Objective To investigate the predictive value of trauma index on the prognosis in pa-tients with traumatic spinal cord injury.Methods Enrolled 168 cases of patients with traumatic spinal cord injury,the traumatic index score and the American Spinal Injury Association (ASIA)grade were as-sessed on admission,then followed up for 6 months,the Spearman correlation analysis was performed to a-nalysis the relationship between trauma index and ASIA grade,and Receiver operating curve (ROC)anal-ysis was used to evaluate the relationship between trauma index and prognosis.Results There was a sig-nificant negative correlation between trauma index score and ASIA grade(r =-0.68,P <0.01).A total of 157 cases (93.5%)completed follow-up,the trauma index score had a good predictive value on the traumatic death in these patients,it's sensitivity was 71.4%,specificity was 76.1%,the best cut-off point was 25 points(P <0.01 );Compared with the low score group (<25 points),the high group (≥25 points)showed a lower ASIA grade and higher mortality,the differences were statistically significant (P <0.01).Conclusion The trauma index score was related with the spinal cord injury,and it is a predictive factor of poor prognosis in patients with traumatic spinal cord injury.

Objective To develop a rapid expansion assay and determine the predominant epitope for HBV-specific CD8 T cells from peripheral blood mononuclear cells(PBMC) of patients with acute hepatitis B(AHB).Methods PBMC were isolated from a patient with HLA-A2 positive AHB,and the frequency of HBV-specific CD8 T-cells was determined using 3 kinds of HLA-A2 antigenic peptide florescence-labeled pentamer agents,i.e.S183-191 and S335-343 derived from HLA-A2 restricted HBsAg epitope,and C18-27 derived from HBcAg epitope.Cytokines and corresponding epitopic peptides were used for induction of positive CD8 T-cell expansion and enrichment in PBMC for 1-2 weeks.T epitope-specific CD8 T-cells were quantified and sorted by flow cytometry.Results After cultivation with antigenic peptide stimulation and proper cultural condition,the frequency increased significantly in the pentamer positive HBV-specific CD8 T cells in total CD8 T cells.The peak value was observed in 2-week cultivation.At the time the HBV-specific CD8 T cell frequencies increased from 0.21% to 15.17% for S183-191,and from 0.44% to 1.79% for S335-343,representing 73.8-folds and 3.1-folds increase for each epitope respectively.However,the frequency of C18-27-specific CD8 T-cells was negative and without obvious proliferation after stimulation.Conclusions Under stimulation of HBV epitopic peptide in proper culture condition,the specific CD8 T lymphocytes may be induced and expanded in quantity via sort-term conditioned culture.CD8 T cells specific for S183-191 may play an important role in the control of acute HBV infection.

Objective To explore the effect of direct observation of procedural skills (DOPS) in teaching acupuncture manipulation skills. Methods Sophomores of acupuncture and Tuina spe-ciality were divided into two groups based on their classes, 36 students in experimental group and 31 in control group. In experimental group, DOPS on filiform needling was done twice in the middle and at the end of the semester respectively. In control group, DOPS was done once at the end of semester. The final exam's DOPS score and satisfaction degree of teachers and students concerning the results of the assessment in two groups were compared by independent samples t-test. P<0.05 indicates signifi-cant differences. The teaching effect of DOPS was also evaluated by questionnaire survey of students in experimental group. Results The total score of DOPS (4.26 ±0.24), scores of needle insertion (4.18±0.42), and scores of reinforcing and reducing method (4.03±0.28) in experimental group were higher than those in control group ((4.14±0.25), (4.00±0.29) and (3.87±0.37), P<0.05). The teachers' satisfaction (8.38±0.51) and students' satisfaction (8.47±1.03) concerning the results of the assessment in experimental group were higher than those in control group ((8.05±0.78) and (7.94±1.15), P<0.05). More than 80% of students in experimental group supported the saying of‘DOPS promoting students' skills training and enhancing the ability of handwork ’ . Conclusions DOPS can be used as an effective teaching and examination method and can improve students' skills of acupuncture manipulation.

We investigated health condition and evaluate the viability of Barthel's measuring scale for 1297 elder patients at 17 nursing homes.We nursed all patients by standards and performed a comparison study.The nursing percentages of highest and lowest levels were higher than the previous ones ( P ＜ 0.01 ),while the nursing percentage of normal level was lower than the previous one ( P ＜ 0.01 ).The cooperation between doctors and nurses became optimized through progressive patient care.Ideal nursing standard should be based upon the doctors' judgment and nurses' evaluation.The new standard will be more suitable for patients and easier to control for nurses.

BACKGROUND:Lipopexia induced by glucocorticoid is fat precipitation in marrow due to abnormal lipomatabolism,or differentiation of cells resulting from hormone-affected bone marrow mesenchymal cells.The precise generating procedure remains unclear.OBJECTIVE:To Jnvastigate effects of vadous concentrations of dexamethasone on adipogenic differentiation of bone marrow mesenchymal cells.DESIGN,TIME AND SETTING:The observational study was performed at the Department of Biochemistry,China Medical University from January 2007 to January 2009.MATERIALS:A total of 80 Sprague-Dawley rats aged 3 or 4 weeks,weighing (110±10) g,of both genders,were used in this study.METHODS:Rat bone marrow mesenchymal cells were isolated and subcultured.Bone marrow masenchymal cells at the third passage were used as samples.MAIN OUTCOME MEASURES:Cellular morphologic changes after treatment of 10~(-7) mol/L dexamethasone were observed under an inverted microscope,as well as at 3,7,14 and 21 days under normal culture condition.Morphological changes of bone marrow mesenchymal cells were observed following alkaline phosphatase and Sudan Ⅲ staining.Alkaline phosphatase activity was measured using phenol reagent.Effects of dexamethasone on cell proliferation were measured using MTT assay.RESULTS:Following 24 hours of incubation,a few adherent cells were found in the bottom of the culture flask,showing spindle shape.With prolonged time,adherent cells became more,presenting radiated shape.Following passage,cells distributed uniformly,showing typical fibroblast-shape.Following dexamethasone stimulation,cells changed from spindle-shape into polygonal or irregular shape.In the late phase,with increased concentration and prolonged time,cell colonies disappeared;cells adhered,and died.In normal cultured cells,no or a few orange particles were found.In dexamethasone-cultured cells,with increased hormone concentration and prolonged time,Sundan Ⅲ stained particles increased.At 21 days,alkaline phosphatase activity under normal culture was separately 1.57-,4.49-and 5.0-fold of 10~(-8),10~(-7),10~(-6) mol/L dexamethasone group.At 7,14 and 21 days,alkaline phosphatase activity under normal culture was separately 2.93-,3.80-and 4.39-fold of 10~(-7) mol/L dexamethasone group (P ＜ 0.05).High concentration of dexamethasone had significant inhibitory effects on cell proliferation activity.Significant difference was detected as compared 10~(-7) mol/L and 10~(-6) mol/L to other groups (P ＜ 0.05).CONCLUSION:High-dose dexamethasone enhances adipogenic and suppresses osteoblastic differentiation of bone marrow mesenchymal cells.The effect will increase along with the increasing content and prolonged duration of demamethasone stimulation.

To improve the clinical skills of medical students and to train qualified and profes-sional ophthalmologist,the school of optometry and ophthalmology in Wenzhou Medical College car-ried out reforms and innovations in clinical practice and training. In order to strengthen and train clin-ical thinking and clinical skills,and to cultivate the humanistic qualities of medical students,the di-verse-training mode were applied in clinical practice and training. In this paper explored the design goal, objective and actual effect of diverse-training mode for clinical practice and training.

Filiform needle acupuncture technique is the core content of needling and moxibustion method. The examination and assessment of filiform needle manipulation are the most important measure for testing the effect of filiform needle acupuncture technique teaching. The establishment of a scientific examination and assessment system of filiform needle manipulation should involve comprehensive examination and assessment contents, definite and detailed evaluation rules and quantified scoring criteria to make the examination and assessment system be able to comprehensively and objectively assess the students' skills of filiform needle manipulation to achieve the purpose of improving the quality of filiform needle acupuncture technique teaching.

AIM: To determine baicalin of scutellaria-extract rapidly by FT-NIRS and data analysis software. METHODS: The correction model was set up based on partial least square and was used to predict baicalin of scutellaria-extract in the samples. RESULTS: Cross validation and test samples determination showed that the co-rrelation coefficient(R2) of this correction model was 95.05,the RMSECV was 0.861,respectively. CONCLUSION: It is fast and convenient.The correction model could be used to predict baicalin of scutellaria-extract rapidly.It can offer reference to content determination of other extracts of Chinese herbs.

Background Different depthes or distances are prompted with many visual cues on the flat screen.Which kind of depth cues plays a major role in the accommodation of human eyes,in addition,whether this effect exists in the different distance are still below understood.Objective This study was to research the effect of the monocular space depth perception on accommodative response at different distances,and to analyze the effect of linear perspective and size-constancy perceptual depth cues on the level and amplitude of accommodative fluctation.Methods Four groups of visual targets were designed by FLASH software and placed at the front of eyes with the distance of 50 cm or 33.3 cm,representing static change from far to near and dynamic change from far to near,from near to far respectively.Twenty-six healthy volunteers aged 22-26 years were included in this study,with the spherical power of (-4.06± 1.99) D and cylindrical power of (-0.38±0.41) D under the informed consent.The accommodative response and accommodative fluctuations during monocularly watching the targets were recorded at 5 times/second by Grand Seiko WAM 5500 automatic infrared refractor.This study was approved by Ethic Committee of Wenzhou Medical University,and written informed consent was obtained from each subject before entering the study group.Results At the distance of 50 cm,the accommodative response caused by the depth perception of near was (1.52±0.46) D,the one of distance was (1.37±0.46) D,with a significant difference of 0.15 D under the combined effect of linear perspective and size-constancy (P =0.016).The accommodative response caused by the depth perception of big car was (1.43 ± 0.35) D,and the one of small car was (1.43 ± 0.36) D,without statistically significant difference under the effect of size-constancy alone (P =0.467).At the distance of 33.3 cm,the accommodative response caused by the depth perception of near was (2.40±0.53)D,and the one of distance was (2.35 ±0.51) D,without significant difference under the combined effect of linear perspective and size-constancy (P=0.379).The accommodative response caused by the depth perception of big car was (2.38±0.48)D,the one of small car was (2.39±0.52)D,without statistically significant difference under the effect of size-constancy alone (P =0.820).In addition,the total curve of accommodative microfluctuation showed apparent fluctuation periodically caused by the distance perception involving linear perspective only.Conclusions Monocular space depth perception has some impacts on the accommodative response at certain distance.Linear perspective,which is one of the depth cues of space perception,plays a major role in the accommodative response.Compared with the size-constancy,linear perspective can provide depth perception at higher level.The size-constancy has a little or contrast impact to the accommodation,because it depends on the assistance from other depth cues like linear perspective.

Background When focusing on a target,the accommodative system exhibits small variations in power within a range,termed microfluctuations.Exploring the correlation between the characters of microfluctuations and the aberrations of the eyes through a critical period-teenager can deepen the understanding of the onset and development of myopia.Objective This study was to investigate the correlation between accommodative microfluctuations and wavefront aberrations of human eyes,and to explore the role of accommodative microfiuctuations in the development of myopia.Methods A cross-sectional study was designed and performed.Fifty-four teenagers aged from 12 to 15 years were enrolled in this study in Eye Hospital,Wenzhou Medical University from 2010 to 2011,including 19 emmetropic subjects,18 incipient myopic subjects and 17 progressive myopic subjects,who were chosen based on the refractive changes for the last two years.The accommodative response and microfluctuations were measured by WAM-5500 infrared autorefractor with RSVP at 25,33 and 50 cm respectively,each RSVP distance was tested for 5 minutes.The accommodative values were divided into low frequency component (LFC) (0-0.6 Hz),middle frequency component(MFC) (0.6-0.9 Hz) and high frequency component (HFC) (1.0-1.4 Hz) after Fourier spectrum analysis.The wavefront aberrations of the whole eye and corneal were recorded by i-Trace aberrometer and Humphrey corneal topography.The differences of accommodative response,microfluctuations and aberrations were evaluated and compared among the emmetropic group,incipient myopic group and progressive myopic group.The correlations of accommodation and aberrations were analyzed.This study followed Declaration of Helsinki,and informed consent was obtained from each subject.Results Under the 25 cm and 33 cm reading distance,the accommodative response values were (2.78 ± 0.35) D and (2.19 ± 0.27) D in the emmetropic group,which were significantly higher than (2.44±0.33) D and (1.89±0.35)D in the progressive myopic group (P=0.002,0.003).LFC,MFC and HFC were remarkably increased as the reading distance decreased (Fdistance =8.480,14.270,21.400;all at P ＜0.01).A significant difference was seen in LFC among different reading distances (Fgroup =4.115,P＜0.05),and the LFCs in the progressive myopic group were considerably higher than those in the emmetropic group in the 25,33 and 50 cm reading distances (P=0.044,0.038,0.032).No significant differences were found in MFC and HFC among the three groups (Fgroup =0.859,0.682;both at P＞0.05).Under the 25 cm and 33 cm reading distances,significant positive correlations were found between LFC and corneal coma,intraocular coma,whole ocular aberrations or intraocular higher order aberrations (all at P＜0.05),however,no significant correlations were seen between MFC or HFC and wavefront aberrations (all at P＞0.05).Conclusions In teenagers,the accommodative response of emmetropia is much stronger than that of progressive myopia,and the accommodative microfluctuation in emmetropia and incipient myopia is much less than that in progressive myopia.These shifts are possibly associated with the variability,and microfluctuations of accommodation is greater in progressive myopes than emmetropes.There are certain correlations between wavefront aberrations and accommodative microfluctuations.The refractive group differences in the accommodative microfluctuations may be related to differences in the wavefront between myopes and emmetropes.Under near reading distance,LFC is correlated with higher order aberrations.