Objective To evaluate the efficacy of ambroxol on community acquired pneumonia (CAP) in elderly patients.Methods Totally 120 patients with CAP were selected and divided into 3 groups:low-dose group (patients received ambroxol 15 mg intravenously,3 times per day,n=40),conventional-dose group (patients received ambroxol 30 mg intravenously,3 times per day,n=40)and control group (patients received routine treatment including antibiotic therapy and oxygen inhalation,n=40).All patients were treated for 7 days.The levels of white blood cell (WBC),high sensitivity C-reactive protein (hs-CRP) and procalcitonin (PCT) were determined dynamically during the treatment.Results The markedly efficient rate,efficient rate and inefficient rate were 62.5％ (25/40),15.0％ (6/40) and 22.5％ (9/40) in low-dose group,82.5％ (33/40),15.0％ (6/40) and 2.5％ (1/40) in conventional-dose group,40％ (16/40),15.0％ (6/40) and 45.0％ (18/40) in control group,respectively.The total efficient rates were 77.5％,97.5％ and 55.0％ in low dose,conventional dose and control groups,respectively.The markedly efficient rate was higher in lowdose,conventional-dose groups than in control group (x2 =15.29,P＜0.05).There was a significant difference in markedly efficient rate between low dose and conventional-dose groups (x2 =4.01,P＜ 0.05).The total efficient rate was higher in low-dose,conventional-dose groups than in control group (x2 20.22,P＜0.05).There was a significant difference in total efficient rate between low dose and conventional-dose groups (x2=7.31,P＜0.05).Compared with before treatment,the levels of WBC,hs CRP and PCT were decreased in 3 groups after treatment (all P＜0.05).The levels of WBC,hsCRP and PCT were decreased more remarkably in low dose,conventional-dose groups than in control group (all P＜0.05).There was a significant difference in the decrease of WBC,hs-CRP and PCT levels between low-dose and conventional-dose groups (all P＜0.05).Conclusions Conventional dose ambroxol treatment (30 mg,iv,3 times/d) is an efficient therapy for community acquired pneumonia in elderly patients.

BACKGROUND:The finite element model has been developed from two-dimensional model to three-dimensional model, from linear model to nonlinear model. As the advantage of this method in the analysis of mechanical characteristics of the irregular objects, the finite element model has been widely used in the research of orthopedic biomechanics, especial y in the research of hip joint. OBJECTIVE:To analyze the stress state of human femur with finite element analysis method and to investigate a method that can rapidly construct femoral finite element model and precisely analyze the biomechanics. METHODS:Normal male femur was used as specimen for CT scan to obtain cross-sectional images of femur in each slice. Three-dimensional reconstruction was performed with DICOM data and MIMICS software, then the femoral three-dimensional finite element model was established with the finite element analysis ABQUS 6.8 software, and the stress distribution of the model was analyzed under loading condition. RESULTS AND CONCLUSION:Based on DICOM data, three-dimensional finite element model of femur was constructed more quickly and precisely. The models were divided into 38 636 nodes and 201 422 units. The model included the parts of cortical and cancel ous bone. The biomechanical test results were accorded with the previous results, so the model could objectively reflect the real femur shape and biomechanical behavior with high precision. The Mimics software provided a simpler and effective method for the construction of femur model and improved the efficiency of modeling, and the three-dimensional finite element model based on DICOM data was accurate in shape and can be used for the normal research on biomechanical behavior of femur. The stress distribution analyzed with ABQUS 6.8 software is consistent with the clinical observation.

The paper tells how the authors' hospital managed under the circumstances of fierce competition in the medical market to integrate the idea of a marketing chain with medical service, construct a quality and efficient marketing chain for medical service, constantly readjust each part and element of the “chain management” of technical items and service manner, and realize multi layer and multi dimensional network management. The hospital also established a “chain management” framework characterized by “compliance with market laws, customers highest and delivery of quality service”. Setting on itself such high demands as “highest speed, best quality, lowest cost and optimal service”, the hospital did its best to create a strong marketing chain for medical service products, thus providing theoretical basis and practical reform experience for the marketing of medical service products.

Objective:To observe the expression of nuclear factor kappa B(NF-kB) during the replacement of primary and permanent teeth in dog. Methods:By immunohistochemistry, expression of NF-kB was examined in the tissues around deciduous tooth root at resorption stage in 2 dogs aged 3-4 months.Results:NF-kB positive signals were observed in the osteoclasts up to the permanent tooth germ and in odontoclasts in the medial wall of the pulp cavity of deciduous teeth.Conlusion:NF-kB may involve in the eruption of permanent teeth during the stage of the replacement of primary and permanent teeth.

BackgroundThe neutrophils infiltration and vascular endothelium damage are found in the patients with diabetic retinopathy (DR).Calprotectin existes in the cytosol outside lysoome.It is thought to be a marker of inflammation.The effect of calprotectin in the development of DR is still in the study. Objective This study was to investigate the contents of plasma calprotectin in different stages of DR in patients with type 2 diabetes mellitus. Methods This was a case-control study.Sixty consecutive patients with type 2 diabetes mellitus were enrolled in this study.The patients were assigned to non-DR (NDR) group,non-proliferative DR (NPDR) group and proliferative DR (PDR)group according to fundus appearance and fundus fluorescein angiography(FFA) manifestation and 20 patients for each group.Twenty healthy subjects matched in gender,age and blood biochemical indicators were collected as the normal control group.The periphery blood samples were collected from the subjects for the detection of plasma calprotectin by ELISA.The plasma calprotectin levels were compared among different stages of DR and normal subjects.All subjects had signed informed consents.Results The contents of plasma calprotectin were (57.70±12.29 ),( 72.07± 10.14 ),( 87.70 ± 10.37 ),( 94.36 ± 9.40 ) ng/L in the normal control group,NDR group,NPDR group,PDR group respectively,with a statistically significant difference among 4 groups (F =73.09,P＜0.001 ).The content of calprotectin in PDR group showed a highest value in comparison with normal control group,NDR group and PDR group(q =20.157,10.648,4.497,P＜0.01 ).The content of calprotectin in NPDR group was significantly higher than that in NDR group( q=6.216,P＜0.01 ). ConclusionsPlasma calprotectin may play a role during the development of DR in type 2 diabetes mellitus patient.

Objective To develop the numerical method for the steady and unsteady wet steam condensing flow in turbine stage. Methods An Eulerian/Eulerian numerical model is used to describe the spontaneous condensation flow in the steam turbine. For the steady condensing flow computations, the mixing plane model was used. For the unsteady condensing flow computations, the sliding mesh method was used to simulate the rotor-stator interactions. Results The numerical results showed the obvious differences between non-condensing and condensing flows. The results also showed the unsteadiness effect due to rotor-stator interactions had a deep influence on the formation and growth process of water droplets. Conclusion The numerical methods presented in this paper are valid for the condensing flow in the turbine stage.

Objective To find out the clinical effect of integrative therapy for pregnant women with viral myocarditis(VMC).Methods The experimental group 60 VMC maternal cases were treated by integrative therapy,while the control group 43 patients were treated by simple western medicine,the efficacy of two treatments were compared,and left ventricular function,myocardial enzymes and other indicators were compared.Results Markedly effective rate of control group was 48.84％,and total effcctive rate was 72.09％ ; markedly effective rate of experimental group was 65.00％,and total effective rate was 91.67％.Markedly effective rate and total effective rate of experimental group were significantly higher(P ＜0.05).After treatment,stroke volume,ejection fraction and cardiac output index of experimental group were significantly higher than before treatment (P ＜ 0.05 ); After treatment,the indexes of experimental group and control group were significantly different ( P ＜ 0.05 ).After treatment,creatine kinase,creatine kinase myocardial isoenzyme,aspartate aminotransferase and lactate dehydrogenase index of experimental group were significantly lower than before treatment ( P ＜ 0.05 ) ; After treatment,the indicators of experirnental group were lower than control group( P ＜ 0.05 ).Conclusion This prescription is used to treat pregnant women with valid prescriptions of VMC,the clinical efficacy of integrative medicine is significant,the cardiac contractile function can he improved,and a strong application advantages is shown compared to conventional therapy with simple western medicine.

Objective To evaluate the efficacy and safety of high-dose ambroxol in treating acute exacerbations in chronic obstructive pulmonary disease (AECOPD).Methods The trial design was random,open,and parallel control.126 patients with AECOPD were involved.High-dose group received ambroxol 150 mg 3 times per day for 7 days (n=46),while conventional-dose group given ambroxol 30 mg 3 times per day for 7 days (n=40) and control group was given a routine treatment (antibiotic therapy,oxygen inhalation and bronchodilators) (n=40).Results The effective rates of high-dose group and conventional-dose group (95.6 ％,77.5 ％) were significantly higher compared with control group (55.0％) (x2 =19.81,4.53,both P＜0.05).The average duration of hospitalization was significantly lower in high-dose group (10.78 ±0.95)d and conventional-dose group (11.75±0.84)d comparing with control group (13.15±0.89)d (q=11.88,7.24,both P＜0.05).The clinical efficacy in high dose group was much better.Conclusions High-dose ambroxol is a safe and efficient therapy in the treatment of acute exacerbations in chronic obstructive pulmonary disease.

It is a difficult problem of forensic medicine to accurately estimate the post-mortem interval. Entomological approach has been regarded as an effective way to estimate the post-mortem interval. The developmental biology of carrion-breeding flies has an important position at the post-mortem inter-val estimation. Phorid flies are tiny and occur as the main or even the only insect evidence in relatively enclosed environments. This paper reviews the research progress of carrion-breeding phorid flies for esti-mating post-mortem interval in forensic medicine which includes their roles, species identification and age determination of immatures.

Objective To evaluate the effect and safety of the argon plas ma coagulation (APC)a non－ touched technique via endoscopy. Methods Various po wer setting (40 W,60 W,80 W) at increasing exposure time (1 sec,3 sec,5 sec) wer e used during application of APC to different mucosa (gastric body and autrum) o f fresh stomaches gotten from 5 pigs.Histologic appearance and measurement of de pth and diameter of tissue necrosis area were examined through light microscope. Results Under the same power,the depth and the diameter were increased with th e exposure time increasing(P