Objective To analyze the value of serum calcitonin level to determine the illness severity of the elderly patients with severe pneumonia within six hours after admission and to dynamically observe the predictive value of serum PCT level change rate in different time points on the prognosis of the patients.Methods A total of one hundred and twenty olderly patients with severe pneumonia were enrolled.Within six hours after admission,the serum PCT level was detected by enzyme linked fluorescence analysis.Acute physiology and chronic health score (APACHEⅡ)were used to assess the severity of the disease.The correlation between serum PCT and APACHEⅡ score was analyzed by Pearson correlation coefficient.The receiver operating characteristic curve (ROC curve)showed the value of serum PCT level for the prognosis.Serum PCT levels were respectively monitored on the 1st,2nd,3rd and 5th day. Based on the prognosis outcome on twenty -first day after admission,the patients were divided into survival group and death group.The changes of serum PCT level in two groups were compared and the rate of change of serum PCT was also compared and the value of the clinical mortality of twenty -first day was assessed.Results Within six hours after admission,the level of serum PCT was positively correlated with APACHE Ⅱ score (r =0.768,P <0.05).The receiver operating characteristic curve (ROC curve)showed that the level of serum PCT was low for the predictive value on the prognosis of the patients,and the area under the curve was 0.502(t =0.915,P =0.153).All patients, there were ninty -four cases in the survival group and twenty -six cases of death group.Dynamic observation of serum PCT levels in the survival group showed a trend of gradual decline with time prolong,the level of PCT change rate was more than or equal to 50 percent within 72 hours.The level of serum PCT change rate in death group showed a gradual upward or downward trend and the change rate of PCT in seventy -two hours was less than 50%.The ROC curve showed that the rate of change of serum PCT level in seventy -two hours was better in predicting the mortality of patients on the twenty -first day,and the area under the ROC curve was 0.892(t =3.895,P =0.001).Conclusion Dynamic monitoring of serum PCT levels can be helped to assessment the prognosis of patients with sepsis and also predict the severity of the illness.The level of serum calcitonin can reflect the severity of severe pneumonia in elderly patients within six hours after admission,but can not accurately determine the prognosis of patients with severe pneu-monia.Dynamic monitoring of changes in serum calcitonin level is helpful to judge the prognosis of the elderly patients with severe pneumonia and the predictive value of serum calcitonin level change rate is higher in seventy -two hours after admission.

The present paper takes an intensive perspective in analyzing learner autonomy and factors influence autonomy.It reveals the actuality of English learning in China,and also gives some advice on how to promote learner autonomy.

FLT can't simply focus on the teaching of grammar,pronunciation and vocabulary,but on its application in practical life.After all,the objective of it is to improve the students' intercultural communication competence.This paper proposes the importance of cultural input in FLT,and analyzes the causes of pragmatic failure,also puts forward several strategies to cultivate students' intercultural communication competence.

Motor imagery can improve upper limb and hand function of stroke patients. This review focused on the research progress of motor imagery about the way of treatment, the clinical effect, and the mechanism.

ObjectiveTo observe the effect of the rehabilitation treatment on the motor function and activities of daily living(ADL) at different period after cerebral hemorrhage.Methods208 patients with cerebral hemorrhage were retrospectively analyzed. Patients were divided into five groups according to the disease course(≤1 month, 1-3 months, 3-6 months, 6-12 months and 12-24 months). Two months before and after rehabilitation treatment, the motor function of the involved limb, ADL and ambulation were assessed.ResultsAfter treatment the motor function of upper and lower limbs and hands, ambulation and ADL of ≤1 month group were improved(P<0.05); except for the hand motor function, 1-3months and 3-6 months group were also improved(P<0.05); the ambulation and ADL of 6-12 months group were improved(P<0.05),but the motor function had no change; in 12-24 months group only ADL improved.Conclusions Rehabilitation treatment do benefit for stroke patients in different periods. Treatment emphasis should vary with the start time of rehabilitation treatment.

ObjectiveTo explore the clinical features and rehabilitation effect of patients with ischemic-hypoxic encephalopathy at recovery stage. MethodsThe clinical features and ADL rehabilitation effect of 32 ischemic-hypoxic encephalopathy patients who were received rehabilitation therapy were retrospectively analyzed.ResultsThe extrapyramidal tract lesion was the most common clinical feature and most of the patients combined with cognitive function impairment. There was no significant improvement in ADL after rehabilitation (P>0.05).ConclusionsThe ADL rehabilitation effect of patients with ischemic-hypoxic encepha1opathy in the recovery stage is not effective. The key points of increasing ADL are to reduce hypertonic muscle and improve cognitive function.

Hemodynamics ; Humans ; Hypertension, Portal ; etiology ; physiopathology ; surgery ; Liver Cirrhosis ; complications ; physiopathology ; surgery ; Liver Transplantation ; Postoperative Period

Objective To determine whether attention allocation deficits contribute to nonfluent aphasia during orthography, phonology, and semantic processing with Chinese characters. Methods Sixteen patients and sixteen controls participated in single and dual tasks. In the single task participants were required to read Chinese characters silently and to make radical, semantic, and final sound judgments (for example, whether the charactersincluded the sound 'ang' ) simultaneously. During the dual task the only difference was that the participants wereasked to read the presented characters aloud and make the same three judgments. Reaction time and error rate were recorded and analysed. Results Reaction times in orthographic judgment were significantly longer for patients than for controls in both task setups. The error rate was also significantly higher. The patients' reaction times in makingphonological judgments in the dual task were significantly longer than in the single task, but there was no significantdifference in error rates between the patients and the controls. In making semantic judgments, neither reaction times nor error rates differed significantly with either the single or dual task protocol. Conclusion Attention allocation deficits play a key role in Chinese character orthographic and phonological processing for nonfluent aphasia sufferers.

Objective To study the influence of carbamazepine on the neuromuscular block induced by rocuronium. Methods Thirty-two ASA Ⅰ- Ⅱ patients scheduled for neurosurgical operations were studied: 16 cases suffered from epilepsy were treated with carbamazepine for 24 to 180 months (carbamazepine group); the others suffered from intracranial tumors without antiepileptic treatment (noncarbamazepine group). Anesthesia was induced and maintained with target controlled with propofol 5 μ g/ml was monitored using train-of-four (TOF) stimulation. The onset time and times of muscle relaxation recovery 25%,50%,75% was recorded. Results The onset time was no difference between two groups (P＞0.05),but the times of muscle relaxation recovery 25%, 50%, 75% in carbamazepine group [(23.9±3.8 ), ( 29.2 ±4.5 ), ( 36.0 ± 5.4 ) min] were shorter than those in non-carbamazepine group [( 34.0 ± 2.8 ), (40.5 ± 4.6),( 49.9 ± 5.3 ) min] ( P ＜ 0.01 ). The recovery index in carbamazepine group [( 12.1 ± 2.9 ) min] was shorter than that in non-carbamazepine group [(15.8 ± 3.1) min](P＜0.05 ). Conclusion The duration of the rocuronium-induced neuromuscular block is significantly shortened by preceding chronic carbamazepine therapy.

Objective To observe the curative effect and safety of recombinant tissue plasminogen acti-vator (rt-PA) in acute ischemic stroke (AIS) patients in more than 15 points of NIHSS scores and less than 4.5 h in onset time. Methods One hundred and twenty-seven cases with AIS in more than 15 points of NIHSS scores and less than 4.5 h in onset time were included into the study. According to the patients′ option to accept the intravenous thrombolytic therapy , 68 patients received intravenous thrombolysis with alteplase as the treat-ment group, 59 patients did not receive intravenous thrombolytic therapy as the control group. The incidence of intracerebral hemorrhage and mortality were observed in the two groups after thrombolytic therapy. Their nerve function defect was scored according to the NIHSS scores before and after treatment at day 7 and day 30. Their living ability was assessed by mRS in modified Rankin chart after the treatment at the day 90. Results The NIHSS scores were significant lower in the 2 groups after therapy (P < 0.05). The NIHSS scores at each time point and mRS scores in the treatment group were lower than the control group (P < 0.05). No significant differ-ence was found in the incidence of intracerebral hemorrhage and mortality between the 2 groups , although these were higher in the treatment group than in control group (1.5% vs 0%, 7.5% vs 5.1%, P > 0.05). Conclusion Intravenous rt-PA thrombolytic therapy is effective and safe for AIS whose NIHSS scores are more than 15 points and onset time are less than 4.5 h.