Objective To explore the application of multislice computed tomographyic ( MSCT) perfusion imaging in the assessment of acute cerebral infarction. Methods 50 patients who initially diagnosed as acute cerebral infarction in 6 hours after their outbreak of infarction were selected. The Siemens semsation 4 MSCT was used to scan the patients and form time versus concentration curve analysis, including the comparision of region cerebral blood flow (CBF) between the necrosis region and the normal region, region cerebral blood volume (CBV), mean transit time ( MTT). Each case had to be examined by computed tomography at least once a week after infarction. Results 50 patients were found having a lower CBF and CBV in their necrosis region compared with the other side(P＜0.05) ,and had a longer MTT in their necrosis region compared with the other side( P ＜0.05) ,45 patients were observed a shrink of the size of the infarction region compared with the perfusion image in first 6 hours when they were reexamined by CT a week later(P ＜0.05) ,which proved the exist of ischemic penumbra area around the infarction center. Conclusion The multislice computed tomographyic perfusion imaging technology could define the infarction region and size at the early stage of acute cerebral infarction. It also provided clues to indicate the exist of a vascular area around the necrosis centre. It could diagnose acute cerebral infarction at hyperacute period and provide image proof for the thrombolysis in early period and treatment in individual manner.

Objective To explore the relationships between antithrombinⅢ(AT-Ⅲ) and D-dimer (DD) level with pediat-ric critical illness score (PCIS) in children with sepsis, and to evaluate the values in assessing the severity of illness. Methods Sixty-one children with sepsis were included in this study. Within 24 hours after admission, blood samples were tested for the ac-tivity of AT-Ⅲ and DD level. The PCIS was calculated. According to PCIS, the patients were divided into extremely critical group (<70), critical group (71-80) and non-critical group (80-100). According to the prognosis, the patients were divided into survival and death groups. The differences of the activity of AT-Ⅲand DD were compared and the relationship with PCIS were analyzed. Results The activity of AT-Ⅲ was lower and DD level was higher in critical group than in non-critical group (P<0.01) and the changes in extremely critical group were more evident than those in critical group. The activity of AT-Ⅲand PCIS were positively correlated (r=0.548, P<0.01).The DD level and PCIS was negatively correlated (r=-0.657, P<0.01). Compared with survival group, the level of DD was significantly higher in death group (P<0.01), and PCIS and the activity of AT-Ⅲwere significantly lower in death group (P<0.05). Conclusions The patients with sepsis have dysfunctions of coagulation. The activity of AT-Ⅲ, DD level are correlated with illness severity, and can be useful for assessing the severity of sepsis.

Objective To study the relation of the variations of serum neuron-specific enolase (NSE) level and brain damage in asphyxia neonatorum.Methods The serum NSE level were detected in 75 asphyxia neonatorum(asphyxia group) and 20 normal neonatorum(control group) by the method of ELISA after parturition 1,3 and 7 d.The relation of serum NSE level and brain damage was analyzed.Results After parturition 1,3 and 7 d,the serum NSE level in mild asphyxia group and severe asphyxia group was higher than that in control group [(29.85 ±8.53),(59.26 ± 15.75) μg/L vs.(15.59 ±6.25) μg/L; (23.69 ± 6.54),(47.28 ±12.46) μg/L vs.(15.38 ±5.84) μg/L; (18.95 ±5.37),(62.57 ±19.62) μg/L vs.(13.92 ±5.37) μg/L],and the serum NSE level in sever asphyxia group was higher than that in mild asphyxia group,there had significantly difference (P＜ 0.05).After parturition 1,3 and 7 d,the serum NSE level in brain damage neonatorum (25 cases) was increased and in CT normal neonatorum (50 cases) was decreased,the serum NSE level in brain damage neonatorum was higher than that in CT normal neonatorum [(37.48 ± 12.09) μg/L vs.(30.95 ± 11.86) μg/L,(51.84 ± 14.21) μg/L vs.(21.73 ±6.15) μg/L,(68.25 ± 18.69) μ g/L vs.(15.62 ± 5.94) μ g/L],there had significantly difference (P ＜ 0.05).Conclusion The variations of serum NSE level can be the important indicator to monitor brain damage in asphyxia neonatorum.

Objective To investigate the state of self-perceived burden (SPB) and depression and to explore the relationship between them for patients with chronic respiratory diseases.Methods 95 patients with chronic respiratory diseases were investigated by the Self-Perceived Burden Scale (SPBS) and Self-Rating Depression Scale (SDS).Results The average score of SPBS was (33.64±10.23) points,which was at the middle level,90.5％ of patients showed different levels of burden,and 34.7％ of patients were at the high level.The average score of SDS was (50.23±11.93),the index was 0.63,which was at the middle to high level,74.7％ of patients showed different levels of depression,and 33.7％ of patients were at the high level.There was a positive conrelation between SPB and depression.Conclusions Patients with chronic respiratory diseases had obvious SPB and depression,and there was a close relationship between them.With chronic respiratory diseases breaking out repeatedly and more severe year by year,most patients have high level of burden and negative emotions.Nurses should take proper measures and psychological interventions to help patients face to the diseases optimistically,and to improve patients' emotion state and enhance their physical and mental health.

This paper took the charity culture cultivation system of the medical university as the research ob-ject, used the method of empirical research , illustrate how to build the charity culture educational system based on the practice of charitable culture education in Wenzhou medical university .The following:imparting charity culture knowledge , setting up the concept of charity;carrying out thematic education activity , cultivating gratitude;carry-ing out community volunteer service , creating the atmosphere of charity;creating charitable culture brand , building a charity culture education platform were discussed .Furthermore , the practice effect of the charity culture cultiva-tion system was also discussed from educating students , campus culture and promoting social morality .

Objective To analyze the effect of a new model in the nursing care ward round in the hand surgery department.Methods The implementation of nursing care ward round in the hand surgery department was retrospectively analyzed.Results The comprehensive quality of nurses were increased obviously when the new model ward round was implemented.Patients were more satisfied with the work of nursing care.The evaluation of new model ward round by nurses was higher than before.Conclusions The new model of nursing ward round showed a great help for increasing the comprehensive quality of nurses,the responsibility awareness of nurses and the nursing quality.It presented an significant application value by developing new nursing care technique and helping establish harmonious relationship between the nursing staff and patients.

Objective To explore the relationships of traumatic brain injury ( TBI ) and recognition and empathy.Methods 120 cases with moderate to-severe TBI and 120 healthy controls with age and gender-matched were chose.Participants were evaluated for facial and vocal affect recognition;and affective and cognitive empathy (empathic concern and perspective-taking,respectively) were detected.Results Participants with TBI had signifi-cantly poorer facial and vocal affect recognition.Facial and vocal affect recognition variances (14.28 ±3.87) points and DANVA2-Voice (14.12 ±3.14) points were significantly lower than those of the control group ( t=-3.927, 4.183,all P<0.05);the empathic concern score (19.58 ±4.87) points and perspective taking(14.46 ±5.34) points were significantly lower than those of the control group too (t=-3.015,-3.935,all P<0.05).Conclusion TBI patients have a tendency to avoid thinking about emotions and more likely to have problems recognizing others′emotions and assuming others′points of view.

Objective To study the diagnostic value of 3T three-dimensional contrast-enhanced MR angiography (3D CE-MRA) of arteriosclerosis occlusive disease of lower extremities using a low dose of gadolinium.Methods 26 patients with arteriosclerosis occlusive disease of lower extremities were prospectively enrolled.DSA and 3D CE-MRA with a low dose of gadolinium were per-formed and directly compared by radiologists.Sensitivity,specificity,accuracy,positive and negative predictive values,Kappa val-ue of 3D CE-MRA were determined for significant stenoses and vessel occlusions (5 1%-100%).Results The diagnosis coincidence rate of 3D CE-MRA was 87.21%,over-and underestimation rates were 8.91% and 3.88%,respectively.Sensitivity,specificity, accuracy,positive and negative predictive values,Kappa value of 3D CE-MRA in the characterization of significant stenoses and oc-clusions were 91.67%,94.29%,93.22%,91.67%,94.29%,0.860,respectively,in aortoiliac arteries,and 90.63%,94.23%, 92.86%,90.63%,94.23%,0.849,respectively,in femoropopliteal arteries and 93.67%,75%,87.83%,89.1 6%,84.38%, 0.718,respectively,in infrapopliteal arteies.The overall sensitivity,specificity,accuracy,positive and negative predictive values, Kappa value in the lower extremity were 92.59%,88.62%,90.70%,89.93%,84.50% and 0.813.Conclusion 3T 3D CE-MRA with a low dose of gadolinium is an accurate method used to depict significant stenoses and occlusions comparable with that of DSA in lower extremity artery disease.

The relationship between immuno-suppression and poor prognosis of sepsis causes widely concern.Immuno-modulatory therapy is one of the research hotspots in critical medical care.Some studies have shown that to enhance the function of lymphocyte might improve the prognosis of septic patients.This paper will review the immune dysfunction and explore the value of immuno-modulatory therapy in process of sepsis.

Objective To study effects of high dosage of atorvastatin in acute coronary syndrome(ACS)patients on high sensitive creactive protein(hsCRP)and atherosclerosis.Methods 126 cases with ACS were divided into A,B and C group.30 patients in A group were given atorvastatin 20mg per night,41 cases in B group were given atorvastatin 40mg per night,while the other 55 patients in C group were taken atorvastatin 40mg per night and tirofiban in the first 24 to 48 hours.The patients were followed 6 months by evaluating serum hsCRP concentration,measuring the intimal thickness in the carotid artery with color Doppler.Results After treatment for 6 months,the patients in the three groups showed significant decrease in hsCRP,however,the therapeutic group showed significant difference amony the three groups.Additionally,the B and C groups further showed significant decrease in intimal thickness.Conclusion Using high-dose atorvastatin and tirofiban not only lowers hsCRP significantly,but also benefit stability of atherosclerotic plaque in carotid artery,and to reduce cardiovascular events.