Objective To investigate the relationship between the changes of serum total bilirubin(TBil) and hybrid muscle crea-tine kinase isozyme(CK-MB),and its clinical implication in neonates with hypoxic-ischemic encephalopathy (HIE). Methods The levels of TBil and CK - MB were measured in 49 neonates with HIE (15 mild cases, 20 moderate cases and 14 serious cases), and 31 normal neonates on the first day and the fourth day after birth. Results The levels of TBil on the first day after birth were significantly higher than those in normal neonates;the levels of TBil were correlated with the severity of HIE(P

Objective To assess whether it have difference between mannitol combined with glycerin fructose and only use mannitol for the treatment of cerebral hemorrhage ,which provides relevant evidence‐based basis for guiding clinical treatment of cerebral hemorrhage .Methods We used literature retrieval through to the China national knowledge internet (CNKI) ,China biolo‐gy medicine disc ,VIP Chinese periodical database ,Wanfang data knowledge service platform and manual retrieval ,and formulate the inclusion and exclusion to screening literature ;and using the Jadad quality evaluation method to evaluate literature which had been included ,heterogeneity inspection at the same time .If the effect of multiple resulted ,we used fixed effect model ;on the other hand , used a random effects model .Results Mannitol combined glycerol fructose significantly improved symptoms and nervous function in patients with cerebral hemorrhage ,and the difference was statistically significant (RR=1 .12 ,95% CI:1 .03 -1 .22 ,P<0 .01);mannitol combined glycerol fructose significantly decreasd impaired renal function and complications (RR=0 .34 ,95% CI:0 .25-0 . 47 ,P<0 .01);mannitol combined glycerol fructose significantly decreasd severe unbalance of electrolyte after taking the medicine (RR=0 .31 ,95% CI:0 .19-0 .49 ,P<0 .01) .Conclusion Compared to use mannitol only ,combination with mannitol and glycerin fructose could effectively improve the prognosis of patients with cerebral hemorrhage ,and reduce the side effects .

Objective To develop a scientific system of core information of health and evaluation index for the elderly Chinese people,which is suitable for the situation of our country.Methods The framework was established by extensive literature review and topic discussions.The index system was constructed with the Delphi method.Results 58 experts in different fields of health were selected in the two rounds of Delphi consultation research.The effective response rates in the two rounds were 96.88％ and 100％ respectively.The average value of the authoritative coefficient was between 0.80 and 0.96.And coefficients of variation were between 6.20 and 12.13.Based on the Delphi consultation research,the core information of health and evaluation index system for the elderly Chinese people were composed of 8 primary indicators closely associated with the positive awareness of aging and senescence and 31 other indicators.Conclusions The architecture of the core information of health and evaluation index system for the elderly Chinese people is stable,and the consultant experts tend to reach a consensus.The evaluation index system contains the most influential factors for the elderly Chinese people,and has the affirmative scientificity,applicability and feasibility.

Objective To investigate the changes of serum osteocalcin and bone micro-structure in ovariectomized mice exposed to low-iron environment.Methods Twenty-four 12-week-old female C57BL/6 mice were divided equally into sham operation (SHAM) group,model(OVX) group,and low iron(OVX+DFO) group.In low-iron group,deferoxamine(DFO) was injected 3 times per week for 5 weeks after operation ; the other groups were injected with the same dose of 0.9％ normal saline for 5 weeks.The serum,left femur,uterus were harvested after five weeks of treatment.The serum osteocalcin and ferritin levels were measured by ELISA kit,the weight of the uterus was recorded by analytical balance.A high resolution micro-CT was used to scan the left femur for cortical bone and cancellous bone analysis.Results (1) The serum osteocalcin and serum ferritin levels in low-iron group were significantly lower than those in the other 2 groups (P＜0.01) ; (2) Compared with the sham group and ovx group,there were significant decrease of the BMD、BV/TV and Tb.N,but increase of Tb.Th and Tb.Sp in low-iron group (P＜0.01).Conclusion A certain dose of DFO (30 mg/kg) can decrease the serum ferritin levels as well as the bone formation index in ovariectomized mice.

Objective To explore the influence and it′s mechanism of workplace mindfulness on thriving at work of nursing staffs. Methods A cross-section survey was conducted to collect data with an online method, the multiple line hierarchical regression analysis method was performed to test the relations between variables. Results The mean workplace mindfulness score of nursewas 4.74±0.63, the mean thriving score was 3.07 ± 0.71. Workplace mindfulness had a significantly positive prediction on thriving at work (β=0.344, P<0.01) of nurses. Conclusions Workplace mindfulness could affect nurses′thriving at work, which is beneficial to improve the growth and vitality of nursing staffs, which in turn to enhance them to abundant and vigorous life.

Objective To evaluate the effects of curcumin on the expression of phosphorylated extracellular signal-related kinase (p-ERK) and phosphorylated cAMP response element binding protein (p-CREB) in the spinal dorsal horn and dorsal root ganglion (DRG) in type 2 diabetic neuropathic pain (DNP) in rats.Methods Type 2 diabetes mellitus was induced by high-fat and high-sucrose diet and intraperitoneal streptozotocin (STZ) 35mg/kg,and confirmed by fasting blood glucose level≥ 16.7 mmol/L in male Sprague-Dawley rats.Type 2 DNP was confirmed by the mechanical withdrawal threshold (MWT) and thermal withdraw latency (TWL) measured on day 14 after STZ administration ＜ 80％ of the baseline value,and the rats with type 2 DNP were randomly divided into 3 groups (n =27 each):type 2 DNP group (group DNP),curcumin group (group Cur) and solvent control group (group SC).Curcumin and corn oil 100 mg/kg (25 mg/ml) were injected intraperitoneally once a day for 14consecutive days starting from 14 days after administration of streptozocin in Cur and SC groups,respectively.Another 27 normal rats were served as control group (group C) and were fed with common forage.MWT and TWL were measured at 3,7 and 14 days after curcumin injection (T1 3),and the lumbar segment 4-6 of the spinal cord and DRGs were removed at the same time for determination of the expression of p-ERK and p-CREB (by Western blot).Results Compared with group C,MWT was significantly decreased,TWL was shortened,and the expression of p-ERK and p-CREB in spinal dorsal horn and DRGs was up-regulated at T1-3 in DNP and SC groups,and at T1 in Cur group (P ＜ 0.05).Compared with group DNP,MWT was significantly increased,TWL was prolonged,and the expression of p-ERK and p-CREB in spinal dorsal horn and DRGs was down-regulated at T2,3 in Cur group (P ＜0.05).There was no significant difference in the MWT,TWL and expression of p-ERK and p-CREB between DNP and SC groups (P ＞ 0.05).Conclusion Curcumin can attenuate type 2 diabetic DNP by inhibiting up-regulation of the expression of p-ERK and p-CREB in the spinal dorsal horn and DRG in rats.

Objective To explore the incidence and risk factors of bacterial infection after othtotopic liver transplantation (OLT). Methods Altogether 56 OLT recipients from January 2005 to October 2007 were included in the study. The incidents and the related variables of the infection were analyzed retrospectively. The related variables were evaluated using multivariate logistic regression model to identify the significant risk factors. Results Bacterial infection was confirmed in 29 recipients (51.8%). Among them, the lung infection was the most common site (53.7%). The Gram-positive cocci were 46.3%, while the Gram-negative bacilli were 53.7%. The risk factors for bacterial infection included duration of the operation and detained respirator using. Conclusion Bacterial infection is a major complication following OLT. Surveillance for the risk factors, enhancement the skill of operation, and improving the recovery of respiratory function is the key to decreasing the incidence of bacterial infection after transplantation.

ObjectiveTo investigate the changes of serum creatine kinase isoenzyme (CK-MB) and creatine kinase (CK) ratio(CK-MB/CK) and cardiac troponin I(cTnI) simultaneously in patients with acute organophosphorus pesticide poisoning (AOPP) and the clinical value in disease condition judgment.Methods Eight hundred and sixty-eight AOPP patients without disease history of heart,lung,brain,kidney,muscle and other connective tissue were extracted 4 ml of fasting venous blood to determine CK,CK-MB and cTnI simultaneously at 2,12,24,48,96 and 120 hours after poisoning,and the CK-MB/CK was calculated.There were 279 mild poisoning cases (mild poisoning group),289 moderate poisoning cases (moderate poisoning group) and 300 severe poisoning group (severe poisoning group) ; and 208 cases with intermediate myasthenia syndrome (IMS)(IMS group) and 660 cases without IMS (non-IMS group).The result was compared with 288 healthy people (control group) in the same period.Results ( 1 ) The CK,CK-MB and cTnI of mild,moderate and severe poisoning groups between 2 to 12 h,13 to 24 h,25 to 120 h after poisoning were significandy higher than those in control group,CK-MB/CK was obviously lower (P ＜ 0.01 ).The CK,CK-MB,cTnI and CK-MB/CK had significant differences between each two of mild,moderate and severe poisoning groups (P＜ 0.01 or ＜ 0.05).The CK,CK-MB and cTnI of IMS group in 2 to120 h after poisoning were significantly higher than those in non-IMS group,and CK-MB/CK was lower (P ＜ 0.05 or ＜ 0.01 ).In IMS group,the rates of sudden cardiac death (SCD) and multiple organ dysfunction syndrome (MODS) were 23.08％(48/208),37.50％(78/208) respectively,while 4.24％(28/660),9.85％(65/660) in non-IMS group.The incidence of SCD and MODS of two groups had statistical significance (P ＜ 0.01 ).(2) According to IMS and non-IMS group,discriminant equation with independent variables of cTnI (X1), CK (X2) and CK-MB/CK (X3) was established:Y =-0.0014X1 + 0.0225X2 + 65.2376X3,F=21.4911,P ＜ 0.01.The discriminant critical value(Y0) was 2.8124.If Y ＜ 2.8124 belonged to IMS group and Y ≥2.8124 was in non-IMS group,the contribution rates of X1,X2 and X3 were 34.5％,25.4％ and 40.1％ respectively.The coincident rate of return was 91.26％.ConclusionsCK-MB/CK change has negative correlation with poisoning degree of AOPP;cTnI level is positively correlated with AOPP poisoning degree.they may be used to assist the clinical classification,disease judgement and to guide the emergency,treatment and prognosis assessment of AOPP.The function equation with cTnI,CK and CK-MB/CK can be used as effective prediction indexes of IMS,MODS and SCD in early period.

Objective To investigate the feasibility of new criteria for evaluating the radiotherapeutic effect on esophageal cancer by barium meal (BM) combined with CT scans.Methods A total of 189 patients who were diagnosed with esophageal cancer (confirmed by biopsy) from January 2004 to December 2010 were enrolled as subjects.All patients underwent BM and CT scans before and after radiotherapy.The maximal esophageal wall thickness (EWT) and changes in the volumes of regional lymph nodes measured by CT scans were analyzed.New criteria for evaluating the short-term radiotherapeutic effect on esophageal cancer was studied considering the analysis results as well as the BM-based criteria for evaluating short-term radiotherapeutic effect and follow-up results.Results The BM-based evaluation criteria were still useful,but had certain limitations.There were 115 patients who had regional lymph node metastasis as detected by CT scans before radiotherapy,and they were divided into complete remission (CR) group and partial remission (PR) group according to BM results after radiotherapy; the local control rate (LCR) of CR group was significantly higher than that of PR group,but there was no significant difference in survival rate (SR) between the two groups.There were 65 patients who had no regional lymph node metastasis,and they were also divided into CR group and PR group according to BM results after radiotherapy;the LCR and SR of CR group were significantly higher than those of PR group.In summary,the patients who had a CR as evaluated by BM and had the maximal EWT of ≤ 1.20 cm and the volumes of residual lymph nodes of ≤ 1.00 cm3 on CT were defined as CR ; the patients who had a PR as evaluated by BM or had the maximal EWT of ＞ 1.20 cm or those who had a CR evaluated by BM and had the maximal EWT of ≤ 1.20 cm and the volumes of residual lymph nodes of ＞ 1.00 cm3 on CT were defined as PR.The cases evaluated by BM as no remission (NR) or showing metastasis were defined as NR or progressive disease.There were significant differences in LCR and SR between the CR group and PR group determined by the new criteria.Conclusions Simply using BM to evaluate the short-term radiotherapeutic effect on esophageal cancer has certain limitations; instead,the evaluation based on both BM and CT scans is more accurate.

ObjectiveTo explore the application of diffusion-weighted magnetic resonance imaging (DWMRI) in precise radiotherapy of esophageal carcinoma.MethodsThirty-seven patients with biopsy proven esophageal cancer from March 2010 to January 2011 were included.To delineate the gross tumor volume (GTV) using CT and DWMRI images,each patient was examined by DWMRI and CT scan using the same position before radiotherapy.To compare the maximum diameters and volumes of tumor between CT and DWMRI. The tumor lengths measured by esophagogram,esophagoscope,CT and DWMRI were compared.ResultsTumor lengths under esophagogram,esophagoscope,CT and DWMRI were 5.70 cm,6.06 cm,7.97 cm and 5.79 cm respectively. The lengths between CT and esophagogram,CT and esophagoscope,CT and DWMRI had statistical significance respectively (F=4.88,P=0.003).The maximum diameters of tumor shown on CT and DWMRI were 3.79 cm and 3.81 cm respectively ( t =-0.32,P=0.751 ).The GTV were 45.75 cm3 and 38.05 cm3 in CT and DWMRI respectively (t=5.30,P =0.001 ).53 lymph nodes were assessed positive on both CT and DWMRI.DWMRI excluded 25 positive lymph nodes assesed by CT; also confirmed 15 negative lymph nodes excluded by CT,6 of which were paraesophageal lymph nodes.The addition of DWMRI information altered the clinical stage in 6 patients.ConclusionsTumor lengths measured on DWMRI and esophagogram had the optimal approximation.It was easy to find paraesophageal lymph nodes via DWMRI.With the addition of DWMRI information,the target range and clinical stage were alerted in some patients.