Objective:To evaluate the diagnostic value and comparison of volume computed tomography digital subtraction angiography(VCTDSA) with 64-channel multidector row CT and three dimensional time-of-flight magnetic resonance angiography(3D TOF MRA) in intracranial aneurysms.Methods:In the blind retrospective study,the imaging data of 34 patients with suspected aneurysms were analyzed and diagnosed by DSA and/or surgery.The angiograms were interpreted by the presence,location,size of aneurysms and relationship of the aneurysms with the adjacent arterial branches(the image quality),as well as the sensitivity and specificity,by using 3D volume rendering techniques.Results:In 41 aneurysms of 34 patients,the overall sensitivity and specificity of VCTDSA on a per-aneurysm basis were 87.0% and 85.7% respectively,and those of 3D TOF MRA were 80.0% and 66.6% respectively.Compared with 3D TOF MRA,there was no significant difference in the size of detected aneurysms by both two angiographies,but with a higher rank of image quality in VCTDSA.Conclusion:VCTDSA is a fast and reliable technique,which can be the primary choice in the detection and characterization of intracranial aneurysms.And 3D TOF MRA can be complementary for patients with contraindications of VCTDSA.

BACKGROUND: Understanding of patch classification, characteristics, and reaction with host is necessary for best selection of reparative surgery materials.OBJECTIVE: To summarize the patch classification, characteristics and its application in pelvic reconstruction, as well as the complications.METHODS: A computer-based online search of PubMed database (http://www.ncbi.nlm.nih.gov/PubMed) and CNKI database (www.cnki.net/index.htm) was performed for related articles with the key words "patch, polypropylene, compound patch" in Chinese and "reconstructive pelvic surgery, repair, replacement" in English. Articles regarding patch classification, characteristics biocompatibility, and application effect, or in the same circle published recently in authoritative journals were included. A total of 24 articles were finally selected.RESULTS AND CONCLUSION: Polypropylene patch is weaved network, with large mesh, which allows for fiber tissue ingrowth and improves tissue intensity and tensile strength. Leukocyte and macrophage can enter the mesh, so the patch has good anti-infection ability. Expanded polytetrafluoroethylene is soft and smooth, with good tissue tolerance, and can prevent affixion with intraabdominal tissues. Moreover, the submicron pore diameter prevents bacteria invasion. The inflammation and foreign body reaction induced by the expanded polytetrafluoroethylene is the most slight among artificial synthetic materials.

Neonatal sepsis is a systemic infection in which bacteria or fungi invade blood circulation and grow in it in the neonatal period,caused by toxin produce from bacteria or fungi.Currently sepsis is the major causing morbidity and mortality in neonatal infectious diseases,its clinical manifestation is not obvious and this brings us a range of clinical problems.In this review,we discussed these characteristics epidemiology,etiology,pathophysiology,clinical features of neonatal sepsis and septic shock in adults,to deepen the understanding of neonatal sepsis.

Objective To evaluate the influence of tracheal intubation guided with light wand on hemodynamics in patients with obstructive sleep apnea syndrome.Methods Seventy-four patients with obstructive sleep apnea syndrome were randomly divided into light wand group (n =37) and laryngoscope group (n =37).The time to successful intubation,rate of successful intubation,changes of heart rate (HR),systolic blood pressure (SBP),diastolic blood pressure (DBP) and complications were compared in two groups.Results The time to successful intubation of light wand group was significantly shorter than that of laryngoscope group,while the rate of successful intubation in light wand group was significantly higher than that in laryngoscope group (P＜0.05).The HR,SBP and DBP at T1 were significantly lower than those at T0 in two groups (P＜0.05).The HR,SBP and DBP in two groups at T2,T3 were significantly higher than those at T1 (P＜0.05),and those indexes of light wand group were significantly lower than laryngoscope group at T2 and T3 (P＜0.05).The incidence rates of complications in light wand group were significantly lower than those in laryngoscope group (P＜0.05).Conclusion With the advantage of higher success rate,shorter time to successful intubation,more stable hemodynamics and fewer complications,tracheal intubation guided with light wand is worthy of popularization and application in clinical.

Dacryocystorhinostomy(DCR) has been regarded as the gold standard for the treatment of nasal lacrimal duct obstruction for over a hundred years.Currently,the treatment of nasolacrimal duct obstruction has grown along with the advances in endoscopic techniques developing and in-depth understanding of the mechanisms of lacrimal drainage.Endoscopic dacryocystorhinostomy,endolacrimal laser and intubation,lacrimal endoscopic recanalization and lacrimal bypass surgery have been employed to substitute for external DCR as treatment for nasolaerimal duct obstruction.The endoscope,laser and minimally invasive techniques provide higher successful rates with minimal wounds,lower rates of both recurrence and complications and allow quicker recovery after surgery.

Objective To observe the effect of Valsartan on a rat model of acute lung injury and the expression of transforming growth factor-β,TGF-β) ,Smad2/3, Smad7. Methods Twenty-four male adult Sprague-Dawley rats were random divided into three groups : The bleomycin (BLM) group, the control group, and the Valsartan group. Each group contained eight rats. The Valsartan group was treated with Valsartan everyday at a dose of 20 mg/kg after a single intratracheal instillation of bleomycin at a dose of 5mg/kg. BLM group was treated with saline instead of Valsartan after an instillation of bleomycin. The control group was treated with saline instead of Valsartan and bleomycin. Each group was killed at the 7th day after instillation. The lung tissues were harvested for H. E. stain, the immunohistochemistry was used to detect the expressions of TGF-β1, Smad2/3 ,and Smad7. Results The degree of alveolitis in the Valsartan group was ameliorated, compared with those in BLM group (P ＜0. 01). The expressions of TGF-β1 and Smad2/3 in lung tissue of the Valsartan group were significantly lower than that of BLM group(P ＜0. 01). The expressions of Smad7 in lung tissue of the Valsartan group were significantly higher than that of BLM group (0.23 ±0. 02 vs0. 36 ±0.03, P ＜0.01). Conclusions Valsartan could alleviate acute lung injury in rats, which probably be due to the expression decrease of TGF-β1 and Smad2/3 and the expression increase of Smad7 in lung tissues.

BACKGROUND: Injectable hydrogel-chitosan is the latest developed material for cartilage tissue engineering. It provides a novel cell attachment mechanism. OBJECTIVE: To investigate the effect of allologous chondrocytes in combination with chitosan in repairing cartilage defects. DESIGN, TIME AND SETTING: Randomized controlled animal trial was performed at the Central Laboratory of China Medical University from November 2004 to March 2006. MATERIALS: Thirty 2-week-old New Zealand rabbits weighing 0.3 kg were selected to model cartilage defect. METHODS: Thirty rabbits were randomly divided into three groups. In the experimental group, the defects were repaired by the injection of second passage of chondrocytes (2.5?1011 L-1) combined with chitosan into articular capsule; the cell suspension group was only injected with chondrocyte suspension (2.5?1011 L-1); the control group was not given any treatment. MAIN OUTCOME MEASURES: The animals were sacrificed at the 4th, 8th, and 12th weeks after operation, respectively to harvest the lateral condyle of knee joint. Hematine-eosine staining, gross and histological examinations, and electron microscopic evaluations were performed to observe the repair condition. RESULTS: The gross observation showed that there was no obvious swelling or other inflammatory responses in each rabbits. Histological examination suggested that in the experimental group, the cartilage defects were repaired by the hyaline cartilage tissue with smooth surface, which integrated smoothly with articular cartilage at 12 weeks after operation. No obvious defect repair was observed in the other groups. The transmission electron microscopic observation showed that in the new-formation tissues of the experimental group, there were round or oval chondrocytes, and abundant rough endoplasmic reticulum, ribosome and Golgi complex in cytoplasm. At 8 to 12 weeks, plenty of collagen fibers were found in cell suspension group. In the control group, only fibrous tissues were seen on the surface of defects. CONCLUSION: The articular cartilage defects of rabbits are repaired with allograft of chondrocytes seeded onto chitosan, indicating chitosan can serve as carrier in cell transplantation.

Tau is the most abundant microtubule-associated protein in the brain .If tau protein lost the normal function, the toxic effect should be showed and plays an important role in various central nervous system lesions .Hypoxic-ischemic encephalopathy ( HIE) is an important cause of mortality in the neonatal period and it is mainly characterized by neurological deficits such as cognitive limitations .However , the mechanism still needs further study , and the underlying re-lationship between tau protein and HIE lacks direct evidence .Some recent clinical study reported that tau protein expres-sion elevated in the serum of asphyxia children and had a high correlation with behavior deficient .In this review , we focus on 3 key points to provide new insights to understand the tau protein-related pathogenesis of HIE as followed:(1) tau pro-tein and its phosphorylation change during central nervous system development ;(2) comparison of tau protein expression in developing brain and adult brain under some neurological disorders;(3) potential pathological change of tau in HIE related pathological conditions , such as dysmyelination , inflammation response and glutamate metabolism .

Objective To discuss the application effect of real time ratio of patients and nurses in nursing human resource dynamic management.Methods Our hospital made full use of the information platform,inquiring the real time ratio of patients and nurses,in combination with mobile nurse library,implement dynamic vertical management of nursing human resources on the level of the hospital-wide nursing management.The overall manpower cost remained the same through internal reasonable adjustment to achieve the best configuration of human resources and met the clinical needs effectively.Results The running effect was satisfactory from July 2012 till now.All the mobile nurses allocated were 71 person-times and the satisfaction degree of patients increased to 97.96％ in the first half of 2013.Conclusions Application of real time ratio of patients and nurses shows good effect,which is worthy of wide application.

Objective To investigate and analyze the structure change of professional title and educa-tion background of nursing human resourse in Liaoning province in recent 3 years and raise up suggestions which suit for the structure and development of human resource of current nursing model. Methods Investi-gation scales for nursing human resource in Liaoning province were sent out to 85 hospitals in Liaoning province.SPSS 12.0 software was used to carry out statisdcal discription for these data. Results The main professional fide was primary. The main education background was junior college and technical secondary school in third-class hospitals and technical secondary school in second-class and first-class hospitals. Conclusions The professional title and education background of nursing human resourse in Liaoning province was not reasonable with imbalanced structure in various level of hespitals.The countermeasures included reform of nursing education, reasonable allocation and effective utilization of current nursing human resource and sys-tematization of continuing education.