Objective To investigate the effects of different head positions during operation on wake-up time and quality among ankylosing spondylitis (AS) patients with thoracolumbar kyphosis following pedicle subtraction osteotomy (PSO).Methods Sixty patients were included in this study.All of them,treated with intravenous anesthesia,took the bow-prone position.The patients were randomly divided into two groups:the experiment group where the head was elevated by 10° and the control group where the head was not elevated.The two groups were compared in respect of wake-up time and quality of wake-up test.Results The wake-up time in the experiment group was significantly shorter as compared to that of the control group (1 3.7±2.0 min vs.24.2±2.7min,P＜0.05).The wake-up quality was better as well.Conclusion Elevation of the head by 10° can shorten wake-up time and improve the quality of wake-up test during the procedure of PSO for AS patients with thoracolumbar kyphosis.

Objective To study the chemical components from the pericarps of Juglans mandshurica with anti-tumor activity.Methods It showed that pericarps of J.mandshurica had a good performance in treating cancer and low toxicity from CHCl3 and EtOAc portions by a lot of pharmacological experiments and modern clinical application in the past.Compounds were isolated by chromatography on silica gel columns and AB-8 macroporous resin.On the basis of spectral evidences including 1D-NMR and 2D-NMR,the structures of these compounds were determined.Results These compounds from CHCl3 portion were identified as 20(S)-protopanaxadiol-3-one(1),dammara-20,24-dien-3?-ol(2),galeon(3),juglanin A(4),2?,3?,23-trihydroxy olean-12-en-28-oic acid(5),2?,3?,23-trihydroxy urs-12-en-28-oic acid(6),oleanolic acid(7),ursolic acid(8).Conclusion Compound 1 is a new natural product.Compounds 2 and 5-8 are isolated firstly from the plants of Juglans L.which are due to pentacyclic triterpane.Compound 3 is isolated from the pericarps of J.mandshurica for the first time.

Objective To discuss the research status and hotspots related to breeding, planting, harvest, processing and storage of Lycium L. in China. Methods Relevant literature about breeding, planting, harvest, processing and storage of Lycium L. in CNKI from January 2004 to December 2013 was retrieved by computers. CiteSpaceⅡ was introduced to carry out key word analysis, high-frequency key word obtaining, co-occurrence network of high-frequency key words, and dendrogram of high-frequency words. Results Totally 759 articles were included. Key words about breeding were “genetic diversity”, “male sterile”, “its sequence”, “callus issue”, and“anther culture”. Key words about planting were“output”,“quality”,“hard twig cuttage”,“irrigation amount”. Key words about harvesting and processing were“picking machine of Lycium L.”,“drying kiln of Lycium L.”,“hot air drying”, and “combined drying”. Key words about storage were “pesticide residue”, “heavy metal”, and“organophosphorus pesticide”. Co-occurrence network of high-frequency key words showed that the research hotspots were pesticide residue, test of heavy metal and the storage of fresh fruits. Dendrogram of high-frequency key words showed that the high-frequency key words were “package”, “refreshment”, and “lycium barbarum polysaccharide”. Conclusion The research hotspots of planting of Lycium L. are planting skills effecting the output and quality of Lycium L.; In the field of harvesting and processing of Lycium L., design and research of picking machine has replaced traditional manual picking. Modern hot air drying has already replaced traditional drying in the sun or drying skills; In the aspect of storage of Lycium L., the study on the refreshment of Lycium L. has attached attention.

Objective To investigate the antibiotic resistance, virulence genes, and sequence types of Enterococcus faecium ( E. faecium) strains isolated from children under 3 years old in Sui county, Henan province. Methods Kirby-Bauer antibiotic testing was performed to analyze the antibiotic sensitivi-ties of E. faecium strains to 15 common antibiotics. PCR analysis was used to detect the virulence genes car-ried by the E. faecium strains. Multilocus sequence typing ( MLST) was performed for the typing of E. faeci-um strains. Results Forty-seven E. faecium strains were isolated from 120 stool samples collected from chil-dren under 3 years old in Sui county, Henan province, of which 95. 7% were antibiotic-resistant strains. Most of the isolated E. faecium strains were resistant to rifampicin, accounting for 91. 5% (43/47) of all isolates, followed by those resistant to erythromycin and tetracycline, which accounted for 68. 1% (32/47). Moreover, high resistance rates to those antibiotics commonly used in clinical treatments of E. faecium infec-tion including β-lactam and aminoglycosides antibiotics were observed. Those strains resistant to more than three kinds of antibiotics belonged to the same clonal complex including 12 strains of clonal complex 17 ( CC17) harboring the virulence gene of hyl. All of the isolated E. faecium strains were susceptible to vanco-mycin, linezolid, chloromycetin and nitrofurantoin. Conclusion The E. faecium strains isolated from chil-dren under 3 years old in Sui county, Henan province were multi-antibiotic resistant. There were drug-resist-ance strains belonging to the CC17 and carrying the virulence gene of hyl.

There existed animal ethical issues in the process of functional experiment including poor breeding environment before animal experiment, insufficient prepare before class, not standard experimental operation, less attention paid to the study of anesthesia, disposal on animals after the experiment. Based on the analysis of these issues and combined with the thought of respect for animals′rights and attention to animal welfare, the authors put forward suggestions from the aspects including the schools′active attention and support, curriculum, standardizing the experimental design and operation steps, improving the animal experiment teachers′ethical consciousness, cul-tivating the students′experimental animal ethical consciousness. In addition, this paper put forward the thinking of further strengthening education:the domestic medical colleges generally need to strengthen medical ethics educa-tion, and should adopt various forms to cultivate medical students′medical ethics quality of treasuring life.

Forensic science is a cross discipline,involving both the subjects of natural sciences and the humanities & social sciences.It needs not only the application of forensic techniques and other theoretical results of natural sciences,but also be bounded by moral and ethical guidance.This paper discusses ethical issues involved in the teaching of forensic medicine in medical colleges,exploring the relationship between the teaching of forensic medicine and ethics,so as to promote the development of forensic science education.

Objective To study the effect of ?-scretase substrate-base peptide(BACEsp) on cellular model of Alzheimer's disease(AD).Methods The cellular model of AD established with neuroblastoma cell SK-N-SH induced by amyloid precursor protein(APP) was infected with the supernatants including recombinant retrovirus pLXSN-BACEsp.MTT assay was used to test cell viability and immunocytochemistry was used to observe APP expresion in cells before and after BACEsp treatment.Results Cell viability and APP expression in the cells that had been first infected by recombinant retrovirus pLXSN-BACEsp were apparently higher than those only transfected by APP and last infected by recombinant retrovirus pLXSN-BACEsp.Conclusion BACEsp has an obviously protective effect on APP-induced neuron toxicity of cellular model of AD.

Objective To propose a modified graph cut algorithm under the elliptical shape constraint to segment the ultrasonogram of cervical lymph nodes. Methods Since cervical lymph nodes were usually oval-shaped, the prior of the elliptical shape information, which was expressed as a distance function, was used to constrain the cut cost of the graph cut algorithm. The initially segmented contour was fitted with an ellipse to get the constraint. Then a certain segmentation was obtained by minimizing the cut cost function constrained with the elliptical prior. This procedure was iterated until it to be convergent. Results Under the same user input, this algorithm successfully segmented nodes on the low contrast ultrasonograms, while the traditional graph cut approach failed. For 20 ultrasonograms, with the average minimum Euclidean distance (AMINDIST) measure and the Hausdorff distance measure, these two distances between contours manually delineated by the radiologist and those segmented by this algorithm were far less than the distances resulted from the traditional graph cut algorithm. Conclusion It is indicated that utilizing the elliptical shape constraint prior can obviously improve the graph cut algorithm for segmenting cervical nodes on ultrasonograms.

ObjectiveTo collect and analyze patients' evaluation of basic medical services in Tianjin community health service institutions and to suggest improvements.MethodsA total of 15 community health service centers and 15 community health service stations in six urban districts of Tianjin were selected by stratified sampling and 300 randomly intercepted patients were surveyed by questionnaire.ResultsApproximately half ( 157/300, 52. 3％ ) the patients selected community health service institution as their first choice to seek medical attention. The most important reason for this, with 89.2％ patients responding yes, was that the community health service institution was close to home and very convenient.One quarter (79/300, 25.3％ ) of the patients regularly consulted the same doctor and 17.7％ (53/300)seldom went to see a doctor. The proportion of patients expressing a high degree of satisfaction to service standards and health professionals was 78. 7％, of which satisfaction with physicians' explanation about the patients' illness ranked highest at 83. 7％ (251/300). Patients' confidence level of doctors' diagnosis,physical examination, and auxiliary examination was 92. 0％. Moreover, most (87. 0％ ) patients reported that doctors communicate well with them; 85.0％ (255/300) patients received health instruction from doctors during visits, and 82. 0％ patients reported that doctors pay attention to protecting patients' privacy.The overall satisfaction of patients to environmental facilities and process management of community health service institutions was 73.6％. On the other hand, patient satisfaction with medicine types, service price,instrumentation and equipment, and environment were all lower than the average satisfaction. Conclusions Patients were basically satisfied with medical service in community health service institutions. Three main problem areas were identified: patients' use of community health services is deficient, medical service ability is partially lacking, and the service feature of general practitioners (GPs) is not obvious. Improvements of basic medical service ability in the community, cultivation of GPs, and basic medicine regulation are advocated.

Objective To observe the changes of intraocular pressure(IOP)in surgical treatment of Arnold-Chiari malformation.Methods The IOP of 20 patients who underwent surgical treatment of ArnoldChiari malformation were detected by Tono-Pen tonometer at 5 min utes after general anesthesia(T0),5 minutes after prone position(T1),30 minutes after prone position(T2),60 minutes after prone position(T3),prone position before the end of operation(T4),5 minutes after recovery prostration position(Ts)and 30 minutes after prostration position(T6),mean aortic pressure(MAP),heart rate(HR)and partial pressure of carbon dioxide in end tidal(PETCO2)were recorded at the same time.With the prone position,head was fixed bead-holder with skull pin.Results There was no statistical difference in MAP,HR,PEtCO2 at each time point(P＞ 0.05).The IOP significantly increased at T1[(20.9 ±2.5)mm Hg(1 mm Hg =0.133 kPa)],T2[(17.7 ± 1.7)mm Hg],T3[(23.9 ±2.4)mm Hg],T4[(26.3 ± 1.0)mm Hg]compared with IOP at T0 [(9.5 ± 1.5)mm Hg](P ＜ 0.05),there were significant differences between T2 and T3,T3 and T4(P ＜ 0.05).Recovery prostration position,the IOP decreased gradually,IOP at T5[(18.6 ± 1.8)mm Hg]was significantly lower than that at T4(P ＜ 0.05),but T5 was still higher than T0(P ＜ 0.05).The IOP at T6[(10.3 ± 1.7)mm Hg]was no difference compared with T0.Inserting of skull pin might be increase IOP for a moment,the IOP at T; was significantly higher than that at T2(P ＜ 0.05).Conclusion IOP gradually increases as the patients prone position changes in surgical treatment of Arnold-Chiari malformation,and inserting of skull pin maybe increase IOP for a moment.