Purpose To evaluate 1H proton magnetic resonance spectroscopy (1H-MRS) in detecting traumatic brain injury (TBI) and its metabolic changes during the initial two weeks after trauma using rabbit modes. Materials and Methods Fifteen Chinese rabbits were randomly divided into sham control group (n=5) and TBI group (n=10), 1H-MRS was performed 1 hour, 6 hours, 24 hours and 2 days, 7 days, 14 days after trauma, the concentration of N-acetylaspartate (NAA), creatine (Cr), choline-compound (Cho), NAA/Cr and Cho/Cr in each group was evaluated. At 6 hours, 24 hours and 168 hours after injury, 1 rabbit was slaughtered after abdominal anesthesia at each time point, the sample was ifxed with left heart catheterization perfusion after death, brain tissue was obtained, blocked, dehydrated into frozen section, HE staining was used for observation. Results Compared with the control group, NAA/Cr ratio in the trauma region decreased by 29%1 hour after trauma, with maximal reduction of 40% (at 24 hours) before increasing slightly, the NAA/Cr ratio returned to control level gradually until 168 hours later. The Cho/Cr ratio decreased by 16% 1 hour after trauma, with maximal reduction of 30%(at 6 hours) and increased gradually until finally su rpassed control level (168 hours) for 20% and then became stable. NAA/Cr ratio and Cho/Cr ratio showed statistically significant changes between each observing time point (P<0.05). Conclusion 1H-MRS can be used for dynamic detection of cerebral metabolism without injury, and is superior to MRI in detecting early abnormality of the brain, with NAA/Cr as the most sensitive parameter. Detecting the changes of NAA/Cr, Cho/Cr ratios in the trauma region can be used as a guide for assessment of the clinical treatment effectiveness of TBI.

With the increasing perfection and improvement of microsurgery technique in modern ophthalmology, especially the popularization of micro-incision cataract extraction and the rise of femtosecond-laser-assisted cataract extraction, the cataract extraction and intraocular lens implantation is gradually transformed from vision rehabilitation surgery into refractive surgery and people also pursue better postoperative visual experiences. However, the preoperative and postoperative corneal astigmatism is always the main factor affecting the postoperative visual effect. ln recent years, the development of design and materials of the intraocular lens ( lOL) provided necessary basic conditions for clinical application of the Toric lOL. The Toric lOL is primarily characterized by effective correction of cataract patients′postoperative corneal astigmatism, which results in the enhancement of patients′postoperative visual function. ln this paper, the design, classification and clinical application of Toric lOL were analyzed, and current problems and prospect were discussed.

Objective To investigate the alterations of peripheral blood T lymphocyte subsets in patients with sepsis and septic acute kidney injury, and explore the clinical significance.Methods Fifty-five patients with sepsis and forty-three patients with septic acute kidney injury were enrolled in this study. At the same period, thirty healthy subjects were enrolled as the control group.T lymphocyte subsets inclu-ding CD3 +T, CD4 +T, CD8 +T cells, and CD4 +T/CD8 +T in peripheral blood were detected by flow cy-tometry, and acute physiology and chronic health evaluation Ⅱ( APACHE Ⅱ) were graded within twenty-four hours after admission.Then, correlation of the APACHEⅡscores and T lymphocyte subsets was ana-lyzed.Results In the septic acute kidney injury group, peripheral blood CD3 +T, CD4 +T cell percenta-ges, and CD4 +T/CD8 +T ratio were significantly lower than those in the control group and the sepsis group (all P <0.05).In the septic acute kidney injury group with stage 3, CD3+T, CD4 +T cell percentages, and CD4 +T/CD8 +T ratio in the patients were significantly lower than those in stage 1 and stage 2 ( all P <0.05).In the septic acute kidney injury group,CD3 +T, CD4 +T cell percentages, and CD4 +T/CD8 +T ra-tio were significantly lower in dead group than those in survival group (all P <0.05).APACHEⅡscores in patients with sepsis were significantly negatively correlated with peripheral blood CD4 +T cell percentages and CD4 +T/CD8 +T ratio ( r =-0.645,-0.492, allP <0.05).Conclusions There are varying de-grees of cellular immune imbalance in patients with sepsis and septic acute kidney injury, characterized by decline of circulating CD3 +T, CD4 +T cell percentages, and CD4 +T/CD8 +T ratio.CD4 +T cell percenta-ges and CD4 +T/CD8 +T ratio are closely related to the severity and prognosis of septic acute kidney injury.

Objective To investigate the quality of life of nurses group in Shenzhen city and explore its influencing factors, so as to provide evidence for health policy making health promotion and science research. Methods Self-designed questionnaires were used in social demography survey and SF-36 was adopted to survey 495 in-service nurses on front line from four hospitals in Shenzhen. Paired samples t Test and multivariable stepwise regression were carried out to analyze the quality of life among nurses in Shenzhen city and general population in China. Results The data showed the scores of the physiological domain, psychological domain and quality of life nurses in Shenzhen city and Chinese general population was (68.60±17.61), (69.91±17.91), (67.29±20.29)and (78.18± 15.88), (79.36±17.00), (77.00± 17.42), respectively. The difference had statistical significance. Multivariable stepwise regression showed that quality of life was positively correlated with APN scheduling, education, department, monthly income, working range, age and the hospital level in descending sort Conclusions Health authorities, hospital leaders and nurses-selves should pay more attention to the quality of life for nurses group and take positive mea-sures to improve quality of life of nurses group.

ObjectiveTo investigate the correlation between the level of resistin and the insulin resistance(IR) and the incorporation of microamount albuminuria(MA) of type 2 diabetes mellitus (T2DM).MethodsTwo hundred and twenty T2DM patients and 40 normal subjects (control group) were enrolled in this study.Two hundred and twenty T2DM patients were divided into 4 groups,IR group (group A,79 cases),non-IR group (group B,48 cases),IR complicating MA group (group C,51 cases),non-IR complicating MA group(group D,42 cases).The fasting serum resistin was measured by enzyme-linked immunosorbant assay (ELISA),and the fasting plasma glucose (FPG),glycosylated hemoglobin (HbA1c),fasting insulin (FINS) was also determined.ResultsThe level of fasting serum resistin in group A,B,C and D was higher than that in control group [(33.45 ± 1.37),(23.36 ± 1.47),(44.45 ± 1.39),(37.45 ±1.57) μ g/L vs.( 17.44 ± 1.26 ) μ g/L],and there was significant difference among 5 groups (P ＜ 0.01 ).The level of fasting serum resistin in group A was higher than that in group B (P ＜ 0.01 ),and the level of fasting serum resistin in group C was higher than that in group D (P ＜ 0.01 ).The level of fasting serum resistin was both higher in group C and D than that in goup A and B (P＜ 0.01 ).Correlation analysis showed the fasting serum resistin was positively correlated with body mass index(BMI),FPG,HbA1c and FINS in group A(r =0.35,0.46,0.37,0.49,P ＜0.05),and the fasting serum resistin was positively correlated with HbA1c,BMI,systolic blood pressure and diastolic blood pressure in group C(r =0.45,0.32,0.37,0.29,P ＜ 0.05 ).ConclusionsSerum resistin may participate in the process of IR and the formation of MA.It may become one of the diagnostic standard of the IR and one of the important index to estimate the MA.

Objective To investigate the level of serum angiopoietin-like protein 4 (ANGPTL4) in normal subjects and patients with obesity and newly-diagnosed type 2 diabetes mellitus (T2DM),and to explore the relationship of serum ANGPTL4 with parameters of body fat,glucose-lipid metabolism,and insulin resistance index (HOMA-IR).Methods A total of 160 subjects with normal glucose regulation(NGR) and newly-diagnosed T2DM,were divided into 4 groups:NGR with normal weight group (NGR-NW),NGR with overweight/obese group (NGROW/OB),T2DM with normal weight group (T2DM-NW),and T2DM with overweight/obesity group (T2DM-OW/ OB) according to their body mass index(BMI).ELISA was used to determine the level of serum ANGPTL4.The weight,height,waist circumference,hip circumference,waist hip ratio(WHR),and BMI,fasting insulin(FINS),lipid metabolism parameters,and insulin resistance index (HOMA-IR) were measured.Results Compare with the NGR group,the level of ANGPTL4 was significantly decreased in the T2DM group [(25.75 ±2.85 vs 31.08 ±3.35)ng/ml,P＜0.01],the level of ANGPTL4 in OW/OB group was significantly lower than that in the NW group [(27.27± 3.05 vs 29.04 ± 4.64) ng/ml,P＜0.01].Partial correlation analysis showed that serum ANGPTL4 was negatively correlated with BMI,WHR,FPG,2hPG,HbA1C,FINS,HOMA-IR,AST,ALT,and TG levels(P＜0.01),but positively correlated with the HDL-C(P＜0.01).Multiple stepwise regression analysis showed that HbA1C,FINS,and HDL-C were independent risk factors of serum ANGPTL4 (β =-0.825,-0.119,3.301,P＜0.01).Conclusion Serum ANGPTL4 level in T2DM and OW/OB group was lower than that in NGR and NW group.Serum ANGPTL4 is associated with FINS and lipid metabolism,suggesting that it may play an important role in the pathophysiology of obesity and metabolic syndrome.

Objective To study the epidemiological characteristics of measles in Fuyong Street in order to predict its occurrence and reduce its incidence by establishing preventive and control measures.Methods Epidemiological data in Fuyong Street between 2003 and 2007 were analyzed.Results The result showed that 393 measles cases were reported in the whole street during 2003 and 2007,329 were confirmed by laboratory,and 60 were local cases.The measles annual average incidence was 18.29/100 000.The high incidence period was from March to August and the most measles cases were young adults and infants.30.79% cases had no immunization history and 24.68% cases had immunization history.Conclusions The incidence of measles is kept at a high level.It will go on possibly for half a year or a year.A comprehensive control measures should be thaken to strengthen vaccination program especially for foreign people and to reinforce the surveillance and analysis of epidemic situation in order to avoid the outbreak of the disease.

Objective To investigate the clinical value and effect of spinal nerve medial branch ablation through transforaminal endoscopic in treatment of lumbar zygapophysial joint pain. Methods From August 2008 to October 2013 ,96 patients diagnosed as lumbar zygapophysial joint pain were included in the research. 36 patients were treated by spinal nerve medial branch ablation through transforaminal endoscopic ,while 60 patients received conservative treatment. The visual analogue scale (VAS) and Japanese Orthopedics Association(JOA) scores before treatment,1,3,6 and 12 months after treatment were recorded and analyzed. The MacNab scores were recorded and analyzed 12 months after treatment. Results The VAS and JOA scores of surgical treatment group showed significant improvement compared with that before operation (P < 0.05),and there were no significant difference at each time point after surgery. The VAS and JOA scores of conservative treatment group in showed significant improved at 1 months after treatment compared with that before treatment(P<0.05),but there were no significant difference at each time after treatment compared with pretreatment. The VAS and JOA scores of surgical treatment group showed significant improvement compared with conservative treatment group at each time after treatment(P<0.05). The MacNab scores of surgical treatment group(94.44%)was significantly higher than that of conservative treatment group(33.33%). Conclusion The spinal nerve branches ablation under transforaminal endoscopic is an effective and safe minimally invasive spine surgery technique with important clinical value in the treatment of lumbar zygapophysial joint pain.

Objective To explore the risk factors for asthma in children.Methods A 1:1 matched and hospital-based case-control study was conducted to analyses risk factors for asthma in 300 pairs of children by logistic regression analysis. Results The result of univariate Logistic regression analysis showed that there were 17 related factors for children asthma, including disease history of parents in respiratory system,family income,atopie character,history of acute respiratory infections, eating habit,the amount of sea foods intakes,foam plastics,family decoration,the way of exhaust fume in kitchen,the exhaust effectiveness,raising pet in house,family history of asthma,family history of allergic rhinitis,family history of food allergy,dust allergy of parents,systemic therapy after the first attack.With multivariate Logistic regression analysis,7 factors were entered the model,6 risk factors including father's history of respiratory diseases(OR 3.771,95%CI 1.533～9.278),low family income(OR 1.503, 95%CI 1.258～1.795),atopy(OR 3.788,95%CI 2.368～6.058),meat-eating habit(OR 2.042,95%CI 1.481～2.815),asthma history of family members(OR 1.710,95%CI 0.988～2.958),the family history of allergic rhinitis(OR 1.991,95%CI 1.234～3.211), and 1 protective factor of raising pet in house(OR 0.443,95%CI 0.265～0.739).The coefficients of these factors in multivariate logistic regression model were 1.327、0.407、1.322、0.714、0.536、0.689、and-0.814 respectively.Conclusion Children asthma was a multi-factorial complex disease,and the interaction of environmental and genetic risk factors played an important role in the onset of this disease.

Objective To investigate the clinical value of 18 F-FDG PET CT scan in the diagnosis of thin lung nodules. Methods 56 solitary cases of nodules in the lungs,nodule size ranged from 1～3 cm,conducted 18 F-FDG PET/CT imaging and thin layer CT scan at the same time, 18 F-FDG PET imaging using visual measurement combined with semi-quantitative method to determine the degree of malignant of the lesions; conducted MPR recon-struction after thin layer CT scan, based on the lesions morphology to determine the degree of malignant. Then com-pared the results of above,and the results of the combination of 18 F-FDG PET imaging and thin layer CT scan,with the pathological results after surgery. Results The sensitivities of PET imaging alone,thln layer CT alone,joint ima-ging diagnosis of SPN are 92.6% ,88.2% ,96.4% ,specificity are 73.3% ,57.1% ,85.7% ,accuracy percentage rate are 89.3% ,80.4% ,94.6% ,the positive predictive values are 92.6% ,91.8% ,96.4% ,and negative predictive val-ues are 84.6% ,61.5% ,92.3% ,respectively. Conclusion 18 F-FDG PET combined with thin layer CT scanning is a very effective method to clinical diagnosis the malignant degree of SPN.