Objective To analyze the alterative characteristics of the extravascular lung water (EVLW ) in the patients with septic shock and clarify its value on the prognosis of these patients.Methods By the methods of retrospective analysis,according to the ultimate survival,21 patients with septic shock were divided into survivor group (10 cases) and non-survivor group (11 cases).The clinical features of the patients were observed and hemodynamic monitoring was made with PiCCO monitor.The EVLW was measured and the relationship between the EVLW and the prognosis of patients was analyzed.Results On the first,second and third day,EVLW was (12.7 ±1.8),(11.3 ±1.3),(10.1 ±1.3) ml/kg in survivor group,and (14.4 ± 1.0),(14.6 ± 1.4),(14.6 ±1.3) ml/kg in non-survivor group respectively,and there were statistical differences between two groups (P <0.05).However,on the second day after the intensive therapy,EVLW in survivor group dropped significantly(P＜0.05),but the non-survivor group only declined slightly,and compared with the result of the first day,there was no obvious difference (P >0.05).Conclusions The EVLW in the patients with septic shock increases significantly.The dynamic changes of the EVLW may be one of the factors for predicting the prognosis of patients with septic shock.

AIM To study the chemical constituents from Schisandra chinensis (Turcz.) Baill..METHODS The ethyl acetate fraction of 95％ ethanol extract of S.chinensis was isolated and purified by silica column and recrystallization,then the structures of obtained compounds were identified by physicochemical properties and spectral data.RESULTS Ten compounds were isolated and identified as dodecane (1),palmitic acid (2),arachidic acid (3),β-sitosterol (4),betulinic acid (5),deoxyschisandrin (6),γ-schizandrin (7),schizandrin C (8),gomisin B (9),schisantherin A (10).CONCLUSION Compounds 1 and 5 are isolated from this plant for the first time.

Objective To optimize the formula of konjac glucomannan-paeonol matrix tablets. Methods The formula of paeonol matrix tablets was optimized by the orthogonal design with the accumulative release rate in vitro as index, with the viscosity of konjac glucomannan ( KGM) , the amount of KGM and lactose as influence factors. Results The optimized formula was as follows:the viscosity of konjac glucomannan was 20 000 mPa·s, KGM 30%, lactose 20% and the release in vitro fit into the Higuchi equation. Conclusion The formula of the paeonol matrix tablets is reasonable and the tablets have well release effect in vitro.

This article was aimed to propose and develop traditional Chinese medicine (TCM) health engineering, using modern science and technology, in order to carry out the detection research which reflected TCM features of human functional state. It was an important way to achieve TCM diagnosis and the objective evaluation on therapeutic effects of TCM. The combination of TCM health engineering with information technology, and the formation of TCM functional state intelligent identification system, as well as the extension into the Health Internet of Things (HIT) could provide more accurate and convenient services for human healthcare in the age of big health. And identification on TCM syndromes was the core to achieve this goal. Using characterization data on TCM syndromes could realize the data processing between TCM syndrome and prescription through intelligent computing, in order to form the TCM syndrome differentiation and treatment intelligent system. It had great significance in the promotion of TCM health project.

Objective Hepatocellular carcinoma with bile duct tumor thrombus (BDTT) is rare,and surgical treatment is currently considered as the most effective treatment.Whether resectional surgery should be carried out on these patients remains controversial.Therefore,this Meta-analysis aimed to find out the long-term survival after resectional surgical treatment.Methods We conducted a literature search on PubMed,Embase and Web of Science from inception to September 2016.11 studies were included which involved 5295 patients.Each study was evaluated using the Newcastle-Ottawa Scale.The pooled effect was calculated and the associations between BDTT and overall survival (OS) or disease-free survival (DFS)were reevaluated using Meta-analysis with hazard ratio (HR) and 95％ confidence interval (CI).Results The HR for OS and DFS was 2.34 and 1.81,the 95％ CI were 1.26 ～ 4.36 and 1.17 ～ 2.78,respectively.Conclusion HCC patients with BDTT had a bad prognosis after hepatic resection or liver transplantation.

Objective To investigate the expression and clinical significance of ROC1 in ovarian cancer tissues ,to provide new ideas for the gene therapy of ovarian cancer .Methods 261 women with ovarian cancer underwent resection from December 2005 to December 2007 in the Affiliated Hospital of Zunyi Medical College and with 5 years follow-up were enrolled .ROC1 mRNA transcription and protein expression level of ovarian cancer tissue and surrounding normal tissue were tested ,and later the correla-tion between the results and patient′s prognosis was statistically analyzed .Results ROC1 in ovarian cancer tissue was over-ex-pressed ,but almost no expression in surrounding normal ovarian carcinoma ;ROC1 expression levels had a negative correlation with the survival rate of the patients .Conclusion ROC1 in ovarian cancer tissue was over-expressed ,but almost no expression in sur-rounding normal ovarian carcinoma ;ROC1 expression levels had a negative correlation with the survival rate of the patients .

Aim To explore the influence of atorvastatin on the ultramicrostructure of the membrane surface of the rabbit endothelial cells in rabbit atherosclerosis(AS)in the nanometer level.Methods A total of 44 male New Zealand white rabbits were randomly divided into 3 groups:control group consisting of 12 rabbits,AS group consisting of 16 rabbits and atorvastatin group consisting of 32 rabbits.By the end of 2nd,6th week 6~8 rabbits of each group were sacrificed and the middle segments of thoracic aortas were obtained to be observed with atomic force microscope.Results The control group vascular endothelial cells(VECs)were fusiform in shape and aligned regularly.Their size were about 11.96 ?m?3.72 ?m and their macroaxis were in parallel with the direction of hemokinesis.VECs in the atherosclerotic group were in deformity and bigger than those of the control group.They aligned irregularly and their volumes changed to be swelled.The membrane protein of VECs in the control group was composed of many round and elliptical eminences,which were almost in the same size.and with distinct boundary lines.The membrane protein of VECs in the atherosclerosis group was composed of many irregular eminences in different size.It was vague among the eminences in which there were many holes.But the VECs of atorvastatin group were better than those of atherosclerosis group.The ultramicrostructure of the membrane surface of the atorvastatin group VECs was obviously improved.Meanwhile,the mean roughness(Ra)of membrane protein of three groups was compared.The Ra of the atherosclerosis group was significantly higher than that of the control group and the atorvastatin group(P

Objective To explore the application of mini-clinical evaluation exercise (Mini-CEX) in training the diagnostic thinking ability for clinical interns.Methods 83 interns who came to the First People's Hospital of Lianyungang for clinical practice in June 2015 were divided into the experimental group (45 interns) and the control group (38 interns) according to their schools.The two groups received the same clinical teaching according to internship program of five-year clinical medicine,while the experimental group had to take a weekly Mini-CEX training in chnical sections.The diagnostic thinking ability of the two groups was measured by the Diagnostic Thinking Inventory in Chinese version at the beginning and the end of the internship respectively.SPSS 21.0 was applied to processing the data.Measurement data were expressed as mean plus or minus standard deviation,and t test was used in the comparison between groups.Results At the end of the internship,the total score of diagnostic thinking,the score of knowledge structure in memory and the score of flexibility in thinking of the experimental group were higher than scores at the beginning statistically,and the experimental group had a statistically higher score than the control groups in knowledge structure in memory [(69.36 ± 4.28) vs.(66.95 ± 4.78),P=0.018].Conclusion Mini-CEX training can enhance the clinical diagnostic thinking ability of interns by improving their knowledge structure in memory.

Objective To discuss the ultrasonic features and diagnostic value of high frequency ultrasound in the diagnosis of the injury of triangular fibrous cartilage complex (TFCC) of wrist joint.Methods The ultrasonic features of 32 patients with pathology confirmed unilateral TFCC injury were retrospectively analyzed.The preoperative MRI and ultrasound data were complete.The difference between the two methods in diagnosis of TFCC injury were contrasted.Results The major ultrasonic features of the injure of TFCC included form swelled,structures disorganized,inhomogeneous echoes,irregular echoless in damaged place.The flow signals could be displayed from the tear opening edge of the injured TFCC by CDFI.Among 32 cases of TFCC injury,there were 26 cases (26/32,81.25％) diagnosed by ultrasound and 27 cases (27/32,84.38％) diagnosed by MRI.There was no significant difference in the detection rate of the two methods for TFCC injury (x2 =0.143,P=0.706).Conclusion High frequency ultrasound can be used to diagnose the injury of TFCC accurately,and can provide imaging evidence simply and rapidly for clinical therapy.

OBJECTIVE:To study the effect of paroxetine combined with low dose of olanzapine on sleep process and architec-ture of depression patients with insomnia. METHODS:84 depression patients with insomnia were randomly divided into control group and observation group. Control group was given 20 mg Paroxetine tablet,once every morning;observation group was addi-tionally given 2.5 mg Olanzapine tablet,once before going to bed. Sleep quality [Pittsburgh Sleep Quality Index(PSQI)],depres-sion scores [Hamilton Depression Scale (HAMD)],sleep process [sleep latency (SL),awakening times (AT),the actual total sleep time (TST),sleep efficiency (SE),rapid eye movement (REM) sleep latency (RL)] and sleep architecture [sleep stage 1 (S1),2(S2),3(S3)and the proportion of REM to sleep] in 2 groups before and 3,6 months after treatment and the incidence of adverse reactions(ADR)were observed. RESULTS:After treatment,PSQI and HAMD scores in 2 groups were significantly lower than before,and gradually decreased by time,and observation group was lower than control group;TST in observation group was significantly higher than before and control group,S1 in observation group was significantly lower than before,SE,S3 and REM in 2 groups were significantly higher than before,and observation group was higher than control group,SL,AT,RL and S2 were significantly lower than before,and observation group was lower than control group,the differences were statistically significant (P<0.05). There were no obvious ADR in 2 groups. CONCLUSIONS:Paroxetine combined with low dose of olanzapine can sig-nificantly relieve depression,optimize sleep process and sleep architecture,then impove sleep quality.