Objectives To determine the causes of cubital tunnel syndrome by performing operation,and to assess the clinical value of neurophysiologic diagnosis in cubital tunnel syndrome Methods Twenty one patients (22 limbs from 16 men and 5 women, aged from 22 to 63 years, with mean age of 49 years)suspected of ulnar nerve involved in clinical symptoms and the signs of ulnar distribution were recorded with motor conduction velocity at different sites along with the ulnar nerve and sensory conduction velocity in the hand,and underwent anterior transposition of the ulnar nerve Results Electromyographic abnormality was seen in 21/22 (range MCV 15.9～47.5 m/s,mean 32.7 m/s) of patients with motor conduction velocity in across elbow segment of the ulnar nerve. And slowing was seen in 13/22 (MCV 15.7～59.6 m/s, mean 40.4 m/s )patients with MCV in the forearms. The absent or abnormal evoked sensory nerve action potential was seen in 14/22 patients in the little finger. The factors of ulnar compressed in this study by operation were:15 ulnar nerves compressed by arcuate ligaments, or muscle tendons, or bone hyperplasia; two were involved in fibrous by adhesion;three compressed by venous plexus or concurrent thick vein;two compressed by cysts Conclusions The factors of cubital tunnel syndrome include either the common factors reported or the rare factors, such as the venous plexus, thick vein and cysts. The tests of motor conduction velocity at different sites along the ulnar nerve should be helpful in diagnosis of cubital tunnel syndrome, especially the slowing velocity of MCV across the elbow segment.

Objective To explore and improve the hospital consumables logistics distribution and cost control system based on consignment mode to solve the current problems in many hospitals for material management.Methods Improvement measures were taken from the aspects of network information system,inventory management,establishing organization architecture and post responsibility as well as introducing IOT technology.Results The system contributed to optimizing consumables management flow and saved hospital cost.Conclusion The hospital consumables logistics distribution and cost control system based on consignment mode is of great value for the management of hospital consumables.

OBJECTIVETo explore the differentially expressed genes and related signaling pathways in MC3T3-E1 osteo- blasts in response to suitable fluid shear stress values and action time with cDNA microarrays.

METHODSMC3T3-E1 cells cultured on a cover slip were subjected to fluid shear stress using a parallel plate flow chamber. The harvested RNA was used for microarray hybridization comprising approximately 44 170 genes, as well as for the subsequent real-time quantitative polymerase chain reaction validation of expression levels for selected genes. Microarray results were analyzed by using both GO and Pathway analysis.

RESULTSMicroarray analysis indicated that 884 differentially expressed genes were found. Among these genes, 444 were upregulated, whereas 440 were downregulated. The Notch signal and RIG- I -like receptor signaling pathways were involved in the Pathway analysis. GO analysis mainly involved different functional classifications, such as prostaglandin biosynthesis, nitric oxide-mediated signal transduction, calcium mediated signal, and cellular immune response, among others.

CONCLUSIONThe mechanism underlying the protective effect of fluid shear stress on MC3T3-E1 cells might be related to promoting cell survival- and inhibiting cell apoptosis-related signaling pathways and biological processes.

Apoptosis ; Calcium ; Humans ; Oligonucleotide Array Sequence Analysis ; Osteoblasts ; Signal Transduction ; Stress, Mechanical

Objective To explore the role of somatosensory evoked potentials elicited by paraspinal stimulation in the detection of spinal cord lesions.Methods Patients with clinically suspected spinal cord lesions underwent somatosensory evoked potentials(SEPs)and spinal cord conduction velocity(SCCV)test using paraspinal stimulating method.96 patients aged 15 to 75 years old with suspected spinal cord lesions of various aetiologies were tested.36 patients had demyelinating disease of the spinal cord,26 had sub-acute combined degeneration of the spinal cord,19 had myelopathy,10 had acute myelitis,5 had spinal cord corhpression.Results Paraspinal stimulation elicited somatosensory evoked potentials were Performed on all 96 patients,68 of whom underwent spinal MRI as well.SEPs and SCCV were found abnormal in a high ratio in all kinds of spinal cord lesions ; in general,78 among the 96 patients had abnormal SEPs with a sensitivity of 81.25%.27 out of 36 with demyelinating disease of the spine had abnormal SEPs with a sensitivity of 75.00%,23 out of 26 with subacute combined degeneration of the spinal cord had abnormal SEPs with a sensitivity of 88.46%,8 out of 10 with acute myelitis had abnormal SEPs,15 patients with myelopathy having abnormal findings,all 5 patients with spinal cord compression had abnormal SEPs.42 of 68 patients undergoing MRI revealed to be abnormal,in which 35 patients also had abnormal SEPs.The other 26 patients had normal spinal MRI,in which 21 patients had abnormal SEPs.Conclusions Paraspinal stimulation somatosensory evoked potentials and spinal cord conduction velocity may objectively document the abnormalities of electrophysiology,which occurs earlier than those of anatomy and radiological finds, therefore it may detect the dysfunction of spinal cord at an early stage.It is even more useful in the detecting of the metabolic myelopathy,which can hardly be detected by MRI.This technique is simple,inexpensive, and maybe useful in the diagnosis for patients with suspected spinal cord lesions.

Abstract: Occupational epidemiology aims to explore the effect of occupational hazards on the health of workers and understand ， their mechanisms. It plays an important role in occupational health and occupational medicine.Currently occupational ， ， exposures in the workplace are complex and diverse and multiple factors affect workers´ health at the same time. Therefore it is important to elucidate the pathogenesis of occupational disease caused by occupational hazards and implement early - - intervention. System epidemiology collects data on multi level exposure and multi omics information to conduct network analysis - on the relationship amongrisk factors. and to study the mechanisms of exposures and health outcomes based on multi level data. ， ， ， ， Using the study design of system epidemiology occupational environmental lifestyle and social factors are combined as a ， system to evaluate the health of workers which can better evaluate the adverse health effects caused by occupational hazards. - ， ， The studies base on multi omics design will explore the pathogenesis of occupational diseases at the molecular cellular and tissue levels to evaluate the impact of occupational hazards on workers´ health and to explore interventions from multiple - perspectives to reduce the occurrence of occupational or work related diseases.

AIM:To discuss the application value of retro-mode imaging by F-10 confocal scanning laser ophthalmoscope (cSLO) for detecting drusen in patients with age-related macular degeneration (AMD).METHODS:This was a retrospective case study.During the period of October 2015 to December 2016, 67 patients with unilateral AMD (67 affected eyes and 67 fellow eyes) were included in this study.All patients underwent color fundus photography, optical coherence tomography (OCT) and retro-mode imaging by F-10 cSLO.The features of drusen by color fundus photography, OCT and retro-mode imaging were comparatively observed in the affected eyes of patients with unilateral AMD.Positive numbers of drusen in the fellow eyes of patients with unilateral AMD detected by color fundus photography, OCT and retro-mode imaging were calculated and compared.RESULTS:Retro-mode imaging by F-10 cSLO gave easier to identify images of drusen than color fundus photography and OCT in the affected eyes of patients with unilateral AMD.In the fellow eyes of 67 patients with unilateral AMD, retro-mode imaging showed drusen in 56 cases(84%), color funds photography showed drusen in 36 cases(54%), OCT showed drusen in 48 cases(72%), the difference was statistically significant(χ2=14.31, P<0.05).The positive numbers of drusen detected by retro-mode imaging were significantly higher than color fundus photography, the difference was statistically significant(χ2=13.87, P′<0.0125).There was no statistically significant difference in the positive numbers of drusen detected by retro-mode imaging and OCT(χ2=2.75, P′>0.0125).CONCLUSION:Retro-mode imaging by F-10 cSLO provides a non-invasive technique and should be useful for detecting and monitoring drusen in AMD.

AIM: To comparatively analyze the application of laser confocal microscopy and corneal smear in the diagnosis of fungal keratitis.METHODS: Totally 77 patients (77 eyes) diagnosed as fungal keratitis were selected.Laser confocal microscopy and corneal smear examination were performed to observe the characteristics of the images, and the detection rate of fungus were compared between the two methods.RESULTS: Of the 77 patients, 66 eyes (86%) were positive and 11 eyes were negative detected by laser confocal microscopy;51 eyes (66%) were positive and 26 eyes were negative detected by corneal smear examination, the difference was statistically significant compared between two group (P<0.05).CONCLUSION: Laser corneal confocal microscopy is relatively safe and sensitive.If combined the application of laser corneal confocal microscopy and corneal smear examination in clinical, the diagnosis rate of fungal keratitis may be improved.

Background This meta-analysis evaluated the effect of noninvasive,positive pressure ventilation on severe,stable chronic obstructive pulmonary disease (COPD).Methods PUBMED,CNKI,Wanfang,EMBASE and the Cochrane trials databases were searched.Randomized controlled trials of patients with severe,stable COPD and receiving noninvasive positive pressure ventilation,compared with sham ventilation or no ventilation,were reviewed.The mortality,physiological and health related parameters were pooled to yield odds ratio (OR),weighted mean differences or standardized mean differences (SMD),with 95％ confidence interval (C/).Results Eight parallel and three crossover randomized controlled trials met the inclusion criteria.Pooled analysis for parallel,randomized controlled trials showed noninvasive positive pressure ventilation:(1) Did not affect the 12-or 24-month mortality (OR 0.82,95％ C/:0.48 to 1.41); (2) Improved the arterial carbon dioxide tension (SMD-0.88,95％C/:-1.43 to-0.34); (3) Did not improve forced expiratory volume in one second (SMD 0.20,95％ C/:-0.06 to 0.46),maximal inspiratory pressure (SMD 0.01,95％ C/:-0.28 to 0.29) or 6-minute walk distance (SMD 0.17,95％ C/:-0.16 to 0.50); (4) Subgroup analysis showed noninvasive positive pressure ventilation improved the arterial carbon dioxide tension in hypercapnic patients.Pooled analysis for crossover randomized controlled trials did not show improvement in arterial blood gas or forced expiratory volume in one second with noninvasive positive pressure ventilation.Conclusions Noninvasive positive pressure ventilation improves the arterial carbon dioxide tension but does not improve the mortality,pulmonary function,or exercise tolerance and should be cautiously used in severe stable chronic obstructive pulmonary disease.

OBJECTIVETo study the characteristics of dental arches in the patients with facial asymmetry.

METHODS20 facial asymmetrical patients were chosen as the study subjects. They were 8 boys and 12 girls, aged from 12-year to 16-year old. 20 normal occlusion persons without signs of facial asymmetry were chosen as control. Dental casts were measured by 3-dimension measuring machine. Dental arch asymmetry, coordination between upper and lower dental arch, and dental inclination were measured. SAS 6.03 was used in statistical analysis.

RESULTSThe distance from cuspid and the first bicuspid to the median palatal raphe in the side of crossbite was larger than that of contralateral side in maxilla. The distance from cuspid, bicuspids and the first molar to the midline in the side of crossbite was smaller than that of contralateral side in mandible (P < 0.05). The dental arch width of cuspid and first premolar in maxilla was smaller than that of mandible (P < 0.05) . Significant buccal inclination of the maxillary posterior teeth coupled with lingual inclination of the mandibular posterior teeth was found on the crossbite side. In contrast, significant lingual inclination of the maxillary posterior teeth coupled with buccal inclination of the mandibular posterior teeth was found on the contralateral side (P < 0.05).

CONCLUSIONThe width of upper anterior dental arch was smaller, and the inclination of upper and lower posterior teeth between crossbite side and counterside was different in facial asymmetry patients.

Bicuspid ; Cuspid ; Dental Arch ; Dental Occlusion ; Face ; abnormalities ; Facial Asymmetry ; congenital ; Female ; Humans ; Hyperplasia ; Male ; Malocclusion ; Mandible ; Maxilla ; Molar ; Tooth

Objective To investigate work stress state of nursing home staff and to analyze the influential factors affecting work stress.Methods Stratified random sampling method was adopted to investigate 180 nursing assistants by self-designed questionnaire,Work Stress Scale(WSS),Simplified Coping Style Questionnaire and internal-external locus of control scale investigation.Results Totally 174 valid questionnaires were collected.Variance analysis revealed there were significant differences of age and other factors.Stepwise multiple regression analysis showed five variables entered the equation,including workexpenence education level number of the cared ages work scheduline coping stule and explain 56.7％ of the total variable.Conclusion Nurse managers should pay attention to and improve achievement sense and mental adjustment ability of nursing assistants,to build a well-organized support system to reduce the workload.