Objective To compare the effects of fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) on classifications and locations of choroidal neovascularization (CNV) located under subretinal hemorrhage in age-related macular degeneration, and on the area-measuring of subretinal hemorrhage. Methods The medical record of 177 patients with subretinal hemorrhage associated with AMD confirmed by photochrome of ocular fundus, FFA and ICGA examinations were retrospectively reviewed. The locations and classifications of CNV on the images of FFA and ICGA in the 177 patients and the area of subretinal hemorrhage of 30 patients randomly selected from the 177 patients were analyzed and measured. Results On the images of FFA, the locations and classifications of CNV could be defined in 160 patients (90.4%), and CNV was considered eligible for laser therapy in 24 patients (13.6%). On the images of ICGA, the locations and classifications of CNV could be defined in 175 patients (98.9%),and CNV was considered eligible for laser therapy in 51 patients (28.8%). There was no statistical difference of the locations (Z=-0.383,P=0.701) and classifications (?2=2.993,P=0.810) of CNV on the images of FFA and ICGA. The areas of blocked fluorescence measured on the images of FFA (=26.610 mm2 and M= 13.548 mm2) were larger than those of ICGA (=24.714 mm2, M=12.875 mm2) with statistical differences (Z=-3.000,P=0.003) between FFA and ICGA. Conclusions ICGA is beneficial for imaging CNV located under subretinal hemorrhage, and may increase the number of the patients who are considered eligible for laser treatment. The effect of measurement of the area of subretinal hemorrhage in AMD evaluated by FFA is better.

Objective To explore the diagnostic value of color Doppler ultrasonography and ultrasonography in the differential diagnosis of ectopic pregnancy.Methods 142 patients with ectopic pregnancy were given ultrasonic examination,to observe whether intrauterine gestational sac,carefully looking for recognition of ovarian masses and distinguish the relationship and structure,and were compared with pathologic diagnosis.Results Ultrasound could clearly display the uterus,ovary,failed to break the gestational sac and blood(block) mass image structure,with pathological diagnosis coincidence rate was 95.1％ (135/142),the misdiagnosis rate was 1.4％ (2/142),the missed diagnosis rate of 3.5％ (5/142).Conclusion Ultrasound was rapid,simple,noninvasive,high-accuracy,it was the preferred method for early diagnosis of the ectopic pregnancy.

The etiology of reversible posterior leukoencephalopathy syndrome(RPLS)is more complex.Its pathogenesis has a lot of controversies,and its clinical manifestations are headache, nausea,vomiting,epileptic seizure,consciousness disturbance and visual abnormality.Neuroim- aging examinations have shown that diffuse symmetrical white matter edema is predominantly in the bilateral posterior brain regions.Clinical symptoms and neuroimaging changes can be recov- ered completely after timely and effective treatment.If the treatment is delayed,it may compli- cate with cerebral infarction or hemorrhage,and lead to irreversible damage.

In this study,we isolated and characterized chlorobenzene degrading bacteria from the effluent and sludge samples of one chemical plant.Minimal medium supplemented with chlorobenzene as sole car-bon source was used during the enrichment and domestication process.Seven major bacterial isolates were obtained and purified.Their 16S rRNA genes were amplified by PCR for sequencing and their identities were determined with homology comparisons.Five of the seven isolates belong to Actinomycetales in-cluding Kocuria KD139,Rhodococcus KD140,Rhodococcus KD142,Arthrobacter KD230,and Ar-throbacter KD232;one is classified as Bacillus d KD178;and another one as Stenotrophomonas KD237.The phylogenetic tree was also constructed based on the analysis of 16S rRNA gene sequences.Chloro-benzene concentrations were quantified with gas chromatography to investigate the bio-degradation rates of the isolated strains.Stenotrophomonas KD237 degraded 60.78% chlorobenzene in the minimal medium within 24 h.

The major satisfaction of college students will influence their learning interest and motivation, and then influence their learning achievement and future employment. Under the guidance of the concept of the micro system engineering of the education reform, the degree of the major satis-faction of the students in TCM colleges is analyzed by SIMPP method. The results show that students' behavior mode such as their preview situation, teaching adaptation, course satisfaction, students' achievement and their attitude of poor academic performance is closely related to the degree of major satisfaction. Teachers can judge the degree of major satisfaction by following these pattern behaviors;improve the rationality and accuracy of the degree of major satisfaction.

ObjectiveTo explore the early diagnostic value of pro-adrenomedullin (pro-ADM) in sepsis. Methods A prospective study was conducted. Eighty-two patients with acute infection admitted to Department of Emergency of Shanxi Medical University Second Hospital from April 2013 to March 2014 were enrolled. According to the diagnostic criteria of sepsis, the patients with acute infection were divided into ordinary infection group [infection without systemic inflammatory response syndrome (SIRS),n = 25] and sepsis group (infection combined with SIRS, n = 57). According to degree of severity of sepsis, the latter group was subdivided into three subgroups: sepsis group (n = 22), severe sepsis group (n = 27) and septic shock group (n = 8). Twenty-four healthy persons were included to serve as healthy control group. The venous blood from all the research objects in hospital was collected within 24 hours. The levels of pro-ADM and procalcitonin ( PCT ) were determined by enzyme linked immunosorbent assay (ELISA), and acute physiology and chronic health evaluationⅡ (APACHEⅡ) score was recorded. The relationship between pro-ADM and PCT and also APACHEⅡ score was analyzed with Pearson correlation analysis. The receiver-operating characteristic curve (ROC) of pro-ADM and PCT were used to evaluate the diagnostic acuity of sepsis.Results The plasma levels of pro-ADM, PCT and APACHEⅡ score in sepsis group were significantly higher than those in ordinary infection group and healthy control group [pro-ADM (ng/L): 66.69±1.73 vs. 53.43±2.70, 45.87±1.43; PCT (ng/L):1 336.49±40.26 vs. 1 083.09±47.99, 959.04±37.53; APACHEⅡ score: 14.60±0.81 vs. 8.10±1.14, 3.00±1.15,allP< 0.01]. With the aggravation of sepsis, the levels of pro-ADM, PCT and APACHEⅡ score were gradually increased, and there were significant differences among sepsis, severe sepsis, and septic shock groups [pro-ADM (ng/L): 64.91±2.50, 73.56±2.80, 84.67±4.52; PCT (ng/L): 1 152.65±48.62, 1 233.93±63.06, 1 475.71±109.93;APACHEⅡ score: 12.91±1.15, 14.55±1.14, 19.37±2.40,P< 0.05 orP< 0.01]. Pearson correlation analysis results showed that the level of pro-ADM was positively related with PCT (r = 0.473,P = 0.006), and it was also positively correlated with APACHEⅡ score (r = 0.707,P = 0.008). ROC curve analysis showed that area under the ROC curve (AUC) of pro-ADM for diagnosis of sepsis was 0.823 (P = 0.003). When the cutoff value was 59.40 ng/L, the sensitivity was 80.7%, the specificity was 68.0%, the positive predictive value was 85.2%, and the negative predictive value was 60.7%. AUC of the PCT for diagnosis of sepsis was 0.653 (P = 0.043). When the cutoff value was 1 194.67 ng/L, the sensitivity was 68.4%, the specificity was 64.0%, the positive predictive value was 81.8%, and the negative predictive value was 44.7%. It was proved that the pro-ADM had a higher diagnostic value for sepsis than PCT.Conclusion The plasma levels of pro-ADM can be used as an early indicator in diagnosis and severity evaluation and prognosis in patients with sepsis .

Objective To study the clinical characteristics of Gitelman′s syndrome, and the differentiation of Gitelman′s syndrome from Bartter′s syndrome. Methods Clinical data of 2 patients diagnosed as Gitelman′s syndrome were retrospectively analysed. Results The symptoms of both patients appeared at adult age, their main manifestation included hypokalaemic alkalosis, hyperreninemia and juxtaglomerular apparatus hyperplasia with normal blood pressure, hypocalciuria and hypomagnesemia, then the diagnosis of Gitelman′s syndrome was established. Potassium and magnesium supplementation ameliorated one patient′s symptom. Another patient treated with indomethacin, serum potassium was recovered to normal level. Conclusion Gitelman′s syndrome and Bartter′s syndrome appear to be similar in the pathogenesis, clinical manifestation and prognosis, but still show some differences, Gitelman′s syndrome should be carefully differentiated from Bartter′s syndrome.

OBJECTIVE:To establish a method for determining the content of Ornidazole gel by first-order derivative spectrophotometry.METHODS:The first-order derivative spectrophotometry was used to determine the content of Ornidazole gel at a wavelength of 259nm and 299nm.RESULTS:The linear range of Ornidazole was 4.01～44.1?g?mL-1.The average recovery was 101.6%,with RSD of 1.3%.CONCLUSIONS:This method can meet the requirements for quality control of Ornidazole gel both in terms of precision and accuracy.

Objective To investigate the in vitro effects of human bone marrow derived mesenchymal stem cells (hBMSC) on Th17 cells of the human peripheral blood.Methods The density gradient centrifugation combined with lymphocyte separation medium was used to isolate hBMSC,which were then cultured.Cytokine IL-17 in the peripheral blood from a healthy person was measured by enzyme-linked immunosorbent assay (ELISA).Proportion of Th17 cells was evaluated by flow cytometry.Results The expression level of IL-17 in spent culture supernatant of the healthy person PBMC and AML hBMSC was (292.32±37.25) pg/ml,and was significantly higher than that of the healthy person PBMC and healthy hBMSC [(169.64±17.47) pg/ml,P ＜ 0.01].There was no significant difference between the expression level of IL-17 in spent culture supernatant of the healthy person PBMC and ALL hBMSC [(159.89±23.71) pg/ml] and the level of the healthy person PBMC and hBMSC.The percentages of Th17 cells of co-culture systems from hBMSC,ALL-hBMSC,and AML-hBMSC and PBMC were (10.13±2.19) ％,(13.77±4.04) ％ and (21.53±5.05) ％,respectively,with the result between AML patients and healthy people being statistically different (P ＜ 0.01).ALL patients and healthy people showed no difference (P ＞ 0.05).Conclusion AML-hBMSC promotes the CD~ T cells to generate Th17 cells,which suggests that the MSC from AML marrow may play a role in the regulation of immune suppression.

High fidelity human patient simulator has become more and more important in clinical medical practice education.Medical circle has more and more realized that non-technical skill (NTS) is closely associated with the improvement of medical quality.This paper attempted to carry out a preliminary discussion on theory and practice of applying NTS in simulation training of critical care medicine based on their own teaching experiences.