Objective To systematically review the effects of air or liquid in a loss of resistance technique for identification of the epidural space. Methods We searched the Cochrane Library, PubMed, EMBASE, Chinese Biomedical Database (CBM), CNKI, VIP and ChinaInfo for studies on the effects of air versus liquid in a loss of resistance technique for identification of the epidural space. The quality of the studies was evaluated by the method recommended by Cochrane Collaboration. Meta-analysis was conducted using the Cochrane Collaboration's RevMan 5.0.1 software. Results Seven prospective randomized controlled trials involving 5183 patients were included in our meta-analysis. The patients were randomly allocated into 2 groups according to the technique by which the epidural space was identified: loss of resistance with air group (group air, n = 2534) and loss of resistance with liquid group (group lidocaine, n = 2649). The results showed that the incidences of difficult catheterization, intravascular catheter insertion, incomplete block and post-operative headache were significantly lower in group liquid than in group air (P ＜ 0.05). There were no significant differences in the incidences of transient abnormal sense and accidental dural puncture between group liquid and air. Conclusion Loss of resistance with liquid can identify the epidural space more correctly than with air, with fewer complications and better analgesic efficacy.

Filial piety and fraternal love ethics is the nucleus of tradition ethics and the base of a person's moral.Reinforcing filial piety and fraternal love education is beneficial to raising the medical students'morality and qualities,consummating their personality,raising their brotherhood life,easing up doctor-patient relationship and promoting the development of medical health.

Low-density lipoprotein receptor-related protein-1 (LRP-1) is a transmembrane receptor protein locatedon the plasma membrane of the cells and involved in receptor-mediated endocytosis.LRP-1 binds to distinct ligandsthat are structurally and functionally unrelated, which makes it not only mediates endocytosis, but also regulates cell surfaceproteolytic activity and specific intracellular signaling pathways related to multiple links in the process of developmentof atherosclerosis.Moreover, LRP-1 plays an important role in maintaining vascular stability.This review focuses on theprogress in LRP-1-regulated vascular integrity, and provides new insights to the target of the blood vessel diseases.

Objective The aim of this study was to compare hypophosphatemia between the sepsis patients and the non-sepsis patients,and between within the subgroups of sepsis patients.Methods We collected 312 sepsis cases and 300 non-sepsis cases by stratified random sampling method yearly.In the sepsis cases,the number infected by gram-negative bacteria was 170,and by gram-positive bacteria was 142,containing 4 different bacteria infected cases in each one.Serum phosphorus of cases in each group were collected.The data were statistically processed to compare the incidence rates of hypophosphatemia,mean serum phosphorus levels and relative risk among groups.Results There was a statistical difference between the sepsis cases and the non-sepsis cases in incidence rate of hypophosphatemia (P ＜ 0.05,and RR ＞ 1.2).There were statistical differences between the cases infected by gram-negative bacteria and the cases infected by the gram-positive bacteria,also among cases infected by 4 different gram-positive bacteria in both incidence rate of hypophosphatemia and average serum phosphorus level (all P ＜ 0.05),and both RR ＞ 1.2.There were no statistical differences among cases infected by 4 different gram-negative bacteria in both incidence rate of hypophosphatemia and average serum phosphorus level (both P ＞ 0.05),and RR ＜ 1.2.Conclusions The sepsis patients were susceptible to hypophosphatemia,especially the ones infected by the 4 gram-negative bacteria,staphylococcus aureus and enterococcus in this study.We should pay attention to the serum phosphorus level seriously and prevent the occurrence of serious complications.

Objective To know the pollution situation by microcystin MC in Tai Lake in Wuxi. Methods The MC content in 12 water samples and 28 fish samples in the Tai Lake were determined by ELISA. Results The positive rates of MC in water samples and fish samples were 100%. The mean content of MC in water samples was higher in July 9 874.8 pg/ml than in November 142.8 pg/ml. The mean content of MC in the livers was 27.84 ng/g, in the muscle it was 3.97 ng/g. Conclusion The Tai Lake has been contaminated by microcystin and it can be detected in the fish living in the lake.

Objective To investigate the value of advanced virtual monoenergetic technique(mono-plus) of dual-energy CT (DECT) in improving imaging quality of the lliofemoral arteries.Methods Forty consecutive patients underwent DECT scan.Mono-plus images (40 keV),optimal monoenergy images and mixed energy images were obtained by using Siemens Syngo.via VB10A workstation.CT values,signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and subjective image quality were calculated in the abdominal aorta,iliac artery,external iliac artery,femoral artery,profound femoral artery, lateral circumflex femoral artery,transversal branch of lateral circumflex femoral artery,medial circumflex femoral artery and profound branch of medial circumflex femoral artery and compared among the three groups.Results Compared with the optimal monoenergy and mixed energy groups,CT value and CNR of the 9 arteries were significantly higher in the mono-plus group (P<0.003).SNR of the transversal branch of lateral circumflex femoral artery and the profound branch of medial circumflex femoral artery showed no significant difference (P>0.05) among the threegroups,whereas SNR of the arties bigger than the 6th grade branch were significantly lower in the mono-plus group (P<0.05).The subjective image quality in the mono-plus group was significant better than the other two groups(P<0.001).Conclusion 40 keV mono-plus technique in DECT can improve the display of lliofemoral arteries especially the small and distal branches.

Objective To explore the image quality of gastric cancer improved by dual-energy CT,and to evaluate the clinical utility in staging gastric cancers.Methods 55 patients suspected gastric cancers were included in the study.Patients underwent dual-phasic scans using dual-energy CT with a dual-source scanner.The relationships image quality parameters in 100 kV,120 kV and 70 keV images were evaluated.Image quality parameters comprised mean density,signal-to noise ratio (SNR) and objective noise.The 120 kV and 70 keV images were compared in TNM staging.Results In arterial and portal phase,the attenuation was significantly higher at 70 keV and 100 kV compared to 120 kV images (P＜0.001).In arterial phase,the SNR were higher at 120 kV and 70 keV in comparison to 100 kV(P＜0.01).In portal phase,the SNR were higher at 70 keV in comparison to 120 kV and 100 kV(P＜0.01).Overall accuracy in assessment of tumor invasion of the gastric wall (T stage) was 83.7％ with 70 keV images and 72.1％ with 120 kV images,this difference was not significant (P=0.25);Overall accuracy for lymph node (N) staging was significantly better with 70 keV images(74.4％) than with 120 kV images(62.8％) (P＜0.05).Conclusion The image quality of gastric cancers using dual-energy CT can be improved by optimizing the energy level.The 70 keV images may be used to improve the N-staging accuracy.

AIM To evaluate whether l glutamine monofluorophosphate(MFP) together with Alendronate sodium may further increase bone mass in ovariectomized rats. METHODS Forty two 3 month old Sprague Dawley female rats were randomized into six groups:group 1 rats were sham operated(Sham),group 2 rats were ovariectomized controls(Ovx),and groups 3～6 were ovariectomized and received either 1 mg?kg -1 ?d -1 of alendronate sodium ,270 mg?kg -1 ?d -1 of calcium gluconate,5 6 mg?kg -1 ?d -1 of MFP or combination of 5 6 mg?kg -1 ?d -1 of MFP and 1 mg?kg -1 ?d -1 of alendronate sodium for 3 months. All animals received double bone fluorochrome labeling prior to sacrifice. At the end of experiment,the left tibiae were havested for histomorphometrical evaluations. RESULTS Alendronate sodium increased trabecular bone volume significantly with suppressed bone resorption and bone formation. Administrated calcium gluconate had no influence on the bone mass. MFP also could not restore cancellous bone of ovariectomized rats. Administration of both MFP and alendronate sodium increased bone mass significantly but did not increase bone mass compared with alendronate sodium. CONCLUSIONS The results indicated administration of both alendronate sodium and MFP could not further increase bone mass of ovariectomized rats.

AIM: To study the relationship between prostaglandins and acute pulpitis. METHODS: Rat traumatic pulpitis model was established by pulp exposure. The kinetic pathological changes in dental pulpal tissues and changes of PGE 2?6-Keto-PGF 1? and TXB 2 concentration in dental pulp were observed. RESULTS: After pulpal trauma, the dental pulp showed inflammatory changes and the concentrations of PGE 2?6-Keto-PGF 1? and TXB 2 were increased, which peaked at 6 hour post-trauma. CONCLUSION: Prostaglandins play a significant role in the pathogenesis of pulpitis.

Objective To study the relationship between the CT features and pathological grade of malignancy of the gastric stro-mal tumors (GST).Methods A retrospective review was performed based on the database of 80 consecutive patients with GST.Age and gender of the patients were recorded,and the CT findings of GST including growth pattern,morphology,tumor site,boundary, mucosa,serosa,ulcer,volume and maximum diameter of the tumor were also measured.The patients were divided into three groups:very low and low risk group,intermediate risk one and high risk one according to the pathology.All parameters were ana-lyzed by one-way ANOVA or Fisher’s exact test.Results The patients in 3 groups (from low risk to high one)were 30,30 and 20 respectively.There were no significant differences in age,gender,location and mucosa among 3 groups(P>0.05).However,the growth pattern,morphology,boundary,serosa,ulcer,volume and maximum diameter of the tumor were significantly different (P<0.05).Conclusion The CT features including growth pattern,morphology,boundary,serosa,ulcer,volume and maximum diameter of the tumor can be used to evaluate the grades of malignancy in GST.