Objective To observe the effect of Shenfu injection on fluid intake volume of resuscitation therapy for patients with septic shock. Methods The clinic data of 36 patients with septic shock admitted to Department of Critical Care Medicine of the Affiliated Hospital of Hangzhou Normal University from June 2010 to June 2013 were retrospectively analyzed. All the patients were treated with western conventional medicine. Twenty cases treated with western medicine combined with Shenfu injection (intravenous drip 100 mL once daily, half of a month was a therapeutic course) were defined as Shenfu group; the rest 16 cases treated with western medicine only were assigned as control group. The following data after treatment for 6, 24, and 72 hours in the two groups were compared:liquid intake and urine volumes, system vascular resistance index (SVRI), mean arterial pressure (MAP), cardiac index (CI), and case fatality rate in 28 days. Results There were no significant differences in the liquid intake volume in 6 hours after treatment (mL:3 101±219 vs. 3 329±295, P>0.05), the urine volumes in 6, 24 and 72 hours after treatment (mL, 6 hours:701±229 vs. 651±292, 24 hours:1 870±566 vs. 1 697±618, 72 hours:7 396±2 546 vs. 5 987±2 497), and the levels of SVRI in 24 hours after treatment between Shenfu group and control group (kPa·s·L-1·m-2:802±158 vs. 741±106, all P>0.05). The total liquid intake volumes (mL) in 24 hours and 72 hours after treatment in Shenfu group were significantly less than those in the control group (24 hours:4 544±425 vs. 4 996±396, 72 hours:10 985±891 vs. 11 612±807, both P<0.05). The SVRI, MAP, and CI in 72 hours of Shenfu group were significantly higher than those of control group [SVRI (kPa·s·L-1·m-2): 1 361±182 vs. 1 163±183, MAP (mmHg, 1 mmHg = 0.133 kPa): 76.2±6.1 vs. 71.8±6.3, CI (mL·s-1·m-2):76.2±7.5 vs. 70.8±7.2, all P<0.05], and the 28-day mortality rate in Shenfu group was significantly lower than that of control group [25.0%(5/20) vs. 62.5%(10/16), P<0.05]. Conclusion The application of Shenfu injection was favorable to the reduction of liquid intake volume in 72 hours after treatment that may be beneficial to the fluid limitation management in the course of treatment for septic shock.

Objective To study the CT and MRI features of peripheral primitive neuroectodermal tumor(PNET).Methods CT and MRI appearances of 10 patients with PNET pathologically proved were analyzed retrospectively.All cases underwent CT scan and 2 cases underwent MR imaging examination.There were 5 men and 5 women,the age ranged from 11 years to 54 years old(mean 24 years).Results The tumors were located in the chest wall(n=4),abdomen and sinus(n=2,each),cervical vertebra and humerus(n=1,each).The lesions in the chest wall and abdomen appeared as larger masses(5~16 cm in diameter).The masses were circular and lobulated with heterogeneous density and in company with bone destruction or periosteal reaction.The solid masses were enhanced after contrast medium administration.The lesions in the sinus showed the soft tissue mass with bone erosion.The lesions in bone demonstrated local iso-intensity on T1WI,hyper-intensity on FSE T2WI and on FATSAT T2WI.There were distant metastasis in 3 cases.Conclusion The clinical and imaging features of pPNET in chest wall were more specific than in other locations.CT and MRI can showed intra-tumor structure,and are helpful in delineated the extent of tumor,predicting resectability and monitoring treatment.

By introducing the PBL teaching model into the probation curriculum of endodon-tics,the authors explored the curricular arrangment and the construction of teaching materials.The monitoring of teaching quality and revision of teaching syllabus were also analyzed.To induce the model profoundly,the authors considered some problems raised during the teaching procedure should be resolved.

Physical and Chemical Analysis of Food is one of the important courses of hygiene quarantine speciality,food science and engineering speciality,food quality and safety speciality,and so on. The application of concept center method on the teaching of the course was discussed in the article. The prolegomenon of the course and the eleventh chapter of the course--Determination of Gene Modified Food had been worked as two examples.

Objective To understand the level of neonatal pain knowledge and attitudes of neonatal and obstetric department nurses, in order to supply the clinical basis for neonatal pain management. Methods Self-designed questionnaires to fill out on-site were distributed to 107 neonatal and obstetric department nurses (of which 40 were from neonatal department, 67 from obstetric department) for neonatal pain knowledge and attitudes. Results About question of neonatal pain, the average percentage of correct answers in the neonatal group was 75.5%, higher than 66.3% of the obstetric group, in the neonatal group, correct rate of seven questions was more than 80%,while in the obstetric group the correct rate of only one question was more than 80%, and 5 questions correct response rate was significantly lower than that of the neonatal group, the difference was significant. All nursing staff considered it essential or necessary to carry out the nursing knowledge of pain-related training. 95.0%(38/40) of neonatal nurses believed that they could properly assess the extent of neonatal pain, but only 83.6% (56/67) for the obstetric group, the difference between the two groups was significant. 97.5% (39/40) of neonatal nurses believed that they could make the right judgments on neonatal crying, and only 85.1%( 57/67) in the obstetric nurses, the difference between the two groups was significant.Conclusions Neonatal pain has gradually been recognized and paid attention to by the clinical front-line medical staff, they believe that it is necessary to receive training on neonatal pain, knowledge of neonatal pain of neonatal nurses is better than obstetric nurses.

Objective The aim of this study was to assess the relationship between the oral health habit and halitosis. It can provide an advisory basis for nurse giving individualized oral health instruction to patients of halitosis and can improve the result of prevention and treatment for halitosis accordingly. Methods 202 patients with periodontal disease were chosen to participate in this study. The study included the questionnaire of oral health habit and the halitosis diagnosis by organoleptic assessment.Comparisons of difference in the knowledge of oral health habit between the subjects with and without halitosis were conducted. Results Brushing times in subjects without halitosis were significantly more than that in subjects with halitosis. Brushing teeth in evening and interproximal brush usage were much better in subjects without halitosis than that in subjects with halitosis,respectively. Conclusions Good oral health habits could decrease the incidence of halitosis.

The hydroa vacciniforme -like lymphoma is clinically manifested by rash ,fever,hepatospleno-megaly and lymphadenectasis .Pathological character showed that lymphocytes infiltrated into dermis and there were some heterocysts.Immunohistochemistory showed that Bcl -6,Bcl -2,CD3,CD8,TIA,CD4,granzyme, EBER were positive,CD56,CD20 all tested negative.The rearrangement of TCR of bone marrow cell was positive . The hydroa vacciniforme-like lymphoma is uncommon clinically ,and it is easy to misdiagnosed .The effect of tra-ditional therapy is poor ,while the allogeneic hematopoietic stem cell transplantation followed by lymphocyte and donor-derived EBV-specific cytotoxic T -lymphocyte immunotherapy is effective ,which may offer an curable therapy for HVLL.

Objective The aim of this report was to study the early and mid-term outcome in hospital and follow-up mortality, predictors for late pulmonary stenosis (PAS) and insufficiency of neo-aortic valve (neo-AVI) in patients with transposition of great arteries (TGA) and Taussig-Bing malformation undergoing arterial switch operation ( ASO ). Methods Between January 2004 and December 2007, 169 patients (129 male, 40 female; mean age of [(11.71 ± 26.3 ) months] with TGA or Taussig-Bing malformation underwent ASO. The patients were divided into Group Ⅰ (n = 56 ): TGA with intact ventricular septum and Group Ⅱ ( n = 113 ): TGA with ventricular septal defect (VSD). All patients were followed up in out-patient department by ultrasonic cardiogram. The mean follow-up periods was (27.66 ± 14.6 ) months. Multiple logistic regression analysis was performed to find out the risk factors. Results The overall hospital mortality was 11.24% (19/169)and there was no significant difference between the two Groups. With the improving of perioperative management, the hospital mortality decreased from 16.67% in 2004 to 3.92% in 2007. The overall actuarial survival at 1-, 3- and 5-year follow-up was 94.00%,91.33%, and 91.33%, respectively. The multivariate analysis revealed that age above 6 months was a strong predictor for poor postoperative survival. Predictors for neo-AVI were: combined with VSD, age > 6 months and postoperative neo-AVI Z-score > 1. Predictors for moderate to severe PAS were age ＜ 1 months and pulmonary artery plasty with an unstretchable patch. Conclusion ASO remains the optimal choice for treating various forms of TGA with an acceptable early and mid-term outcome regarding overall survival rate. Patients with TGA should be treated as early as possible. Age >6 months is a predictor for poor postoperative survival and neo-AVI. Mismatch between the neo-aortic root and distal aorta may induce neo-AVI. Unstretchable patch in pulmonary artery plasty may induce PAS.

Objective To express and purify the human scFv antibody,SA3,against the hepatoma fused to enhanced green fluorecsent protein,and to observe the targeted capacity of fusion protein EGFP-SA3 in vivo.Methods SA3 and EGFP genes were cloned into plasmid pET-25b( + )to construct the recombinant plasmid EGFP-SA3/pET-25b ( + ),followed by DNA sequencing.Then it was transformed into E.coli BL21 ( DE3 ) and induced for fusion expression of EGFP-SA3with IPTG.The expressed fusion protein EGFP-SA3 was purified and detected with SDS-PAGE.HepG2 cells were incubated with the fusion protein EGFP-SA3 in vitro,and the binding bioactivity was observed under the fluorecsent microscope.Further more,we injected the EGFP-SA3 by caudal vein into nude mice planted by hepatoma and observed the whole body fluorescence image of EGFP.Results SA3 and EGFP genes were successfully cloned into pET-25b( + ),which was confirmed by restriction enzyme Nco I-Xho I or Nco I-Eco RI.A band migrated at the position 750 bp,same to EGFP gene,emerged when recombinant plasmid was digested by restriction enzyme Nco I-Eco RI.Similarly,a band,about 1 500 bp,emerged when digested by Nco I-Xho I.The open-reading frame was confirmed by DNA sequencing.Fusion protein EGFP-SA3 was expressed as inclusion body.After purification and refolding,the result of immunofluorecsence detection verified that EGFP-SA3could specifically bind to HepG2 cells and maximum tumor penetration was at 24 h after the injection.Conclusion The purified fusion protein EGFP-SA3 has strong binding capacity to HepG2cells,indicating the scFv SA3 has a potential value as a targeting molecule for diagnosis and targeted therapy for liver cancer.