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.

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.

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.

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.

Objective:To study the quality standard for Herba Desmodii,and provide the scientific basis for a reasonable method of quality control. Methods:With the methods of microscopic identification,thin-layer chromatography and high performance liquid chromatography for the qualitative and quantitative determination of Herba Desmodii,the ethanol soluble extracts,moisture content and total ashes of Herba Desmodii were determined. Results:The characteristics of thin-layer chromatography were obvious;a good lineari-ty of quercetin and kaempferol was within the range of 0. 002-0. 050 μg(r=1. 000 0)and 0. 004-0. 100 μg(r=0. 999 9)with the av-erage recovery of 97.89%(RSD=0.89%,n=6)and 98.93%(RSD=1.31%,n=6),respectively. Conclusion:The method is simple,accurate and reproducible,which can effectively control the quality of Herba Desmodii.

Objective: To discuss the quality control method and index of traditional She medicine -Melastoma dodecandrum. Methods:The contents of gallic acid , ellagic acid and total flavonoids ( the total amount of quercetin and kaempferol) were deter-mined by HPLC. Water content, acid insoluble ash content, extract, heavy metals and harmful elements in 26 batches of herbs were also detected. Results:The content range of gallic acid, ellagic acid and total flavonoids was 9. 84-26. 31 mg·g-1 , 4. 13-16. 11 mg· g-1 and 1. 31-38. 28 mg · g-1 , respectively. The content range of water, acid insoluble ash and extract was 6. 70%-13. 90%, 1. 05%-6. 20% and 18. 00%-40. 80%, respectively. The content of Pb in all the samples was more than 5 ppm, the number of sam-ples with the content of Cd above ten thousand three was 7, and the content of As, Hg and Cu in all the samples was less than 1 ppm, ten thousand one and 20 ppm, respectively. Conclusion:The contents of gallic acid, ellagic acid and total flavonoids can comprehen-sively reflect the content of active ingredients in Melastoma dodecandrum. The contents of acid insoluble ash, Pb and Cd in Melastoma dodecandrum are relative high, which should be studied further to draw up reasonable limit.

Immobilization conditions of Candida tropicalis to be absorbed in polyurethane foam carrier materials were studied on the xylitol production from corn hemicellulosic hydrolysate. Optimum batch-fermentation conditions were as follows: inoculum amount, 7% (volume ratio); polyurethane foam quantity, 1.0 g/100 mL; 30?C; initial pH, 6.0. Shaking speed was divided into two-phase to accommodate the dissolved oxygen, with 200 r/min at 0~24 h and 150 r/min at 24 h~46 h. The immobilized cells on polyurethane foam carrier have high density and good resistance to inhibitors in the hydrolysates. Average xylitol yield and volumetric productivity of polyurethane foam immobilized fermentation were much higher than the fermentation without immobilization. Corn cob hydrolysates can be directly biotransformed to xylitol without decoloration or ion-exchange treatment. This process can effectively reduce production costs, and it shows broad prospects of applications. Average xylitol yield was 67.6% and xylitol volumetric productivity was 1.92 g/(L?h).

Objective To explore the effect of flipped classroom in teaching auricular needling method. Methods Sophomores of acupuncture and Tuina speciality were divided into two groups based on classes, with 33 students in experimental group and 30 in control group. In teaching auricular needling method, experimental group adopted flipped classroom by online resources and classroom activities, while control group adopted traditional classroom such as teaching, watching video, demonstration. Post-test score of two groups were compared by independent samples t-test. The teaching effect of flipped classroom was evaluated by questionnaire survey of students in experimental group. Results The total score of auricular needling (88.4±13.91), score of location (55.40±7.34), and score of application (32.00±10.31) in experi-mental group were significantly higher than those in con-trol group (71.48±15.93, 47.55±12.23 and 23.94± 11.97) (P<0.05). Students' satisfaction concerning the flipped classroom in experimental group was up to 90%. Conclusion Flipped classroom can be used in teaching auricular needling method, which can improve teaching quality and promote improvement of students' self-study and communication skills.

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.