Objective To study the relation between kidney function impairment and respiratory tract infections(RTI) in the elderly.Methods Two hundred and twenty-four patients above 65 years old were divided into five groups according to stages of chronic renal disease and estimated glomerular filtration rate (e GFR):(A group,n =65):≥90 ml/(min · 1.73 m2),(B group,n =55):60-89 ml/(min · 1.73 m2),(C group,n =27):30-59 ml/(min · 1.73 m2),(D group,n =28):15-29 ml/(min · 1.73 m2) and(E group,n =49):＜ 15 ml/(min · 1.73 m2).Taking A group as the control baseline.Logistic regression was employed to analyze the relationship between kidney function and RTL Results Compare with A group(10.8％,7/65),the incidences of RTI in three groups(C group,D group and E group were 63.0％ (17/27),85.7％ (24/28) and 100％ (49/49) respectively.The incidence in these groups was higher than that in A group(x2 =26.95,49.46 and 89.00 respectively,P ＜ 0.05).We identified the risk factors with RTI were smoking (Waldx2 =17.66,P ＜ 0.01),respiratory underlying diseases(Waldx2 =14.38,P ＜0.01),invasive operation history(Waldx2 =4.50,P ＜ 0.05),diabetes (Waldx2 =3.86,P ＜ 0.05),stay in hospital for above 2 weeks (Waldx2 =18.18,P ＜ 0.01),Gender(Waldx2 =4.12,P ＜ 0.05),eGFR (Waldx2 =13.57,P ＜ 0.01).After adjusting for other risk factors of RTI,Logistic regression analysis showed that the risk of RTI still increased with the decrease of eGFR (eGFR≥90 ml/(min · 1.73 m2):(Waldx2 =0.053,P ＞0.05);60-89 ml/(min · 1.73 m2):(Waldx2 =0.046,P＞0.05) ;30-59 ml/(minl · 1.73 m2):(Waldx2 =7.61,P＜0.05),15-29 ml/(min · 1.73 m2):(Waldx2 =4.38,P＜0.05); ＜15 ml/(min · 1.73 m2):(Waldx2 =13.57,P＜0.01)).Conclusion Kidney function impairment in patients above 65 years old is an independent risk factor for RTI.

OBJECTIVE: To study the effect of binaural bi-modal fitting (one cochlear implant and a contralateral hearing aid) on speech recognition of cochlear implant recipients with low frequency electrodes incompletely implanted. METHOD: A total of 15 cochlear implant(CI) users who have low residual hearing (250 Hz 45-90 dBHL, 500 Hz 75 - 100 dBHL) of their non surgery ears. We closed the top three electrodes to simulate the state of low-frequency electrodes incompletely implanted by fitting software. (1) The same tester received twice speech recognition tests in incompletely implanted state, one test used single CI model and the other used binaural bi-modal fitting model. (2)The same tester received above twice speech recognition tests again, but in completely implanted state. Then we compared the results of tests. RESULT: The CI users used binaural bi-modal fitting have higher speech recognition score than the same users used unilateral cochlear implant model in low-frequency electrodes incompletely implanted state(P<0. 05). The gap between the scores of the tests by using two usage patterns in low frequency electrodes incompletely implanted state was more than that in completely implanted state (P<0. 05). CONCLUSION Binaural bi-modal fitting can help CI users to improve their speech recognition ability in low-frequency electrodes incompletely implanted state.
Cochlear Implantation ; methods ; Cochlear Implants ; Electrodes, Implanted ; Hearing ; Hearing Aids ; Hearing Tests ; Humans ; Speech ; Speech Perception

ObjectiveTo explore the prognosis and relationship between soluble differentiation antigen of cluster designation 14 (sCD14) and the injury severity score (ISS) of casualties with multiple injuries.Methods A total of 86 casualties with multiple injuries were enrolled from October 2009 to March 2010,and the severity of trauma of casualties were assessed in ISS score within the first 24 hours after accident,and the patients were divided into survival and non-survival groups as per the outcomes in 28 days after accident. Another 20 healthy subjects served as control group. In multiple injuries group,sCD14 concentrations were detected and APACHE Ⅱ scores were calculated on the 1st,3rd,5th and 7th days after accident.The related coefficient between sCD14 and ISS was calculated and then the values of sCD14 in predicting prognosis were analyzed by ROC curve. ResultsCompared with control group, sCD14 concentrations were obviously higher in casualties of multiple injuries group at all observation intervals ( P ＜0.01). Compared with survival group, casualties of non-survival group had more higher sCD14 concentrations and APACHE Ⅱ scores ( P ＜ 0.05 ).The sCD14 concentration was correlated with ISS and the related coefficient was 0.469 ( P ＜ 0.01 ). ROC curve analysis suggested sCD14 had values in predicting prognosis of casualties with multiple injuries and area under ROC curve was 0.820.Conclusions The concentration of sCD14 is correlated with ISS and can be used for predicting the prognosis of casualties with multiple injuries.

Mesenchymal stem cells (MSCs) are multipotent stem cells existing in multi-organs and can differentiate into several kinds of somatic cells. Recently it has been found that MSCs, under defined conditions in vivo or in vitro, can be induced to trans-differentiate into islet-like cells, which can secrete a small amount of insulin and lower blood glucose levels in diabetic mice. Thus, two major obstacles of islet transplantation, the insufficience of donor islets and immunologic rejection, might be solved simultaneously with this technique. This finding provides a new insight into treatment for diabetes.

With the economic growth and better standards of living,the prevalence of non-alcoholic fatty liver disease (NAFLD) is expected to increase dramatically worldwide.NAFLD is a common chronic inflammation disease.NF-κB is a transcription factor that plays crucial roles in inflammation,immunity,cell proliferation and apoptosis.It can facilitate the occurrence and development of NAFLD,and the underlying mechanisms are related to insulin resistance,oxidative stress,alteration of intestinal flora,activation ofrenin angiotensin system,etc.

By using the famous American pedagogical and psychological scientist Gagne,Robert's opinion about the component and organization of study diathesis mentioned in his book named Principle of Teaching Design, the author analyzes the construction of diathesis of Chinese students : the innate diathesis , the acquired diathesis and the naturally developed diathesis. Based on the knowledge and ability that high quality medical talents should have in the future, the article prefer the thought and methods to cultivate high quality medical talents by complying with the modern psychological theory.

OBJECTIVE:To prepare Stemoninine orally disintegrating tablets,and to optimize its formulation and preparation technology. METHODS:Direct powder compression method was used to prepare Stemoninine orally disintegrating tablets. Using material angle of repose,disintegration time and taste evaluation as index,single factor test was used to screen several factors as bulking agent,disintegrating agent,glidant and flavoring agent;using disintegration time as index,L9(34) orthogonal test was used to optimize the formulation with ratio of MCC+mannitol,PVPP,silica powder and aspartame+stevia as factors. Validation test was also conducted. RESULTS:Optimized formulation was that MCC+mannitol(1∶1)was 50%,PVPP was 20%,silica powder was 2% and aspartame+stevia(10∶1)was 7%. 3 batches of prepared Stemoninine orally disintegrating tablets were smooth in sur-face and good in taste;their disintegrating time was(22.6±2.1)s,and weight variation,hardness,contents were within the speci-fied range (all RSD≤0.97%,n=3). CONCLUSIONS:The formulation and technology of Stemoninine orally disintegrating tab-lets are reasonable,and the quality indexes are all in line with the requirements of orally disintegrating tablets.

Objective To explore the clinical value of colour doppler flow imaging (CDFI) in selecting the ectopic pregnancy(EP) suitable for medical treatment. Methods 50 cases of ectopic pregnancy with hematodynamic stability were injected with a single dose of 50mg/m 2 MTX after CDFI examination. All patients were followed up until clinical results were confirmed. The CDFI characteristics of the failure and the success cases were analysed in combination with their serum HCG levels, and a CDFI-based pretherapeutic score were designed. Results CDFI could reflect the viability of ectopic fetus directly.There was a significant difference in the successful rate of medical treatment of ectopic pregnancy among the patients with various types of CDFI images and the various levels of serum HCG (P10 had the high failure rate, thus medical treatment of ectopic pregnancy is not recommended to them.

OBJECTIVE:To study the extraction process of ginsenoside.METHODS:The optimal extraction process was selected with the orthogonal design.The content of ginsenoside in ginseng was determined by UV-Spectrophotometry.RESUL_TS:The amount and concentration of alcohol and extraction time showed significant influence on extract obtained.CONCLUSI_ON:The optimal extraction process is as follows:adding 75% alcohol into crude ginseng(6∶1 in weight) and extracting 6 times for 45 min each extraction.