Objective To study the clinical effect of percutaneous laser disc decompression(PLDD) combined with ozone injection in the treatment of cervical spondylosis.Methods 183 cases of cervical spondylosis were randomly divided into two groups.One group of 80 cases with 118 cervical discs herniation were treated with PLDDonly.while the other group of 103 cases with 142 cervical discs herniation were treated with PLDD combined with ozone injectlon.The patients were followed up for 3 to18 months(mean 7 months).The clinical effects were assessed according to the Japanese Orthopaedic Association scoring system(JOA score)and the improvement rates of the two groups were compared.Results 167 cases were followed up.The average point of the group treated with PLDD is 15.2 and the improvement rate is 74.7%.The average point of the group treated with PLDD combined with ozone injection is 16.3 and the improvement rate is 91.3%.The difference between two groups has statistical significance(P＜0.05).Conclusion The treatment of cervical spondylosis with PLDD combined with ozone injection is safe.painless and minimally invasive.The clinical effect is impmved tremendously and much better than monotherapy.

Objective To explore the relationship among psychological empower,role stressors and job burnout in doctors.Methods According to convenience sampling principle,350 doctors were selected and assessed with the job burnout scale (MBI-GS),the psychological empower scale and role stressors scale.Results The scores of meaning(10.80±3.12) and self-determination (9.33 ± 3.19) were negatively correlated with the scores of job burnout (r value was from-0.28 to-0.47,P＜0.01),the scores of self-efficacy(11.42±2.67)were negatively correlated with the scores of cynicism (1.61 ± 1.21)and reduced personal accomplishment (3.62±1.51)(r=-0.23,-0.51,P＜0.01),and the scores of impact(8.04±3.18) were negatively corrclated with the scores of emotional exhaustion(1.89±1.19) and cynicism(r=-0.17,-0.25,P＜0.01).The scores of role stressors were positively correlated with the scores of emotional exhaustion and cynicism(r=0.15-0.45,P＜0.01),and the scores of role ambiguity(19.09±3.76) were positively correlated with the scores of reduced personal accomplishment (r=0.42,P＜0.01).The self-efficacy and self-determination can negatively predict job burnout(P＜0.01) ;the role overload(15.24±4.62) and role ambiguity can positively predict job burnout(P＜0.01).Conclusion Psychological empower and role stressors are closely related with job burnout,and have significantly predictive effects on job bumout.

Objective:To develop a chemiluminescent microparticle immunoassay ( CMIA) method for the determination of meco-balamin in human serum to investigate the pharmacokinetics and bioequivalence of mecobalamin. Methods:A single oral dose of two kinds of mecobalamin was given to 19 healthy volunteers in a randomized three-period crossover study. The concentrations of mecobal-amin in serum were assayed by CMIA, the main pharmacokinetic parameters were analyzed by DAS 3. 0 software, and the bioequiva-lence was evaluated. Results: The main pharmacokinetic parameters of test and reference mecobalamin tablets were as follows: tmax were (4.2 ±1.9)h and (4.4 ±2.4)h,Cmax were (322.0 ±145.4) ng·L-1 and (282.2 ±108.1) ng·L-1,t1/2 were (19.2 ±5.3) h and (20.0 ±6.3)h,AUC0-72 were (6 769.1 ±2 169.4) ng·h·L-1 and (6 400.6 ±1 921.5) ng·h·L-1. F(0-72) and F(0-∞) of the test tablets was 105. 9% ± 13. 2% and 104. 9% ± 12. 6%,respectively. Conclusion:The method is simple and precise. The two tablets are bioequivalent.

ObjectiveTo investigate and evaluate the result and the possibility of the clinical application of autologous chondrocyte implant (ACI).MethodsFrom November 2007 to June 2009,6 cases of knee articular cartilage defect were treated with ACI,including 2 males and 4 females with an average age of 39.5 years (range,19-55).All the defects were located on the condyles of femur with a mean size of 7.3 cm2 (range,3.8-11.6).ACI comprises a two-stage procedure:chondrocytes are first harvested from the non-load bearing area of the joint,expand in vitro to acquire enough cells,and then the chondrocytes are implanted.The defect of cartilage were covered with bone membrane and fixed with sutures and fibrin albumen glue.Lysholm score system,International Knee Documentation Committee (IKDC) grading system,and MRI were used to evaluate the effect of ACI,6 and 12 months post-operatively.ResultsAll the patients were followed up.The clinical outcomes of the 6 and 12 months follow-ups demonstrated increased of clinical scores.The MRI follow-up showed good filling of the defect with tissue having the imaging appearance of cartilage in all patients.Only one patient suffered adhesion,because she refused to finish rehabilitation exercises as our treatment advises.ConclusionAs the clinical effect of ACI for knee cartilage defect is satisfied,the ACI may be a good choice for treating knee cartilage defect in future.It is very important to control the indications strictly and guarantee to finish the post-operative rehabilitation exercises.

The experiment aimed to study the toxic effect of oral ricin on gastrointestinal tract and immune organs of mice with the dose of 1/5 LD50.In early days of intoxication,there was an obviously decrease in daffy weight and relative weight of thymus and spleen,fllowing the excretion of toxin,they had a trend of recovering to the normal state.Also,results of pathological section,scanning electron microscope and transmission electron microscope showed that ricin would induce a series of pathological reaction in intestines,meanwhile,the splenocytes displayed significant symptom of apoptosis and necrosis.

Objective To explore the effect of β-element on the oadiosensitivity of transplanted tumor, and its relationship with the expression of survivin. Methods The transplanted mice model was established through the cell suspension inoculation. The mice with transplanted tumor size of 0. 8-1.0 cm3 were randomly divided into 8 groups as blank control, 25, 45 and 100 mg/kg group, irradiation group,25 mg/kg + irradiation group, 45 mg/kg + irradiation group, 100 mg/kg + irradiation group. The tumor size was measured every other day until tumor size was double, and the growth curve was obtained. The average tumor growth inhibition rate of β-element and tumor size were attained at 2,4,6 and 8 d after β-element injection. The expression of survivin was detected with immunohistochemistry. Results The nude mice model was successfully established and the growth curves were obtained according to the tumor size.Between 2 and 8 d after β-elemene injection, the variation tendency of the average tumor growth inhibition rate was consistent with the size in β-elemene treatment groups. The antitumor effect of β-elemene was in a dose-dependent manner. The values of radiosensitivity enhancement factor were 0. 84,1.24,2.04 for 25,45 and 100 mg/kg group, respectively ,and the optimal dose was 45 mg/kg. β-element had little effect on the expression of survivin, and the expression of survivin significantly enhanced in irradiation group and decreased in β-element + irradiation groups. Conclusions β-elemene could enhance the tumor radiosensitivity through inhibitiong the expression of survivin.

Objective To investigate the CT features of hepatic mesenchymal hamartoma (HMH)in children.Methods Nine patients with HMH confirmed by postoperative pathology were enrolled,including 4 were males and 5 were females.Their age ranged from 3 days to 9 years 5 months (the median age was 7 months).All patients admitted due to palpable abdominal mass without jaundice.All patients were examed by contrast-enhanced CT before the operation.Results All the 9 cases showed solitary hepatic mass,among which 6 were in the right lobe,2 were in the left lobe and 1 involved in both lobes.The tumor size ranged from 7.0 to 22.5 cm (mean size was 13.5 cm) in diameter.The CT manifestations of HMH was related to the proportion and distribution of component in the masses.The masses were cystic (n =1),cystic-solid mixed (n =6) and solid (n =3).After contrast administration,the solid component and the septa of the mass showed enhancement while cystic component was not enhanced.Calcification was seen inside the tumor in one case.Conclusions The CT features of HMH in children are multitudinous which are related to postoperative pathological findings.With the clinical history,it is easy to distinguish HMH from the other hepatic tumors.

Objective To explore the correlationship between level of bFGF (basic fibroblast growth factor) in serum and synovia and X-ray severity (Kellgren-Lawrence Grading System) in patients with knee OA. Method 68 patients with knee OA were enrolled into this study. Knee OA grading was evaluated according to the Kellgren-Lawrence classification. bFGF levels in both serum and synovia were examined using enzyme-linked immunosorbent assay. Results The level of bFGF in serum and synovial fluid in patients with knee OA were positively correlated with radiographic severity (r = 0.619, P < 0.001 and r = 0.603, P < 0.001, respectively). Further analysis revealed that there was a positive correlation between the level of bFGF in serum and in synovia fluid (r = 0.688, P < 0.001). Conclusions Levels of bFGF in serum and synovial fluid were significantly increased in patients with OA, and levels of bFGF were positively correlated with radiographic severity. These findings indicate that bFGF levels may be a biomarker of disease severity and could play an crucial part in the pathophysiology of degenerative process in OA.

Objective To investigate the diagnostic and prognostic value of presepsin for sepsis.Methods Diagnostic accuracy test.The plasma presepsin levels of 57 sepsis patients,64 systemic inflammatory response syndrome (SIRS) patients and 120 healthy individuals admitted to the 263 Clinical Branch,General Hospital of Beijing Military Region between January 2012 and December 2013were detected by PATHFAST system.Receiver operating characteristic (ROC) curve analysis was used to assess and compare the diagnostic value of presepsin and procalitonin (PCT).Logistic regression model was used to estimate the association between presepsin and sepsis.In addition,the correlations between presepsin and the clinical characteristics were analyzed in sepsis patients.Results Sepsis patients [1 266 (754-2 181) pg/ml] had higher presepsin level than SIRS[517 (349-939)pg/ml] and healthy individual controls [(182 ± 56)pg/ml] (Z value was 5.94 and 10.71,respectively,P value was ＜ 0.01 for all).The areas under curve (AUCs) of presepsin and PCT were 0.81 (95％ CI:0.74-0.89) and 0.78 (95％ CI:0.71-0.86),respectively,with no statistical significance (x2 =0.60,P =0.47).After adjusted for PCT,presepsin ＞ 1 060 pg/ml was independently associated with sepsis,with odds ratio (OR) of 7.80 (95 ％ CI:3.07-20.32).Severe sepsis patients [2 723 (2 002-4 234) pg/ml] had higher presepsin than sepsis patients[1 145 (656-1 436) pg/ml] (Z =4.00,P ＜0.01).The patients with inhosptal mortality [2 365 (1 256-3 567)pg/ml] had higher presepsin than survival ones[1 146 (660-1 452) pg/ml] (Z =2.99,P =0.003).Presepsin was positively correlated with PCT (r =0.75,P ＜ 0.01).The reference for presepsin was 72 to 292 pg/ml.Conclusions Presepsin was an useful biomarker for sepsisdiagnosis.The diagnostic value of presepsin and PCT was not completely overlap,and combinational using of these two biomarkers may improve the diagnostic accuracy of sepsis.In addition,presepsin had potential value for prognosis estimation.

This study observed the protective effect of hypercapnic acidosis preconditioning on rabbit heart suffered from ischemia-reperfusion injury. Hypercapnic acidosis was established in animals with mechanical hypoventilation before ischemia-reperfusion. Thirty-two rabbits were randomly divided into 4 groups, with each having 8 animals in term of the degree of acidification: hypercapnic acidosis group A (group A), hypercapnic acidosis group B (group B), hypercapnic acidosis group C (group C), ischemia and reperfusion group (group IR). Animals in group IR were ventilated normally (tidal volume: 15 mL/kg, breathing rate 35 bpm). The PETCO(2) was maintained at the level of 40-50 mmHg for 30 min. Animals in groups A, B, C received low-frequency, low-volume ventilation to achieve hypercarbonic acidosis and the target levels of PETCO(2) were 75-85,65-75, 55-65 mmHg, respectively, with levels being maintained for 5 min. The animals then were ventilated normally to lower PETCO(2) to 40-50 mmHg. The left anterior branch artery of all the animals was ligated for 30 min and reperfused for 180 min. Then the infarct size was calculated. The cardiomyocytes were morphologically observed and ECG and hemodynamics were monitored on continuous basis. Acid-base balance was measured during procedure. Our results showed that the infarct size was (48.5+/-11.5)% of the risk area in the control group and (42.4+/-7.9)% in group C (P>0.05). Mean infarct size was significantly smaller in group B (34.5%+/-9.4%) (P<0.05 vs control group) and group A (31.0%+/-9.1%) (P<0.01 vs control group). It is concluded that HA-preconditioning can effectively protect the myocardium.
Acidosis, Respiratory/*physiopathology ; Hypercapnia/*physiopathology ; Ischemic Preconditioning, Myocardial/*methods ; Myocardial Reperfusion Injury/*prevention & control ; Random Allocation