Objective To assess the protective effect of mastoparan-1(MP-1) on acute lung injury in mouse model with endotoxemia(ETM) induced by lipopolysaccharide(LPS),and to investigate the possible mechanism of protcetive effect.Methods The endotoxemia murine model was reproduced by tail vein injection of LPS(5mg/kg) in mice.Animals were randomly divided into normal control group(n=8),endotoxemia group(n=48) and MP-1-treatment group(MP-1 was injected in 3mg/kg at the same time of LPS injection,n=48).Animals of the latter two groups were sacrificed at 2,6,12,24,48 and 72 hours after injection,and then the blood and lung tissue samples were collected.Plasma LPS was assayed using kinetic turbidimetric limulus test,TNF-? and IL-6 were measured by appropriate ELISA kits,TLR4,TNF-? and IL-6 mRNA expressions in lung tissues were analyzed by real-time RT-PCR,myeloperoxidase(MPO) activity of lung tissues was determined by spectrophotometric method,and the pathological changes in lung tissues were observed under microscope.Result The plasma levels of LPS,TNF-? and IL-6 in the mice of endotoxemia group were increased at 2-48 hours after LPS injection(P

To investigate the effective principles of early management in extensively burned patients,162 patients (from 1990 to 1999) with extensive burn were treated according to the following principles: ① prompt and rapid fluid resuscitation during shock stage for delayed resuscitation patients; ② early tracheostomy,air way humidification and lavage for moderate and severe inhalation injury;③ escharectomy and grafting performed during early stage, presenting the experiences of escharectomy during shock stage in grassroot hospitals ; ④ undergoing enteral nutritional support in early stage; ⑤ emphasizing the importance of functional excise in early stage to stress that rehabilitation therapy should be implemented throughout that whole course of treatment. The results showed that the successful rate of treatment was raised and the incidence of complications and disability decreased after implementing the aforementioned treatment principles in extensively burned patients. It is suggested that the application of “Five early Principle” on extensively burned patients is effective and feasible

Objective To explore the outcome, recurrence rate and postoperative MRI of the modified microendoscopy discectomy (MED) and the conventional MED. Method A total of 107 patients with disc herniation treated from January 2005 to December 2009 were randomly divided into Group A (54 patients) and Group B (53 patients). The patients in Group A were treated with the modified MED that removed the prominent nucleus pulposus but did not access into the annulus. The patients in Group B were treated with traditional MED that removed the prominent nucleus pulposus and cut annulus fibrosus and removed the nucleus pulposus within the annulus fibrosus. The operation outcome, recurrence rate and lumbar spine MRI were compared for observing the morphological changes of intervertebral disc and its surrounding structures. Results All patients were followed up for 1-4 years ( average 2 years),which showed no recurrence in Group A but four patients with recurrence Group B. According to Japanese orthopedic association (JOA) scoring of low back pain, the efficacy was excellent in 51 patients (94%)and good in three (6%), with excellence rate of 100% in Group A; while the efficacy was excellent in 42 patients (79%), good in seven (13%) and poor in four (8%), with excellence rate of 92% in Group B. Videman semi-quantitative assessment of disc signal showed no significant difference of MRI in aspects of signal intensity, thickness, diameter of the spinal canal in Group A before and after operation but highlighted significant differences in protruding degree,spinal canal diameter and lateral recess diameter. Substantial differences of MRI in aspects of signal intensity, thickness, protruding degree, spinal canal diameter and width were observed before and after operation in Group B. There was no significant difference in spinal canal diameter. Conclusions Both methods have sound clinical efficacy. However, the modified MED procedures take advantages of minimizing the damage of disc structure, maintaining the relative stability of the spine and delaying the disc degeneration, which contributes to lower recurrence rate.

BACKGROUND:Someone regards that treatments such as root canal therapy and post-core restoration can increase the fracture probability of teeth. Can fiber reinforced composite post enhance the fracture resistance of the severe wedge-shaped defected premolar? Three-dimensional finite element can simplify complex dental systems into a model analyzed by computer, and conduct biomechanical research through the model analysis. OBJECTIVE:To analyze the stress distribution of sever wedge-shaped defected first premolar which restored by fiber reinforced composite post and composite resin. METHODS:We established the three-dimensional finite element models of severe wedge-shaped defected maxil ary first premolar before and after restoration with fiber reinforced composite post and composite resin. The maximum bite force was designed to 267 N that was applied at 45° angle. Then, we analyzed the distribution of maximum principal stress in finite element models. RESULTS AND CONCLUSION:The maximum principal stress was concentrated in the tip of defected region. After restoration, the distribution of maximum principal stress was similar to that of the normal premolar, and the tensile stress was distributed uniformly in the upper-central part of buccal root. It may be beneficial for improving fracture resistance ability of severe wedge-shaped-defect premolar by restoration with fiber reinforced composite post and composite resin.

Objective: To explore the advantage of RR-Lorenz plot (RR-LP) in analyzing the patients of sinus rhythm with long RR interval.
Methods: A total of 308 RR-LP patients with long RR interval were retrospectively studied. The patients were divided into 7 groups according to the type of long RR intervals. ① Sinus bradycardia with arrhythmia group, n=63,②Repeated transient sinus arrest group, n=16, ③Ⅱ° sino-atrial block group, n=14, ④Ⅱ° atrial ventricular block (Ⅱ° AVB) group, n=47, ⑤ Un-passed atrial premature beats (APB) group, n=28, ⑥ Atrial premature beats group, n=72 and ⑦ Premature ventricular beats group, n=68. We analyzed the patients of RR interval greater than 1500 ms with ambulatory electrocardiogram record.
Results: ①RR-LP of sinus bradycardia with arrhythmia group showed a single distributing area with 1500 ms for the origin of transverse and longitudinal axis with B line slope at 1, tilt angle of 45°.②RR-LP of repeated transient sinus arrest,Ⅱ° sino-atrial block,Ⅱ° AVB and APB groups showed special four distributing areas with B line slope at (0.51 ± 0.01), tilt angle of (23.04 ± 0.50) °, B line slope at 0.6, tilt angle of (27°), B line slope at (0.57 ± 0.21), tilt angle of (25.69 ± 9.59)° and B line slope at (0.50 ± 0.01), tilt angle of (22.59 ± 0.54) ° respectively.③RR-LP of premature beats groups showed special four regional distributing areas, B line slope for atrial premature beats was at (0.38 ± 0.12), tilt angle of (17.06 ± 5.22) ° and B line slope for ventricular premature beats was at (0.07 ± 0.05), tilt angle of (3.02 ± 2.39) °.
Conclusion: RR-LP in patients of sinus rhythm with long RR interval had speciifc morphology and distribution features, the local abnormality could be found in a plane via all RR intervals which provided a differential diagnosis for repeated occurrence of short RR interval.

Objective To investigate the therapeutic effect of the meso-cavo-atrial shunt (MCAS) in the treatment of combined Budd-Chiari syndrome (BCS). Methods The clinical data of 17 cases of combined BCS with all or bilateral hepatic vein occlusion and long range occlusion or obstruction of inferior vena cava (IVC) were admitted to the Qilu Hospital from February 2000 to May 2004. All patients were treated by MCAS with artificial blood vessels. The pre- and postoperative clinical symptoms, the IVC and portal venous (PV) pressures, the incidence of postoperative complications and the patency rate of the artificial vessels were analyzed. The survival of patients was analyzed using the Kaplan-Meier analysis, and the data were analyzed using the chi-square test and t test. Results No patient died during the perioperative period, and the symptoms of 15 patients disappeared or were relieved after operation, with a significant difference compared with those before operation (χ2 =9.78, P <0. 05 ). Three patients had complications after the operation. The postoperative PV and IVC pressures were decreased by 1.2 cm H2O (1 cm H2O =0.098 kPa) and 18.5 cm H2O, respectively. There were significant differences in the decrease of IVC and PV pressures ( t = 2.38, 3.06, P < 0.05 ). The 1-, 3-, 5-year survival rates were 16/17, 15/17 and 14/17, respectively, and the 5-year patency rate of the artificial vessels was 14/17.Conclusions MCAS can simultaneously relieve IVC and PV hypertension for patients with combined BCS. The postoperative complication rate was decreased, the 5-year survival rate and the patency rate of the artificial vessels were improved after the treatment, so MCAS is an optional surgical method for treating combined BCS.

OBJECTIVE: To investigate the characteristics of adductor spasmodic dysphonia phonatory break in mandarin Chinese and select the stimuli phrases. METHOD: Thirty-eight patients with adductor spasmodic dysphonia were involved in this study. Standard phrase " fù mŭ xīn" and a speech corpus in mandarin Chinese with 229 syllables covering all vowel and constant of mandarin Chinese were selected. Every patient read the phrases above twice in normal speed and comfortable voice. Two auditory perpetual speech pathologists marked phonatory break syllables respectively. The frequency of phonatory break syllables and their located phrases were calculated, rated and described. The phrases including the most phonatory break syllables were selected as stimuli phrases, the phonatory break frequency of which was also higher than that of standard phrase "fù mŭ xīn". RESULT: Phonatory break happened in the reading of all patients. The average number of phonatory break syllables was 14 (3-33). Phonatroy break occurred when saying 177 (77.3%) syllables in the speech corpus. The syllables "guŏ, rén, zāng, diàn, chē, gè, guăn, a, bā, ne, de" broke in 23.1%-41.0% patients. These syllables belonged to the phrases "pĭng guŏ, huŏ chē, shì de, nĭ shì gè hăo rén, wŏ mén shì yŏu zŏng shì bă qĭn shì nong dé hĕn zāng, wŏ mén nà biān yŏu wăng qiú yùn dong chăng, cān gŭan, jiŭ bā hé yī gè miàn bāo dìan, tā shì duō me kāng kăi a,wŏ yīng gāi zài xìn lĭ xiĕ yī xiē shén mē ne?". Thirty-seven patients (97.3%) had phonatory break in above mentioned words. Ratios of these words phonatory break also were more than "fù mŭ xīn". CONCLUSION Adductor spasmodic dysphonic patients exhibited different degrees of phonatory break in mandarine Chinese. The phrases" shì de, pĭng guŏ, huŏ chē, nĭ shì gè hăo rén, wŏ mén nà biān yŏu wăng qiú yùn dong chăng, cān gŭan, jiŭ bā hé yī gè miàn bāo dìan, tā shì duō me kāng kăi a" were recommended as stimuli phrases for adductor spasmodic dysphonia evaluation.
Dysphonia ; diagnosis ; physiopathology ; Female ; Humans ; Language ; Male ; Phonation ; Spasm ; diagnosis ; physiopathology ; Voice

Objective To investigate the effect of voice training therapy on the voice improvement in patients with vocal nodules .Methods Twenty one patients with vocal nodules were recruited and were evaluated by the GRBAS perpetual evaluation ,voice handicap index (VHI)-30 subjective assessment ,vocal laryngostroboscopy , maximum phonation time (MPT) and acoustic analysis pre- and post-therapy .These patients completed 5 cour‐ses of voice training .Results The VHI value(29 .48 ± 21 .21) of post-therapy was less than the value (52 .95 ± 24 . 30)of pre -therapy (P< 0 .01) .There were significantly differences in voice perpetual evaluation between pre -training and post-training ,especially for G (grade) (P<0 .01) and R (roughness) (P<0 .01) .The post-training laryngostrobescopy vocal vibration improved comparing with pre-therapy in the closure of vocal cords ,symmetry of vibration ,the mucosal wave and vibration regularity of the vocal cords .After therapy ,three patient nodules dis‐appeared ,thirteen patient nodules became smaller ,and five patient nodules remained the same .The maximum pho‐nation time (MPT) (12 .54 ± 3 .68)of post-therapy was longer than MPT(8 .87 ± 3 .75) of pre-therapy MPT(P<0 .01) .The jitter value (0 .18% ± 0 .08% ) of post -therapy was less than that of pre-therapy(0 .43% ± 0 .31% ) (P<0 .01) .The shimmer of post -therapy (2 .10% ± 0 .98% ) was less than that of pre -therapy (4 .55% ± 1 .80% )(P<0 .01) ,The ratio of noise to harmonic(NHR)(0 .0034 ± 0 .0022 dB) of post-therapy was significantly less than NHR(0 .0184 ± 0 .028 dB)(P<0 .05) of pre-therapy .Conclusion The voice therapy could significantlyimprove voice of patients with vocal nodules .

Objective To evaluate the application value of real-time three-dimensional transesophageal echocardiography (RT-3DTEE) for the risk assessment of unusual atrial septal defect (ASD) in clinic therapy.Methods Accurate assessment before operation was conducted in 57 cases of patients with unusual ASD by two-dimensional transthoracic echocardiography (2DTTE),two-dimensional transesophageal echocardiography (2DTEE) and RT-3DTEE.The ultrasound manifestations were observed.And the guidance in clinic therapy were compared.Results The shape and number can be displayed clearly by 2D-TTE and 2D-TEE in 46 of 57 eases.Another 11 cases were diagnosed as irregular or two holes possibly.RT-3DTEE can help to observe the morphology and quantity of ASD visually and comprehensively in all cases.There was no statistical difference among 2DTTE,2DTEE and RT-3DTEE for the measurement of right atrium end-systolic transverse diameter (RATD),left atrium end-systolic transverse diameter (LATD),right ventricular end-diastolic diameter (RVDD) and left ventricular end-diastolic diameter (LVDD;all P＞0.05).The statistic difference for the diameter of atrial septal defect (ASDD) was found between 2D-TEE and 2D-TTE (P＜0.05) and RT-3DTEE and 2D-TTE (P＜0.05).There was no statistical difference among 2D-TEE,2DTTE and RT-3DTEE for the measurement of residual boundary condition of superior vena cava,aorta side and the top side of the atrium (all P＞0.05),whereas significant difference was found in measuring the residual boundary condition of inferior vena cava (F=50.39,P＜0.001).There were statistic differences between 2DTEE and 2DTTE,RT-3DTEE and 2DTTE,RT-3DTEE and 2DTEE (all P＜0.05).The clinic therapy can be directed by RT-3DTEE in all 57 cases.The diagnosis of 5 cases was failed by 2D-TTE,and 2 cases was failed by 2D-TEE.Conclusion Abundant image information can be offered by RT-3DTEE which plays an important role in the risk assessment of unusual atrial septal defect.

Objectives To identify the Francisella strain isolated from blood of a patient with drowning-associated pneumonia.Methods The whole genome of the strain,designated Wenzhou1,was sequenced using the high throughput sequencing technology by 2000/miSeq system of Illumina platform,and the obtained genome draft was assembled by MicrobeTrakr Plus software.The phylogenetic neighbors of Wenzhou1 were obtained by NCBI BLAST analysis from GenBank database for the gene sequences of 16S rRNA,malate dehydrogenase(mdh),DNA-directed RNA polymerase subunit beta (rpoB) and succinate dehydrogenase subunit alpha (sdhA).The average nucleotide identity(ANI) between Wenzhou1 and its phylogenetic neighbors was analyzed by the software OrthoANI using NCBI BLAST search under the Java Runtime Environment Version 8.Results The genome size of Wenzhou1 was 1.96 × 106 bp,containing 74 contigs.The genomic G + C mol％ of Wenzhou1 was 32.1％,which was similar to the other species of genus Francisella and Allofranicella.Based on the analysis of NCBI BLAST of GenBank for the similarities of 16S rRNA gene,mdh gene,rpoB gene and sdbA gene sequences,Wenzhou1 was most closely related to F.hispaniensis FSC454 and Francisella cf.novicida 3523.The ANI of Wenzhou1 was 97.8％ to F.hispaniensis FSC454,97.5％ to 97.6％ to Francisella cf.novicida 3523,but only 91.3％ to 91.5％ to the four subspecies of F.tularensis.Conclusion ANI analysis based on whole genome sequence should be an accurate,effective method for bacterial identification.Wenzhou1 could be identified as F.hispaniensis by ANI with high-throughput whole genome sequencing technology.