Otoneurological operations were performed in 96 patients through the retrosigmoidal approach. The anatomical structures in the cerebello-pontine angle can be clearly exposed with this procedure. The approach has the advantage that it is of convenience in manipulation with only gentle trauma, and that some drawbacks of suboccipital or retrolabyrimhine approach may be overcome. On the other hand, operation indications can be extended and operation complications reduced. It is an ideal approach which enters the cerebello-pontine angle. The surgical technique and clinical experience have been reported in detail in this paper.

Objective To investigate the effectiveness analysis of fine nursing care on quality of nursing of critically ill patients with stroke. Methods The control group who came from the neurology department of our hospital between February and April in 2015 were given the routine care. The test group who came from the neurology department of our hospital between May and July in 2015 were given the fine nursing care. The quality of nursing and satisfaction of the relatives of patients were compared. Results In the test group, unqualified rates of nursing quality was 8.8%(81/924) and satisfaction of the relatives of patient was 90.9% (229/252); In the control group, unqualified rates of nursing quality was 22.5%(183/814) and satisfaction of the relatives of patient was 82.0%(182/222).There were significant differences between two teams (χ2=63.191, 8.096, P<0.01 or 0.05). Conclusions Fine nursing care can significantly improve the quality of nursing, improve the nurse-patient relationship and improve satisfaction of the relatives of patients.

Objective To investigate the application effect of Problem based learning (PBL) combined with role play teaching method in the training of emergency internal medicine.Methods Totally 60 medical students were randomly divided into two groups.The students in the observation groop were trained with PBL teaching method while those in control group were trained with traditional teaching method.The practical performances of the students in both groups were evaluated by virtual experience of dealing with patients in the emergency department through the role play teaching method.The grasp of basic knowledge was assessed by writing tests.Finally all the students in the observation group answered a survey about the teaching methods.Results There was uo difference in the scores of the basic knowledge test between the two groups ( P ＞ 0.05 ).The practical ability of the observation group was much better than that of the control group in the role play practice ( P ＜ 0.05 ).Almost all the students in the observation group accept the PBL teaching method.Conelusion PBL combined with role play teaching method is effective based on the characteristics of emergency medicine.

Objective To assess the clinical significance of endoscopic ultrasonography (EUS) in the diagnosis and preoperative staging of gastric cancer. Methods EUS was carried out in 22 patients inclu-ding 17 gastric cancer patients and 5 patients in suspicion. Helical CT scanning was performed in all of the patients and fine needle aspiration biopsies ( FNAB) were administrated to 5 suspicious patients. Compared the results of operation and pathology with those of tumor staging by estimating the depth of tumor invasion ( T) , local lymph node metastasis ( N) and metastasis to neighboring or remote organs ( M) in order to esti-mate the accuracy of diagnosis and TNM staging. The sensitivity and specificity of tumor-node-metastasis staging of gastric cancer by EUS were compared with those of the spiral CT according to the final histopatho-logical results. Results In 5 suspicious patients specimens were successfully obtained by FNAB under the guide of EUS with the pathological diagnosis of adenocarcinoma in 4 cases and signet ring cell carcinoma, 1 case. All patients underwent radical gastrectomy except one in T1N0M0, staging was treated by endoscopic mucosal resection (EMR). The sensitivity and specificity of EUS in T, N, and M stage were 84.9% and 74. 2% , 92. 1% and 77. 1% , 63. 4% and 87. 5% respectively; whereas those of CT in T, N, and M stage were 27. 3% and 75% , 31.5% and 100% , 50% and 100% respectively. The sensitivity of EUS in T and N staging were higher than those of CT with significant statistical difference (P

Humans ; Electronic Nicotine Delivery Systems ; Prevalence ; Mental Disorders/epidemiology* ; Smoking/epidemiology* ; Perception

Objective To observe the effect of salidroside on the cognitive dysfunction of rats with diabetes induced by streptozotocin (STZ) and to explore its related mechanisms. Methods According to the random number table method, 45 Sprague-Dawley (SD) rats were divided into three groups: the normal control, diabetic model and salidroside groups, 15 rats in each group. The diabetic rat model was established by intra-peritoneal injection of 60 mg/kg STZ (72 hours after STZ injection, the caudal venous blood glucose was measured by a glucose meter, if the glucose level reached ＞16.7 mmol/L , the model was regarded as a successful one). The rats in the normal control group were injected with equal volume of citrate buffer. After model making, the salidroside group was treated with salidrosidec 15 mg/kg by intragastric administration; the normal control group and the diabetic model group were given the same volume of normal saline for gavage, 1 times a day. Morris water maze was used to test cognitive function in rats after consecutive four weeks of treatment, and the blood glucose levels of rats in various groups were detected at the onset and the end of the experiment; the protein expression and contents of tumor necrosis factor-α (TNF-α) and intedeukin-6 (IL-6) in hippocampus were detected by enzyme linked immunosorbent assay (ELISA) and Western Blot analysis. Results Compared with the normal control group, the escape latency in diabetic model group was significantly prolonged (seconds: 62.54±7.67 vs. 19.37±4.23), the time in target quadrant was shortened (seconds:18.76±4.75 vs. 43.09±8.09), the number of crossing platform was also obviously reduced (frequency: 2.26±0.57 vs. 6.84±1.56), blood glucose levels were significantly higher (mmol/L: 24.27±3.69 vs. 6.95±1.52), protein expressions and contents of TNF-α and IL-6 in hippocampus were markedly increased [TNF-α (μg/L): 482.09±45.72 vs. 92.53±14.84, IL-6 (μg/L): 8.26±1.14 vs. 3.03±0.48; TNF-α protein (A value): 0.61±0.15 vs. 0.25±0.04, IL-6 protein (A value): 0.53±0.11 vs. 0.12±0.03, all P ＜ 0.05]. Compared with the diabetic model group, the escape latency in salidroside group was significantly shortened (seconds: 38.07±5.84 vs. 62.54±7.67), the time in target quadrant was prolonged (seconds: 31.29±5.61 vs. 18.76±4.75), the number of crossing platform was also significantly increased (frequency: 4.72±1.24 vs. 2.26±0.57), blood glucose levels were obviously lowered (mmol/L: 18.34±2.75 vs. 24.27±3.69), protein content and expression of TNF-α and IL-6 in hippocampus were remarkably decreased [TNF-α (μg/L): 328.46±39.33 vs. 482.09±45.72, IL-6 (μg/L): 6.09±0.97 vs. 8.26±1.14; TNF-α protein (A value):0.47±0.09 vs. 0.61±0.15, IL-6 protein (A value): 0.28±0.06 vs. 0.53±0.11, all P ＜ 0.05]. Conclusion Salidroside can ameliorate the cognitive impairment in STZ-induced diabetic rats, and its mechanism may be closely related to the reduction of the hippocampal inflammatory response and blood glucose level of diabetic rats.

Objective To explore relationship between the change of serum N terminal brain natriuretic peptide (NT-proBNP) , central venous oxygen saturation (SCVO2 ) and venous-arterial partial pressure of carbon dioxide [P(v-a)CO2 ] levels and prognosis in elderly patients with septic shock .Methods 94 cases of elderly patients with septic shock ,treated from March 2015 to July 2016 in Intensive Care Unit (ICU) of our hospital ,were chosen as the observation group A ,another 80 cases of nonsevere sepsis patients were chosen as the observation group B ,and a total of 56 patients healthy volunteers with the physical examination at the same peri-od of time in our hospital as normal control group .The serum NT-proBNP level was detected by electrochemiluminescence immuno-assay ,and PvCO2 ,PaCO2 and SCVO2 levels were detected by blood gas analyzer .records of patients with central venous blood car-bon dioxide .The NT-proBNP and P (v-a) CO2 levels in the serum of the three groups were compared between the groups of pa-tients in the observation group (SCVO2 ) .Logistic regression analysis was used to analyze the prognostic factors in elderly patients with septic shock ,and the receiver operating characteristic curve (ROC) was used to analyze the predictive value of NT-proBNP ,P (v-a)SCVO2 and SCVO2 levels .Results The serum NT-proBNP level of the observation group A was higher than that in the the observation group B and the control group (P<0 .05) .The SCVO2 level of the A group was lower than that in the B group ,and the P(v-a)CO2 level of the A group was higher than that in the B group ,the difference was statistically significant (P<0 .05) .The age , NT-proBNP ,P(v-a)CO2 ,lactic acid level and APACHE II score in the death group were higher than those in the survival group , and the difference was statistically significant (P< 0 .05) .SCVO2 level in the death group was lower than that in the survival group ,and the difference was statistically significant (P<0 .05) .Logistic multivariate regression analysis showed that NT-proBNP , P(v-a)CO2 and SCVO2 levels were the risk factors for the prognosis of elderly patients with septic shock .ROC curve showed AUC and the sensitivity of P(v-a)CO2 were higher than those of NT-proBNP ,SCVO2 .Conclusion The levels of serum NT-proBNP ,SC-VO2 and P(v-a)CO2 are related to the prognosis of elderly patients with septic shock ,and P(v-a)CO2 has a high value in the prog-nosis of the patients with septic shock ,and has a good clinical value .

Objective To explore the effect of quality control circle activity on depression and activities of daily living of Parkinson ’ s disease with depression .Methods Totals of 80 patients of Parkinson ’ s disease with depression were divided into treatment group and control group with 40 cases in each group according to the time of admission.Treatment group took part in quality control circle activity for 3 months, two groups were obliged to attend a constant activity with all patients per month , received collective health education .Hamilton depression scale ( HAMD) and Activities of Daily Living ( ADL) were used to measure depression degree and activities of daily living of patients before and after the intervention .Results Three months after the intervention, HAMD score of patients in treatment group was reduced to (8.80 ±2.36), that in control group was (19.47 ±1.85),and the difference was statistically significant (t=22.50,P<0.01).ADL score of patients in treatment group was increased to (89.14 ±2.25), while that score of patients in control group was (58.32 ±2.21), and significantly difference was found between two groups (t =61.81,P <0.01). Conclusions Quality control circle activity can improve the effect of health education through continuously giving the patients and caregivers health education , and establishing an effective social support system . Meanwhile , it can improve the patients ’ depression condition and self management ability , so as to improve the quality of their life .

The present paper was conducted to a systematic method of surgical guide for dental implant based on computer-aided technology through CT data and dental-cast data. By analyzing the patient's CT data, the implant region was planned using image processing techniques. For the specified implant region, the computer-aided method for the rational allocation of dental implant was addressed in a sense of anatomy. With biomechanical principles as well as aesthetical and functional requirements as preconditions, this method can make full use of bone quantity and quality to produce the optimum implantation axis. The transferring of implant planning to the patient was then realized by registration between CT models and dental-cast models. A case research explained the whole process of the surgical guide. The results validated the correctness and feasibility of this method, which has a great significance to enhance the quality and accuracy of implant surgery.
Computer-Aided Design ; Dental Implantation, Endosseous ; instrumentation ; methods ; Dental Models ; Dental Prosthesis Design ; instrumentation ; methods ; Humans ; Oral Surgical Procedures, Preprosthetic ; methods ; Patient Care Planning ; Surgery, Computer-Assisted ; Tomography, X-Ray Computed

OBJECTIVETo develop an assay methodology for determination of lumbrukinase potency in Rongshuan capsules.

METHODThe agarose-fibrin plate assay methodology for determination of Lumbrukinase potency in Rongshuan capsules was studied including durability, specificity, linearity range, product's handling method, accuracy , repetitiveness, solution stability, recovery and statistical method. The method of parallel line assay based on quantitative responses in statistical methods for biological assays was used in the statistics of potency assay.

RESULTThe durability and specificity of assay accord with the requirement; The linearity range was 12.5 to approximately 400 U, the RSD of accuracy tests was 3.2%, the RSD of repetitiveness tests was 8.3%, the solution is stable under 4 degrees C for 72 hours, the recovery rate was 97.0% and the RSD of recovery assays was 16.5%.

CONCLUSIONThe agar-fibrin plate assay is rapidly, feasible, simple, convenient and accurate way for determining the Lumbrukinase potency. The method of parallel line assay based on quantitative responses in statistical methods for biological assays can control the error of determination.