessed by histological examination, and hydroxyl radical, ATP (adenosine triphosphate), ADP (adenosine diphosphate),AMP (adenosine monophosphate) levels were determined by high performance liquid chromatography with electrochemical or ultraviolet detection. RESULTS: The number of survival neuronal in hippocampal CA1 sector in mild hypothermia + I/R group was more than that in I/R group after ischemia/reperfusion 96 h. The content of 2,3-DHBA (2,3- dihydroxybenzoic acid) in hippocampus in I/R group was much higher than those in sham operation and mild hypothermia + I/R group after reperfusion 6 h (P

Objective To study the effect of laparoscopic cholecystectomy(LC) in the treatment of patients with schistosomiasis hepatic cirrhosis(SHC) complicated with symptomatic gallstone. Methods The clinical data of 256 cases of SHC with symptomatic gallstone underwent cholecystectomy in recent 4 years in our hospital were reviewed retrospectively. Of them, 74 underwent LC , which was compared with the cases who underwent open cholecystectomy(OC) in operation time, operative heamorrage,operative complications, and hospital stay.Results The operation time in LC group and OC group was 63 min and 54 min respectively; the operative bleeding of LC group was 15.6ml, OC group 85 ml;and hospital stay was 1.2days in LC group,8.9 days in OC group。Six cases of LC group was converted to OC.None had postoperative complications in LC group; but 1 case in OC group had bile leakage. Conclusions With strict the operative indications and proper operative method,LC in the treatment of SHC patients with gallstone is safe and feasible.

ObjectiveTo evaluate a computer-assisted operation planning system in curative hepatectomy for complex hilar cholangiocarcinoma.MethodsThe clinical data of 15 patients with complex hilar cholangiocarcinoma who were admitted to the Chinese PLA General Hospital from January 2008 to December 2009 were retrospectively analyzed.Based on triple-phase contrast-enhanced computed tomography inages,a computer-assisted operative planning system was used to evaluate the anatomic relationship between the tumor and its adjacent vessels,liver volume,operative feasibility,and the potential surgical approaches.The accuracy of three-dimensional reconstruction was tested by comparison to actual intraoperative findings.The correlation between actual liver resection volumes and predicted liver resection volumes was analyzed by calculating a Pearson correlation coefficient.Differences in liver volumes calculated by two-dimensional techniques versus three-dimensional reconstruction were analyzed using the paired t test,and the error rate was compared using the chi-squarc test. Results Fifteen patients received curative hepatectomy,including extended hemihepatectomy in 8 patients and trisectionectony in 7 patients.Preoperative evaluation of the hepatic anatomy based on three-dimensional reconstruction imaging was confirmed with operative findings.The sensitivity,specificity and accuracy rates were 100.0％,72.7％ and 72.7％ for patients with portal invasion and 100.0％,78.6％ and 78.6％ for patients with hepatic arterial invasion,respectively.The actual liver resection volume was positively correlated with the predicted liver resection volume ( r =0.974,P ＜ 0.05 ).The mean liver volumes calculated by the three-dimensional reconstruction and the two-dimen-sional techniques were (458 ±86)ml and (491 ± 103 )ml,respectively,with no significant difference (t =-1.911,P ＞0.05 ).The error rates of the three-dimensional reconstruction and the two-dimensional techniques were 4.7％ and 7.2％,respectively,with no significant differnece ( x2 =2.381,P ＞ 0.05 ).Five patients had postoperative complications,and each was cured with conservative or interventional management. Conclusion The application of a computer-assisted operation planning system may improve the safety and accuracy of curative resection for complex hilar cholangiocarcinoma.

ObjectiveTo evaluate the value of serum galactomannan platelia aspergillus kit in the diagnosis and treatment of invasive fungal infection(IFI) patients. MethodsA total of 178 serum samples from 74 high risk patients were collected. ELISA assay was used to detect the level of GM antigen. Refer to domestic IFI diagnostic criteria, 16 patients include the proven cases and probable cases were defined as study group, while 29 patients of improbable cases defined as control group. Fourflod table was founded,by which the sensitivity,specificity,positive predictive value, negative predictive value of this GM test were calculated. Meanwhile, a total of 53 patients received antifungal therapy which divided into GM-positive group(21 patients with I≥0. 5) and GM-negative group(32 patients with I ＜0. 5). The therapeutic effect comparison of two groups was made according to curative effect criterion. ResultsAccording to the certainty level of IFI diagnosis, 1,9,10 and 4 patients were identified as GM positive in proven, probable,possible and improbable IFI groups respectively. The prevalence of GM in these 4 groups was 50％ ,64％ ,34％ and 14％ ,respectively. The sensitivity and specificity of galactomannan ELISA assay were 63％ ,86％ respectively. The positive and negative predictive values were 71％ and 81％ respectively. The diagnose accordance rate was 78％, the Younden index was 0. 49. The efficacy of fluconazole in GM-positive patients was significant lower than in GMnegative patients( x2 =4. 95 ,P ＜0. 05) ,while The efficacy of non-fluconazole drug was superior to that in GM-negative patients( x2 =4. 88,P ＜ 0. 05). After antifungal therapy, the GM value of GM-positive patients decreased significantly( t =2. 13 ,P ＜0. 05). ConclusionThe galactomannan ELISA assay with high specificity, could be helpful in diagnosis and choicing effective anti-fungi drug in clinic.

Objective To study the changes of circulating triglyceride (TG) in the obese elderly, and to investigate the effect of hypertriglyceridemia on the development of insulin resistance. Methods A total of 82 subjects were divided into simple obesity group, obesity with IGT group, obesity with T2DM group and normal control group. The body height, body weight, blood pressure, fasting plasma glucose (FPG) and insulin(FPI), circulating TG and total cholesterol (TC) were measured. The homeostasis model assessment-insulin resistance (HOMA-IR) was calculated. Results The levels of serum TG were significantly higher in the simple obesity group ( 1.3 ± 0. 6) mmol/L, obesity with IGT group (1.9 ± 0.9)mmol/L and obesity with T2DM group (2.1±0.7) mmol/L than in the normal controls [(1.0±0.2)mmol/L, all P<0. 05], Furthermore, the levels of TG, FPG, FPI, HOMA-IR and systolic pressure were significantly higher(all P<0. 05) in obesity with IGT group and obesity with T2DM group than in simple obesity group. There were significantly positive correlations between TG and body mass index (BMI), FPG, HOMA-IR, TC, systolic pressure respectively (all P < 0.05). Multiple linear regression analysis indicated that FPG and HOMA-IR were the independent factors affecting TG (both P < 0. 05 ). Conclusions Hypertriglyceridemia may play an important role in the development of insulin resistance.