Sepsis is one of the most common diseases in the intensive care unit, which receives much concern because of its severe condition, high mortality rate and expensive medical costs. The definition and diagnostic criteria of sepsis are put forward in 1991 for the first time, and are widely accepted and used in clinical medicine. As the progress and development of critical care medicine and clinical pathophysiology, the definition and diagnostic criteria of sepsis are constantly updating, which is cause widely and heated discussion every time.

[Summary] Following shoulder surgery , proper regional anesthesia is usually required to minimize the use of opioids .Regional anesthesia techniques commonly used include subacromial or intra-articular local anesthetic infiltration , suprascapular nerve block with or without axillary nerve block , and interscalene block .This paper summarized literatures on the three abovementioned techniques in respect with performance , merits and flaws , and future perspectives .

The implantation of aqueous drainaging devices combined with non-penetrating trabecular surgery(NPTS) has been an effective way to treat open-angle glaucoma.Studies concerning characteristics and outcome of various implants have obtained great progresses,and a large number of implants have been used in clinic.This study was designed to summarize present progress of aqueous drainaging devices combined with NPTS by analyzing aqueous drainaging devices combined with NPTS.

Objective To identify iron nutritional status in very low birth weight infants (VLBWI) and its influence factors.Methods A total of 115 babies admitted from January to December 2014 were included in the study.Serum ferritin of new born infants was analyzed.The clinical data of gestational age,birth weight,hemoglobin,iatrogenic blood loss,cumulative volume of blood transfusion and pregnancy maternal diseases(diabetes,hypertension and anemia) were analyzed.Results The serum ferritin of 115 VLBWI were 100.8 to 210.3 μg/L,the average were(140.32 ± 13.21) μg/L;the minimum serum ferritin of babies born ＜ 32 weeks gestational age were(124.5 ± 31.3) μg/L.Smaller the VLBWI gestational age,the lower the basic baby serum ferritin(F =14.367,P =0.000).More severe the maternal anemia,the lower the basic baby serum ferritin levels [no anemia:(230.9 ± 68.7) μg/L,mild anemia:(189.5 ± 75.3) μg/L,moderate anemia:(133.5 ± 88.1) μg/L,severe anemia:(122.2 ± 56.8) μg/L;P ＜ 0.05].Lower the level of hemoglobin,the lower the basic level of serum ferritin(P ＜ 0.05).Volume of blood transfusion had a huge impact on the last serum ferritin levels (P ＜ 0.05).Conclusion Improvement of the basic baby serum ferritin level in the early stage is useful to ensure the VLBWI iron reserves.It is necessary to regularly monitor serum ferritin during hospitalization and even after discharge.

Objective To analyze diagnostic classification and karyotype characteristics of patients with myelodysplastic syndrome(MDS)in Xinjiang Uygur Autonomous Region.Methods 149 patients with MDS were retrospective observed.The features of clinical,laboratory examination,morphologic and cytogenetics were analyzed from patients classified by the 2008 WHO classification.The rates of survival and leukemia conversion in different subgroups,the differences between uygur and han nationalities,and the rates of abnormal karyotypes in different subgroups were compared.Results Among 149 cases,there were 28 cases of RCUD(including 25 RA and 3 RN),8 cases of RARS,32 cases of RCMD,30 cases of RAEB-Ⅰ,44 cases of RAEB-1,5 cases of MDS-U and 2 cases of 5q-.There was no difference between uygur and han nationality of diagnostic classification(x2=3.627,P=0.822).The overall survival time and AML conversion rates were different among subtype groups.Karyotype abnormalities were found in 74 cases(49.7 ％),which showed no difference between uygur and han nationalities.The distribution of karyotype were normal karyotype(72 cases),complex karyotype(34 cases),+8(14 cases),-7(11 cases),+11(7 cases),20q-(5cases),-Y(2 cases),+21(2 cases)and 5q-(2 cases),which were no differences between uygur and ban nationality(X2=10.015,P=0.264).When comparing abnormal karyotype rates in different diagnostic classification subgroups excepting 5q-,RAEB-Ⅰ and RAEB-Ⅱ subtype were higher than that of RCUD subtype(X2=7.034,P=0.008;X2=6.395,P=0.016).Conclusions According to the 2008 WHO classification,the incidence of abnormal karyotype,survival time and AML conversion rates are different among subtype groups.There are no regional and ethnical differences in distribution of diagnostic classification and karyotype in patients with MDS in Xinjiang Uygur Autonomous Region.

Objective To investigate the correlation between JAK2V617F mutation and clinical characteristics in patients with myeloproliferative neoplasm(MPN) in Xinjiang area.Methods The correlation between JAK2V617F mutation and clinical characteristics about gender,age,nationality,leukocyte counts,platelet counts,hemoglobin and LDH levels,complications of thrombosis,bleeding and vascular disease in 134patients with MPN were analyzed. Results 73.1％ (98/134) JAK2V617F mutation was found in patients (51with PV,66 with ET, 17 with IMF). Compared with negtive mutation, the rata of ≥60 years was significantly higher in positive group [78.6 ％(77/98)vs25.0 ％(9/36)(χ2=32.867,P＜0.001)]. Patients harboring JAK2V617F mutation have higher leukocyte counts[(15.9±8.2)×109/L vs (9.6±5.3)×109 L,t=4.296,P＜0.001],hemoglobin levels [(156.4 ±44.9)g/L vs (133.8 ±44.1)g/L,t=2.590,P =0.011],incidence of thrombosis [73.5 ％(72/98)vs22.2 ％(8/36),χ2=28.740,P＜0.001)] and vascular diseas [81.6 ％(80/98)vs25.0 ％(9/36),χ2=37.859,P＜0.001)]. There was no significant difference in gender, nationality, platelet counts, LDH levels and bleeding complications between JAK2V617F positive and negative patients. Conclusion There is a correlation between JAK2V617F mutation in MPN and age,leukocyte counts,hemoglobin levels,thrombosis and vascular disease complications.

Objective To analyze the clinical features of Hashimoto thyroiditis with thyroid cancer, and provide scientific basis for clinical diagnosis and treatment. Methods The clinical data of 87 patients of Hashimoto thyroiditis with thyroid cancer and 105 patients of Hashimoto thyroiditis were retrospectively analyzed. Results The rates of Hashimoto thyroiditis with thyroid cancer in age <30, 30-39, 40-49, 50-59 and≥60 years were 1/3, 47.5%(29/61), 51.4%(38/74), 36.0%(18/50) and 1/4. The rates of Hashimoto thyroiditis with thyroid cancer in patients of age 30-39 years and 40-49 years were higher than that in patients of age ≥60 years, but there were no statistical differences (χ2=0.327 and 0.418, P>0.05). There were statistical differences in total thyroxine (TT4), thyroid stimulating hormone (TSH), thyroglobulin antibody (TgAb) and thyroid peroxidase antibody (TPOAb) levels between Hashimoto thyroiditis with thyroid cancer and Hashimoto thyroiditis, there were statistical differences (P<0.05 or <0.01). Multiariable Logistic regression analysis result showed that the decreased serum level of TT4 and the increased levels of TSH, TgAb and TPOAb were the correlated factors of Hashimoto thyroiditis with thyroid cancer (P<0.05 or <0.01). Conclusions Low level of TT4 and high levels of TSH, TgAb and TPOAb may increase the risk of Hashimoto thyroiditis with thyroid cancer. The 30-49 years male patients with Hashimoto thyroiditis should be highly suspected of the possibility of merger thyroid cancer.

Objective To study the short-term outcome of transforaminal posterolateral endoscopic discectomy and radiofrequency annuloplasty in patients with discogenic low back pain. Methods A total of 25 patients with discogenic low back pain,who were diagnosed by provocative discography,received transforaminal posterolateral endoscopic discectomy and radiofrequency annuloplasty in our hospital. The VAS scores determined before and 6 months after the operation were compared in the patients. Their MacNab scores were also evaluated at 6 months postoperation. Results After the surgery,2 patients who had ruptured intervertebral discs (L5-S1) developed sunburn syndrome,and then was relieved by pulsed electrical stimulation for one week. The patients were followed up for 6-10 months,during which no other postoperative complications occurred. The mean VAS score of this series decreased significantly after the treatment,and kept being reduced in 6 months [preoperation:6.24?0.97,1,3,6 months after the operation:0(0~2); Kruskal-Wallis rank-sum test,H=61.680,P=0.000]. Four patients showed lower limbs pain before the treatment and were relieved after the surgery. The evaluation of MacNab score showed excellent in 11 pateints,good in 12,and fair in 2,suggesting an effective rate of 92.0%(23/25). Conclusions Transforaminal posterolateral endoscopic discectomy plus radiofrequency annuloplasty is effective for discogenic low back pain in a short term.

ObjectiveTo investigate the effectiveness of introducing CAD/CAM system into Prosthodontics experimental teachin.MethodsStudents from Chongqing Medical University with major of Dental Department in Grade 2007 was selected.To make all students master the basic knowledge of CAD/CAM system,problem-based learning was used to teach the undergraduate grasping the CAD/CAM system of the affiliated hospital.Results 90 ％ of the students showed strong interest in learning knowledge of the CAD/CAM system.98 ％ of the students could master CAD/CAM system knowledge.ConclusionCAD/CAM system knowledge is suitable for development of prosthodontics.It is necessary that the basic knowledge of CAD/CAM was introduced into prosthodontics experimental courses.

Aim To establish a reliable and practical rat model with hypertension induced by DOCA-Salt.Methods One week after nephrectomy,the rats were subcutaneously injected with DOCA (30 mg?kg-1) once a week and fed with a chaw with 10 g?L-1NaCl plus 2 g?L-1 KCl in drinking water for 4 weeks. Blood pressure was measured and,urine was collected for measurement of volume(UV),UNaV,UClV,UKV,UCaV and pH values,once a week. SGPT,CREA,SUGA,TRIG,CHOL,INS,ALD,ADH were measured in circulating blood samples. Kidney morphological changes and Na+,K+-ATPase activity of the renal tubular epithelial cells were also examined. Results Blood pressure,UV,UNaV and UClV were increased and histopathological changes of the kidney such as glomerulus sclerosis and tubular pachynsis were observed in the DOCA-Salt rats. Whereas UKV,UCaV,urine pH values,SGPT,CREA,SUGA,TRIG,CHOL,INS,ALD and ADH were not changed. In contrast,Na+,K+-ATPase activity of the renal tubular epithelial cells was decreased. Conclusion DOCA-Salt is a reliable hypertensive model with sodium retention.