Objective To observe the early rehabilitation effect of mild hypothermia on patients with herpes simplex viral encephalitis (HSE). Methods A total of 58 patients with HSE were randomized into two groups, a mild hypothermia therapy group (30 cases) and a normothermia control group (28 cases). Their rectal temperatures were controlled to (34±1)℃ and (37.0±0.5)℃ respectively. Serum levels of neuron specific enolase (NSE) were determined through radio-immunoassay (RIA). Soluble intercellular adhesion molecule-1 (sICAM-1) was measured with ELISA before and 1, 3, 5, and 7 d after treatment. The outcome was evaluated using the Glasgow Outcome Scale (GOS) 30 days after treatment. Results Compared with the normothermia control group, the mild hypothermia group's serum levels of NSE and sICAM-1 decreased quickly and significantly during the early stage of treatment and remained better 30 d later. Conclusion Mild hypothermia therapy can dramatically reduce inflamma-tion and facilitate the rehabilitation of damaged neurons, provide protective effects and improve the outcome for pa-tients with SHE.

Objective To evaluate the safety and efficacy of clinical application of three-dimensional printing technology (3D printing) in Orthopedics.Methods The safety and effectiveness of clinical application of three-dimensional printing technology in Orthopedics were analyzed by systematic review of non-control studies.Results Non-control studies showed that cortical perforation rate of screws was 3.83％ (calculated by the number of screw).Complication rate was 2.13％,surgical infection rate was 0.28％,prosthesis problematic rate was 0.79％,the average operation time was 139.23 minutes,and some results of the indicators for safety and effectiveness were similar between studies with and without control groups.Conclusion Although 3D printing application in Orthopedics has some clinical value,and its extension needs economic assessment.

Objective To assess the effect of clinical application of three-dimensional printing technology (3D printing) in Orthopedics.Methods Comparing the effect of clinical application of three-dimensional printing technology with traditional Standardized technology,through using a systematic review and Meta Analysis.Results Meta analysis of 25 studies included in the research showed that application of 3D printing reduced operation time by 26 minutes,decreased intraoperative blood loss by 77 ml,and increased accuracy rate or success rate of screw implanting(increased by 2.10 times compared with tradit onal standardized technology).Conclusion The application of 3D printing in Orthopedics has good short-term effect But its deVelopment in clinical application should be cautious.

Objective To study onclinical researches of 3D printing technology in Orthopedics.Methods Through literature search,107 literatures were included and systematically reviewed,and the status of clinical researches of 3D printing technology in orthopedics was described.Results The clinical researches of 3D printing technology in Orthopedics were mainly focused on males and adults population conducted from 2007 to 2012.3D printing technology frequently used in Orthopedics were reduction and internal fixation,deformity correction,pedicle screw placement,tumor resection,revision and reconstruction,and knee replacement.Conclusion 3D printing technology in Orthopedics is still at an initial stage of clinical development.

OBJECTIVE:To provide reference for better improving the risk perception of Omeprazole sodium for injection in nurses in a third-grade class-A hospital,strengthening risk management of ward drugs and ensuring safety of patients. METHODS:Nurses in the clinical departments in a third-grade class-A hospital where usage frequency of Omeprazole sodium for injection was relatively more were adopted as study subjects and a self-designed questionnaire was used to investigate on related knowledge on medication risk in nurses in emergency department,gastroenterology department,ICU and CCU in 2012 and 2014. RESULTS:51 and 81 questionnaires were distributed in 2012 and 2014,and 51 and 81 were effectively received with effective recovery of 100%and 100%,respectively. In both surveys,100% surveyed nurses could correctly choose one solvent at least,1.96% and 3.70%nurses could correctly choose 2 solvents;correct answering rates of intravenous administration time were 94.12% and 96.30%,re-spectively;correct answering rates of stable duration after preparation were both lower than 9%;correct answering rates of adverse reaction of this drug were 3.92% and 1.23%,respectively;correct answering rates of interaction of this drug were 1.96% and 6.17%,respectively;correct answering rates of stable formulation of this drug were 17.65%and 22.22%,respectively;the propor-tion of nurses observing ADRs were 25.49% and 13.58%,respectively;the proportion of nurses finding inappropriate compatibility were 15.69% and 22.22%,respectively,Ornidazole and sodium chloride injection was the most used incompatible drug;45% or more nurses hoping to strengthen the continuing education of nursing personnel. CONCLUSIONS:Nurses in this third-grade class-A hospital lack certain knowledge on the medication risk of Omeprazole sodium for injection,the drug risk management is not sufficient,and awareness prevention of drug risk is relative weak. It is suggested that the hospital should strengthen drug risk management system,nurses should strengthen the learning about drug risk and play the role of clinical pharmacists in the drug risk management to reduce the related drug risk and incidence of adverse reactions.

Objective To determine the relationship between cigarette smoking and the incidence of systemic lupus erythematosus.Methods Database including Cochrane Library,Pubmed,OVID and Elsevier were electronically searched to collect case-control and cohort studies on the relationship between cigarette smoking and incidence of systemic lupus erythematosus.The literatures were screened and the data were extracted independently according to the inclusion and exclusion criteria.The quantitative analysis were performed by using Stata 12.0 software.Results The pooled OR values (95％ confidence interval)of current smoking and ever smoking were 1.82 (95％CI 1.42～2.34) and 1.22 (95％CI 0.96～1.56) respectively.Conclusions Our Meta-analysis revealed a moderate but statistically significant association between current smoking and development of systemic lupus erythematosus.However,it is still not confirmed whether the past smoking is one of the risk factors of systemic lupus erythematosus.

Objective To explore the effect and safety of transcranial approach for spheno-orhital meningioma. Design Retro- spective case series. Participants Thirty-two patients being operated with transcranial approach. Twenty-four cases were meningothelial meningiomas, 3 cases were fibrous meningiomas, 1 case was psammomatous meningioma, 2 cases were atypital meningiomas, 2 case were malignant meningiomas. Methods All patients underwent frontal-temporal craniotomy, the involved sphenoid wing bone and peri- orbit were removed to prevent recurrence. The superior orbital fissure and optic canal were decompressed, the dural and periorbital de- feet were repaired by autogenous temporal fascia or artificial dura. Main Outcome Measures Preoperative and postoperative exoph- thalmus and eyeball movement, the extent of tumor resection, the ratio of recurrence. Results The extent of tumor resection: 8 cases were Simpson gradeⅡ, 20 cases Simpson gradeⅢ, 4 cases Simpson grade IV. After surgery, proptosis were improved in all patients, ophthalmoplegia was found in 6 eases. There was no operation-related death or other significant complication. Tumor recurred in 6 cas- es. Conclusions Adequate exposure of the tumor and bony decompression of the cranial nerves can result from transcranial approach, all the involved bone should be removed in order to prevent recurrence. This approach is relatively safe and the ptoptosis are improved significantly. Complete surgical resection is difficult because of the involvement of the orbital apex, superior orbital fissure and cav- ernous sinus.

Objective To appraise the clinical value of velocity vector imaging(VVI) by analyzing the peak systolic velocities,strain and strain rate of ventricular segments in patients with DDD pacing. Methods eventeen patients with DDD pacing were enrolled in this study. The peak systolic velocities, strain andstrain rate of ventricular segments were measured with VVI. The difference at baseline and after pacemaker implantation was analyzed. Results Left and right ventricular (LV and RV) longitudinal peak velocities at baseline and after DDD pacing were significantly decreasing from basal, mid to apical segments. But no significant difference was found in longitudinal strain,strain rate and radial motion characteristic of LV. The mean systolic velocities and strain rate at baseline and after pacemaker implantation and strain with pacing of RV posterior septum and free wall were higher than those of posterior septum and lateral segment of LV respectively. The mean strain and strain rate of RV after pacing were higher than that of LV. Compared with the values at baseline, mean strain of LV with pacing was lower significantly. Conclusions VVI can accurately assess ventricular systolic function in patients with DDD pacing, and can become a powerful means in assessing the regional myocardial function.

Objective To survey the biliary flora in patients with obstructive jaundice due to pancreatic head cancer,also the multiple factors which affect the positive findings of bile culture in these patients.Methods The information of 65 patients with obstruetive jaundice due to pancreatic head eancer,who admitted to surgery in Huashan Hospital from Oetober 2007 to October 2008 were reviewed retrospectively.The factors which may potentially affect the detection of bile pathogen in patients with malignant obstructive jaundice were studied with univarite analysis and muhivariate analysis,including age,history of biliary surgery,yellow stained time,serum alanihe aminotransferase level,serum bilirubin level,CA19-9 level,tumor size,site of obstruction,with or without clinical manifestations of biliary infection,and APACHE Ⅱ score.Results Twenty-five positive cultures happened in 65 bile samples (38.5％),including 21 strains of Gram-negative baeilli (72.4％),6 strains of Gram-positive bacteria (20.7％),and 2 strains of fungi (6.9％).Univariate analysis showed that the relevant factors which may affect the rate of positive bile culture in patients with malignant obstructive jaundice were age,history of biliary surgery,biliary obstruction site,biliary tract infection symptoms and APACHE Ⅱ score.Multivariate analysis showed that age,history of biliary surgery,biliary obstruction site and APACHE Ⅱ seore were independent risk factors.Conctusion Age,history of biliary surgery,biliary obstruction site and APACHE Ⅱ score were independent risk factors which led to positive findings of bile cultures in patients with obstructive jaundice due to pancreatic head cancer.

Objective To identify the types of pulmonary complications after pancreaticoduodenectomy,and to discuss the prevention and management of these complications.Methods Clinical data of 165 cases of pancreaticoduodenectomy in our hospital were retrospectively analyzed.Pulmonary complications were identified,therapeutic effects were observed.Results The incidence rate of pulmonary complications was 19.4％ ( 32/165),case-fatality rate was 6.25％ (2/32),two patients died from pneumonia,respiratory failure and ARDS.Complications mainly included pneumonia 13.9％ (23/165),pleural effusion 4.2％ (7/165),atelectasis 3.6％ (6/165),pneumothorax 1.8％ ( 3/165 ),respiratory failure 2.4％ (4/165) and ARDS 1.2％ (2/165).Conclusion Pulmonary complications after pancreaticoduodenectomy are not rare,especially for pulmonary infection and most are hospital acquired pneumonia.To understand rules and particularity of respiratory physiopathological changes after pancreaticoduodenectomy is very important for patients to safely pass over the perioperative period.