Objective　To explore the generative mechanism of bacterial wave growth in view of the open living system of microorganism. Methods　With the single strain of bacterium as the subject, the nonlinear method of the dynamic systems and the analyzing method of the numerical simulation were used to study the effect of the changing environment on the bacterial growth. Results　A mathematical model of the relationship between the bacterial wave growth and environment was established. Conclusion　This model is verified to be scientific and its numerical simulation results are obtained, providing a helpful quantitative analysis for the research on the laws of bacterial wave growth.

Objective To evaluate the clinical efficacy and safety of methotrexate(MTX) plus low dose glucocorticoid in the treatment of rheumatoid arthritis (RA) from thetarget control point of view.Methods Patients diagnosed as RA according to American College of Rheumatology(ACR)/European League against Rheumatism (EULAR) 2010 classification criteria were enrolled.All of the patients were prescribed with 15 mg/week MTX,5 mg/week folic acid and prednisone (not exceeding 10 mg/day) orally.At week 0,4,12,disease activity and clinical efficacy were recorded.Co-primary assessment criterion was disease activityscore (DAS28)-based on C-reactive protein (CRP).Secondary assessment criteria included EULAR response criteria,ACR response criteria,simplified disease activity index(SDAI),clinical disease activity index(CDAI).The tolerability and toxicity of MTX was recorded at week 4,12.All patients were evaluated for the occurrence of adverse drug reactions associated with prednisone at week 12.Results A total of 76 patients were enrolled in the study.At week 4 and 12,68 and 65 patients completed regular follow-up respectively.At week 12,there were 30(46.2％),9(13.8％),26(40.0％) patients who met DAS28-CRP remission,low disease activity,middle and high disease activity criterion respectively.Three of nine patients who grouped in low disease activity after therapy were early or intermediate patients and didn't reach the target.Thus 36 (55.4％) patients met the standard of target control.The percentage of patients who met the criteria of EULAR good response,the ACR criteria for 20％ improvement (ACR20),the ACR criteria for 50％ improvement (ACR50),the ACR criteria for 70％ improvement (ACR70) were 29.2％,75.4％,69.2％,64.6％,respectively.The proportion of patients meeting the standard of treat to target using SDAI and CDAI were 76.9％,58.5％ respectively.The rate of liver injury,abdominal pain,abdominal distention and acid reflux,nausea were 11.8％,4.4％,4.4％,2.9％ respectively at week 4.At week 12,4.6％ of patients reported abdominal distention.There was only one patient (1.5％) each who complained of abdominal pain,nausea,loss of hair,varicella zoster virus infection and pulmonary infection at week 12.No serious adverse event was observed during the study.Conclusions Based on the view of target control,drug efficacy and safety,MTX plus low dose prednisone is still a useful therapeutic regimen for RA at present.

Objective To study a statistical method about agreement testing to continuous variable.Methods Two measurements was carried out to the same subject,or the same two instruments were used to measure many paired individuals.Results We provided a statistical method(scatter gram,F-test)to repeated data and non-repeated data.Conclusion Correct choice of statistical method relies on the purpose and condition of actual problem.

Objective To observe the clinical effects of laparoscopic varicocelectomy to ejaculum quality in patients with varicocele.Methods Fifty patients with varicocele were treated by laparoscopic varicocelectomy.The patients were grouped into Group A and Group B according to venous diameter.Semen parameters including semen volume,sperm density,sperm motilities (a + b + c),sperm motilities (a + b),sperm motilities (a),total sperms,normal spermmorphology rate and sperm survival rate were measured and recorded before operation and 1,3,6 months after operation.Results After the follow-up of 6 months above in 50 cases,there is no significant difference about semen volume preoperative and postoperative at different follow-up time(P ＞ 0.05).In some semen parameters(sperm density,sperm motilities,total sperms,normal spermmorphology rate),there is no significant difference between preoperative and postoperative 1 month(P ＞ 0.05),but there is significant difference between postoperative 3 months and postoperative 6 months(P ＜ 0.05).There is no significant difference in preoperative semen parameters between the 2 groups(P ＞ 0.05),but there is significant difference in postoperative 6 month(P ＜0.05).In Group A,there is significant difference in sperm density between preoperative and postoperative 1 month (P ＜0.05).In Group B,there is significant difference in sperm density,sperm motilities and normal spermmorphology rate between preoperative and postoperative 1 month(P ＜ 0.05).Conclusions Laparoscopic varicocelectomy has a positive effect on sperm parameters,it can significantly improve postoperative semen parameters.Semen parameters improve to a relatively stable level by 3 months following operation.

Objective To study the changes of neuron specific enolase(NSE) and S100? protein levels in serum after cardiopulmonary resuscitation(CPR) in rats,and and to evaluate their significance on early diagnosis of brain injury. Methods Caridiac arrest model was induced by asphyxiation with ice-cold 0.5 mol KCl in rats,and resuscitation 5 minutes after arrest.Fifty male Sprague Dawley rats were randomly divided into 5 groups : sham control group (n=10) and 4 routine treatment group (experimental group) (n=10,per group) . The blood samples were taken from rats at 6 , 12 , 24 , 48 hours after restoration of spontaneous circulation(ROSC).NSE and S100? measured by enzyme-linked immunosorbent assay were compared between each experimental group,serum from sham control animals was also analyzed. Results Both NSE and S100? were significantly increased in serum after ROSC when compared to sham controls(P

Nowadays more and more medical study fields need mathematics knowledge.The mathematics abilities of medical students include the ability of basic logic thought,changing medical problems into mathematics ones,understanding and applying mathematics knowledge as well as solving mathematics problems with computers.

Academic Inspection is not only an important part of clinical teaching,but also a vital tache of improvement for medical treatment quality.Unlike internal medicine and surgery,acdemic inspection of ICU has its own characteristics.PBL teaching method on acdemic inspection of attending doctor in ICU is explored in this article.

Objective To understand the status of tobacco epidemic among adults in Zhejiang province in 2013.Methods A total of 2 779 residents aged 15-69 years from 15 counties were selected using stratified multi-stage cluster sampling method and surveyed by face to face interview to complete questionnaire.Results The current smoking prevalence was 25.62％ among the adults 15-69 years old in Zhejiang province,50.88％ among males and 0.78％ among females.The daily smoking prevalence was 21.85％;40.56％ of the current daily smokers smoked within 30 minutes after waking;95.19％ of current smokers were not willing to quit;64.04％ of all respondents reported someone smoked in their own homes;67.48％ smokers thought they would continue to smoke even if the price of tobacco rises;21.09％ of all respondents saw tobacco AD at shops and on TV;42.00％ of people were aware that smoking could cause stroke,heart attack and lung cancer;89.69％ smokers still believed that low-tar cigarettes were less harmful than regular cigarettes;73.92％ of people agreed with completely no-smoking in public places.Conclusions Male smoking prevalence in Zhejiang remains at a high level,coupled with low rate of quitting,second hand smoke exposure remains a serious issue in household,low awareness of the harms of smoking for people,suggesting that the task of controlling smoking needs to be strengthened.

Objective To construct a qseC-deleted mutant strain of E.coli by Red recombination and to study the effect of qseC gene on biofilm formation in the mutants.Methods The chloramphenicolresistant gene flanked by homologues of target genes was amplified by PCR and electro-transformed into E.coli MC1000.When induced by L-arabinose,the plasmid pKD46 could express three recombinant proteins of λ-prophage,which led to the replacement of target gene(qseC) with chloramphenicol-resistant gene.Then the chloramphenicol-resistant gene was eliminated by FLP-promoted recombination events.The biofilm formation of wild-type and mutant strain was detected by crystal violet staining.Results The qseC-deleted mutant of E.coli was confirmed by various PCR and DNA sequencing.Gene qseC was completely deleted.There was no significant difference in growth ability between the qseC mutant strain and the wild-type strain MC1000.The biofilm formation of wild-type and mutant strain was quantified by crystal violet staining.The absorbance determined with a plate reader at 570 nm was 1.00±0.15 and 0.47±0.10 respectively.Conclusion The qseC-deleted mutant of E.coli was constructed successfully.And the qseC gene plays an important role in regulation of biofilm formation in E.coli.

Objective To investigate the affect of rhTNFR:Fc on the postoperative recovery of patients with inflammatory arthritis after arthroplasty. Methods Patients with inflammatory arthritis undergoing arthroplasty were included and divided into rhTNFR:Fc group (rhTNFR:Fc only or combined with conven-tional DMARDs) and conventional DMARDs group (monotherapy with or combination of conventional DMARDs). We retrospectively analyzed the incidence of postoperative infection, wound healing time, the febrile period (body temperature ≥37.5 ℃) and the duration of antibiotics treatment after arthroplasty. x2 test and t test were used for statistical analysis. Results Sixty-seven patients were included, 18 in the rhTNFR: Fc group and 49 in the conventional DMARDs group. One postoperative infection occurred in rhTNFR :Fc group but none in the DMARDs group. There was no significant difference by Fisher's exact test (P＞0.05). The febrile duration was (4±3) days in the rhTNFR :Fc group and (3±3) days in the conventional DMARDs group, the difference was not statistically significant (P＞0.05). The wound healing time was (14.0±3.1) days in the rhTNFR :Fc group and (14.7±2.9) days in the conventional DMARDs group, which was not statistically different(P＞0.05). The duration of antibiotics treatment after operation was (14.8±9.3) days in the rhTNFR: Fc group and (10.3±2.7) days in the conventional DMARDs group, the difference was statistically significant (P＜0.05). Conclusion Using rhTNFR:Fc during perioperative period in patients with inflammatory arthritis does not increase the risk of infectious complications or extending wound healing time and the febrile duration.