Objective To evaluate the effects of temperature of the irrigation fluid on body temperature and cardiovascular performance during transurethral surgery. Methods 87 cases were randomly divided into two groups according to the temperature of irrigation fluid used: the ambient (21～ 24 ℃) and the isothermic (35～36 ℃). Body temperature, blood glucose, ECG, HR, SaO 2, cardiac output (CO), mean arterial pressure (MAP) and systemic vascular resistance (SVR) were monitored during the transurethral surgery. Results Body temperature was decreased 2.1 ℃, MAP elevated, CO decreased and SVR increased in the ambient group, while body temperature was decreased only 0.3 ℃ and cardiac performance was maintained relatively stable in the isothermic group. Conclusions Hypothermia, resulted from the use of large amount of low temperature irrigation fluid during transurethral surgery has detrimental effects on body temperature and cardiovascular performance. Isothermic irrigation fluid would stablize the cardiovascular performance and so increases the safety of transurethral surgery.

Objective:To investigate the possibility of predicting facial nerve involvement in the pa-tients with parotid tumors using facial electroneurography (ENoG).Methods:In the study, 53 patients with primary parotid tumors were included in the study , 28 were benign tumors and 25 were malignant . There was no significant difference of tumor locations and sizes between the two groups . House-Brackmann facial nerve function evaluation was gradeⅠin all the patients who received examination of fa-cial electroneurography , including stimulation strength , amplitude , and latent time bilaterally .The facial electroneurography results in the affected side were compared with the results of contralateral normal side , intraoperative appearance and postoperative histopathological diagnosis .The facial electroneurography results were analyzed by Wilcoxon signed rank test and receiver operator characteristic ( ROC) curve. Results:During the facial electroneurography examination , the mean stimulation strength in the patients with benign parotid tumor was 20.0 mA.There was significant decrease in the amplitude at the affected side compared with the normal side upon posterior auricular stimulation ( P<0 .05 ) .But there was no significant difference in the latent time between the bilateral sides (P>0.05).However, in the patients with malignant parotid tumor , the mean stimulation strength was higher at 24.5 mA.There was signifi-cant decrease in the amplitude or even no response at the affected side compared to the normal side upon posterior auricular stimulation ( P<0 .05 ) .No response was detected in the multiple branches of facial nerve of affected sides in 36 .0%patients upon posterior auricular stimulation .The amplitude of branchesⅢand Ⅳwas significantly lower at the affected side than that at the normal side upon anterior auricular stimulation (P<0.05).The area under the ROC curve for ENoG was 0.884.Conclusion: When the facial nerve was involved by the parotid tumors , the stimulation strength in the electroneurography was larger .There was significant difference in the amplitude and the latent time of the facial nerve between the affected side and the normal side upon the posterior auricular stimulation .The rate of absence of reac-tion wave was higher in the patients with malignant tumors .It was feasible to predict the facial nerve in-volvement by ENoG for the parotid gland tumor patients without clinical appearances of facial paralysis .

Objective To understand the comments for the essential drug system by doctors at township health centers in Nantong's six counties and to discuss the effect of implementing the essential drug system to different ownership systems.Methods The survey was made with stratified clusters random sampling method to select township health centers.Questionnaires were filled out by doctors,and leaders of the health bureau and township health centers were interviewed.Results After the implementation of the essential drug system,94.6％of the doctors found that the number of laboratory examinations increased in Rugao,Rudong and Haian.23.2％of the doctors in Tongzhou,Qidong and Haimen found that enthusiasm for work increased.Conclusion The compensation mechanism should be perfected and the financial subsidies should be paid in time.Supervision and management should be strengthened and the grassroots need for medicine be ensured.The skills training should be enhanced and the medical service ability be improved.

Objective To evaluate the diagnostic value of contrast-enhanced ultrasound(CEUS) in regenerative nodules(RNs)and small hepatocellular carcinoma(sHCC).Methods Thirty-four cases of liver cirrhosis with small nodule were examined by CEUS.Among these cases,18 cases with 20 lesions were diagnosed s HCC,16 cases with 18 lesions were diagnosed RN eventually,all the diagnoses were confirmed by pathology.Perfusion characteristic and quantitative difference of RNs and sHCC were summarized.Results ①The majority of sHCC showed hyper-enhancement during the arterial phase,iso-enhancement or hypo-enhancement during the portal phase,hypo-enhancement during the late phase.The enhanced phase and degree of RNs were diverse,most of RNs showed iso enhancement during the three phases.The enhanced phase of two groups had significant difference(P ＜0.05).②The enhancement type of RNs and sHCC had no significant difference (P ＞ 0.05).③ 11 of 20 sHCC lesions showed contrast-enhancement pattern of fast-in and slow-out,9 lesions were fast-in and fast-out;among 18 RNs,1 lesion enhanced during the portal phase and the late phase,it didn't enhanced during the arterial phase,3 lesions started to enhanced at the late arterial phase,14 lesions were iso-enhancement during the three phases.④Comparison of parameters of RNs and the adjacent liver parenchyma had no significant difference(P ＞0.05).Compared with the adjacent liver parenchyma or RNs,the arrival time and peak time were shorter,the peak intensity and the curve sharpness were higher in sHCC (P ＜ 0.05).Conclusions CEUS is a useful method to distinguish RNs and sHCC in liver cirrhosis.

OBJECTIVETo analyze the relationship between symptoms and signs of temporomandibular disorders (TMD) and the patients' quality of life (QOL).

METHODSA total of 492 TMD patients were included in this study. The clinical examination results were recorded using Fricton index of temporomandibular joint function. "Visual analog scale (VAS) evaluation of QOL disturbance" was designed to quantitate patients' QOL, to evaluate the degree that the patients QOL was affected.

RESULTSChewing, daily life and emotion among all 8 items of QOL were frequently affected by TMD, and joint clicking had the least influence on QOL. Intermittent closed lock had more severe interference with QOL than joint clicking only. Severe and moderate pain or limited mouth opening affected the QOL more severely than mild pain or mild limited mouth opening. The simple linear relationship between Fricton index and patients' QOL was poor (r < 0.4).

CONCLUSIONSPain is the most frequently seen symptom in TMD. TMD could affect patients' QOL, including both physical and social-psychological functions. The results suggest that the patients' QOL as well as TMD symptoms and signs should be considered in the management of TMD.

Antigens, CD19 ; analysis ; Asthma ; blood ; Child ; Child, Preschool ; Female ; Flow Cytometry ; Humans ; Immunoglobulin E ; blood ; Lymphocytes ; immunology ; Male ; Receptors, IgE ; analysis

Objective To analyze the chemokine receptor CXCR4 expression in acute leukemic cells of children and its relationship with extramedullary infiltration.Methods The immunotypes of cases of acute leukemia in children and the expression of CXCR4 in marrow leukemic cells were studied by flow cytometry respectively. The relationship between CXCR4 expression and extramedullary infiltration of leukemic cells were analyzed by statistical method.Results The expression rates of CXCR4 in ALL children were higher than those in NALL children(P

Objective To compare the effect of two different treatment approaches on femoral shaft fractures in polytrauma patients.Methods One hundred and forty-eight polytrauma patients were selected as our subjects,who were hospitalized from Jan.2000 to Dec.2009.They were randomly divided into cast group and external fixation group.Patients in cast group were fixed with cast within the first 24 h after the injury and patients in external fixation group were stabilized with a unilateral external fix stent within the first 24 h after the injury.Results In cast group,71 of 75 patients were followed up and follow up periods was 26.4 months.Follow up data showed that 18 patients developed multiple organ failure (MOF) and 26 patients developed ARDS.The average healed periods was 5.9 month.Three patients developed nonunion and 4 cases developed wound infection.The average of the knee motion angle was 107 degrees (60 to 110 degrees).In external fixation group,68 patients were followed up and the follow-up period was 27.5 months.Of which,13 patients developed MOF and 12 patients developed ARDS.The average healed periods was 5.6 months.2 patients developed nonunion and 3 cases developed for.wound infection.The average of the knee motion angle was 120 degrees (60 to 140 degrees).Conclusion The damage control orthopedics surgery was proved as a safe and effective treatment approach for fractures of the shaft of the femur in selected multiply injured patients compared with cast methods.

Objective To observe the distribution proportion of insulin resistance(IR) and non -insulin resistant(NIR) in aged subjects with impaired glucose tolerance (IGT)and to evaluate their states of metabolic syndrome and atherosclerosis. Methods Some indexes were detected in elderly subjects with IGT such as body mass index(BMI),waist-to-hip ratio(WHR), cholesterol(TC),triglyceride(TG), low density lipoprotein cholesterol(LDL-C) and high density lipoprotein cholesterol(HDL-C), systolic blood pressure (SBP), diastolic pressure (DBP), insulin,insulin area under curve(InsAUC) , inflammation markers(hsCRP,Fg), proinsulin and proinsulin area under curve(PIAUC),IMT and carotid artery atheromatous plaque were also examined in some people. Subjects were divided into insulin resistance group(IR group) and non-IR group(NIR group) according to HOMA-IR. Results (1)156 subjects with IGT, the rates of IR and NIR were 75.6% and 24.4% respectively.(2)BMI, TG,TC,LDL-C,hsCRP, Fg, SBP, DBP,HOMA-IR, InsAUC, PIAUC in IR group\[(26.8?2.1) kg/m2,0.96?0.23,(2.9?1.3)mmol/L,(5.4?1.8)mmol/L,(3.9?1.5)mmol/L,(154?12)mm Hg,(96?7) mm Hg,(239?71)mU/L,(170?42)pmol/L,(7.5?1.2)mg/L,(4.5?1.4) g/L \] were higher than those in NIR group\[(22.8?2.5) kg/m2, 0.80?0.2,(1.7?1.2) mmol/L,(4.5?1.5)mmol/L, 3.0?0.8 mmol/L,(133?10)mm Hg,(83?1)mm Hg,(180?66)mU/L,(109?25) pmol/L,(4.3?0.8)mg/L,(3.8?1.5 )g/L\], but HDL-C in IR group was lower than that in NIR group(1.0?0.4)mmol/L (P

Four primers against the genes encoding(cpa,cpb,etx,and iA) four major toxins(?,?,?,?) of Cl. perfringens were designed and the colony multiplex PCR of identification and genotyping of Cl. perfringens strains were developed. Cl. perfringens reference strains stored in china institute of veterinary drug control including A,B,C,D and E genotyping were genotyped using the colony muitiplex PCR assay. The expected sequences were obtained successfully by the colony multiplex PCR assay. But the sequences were not obtained from Cl. novyi,Cl. septicum and Cl. tetani. The expected sequences were obtained from Cl. perfringens individual colony diluted to 100 times with 0.85% saline solution.13 Cl. perfringens strains isolated from diferent animals were genotyped using the colony multiplex PCR assay,and the results were comparaed with the results of toxins neutranization test in mice. The two assays showed good accordance. These results showed that the development of the colony multiplex PCR is very important for early and fast identification and genotyping of Cl. perfringens in china.