Objective To investigate the predictive value of mnodified early warning score (MEWS) in predicting emergency potential in critically ill patients and its feasibility.Methods A total of 298 patients in the emergency department and emergency room were evaluated using the MEWS.The distribution of transfer to cadiopulmanary resuscitation (CPR),intensive care unit (ICU) and high dependency unit (HDU),length of hospital stay ( more than 1 month or not) and transferred to advanced hospital,death were recorded,and all patients were followed up.Results Patients with different MEWS were treated significantly differently ( x2=258.697,P ＜ 0.001 ),and their prognosis were also significantly different ( x2=115.938,P ＜ 0.001 ).the condition of patiens were significantly correlated with MEWS ( r=0.848,P ＜ 0.001 ).Conclusion The MEWS in the prediction of potential in critically ill patients in emergency department is feasible as a special emergency assessment system and is recommended for promotion.

Peroxisome proliferative-activated receptor (PPAR) γ coactivator-1α (PGC-1α) is a transcriptional coactivator of PPARγ.PGC-1α can bind with many different transcription factors.It plays a number of functions in the different tissues and the process of biological reaction.Recent studies have shown that PGC-1α signaling pathway has a neuroprotective effect.This article reviews the neuroprotective effect of PGC-1α in cerebral ischernia and its possible mechanisms.

Objective To evaluate the clinical outcome of reconstruction of the superior peroneal retinaculum (SPR) by using a portion of Achilles’s tendon and suture anchors in the treatment of chronic peroneal tendon dislocation .Methods Seven patients in our hospital from January 2010 to January 2015 who underwent surgical reconstruction of SPR by using a portion of Achilles ’ s tendon and suture anchors were evaluated .The ankle ’ s range of motion ( ROM) and The American Orthopaedic Foot and Ankle Society ( AOFAS) ankle-hindfoot score were used to evaluate the clinical outcome .Results All 7 cases were followed up for 6 to 24 months,the average time was 14 months,with-out recurrence.The ankle’s ROM improved from (23.6 ±1.9) °preoperative to (30.0 ±1.5) °at the final follow-up,and the AOFAS An-kle Hindfoot Scale improved from (60.6 ±3.6) point preoperative to (93.6 ±3.9) point at the final follow-up.Conclusion Surgical re-construction of SPR by using a portion of Achilles ’ s tendon and suture anchors may be an effective alternative surgical method for chronic peroneal tendon dislocation .

Since enrolling oral medical undergraduates, under the guiding ideology of “culti-vating applied medical personnel for grass roots”, Xi 'an Medical University has kept trying to find effective measures to strengthen tooth carving training. It has made full use of resources and advan-tages of oral professional technology, cleared the aim, significance, content and form of tooth carving training, paid attention to linking up tooth carving skill and oral clinical courses, then formed a set of distinctive tooth carving experimental teaching mode by strengthening teacher training, innovating pra-ctice teaching methods, making teaching models, carrying out opening experiment, designing com-prehensive experiment examination methods, and actively taking part in skill competitions, and so on.

We analyzed the pathogenic characteristics of Salmonella strains isolated from diarrhea patients in Wuxi City,Jiangsu Province,China and compared the differences among pulse field gel electrophoresis (PFGE) patterns of main serotype strains,so as to provid scientific basis for disease control.After biochemical identification of the Salmonella strains isolated from infectious diarrhea patients in Wuxi in 2015,drug susceptibility test,serotyping and PFGE were applied to analyze these strains.Results showed that a total of 32 Salmonella strains were detected from 756 diarrhea specimens with a positive rate of 4.23 ％.The infection occurred more frequently between May and October and adults aged more than 60 years old affected mostly.There was no significant difference between genders in infected population.The drug susceptibility test indicated that the antibiotic resistance rate of these Salmonella strains to ampicillin (56.25 ％) was the highest,and to ciprofloxacin(6.25 ％)and Ceftazidime (6.25％) were the lowest.The 32 Salmonella strains belonged to 11 serotypes,and S.enteritidis(31.25％)and S.typhimurium(21.88％) were the predominant serotypes.PFGE showed that the pattern similarity of all S.enteritidis was more than 85 ％;PFGE patterns of S.typhimurium were different.In conclusion,the infection of Salmonella from diarrhea patients in Wuxi City had obvious season and age specific distribution,and the most prevalent serotype of Salmonella was the S.enteritidis.It is necessary to strengthen the surveillance of Salmonella concurrently in food and environment.

Objective To detect the serum growth hormone(GH),insulin-like growth factor-I(IGF-Ⅰ),insulin-like growth factor binging protein-3(IGFBP-3) levels in children with hypothyroidism and explore the change regulation of GH-IGF axis and thyroxine.Methods Fifty-six hypothyroidism children were divided into congonital hypothyroidism(CH)(14 cases) and Hashimoto's thyroiditis(32 cases).Serum GH,IGF-Ⅰ,IGFBP-3 levels of 56 hypothyroidism children before and after luothyroxine sodium L-T4 treatment and 50 normal children were detected with radioimmunoassay or enzyme-linked immunosorbent assay methods.Results Serum IGF-I,IGFBP-3 levels in 9 CH newborn group were lower,and they were normal after thyroxine substitute therapy.But those of 5 children with CH and 32 cases with Hashimoto's thyroiditis were not significantly changed.Conclusions The GH-IGF axis is inordinate in the CH children,which is an important reason of stature short.Early thyroxine substitute therapy is very helpful to maintain normal growth and development of children with CH.

Objective To evaluate the role of different imaging examinations in diagnosis and minimally invasive surgery of intercondylar eminence fracture of the tibia. Methods Different imaging examinations and minimally invasive surgery were done on 43 patients with intercondylar eminence frac-ture of the tibia admitted from July 2004 to December 2007. Preoperative and postoperative imaging data were collected for comparative analysis of functional score. Results Fracture detection rate of X-ray was 95%, that of CT three-dimensional reconstruction 100% and that of MRI 90%. All fractures were healed at one stage, with sound knee function. Conclusions The traditional X-ray examination is the first choice for diagnosis of the intercondylar eminence fracture of the tibia. In the meantime, three-di-mensional reconstruction of CT can help enhance accuracy of diagnosis and MRI can help diagnose cruci-ate ligament injury. Arthroscopic and minimally invasive surgery is rather complex but good to recovery of knee joint function. Compared with other methods, tension band is simple but reliable, for it can avoid breakage of the fractured bone and is suitable for all types of fractures.

Objective To investigate the effect of cocaine-amphetamine-regulated transcript peptide (CART) on the content of 4-hydroxy-2-noneral (HNE) and infarct volume after cerebral ischemia/reperfusion in mice.Methods A total of 96 healthy male mice were randomly divided into four groups:ischemia/reperfusion (n =27),CART (n =27),normal saline control (n =27) and sham operation (n =15) groups.A middle cerebral artery occlusion (MCAO) model was induced.Two hours after MCAO,CART 55-102 and equivalent normal saline were injected respectively via the tail veins of mice in the CART group and the normal saline control group,and then they were injected every other 24 hour.The neurological scores,infarct volume and the HNE content of lipid metabolism of oxidative stress were performed and detected respectively at 12,24,48 and 72hours after reperfusion.Results CART could significantly improve the neurological deficit scores (all P ＜0.05) and reduce infarct volume (all P＜0.05) at different time points after ischemia/reperfusion.The content of HNE was upregulated (all P＜0.05) at different points after referfusion.CART could significantly down-regulate the increased HNE levd in brain after ischemia (all P＜0.05).Conclusions CART may protect ischemic brain injury in mice by inhibiting lipid peroxidation.

Exercise Test ; Female ; Heart Sounds ; physiology ; Humans ; Male ; Phonocardiography ; methods ; Pregnancy ; Stress, Physiological ; physiology ; Young Adult

Objective To investigate the protective effect of lipsomal clodronate against hepatic injury in rats with acute necrotizing pancreatitis (ANP). Methods 48 SD rats were randomly divided into control group, ANP group and lipsomal clodronate group, respectively. The models of ANP were established by injection of sodium taurocholate into the pancreatic capsule. Lipsomal clodronate was prepared by means of thin film. Blank liposomes and clodronate-containing liposomes was injected via caudal vein in ANP group and lipsomal clodronate group, respectively. The rats were sacrificed at 2, 6 h after ANP induction, the serum levels of ALT, AST and AMS, IL-6,IL-12 were measured, and pathologic changes of liver and pancreas were observed. Results At 6 h, serum level of ALT was (73 ± 11) U/L, (257 ± 33) U/L and (184 ± 29) U/L in control group, ANP group and lipsomal clodronate group, respectively;serum levels of AST were (190 ± 32)U/L, (590 ± 70)U/L and (430±52)U/L, respectively;serum levels of AMS were (814±80)U/L, (5031 ± 471) U/L and (2843 ± 236) U/L, respectively, serum levels of IL-6 were (26.7 ± 5.7) pmol/L, (218.0 ±4.7)pmol/L and (112.3 ± 8. O) pmol/L, respectively;serum levels of IL-12 were (4. 2 ± 1.0) pmol/L,(309.5 ± 8.5) pmol/L and (153.7 ± 6.3) pmol/L. The values in ANP group and lipsomal clodronate group were significantly higher than those in control group, while the values in lipsomal clodronate group were significantly lower than those in ANP group (P < 0. 01). Pathologic changes of liver and pancreas were significantly attenuated in lipsomal clodronate group. Conclusions Intravenous liposomal clodronate could exert protective effects on the hepatic injury in rats with ANP.