Laser scanning confocal microscope is a kind of new analytical apparatus for molecular cell biology research.It has been used in many fields of biomedical research.Brief introduction of its function and feature is given in this article.Recent development is summarized in application of laser scanning confocal microscope for localization and quantification of tumor tissue and cell protein,observation of sub-cellular structure of tumor ceils,study on tumor related receptor,distribution of antitumor drug and mechanism of tumor multi-drug resistance.

A harmonious physician-patient relationship is closely correlated with hospital culture construction.This paper explores the correlation from the perspectives of roles in building up decent fame of hospitals,promoting the construction of medical ethics,cultivating a fine humanistic medical atmosphere,strengthening the social responsibility of hospitals,and further clarifies the important function of hospital culture construction in constructing a harmonious physician-patient relationship.

Objective To investigate the influence of different kinds of post?core materials on fracture resistant ability of different walls during weakened root restoration. Methods Forty?eight human single root mandibular first premolars were randomly assigned to two groups(groupⅠwas repaired with quartz?fiber post?core and mental crown ,and groupⅡwas repaired with Co?Cr cast metal post?core and mental crown). Each main group was then divided into four subgroups of 6 specimens. All samples were tested on the universal test machine. We observed the fracture load and the fracture mode of the specimens. Results Cr?Co ally post?core group exhibited significantly higher resistance to fracture than quartz fiber post?core in the same number weakened root walls(P<0.05). With the increase in the quantity of weakened root walls ,the fracture resistance was significant decreased in the same post?core material(P<0.05). The possibility of repairable fractures in groupⅠwas significantly higher than that in groupⅡ(P<0.05). Conclusion Cr?Co alloy post?core can bear a higher bite ,but quartz fiber post?core has the most favorable fracture modes.

Objective To investigate the joint value of early peak temperature and 48 h-△sequential organ failure assessment (SOFA) score in predicting the prognosis for patients with sepsis in emergency department.Methods Two hundred and thirty-one patients with sepsis admitted from January 2013 to January 2015 in Emergency Intensive Care Unit of the First Affiliated Hospital of China Medical University were enrolled.Clinical features,early peak temperature,SOFA scores,the length of stay in EICU and the mortality in 28 days were studied.The patients were divided into two groups according to the 48 h-△SOFA.Each group were divided into three subgroups according to the early peak temperature.For example,hypothermia subgroup had temperature below 36 ℃,normothermia subgroup had temperature between 36 ℃ and 38 ℃,and hyperthermia subgroup had temperature above 38 ℃.The relationship between peak temperature plus 48 h-△SOFA and the length of stay in EICU as well as mortality were analyzed.Results Of 231 patients,in 48 h-△SOFA＞0 group (n =142) 27 (19.0％) patients died,and in 48 h-△SOFA≤0 group (n =89) 33 (37.1％) patients died (P ＜ 0.05).Hypothermia subgroup had a higher odds ratio value in predicting nonsurvival in 48 h-△SOFA≤0 group (OR =4.51,95％CI:1.33-2.17,P =0.01).Hyperthermia subgroup had a longer stay in EICU than hypothermia subgroup and normothermia subgroup (P ＜ 0.05).Conclusion The combination of the early peak temperature and 48h-△SOFA score is an effective indicator to evaluate the prognosis and to stratify patients with sepsis in emergency department.More attention should be paid to the patients with an early peak temperature ＜ 36 ℃ and 48 h-△SOFA ≤0 because of higher mortality.The condition of patients should be reassessed and try to make a more rational treatment for the patients with an early peak temperature ＞38 ℃ and 48 h-△SOFA ＞0 because of its longer stay in EICU.

Objective To establish an animal model of passive transferred myasthenia gravis(PTMG) in C57BL/6 mice aged 4 to 5 weeks with nicotinic acetylcholine receptor monoclonal antibody-mAb35 so as to decide the effective dose of mAb35 required to induce PTMG and to supply animal model for further study of the pathogenesis and immunotherapy of human MG.Methods The C57BL/6 mice aged 4 to 5 weeks in the experimental group were divided into three subgroups(E1,E2,E3),injected intraperitoneally(i.p.) with 0.2 ml of Ringer's buffer solution containing 0.5,1.0 or 1.5 mg/kg capital monoclonal antibody mAb35 of acetylcholine receptor respectively.The control group(N) were injected i.p.with 0.2 ml of Ringer's buffer solution without mAb35.To decide whether the model was successful,the clinical symptoms,ultrastructural changes of the mice as well as pharmacological and electrophysiological evaluation were observed and the serum levels of acetylcholine receptor antibody(AChRAb) were detected.Results All mice in the experimental groups were induced of clinic symptoms of myasthenia.The features in pharmacology,electrophysiology,ultrastructure and increased level of acetylcholine receptor antibody were in accordance with those of MG patients.Conclusion The model of PTMG can be successfully induced in C57BL/6 mice with mAb35 at effective dose of 1.0 mg/kg.The method is convenient and reliable.A fine animal model is established for experimental study of myasthenia gravis in children.

Objective To investigate the clinical value of combining early urine paraquat early clearance rate (UPCR) with severity index of paraquat poisoning (SIPP) in predicting the prognosis for paraquat poisoning patients.Methods In this retrospective research,a total of 425 cases diagnosed with acute paraquat poisoning from March 2014 to March 2016 in Emergency Intensive Care Unit,First Affiliated Hospital of China Medical University were enrolled.The general data of patients,the results of rapid qualitative test of paraquat in blood and urine,the concentration of paraquat in blood / urine,the poisoning time,the concentration of blood lactic acid and the APACHE Ⅱ score were collected.The early UPCR and SIPP were measured at different time intervals,and the ratio of 6-SIPP and 12 h-UPCR were calculated.These patients were divided into death groups and survival groups according to the 28-day mortality.The relationship between these factors and the mortality were analyzed.Results Of all the 425 patients,268 cases (63.1％) died,157 cases (36.9％) survived;the blood concentration of paraquat,the lactate concentration,SIPP values and the APACHE Ⅱ scores were significant difference between the two groups (P ＜ 0.05).The mortality of 2-6 hour paraquat rapid qualitative test result positive patients was higher (96.4％) than that of the negative patients (3.6％) (P ＜ 0.05);the mortality of 12-24 hour paraquat rapid qualitative test result negative patients was lower (11.5％) than that of the positive patients (88.5％) (P＜0.05).The 2-6 hour SIPP value was 19.8 ±6.7 in death group,which was higher than that in survival group (4.9±3.1) (P＜0.05);the 2-6 hour UPCR value was (41.7±9.3) indeath group,which was lower than that in survival group (86.3 ± 15.8) (P ＜ 0.05).There was no significant difference in the 2-6 hour UPCR value and 12-24 hour UPCR value between two groups (P ＞0.05).The 6 h-SIPP/12 h-UPCR value was (41.94 ±5.9) in death group,which was higher than that in survival group (5.27 ± 3.6) (P ＜ 0.05).Conclusion The combined use of early UPCR and SIPP values is an effective indicator of the prognosis of patients with acute paraquat poisoning and is helpful for the early stratification.We should pay more attention to the patients whose rapid qualitative blood test is positive because of their high mortality risk;for the patients whose 12 h urinequalitative test was negative,the hemoperfusion therapy might be stopped because the toxin was completely excluded,and the medical resources can be saved reasonably.The UPCR might indicate the excretion of toxins,and SIPP might indicate the severity of poising.

Humans ; Integrative Medicine ; Medicine, Chinese Traditional ; Oral Medicine

Acute Kidney Injury ; etiology ; pathology ; therapy ; Anti-Bacterial Agents ; administration & dosage ; therapeutic use ; Anticoagulants ; administration & dosage ; therapeutic use ; Child ; Child, Preschool ; Consensus ; Female ; Hemofiltration ; instrumentation ; methods ; Humans ; Infant ; Intensive Care Units, Pediatric ; Male ; Multiple Organ Failure ; etiology ; pathology ; therapy ; Practice Guidelines as Topic ; Sepsis ; complications ; pathology ; therapy ; Severity of Illness Index

OBJECTIVETo observe the clinical effects of clavicular hook plate combined with suture anchor in treating type Tossy III chronic acromioclavicular dislocation.

METHODSFrom January 2008 to December 2012,18 patients with type Tossy III chronic acromioclavicular dislocation were treated with clavicular hook plate and suture anchor. There were 12 males and 6 females, aged from 20 to 56 years old with an average of 31.5 years. Ten cases were left dislocation and 8 cases were right dislocation. Operation time was 3 weeks to 4 months after injury with a mean of 1.8 months. Functional exercise was adopted 2 weeks after operation. And Karlsson standard was used to evaluate curative effect.

RESULTSAll patients were followed up for 6 to 24 months with an average of 16 months. According to Karlsson standard, 17 cases were excellent and 1 was poor.

CONCLUSIONClavicular hook plate combined with suture anchor can repair conoid ligament and trapezoid ligament in treating type Tossy III chronic acromioclavicular dislocation, and had advantages of simple operation, less trauma, stable fixation, it can obtain satisfactory effects.

Acromioclavicular Joint ; diagnostic imaging ; injuries ; surgery ; Adult ; Bone Plates ; Female ; Follow-Up Studies ; Humans ; Joint Dislocations ; diagnostic imaging ; surgery ; Male ; Middle Aged ; Radiography ; Suture Anchors ; Treatment Outcome ; Young Adult

Objective To investigate complications in patients after noncardiac thoracotomy in hypothyroidism with ST changes. Methods Sixty one patients with hypothyroidism undergoing noncardiac thoracotomy were divided into ST segment change group(28 patients having ST segment depression≥0.05 mV) and controls(33 patients) according to the results of Holter. All patients were added with thyroid hormone, until the function of thyroid gland was normal before thoracotomy. The myocardial ischemia was measured by Holter within 48 hours after thoracotomy. Serum thyroid hormones was examined by radioimmunoassay during, before and after thoracotomy. And cardiovascular events were foliowed-up to hospital. Results Before and after thoracotomy serum TT3 in ST segment change group was (1.30±0.41), (2.09±0.45)nmol/L, TT4 was (80.56±30.28), (84.55±33.57) nmol/L, respectively; compared with the control group[TT3: (1.43±0.52), (2.38±0.51)nmol/L, TT4:(82.70± 29.43), (93.47±35.02)nmol/L], no significant differences were found(all P>0.05). After thoracotomy, 24 patients occurred myocardial ischemia, 10 patients occurred cardiovascular events in ST segment change group; 8 patients occurred myocardial ischemia, a patient occurred cardiovascular events in control group, there were significant differences between two groups(χ2=22.95,10.95, all P<0.05). The positive predictive value of ST segment change in Holter detection was 36% (10/28) recording in cardiovascular events of patients with cardiovascular disease undergoing noncardiac thoracotomy and hypothyroidism, negative predictive value was 97%(32/33). Conclusions Myocardial ischemia and other cardiovascular events tend to occur in hypothyroidism patients with ST segment change after noncardiac thoracotomy. ST segment change of preoperative Hoher detection recording cardiovascular events of hypothyroidism patients undergoing noncardiac thoracotomy has certain predictive value.