Objective To explore the effect of surgical treatment of low back pain patients with Modic change or high intensity zone(HIZ) on MRI of the lumbar spine .Methods 32 cases with intervertebral disc herniation underwent posterior lumbar inter-body fusion and 17 cases with lumbar discogenic pain underwent radiofrequency ablation from March 2011 to July 2012 were retro-spectively reviewed .For intervertebral disc herniation patients ,all patients were divided into two groups :groupⅠ (no with Modic changes group)and groupⅡ(with Modic changes group) ,according to the Admission MRI .GroupⅡ was sub-divided intoⅡa(Mod-ic type Ⅰgroup) andⅡb(Modic type Ⅱgroup) .For lumbar discogenic pain patients ,all patients were divided into group A (without HIZ group) and group B(with HIZ group) .The VAS and ODI scales at the preoperative and follow-up were recorded and analyzed . Results The postoperative scores of VAS and ODI of all the patients were improved ,and the difference was statistically significant (P<0 .05) .For intervertebral disc herniation patients ,three groups have no statistically significant difference (P>0 .05) .For lum-bar discogenic pain patients ,the improvement rate of VAS (low backpain) of A was better than that of B ,and the difference was sta-tistically significant(P<0 .05) ,but the differences of VAS (leg pain) and ODI scores weren′t statistically significant (P>0 .05) . Conclusion Posterior lumbar interbody fusion is effective for lumbar disc herniation patients with Modic changes ,and can obtain good clinical effect .For lumbar discogenic pain patients with high intensity zone on MRI ,radiofrequency ablation can cause clinical symptoms get some relief ,but the effect is poor .

This Paper reports the histochemical changes occcured at the early acute cardial ischemic area in-duced experimentally by ligation of left coronary artery of 50 male Wistar rats. The following histo-chemical changes at the ischemical areas were observed: obvious decrease of glycogen of cardical is-chemical for 1h, of both NADHD and LDH activity of ischemical for 2h as well as CCo,CK and ATP activity of ischemical for 4h. The decrease of CCo,CK and ATP activity propagated to the whole is-chemical area at the time of ischemical for 8h. The activity of NADHD,LDH'CK and ATP can toler-ated the postmortem autolysis influence up to 24h after death.

Medicine is related to people's wellbeing,which is an eternal topic that all mankind concern.Studying on the process from the origin to the development of medicine can figure out the development rules of medicine,gain experience from it,and provide guidance for better development of medicine in the future.Medical anthropology is a new discipline which focuses on the study of disease and culture.From this special perspective,studying on the process from the origin to the development of medicine can help us to have a profound and comprehensive understanding of medicine.This paper reviewed the relevant concepts of medical anthropology and the research status and research characteristics of the origin and development of Chinese and Western Medicine,providing a reference for the colleagues.

Brain Abscess ; etiology ; Female ; Humans ; Leuconostoc ; pathogenicity ; Male ; Sepsis ; complications ; microbiology

There is still evident gap between the humanity education of medical college in China and the foreign country's.We can find the heart of the matter and explore ways of solving the problem,by comparing the present condition of the humanity education of medical college in China and the foreign country's.

Objective To investigate the effect of nicergoline on cognitive ability and executive function for patients with vascular cognitive impairment without dementia (VCIND).Methods Totally 68 patients with VCIND were divided into conventional treatment group (33 cases) and nicergoline treatment group (35 cases,nicergoline 10 mg,tid added on basal conventional treatment).All of cases were continuously treated for 12 weeks.Cognitive ability and executive function before and after treatments were evaluated.Results Test scores of immediate free recall of a list of words,the numbers and symbols transformation,the word fluency,clocks and watches painting,and minimental state examination (MMSE) were significantly higher in nicergoline treatment group than in conventional treatment group (P＜0.05).Conclusions Nicergoline may improve attention and memory as well as cognitive ability in patients with vascular cognitive impairment without dementia.

Objective To study the expressions of heat shock protein 27(HSP27)in brain tissue and the changes of antibody of HSP27 in serum after transient cerebral ischemic reperfusion in gerbils.Methods A cerebral ischemia-reperfusion model in gerbils was established by clamping both common carotids.Sixty gerbils were randomly divided into normal control group,sham operation group and ischemia-reperfusion(IR)group.The expressions of HSP27 in brain tissue were detected by immunohistochemistry technique and the changes of antibody of HSP27 were detected by ELISA technique at the 6th hour,1st day,3rd and 7th day after IR.Experimental results were analyzed with the statistic soft package of Spss11.5.Results Experimental results revealed that HSP27 were expressed in neurons and gliacytes of the brain tissue in the 60 gerbils.There was mild expressions of HSP27 in neurons and gliacytes in normal control group and sham operation group, but it has no significant difference between the two groups(P＞0.05).Compared with normal control group,the expressions of HSP27 in neurong and gliacytes of ischemia-reperfusion gerbils were evidently increased at the 6th hour,1st day,3rd day and 7th day,especially at the 3rd day(P＜0.01).Conclusions Expressions of HSP27 in neurons and gliacytes of gerbils were increased markedly.This suggested that the increased expressions of HSP27 could protect the brain tissue from damage.The changes of antibody in serum of normal control group,sham operation group were evidently less than that in group IR,which suggest the HSP27 antibody may damage our body.

Objective To investigate the effect of hypertonic sodium chloride hydroxyethyl 40 injection (HSH)on craniocerebral injury accompanied with hypovolemic shock and ICP.Method Sixty patients suffering from craniecerebral injury accompanied with the hypovolemic shock and admitted to ICU and Neurosurgical Department of Guang dong General Hospital from September 2007 to June 2008,were chosen into the study prospectively.Those who was younger than 18years or older than 70 years,and those who were pregnant or meustruous women,or serious hepatic and renal insufficiency,hypertension,coronaxy artery disease,diabets mellitue,uncontrolled bleeding,brain death,erc were excluded.The patients were randomly divided into 3 groups.Each group included 20 patients and they were resuscitated with LR(500 ml),HIS(4 ml/kg)and HSH(4 ml/kg)respectively.The changos of blood pressure,laboratory examination indices and ICP Were detected before and at 30,60,120 minutes after resuscitation.Results MAP raised over 60 mmHg and ICP declined 10%within 30 min in HIS and HSH groups.The effect of HSH on the improving of blood pressure and the reduction of ICP wag more obvious than that of LR and HIS at 120 minutes(F=18.43,8.99,P<0.05)after resuscitation.There were no obvious oboes of the laboratory examination indices after resuscitation.Conclusions The themputic effect of HSH on ICP and MAP in craniocerebral injury accompanied with hypovolemic shock is obvious and lasting,which would be beneficial to the protection of cerebral function.

Objective To assess the disease severity and prognosis value by observing the kinetic change of serum procalcitonin(PCT)and PCT clearance rate(PCTc)in the patients with ventilator associated pneumonia (VAP). Methods A single-center prospective observational study was conducted. A total of 128 patients with VAP admitted into intensive care unit(ICU)of First Affiliated Hospital of Xinjiang Medical University from February 2012 to June 2014 were enrolled. The patients were divided into recovery group(n=88)and deterioration group(n=40) according to the therapeutic outcome. The acute physiology and chronic health evaluationⅡ(APACHEⅡ)scores were estimated within 24 hours when VAP was diagnosed. The serum PCT(PCT1,PCT5,PCT7,PCT9)and PCTc(PCTc5, PCTc7,PCTc9)were examined at 1,5,7 and 9 days after the VAP was diagnosed. The diagnostic and predictive performance of PCT,PCTc and APACHEⅡ scores were assessed by the receiver operating characteristic curve (ROC). Results APACHEⅡscores in recovery group were significantly lower than those in the deterioration group (14.49±5.30 vs. 18.90±5.30,t=-4.349,P=0.000). There was no significant difference in PCT level(μg/L)at 1 day after VAP was diagnosed between recovery group and deterioration group〔2.84(0.81,6.43)vs. 3.50(0.97,10.27), Z=-1.431,P=0.152〕. With prolonged treatment,PCT was gradually decreased in recovery group,while remained at higher level in deterioration group,which was significantly lowered at 5 days after VAP diagnosed in recovery group compared with that in the deterioration group〔1.28(0.65,3.13)vs. 2.39(0.78,9.35),Z=-2.012,P=0.044〕. PCTc maintained higher level in recovery group which was gradually increased with the improvement of the disease, and PCTc in deterioration group was lowered which was gradually decreased with the development of the disease. PCTc at 5,7,9 days in recovery group was significantly higher than that in deterioration group〔5 d:50.43(20.39,80.60)%vs. -56.68(-286.28,172.92)%, Z=-2.250, P=0.024;7 d:54.01(5.70,102.30)% vs. -76.91(-335.03, 181.21)%,Z=-2.561,P=0.010;9 d:63.88(25.93,101.80)%vs.-133.49(-547.20,280.16)%,Z=-3.133, P=0.002〕. The area under ROC curve(AUC)of PCT5,PCT7,PCT9 predicting the prognosis was 0.591,0.683, 0.746,respectively〔95% confidence interval(95%CI)was 0.456-0.726(P=0.161),0.557-0.808(P=0.005), 0.631-0.860(P=0.000)〕. When PCT9 was 5.65μg/L,the sensitivity of 95%and the specificity of 61%. The AUC of PCTc5,PCTc7 and PCTc9 was 0.648,0.685,0.729,respectively〔95%CI was 0.513-0.783(P=0.028),0.555-0.815(P=0.006),0.607-0.851(P=0.001)〕. When PCTc9 was 92%,the sensitivity was 98%and the specificity was 71%. The AUC of APACHEⅡscore was 0.693(95%CI 0.578-0.808,P=0.003). When APACHEⅡscore was 19.5,the sensitivity was 77%and the specificity was 58%. Conclusions The increased levels of PCT in patients with VAP were associated with the poor control of infection and may indicate the deterioration of VAP,it also can reflect the activity of lung infection in time. Keep observing the dynamic change of PCT and analyzing PCTc is more useful. The PCTc levels may provide evidence of disease progression and helpful in risk stratification in patients with VAP,and lower level of PCTc may accompany serious infection and predict poor prognosis.

From the view of medical professionals, this paper explored the standards of residents′ competency cultivation in Zhuhai using Delphi method. The research outcome that consisted of 53 factors and 6 dimensions was obtained after two rounds of expert consultation. There are 6 first-level indexes including professionnalism and body-mind quality, clinical practice skill, the competency of lifelong learning and self-improvement, humanistic medicine practice skill, medical knowledge, and the competency of promoting the medical system to develop. As well, there are 18 second-level indexes and 29 third-level indexes. The standards stated that the clinical prac-tice skill would not be the main part of residents′competency cultivation. Qualified residents should reach the na-tional standard of the clinical practice skill but also the other five indexes.