Acupuncture Points ; Acupuncture Therapy ; Humans ; Male ; Middle Aged ; Raynaud Disease ; therapy

Objective To explore the targeted nursing care for patients with severe traumatic brain injury complicated with intracranial infection. Methods 35 patients of severe traumatic brain injury complicated with intracranial infection from January, 2009 to December, 2011 were reviewed. Results There were 10 cases cured, 12 cases improved very well, 4 cases improved, 5 cases invalid and 4 cases died. The total effective rate was 62.86%and the fatality rate was 11.43%. Conclusion Intracranial infection can be controlled effectively by the venous and intrathecal injection of antibiotics and targeted care in the patients with severe traumatic brain injury.

Objective To establish an effective qualitative discrimination method for Selaginella medicinal materials.Meth- ods Thin layer chromatography(TLC)method was used.Results The TLC method has a good specialization for identifying Selaginella medicinal materials and can distinguish Selaginella rnoellendorfii from other 10 familiar species in northern areas of Guangdong province.Conclusion The method can help to control the quality of Selaginella moellendorfii Tablet.

Background Trachoma is a common infectious eye disease,and its incidence is associated with region,economy and sanitary condition.To survey the prevalence status of an area is very important for the prevention and treatment of trachoma.Objective Aim of this study was to survey the prevalence of trachoma in primary and secondary school students of Chifeng Keshiketengqi,and to investigate the relationship between the prevalence of trachoma with age,gender,ethnicity and living environment.Methods This was a cross-sectional study.According to cluster random sampling method,2067 students were drawn from 10 primary and secondary schools,including 1061male and 1006 female.The age of students ranged from 6 to 17 years old,with the average age (12.53 ± 2.31)years.In the taken samples,Han students were 1768,and Mongolian students were 299;the agricultural and pastoral students were 1209,and the urban students were 858.The general life factors associated with trachoma were surveyed by questionnaire.Trachoma was diagnosed and graded based to 1987 WHO Simplified Trachoma Grading Standards.Eye examinations included visual inspection,eyelids,conjunctiva and cornea neovascularization under the slit lamp microscope,and the clinical data were recorded and collected.The results were statistically analyzed by SPSS13.0 software.Results According to the sampling proportion of 10.05％,2153 students were included and 2067 students participated in this study with the response rate 96％.Trachoma was diagnosed in 972 students with a morbidity 47.0％.The prevalence rate of trachoma was increased with the ageing,and a statistically significant difference was seen among the 6-8 years group,9-11 years group,12-14 years group and 15-17 years group (x2 =11.043,P =0.011),and the prevalence of trachomatous infiltration was significantly higher than that of trachomatous folliele (x2=11.493,P＜0.05).The prevalence rate of trachoma in Han and Mongolian students was 45.8％ and 54.5％,showing a significant difference between them (x2 =6.228,P =0.013).In addition,statistically significant differences also were found in the prevalence rate of trachoma between the pastoral areas students and urban students (56.1％ vs.39.7％,x2=30.226,P =0.000),but no significant difference was seen between male and female (47.0％ vs.46.9％,x2 =0.000,P =0.995).Conclusions The trachoma prevalence rate is relatively higher in the primary and secondary students in Chifeng Keshiketeng.These results offer a basis for the prevention and treatment of trachoma.

Objective To investigate the resistance rates of the Candida albicans strains isolated from patients with vulvovaginal candidiasis to 5 antifungal agents and examine the mechanism of azole resistance in these strains.Methods A total of 1 646 C.albicans strains were collected in Obstetrics and Gynecology Hospital of Fudan University from January to December 2015.The resistance rates of these isolates to five antifungal agents were analyzed.Azole-resistant (n=30),dose dependent sensitive (S-DD) (n=13),and susceptible isolates (n=10) were randomly selected from the microbiology laboratories of three obstetrics and gynecology hospitals in Shanghai.The expression levels of drug efflux pump related gene CDR1,CDR2,MDR1 and drug target enzyme gene ERG11 were analyzed by real-time fluorescence quantitative polymerase chain reaction (PCR).At the same time,the ERG11 and ERG3 genes were amplified by PCR and sequenced,and analyzed for resistance-related mutations.Results Of the 1 646 C.albicans strains,5.2％,3.2％,2.5％ and 2.1％ were resistant to itraconazole,voriconazole,fluconazole and 5-fluorocytosine,respectively.All isolates were sensitive to amphotericin B.The expression of ERG11 gene was significantly higher in S-DD group and azole-resistant group than in azole-sensitive group (P＜0.05).The expression of CDR1,CDR2 and MDR1 did not show significant difference among the three groups.There were 13 missense mutations in the ERG11 gene,of which T123I,P98S and Y286D amino acid substitutions were newly discovered.Both T123I and Y132H were identified in 26 resistant isolates,of which 16 gene mutation was detected in two pan-azole-resistant isolates.Conclusions The C.albicans strains isolated from vulvovaginal candidiasis showed higher resistance rates to azole antifumgal agents than that to 5-fluorocytosine and amphotericin B.Mutation and over-expression ofERG11 gene may be one of the prevalent molecular mechanisms underlying azole resistance in C.albicans.were pan-azole-resistant.In addition,the ERG3 heterozygous

Objective To dynamically observe and evaluate the position and movement of anterior pelvic floor organs in vaginal delivery and selective caesarean section primipara with translabial two-dimensional 2D ultrasound and discuss the short-term effect of delivery mode on the anterior compartment of pelvic floor Methods Translabial 2D ultrasound was performed on selective caesarean section and vaginal delivery primipara in 6-8 weeks The position of bladder the existence of bladder neck funneling were observed and the mobility of bladder neck and the urethral rotation angle were measured during maximum Valsalva maneuver Results The mobility of bladder neck was larger in vaginal delivery group than selective caesarean section group during maximum Valsalva maneuver The rates of bladder neck funneling cystocele and stress urinary incontinence were higher in vaginal delivery group Conclusions Translabial 2D ultrasound could dynamically observe and evaluate the position and movement of anterior pelvic floor organ which could be used to assess the effect of delivery mode on anterior compartment of pelvic floor The short-term effect of vaginal delivery on anterior compartment of pelvic floor is greater than that of selective cesarean delivery.

Objective To characterize the association between the mean CT value on a scout view and the dependent mA selection method, and to evaluate the clinical value of a mA selection method based on scout view mean CT value in obtaining individualized scan protocol and consistent image quality for patient population on 64-row MSCT CT coronary angiography (CTCA).Methods One hundred patients (group A) underwent CCTA consecutively using standard protocol with a fixed mA.The mean CT value of a fixed ROI (region of interest) from the scout AP view and the CTCA image noise (standard deviation on the root of ascending aorta) were measured.The correlation between CT values and noise was studied establish a formula and a list to determine the required mA for obtaining a consistent CTCA image noise based on the measured SV CT value.Another 100 patients (group B) were scanned using the same parameters as group A except the mA and the CT value was also measured.The mA was determined by the list established previously.The CTCA image quality (IQ) as well as the image noise (IN) and the effective dose (ED) from the two groups were statistically analyzed using t-test.The CT findings for the 32 patients in the group B were also compared with the selective coronary angiography (SCA) results.The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of CCTA for detection of significant stenosis were obtained.Results The formula between the required mA and the CT value was : XmA=FmA×[(K1×CTscout + C1)/INa]2.The CCTA images in B group had statistically higher IN (27.66±2.57,22.22±4.17,t=11.33, P=0.000), but no statistical difference between IQ scores for the two groups (3.29±0.66,3.37±0.67,t=0.009, P=0.990), and ED[(8.72±2.51) versus (12.53±0.90) mSv]was 30% lower for the B group (P<0.01).For the 32 patients in the B group who had SCA, the CCTA sensitivity, specificity, positive predictive value, negative predictive value, and stenosis detection accuracy were 94.92% (56/59), 92.13% (82/89) ,88.89% (56/63) ,96.47% (82/85) and 93.24% (138/148) wspectively for stenosis greater than 50%.Conclusion The mA selection method based on the SV CT value for CCTA in 64-row MSCT provides individualized protocol to obtain consistent image quality and to optimize dose delivery to patients.

Cultivating Clinical thinking ability is an important tache of clinical medical education. Teachers'guidance, the charateristics that suit teaching, the organic combination of the active methods which can mobilize clinical medical interns' learning enthusiasm, such as problem-based learning, and humanity education are effective approaches to enhancing interns' clinical thinking ability.

Objective To investigate blood gas analysis and lactic acid evaluation in aerobic forearm exercise and the significance of aerobic forearm exercise for the auxiliary diagnosis of mitochondrial myopathy and encephalopathy patients.Methods Forty-two patients with mitochondrial myopathy and encephalopathy patients, 40 healthy control, and 40 patients control were studied.They performed a protocol under aerobic exercise conditions, consisting of intermittent forearm exercise for 4 minutes at 40% of intented maximal voluntary contraction force.Blood samples were collected to monitor blood gas and plasma lactate before, during arid after exercise.Results During exercise venous PO_2(mm Hg, 1 mm Hg=0.133 kPa)decreased in mitochondrial myopathy and encephalopathy patients from 41.2?12.6 to 39.5?16.2, whereas PO_2 fell from 50.5?14.4 to 30.8?13.1 in healthy control and from 50.1?7.9 to 44.3?35.5 in patient control.Venous PO_2 decreased much more in healthy control group than the other 2 groups(F= 6.34,P

Background With the development of phacoemulsification surgery,the minimization of the size of the incision in order to reduce the damaging of eye tissue and postoperative complications becomes a focus.Objective This study aimed to assess the clinical efficacy of coaxial phacoemulsification type cataract surgery through a 1.8 mm microincision with foldable intraocular lens (IOL) implantation in eyes with age-related cataract.Methods Informed consent was obtained from each patient at the beginning of this study.A serial case observation study was designed.Thirty-two eyes of 32 patients with age-related cataract were enrolled in the Inner Mongolia Autonomous Region People' s Hospital from April 2012 to May 2012,including 8 eyes of grade Ⅱ hard nucleus cataract,16 eyes of grade Ⅲ hard nucleus cataract and 8 eyes of grade Ⅳ hard nucleus cataract.Ocular axial length was measured by an A-mode ultrasonic apparatus,and IOL diopter was calculated using the SRK-Ⅱ formula.Under ocular surface anesthesia,a 1.8 mm clear corneal tunnel incision was made at the 10-11 o' clock position,and then an auxiliary incision was made at the 2 o' clock position.The opaque lens was extracted by routine phacoemulsification.An Akreos MI60 IOL was implanted through the 1.8 mm incision.The time and level of ultrasonic power required for phacoemulsification,postoperative visual acuity and incidence of postoperative complication were assessed.Postoperative examinations were scheduled at 1 day,1 week and 1 month after the surgery.Results All the operations proceeded smoothly.The mean phaco-time was (7.0±3.6) seconds and the mean ultrasonic power level was (15.3 ±6.1)％ among the different grades of cataract groups.The number of eyes presenting an uncorrected distance visual acuity of ≥ 0.5 was 18 (56.25％),28 (87.50％) and 30 (93.75％) 1 day,1 week and 1 month after surgery,respectively.The number of eyes with a best corrected distance visual acuity of ≥ 0.5 and 0.8 were 31(96.88％) and 26 (81.25％),respectively,1 month after surgery.Negligible changes were detected in the anterior chamber depths,and no thermal damage was found at the incision during the operation.Conclusions Coaxial phacoemulsification and IOL implantation through a 1.8 mm microincision is safe and effective.Thorough planning and precise execution are necessary.