Objective To investigate the effects of distraction on tourniquet pain in healthy subjects .Methods Tourniquet pain was induced by the tourniquet at continuous pressure of 200 mm Hg for 10 min .20 healthy college students were asked to perform two distraction tasks during the pressure ,one of which is pictorial dot-probe task with three kinds of emotional pictures ,the other is word dot-probe task with five kinds of pain-related words ,and a control task ,in which no distraction task was performed .The pain intensity ,pain distress were recorded by Visual Rating Scale(VRS)and Modified McGill Pain Questionnaire short-form(MPQ-SF) . Results Compared with the control task[(4 .1 ± 1 .8) ,(4 .0 ± 1 .8)] ,the pain intensity and distress were significant lower in picture [(3 .1 ± 1 .3) ,(3 .0 ± 1 .2)]and word[(3 .3 ± 1 .4) ,(3 .4 ± 1 .5)] distraction tasks[(F(2 ,8)=21 .424 ,P<0 .001;F(2 ,8)=17 .962 ,P<0 .001)] .The pain distress in word distraction task (3 .4 ± 1 .5) was higher than that in the pictorial distraction task (3 .0 ± 1 .2) (P<0 .05) .Meanwhile ,for the last four minutes ,the pain intensity was significant lower in pictorial distraction task compared with the control task(P<0 .05) .And at the beginning of the experiment ,the pain distress was significant lower in pictorial[(2 .3 ± 0 .7) , (2 .5 ± 0 .8)]and word[(2 .4 ± 0 .8) ,(2 .9 ± 0 .9)] distraction task compared with the control task [(3 .7 ± 1 .3) ,(4 .0 ± 1 .4)](P<0 .05) .Compared with the control task (5 .0 ± 1 .6) ,the present pain index (PPI) was significant lower in the pictorial distraction task(3 .5 ± 1 .4)(F=5 .097 ,P<0 .05) .Conclusion The tourniquet pain was attenuated by distraction of cognitive tasks in pain in-tensity and pain distress .

Objective To analyze the positive rate of HBsAg in different population at different periods after widely using Hepatitis B Vaccine and provide strategy for Hepatitis B Control.Methods Using ELISA method to detect the HBsAg carrier in polulation under 18 years old in local area.Results After six year investigating,the HBsAg carrier rate in tested population decreased.For 0-4,4-8,8-12,12-15,15-18 age group,the carrier rate were 3.76% vs 0.30%,4.74% vs 1.39%,5.59% vs 2.52%,8.51% vs 3.03%,and 12.58% vs 2.98% in 2000 and 2006.Conclusion The reduction in carrier rate had a direct relationship with Hepatitis B Vaccine inoculation.Hepatitis B Vaccine had important effect to Hepatitis B control.We should gradually intensify Hepatitis B Vaccine inoculation.It is not only for newborn but also for adult.

BACKGROUND: Currently,the research of posterior cruciate ligament (PCL) construction mainly focuses on the surgical technique or graft selection. However,studies on vascular regeneration after construction are few,especially those on allograft construction. OBJECTIVE: To observe the effect of vascular endothelial growth factor (VEGF) on vascular regeneration of reconstructed PCL with femur-anterior cruciate ligament (ACL)-tibia allograft in rabbits. DESIGN,TIME AND SETTING: The factorial design experiment was performed at the Orthopedics Laboratory of the Third Affiliated Hospital of Weifang Medical College from March 2006 to September 2007. MATERIALS: Sixty-eight adult female Japanese white rabbits,weighing (3.3?0.1) kg,were adopted. Twenty-three of them were used to excide the femur-ACL-tibia complexes to establish the animal model of PCL reconstruction with allograft. METHODS: Forty-five rabbits were randomly divided into 3 groups,15 rabbits in each group. In the control group,no additional treatments were applied. In the phosphate-buffered saline (PBS) group,0.2 mL of PBS was injected into the knee joint. In the VEGF group,30 ?g VEGF mixed with 0.2 mL PBS was injected into the knee joint. MAIN OUTCOME MEASURES: The immunological rejection of allograft was observed after reconstruction. Five rabbits were randomly selected in each group at 3,6,12 weeks,respectively,for immunohistochemistry staining; and the microvessel density of the medio-one-third ligament part of allograft was evaluated with the Chalkley scoring method. RESULTS: Forty-five rabbits were involved in the result analysis. There were no hydrops articuli or aneretic cartilage when every rabbit’s knee joint was opened. The gross morphology of the grafts was similar to normal posterior cruciate ligament. Immunological rejection,such as degeneration,necrosis,dilapsus or defluxion was not appeared. Plenty of good vascular tissue in the arthrosis could be seen in the VEGF group,but could not be found in the control group or in the PBS group. The microvessel density score of the allograft in the VEGF group was higher than that in the control group and PBS group (P

Objective To study the effect of plasminogen activator inhibitor type-1 ( PAI-1 ) on the protein expression of transforming growth factor-beta 1 ( TGFβ1 ), hyaluronic acid ( HA ) and tissue inhibitor of metalloproteinase-1 (TIMP-1) of hepatic stellate cells(HSC). Methods Methyl thiazolyl tetrazolium (MTT)was performed to detect the effect of PAI-1 on the proliferation of LX-2 ,and to determine the perfect intervention concentration of PAI-1. After incubation with PAI-1 in LX-2 culture solution for 12 h,24 h,48 h,the protein expression of TGFβ1 ,TIMP-1 and HA was observed with enzyme linked immunosorbent assay (ELISA). Results A492 in the negative control was 0. 473 ± 0. 353, and 1. 249 ± 0. 440, 1. 636 ± 0. 315,1.283 ± 0. 413,0. 938 ±0. 263 and 0. 303 ±0. 125 when the concentration of PAI-1 was 5,10,20,40 and 80 μg/L,respectively,a concentration of 10 μg/L of PAI-1 showed the strongest stimulation remarkablely ( F = 11. 697, P ＜ 0. 01 ).After incubation with PAI-1 for 12 h,24 h,48 h,the protein expression of HA,TGFβ1 and TIMP-1 in the LX-2 supernatant significantly increased compared to negative control (F = 1566. 752,235. 632 and 67. 359,respectively,P ＜ 0. 01 or ＜ 0. 05 ). Conclusion PAI-1 may influence the development of hepatic fibrosis through promoting the protein expression of HA ,TGFβ1 and TIMP-1 of HSC.

The phenomena of attention economyand influence economypresented in news media also applies to medical library.Proposed in this paper are the ways and measures for medical libraries to realize their influence economybased on the analysis of their attention economy.

Twenty-two neurosurgical patients were randomly divided into two groups:Group 1 iv drip midazolam and isoflurane inhalation;Group 2 isoflurane inhalation only. The hemodynamic indices and concentration of isoflurane were studied. The results showed that the blood pressure of all the patients were significantly decreased(PMO.01). The concentration of isoflurane in group 1 were .signicantly lowered by 27% than in group 2(P

Objective To compare humoral immune response of BALB/c mice immunized by recombinant plasmids poDNA3.1-BE and pcDNA3.1-NE. Methods The BALB/c mice were immunized by recombinant plasmids pcDNA3.1-BE, pcDNA3.1-NE with adjuvant. Each animal received a primary inoculation and two boosts at 2-week intervals. Then the blood samples of BALB/c mice were collected from different experiment groups at day 14, 28, 42, 70 and 98, respectively after first immunization. The specific IgM/IgG antibodies for E protein in serum were confirmed by indirect ELISA. And then the activities of the specific neutralizing antibody were determined by cytopathic effect inhibition (CPEI). Results The levels of specific IgM/IgG antibodies and neutralizing antibody activities were increased in PODNA3.1-BE enhance immunization group than that of other groups. The result had been observed longer duration of antibody level in pcDNA3.,-BE enhance immunization group. Conclusion Humoral immune response were significant differences between recombinant plasmid pcDNA3.1-BE and PcDNA3.1-NE immunized mice groups.

Objective To evaluate the method and effect of double-bundle posterior cruciate ligament (PCL) reconstruction using bone-semitendinosus and gracilis tendons under arthroscope.Methods The data of 16 patients was reviewed,who had underwent arthroscopic PCL reconstruction using the bone-semitendinosus and gracilis tendons from March 2004 to March 2007.A special technique using trephine was allowed for the cylindrical bone plugs attached to the semitendinosus and gracilis tendons.The femoral double-tunnel and the tibial tunnel were prepared,and the adequate press-fit fixations of tendon grafts were ensured within them.Results All patients were followed up.Before operation,the mean Lysholm score was 57 points (43-65 points).While 12 months later after operation,the mean Lysholm score was 86 points (68-92 points).The excellent and good results were obtained in 87.5%.Conclusions Arthroscopic PCL reconstruction using bone-semitendinosns and gracilis tendons can effectively improve the stability of the knee joint.The key to achieve a good treatment is that precise positions of femoral and tibial tunnels in operation and systematic rehabilitation trainings after operation were performed.

The tuberous sclerosis complex (TSC) in children is also named Bourneville disease,the 3 main symptoms namely epilepsy,mental retardation and facial angiofibromas.It is an autosomal dominant disease.It is an important cause of epilepsy,skin disease,and renal and pulmonary disease in children and adults.The appropriate therapy and prognosis for TSC patients are often different than that for individuals with epilepsy,renal tumors,or interstitial lung disease from other causes.In recent years,certain progress has been made in management of tuberous sclerosis,inhibitors of the mammalian target of rapamycin (mTOR) have demonstrated regression of astrocytomas,angiofibromas,and angiomyoliomas,as well as improved pulmonary function in persons with TSC.This article reviews the current therapeutic recommendations for medical and surgical management of neurologic,renal,and pulmonary manifestations of TSC.

Objectives To investigate the association of fluid overload (FO) with the development and mortality of acute kidney injury (AKI) and to evaluate the predictive value of FO in mortality of critically ill children. Method A prospective study was conducted among critically ill children who were admitted to the children's intensive care unit (PICU). FO levels were assessed during the course of the disease and PRISM Ⅲ scores were evaluated within 24 hours of admission. Binary logistic regression analyses were conducted to evaluate the association of FO with the development and mortality of AKI after adjusting for confounding factors. The area under the receiver operating characteristic curve (AUC) was calculated to assess the predictive value of FO for mortality. Results In 362 children included, there were 26 children (7.18%) having average FO≥5%, and AKI in 24 children (6.63%) and 18 children (5.0%) died. The mean FO (OR=1.26, 95%CI: 1.10～1.43, P=0.001) and the maximum FO (OR=1.12, 95%CI: 1.02～1.23, P=0.018) were significantly correlated with the development of AKI in critically ill children within 7 days of admission to PICU. However, after adjusting for age and PRISM Ⅲ, both factors had no association with AKI (all P>0.05). After adjusting for the potential confounders such as AKI and the severity of disease, the average FO was significantly associated with mortality (AOR=1.34, 95%CI: 1.12～1.60, P=0.002). The AUC of mean FO that predicted mortality risk was 0.801 (P<0.001). Conclusion Fluid overload is associated with the development and the prognosis of AKI in critically ill children, and has important predictive value for mortality.