Since the definition of sepsis has been first proposed in 1991, the main content of the definition has been developed by infection + systemic inflammatory response syndrome as infection + organ dysfunction,and organ dysfunction is indicated by an increase in sequential organ failure assessment(SOFA) score.These are components of Sepsis-3 which was published in 2016.In Sepsis-3,the SOFA score in the identification and diagnosis of sepsis plays an important role,but Sepsis-3 was mainly used in adults,how to adjust it to children,some questions and details were proposed in this article.

Objective:To study effects of the cooling rate on the bonding characteristics of titanium porcelain bonded to cast titanium.Methods:According to ISO 9693,24 cast titanium plates(25 mm?3 mm?0.5 mm)were prepared.The middle of the samples(8 mm?3 mm) were bonded with bonding porcelain,opaque porcelain and dentin porcelain.The specimens from each porcelain-metal combination group were randomly assigned into four experimental cooling rate conditions,namely cooling rate of 15,40,50 and 100 ℃/min.A three-point-flexure-test was used to evaluate the bonding strength of titanium porcelain bonded to cast pure titanium.SEM/EDS were taken to characterize the failed surface of the titanium-porcelain interface.Statistical analyses were made by one-way analysis of variance(ANOVA).Results:The bonding strength of 15 ℃/min group was significantly higher than other groups.There were no significant differences in bond strength between 40 ℃/min and 50 ℃/min groups.SEM/EDS revealed that with an increase cooling rate,the remained porcelains on the titanium side were decreased.Conclusion:The 15 ℃/min cooling rate might be an effective method to improve the titanium-porcelain bonding strength.

Objective To probe into urban residents' mental health knowledge awareness in Jingmen city. Methods By means of self-compiled questionnaires, 563 community residents were surveyed about their mental health knowledge and access to it. Results For mental health- care knowledge, community residents scored a total of (42.52±8.79), among which, (15.34±3.25) points for relevant causes,(12.23±4.89) points for corresponding symptoms, and (14.92±4.26) for health behavior. Such aspects would affect a resident's awareness of mental health knowledge as the resident's education background,marriage and chronic diseases. Radio and television (48.3%), newspapers and magazines (41.4%), hospital expert advice (39.8%), and community medical services (36.1% ) were considered the better access to mental health knowledge. Conclusions Residents had considerably inadequate knowledge of mental health. Therefore, a variety of health- care education activities should be carried out to improve residents'mental health knowledge.

Objective To evaluate the accuracy of prediction equations in calculating energy expenditure in elderly patients with type 2 diabetes mellitus (T2DM).Methods In 75 elderly T2DM patients hospitalized in our hospital between August 2014 and August 2015,the resting energy expenditure (REE)measured with indirect calorimetry was compared with those calculated with six different prediction equations.Statistical analysis was performed with paired t-test,the percentage of individual coincidence,and BlandAltman method.Results The measured REE of the patients was (1 513.2 ± 240.6) kcal/d.There were statistically significant differences between the measured REE and the values predicted with Harris-Benedict,Owen,Mifflin,and Liu equations (all P ＜ 0.05),while no statistically significant differences were observed between the measured REE and the values predicted with FAO/WHO/UNU and Schofield equations (both P ＞0.05).FAO/WHO/UNU equation showed the smallest average difference from the measured value (-18.9 kcal/d),but the 95％ consistency limit (-363.3 kcal/d,325.5 kcal/d) was still beyond the acceptable clinical range.Conclusion The accuracy of prediction equations in estimating REE in elderly patients with T2DM may be dissatisfactory.

Objective:To evaluate the effects of three bond agents on bond strength of titanium- ceramic system. Methods: The pure titanium specimens were randomly divided into three groups. Three different manufacturers' porcelains(Super Ti22,Duceratin,Titankeramik) were used specially for titanium- ceramic bonding. The specimens in each group were further divided into two subgroups:bond agent group and no bond agent group. Bond strength of specimens was measured by the three- point bending test according to ISO9693. The titanium- ceramic interfaces were investigated by SEM/EDS. Results:The bond strength of Super Ti22(35.84±2.17) MPa and Duceratin(35.45±2.37) MPa with bond agent group was significantly higher than that of no bond agent group(P<0.05). Titankeramik with bond agent group showed a little higher bond strength than without bond agent, but no significant difference in statistics(P>0.05). The interfaces of Super Ti22 and Duceratin with bond agent groups were compact, while there were visible cracks and pores at the interface of other groups. Conclusion:The application of bond agent can improve bond strength of titanium- ceramic system.

Objective; To evaluate the influence of electrolyte's concentration at micro-arc oxide treatment on the bonding strength of titanium to porcelain. Methods; CP titanium specimens with size of 25 mm ×3 mm ×0. 5 mm were treated with micro-arc oxidation (MAO) in Na_2SiO_3 solution of three different concentrations. After ultra-low-fusing porcelain was applied, a three-point-flexure-test was used to evaluate the bonding strength of titanium to porcelain. The surface of the specimens was observed by SEM and EDS, as well as the interface between titanium and porcelain. Results; The bonding strength values between titanium treated with MAO and porcelain was significantly higher then the control groups, Croup 20 g/L has the highest bonding strength values. SEM/EDS suggested that a porous thin layer of oxide which contains Si element is created by MAO, and higher concentration of Na_2SiO_3 leads to more Si element in oxide. Conclusion; MAO treating can improve the bonding strength between titanium and ceramic. Electrolyte's concentration has an effect on the bond strength between titanium and porcelain.

Objective To assess the safety and effectiveness of nasegastric enteral nutrition (NGEN) in patients with severe acute pancreatitis (SAP).Methods A meta-analysis of all the relevant clinical trials was performed.Clinical trials were identified from the following electronic databases:Medline,EMBASE,the Cochrane Controlled Trials Register,and Chinese Bio-medicine Database.The search was undertaken in October 2008.The literature quality was evaluated with Cochrane Handbook 5.0.The statistical analysis was performed by RevMan 4.2 software.Results Four trials involving 157 patients were included.The combined results showed that no significant differences in the safety and tolerance between nasogastric and conventional routes in patients with SAP.Conclusions Currently available data show early NGEN appears to be effective,safe,and tolerable in patients with SAP.However,more large-scale high-quality trials are required to further elucidate this topic.

Objective To study the anti-tumor effect of Zhongjiefeng Injection in vitro and its combination with adriamycin.Methods MTT assay was adopted to determine the in-vitro anti-tumor effect,IC50 was used to measure the direct anti-tumor effect,and Jing' s formula was applied to analyze the combination of the drugs.Results Zhongjiefeng Injection can inhibit the proliferation of Bel 7402(human hepatoma cells),HCT-8(human colon cancer cells),and the IC50 was 33.13 mg/mL for Bel 7402 and 52.39 mg/mL for HCT-8 respectively.Zhongjiefeng Injection at the concentrations of 3.125,6.25,12.5 mg/mL showed an efficancy potentiation action with doxorubicin on the inhibition of HCT-8 cells in vitro,and 25,50 mg/mL showed a synergic effect on HCT-8 .Conclusion Zhongjiefeng Injection has a certain in-vitro inhibitory effect on the growth of Bel 7402 and HCT-8,its combination with doxorubicin in vitro can produce synergic effects(a simple combined or enhanced effects)to HCT-8 cells,especially high concentrations of Zhongjiefeng Injection with doxorubicin.It is suggested that Zhongjiefeng Injection in the doubled dosage may have a better synergistic effect with doxorubicin in clinical treatment of colon cancer.

Objective:To evaluate the effects of three bond agents on bond strength of titanium-ceramic system.Methods:The pure titanium specimens were randomly divided into three groups.Three different manufacturers' porcelains(Super Ti22,Duceratin,Titankeramik)were used specially for titanium-ceramic bonding.The specimens in each group were further divided into two subgroups:bond agent group and no bond agent group.Bond strength of specimens was measured by the three-point bending test according to ISO9693.The titanium-ceramic interfaces were investigated by SEM/EDS.Results:The bond strength of Super Ti22(35.84?2.17)MPa and Duceratin(35.45?2.37)MPa with bond agent group was significantly higher than that of no bond agent group(P0.05).The interfaces of Super Ti22 and Duceratin with bond agent groups were compact,while there were visible cracks and pores at the interface of other groups.Conclusion:The application of bond agent can improve bond strength of titanium-ceramic system.

Aim To study the molecular basis of protection on myocardial ischemic injuries of total flavones of choerospondias axiaris fructus(TFC). Methods The microarray analysis for the protein expression in myocardium provide a strong tool to explore the key protein candidates involved in the pathogenesis of ischemic injury.Surface enhanced laser desorption/ionization(SELDI) mass spectrometry with protein chip IMAC3,SAX2 and NP20 was used to compare the differentially expressed protein in TFC-treated and untreated ischemic myocardium in rats and the results were analysized with Proteinchip Software 3.0.2.Results Seven differentially expressed proteins were indentified in TFC treated myocardium.These differential effects correlated with the expression of five downregulated proteins and two upregulated proteins,and four of them were discovered on the IMAC3 chip and one of them was discovered on the SAX2 chip.Conclusions The myocardial protection of TFC may be mediated by the differential expression of these proteins which could be the key protein candidates for further investigation.