0.05.The neuronal necrosis area in group A are significantly higher than group B and C [(1.8?0.7)vs(0.9?0.4)and(0.6?0.3),both are P0.05.The neuronal necrosis area and the level of NSE in fetus were positively correlated with each other,r=0.798,P0.05.The volume of mitochondria of nerve cells in group A and B are significantly higher than that of group C [(7.0?1.8)?10~(-4)?m~3 and(5.7?1.6)?10~(-4)?m~3 vs(3.2?1.2)?10~(-4) ?m~3,both are P0.05). Conclusions There is apparente pathological change of fetal rats brain in cholic acid groups,the neuronal degeneration and the mitochondria swelling was mainly found in low cholic acid group,the neuronal necrosis and the mitochondria decrease was mainly found in high cholic acid group.The serum concentration of TBA and NSE in fetal rats were positively correlated with each other.

Objective To investigate the clinical curative effect of closed thoracic drainage by minimal invasive with needle catheter in treating spontaneous pneumothorax.Methods Seventy-six patients with spontaneous pneumothorax were divided into two groups randomly,the control group was treated by traditional thick tube closed thoracic drainage,the experimental group was treated by the needle catheter minimally invasive thoracic closed drainage.Compared clinical curative effect,pulmonary reexpansion time,the wound healing time,the degree of pain and the occurrence of complication between two groups.Results The effective rate of experimental group and control group was 91.9％ (34/37) and 92.3％ (36/39),the pulmonary reexpansion time of experimental group and control group was (5.38 ± 2.21) d and (5.29 ± 2.27) d,there was no significant difference (P ＞ 0.05).The pain scores during draining and wound thealing time of experimental group and control group was (1.32 ±0.92) scores,(2.93 ± 1.14) scores,(2.13 ± 1.40) d and (5.32 ± 1.78) d,there was significant difference (P ＜ 0.01).Complication such as subcutaneous emphysema,dislodgment of the catheter and wound infection in experimental group was lower than that in control group.Conclusions The effect of needle catheter minimally invasive thoracic closed drainage in spontaneous pneumothorax is better,simple and less invasive.The wound healing time is short,and little pain.It is worthy of promotion.

Objective:To observe the efficacy of acupuncture at points of Shaoyang meridians plus moving cupping on neck and shoulder for migraine. Methods:A total of 64 migraine cases were randomly allocated into an observation group and a control group, 32 cases in each group. Random number table method was used in allocation. Acupuncture at points of Shaoyang meridians and cupping on neck and shoulder were used for cases in the observation group, which contain acupuncture 5 times a week and cupping once a week. Oral flunarizine hydrochloride capsules were used for cases in the control group, 10 mg for each dose, 1 dose a day. 2 weeks constitutes a course of treatment. The patients were treated for two courses of treatment in both groups. After that, the changes of visual analogue scale (VAS) and the migraine disability assessment questionnaire (MIDAS) were observed, as well as the clinical efficacy. Results:The total effective rate and recovery and marked effective rate in the observation group were 93.8% and 71.0% respectively, versus 78.1% and 43.8% in the control group, showing statistical significant differences (both P<0.05). There were significant decreases in VAS and MIDAS scores after treatments in both groups (both P<0.05). VAS and MIDAS scores in the observation group were significantly different from those in the control group (both P<0.05). Conclusion: Combining acupuncture at points of Shaoyang meridians and cupping on neck and shoulder can relieve headache and reduce influence of migraine on life. It can produce a better efficacy than oral flunarizine hydrochloride capsules in treating migraine patients.

Objective To understand the clinical distribution of Acinetobacter baumannii and its resistance to commonly used an‐tibiotics so as to provide the theoretical basis for rational clinical use of antibacterial medicines .Methods The clinical distribution and drug resistance situation of 206 strains of clinically isolated Acinetobacter baumannii in the Anhua County People′s during 2012-2014 were analyzed .The bacterial identification was completed by the department of clinical laboratory ,the drug susceptibili‐ty test was performed by adopting the disk diffusion method ,and the detection results were judged according to CLSI 2012 criteria . Results A total of 2 803 strains of bacteria were isolated during 2012-2014 ,including 206 strains of Acinetobacter baumannii .Its constituent ratios during this period were 6 .71% ,6 .82% and 8 .19% ,showing the increasing trend year by year .The samples were mainly isolated from sputum (78 .16% ) ,followed by urine (7 .28% ) ,bronchoaleolar lavage fluid (6 .80% ) ,wound secretion (3 .40% ) and blood(2 .91% ) .The infected patients were mainly distributed in the respiratory department (40 .29% ) and neurosur‐gery department(22 .82% ) .The detection results of Acinetobacter baumannii showed the higher resistance to 20 kinds of commonly used antibacterial drugs ,in which the drugs with most significantly increase in 3‐year drug resistance rate were in turn ceftazidime , cotrimoxazole ,levofloxacin ,piperacillin and ciprofloxacin ,the 3‐year resistance rate to meropenem ,imipenem ,cefoperazone/sulbac‐tam and cefepime was less than 35% .Conclusion Acinetobacter baumannii is the major opportunistic pathogenic bacterium in noso‐comial infection with higher drug resistance rate .It is necessary to strengthen the monitoring of Acinetobacter baumannii drug re‐sistance and rationally use antibacterial medicines in order to stop the drug‐resistant strains colonization and cross expansion in hos‐pital .

Objective To investigate the effect of smoking on large arterial stiffness in patients with essential hypertensive.Methods The aortic,carotid and brachial arterial dimension,intimal-medial thickness were determined by vascular ultrasound technique.Wall cross sectional area and indices of compliance and distensibility were calculated in essential hypertensive patients with smoking(n=75) or without smoking(n=70).Results Hypertensive patients with smoking have increased wall intimal-medial thickness and wall cross sectional area in aortic,carotid and brachial arteries associated with decreased compliance and distensibility.After adjusting for the confounding effects of other variables including Age,BMI,HR,BP,PP,FPG,LDL-C and TG,covariance analysis show smoking remained as predisposed factors for vascular remodeling.Conclusion Smoking aggravates large arterial stiffness in essential hypertensive patients.

Many Chinese medicinal materials are difficult to be distinguished in characters resulting in easy confusion. In the pa-per, the basic concepts of three groups of easily confused Chinese medicinal materials ( schisandrae chinensis fructus and schisandrae sphenantherae fructus, phellodendri cortex and phellodendri amurensis cortex, akebiae caulis and clematidis armandii caulis) were illus-trated and the development of verification methods were reviewed in the respect of modern instrumental analysis technology. With the improvement of analysis technology, the identification of Chinese medicinal materials relies on experimental data instead of artificial ex-perience, which makes it more objective and accurate.

Objective To explore theDNA damage of brain cells of goldfishs through formaldehyde exposure.Methods The goldfishs were treated with liquid formaldehyde at different concentrations(0.01 mmol/L,0.1 mmol/L和1mmol/L)for three days.Single cell gelelectrophoresis technique(comet assay)was used to test the DNA damage of the brain cells.Results Formaldehyde caused significant DNA strand break at the concentration of 0.01mmol/L,0.1mmol/L and 1.0mmol/L.Conclusions Formaldehyde was both a DNA strand breaker when the concentration is higher,it may cause crosslinkagent to the brain in vivo.

Objective To investigate the prognostic value of fever burden in traumatic brain injury (TBI) patients.Methods A retrospective analysis of 355 TBI patients admitted to the emergency department and intensive care unit from November 2010 to October 2012 was performed,and the Glasgow outcome scale (GOS) was followed-up 6 months after the injury.The patients were divided into two groups according to the GOS:good outcome group (4 to 5) and poor outcome group (1 to 3).Relevant clinical findings were studied by statistical description,logistic regression analysis,Spearman correlation analysis and ROC curve analysis.Results Fever burden level was continuously increased with the decrease of GOS from score 5 to 2,except for score 1 of GOS,which was corresponding to a significant lower fever burden.There were significant differences in age,pupil reactivity,Glasgow coma scale (GCS) and fever burden between two groups (P ＜ 0.05).Compared to the good outcome group,the poor outcome group was featured with more advanced average age (P =0.000),poorer pupil reactivity (P =0.000),lower GCS score (P =0.000) and higher fever burden level (P =0.000).Univariate logistic regression analysis suggested that age,GCS,pupil reactivity and fever burden level (OR 1.166,95％ CI:1.117-1.217) were associatedwith poor outcome.The fever burden level and the other independent prognostic predictors as age,GCS and pupil reactivity were further included in the multivariate logistic regression model,and the adjusted OR of fever burden level was 1.098 (95％ CI:1.031-1.169,P =0.003).ROC curve analysis showed the respective AUC for fever burden was 0.713 (95％ CI:0.663-0.760).The relevant analysis revealed a significant negative correlation between the fever burden and the GOS score (r =-0.376,95％ CI:-0.462--0.283,P =0.000).Conclusions Fever burden can be considered as an independent predictor of poor outcome of patients with TBI.The TBI patients with early onset of high levels of fever burden will have increased poor outcome risk.

Objective To explore the effects of high-dose ambroxol hydrochloride (Mucosolvan) on pulmonary protection and anti-inflammatory in traumatic brain injury patients treated by mild hypothermia.Methods From June 2008 to June 2012,40 elderly traumatic brain injury patients aged 60-70 years treated by mild hypothermia in our hospital were selected.Patients were randomly divided into two groups:low-dose ambroxol hydrochloride group and high dose ambroxol hydrochloride (n=20,each).Patients in low-dose ambroxol hydrochloride group were treated with ambroxol 30 mg plus saline infusion,3 times/day; while patients in high-dose ambroxol hydrochloride group were treated with ambroxol 300mg plus saline infusion,3 times/day; both groups were treated for 7 days.The changes of characteristic and quantity of sputum,PaO2and PaO2/FiO2,and serum TNF α level were analyzed at day 1,3,7.Duration of mechanical ventilation,tracheotomy proportion,and mortality were compared between the two groups 3 months after treatment.Results At day 3-7 after the intervention,the sputum got thinner and less,and more easy to suck in highdose group than in low-dose group (thin sputum proportion:75％ vs.40％,P =0.025; clean proportion by once suction:65％ vs.25％,P=0.011).The improvement of PaO2,PaO2/FiO2 were more significant in high dose group than in low dose group (PaO2 ∶ 3d,(92.3±12.3) mm Hg vs.(83.3±15.2) mm Hg,P=0.046;7d,(95.9±12.5) mm Hgvs.(87.1±11.7) mm Hg,P=0.028;PaO2/FiO2∶3d,(290.8± 15.8) mmHgvs.(221.8± 16.4) mm Hg,P=0.000;7d,(296.3±16.9)mm Hg vs.(238.4±15.0) mm Hg,P=0.000).Serum concentrations of TNF α was lower in highdose group than in low dose group [3d,(54.1± 4.9) ng/L vs.(71.4± 5.6) ng/L,P=0.000;7d,(35.1± 2.7) ng/L vs.(63.3±4.3) ng/L,P 0.000].Duration of mechanical ventilation was shorter and tracheotomy proportion was lower in high dose group than in low dose group [(116.8±18.7) hrsvs.(178.4±35.5) hrs,P=0.000; 25％ vs.60％,P=0.025].There was no significant difference in mortality between groups 3 months after treatment.Conclusions The application of high dose ambroxol can improve respiratory function,decrease duration of mechanical ventilation and tracheostomy proportion,and reduce the systemic inflammatory response in elderly traumatic brain injury patients treated by mild hypothermia,but without long-term survival benefit.

Objective To investigate the reason and prevention of complications of head and neck expander implant.Methods From May,2003 to October,2007,patients with expander implant in the skin soft tissues of head and neck were retrospectively reviewed.Results A total of 139 expanders were implanted in 68 patients.Complications caused by the expander included appearance(1 case),leaking(1 case),haematoma(2 cases)and infection(2 cases).Conclusion The complications induced by expander implanted in head and neck are more commonly occurred.The prevention and early detection of the complication are important to decrease its ineidence and the degree of damage.Moreover,surgeon's procedure and operational methods are main factors in the prevention of complications.