Objective To study the effect of the neck rotation and lateral bending on the vertebral artery blood flow, and to analyze the relationship between the artery blood flow and cervical vertigo. Methods Thirty patients with cervical vertigo were studied with exclusion of auditory vertigo and severe cardio-cerebrovascular disease, which involved 18 males and 12 females, whose average age was 52.13 years with a range of 42-73 years. They all had cervical degenerative change in different degree and neck-shoulder-back pain history. The study also included 15 volunteers without vertigo, 8 males and 7 females, the average age was 49.47 years with range, 38-70 years, they also had some cervical degenerative change. They were selected to detect the blood flow of bilateral intracranial segments of the vertebral arteries using TCD with the neck in neutral, bilateral rotation 15?,30?,45?,60? and bilateral bending. Results In neutral position, vertebral artery blood flow was lower in study group than in control(P

Objective To study the effect of trans-theoretical model of behavior on ambulation training in stroke hemiplegic patients. Methods Sixty hospitalized stroke hemiplegic patients from June to December 2013 were selected as control group. The control group was treated with routine nursing and ambulation training guidance. Sixty-two hospitalized stroke hemiplegia patients, from January 2014 to June 2014, were selected as intervention group. Patients in the intervention group received trans-theoretical model of behavior together with ambulation training guidance for 3 weeks and follow-up record for 6 months. Holden functional ambulation categories ( FAC ) and Bathel index were used to evaluate the effect of ambulation training . Result Trans-theoretical model of behavior training improved the walking function and activities of daily living in intervention group patients , compared with those of the control group. Conclusions Taking trans-theoretical model of behavior in walking training health education can improve the ambulation ability and ability of daily living of stroke hemiplegic patients. Therefore this theory can enhance the stroke hemiplegic patients′life quality.

In this article we report the results on the synthesis and accumulation of PHAs by Rhodocista pekingensis (strain 3-p), a phototroph that was isolated from wastewater treatment plant. Our results showed that the optimal conditions for PHAs accumulation with strain 3-p were as following: 0.01% Yeast Extract, 0.01% NH 4Cl, Acetate 5 g/L, and medium pH of 7.0～7.2.Under optimized conditions, strain 3-p accumulated PHAs up to 60% of its cellular dry weight. Enzymatic activities of ?-ketothiolase, acetoacetyl-CoA reductase, and PHA polymerase were detected and their activities increased as PHA synthesis initialized. Based on these study, we proposed the metabolic pathway of this strain should be:Acetate (or other fatty acids) - Acetyl-CoA --- thiolase Acetoacetyl-CoA --- reductase D (-)-?-Hydroxybutyryl-CoA ----- PHA polymerase PHAs.

Purpose To investigate the expression of insulin-like growth factorIImRNA binding protein 3 ( IMP3 ) and microvessel density (MVD) in squamous carcinoma of the cervix (SCC) and analysis their relationship in SCC. Methods The expression of IMP3 and MVD was examined by immunohistochemistry SP method in normal cervical epithelium ( NCE) , low-grade cervical intraepi-thelial neoplasia (CIN-L), high-grade cervical intraepithelial neoplasia (CIN-H) and SCC. Results (1)The positive expression rates of IMP3 in NCE, CIN-L, CIN-H, SCC tissues were 0(0/15), 0(0/11), 37.5%(9/24) and 86.0%(43/50), the difference was statistically significant (x 2 =53.345, P=0.000). IMP3 expression was significant difference among NCE and CIN-H, SCC (P<0.008 3), and that was also among SCC and CIN-L, CIN-H (P<0.008 3). (2)The MVD count was increased with the development of cervical squamous lesion, there was significant difference among those groups (F=145.968, P<0.01), and the difference was al-so statistically significant between every two groups (P<0.05). The positive expression of IMP3 and MVD count in 50 cases of SCC tissues showed statistical difference in different pathologic grade, lymph node metastasis, and depth of tumor invasion groups ( P<0.05), but didn't in different patients’age groups (P>0.05). And the positive expression of IMP3 was closely related with MVD count in SCC tissues (rs =0.323, P<0.05). Conclusion IMP3 plays an important role in the occurrence, infiltration and metasta-sis of SCC, and the abnormal expression of IMP3 may relate with the angiogenesis of tumors.

In order to improve the Geriatrics education quality,Hierarchical teaching was applied in the process of Geriatrics education.On the one hand,the overall thinking,the international perspective,the scientific spirit and humanistic care concepts were cultivated.On the other hand,the distinction between the undergraduate,graduate,postgraduate students and individual differences were paid attention to and hierarchical teaching was given to them respectively.Setting different teaching goals,using different teaching methods and evaluation methods is used to improve the teaching pertinence.With the application of the traditional teaching method and hierarchical teaching,as far as possible to teach students in accordance with their aptitude,improve the pertinence of teaching,arouse students' learning potential,thus improving the quality of teaching,satisfactory results was obtained.

Objective To probe into the reasons for and results of remedial surgical therapy in thoracic aortic dissection patients after first endovascalar repair.Methods From July 2000 to December 2012,12 cases received second interventional surgery.The average time from second therapy to first surgery was ( 14 ± 11 ) months.Main reasons for second endovascular therapy were sustained type Ⅰ endoleak at proximal landing zone and type A dissection caused by retrograde tear.Therapies included hybrid operations in 8 cases and absnlute endovascular therapy in 4 cases.Results The 30 day mortality after the second intervention was 5.6％ ( 1/12),total mortality rate was 16.7％ (2/12).In 7 cases with endoleak,small endoleak remained after remedial therapy (57.1％ ) in 4 cases.Among 4 cases with secondary type A aortic dissection,successful staged hybrid operation with mid-sternal thoracotomy was adopted in 3 cases,one died of pulmonary emtbolism during follow-up period,1 case with Bebcet disease still had proximal type Ⅰ endoleak after second hybrid operation,and died from tear of aorta.Conclusions Endoleak and secondary type A aortic dissection are the main cause necessitating second intervention after primary endovascular therapy for thoracic aortic dissection.Hybrid operation remains the best choice to treat postoperative complications after endovascular therapy for thoracic aortic dissection.

Objective To evaluate early results of Endurant stent-graft in the treatment of abdominal aortic aneurysms (AAAs).Methods From July 2010 to June 2011,68 patients (57 men,11 women; mean age 74.3 years) were treated with Endurant stent-graft at our center.26 cases had hostile proximal neck in the anatomy.According to ASA classification,15 cases were class Ⅱ ; 32 cases were class Ⅲ and 21 cases were class Ⅳ.Results Intraoperative immediate technical success was achieved in all cases.At completion angiography,a type Ⅱ endoleak was detected in 18 (26％) of the 68 patients.The mean operation time was (96 ± 29) min,the mean blood loss was (99 ± 68 ) ml,and the mean contrast usage was (122 ± 65) ml.No intraoperative conversion to open surgery,stent migration,types Ⅰ/Ⅲ endoleak,other major complications,or death was encountered.49 patients (72％) had a postimplantation syndrome with fever,leukocytosis,and increase of C-reactive protein levels,which completely resolved within two weeks.The mean follow-up time was (8 ± 5) months.Conclusions Endurant stent-graft seems to be safe and effective in endovascular aneurysm repair,even in patients with hostile aortoiliac anatomy.

10.3969/j.issn.1000-3606.2013.06.004

Covered in the paper are concepts and contents of medical risk and emergency response technology.Based on a description of medical risk information management experiences in Japan,Sweden and the United States and the current studies of medical risk response information management,the paper proposed measures for China in medical risk information emergency technology.Recommendations made include establishing a comprehensive emergency medical risk information management system,scientific medical risk information collection,monitoring,assessment,early warning systems,as well as building an intelligent risk emergency information decision system and establishing medical risk communication channels,thereby preventing effectively the occurrence of medical risks.

Objective To design a bone marrow histological scoring system for myelodysplastic syndrome(MDS) in order to provide an objective evaluation of clinical diagnosis,disease development and outcome prediction. Methods HE and Gomori staining were used to observe the morphological alterations in 149 bone marrow biopsies.Immunohistochemical staining for MPO,CD235,F8,CD42b,CD61 and CD34 was performed.The scores of distinct morphological changes of MDS were valued. Results The bone marrow histological scoring system for MDS was established and validated.The scoring system comprised 8 distinct histological features of MDS in bone marrow biopsy.When the score was ≥5,there was significant difference between normal bone marrow biopsy and bone marrow biopsy with MDS(P