Objective To investigate the injury posterior vertebral pedicle nail fixed treatment of thoracolumbar fractures of the clinical efficacy and safety .Methods Forty-eight cases of thoracolumbar fractures were treated by the posterior vertebral pedicle screw fixation ,according to cases decompressive laminectomy ,underwent intertransverse fusion treatment .Postoperative follow-up of 1 year ,preoperative ,postoperative 3 months ,after 1 years of vertebral compression rate ,Cobb Angle were compared .Results Forty-eight patients with postoperative 3 months and 1 year after injury postoperative spinal vertebral body compression rate were significantly decreased compared with preoperative (P<0 .05);After 3 months and 1 year after the Cobb Angle were markedly sig-nificant reduction than preoperative(P<0 .05) .X-ray showed all fractures were obtained good reduction ,internal fixation with no looseness or breakage ,no protruding after spinal deformity ,neural function were all in 1 -3 level recovery .Conclusion Posterior vertebral pedicle injury by nail fixed treatment of thoracolumbar fractures with fixed reliable ,reset effect is good .

Objective To study the blood pressure changing patterns in normal pregnancy and pregnancy induced hypertension(PIH). Methods 24 hour ambulatory blood pressure monitoring (ABPM) were performed in 38 cases of normal pregnancy and 36 cases of PIH during 18～20,28～30 and 38～40 gestational week. Results The 24 hour mean blood pressure were increased with pregnancy advanced. In normal pregnancy, a typical circadian rhythm of blood pressure pattern was shown that it increases during the day and decreased during the night with the disparity of (16.3? 4.1)%, (14.1?3.2)% and (15.7?2.0)% in three different gestational week respectively. In moderate and severe PIH, the 24 hour mean blood pressure,blood pressure load and the frequence of abnormal rhythm were significantly higher than those in mild PIH and normal pregnancy, while the disparity between day and night blood pressure was lower. Conclusion The blood pressure patterns show a typical circadian rhythm in most normal pregnancy. The more severe the PIH is, the higher rate of abnormal blood pressure rhythm occured.

OBJECTIVETo observe and evaluate the clinical performance of zirconia crowns made by CEREC inLab computer aided design/computer aided manufacturing(CAD/CAM) for posterior teeth.

METHODSA total of 242 patients were implanted with zirconia crowns fabricated by CEREC inLab CAD/CAM. The crowns were evaluated by Modified US Public Health Service criteria at baseline, 6, 12, 24, and 36 months. The chi-square test was used to analyze the survival rate.

RESULTSAll but five crowns were evaluated by an independent evaluator at baseline, 6, 12, 24, and 36 months. The survival rate declined with time. The A score percentage was above 85% at 36 months.

CONCLUSIONThe single zirconia crowns fabricated by CEREC inLab CAD/CAM demonstrate satisfactory clinical performance during a short period.

Objective To investigate the effects of vitamin D deficiency on pregnancy and fetal development in mice. Methods All female ICR mice were randomly divided into two groups. In control group, mice were fed with standard feeds (vitamin D3 >800 IU/kg). In vitamin D deficiency group (VDD), female mice were fed with feeds with vitamin D depletion (vitamin D3 <25 IU/kg). For mating purposes, four females were housed overnight with two males starting at 9 : 00 PM. Females were checked 7 : 00 AM the next morning, and the presence of a vaginal plug was designated as gestational day (GD) 0. All pregnancy mice were sacrificed on GD18. For each litter, the number of live fetuses, dead fetuses and resorption sites were counted. Live fetuses in each litter were weighed. Crown-rump lengths were examined. And skeletal development of all live fetuses in each litter was evaluated. Re-sults The pregnancy rate was lower in VDD group than that in control group(P<0.05). The number of live fetu-ses was significantly decreased(P<0.05). By contrast, the numbers of dead fetuses and resorption sites were sig-nificantly increased(P<0.05). In addition, the average weights of fetuses and placenta were reduced in vitamin D deficiency group. Moreover, vitamin D deficiency resulted in skeletal development retardation in fetuses. Conclu-sion Vitamin D deficiency impairs pregnancy and developmental outcomes in mice.

Objective To evaluate the valRe of Geneva score,plasma D-dimer lUmitel,lower extremity compressive ultrasonography and transthoracic echocardiography,as well a8 their combination,in diagnosis for suspected pulmonary thmmboernbolism(PTE)and its exclusion.Methods In total,139 confirmed FrrE patients were enrolled in the study,with 50 patients with suspected PTE at admission but excluding PTE after testing as controls,Geneva scores and plasma level of D-dimer were determined,and deep vein uhrasonography in the lower extremity and transthoracic echocardiography were performed for all the confirmed cases of PTE and controls.Diagnostic values were evaluated with each teat index alone or in combination,to confirm or exclude PTE.Results FrrE could be diagnosed by hish Geneva score,with a positive likelihoed ratio more than 10 and it could not be excluded by a negative likelihood ratio more than 0.1 with Latex semi.quantitative method and quantitative methed Latex method P,rE could be excluded by a multi-tests in parallel with negative likelihoed ratio less than 0.1.High Geneva scores,in combination with ultrasonography of the lower extremity and transthoracic echoeardiography in combination with Youden index greater than 0.6 could indicate PTE.Sensitivity and specificity of P1'E diagnosis could be improved by multi-tests in parallel or in series.Conclusions Geneva SCOre is more objective indicator and hish score has diagnostic value for PTE.PTE could be excluded reliably by negative result of multi-diagnostic tests in paralleL Misdiagnosis and under-diagnosis for PTE can be reduced by Geneva score,blood D-dimer level,lower extremity compressive ultrasonogaphy and transthoracic echocardiography,as well as their combination,in parallel in hospitals without ECT or spiral CT.

Objective To discuss possible mechanism of chronic obstructive pulmonary disease(COPD)coagulation and fibrinolysis dysfunction.Methods Totally 47 healthy controls(Group A)and 38 cases of AECOPD(Group B)were chosen respectively.The plasma levels of vWF,Factor Ⅹ,TF,TFPI,TM,PC,tPA,PAI-1 and D-dimer were measured by ELISA method,and the blood AT-Ⅲ activity was measured by chromogenic assay.The cases of Group B were measured for RBC,WBC,PLT,PH,PaO2,PaCO2,HCO-3,PT,APTT,FBG,and so on.Results The plasma levels of vWF,TF,Factor Ⅹ,t-PA and D-dimer in Group B were significantly higher than those in Group A while TM and PC were significantly lower in Group B(P

Objective To observe the effect of sinomenine(SINO) on immune function of adjuvant arthritis(AA) rats.Methods SD rats were randomized into normal group,model group,SINO groups(treated with gastric gavage of SINO at the doses of 60,120 and 240 mg/kg respectively),and glucosides of Tripterygium Wilfordii(30 mg/kg) group.Except the normal group,the rats in other groups received subcutaneous injection of the complete Freund's adjuvant 0.1mL into the left hind foot to induce AA.The medication began from 12 days after the modeling and lasted 12 days.The pedal swelling and joint function scores were observed in different time.Radioimmunoassay was used to detect the contents of interleukin-1?(IL-1?) and tumor necrosis factor ?(TNF-?) in synovial cells.Expression of IL-1? and TNF-? mRNA was examined by reverse transcription-polymerase chain reaction(RT-PCR) assay.Results SINO at different concentrations decreased the pedal swelling and arthritis scores to various degrees,inhibited the production of IL-1? and TNF-? in the synovial cells,reduced the expression of IL-1? and TNF-? mRNA,and recovered the normal histological features of synovial cells in AA rats.Conclusion The therapeutic mechanism of SINO for rheumatoid arthritis may be related with the inhibition of secretion of inflammatory mediators in synovial cells,and with the recovery of histological features of synovial cells.

Objective To research the correlation of the expressions of lipocalin-2 (LCN-2) and its receptor (NGALR) in serum and placenta with preeclampsia.Methods From Dec.2010 to Apr.2011,64 women with preeclampsia who delivered in Affiliated Hospital of Qingdao University Medical College were recruited in the study,including 26 women with moderate preeclampsia ( MPE group) and 38 women with severe preeclampsia (SPE group).Twenty-five healthy pregnant women were taken as control group.LCN-2 and NGALR mRNA and protein expression in placenta were measured by reverse transcription-PCR ( RTPCR) and western blot,respectively.Results ( 1 ) The serum levels of LCN-2 in MPE group and SPE group [ (58 ±20),(90 ± 18) μg/L] were significantly higher than that in control group [ ( 19 ±6) μg/L,P＜0.01] ; the serum LCN-2 level in SPE group was significantly higher than that in MPE group (P ＜0.01).(2) LCN-2 mRNA expression in placenta in MPE group and SPE group (0.55 ±0.14,0.61 ±0.14) were both significantly higher than that in control group (0.28 ±0.16,P ＜0.01 ) ; LCN-2 protein expression in placenta of MPE group and SPE group ( 2.2 ± 0.4,2.4 ± 0.5 ) were also significantly higher than that in control group (1.4 ±0.4,P ＜0,01 ),no significant difference was found between MPE group and SPE group ( P ＞ 0.05 ),(3) No significant difference was found in the expressions of NGALR mRNA in placenta among MPE group,SPE group and control group (0.46 ±0.1l,0.46 ±0.14,0.45 ±0.15,P ＞0.05 ).(4) NGALR protein expressions in MPE group,SPE group and control group were 2.7 ±0.8,3.0 ±0.9,and 2.7 ± 0.9,and there were no significant difference among these three groups ( P ＞ 0.05 ).(5) In preeclampsia,serum LCN-2 level significant associated with 24 hours total urinary protein and uric acid ( r =0.565,0.476,P＜0.01).LCN-2 serum level were not associated with systolic pressure and diastolic pressure (P ＞ 0.05 ) ; there were no association with the expressions LCN-2 mRNA aud protein in placenta ( P ＞ 0.05).Conclusions Serum LCN-2 level is closely related to the progress of preeclampsia.Increasing expression of LCN-2 in placenta may be a compensatory response to preeclampsia.

Objective To approach the effect of different vasopressor on hemodynamics, volume responsiveness, fluid volume balance, renal function and prognosis in patients with acute respiratory distress syndrome (ARDS) complicated with septic shock.Methods A prospective single-blind randomized controlled trial was conducted. ARDS patients with septic shock admitted to the Department of Critical Care Medicine of Jiangxi Provincial People's Hospital from January 1st, 2015 to May 1st, 2016 were enrolled. The patients satisfied ARDS Berlin diagnostic criteria, over 15 years old, needing vasopressor after fluid resuscitation were enrolled. The patients were divided into norepinephrine group (NE group) and terlipressin group (TP group) by randomise number table derived by computer. Patients in TP group were given terlipressin (0.01-0.04 U/min) with an intravenous pump, while those of NE group were given norepinephrine (> 1μg/min) with an intravenous pump, and the target mean arterial pressure (MAP) was maintained at 65-75 mmHg (1 mmHg = 0.133 kPa). Hemodynamics and extravascular lung water index (EVLWI) were monitored by pulse indicator continuous cardiac output (PiCCO). The volume responsiveness of patient was evaluated by passive leg raising (PLR) test, and cardiac index (CI) change (ΔCI ≥ 10%) served as positive volume responsiveness. The differences in hemodynamics, EVLWI, oxygenation index (OI), lactate clearance rate (LCR), rate of positive volume responsiveness, urinary output, fluid volume balance, renal function, and prognostic indicators were compared between the two groups.Results Fifty-seven patients with ARDS complicated with septic shock were enrolled, with 26 patients in NE group, and 31 patients in TP group, thebaseline data in both groups was balanced with comparability. Compare with NE group, 48-hour and 72-hour heart rate (HR) in TP group was significantly slowed (bpm: 82.1±6.8 vs. 87.6±7.4, 81.3±6.1 vs. 85.6±8.3, bothP < 0.05), 72-hour central venous pressure (CVP) was significantly decreased (mmHg: 9.4±2.6 vs. 10.9±3.0,P < 0.05), but no significant difference was found in HR, MAP, CVP, CI, EVLWI, OI and LCR at other time points between the two groups. 48-hour and 72-hour positive volume responsiveness rate in TP group were significantly increased as compared with those of NE group (74.2% vs. 46.2%, 64.5% vs. 38.5%, both P < 0.05), urinary output on the 2nd day (mL/24 h: 2342.8±704.1 vs. 1944.6±684.3) and fluid volume balance (mL: -319.7±54.8 vs. -169.6±27.2) were significantly decreased (bothP < 0.05). There was no significant difference in positive volume responsiveness rate, urine output, fluid volume balance, and the level of serum creatinine at other time points between the two groups. There was no statistically significant difference in the following features between TP group and NE group: duration of mechanical ventilation (days: 8.41±2.97 vs. 9.67±3.56), length of intensive care unit (ICU) stay (days: 12.84±4.47 vs. 14.77±5.01), total length of hospital stay (days: 19.34±7.37 vs. 21.07±8.41), and 28-day mortality (29.0% vs. 30.8%, allP > 0.05).Conclusions Compared with norepinephrine, terlipressin for ARDS patients with septic shock is more conducive to restrict fluid load, improve the renal perfusion and increase urine output. However, in both groups therewas no significant difference in the efficiency of stabilizing hemodynamics, shortening the duration of mechanical ventilation, reducing ICU or hospital days and decreasing 28-day mortality.

Objective To explore the influence of different positive end-expiratory pressure (PEEP) levels on cerebral blood flow (CBF) and cerebrovascular autoregulation in patients with acute respiratory distress syndrome (ARDS).Methods A prospective study was conducted.Moderate or severe ARDS patients admitted to Department of Critical Care Medicine of Jiangxi Provincial People's Hospital from January 1st,2013 to October 1st,2013 were enrolled.The changes in hemodynamics,respiratory mechanics and gas exchange under different levels of PEEP were observed.CBF velocity of middle cerebral artery (MCA) was measured using transcranial Doppler (TCD),and breath-holding index (BHI) was also calculated.Results 35 patients with ARDS were included.The oxygenation index (OI),peak inspiratory pressure (PIP),plat pressure (Pplat) and central venous pressure (CVP) were markedly elevated [OI (mmHg,1 mmHg=0.133 kPa):324.7± 117.2 vs.173.4± 95.8,t=5.913,P=0.000; PIP (cmH2O):34.7 ± 9.1 vs.26.1 ± 7.9,t=4.222,P=0.000; Pplat (cmH2O):30.5 ± 8.4 vs.22.2 ± 7.1,t=4.465,P=0.000; CVP (mmHg):12.1 ± 3.5 vs.8.8 ± 2.2,t=4.723,P=0.000] when PEEP was increased from (6.4 ± 1.0) cmH2O to (14.5-± 2.0) cmH2O (1 cmH2O=0.098 kPa).But no significant difference in the heart rate (beats/min:85.5 ± 19.1 vs.82.7 ± 17.3,t=0.643,P=0.523),mean arterial pressure (mmHg:73.5 ± 12.4 vs.76.4 ± 15.1,t=0.878,P=0.383) and CBF velocity of MCA [peak systohc flow velocity (Vmax,cm/s):91.26 ± 17.57 vs.96.64 ± 18.71,t=1.240,P=0.219; diastolic flow velocity (Vmin,cm/s) 31.54 ±7.71 vs.33.87 ±8.53,t=1.199,P=0.235; mean velocity (Vmean,cm/s) 51.19 ± 12.05 vs.54.27 ± 13.36,t=1.013,P=0.315] was found.18 patients with BHI＜0.1 at baseline demonstrated that cerebral vasomotor reactivity was poor.BHI was slightly decreased with increase in PEEP (0.78 ± 0.16 vs.0.86 ± 0.19,t=1.905,P=0.061).Conclusions Some of moderate or severe ARDS patients without central nervous system disease have independent of preexisting cerebral autoregulation impairment.However,independent of preexisting cerebral autoregulation may not further be impaired when a high PEEP was chosen.