Objective To investigate the clinical value of color Doppler ultrasound in the early diagnosis of acute cholecystitis infection ,in order to improve the diagnosis of acute cholecystitis infection .Methods 36 cases with acute cholecystitis infection were selected as the observation group , and during the same period the healthy people were randomly selected as the control group .The color Doppler performance of ultrasound was observed .The hepatic artery blood flow velocity and the maximum peak of the cystic artery (Vmax) and resistance index(RI) were meas-ured.ROC curve was observed to evaluate the specificity of color Doppler ultrasound for the disease .Results The incidence rates of weak bile sound transmission ,gallbladder wall thickness ,gallbladder enlargement ,ultrasound Mur-phy positive in the control group were 25.0%,16.7%,22.2%,8.3%,which in the observation group were 72.2%, 47.2%,100.0%,94.4%,the differences were statistically significant (χ2 =4.571,4.571,4.589,5.689,all P<0.05).The differences in hepatic artery and the cystic artery Vmax and RI were statistically significant between the two groups(P<0.05).ROC curve comparison showed that the correct rate of gallbladder enlargement in the observa -tion group was the highest (90.7%),the specificity was 90.7%,sensitivity was 90.6%,and other indicators of ultra-sound had no significant difference (χ2 =0.893,P>0.05).Conclusion Color Doppler ultrasound can show the form of acute infectious cholecystitis ,gallbladder wall degree of bile through sound etc .,it can improve the diagnostic value of the disease.

Objective To explore the neuroprotective mechanism of propofol by comparing the influence of propofol and isoflurane on inflammatory cytokines ( TNF-α、IL-1、ICAM-1 ) in patients with intracranial tumors. Methods One hundred and sixty-eight patients with intracranial neoplasm were randomly divided into two groups:the propofol ( Group P) and isoflurane (Group I),84 cases in each. Patients were given with propofol (3-6 μg·mL-1) by plasma target-controlled infusion or with continuously inhaled isoflurane ( 1%-2%) , respectively. The serum levels of TNF-α, IL-1 and ICAM-1 were detected before anesthesia and at 0,24,and 48 h after operation. Results The serum levels of TNF-α,IL-1 and ICAM-1 were significantly increased after operation as compared to baseline in both groups. The serum level of TNF-α was(69. 11±8. 95) and (76. 26±11.28) μg·mL-1,IL-1 was(21.57±3.19) and (29.58±4.38) ng·L-1,and ICAM-1 was (1.63±0.24)and (1.94±0.29) g·L-1 at 24 h post operation in Group P and Group I,respectively. These inflammatory cytokine levels were significantly higher in group I compared to group P at 24 and 48 h after operation (P<0. 05 or P<0. 01). Conclusion The target-controlled infusion of propofol brings about lower level of inflammatory reaction than isoflurane inhalation in patients with intracranial neoplasm,which may attribute to the mechanism of brain protection against injury.

Objective To explore the regulation and effect factors of arsenic expose and arsenic methylation level, then to provide a reference for study the function of arsenic metabolism in a arsenic poisoning process. Methods A meta-analysis was performed by two researchers. Twenty-five papers satisfying our priori eligibility criteria were included by searching Cochrane library, Pubmed, Springer, Embase and China National Knowledge Infrastructure. Based on the results of heterogeneity, a random or fixed effects model was chosen for the meta-analysis. Results The results showed that the following arsenic metabolites increased (all P<0.01) following arsenic exposure: inorganic arsenic [iAs; standardized mean difference (SMD): 1.07; 95% confidence interval (CI):0.61 - 1.53)], monomethyl arsenic (MMA; SMD: 1.10; 95% CI: 0.81 - 1.40), dimethyl arsenic (DMA; SMD: 2.50;95%CI:1.50-3.69), and total arsenic (TAs, SMD:3.10;95%CI:2.13-4.07). Additionally, the percentages of iAs (iAs%; SMD: 1.00; 95% CI: 0.60 - 1.40) and MMA (MMA%; SMD: 0.49; 95% CI: 0.21 - 0.77) also increased, while the percentage of DMA (DMA%; SMD: - 0.55; 95% CI: - 0.80 - - 0.31) decreased (P<0.01). The primary methylation index (PMI; SMD: - 0.57; 95% CI: - 0.94 - - 0.20), and secondary methylation index (SMI;SMD: - 0.27; 95% CI: - 0.46 - - 0.09) decreased (all P< 0.01). Compared to female, male had higher MMA%(SMD:0.44;95%CI:0.35-0.52), lower DMA%(SMD:-0.33;95%CI:-0.38--0.28) and SMI (SMD:-0.36;95%CI:-0.53--0.19). The smoker had higher MMA%(SMD: 0.22; 95%CI: 0.07 - 0.37) and lower DMA%(SMD:-0.16;95%CI: - 0.26 - - 0.05). The drinker had higher MMA% (SMD: 0.17; 95% CI: 0.07 - 0.27) and lower DMA%(SMD:-0.24;95%CI:-0.39--0.10). The older people had higher MMA%(SMD:-0.23;95%CI:-0.40--0.06). In addition, the body mass index may influence the percentages of MMA (SMD: - 0.18; 95% CI: - 0.31 - - 0.04, P < 0.01). Conclusion Arsenic exposure, smoking, drinking, and older age can reduce the capacity of arsenic methylation. Arsenic methylation is more efficient in women than in men.

OBJECTIVE:To establish a method for simultaneous determination of the contents of Cu,Pb,As,Cr,Cd,Ba, Mn,Sb and Hg in Ganmaoling granule. METHODS:ICP-MS was conducted. The sample was handled by nitric acid microwave di-gestion system,the mass concnetration of 9 metal elements were determined by ICP-MS with Ge,In,Bi as internal standard and standard substance of test element standards. RF power was 1 100 W,sampling depth was 8 mm,carrier gas was argon(Ar)with high purity and flow rate was 1.0 L/min. RESULTS:All 9 elements had good linear range between mass concentration and ion peaks (r=0.999 1-0.999 9),detection limits were in the range of 0.3-6.0μg/L;RSDs of precision,stability and reproducibility tests were no more than 6.0%;average recoveries were in the range of 80.0%-113.5%,and RSDs were in 1.0%-4.5%. CONCLUSIONS:The method is simple,rapid and accurate,and can be used for the determination of 9 metal elements in Ganmaoling granule.

Objective To investigate the impact of sputum suction under laryngoscope in stroke patients on the occurrence and prognosis of ischemic stroke-associated pneumonia (SAP).Methods A total of 127 cases with acute ischemic stroke (AIS) with Glasgow Coma Scale 6-12 scores,non-artificial airway and need for intensive care were enrolled.According to the suction practice,the cases were divided into laryngoscope euthyphoria group (practice group,PG,n =59),and conventional oral or nasal sputum suction group (control group,CG,n =68).The PG was perspectively studied,while the CG were analyzed retrospectively.All patients were cared with the Guidelines for the management of adult with hospitalacquired ventilator-associated and healthcare-associated pneumonia set by American Thoracic Society/Infectious Diseases Society of America in 2005 and the Guidelines for the early management of patients with acute ischemic stroke set by American Heart Association/American Stroke Association in 2013 including patting on the back of patients in prone position routinely in order to facilitating expectoration,phlegm elimination with physical vibration and apophlegmatic agent application during their stay in ICU.Incidences of SAP and 28-day mortality were calculated.Levels of inflammatory markers (white blood cell,WBC;highsensitive C-reaction protein;procalcitonin,PCT) in serum were detected.Adverse events related to laryngoscopy were documented.Results There were no significant differences in incidences of SAP and 28-day mortality between PG and CG groups (32.20％ vs.41.18％,P ＞ 0.05;47.37％ vs.53.57,P ＞ 0.05,respectively).However,there was statistically significant difference (P ＜ 0.05) in the ICU stay length and inflammatory markers,and the sputum suction process in PG did decrease the incidence of artificial airway establishment and mechanical ventilation (18.64％ vs.35.29％,P ＜ 0.05),and the laryngoscope euthyphoria method was proved to be a protective factor (HR =0.515;95％ CI 0.281-0.057,P =0.038).WBC and PCT were lower in PG group than in CG group (P ＜ 0.05).Conclusion Sputum suction under laryngoscope can reduce the probability of artificial airway establishment and invasive ventilator employment in patients with AIS,shortening ICU stay length and down-regulating levels of WBC and PCT.

Objective To analyse the breast conserving surgery feasibility in patients with advanced breast cancer after neoadjuvant chemotherapy.Methods Sixty patients with advanced breast cancer were collect-ed from June 2010 to June 2011, and were divided into breast conserving surgery after neoadjuvant chemotherapy group and modified radical mastectomy group according to the intention,30 cases in each group.They were given breast conserving surgery after neoadjuvant chemotherapy and modified radical mastectomy respectively,with fol-lowing-up for 3 years.The treatment effect and contrast analysis of two groups of breast cancer CTCs positive of the two groups were compared,two groups of late follow-up of patients with local recurrence and distant metasta-sis rate,overall survival and disease free survival rate were recorded.Results Compared with the modified radi-cal mastectomy group,CTCs detection rate in breast conserving surgery group had no statistical differences(P>0.05).Two groups of patients in clinical complete remission rate,partial remission rate,disease stability factor and local recurrence and distant metastasis rate,overall survival and disease free survival rate had no statistical significances(P>0.05).Conclusion The application of breast conserving surgery after neoadjuvant chemother-apy for patients with advanced breast cancer can achieve similar effect as modified radical mastectomy surgery treatment,and can be used as a effective treatment for advanced breast cancer.

Objective To analyze the data on hearing of recruited students from a teenager aviation school according to both the standards of PLA and those of the US Armed Forces , to learn about their differences in hearing standards in medi-cal selection, and to raise suggestions on establishing hearing standards for medical selection of flying cadets from teenager aviation schools .Methods The data collected on the first hearing test about hearing of students from Hebei Teenager Aviation School were collected .The validity of the data was determined according to the medical selection standards both of PLA and of the US Armed Forces respectively .The cases of qualified or unqualified recruits at high frequency and middle -low frequency were counted respectively and analyzed statistically .Results The unqualified recruits determined by PLA′s standards tended to be unqualified too when determined by the US Armed Forces standards .During the screening of high frequency hearing and the general hearing condition , the proportion of unqualified cases determined by the US selection standards was higher than that determined by PLA′s selection standard .In the screening of middle-low frequency hearing , no statistically significant difference was found in the proportion of unqualified cases when the two different selection standards were used.Conclusion The hearing standard for medical selection of flying cadets at high frequency in the US Armed Forces is stricter than that in the PLA .Meanwhile, the hearing standard at middle-low frequency in the US Armed Forces is different from that in the PLA , though there are no statistically significant differences in the proportion of unqualified cases.The hearing standards of the US Armed Forces are recommended in recruiting flying cadets for teenager flying schools .

Objective To investigate the etiologic effect of the lumbar facet joint morphology on the occurrence of degener?ative lumbar spondylolisthesis (DLS). Methods From January 2007 to July 2013, 115 patients with DLS treated in our hospi?tal were randomly selected. There were 28 males and 87 females with an average age of 57.3 years (range, 41-76 years). 115 age? and sex? matched people including 31 males and 84 females with an average age of 56.4 years (range, 45-77 years) free from DLS and back or leg pain were selected randomly as control group from a group coming for routine physical examination in our hospital. Both groups received lumbar anteroposterior and lateral X?ray films、CT scanning and multiplanar reformation, the degree of spondylolisthesis (Taillard index) was measured in DLS group on lateral radiographs; at L3,4 and L4,5 level of both groups the facet joint angles on CT scan images were measured and facet tropism was evaluated, the pedicle?facet angle (the P?F angle) was measured in the sagittal plane on multiplanar reformation CT images, and then all angles of corresponding level were compared and analyzed; L4,5 facet joint degeneration in both groups was evaluated and compared in bone window, the de?gree of spondylolisthesis (Taillard index) in DLS group at different degenerative grade of facet joints were analyzed. The corre?lation between L4,5 facet joint angle、P?F angle and degrees of spondylolisthesis were analyzed. Results All L4,5 spondylolisthe?sis in DLS group were grade I, the facet joint angles were more sagittal in DLS group than those in the control group at L 3,4 and L4,5 levels, and the P?F angles were more horizontal in DLS group compared with control group;the facet tropism in DLS group at L 4,5 level were significantly different as compared to the control group, but there was no significant difference at L 3,4 level between the two groups. Significant difference was found in L4,5 facet joint degeneration grade between two groups,but there was no significant difference in degree of spondylolisthesis during different degeneration grades in DLS group. There was no significant correlation between the facet joint angle and the P?F angle and degree of spondylolisthesis at L4,5 level in DLS group. Conclusion The facet joint morphology abnormality (smaller facet joint angle, horizontal P?F angle, the facet tropism) has an important etiologic meaning in the occurrence of degenerative lumbar spondylolisthesis, however its role cannot be excessively exaggerated. The facet joint de?generation is a secondary change with aging,while the development of DLS aggravates the degeneration.

Objective A method for quantitative determination of 16 kinds of organochlorine pesticide (OCPs) in aquatic prod-ucts by gas chromatography (GC)was established .Methods The sample was extracted by acetonitrile ,purified by Carb/NH2 ,and then determined by GC .Results The linear relations of 16 kinds of OCPs were good at 0 .05 - 1 .00 mg/L(r> 0 .998) .The limit of detection of OCPs was in the range of 0 .04 - 0 .31 μg /kg(S/N = 3) .When the standard levels were 50 ,100 ,200 μg /kg ,the recovery rates were 72 .6% - 115 .2% ,the relative standard deviations were 0 .6% - 7 .5% .Conclusion The method established in this stud-y is applied to the determination of 16 kinds of OCPs in real samples with satisfactory results .