Objective To investigate the correlation between the D-dimer level and the acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods The changes of D-dimer levels in 156 patients (AECOPD group) before and after treatment were measured and compared with the D-dimer levels of 156 healthy subjects(control group).Results The concentration of plasma D-dimer in the AECOPD group was (1.35 ± 1.46) mg/L,which was significantly higher than (0.25 ± 0.16)mg/L in the control group,and the difference was statistically significant(t =9.354,P ＜0.05).The level of plasma D-dimer in the AECOPD group was (0.69 ± 0.87)mg/L,and compared with (1.35 ± 1.46)mg/L before treatment,the difference was statistically significant(t =4.850,P ＜ 0.05).Conclusion D-dimer level is correlated to the condition of patients with chronic obstructive pulmonary disease,it can be used as one of the indicators to diagnose whether a patient is in hypercoagnlable state or suffers thrombotic diseases.

Objective:To explore a method for setting up three dimensional finite element model of posterior glass fiber reinforced composite resin-bonded-fixed-partial dentures (GFRC-RBFPD) including restoration, periodontal tissue and alveolar bone. Methods:A stone model was fabricated including abutments and pontic of restoration, then it was scanned with laser scanner. Acquired data were integrated in Geomagic 5.0. Basic 3D geometric model was established. Different parts of abutement and prosthesis were designed in I-DEAS 10 NX Series and Geomagic, then periodontal tissue and alveolar bone were set up in Geomagic 5.0. Completed 3D geometric model was input into MSC.Marc Mentat 2003 for mesh generation. Boundary conditions were defined. Model was calculated in Mentat 2003. Results:3D geometric model and finite element model including GFRC-RBFPD, abutments, periodontal membrane and bone (bone lamina dura,cortical bone and cancellous bone) were established.Little contour information was lost, comparability between models was improved.Conclusion:The 3-dimensional laser scanning technique, CAD and mesh generation technique are effective in the establishment of 3-dimensional finite element model of GFRC-RBFPD.

Objective To study the characteristics of pulmonary function in atypical asthmatic children with chest tightness or sighing breath as the sole presenting manifestation,and explore the diagnostic values of fractional exhaled nitric oxide (FeNO) for the atypical asthma.Methods Seventy-nine atypical asthmatic children with chest tightness as the sole presenting manifestation during January 2012 to June 2015 were selected as subjects.All of the subjects performed spirometry,FeNO measurement,total serum IgE and specific IgE determination on their first visit,and with either positive bronchial provocation test or positive bronchial dilation test.As well as 100 healthy children who perfomred FeNO measurement were selected as control group during the same period.The pulmonary function data and FeNO values were analyzed in children who were finally confirmed as atypical asthma.Results In atypical asthma children,the abnormal rate of forced expiratory flow 50％,75％ (FEF50,FEF75) and maximum mid-expiratory flow (MMEF) were 27％,43％ and 33％.Methacholine provocation dose causing a 20％ fall in FEV1 (PD20-FEV1) were 0.41 (0.19 ～0.67)mg and were positively related with MMEF(r =0.301,P =0.007).FeNO concentration in atypical asthma patients were 13.0 × 10-9 (7.0 ×10-9 ～24.0 × 10-9),higher than that in control group(P ＜0.05).Significant correlations were found between FeNO and total serum IgE (r =0.672,P =0.001).No correlations were found between FeNO and FEV1 (P ＞0.05),between FeNO and FEV1/FVC％ (P ＞0.05) or between FeNO and PD20-FEV1 (P ＞0.05).The diagnostic values of FeNO for the atypical asthma were analyzed using the receiver operating characteristic curve,the area under the curve was 0.600.Conclusion The characteristics of pulmonary function in atypical asthma are hypofunction mainly in small airway and patients with lower MMEF had higher airway hyperresponsiveness.The diagnostic values of FeNO in atypical asthma are limited.

Objective To explore the role of clinical pharmacist in individualized treatment of hypertension.Methods A patient withH hypertension receiving pharmaceutical care from clinical pharmacists was retrospectively analyzed.Results Patient's MTHFR (C677T) gene type was TT homozygous.Clinical pharmacist suggested doctor modify treatment,and then patient's plasma homocysteine dropped from 61.5 to 16.0 μmol·L-1,and blood pressure dropped from 173/ 111 mmHg(1 mmHg =0.133 kPa) to 130/80 mmHg.Conclusion Clinical pharmacist provides individualized treatment for patient with hypertension to ensure the safety and effectiveness of the drug by genotyping.

Objective To investigate the application of the Monte Carlo dose calculation of output factors for electron beams in radiotherapy.Methods The code EGS4/MCTP was used to simulate the head of a medical linear accelerator (Varian 23EX) to calculate the output factors for 6 MeV,9 MeV and 18 MeV electron beams.The source-to-surface distance used was 100 cm.The field sizes ranged from 2 cm × 2 cm to 25 cm × 25 cm.The calculated output factors agreed with the corresponding measured factors which were measured by the IBA Phantom system to within 2％.Then,the output factors of direct articles and indirect articles which were under different energy and various cone-insert combinations were calculated by the code EGS4/MCTP.Results The calculated output factors agreement with the measurements is found to be mostly under the 1％ level.The variation of output factors depends on the characteristics of the beams and the modifications that the various cone-insert combinations introduce to these characteristics.Conclusions Monte Carlo dose calculations for electron beams in homogeneous water phantoms have been demonstrated to be accurate under the 1％ level in comparison with measurements.The output factors were influenced by energy and cone-insert combinations in complex ways.

OBJECTIVETo investigate therapeutic effects of vacuum sealing drainage (VSD) in the treatment of soft tissue defect combined with tendon and bone exposure.

METHODSFrom October 2007 to February 2011, 397 patients (412 feet) with open ankle fracture and dislocation combined with soft tissue defected were treated by VSD. There were 301 males and 96 females with an average age of 36 years (ranging age from 20 to 73 years). According to AO classification, 74 feet were type I, 211 feet were type II, 108 feet were type III and 19 feet were type IV. The mean time from injury to operation was 5.6 h ( 2 to 12 h). The mean treatment time of was 10 months (4 to 19 months).

RESULTSOne hundred and forty-one patients were primarily healed, 97 patients were sutured at stage II. Split-thick skin grafting was performed at stage II was performed in 103 patients; free flap transplantation was performed in 25 patients. Three of the 34 patients with infection were removed steel plate; Eviscerate flap coverage wound was performed in 14 patients caused by the first metatarsal bone exposure; Toe amputation were performed in 22 cases caused by toes necrosis. Tarsometatarasl joints perforators' surgery was performed in 10 patients with forefeet necrosis. Thirty hundred and six patients were followed up from 3 to 20 months (averaged 10 months). The wounds healed well.

CONCLUSIONVSD for soft tissue defects caused by ankle injury is a simple and effective method, but can not replace debridement and transfer flap.

Adult ; Aged ; Ankle Fractures ; Debridement ; Drainage ; methods ; Female ; Humans ; Joint Dislocations ; surgery ; Male ; Middle Aged ; Skin Transplantation ; Treatment Outcome ; Vacuum ; Young Adult

This paper introduces a kind of bone mineral density(BMD) measuring system with quantitative CT(QCT). This system includs a self-made solid calibration phantom for BMD and the measuring software. The results of the tests have showed that this system is reliable,cheap and ease of use for BMD measurement.

OBJECTIVETo explore the regulatory effect of Suifukang (SFK), a compound Chinese patent drug on the change of free radical in tissue of spinal cord and blood caused by experimental spinal injury.

METHODSSeventy male adult SD rats were randomly divided into 4 groups, the SFK group (n = 20), the hormone group (n = 20), the control group (n = 20) and the normal group (n = 10). Rats in the former three groups were made into the right hemitransected spinal cord (T12) injury. SFK were given to the rats in the SFK group 3 days before and 2 hrs after modeling via gastrogavage, saline was given to rats in the control group at the same time. As for the rats in the hormone group, methyl-prednisolone 30 mg/kg was given once immediately by peritoneal injection. The rats were sacrificed in two batches (10 of each group in each batch) at 8 hrs and 24 hrs after modeling to obtain the serum and injured spinal cord tissue for determining superoxide dismutase (SOD) activity and malondialdehyde (MDA) content.

RESULTS(1) As compared with the normal group, SOD activity in serum and spinal tissue of the control group was lower significantly both at 8 hrs and 24 hrs after modeling, but the changes of SOD activity in the SFK and the hormone group were insignificant; (2) Content of MDA in serum and spinal tissue of rats elevated after modeling, which in the control group at 8 hrs after modeling were higher than that in the normal group, also higher than that in the SFK group and the hormone group; but at 24 hrs after modeling, it lowered significantly in both treated groups. The changes of MDA content in serum were similar to those in the spinal tissue.

CONCLUSIONSFK could effectively eliminate the excessive free radical in serum and injured spinal tissue, and raise the capability of antioxidation of organism.

Animals ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Free Radical Scavengers ; pharmacology ; therapeutic use ; Male ; Malondialdehyde ; metabolism ; Neuroprotective Agents ; pharmacology ; therapeutic use ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Spinal Cord Injuries ; drug therapy ; metabolism ; Superoxide Dismutase ; metabolism

Objective To analyze the characteristic of trauma in 246 fatal falls. Methods We collect 246 cases of fatal falls from Pudong district of Shanghai from 2005 to 2014, and then analyze the characteristics of trauma by using different parameters. Results The height in suicides by fall is higher than accidents by fall (25.7m:13.98m). In all fatal falls, head has a higher possibility in suffering trauma than other body regions (75.2%), while neck has a lower possibility (6.5%). The possibility of head trauma in accidents by fall is higher than suicides by fall (89.4%:75.2%). Conclusion Comparing with suicides by fall, victims in accidents by fall have lack of protection from limbs. Besides, the low rate of ifnding neck trauma suggests legal physicians should be more careful in examining this area.

Objective To assess the incidence,risk factors and mortality of acute kidney injury(AKI)in patients with chronic myelogeneous leukemia(CML)after myeloablative allogenetic hematopoietic stem cell transplantation(HSCT). Methods Renal function in 93 CML patients undergone myeloablative allo-HSCT was retrospectively analyzed by the RIFLE criteria. Results Thirty-nine patients (41.9%) developed AKI at a median of 40 days after allo-HSCT, including 24 AKI-R patients(25.8%), 10 AKI-I patients(10.8%) and 5 AKI-F patients (5.4%). The morbidity of AKI in patients with ≥Ⅲ acute graft-versus-host disease (aGVHD) and without ＜Ⅲ GVHD was (81.82±11.63)% and (36.59±5.32)% (P=0.0037)rospectively. The morbidity of AKI in patients with increased total bilirubin and without increased total bilirubin was (72.73±13.43)% and (37.04±5.37)%(P=0.0192) respectively. ≥Ⅲ aGVHD was peor-prognostic factor of AKI and RR was 2.773 [95%CI (1.073-7.167), P=0.035]. RR of AKI-I and AKI-F in patients with ≥Ⅲ aGVHD was 6.320195%CI (1.464-27.291), P=0.013]. The mortality within 100 days after allo-HSCT of patients with AKI was significantly different as compared to patients without AKI (P=0.001). Six-mouth survival rates of different class AKI patients after myeloablative allo-HSCT were (86.96±7.02)% (AKI-R), (70.00±14.49)% (AKI-I), 0 (AKI-F) (P=0.000)respectively. Conclusions AKI is one of the main complications in CML patients after myeloablative allo-HSCT. ≥Ⅲ aGVHD and increased total bilimbin are poor-prognostic factors of AKI, and higher morbidity of AKI-I and AKI-F can be found in patients with ≥Ⅲ aGVHD. With the deteriorated AKI, 6-month survival is decreased. RIFLE criteria is sensitive to the early diagnosis of renal function. Moreover RIFLE can monitor the progression of AKI and predict the clinical outcome.