Objective To explore the predictive effect of modified DECAF,DECAF,CAPS and APACHEⅡin the assessment of prognosis of AECOPD patients with respiratory failure. Methods Clinical data of 186 AECOPD cases complicated with respiratory failure were analyzed and four score modes were used within 24 hours of admission. Clinical endpoints were patients′ survival status 28 days after admission. The discriminative power of the four score modes was evaluated by the area under the receiver operating characteristic curve (AUC). Results AUC of the modified DECAF(0.777,95%CI:0.710-0.835) and DECAF (0.766,95%CI:0.699-0.825) for prognosis was significantly greater than that of CAPS(0.699 ,95%:0.628-0.764) and APACHEⅡ(0.715,95%:0.645-0.779). Conclusion The modified DECAF and DECAF have predictive values on assessing the prognosis of AECOPD patients with respiratory failure ,which are simple and efficient.

Objective To evaluate the value of preoperative spiral CT (SCT) scanning in the diagnosis and staging of middle-late stage rectal carcinoma. Methods The results of SCT scanning of 34 patients with middle-late stage rectal carcinomas were compared with the pathological examination results and the findings of surgical operation. Results SCT could display the manifestations of middle-late stage rectal carcinoma, such as rectal wall thickening, local tumor mass, tumor invasion of rectal circumference, narrow rectal cava, lymph node enlarging (diameter≥10mm) and tumor distant metastasis. According to Duke's staging, the overall accuracy of SCT staging was 70.6%, and for the stages B1, B2, C, and D the sensitivity was 83.3%, 50%, 66.7%, 78.5%, and the specificity was 62.5%, 44.4%, 57.1%, 100%, respectively. According to TNM staging, the overall accuracy of SCT was 73.5%, and for the stages T2, T3, T4 the sensitivity was 85.7%, 61.5%, 78.6%, and the specificity was 54.5%, 66.7%, 100%, respectively. Conclusion Preoperative SCT could display the invasive range of middle-late stage rectal carcinoma and the tumor lymph nodes metastasis, especially distant metastasis, and had a definite diagnostic value.

Kinesio Taping therapy is commonly used in sports injury, and has been focused in central neurological rehabilitation in recent years. This article reviewed the efficacy, mechanism of Kinesio Taping in central neurological rehabilitation.

Objective To study the advantage and disadvantage of two types of rat heart trans- plantation models.Methods Twenty Wistar rats served as donors and 20 SD rats as recipients ran- domly in two groups.Abdominal working and nonworking cardiac transplantation models from Wistar to SD rats were established.In the working model,the donors pulmonary artery was anastomosed to the left atrial appendage.The left ventricle ejected volume through an end to side anastomosis of the donor's aorta to the recipient's abdominal aorta.In the nonworking cardiac transplantation model,the donor's pulmonary artery was anastomosed to the recipient's inferior vena cava and the donor aorta was anastomosed to the recipient aorta.Results Working model and nonworking model were successfully established.The survival rate of both models was 90 %.Total operating time of the working model was 10 min shorter than the nonworking model.Postoperative UCG demonstrated the working trans- planted hearts had ejection.Conclusions Rat abdominal working cardiac transplantation model was used perfectly with high rate of survival and shorter total operating time.The working model approached cardiac physiological functions more than the nonworking model.

Objective To evaluate the effect of lipoic acid on endothelial microparticles (EMP) in diabetic patients with peripheral artery disease (PAD) of the lower limbs. Methods Forty eight diabetic patients with PAD of the lower limbs were randomly divided into two groups: the therapeutic group and control group (each group has 24 cases). Patients of control group only received internal comprehensive medicine therapies for 3 weeks. Patients of therapeutic group were treated with both lipoic acid (600 mg lipoic acid injection in normal saline solution for intravenous drip, once daily for 3 weeks) and internal comprehensive medicine therapies at the same time. The levels of EMP in venous blood and Ankle-brachial index (ABI) were estimated before and after treatment by flow cytometry. Results Compared to the control group after treatment [(1 179. 8± 120. 1) per μL], EMP value showed a significant reduction in therapeutic group [(1 032. 4±117. 2) per μL] (P<0. 01). The levels of ABI of therapeutic group (0. 68 ±0. 10) was increased obviously as compared that before lipoic acid treatment (P<0. 01). Patients treated with lipoic acid showed the higher levels of ABI than the control group after treatment (0. 58±0. 11) (P<0. 01). Conclusion Lipoic acid injection significantly decreased the level of EMP in diabetic patients with PAD of lower limbs. Lipoic acid might be an effective drug for diabetic patients with PAD.

Objective To review the experience of perioperative management and effect of coronary artery bypass grafting (CABG) for patients of aged＞80 years.Methods We studied 118 cases with CABG for patients of age＞80 years from January 2002 to December 2012.The other 1034 cases with CABG for patients aged 60-80 years were enrolled as control group.Logistic regression analysis was used to assess the effect of age on operative mortality and morbidity.Results The recent mortality was higher in group aged＞80 years [6.8％(8 cases) vs.3.1％(32 cases)].Through multivariate logistic regression,the patients aged＞80 years versus control were concerned about some postoperative adverse events as follows:higher mortality (OR =3.45,95 ％ CI:2.86-4.23),dialysis (OR=3.56,95％CI:3.01-4.32) and re-intubation(OR=3.87,95％CI:3.45-4.87),delayed healing of incision(OR=4.05,95 ％ CI:3.47 5.74),prolonged mechanical ventilation(OR=3.76,95 ％ CI:3.435.01),prolonged ICU stay (OR =2.98,95 ％ CI:2.67 4.12),prolonged hospital stay (OR =2.87,95％CI:2.36-3.96).Conclusions Age＞80 years is an important factor of postoperative mortality and morbidity for CABG.We need pay more attention to perioperative management.

Objective:To explore the roles of the caudal ventrolateral medulla(CVLM) in the central anti-hypertensive mechanism. Methods : In 20 urethane-anesthetized SD rats, the effects of I1-imidazoline receptor and ?2-adrenceptor antagonists (microinjection into the CVLM) on the cardiovascular responses induced by intravenous clonidine were observed. Results: Prior bilateral microinjection of mixed antagonist idazoxan (I1-imidazoline receptor and a2-adrenceptor) into the CVLM not only decreased the mean arterial pressure [(-17. 3 ? 6. 9) mmHg, 1 mmHg = 0. 133 kPa, P

Objective To investigate the suitable injection rate and dose in multi-slice CT perfusion imaging.Methods Randomized block design was adopted in this study.The treatment factor-contrast medium injection rate was classified into 3,4,5,6 and 8 ml/s;thesubjects were divided into 5 blocks grouped by contrast medium injection dose: 0.5,0.75,1,1.25 and 1.5 ml/kg.25 Beagles wererandomly enrolled to undergo cerebral CT perfusion imaging.After post processing,time to peak(TTP) and rise value(RV) were measured in superior sagital venous.Results Injection rate had a significant effect on TTP of superior sagital venous.There was no significant difference among group 5,6 and 8 ml/s.Compared with 8 ml/s,TTP of superior sagital venous was prolonged when injection rate 3,4 ml/swere adopted.Injection dose had a significant effect on RV of superior sagital venous.There was no significant difference among group 1,1.25 and 1.5 ml/kg.In comparison with 1 ml/kg,RV of superior sagital venous was prolonged when injection dose 0.5 and 0.75 ml/kg were adopted.Conclusion The quality of cerebral CT perfusion imaging is well enough even injection rate as low as 5 ml/s or injection dose as few as 1 ml/kg.

Based on the characteristics of salt.alkalinized soil in northeastem China,twenty-five kinds of salt alkaline conditions with different salinities and pH were simulated by mixing NaCl,NaHCO3,Na2SO4,and Na2CO3,in various proportions and applied to sunflower (Helianthus annuus L.) seedlings to investigate the coordinative effects of salt and alkali stresses on its antioxidant enzyme system.The soil was conditioned with a salt concentration range between 50 to 250 mmol/L and pH values from 7.12 to 10.46.Several physiological indexes of stressed seedlings were measured,including the activities of superoxide dismutase (SOD),catalase (CAT),and pemxidase (POD),as well as the content of malondialdehyde (MDA).The results showed that the responses of the antioxidant enzyme system in sunflowers were influenced by salinity and alkalinity,which all three antioxidant enzymes exhibited a rise-drop pattern as salinity increased,whereas their responses to alkalinity appeared to be diverse:decreased for SOD and CAT,and increase for POD along when increasing alkalinity.A two-way analysis of variance (ANOVA) showed that the effects of salinity and alkalinity on the activities of the three enzymes were significant (P＜0.001).The effect of salinity on POD and SOD was greater than that of alkalinity,whereas the effect of alkalinity on CAT was greater than that of salinity.The interrelation of salinity and alkalinity on each antioxidant enzyme was significant (P＜0.001) except for SOD.The correlation and stepwise regression analyses between the activity of the antioxidant enzyme system and the MDA content were significant to difierent extend,SOD was a dominant factor,and POD was neglectable.

Objective To investigate the clinical distribution and the drug resistance of carbapenemresistant Proteus mirabilis strains isolated from 2009 to 2012 ; and to study carbapenemase genotypes of the isolates.Methods A total of 15 non-repetitive carbapenem-resistant Proteus mirabilis strains were selected from 422 Proteus mirabilis strains isolated from Ningbo First Hospital during January 2009 to December 2012.The minimal inhibitory concentrations (MIC) of 6 antibacterial agents,including imipenem (IPM),meropenem (MEM),ertapenem (ETP),ciprofloxacin (CIP),amikacin (AK) and minocycline (MIN),against 15 isolates were determined by E-test.The modified Hodge test (MHT) was used to detect the carbapenemase production in isolates.The PCR assay was performed to detect drug resistance genes of blaKPC,blaNDM-1,blaGES,blaSME,blaIMI-1/NmcA and blaSHV-38.Plasmids were extracted from the blaKPC-positive strains and then transformed into Escherichia coli J53 strains by electroporation.The transformed and untransformed Escherichia coli J53 strains were tested for MIC values and blaKPC gene by E-test and PCR respectively.Results The resistance rates of the 15 carbapenem-resistant Proteus mirabilis strains to IPM,MEM,ETP,CIP,AK and MIN were 100％,100％,100％,86.7％ (13/15),33.3％ (5/15) and 80％ (12/15),respectively.7 out of 15 strains were Hodge test positive,and 11 strains were blaKPC-2 positive.Results of PCR amplification showed that the transformed Escherichia coli J53 strains,whose MIC values to IPM,MEM,and ETP were increased by 2 to 64 times,were blaKPC-2 gene positive.Conclusion The carbapenem-resistant Proteus mirabilis strains in this study were resistant to many commonly used antibiotics,however,the resistance rates to AK were relatively low.The dominant carbapenemase genotype was blaKPC-2 carried by the plasmid.Attention should be paid to its easily transmissible feature among the strains in clinic.