Objective To test the reliability and validity of the collective self-esteem scale for freshman.Methods 800 freshmen finished the Collective Self-Esteem Scale,the Life Satisfaction Scale,and Self-esteem Scale.Results The confirmatory factor analysis shows that collective esteem includes membership esteem,private collective esteem,public collective esteem,and importance to identiy intemal consistency a of the scale and the 4 components of the scale ale between0.6357and 0.8369.All components of the scale except importance to identity have significantly positive correlation with life satisfaction and self-esteem.(0.14＜r＜0.41,P＜0.01).Gids have more scores than boys in total collective esteem(t=3.38,P＜0.01),Private CSE and Importance to Identity (t=3.32,P＜0.01).Conclusion The revised collective self-esteem scale for freshmen has sound reliability and validity.It is a good instrument for measuring collective self-esteem of Chinese freshman.

Objective;To test the relationship between Collective Self-Esteem,Self-Esteem and Depression,Anxiety.Methods;800 freshmen completed the Collective Self-Esteem Scale,the self-Esteem Sale,Self-Rating Depression Scale and Self-Rating Anxiety Scale.Results;①The rate of slight depression was 21.6%;moderate depression,5.9%;high depression,1.6%.The mean of anxiety was 42,the mode of anxiety was 36.②The predicting effects of Self-Esteem,private collective self-esteem and public collective self-esteem on depression were significant(P

OBJECTIVE： To analysis the adverse reactions of angiotension converting enzyme inhibitor（ ACEI） ， so as to deepen the understanding to the ARDs and improve the therapeutic effect of ACEI METHODS： The therapeutic effects and ARDs of ACEI were retrospectively reviewed and the incidence of ARDs induced by ACEI and the relationship between different ACEIs and their ARDs were analyzed RESULTS： （ 1） The incidence of ARDs of ACEI was 12％  Stimulating cough， parageusia， gastrointestinal tract discomfort， skin rash， itch of skin， hypotension， headache， dizziness， proteinuria and angioedema were the common symptoms （ 2） Of five kinds of ACEIs， captopril induced the highest incidence of ARDs and stimulating cough， parageusia， gastrointestinal tract discomfort， skin rash and itch of skin were the most common manifestations CONCLUSION： Stimulating cough， parageusia， gastrointestinal tract discomfort and skin rash are the most common symptoms of ARDs， and the symptoms will disappear when drug administration is discontinued

Objective To explore the value of procalcitonin (PCT)and lipopolysaccharide (LPS)in identifying pathogens and evaluating therapeutic efficacy of hospital-acquired pneumonia (HAP).Methods A total of 110 HAP patients were enrolled in a prospective study,patients were divided into gram-negative bacterial infected HAP group (G- infected group,n=50),gram-positive bacterial infected HAP group (G+ infected group,n=30),and control group (nontypical pathogen or virus infected group,n =30).Serum levels of PCT,LPS and C-reactive protein (CRP)of patients were dynamically detected,receiver operating characteristic (ROC)curve and area under the curve (AUC)were adopted to assess the value of PCT and LPS in predicting pathogenic bacteria causing HAP. Results PCT and LPS levels of G - infected group were (3.43 ±1 .15)ng/mL and (0.20 ±0.08)EU/mL respec-tively,which were higher than G+ infected group ([0.42±0.12]ng/mL and [0.05±0.02]EU/mL respectively)and control group([0.14±0.08]ng/mL and [0.02 ±0.01 ]EU/mL respectively)(all P <0.05 ).Levels of PCT and CRP of G- infected group before and after therapy were both significantly different ([3.43±1 .15]ng/mL vs [0.63 ±0.22]ng/mL,[47.26±30.35]mg/L vs [9.21 ±6.54]mg/L,respectively)(both P <0.01).The levels of PCT, LPS,and CRP in moderate and severe patients were all significantly higher than mild patients ([5.43±1 .05]ng/mL vs [0.72±0.32]ng/mL,[0.33±0.07]EU/mL vs [0.09 ±0.04]EU/mL,[57.46 ±20.15 ]mg/L vs [8.25 ± 5.24]mg/L,respectively)(all P <0.05).Sensitivity and specificity of combined detection of PCT and LPS in dif-ferentiating gram-negative bacteria infected VAP from gram-positive bacteria infected VAP were 95.83% and 96.15% respectively,AUC was 0.95.Conclusion PCT and LPS have certain value in identifying pathogens of HAP,combined detection of PCT and LPS can increase specificity in identifying HAP type,and assess the efficacy of antimicrobial therapy in accordance with the dynamic change.

ObjectiveTo compare the clinical results of pedicle screw fixation via the injured vertebra versus across the injured vertebra for thoracolumbar spine fracture.MethodsThe study reviewed 56 patients (41 males and 15 females,at age range of 21-66 years,mean 41.5 years) with thoracolumbar spine fractures managed with the two fixation methods from June 2005 to December 2008.The fracture segment included T12 in 13 patients,L1 in 27 and L2 in 16.According to the AO classification,there were six patients with type A1.2,29 with type A3.1,nine with type A3.2 and 12 with type A3.3.McCormack load score was 5-8 points (average 6.3 points). The spinal cord injury was classified as grade A in three patients,grade B in four,grade C in eight,grade D in 17 and grade E in 24 according to Frankel scale.The patients were divided into two groups,ie,across vertebral fixation group (27 patients) and via the vertebral fixation group (29 patients).All patients were selectively treated with monosegment bone graft simultaneously.The Cobb' s angle,restoration of the anterior height of the injured vertebra,improvement of spinal canal stenosis rate and Denis scale in local pain and work status were compared between the two groups.The bone graft fusion and spinal cord recovery of both groups were observed during follow-up.ResultsAll patients were followed up for 12-48 months (average 25.8 months).Implantation loosening occurred in one patient 1.5 month after operation in across vertebral fixation group.There were no significant differences in aspects of correction of Cobb' s angle,restoration of the anteriorheight of injured vertebra and improvement of spinal canal stenosis rate postoperatively as well as in aspects of restoration of anterior height of injured vertebra and improvement of spinal canal stenosis rate at the latest follow-up between the two groups ( P ＞ 0.05).The postoperative loss of correction rate of Cobb's angle of both groups existed,with significant difference (P ＜0.05). The differences of the Cobb's angle at the latest follow-up and after operation were significant in the across vertebral fixation group ( P ＜ 0.05) but insignificant in the via vertebral fixation group (P ＞ 0.05 ).Bone graft fusion occurred in 21 patients (78％) in the across vertebral fixation group and in 27 patients (93％) in the via vertebral fixation group ( P ＜ 0.05 ).Denis scale indicated a better recovery in the local pain of via vertebral fixation group compared with the across vertebral fixation group ( P ＜ 0.05 ),but showed no significant differenc e in work status between the two groups ( P ＞ 0.05 ).ConclusionsCompared with across vertebral fixation,the pedicle screw fixation via the vertebra has the advantages of higher fusion rate and better correction rate of Cobb' s angle and is a better choice for thoracolumbar spine fracture with posterior approach.

A method was developed for the determination of 54 volatile hydrocarbons in workplace air by thermal desorption/gas chromatography-hydrogen flame ionization detector. The workplace air was adsorbed by Tenax-TA thermal desorption tubes, then desorbed by thermal desorption and detected by gas chromatography. The experimental results indicated that the coefficients efficiency of 1,1-dichloroethylene, dichloromethane, trans-1,2-dichloroethylene, cis-1,2-dichloroethylene, 2,2-dichloropropane, bromochloromethane, 1,1,1-trichloroethane, 1,2-dichloroethane, 1,1-dichloropropene were 0.9941-0.9986. The detection limits of bromochloromethane, dibromomethane, trichloromethane, bromodichloromethane, 2,2-dichloropropane, dibromochloromethane, bromoform were 5.4-10.3 ng, the minimum detectable concentration was 0.01-0.1 mg/m~3 (the air volume=0.5 L). The coefficients efficiency of other 38 volatile hydrocarbons was above 0.999, the minimum detectable concentration were 0.001-0.01 mg/m~3. The detection limits of alkenes were 0.4-2.7 ng, alkanes 1.4-3.7 ng, aromatic hydrocarbons 0.2-1.0 ng and naphthalene 2.2 ng. The desorption efficiencies of 54 volatile hydrocarbons were 92.1%-113.1% and the relative standard deviations(RSDs) were 0.6%-17.4%. Except for the RSD values of cis-1,2-dichloroethylene, 1,1-dichloroethane, 1,1,1-trichloroethane, 1,1-dichloroethylene, 2,2-dichloropropane, trichloromethane, trans-1,2-dichloroethylene, dichloromethane, bromochloromethane were 5.1%-17.4%, those of other volatile hydrocarbons were below 5%;The experimental results indicated that the breakthrough capacities of 9 volatile hydrocarbons were 400-4000 ng, those of the other volatile hydrocarbons were above 10 μg. Except for the loss rates of 2,2-dichloropropane, bromodichloromethane were 10%-15% in stable experiment, those of other volatile hydrocarbons in Tenax desorption tubes were below 5%, which indicated that 54 volatile hydrocarbons stored in Tenax tubes were stable. The method is a quick and accurate for the detection of volatile hydrocarbons in workplace air.

Objective To compare the advantages and disadvantages of three different fixation methods via muscle-splitting approach for the treatment of single segmental lumbar vertebral diseases.Methods All of 90 patients with the single segmental lumbar vertebral diseases were treated from June 2012 to June 2013,including 34 males and 56 females,at the age of 27-76 years old,averagely (53.37± 15.41) years.Twenty-seven patients were treated with unilateral pedicle screws via unilateral muscle-splitting approach (unilateral fixation group).Thirty-three patients were treated with unilateral pedicle screws and contralateral translaminar facet screw via unilateral muscle-splitting approach (combined fixation group).Thirty patients were treated with unilateral pedicle screws via bilateral muscle-splitting approach (bilateral fixation group).Observe and compare the imaging and clinical results of these three groups.Results There were no significant difference in incision length and postoperative wound drainage between these three groups.The operation time was shortest in unilateral fixation group,while longest in bilateral fixation group.In the intraoperative blood loss,the unilateral fixation group was the same as the combined fixation group,while less than the bilateral fixation group.No infection was found after operations.Seven patients experienced epidermal necrosis of the incision,including 1 patient of unilateral fixation group,4 patients of combined fixation group and 2 patients of bilateral fixation group.Three patients suffered from nerve injury,including 2 patients of combined fixation group and 1 patients of bilateral fixation group.The follow-up time was from 12 to 36 months,averagely 25.5 months.The intervertebral height of lesion segments was apparently recovered after surgery,and maintained during the follow-up in these three groups.No significant changes of area and grade of multifidus muscle were detected at 1 year after surgery compared with preoperative.Seven patients experienced endplate cutting and cage partially embedded into vertebral body,including 3 patients of unilateral fixation group,3 patients of combined fixation group and 1 patient of bilateral fixation group.There was no loosening,displacement,breakage or cage shifting.Except 5 patients (2 patients of unilateral fixation group,2 patients of combined fixation group and 1 patient of bilateral fixation group),the remaining cases had well interbody fusion.At the final follow-up time,the JOA score significantly increased compared with preoperative.Besides,unilateral fixation group and combined fixation group were superior to bilateral fixation group.Conclusion Three different fixation methods via muscle-splitting approach for the treatment of single segmental lumbar vertebral diseases had well clinical results.The unilateral fixation and combined fixation via muscle-splitting approach had more advantages.The combined fixation via muscle-splitting approach is an innovation in approach,exposure and fixation aspects.

Objective Hypoalbuminemia is a typical symptom of nephrotic syndrome ( NS) , which may result from the loss of much protein with urine.Hyperbilirubinemia is also a common symptom in patients with NS.This study is intended to reveal the relationship between hypoalbuminemia and hyperbilirubinemia in patients with NS by investigating urine bilirubin, albumin( ALB ) and 24-hour urine protein in the NS group, chronic glomerulonephritis ( CGN ) group and postoperative gastroparesis syndrome ( PGS) group ( ALB<35 g/L) .Methods Totally 187 patients with NS, 70 patients with CGN and 64 patients with PGS ( ALB <35 g/L ) were recruited before ALB, urinary protein ( UPR ) , urinary microalbuminuria/creatinine(Umalb/cr) and total bilirubin(TBIL) were detected.SPSS 17.0 Software was used to analyze the difference between the three groups and to reveal the correlations between TBIL and UPR, ALB.Results TBIL, ALB, UPR and Umalb/Cr levels were significantly different between NS, CGN and PGS groups ( one-way ANOVA test, P <0.05), and TBIL was positively correlated with ALB but negatively correlated UPR and Umalb/Cr in both NS and CGN groups (Spearman′s rho test,P<0.05);but no correlation was found between these items in PGS group (Spearman′s rho test,P>0.05) .Conclusion Serum bilirubin of patients with NS is at a low level and shows significant correlations with serum albumin and urinary protein levels.No similar association is found with the other two groups.The results in this study show that the causes of low serum bilirubin in patients with NS may related to the large amount of protein lost in urine.

Objective To explore the feasibility and effectiveness of channel-assisted spatium intermusculare approach interbody fusion for treating lumbar vertebra diseases.Methods A total of 81 patients with lumbar vertebra diseases were treated from June 2012 to December 2013,including 35 males and 46 females between 29 and 76 years old with an average age of 54.6.There were 36 cases of lumbar disc degeneration,10 cases of recurrence in situ after lumbar disc herniation surgery,6 cases of huge lumbar disc herniation,11 cases of lumbar disc herniation with spinal canal stenosis,5 cases of extreme lateral lumbar disc herniation and 13 cases of lumbar degenerative spondylolisthesis.There were 67 cases of single segment lesion and 14 cases of two segment lesions.Lesion sites contained L1,2 in 1 case,L3,4 in 4 cases,L4,5 in 50 cases,L5S1 in 12 cases,L3,4 and L4,5 in 8 cases,and L4,5 and L5S1 in 6 cases.Results The length of incision was 2.42±0.45 cm in cases of single segment lesion and 4.28±0.38 cm in cases of two segment lesions.The operation time was 96.00±21.53 minutes and intraoperative blood loss was 347.50± 241.62 ml.During the operation,one case suffered from dural laceration,cerebrospinal fluid leakage and ipsilateral nerve root injury.Two cases suffered from pedicle fractures.Eight cases experienced epidermal necrosis of the incision.One case had poor wound healing.Three cases suffered from nerve injury.A total of 76 patients were followed up for 12-30 months,averagely 20.5 months.Intervertebral height of lesion segments was apparently recovered after surgery,and maintained in good condition during the final follow-up.No significant difference in the changes of area and grade of multifidus was detected 12 months after surgery and before surgery.Except 4 cases,the remaining had interbody fusion with a fusion rate of 94.7％.The balance between the coronal plane and sagittal plane of the lumbar spine was evidently improved.Average Japanese Orthopaedic Association score increased from 12.66±1.88 points preoperatively to 26.4±1.92 points during the final follow-up,which showed significant differences.Conclusion The method of channel-assisted spatium intermusculare approach interbody fusion has some advantages for treating lumbar vertebra such as small incision,fewer traumas,less bleeding,fast recovery,and high fusion rate.However,there is a long time of operation in the early stage and high occurrence rate of complications.

Objective To investigate the efficacy of modified 270°spinal canal decompression combined with one-stage pedicle screw fixation and vertebral reconstruction for severe thoracolumbar fractures.Methods A retrospective case-control study was made on 44 cases of severe thoracolumbar fractures treated from January 2009 to June 2014.There were 34 males and 10 females, with age range of 20-68 years (mean, 37.9 years).The injured vertebrae included T11/12 in one case, T12-L1 in 10, L1/2 in 21, L2/3 in nine and L3/4 in three.Injury type was all AO type B2.According to the American Spinal Injury Association (ASIA), neurological deficit was Grade A in three cases, Grade B in five, Grade C in 22, and Grade D in 14.Load sharing score (LSC) was 7-9 points (mean, 8.1 points), while the thoracolumbar injury classification and severity score (TLICS) was 7-9 points (mean, 8.2 points).According to the difference of surgical procedures, all cases were divided into traditional group (21 cases) and improved group (23 cases).The patients in traditional group were treated by 270° spinal canal decompression combined with one-stage pedicle screw fixation and vertebral reconstruction, and those in improved group were treated by modified 270°spinal canal decompression combined with one-stage pedicle screw fixation and vertebral reconstruction.Between-group differences were compared with regard to operation time, intraoperative blood loss, postoperative drainage, allogeneic blood transfusion, pain visual analogue scale (VAS) at postoperative 72 hours, Cobb angle, anterior vertebral height, spinal canal compromise, Denis score, work state, neurological function, bone graft fusion and complications.Results Duration of follow-up was (32.4±15.8)months (range, 12-60 months).No wound infection or deterioration of neurological function was found after operation.Operation time was (2.4±0.5)hours in traditional group, less than (2.8±0.6)hours in improved group (P<0.05), while there were no significant differences in intraoperative bleeding, postoperative draining and blood transfusion between the two groups (P>0.05).VAS was (3.2±0.9)points in traditional group and (3.3±0.9)points in improved group at postoperative 72 hours (P>0.05).Cobb angle, anterior vertebral height and spinal canal compromise in both groups obtained well recovery and maintained after operation (P<0.05), but the recovery of spinal canal compromise was better in improved group than traditional group [(2.1±1.8)% vs.(11.8±6.1)%] (P<0.05).Denis score and work state were similar between the two groups (P>0.05).At the last follow-up, ASIA Grade A was noted in three cases, Grade C in two, Grade D in 23, and Grade E in 16.Bone union was achieved in all cases, with no implant loosening or breakage observed.Thirteen cases in traditional group were found with residual bone fragments in the spinal canal after surgery, and two of them received revision surgery.Conclusions Either modified or traditional 270° spinal canal decompression combined with one-stage pedicle screw fixation and vertebral reconstruction can attain satisfactory clinical results in treatment of severe thoracolumbar fractures.However, the modified 270°spinal canal decompression can achieve more thorough decompression without reducing stability of the spine.