Delirium is an acute cerebral disorder syndrome with mean features of fluctuating course,attentional deficits,disorganization of thinking and consciousness change.The biggest difference between delirium and restless is cognitive function.Hypoactive delirium and mixed delirium are usually ignored for their inconspicuous clinic feature,while intensive care unit (ICU) delirium is paid more and more attention by clinicians.Society of Critical Care Medicine (SCCM) IPAD guidance suggests that only recommended prevention of delirium is early mobilization,which the article will further discuss.

After the development of medical informatics and the challenges it is faced were described, the charac-teristic and differential strategies for its development were put forward, including combining electronic information technology with medical informatics practical skills and medical knowledge, training more health information profes-sionals for the society, and improving the overall health information level in our country in order to achieve the sus-tainable development of medical informatics.

Objective To confirm the difference in the biological characteristics between V?24 natural killer T cells(NKT) and the cytokine-induced killer cell(CIK).Methods V?24 NKT cells and CIK cells were expanded from human peripheral blood mononuclear cells.Purified TCRV?24~+ NKT cells and CD3~+CD56~+CIK cells were obtained by using Dynal beads.The phenotype and the levels of cytokine and necrosis-related factors expression on the purified NKT cells and CIK cells were determined by flow cytometry.The cytotoxicity of the purified NKT cells and CIK cells were measured by means of DIOC18 staining and flow cytometry.Results The proportions of TCRV?24~+V?11~+NKT cells and CD3~+CD56~+CIK cells were elevated up to 90% after purification.The majority of V?24 NKT cells were CD4~+ and DN NKT cells.They demonstrated high levels of expression of TCRV?24,V?11,CD3 and CD161 and a low level of expression of CD56,but most purified CD3~+CD56~+CIK cells were CD8~+ T cells,with high levels of CD3 and CD56 expression,low level CD161 expression and little TCRV?24 and V?11expression.After antigen stimulation,the purified CD3~+CD56~+CIK cells showed higher levels of expression of IFN-?,TNF-?,Perforin,FasL and TRAIL,compared to the NKT cells.CD3~+CD56~+CIK cells secreted little IL-4,whereas,V?24~+NKT cells secreted high level of IL-4.In addition,the cytotoxic effect of the CD3~+CD56~+CIK cells on tumor cell lines K562,U937 and Jurkat were more intense than that of the NKT cells.Conclusion It is evident that TCRV?24~+ NKT cells and CD3~+CD56~+CIK cells differ absolutely in many ways and might play different roles in anti-tumor immunity and immune regulation.

Oral and maxillofacial radiology (OMR) in the United States is one of the nine dental specialties recognized by the American Dental Association (ADA). It has a nearly 100-year history of development and has also established a complete set of specialist training system. Staffing, base facilities, financial status, timing of training courses, contents, plans, and goals to be achieved are all clearly defined. All training centers need to undergo regular assessments every seven years with the ADA's Commission on Dental Accreditation (CODA). After graduation, the specialist graduates can be engaged in the clinical teaching and scientific research of radiological diagnosis in universities or general hospitals. They also have the option to open their own business by setting up imaging diagnostic centers or being specialized in tele-radiology to provide imaging diagnosis or consultation report to clinicians in other disciplines, or even assisting in the development of treatment planning for dental implants and orthodontic procedures. Of course, stomatology and OMR education systems are different in China and the United States due to different national conditions. Although the experience in the United States cannot be completely copied, many concepts, standards and goals of OMR specialty training there have been practiced and improved for a long period of time and are worth learning by the Chinese OMR counterparts or relevant agencies.

Stenosis or occlusion of vertebral artery origin is one of important reasons of posterior circulation ischemia. Vertebral artery stenting can reduce posterior circulation ischemia in patients with vertebral artery origin stenosis. Restenosis after stenting is an important reason influencing the long-term efficacy.This article reviews treatment approaches of vertebral artery origin stenosis, restenosis after stenting and the related factors.

Neurological outcome in critically ill neonates has become the focus of attention.Amplitude-integrated electroencephalography (aEEG),as a brain function examination of noninvasive and relatively simple operation,offers a variety of information for pediatricians while early applying to the critically ill newborus,and is helpful to predict the long-term neurological outcome.Currently,the increasing number of neonatal intensive care units are using aEEG as the neurological examination.

Objective　To evaluate the safety of biopsy of the prostate guided by transrectal ultrasound.Methods　Three hundred and seventeen patients suspected to have prostate cancer were examined and 208 patients were followed up.Results　One hundred and eighty-one patients followed up did not feel severe pain during the biopsy of the prostate. Clinical manifestations induded 12 cases of hematuria,4 dases of hematospermia,1 case of fever, 2 cases of pollakisuria and urodymia,2 cases of uroschesis,which disappeared after corresponding treatment.Conclusions　Biopsies of the prostate guided by transrectal ultrasound is advantageous in diagnosis of prostatic carcinoma.

Glycohemoglobin (HbA1c) is an important indicator for assessing long-term glycemic levels and diabetic complications of blood vessels in diabetic patients.However the test methods,reagents and technological capabilities in different laboratories are various,so there are significantly differences of the results in bias.In 2010 HbA1c was included in new guidelines from ADA for diagnosing diabetes,and recommended by WHO in 2011,which promoted the standardization process of HbA1c tests.In this article we analysed and reviewed main detection methods,the international advancement of standardization,current status of the establishment of HbA1c Reference system in China and its clinical application.

Hepatic resection is the treatment of first choice for patients with primary or secondary hepatic tumours.Although liver resection techniques have improved considerably in the past 10 years,liver failure is still the most scared complication,particularly in patients with cirrhosis.In recent years,surgeons constantly attempt to overcome the limits of anatomy and the volume of tumor to increase resection rates.Therefore,accurate evaluation of the hepatic functional reserve is very important in the development of hepatobiliary surgery.

Meshes or prostheses for hernia repair have been developing for half a century, while the best material is far away from being found.Although a few of disadvantages have been made up with products updating, new problems with usage have still arisen.In this review, development process of the repair materials for hernia was summarized and explored.