Objective To determine the relationship between the residue amniotic fluid volume after preterm premature rupture of membranes(PPROM)and maternal-fetal prognosis.Methods One hundred and forty-five pregnant women with PPROM during 28-34 gestational weeks were studied,hospitalized in department of Obstetrics and Gynecology,The First Affiliated Hospital of Chongqing Medical University from Jan.2002 to Feb.2009,and Chongqing Health Center For Women And Children from Jan.2005 to Feb.2009.All patients are willing to take part in these experiments.According to Amniotic fluid index(AFI)by ultrasound,patients were derided into three groups:(1)Group of oligohydramnios:AFI＜50 mm;(2)Group of berderline oligohydramnios:50 mm≤AFI＜80 mm;(3)Group of normal amniotic fluid:80 mm≤AFI＜180 mm.All the groups weFe similar with patient's age.gravidity and parity,white blood cell count (WBC),gestational age at rupture of membrane,rates of placental abruption,neonatal jaundice,neonatal hypoglycemia,neonatal respiratory distress syndrome(NRDS),neonatal hypoxic ischemic encephalopathy (HIE)and neonatal respiratory failure(RF;P＞0.05).Resalts (1)Group of oligohydramnios had a shorter latent period(P＜0.05)compared with other two groups;(2)Group of oligohydramnios had a hish rates of cesarean section(69%),Intra-amniotic infection(IAI,36%),fetal distress(19%),neonatal asphyxia(28%).early-onset neonatal sepsis(28%)and hypoxic-ischemic myocardial injury(56%)than those in Group of normal amniotic fluid(39%,9%,3%,8%,9%,13%;P＜0.01);(3)Logistic regression analysis showed that group of oligohydramnios wag an independent risk factor of IAI and earlyonset neonatal sepsis(P＜0.05).Conclusions Oligohydramnios after pprom is associated with the shorter latent period,as well as the increasing risks of pregnancy complications of cesarean Section,IAI,fetal distress,neonatal asphyxia,early-onset neonatal sepsis and neonatal hypoxic-ischemic myocardial injury.So,the amniotic fluid volume might be an important prognostic indicator to assess the outcomes of maternal and neonatal when PPROM happened.

Objective To summarize the clinical experience of laparoscopic appendectomy(LA).MethodsA retrospective analysis was conducted on the clinical data of 683 patients with appendicitis treated by LA,including 258 cases of chronic appendicitis,425 cases of acute appendicitis(87 cases of complicated appendicitis).ResultsThe procedure was completed in all the patients without conversion to open surgery.The operation time was 30 min in average(15-150 min).The average hospital stay was 4d (2-15d).Postoperative complications included 26 cases of incision infection,3 cases of abdominal abscess,1 case of appendical mesenterium hemorrhage,1 case of small intestine fistula and 1 case of appendical stump fistula.The patients were followed up for 2 to 12 months with a mean of 6 months,during which no intestinal adhesive obstruction occurred.Conclusion LA is safe and effective for appendicitis,with advantages of minimal trauma,lighter pain,quicker recovery,shoter hospital stay,less complications and so on.For complicated appendicitis,the abundant surgical experience and proficient endoscopic technique are indispensable to reduce the occurrence of complications effectively.

Objective To investigate the association of chest pain patients with primary level in high-sensitivity troponin T (hs-cTnT) level no more than 14 ng/L in the onset of acute myocardial infarction in pa-tients with chest pain. Methods We enrolled 3 096 participants from January 2012 to December 2013 in West China Hospital, Sichuan University. All patients were classified two groups (hs-cTnT > 14 ng/L, hs-cTnT ≤14 ng/L and no ischemia on ECG) according to hs-cTnT levels and ECG. We evaluated the risk of myocardial in-farction and death and negative predictive value in 30 days. Results Thirty-seven patients were diagnosed in having acute myocardial infarction (AMI) and 4 patients were dead in the hs-cTnT > 14 ng/L group in 30 days in the absolute risk 2.35(1.86-2.74) and 0.29(0.12-0.53); 9 patients were diagnosed as having AMI and no patients were dead in the hs-cTnT ≤ 14 ng/L group in 30 days in the absolute risk 0.58 (0.42-0.74). Conclu-sion Chest pain patients whose primary levels no more than 14 ng/L in hs-cTnT with no ischemia on ECG can be ruled out AMI in negative predictive value 99.6%. the levels of hs-cTnT which were dynamic monitored at least 5 h and still no more than 14 ng/L can rule out AMI directly.

Objective To evaluate the relationship between thyroid autoimmunity and the risk of preterm birth. Methods Literature search was done among PubMed, Embase, Wanfang Medical Database, China Academic Journal Network Publishing Database and China Biology Medicine disc from Jan. 1st 1980 to July 31st, 2015. (1) Literature were extracted according to inclusion and exclusion standards, and the quality of the extracted literature were evaluated by Newcastle-Ottawa Scale (NOS). (2) Meta-analysis was performed by RevMan 5 software formulated by using the Cochrane library databases. Various heterogeneity of the research was inspected firstly. According to the results of the inspection a certain effect model was selected (including fixed effects model, the random effects model) to be utilized in merger analysis. In this study pregnant women with both thyroid peroxidase antibodies (TPO-Ab) and thyroglobulin (TG-Ab) positive were defined as thyroid antibody positive pregnant women. Pregnant women with only TPO-Ab positive were defined as TPO-Ab positive pregnant women. Then the relationship of antibody positive and the risk of a pre-term birth was analyzed respectively. Results (1) Ten cohort studies were enrolled, of which NOS scale score were 7 or higher. All the studies are of medium quality and above. A total of 1 322 cases of preterm birth occurred among 19 910 pregnant women. (2) Positive thyroid autoantibodies did not increase the risk of preterm birth in euthyroid pregnant women (OR=1.41, 95%CI:0.83-2.40, P=0.200) or in pregnant women with hypothyroidism (OR=0.68, 95%CI: 0.32-1.44, P=0.310). Positive TPO-Ab in euthyroid pregnant women increase the risk of preterm birth significantly (OR=2.08, 95%CI:1.09-3.97, P=0.030), but positive TPO-Ab in pregnant women with hypothyroidism did not increase the risk of preterm birth significantly (OR=1.21, 95%CI:0.65-2.24, P=0.550). Conclusion Positive TPO-Ab is an independent risk factor of preterm birth in euthyroid pregnant women.

Objective To explore the effect of diammonium glycyrrhizinate(DG) and astragalus membranaceus (AM) injection on the clinical comprehensive score in patients with acute lung injury (ALI). Methods According to the random number table method,a prospective random controlled study was conducted in which 60 cases of patients with ALI were divided into a study group and a control group(each,30 cases). Both groups received a comprehensive treatment based on the new guidelines,and the study group was additionally given DG and AM injection(DG 150 mg+AM 20 ml)one time per day for 7 days. The scores of lung injury,acute physiology and chronic health evaluationⅡ(APACHEⅡ)and systemic inflammatory response syndrome(SIRS)were measured at baseline,3rd and 7th day after treatment,and ventilation support time and final disease mortality rate were also calculated in all the patients. Results There were no statistically significant differences between the two groups in the scores of lung injury,APACHEⅡand SIRS before treatment and after treatment for 3 days(all P>0.05),with prolonged treatment,the above indexes were significantly reduced compared with those before treatment in the two groups,and the decreases in scores of indexes in study group was more significant than those in control group after treatment(lung injury score:1.31±0.99 vs. 2.29±1.08,APACHEⅡscore:18.43±8.17 vs. 24.23±6.98,SIRS score:1.69±0.89 vs. 2.60±1.04,all P<0.01). The time(hour)for ventilator support in study group was shorter than that in the control group(176.10±57.81 vs. 286.07 ± 156.27,P<0.01),but there was no statistically significant difference in mortality rate between the two groups(13.33%vs.16.67%,P>0.05). Conclusion The results suggest that DG and AM injection improve the scores of lung injury,APACHEⅡand SIRS,and alleviate the lung injury,so that the injection is beneficial to the early weaning from the ventilator to support treatment in patients with acute lung injury,and has certain therapeutic effect on ALI.

As a new learning tool, mind mapping helps students master the learning content in a visual and radical way. This paper intro-duced the concept and method of making the mind map and analyzed the advantages of mind mapping in improving learning efficiency and its application in rehabilitation. It is pointed out that the use of mind mapping would help students to integrate new and old knowledge, to improve the ability to solve clinical problems, and to train innovative talents by stimulating students' divergent thinking. It is believed that the mind map has a broad application prospect in rehabilitation education in China.

BACKGROUND: Thoracolumbar segments (T11-L2) prone to damage due to its special anatomical and biomechanical characteristics. Therefore, fully understanding the shape of pedicle of vertebral arch and finding the visible, constant, and the point of insertion of the pedicle axis is very important to the safety of pedicle screw placement.OBJECTIVE: To measure the surgically relevant parameters of thoracolumbar pedicles between Han and Uygur males using computed tomography (CT) scan to provide some anatomic reference data for pedicle screw fixation.METHODS: The vertebral bodies and pedicles of adult males were scanned (60 cases of Han people and 60 cases of Uygur people) from T10-L3 with CT. The parameters were processed by three-dimensional reconstruction. Transverse pedicle width, pedicle axis length, transverse pedicle angle, and sagittal pedicle angle were measured by using length and angle measurement tool of browser in bone-window CT images. The age and stature information were recorded. All the data above were processed by SPSS 13.0 software.RESULTS AND CONCLUSION: (1) The mean transverse pedicle width of T12 and L1 in Han was bigger than that in the Uygur. (2) The mean transverse pedicle angle of T12 and L2 in Han was bigger than that in the Uygur. (3) The mean pedicle axis length and sagittal pedicle angle of T11 and L1 in Han were bigger than that in the Uygur (P < 0.05). (4) There were some differences among some parameters of the thoracolumbar pedicles between the Han and Uygur people.Data from any study only can be used as a guide for pedicle screw fixation. Preoperative CT evaluation may provide an individualized strategy to reduce the incidence of postoperative complications caused by misplacement.

Objective To investigate the ecological structure of intestinal fungal flora of patients with chronic hepatitis B infection. Methods HBV-liver cirrhosis patients, chronic hepatitis B patients, HBV carriers, and healthy volunteers were selected as research subjects to extract the total DNA from stool of each subject, 18S rRNA genes of intestinal fungi was cloned and sequence was analyzed for the construction of 18S rDNA clone libraries and phylogenetic tree, diversity and structural characteristics of intestinal fungal flora in each group was then analyzed. Results A total of 29 operational taxonomic units (OTUs) of intestinal fungal flora in all research subjects was acquired. All positive clones belonged to three fungal taxa: Zygomycetes (3.4%) , Ascomycetes (82. 8%) and Basidiomycetes (13. 8%) . The dominant fungal community was Candida spp. , uncultured fungus and Saccharomyces spp. , which accounted for 29. 2% , 15. 9%, 15.0% respectively. The OTUs which belonged to HBV-liver cirrhosis patients, chronic hepatitis B patients, HBV carriers, and healthy volunteers was 20,16,12,14 respectively. Conclusion There is an abundant fungal flora in the human intestine. Ecological structure of intestinal fungal flora appears to be various in patients with chronic hepatitis B infection, which indicate the close relationship between the alteration of ecological structure of fungal flora and the stage of chronic hepatitis B infection.

BACKGROUND: In recent years, ultrasound microbubble gene transfer system has been applied for gene transfection in many parts of the body, but it has been seldom reported to be used for gene transfection in bone parts. OBJECTIVE: To investigate the efficiency and feasibility of ultrasound-targeted microbubble destruction applied for transfection of enhanced green fluorescent protein plasmid into the femoral head of rabbits.METHODS: Japanese big-ear rabbits were randomly divided into five groups: bare transfection, pre-irradiation + bare transfection, ultrasound transfection, pre-irradiation+ultrasound transfection, and repeatable transfection. In the first two groups, ultrasound-targeted gene transfection and irradiation was not used, but in the latter three groups, ultrasound-targeted microbubble destruction was used to transfect enhanced green fluorescent protein (EGFP) plasmid into the femoral head of rabbits. At 1 week after transfection, EGFP expression in femoral head was observed under the fluorescence microscope. RESULTS AND CONCLUSION: EGFP expression appeared in the ultrasound transfection, pre-irradiation + ultrasound transfection and repeatable transfection. The transfection efficiency of EGFP plasmid was significantly higher in the repeatable transfection group than in the other groups (P < 0.01). Obvious injury loci were not observed in the soft tissue and bone tissue slices of ultrasonic irradiation parts in the ultrasound transfection, pre-irradiation + ultrasound transfection and repeatable transfection groups. These results confirm that ultrasound-targeted microbubble destruction is a safe and effective method to transfect EGFP plasmid into the femoral head of rabbits.

Objective To investigate the clinical effects of comprehensive rehabilitation treatment for patients with a diabetic foot. Methods Fifty-two patients with one diabetic foot were randomly divided into a rehabilitation group ( n =26 ) and a control group ( n =26).The patients in the control group received conventional treatment including health education,basic medical therapy and focal treatment of the foot.In addition to the conventional treatment,the rehabilitation group was treated with aerobic exercise,Beecher's exercise regimen,infrared therapy and ultrashortwave therapy 6 days a week for 4 weeks.The therapeutic effect and quality of life were evaluated before and after treatment. Results The effectiveness rate of the rehabilitation group was significantly higher than that of the control group ( 88.46％ vs 73.08％ ) after treatment.The quality of life scores in both groups were significantly better than those before treatment,including on the social relationship dimension,the physiological function dimension,the mental/psychology dimension and the therapy influence section.Average quality of life scores in the rehabilitation group had improved significantly more than in the control group. Conclusion Comprehensive rehabilitation is beneficial to prevent the progress of diabetic foot and to improve the quality of life of patients with a diabetic foot.