Objective To establish a method to evoke cerebral potentials by stimulating nociceptive fibers with contact heat evoked potential stimulator,evaluate the state of nociceptive system in patients with multiple sclerosis and assess the value of the potentials in multiple sclerosis(MS).Methods Thirty-six definite MS patients and 40 sex-,height-and aged-matched healthy persons underwent stimulation of contact heat delivered via a circular thermode to excite selectively nociceptors with a rapid rising time at 70℃/s to elicit pain and contact heat evoked potentiaI(CHEP).Thermal stimuli were sent at two intensity levels (47 ℃ and 51℃)to 3 body sites:volar surface of the forearm,the skin of leg 5 cm proximal to the medial malleolus and lumbar part.The CHEP were recorded from Cz.The relationship between the stimulus intensity and pain rating was observed,and the main components of the evoked potential were recorded.Then,somatosensory evoked potential(SEP)was examined in 36 patients with MS.Results CHEP were elicited reliably and stably in all control subjects.In contrast,in 4 patients there were no recordable CHEP on stimulation of the upper limb,and in some cases of lower limb(n=5).Conduction velocity of Aδ fihers was(18.1±7.3)m/s.The 21 MS cases had hypesthesia in upper limb and 29 cases in lower limb.The visual analog scale(VAS)for pain perception was higher in control subjects(upper limb:8.0±0.7;lower limb:7.9±0.7)than MS with hypesthesia(upper limb:6.1±0.9;lower limb:5.6±1.3,Z=-3.249 and -5.272,both P＜0.01).The group of patients (MS) with hypesthesia(upper limb 17 cases,lower limb 24 cases)had markedly reduced N-P amplitudes(upper limb:(30.5±12.8)μV;lower limb:(28.2±16.2)μV,t=-4.612 and -3.144,both P＜0.01)and prolonged N-wave latencies(upper limb:(387.3±34.2)ms;lower limb:(489.9±70.2)ms,t=4.790 and 4.798,both P＜0.01)compared with the control group in CHEP mediated by Aδ fibers.CHEP abnormality was observed more often in the lower(26/36,72.2%)than the upper limb(16/36,44.4%,P=0.031)and SEP(19/36,52.8%,χ~2=4.261,P=0.039).CHEP were abnormal in 3 of 15 skin areas with clinically normal nociception in upper limb,and in some cases of lower limb(2 of 7).Conclusions CHEP provides a clinically practical,non-invasive and objective measure,and can be a useful additional tool for the assessment of nocieptive system.Combined assessment of other Eps can help to document dissemination of demyelinating CNS lesions and detect subclinical lesions thus contribute to the diagnosis of multiple sclerosis.

Objective To explore the effects of the multidisciplinary cooperative continue nursing on the quality of life of patients with chronic obstructive pulmonary disease (COPD). Methods From December 2012 to December 2014, hospitalized COPD patients who were in the stable stage of disease and would soon be discharged and met the criteria standards were chosen. Convenient extraction of 64 patients were set as the experimental group in one ward and 50 patients as the control group in the other ward. The conventional discharge guidance was employed in the control group. While the continuation of care before discharge and 1, 3, 6 months after discharge was employed in the experimental group. The indexes such as the quality of life and 6 min walking test distance (6MWD) were observed and compared. Results The total scores and symptoms, activities, influence scores of the quality of life were 48.53±15.78, 35.38± 18.61, 57.95 ±23.69, 52.28 ±15.27 after 6 months intervention in the experimental group and 60.24 ±10.14, 52.76 ±12.36, 68.34 ±15.59, 58.55 ±11.79 in the control group, and there were significant differences (t=-5.69--2.38, P<0.05). 6MWD was (267.46 ±64.64) m after 6 months intervention in the experimental group,which was more than that before intervention (169.42±48.46) m, and there was significant difference (t=-9.71, P<0.01). 6MWD was (201.32±53.93) m after 6 months intervention in the control group, which was not significantly better than that in the experimental group (t=5.82, P<0.01). Conclusions The quality of life of patients with COPD can be significantly improved by the multidisciplinary cooperative continue nursing education after discharge.

Objective:To observe the clinical efficacy of electroacupuncture and rehabilitation exercises in the treatment of cerebral infarction.Methods:Seventy-four patients with cerebral infarction were randomized into treatment group and control group in visit sequence.Thirty-seven cases in treatment group were treated with electroacupuncture and rehabilitation exercises,and other 37 cases in control group were treated with electroacupuncture alone.The treatment was given once a day and there was a 2-day interval after any consecutive 5 treatments.After total 30 treatments,Fugl-Meyer scale was used to evaluate motor function and Barthel Index to evaluate the activities of daily living.Results:After treatments,the motor function of paralyzed limb and activities of daily living were obviously improved in both groups,with more significant improvement in treatment group than in control group (P＜0.05).Conclusion:Combination of electroacupuncture and rehabilitation exercises has better effects than simple electroacupuncture in the treatment of cerebral infarction.

Purpose　To judge the value of CT in the diagnosis of acute pancreatitis. Methods　74 cases of acute pancreatitis confirmed by operation were reviewed. All patients underwent CT plain and contrast -enhanced scanning. Oral contrast agents were used. Results　According to clinical diagnosis, they were devided into edematous type(n=53),and necrotic type(n=21). 7 cases were complicated with abscesses, and 5 cases died. According to CT finding, Grade A,n=10; Grade B,n=16; Grade C,n=19; Grade D,n=16; Grade E, n=13. Conclusion　 CT is valuable in the diagnosis of acute pancreatitis, and CT grade is referable.

This article reviewed the researches proceeding on the contamination and detection of the foodborne pathogen noroviruses (NoVs) in fresh produce, which involved the NoVs contaminations in fresh produce, the special attachment of NoVs in fresh produce, the NoVs outbreaks associated with fresh produce and the NoVs detection in fresh produce. There had been an increase in reported infectious disease risks associated with the consumptions of fresh produce for recent 30 years. Because the NoVs, as a primary cause of viral gastroenteritis thoughout the world, were highly contagious, had a low infectious dose, and were persistent in the environment. And also the methods for NoVs detection in food had significantly developed over the last 15 years. Currently NoVs were the most common pathogen accounting for 40% of outbreaks associated with fresh produce (i. e., fruits and vegetables). Data from outbreaks investigations verified fresh produce as the high risk food products for NoVs. The fresh produce were typically eaten raw with no thermal processing, can be contaminated at any step during production and processing from faecally polluted water and fertilizers, the poor hygiene practices by food handlers and the cross-contamination. The attachment of NoVs to the fresh produce was due to the physio-chemical factors of virus protein coat, the special attachment to different fresh produce, and the possibility for internalization of NoVs. It might provide answers to why those high risk foods were more frequently implicated (i. e., lettuce and raspberries). According to the data of foodborne NoVs outbreaks which were associated with fresh produce from EU countries and the USA, the outbreaks in EU countries were mainly associated with NoVs contaminated raspberries and lettuce, while in USA which were associated with NoVs contaminated lettuce. Unfortunately, there were no NoVs detection methods for fresh produce or the data of foodborne NoVs outbreaks which were associated with fresh produce in China. That made it difficult to analyze the NoVs contamination situation in China. The heterogeneous distributions of presumably low levels of virus, which presented in contaminated fresh produce, also made it difficult to detect NoVs. To solve this problem, different sampling methods, viral elution methods and RT-qPCR methods were chosen. For example, according to the isoelectric point of NoVs particles, high pH and high ionic strength solution could be used as means for releasing NoVs. For the elution from acidic fruit, the buffer capacity and the virus recovery could be increased by the addition of tris-HCl. When analyzing pectin containing raspberries or strawberries, the viral elution usually incubated with pectinase at neutral pH to avoid from foaming jelly. In this paper, the latest ISO standard for NoV detection in food and the new approaches for NoV detection were also reviewed to provide references for domestic researches. It was necessary to establish and develop domestic methods for NoV detection in fresh produce, especially the different NoV conventional molecular detection methods with corresponding NoV extraction methods, which targeted to the different adsorption characteristics of different fruits and vegetables, in order to strengthen the national food safety monitoring.
Food Analysis ; methods ; Food Contamination ; analysis ; Foodborne Diseases ; virology ; Fruit ; virology ; Gastroenteritis ; virology ; Humans ; Norovirus ; classification ; genetics ; isolation & purification ; physiology ; Vegetables ; virology

The ultraviolet spectrophotometric method for determination of vitamin A in breast milk was simplified. The milk sample was extracted directly with ammonia water, ethyl alcohol and ether, the saponification procedure be- ing omitted. The optimal height of the aluminum oxide adsorption column and the optimal rate of flow for elution were developed. The observation was made whether the elution for vitamen A was complete by identifying the fluorescence of vitamin A directly under ultraviolet light in the eluat-es collected instead of SbCl3-Vitamin A blue color reaction. The simultaneous estimation of Vitamin A in breast milk and in the standard solution of Vitamin A with this method showed E300nm/E325nm less than 73%, agreeable with the British Pharmacopoeia. The recovery was 100.8%. This procedure has advantages of high sensitivity, simplicity, time saving and economy.

0.70,and the Cronbach's ? value for satisfaction of management domain was 0.44.The ICC of the SRS-22 questionnaire,0.94,0.86,0.77,0.74,0.84,showed a satisfactory reproducibility.Five public factors were obtained by factor analysis compared with the five domains of SRS-22 questionnaire.For the concurrent validity,5 domains had excellent correlation,9 had good correlation,and 26 had correlation.CONCLUSION:The adapted simplified Chinese version of the SRS-22 questionnaire has satisfactory reliability and concurrent validity,and might be suitable for post-operative clinical evaluation of Chinese adolescent scoliosis patients.

10% at 24-hour later than the initial value.Conclusion In patients with refractory septic shock who achieved the goal of combiming CVP ≥ 8mmHg,MAP ≥ 65mmHg,SmVO2 ≥ 65% hyperlactemia was ameliorated.Lactate clearance rate can be used as a good marker to predict outcome of septic shock patients.

Objective To construct a vector carrying tyrosine hydroxylase (TH) and glial cell line-derived neurotrophic factor (GDNF) in order to establish a new gene therapy method in Parkinson's disease. Methods Human TH gene fragment from the plasmid pWAV2-TH was cloned into pIRES to construct pIRES-TH. The mouse GDNF gene, amplified by PCR was inserted into pIRES-TH to construct pIRES-TH-GDNF. Restriction analysis and nucleotide sequencing were used to confirm the structure of pIRES-TH-GDNF. Then MES23.5 cells were transfected with this eukaryon vector using Lipofectamine TM2000. The expression of TH and GDNF in mRNA and protein levels were detected by RT-PCR and immunofluorescence after G418 selection. Results The 2 objective fragments were inserted into pIRES correctly. RT-PCR and immunofluorescence results showed that TH and GDNF were highly expressed in MES23.5 cells. Conclusion The plasmid pIRES-TH-GDNF is constructed successfully and can express TH and GDNF in vitro.

Bases on the changing idea and management policy,the out-patient service process rebuilding focuses on the patient,makes use of the information technology,imports the theory of operation process reforming,reconsiders and redesigns the operation process of the out-patient department,and improves the medical quality and service.The digitizing procedure in out-patient service is the important base of process rebuilding.In the paper,we try to discuss how to improve the digitizing procedure in out-patient service and rebuild the service process.