Sepsis is a life-threatening organ dysfunction caused by dysregulated immune response to infection, which has high rates of morbidity and mortality.The imbalance between the response to inflammation and that to anti-inflammation is one of the most important pathophysiological processes in patients with sepsis.Despite the variety of its treatment options, their therapeutic effects remain unsatisfactory.Continuous renal replacement therapy (CRRT) is gaining a wider application in critical care medicine, especially in the treatment of sepsis, which can significantly increase the survival rate of sepsis patients by immunity modulation, organ support, and internal environment stabilization, so as to improve the immune disorder, protect the organ functions, and maintain homeostasis in the body.

OBJECTIVE:To establish a method for the simultaneous determination of chloramphenicol and dexamethasone sodium phosphate in ear drops by HPLC METHODS:Chloramphenicol and dexamethasone sodium phosphate were separated with a mobile phase of methanol-phosphate buffer solution(0 34% KH2PO4 solution)(60∶40,v/v,1 0ml/min)on Kromasil C8 column and detected at 240nm RESULTS:Good linearity appeared in the concentration of chloramphenicol 100～500?g/ml,r=0 9 999,the recovery was 98 5%～100 8%,RSD≤1 5%;and good linearity showed in the concentration of dexamethasone sodium phosphate 16～80?g/ml,r=0 9 990,the recovery was 98 8%～100 6%,RSD≤2 0% CONCLUSION:This method can simultaneously detect both ingredients in the ear drops

Object To investigate the effects of ethanol sediments obtained from the tuber of Angelica sinensis (Oliv). Diels (ESA) and its litmusless component (ESA 1) on the secretion of TNF ? and IL 1 by mice peritoneal macrophages in vitro. Methods L929 cell line cytotoxicity was used for the assay of TNF ?. The proliferation of L929 cell line was used for the assay of IL 1. Results The secretion of TNF ? and IL 1 by mice peritoneal macrophages which were co cultured with ESA or ESA 1 in vitro can be significantly promoted. At the concentrations in range of 5～20 ?g/mL, there is a dose dependence in the action of ESA, while there is not the similar effect of ESA 1, even though it showed the marked effect. Conclusion ESA and ESA 1 can enhance the secreting TNF ? and IL 1 of mice peritoneal macrophages in vitro.

Objective To investigate a new automatic inverse optimal solution based on VMAT optimization model and verify its result.Methods A variant of the new automatic inverse optimal solution was proposed in this study,which provided a solution to calculate treatment plan with the minimized number of beams and the minimized levels of their intensities on the basis of VMAT optimization model by customized software tools.The verifications were evaluated on the simulated head-neck phantom by dosimetric parameters.Results Compared with conventional IMRT/VMAT treatment plans,the adaptive optimization program(AOP)plan showed that plan20/40(20 fields with totally 40 sub-fields,m=2)made the best achievement and it was clinicable.Conclusions The proposed new optimization technique provides an effective way to reach an inverse treatment plan with the best compromise and less sub-fields compared with IMRT/VMAT plans.

BACKGROUND:Under physiological conditions, nerve roots can move along with the movement of limbs and spine. However, the mechanisms of nerve root stretch injury under physiological conditions and the neurological dysfunction after injury are unclear.
OBJECTIVE:To review the reason of nerve root stretch injury, and to analyze the mechanism of nerve function from biomechanics, pathology and neurophysiology.
METHODS:A computer-based online search of PubMed database was undertaken by the first author to identify the articles related to the research of nerve root injury and nerve stretch injury between 1990 and 2012, with the key words of“nerve root, nerve, stretch injury”. A total of 391 articles were screened out. The articles on the anatomy and biomechanics research of nerve root were included, as wel as the pathology and neurophysiology research after nerve root stretch injury. Final y, 44 articles were included for review.
RESULTS AND CONCLUSION:Nerve root can be stretched along with limbs and spine movement. However, diseases or trauma may cause pathological nerve root stretch, and thus leading neurological dysfunction. The nerve root is often influenced stretch because of its anatomical and tissue structure. Mechanical injury mechanism of stretch composes of peripheral (peripheral nerve conduction stress) and central mechanism (displacement of spinal cord content). Pathological studies found that the local fibrosis is caused by the extracted serum protein that difficult to remove after injury, and this is because of the shortage of lymphatic system in nerve roots. Fibrosis can cause nerve root ischemia, affect the nerve function, and change the biomechanical properties of nerve root. Nerve root injury can cause primary and secondary injury of internal axons, and this is the main reason for neurological dysfunction after injury.

Objective To explore the effect of Shenling Baizhu Powder and moxibustion on serum brain-gut peptide in patients with diarrhea predominant irritable bowel syndrome (D-IBS). Methods Sixty D-IBS cases were randomly divided into two groups, 30 cases in the treatment group were given Shenling Baizhu Powder and moxibustion therapy, and 30 patients in the control group were given loperamide hydrochloride capsule. Treatment for the two groups lasted for 4 weeks. Clinical symptoms and serum brain gut peptide (5-HT, VIP and SP) levels of two groups were observed before and after treatment, clinical efficacy were evaluated. Results Markedly effective rate of the treatment group was 66.7% (20/30), better than 33.3% (10/30) in the control group (P<0.05). After treatment, clinical symptom scores of the treatment group decreased significantly (P<0.01), while only diarrhea and abdominal pain improved in the control group (P<0.01), with statistical significance (P<0.01). After treatment, serum 5-HT, VIP, and SP of the treatment group were decreased (P<0.01), while these indexes of the control group did not change significantly (P>0.05), with statistical significance (P<0.01). Conclusion Clinical efficacy of Shenling Baizhu Powder and moxibustion in treating D-IBS is better than that of loperamide hydrochloride capsule, and can significantly improve clinical symptoms and regulate serum brain-gut peptides levels.

BACKGROUND:Posterior lumbar interbody fusion is a typical therapeutic method of lumbar degenerative disease. Present studies suggested that adjacent segment degeneration occurs after fusion. Recently, more and more scholars paid attention to the development of non-fusion of the spine. ＜br> OBJECTIVE:To compare clinical effects of Dynesys dynamic stabilization system fixation and posterior lumbar interbody fusion in treatment of lumbar degenerative disease. ＜br> METHODS:From July 2009 to July 2011, clinical data of 56 patients with lumbar degenerative disease were retrospectively analyzed. There were 28 cases of Dynesys dynamic stabilization system fixation, and 28 cases of posterior lumbar interbody fusion. Operation time, bleeding volume, and postoperative hospitalization time were compared in both groups. Visual analog scale was used to assess pain. Oswestry disability index was utilized to evaluate clinical effects. ＜br> RESULTS AND CONCLUSION:A total of 56 patients were fol owed up for 18-24 months. Visual analog scale and Oswestry disability index scores were significantly improved at 12 months after treatment in both groups (P＜0.01). Significant differences in operation time, bleeding volume, and postoperative hospitalization time were detected between both groups (P＜0.01). Dynesys dynamic stabilization system group was better than posterior lumbar interbody fusion group. Range of motion was better in the Dynesys dynamic stabilization system group than in the posterior lumbar interbody fusion group (P＜0.01). During fol ow-up, nail rope system and polyester sleeve loose were not detectable in the Dynesys dynamic stabilization system group. These results verified that compared with posterior lumbar interbody fusion, Dynesys dynamic stabilization system for lumbar degenerative diseases has a high safety and smal trauma, and can keep advantages of a fixed segment, and exert a certain effect on degeneration of intervertebral disc in the adjacent segment.

Objective To investigate the influence of two general anesthestic modes on postoperative cognitive dysfunction (POCD) in the patients undergoing laparoscopic radical hysterectomy .Methods One hundred ASA Ⅰ‐Ⅱ patients undergoing lapa‐roscopic radical hysterectomy were randomly allocated to the propofol group (group P) and sevoflurane group (group S) ,50 cases in each group .The anaesthesia time ,total dose of sufentanil ,total dose of vecuronium ,recovery time ,recovery time for regaining ori‐entation and complications during anesthetic recovery period were recorded .The cognitive function was assessed by the mini‐mental state examination (MMSE) on preoperative 1 d (T0 ) ,postoperative 1 d (T1 ) ,postoperative 3 d ,(T2 ) ,postoperative 7 d (T3 ) ,post‐operative 1 month (T4 )、postoperative 3 months (T5 ) and the POCD occurrence situation was evaluated by adopting the Z scoring . Results The total dose of sufentanil and vecuronium in the group S was lower than that in the group P (P<0 .05) ,the recovery time and time for regaining orientation in the group S was longer than that in the group P (P<0 .05);the incidence rates of shive‐ring ,dysphoria and upper respiratory tract obstruction in the group S were higher than those in the group P (P<0 .05) .There were no statistically significant difference in the MMSE scores between the two groups (F=0 .14 ,P=0 .709);the MMSE scores in each group had statistical differences among different time points (F=74 .46 ,P<0 .01) .The interaction effect existed between the gen‐eral anesthetic mode and time with MMSE score (F=7 .99 ,P<0 .01);the MMSE scores at T1 ,T2 in the group S were lower than those in the group P (P<0 .05) .The incidence rate of POCD at T1 ,T2 、T3 ,T4 in the group S was higher than that in the group P (P<0 .05) .Conclusion The incidence rate of POCD in the patients undergoing laparoscopic radical hysterectomy by adopting sevoflurane inhalation general anaesthesia is higher than that by adopting propofol anesthesia ,but which has no difference after postoperative 3 months .

Objective To quantitatively evaluate the image quality, stability and volume precision in kilovoltage cone beam CT (CBCT) on Varian linear accelerator. Methods The Catphan (R) 600 phantom was repeatedly scanned in the full-fan and half-fan CBCT scanning modes. A simulation fan-beam CT (FBCT) was used as a benchmark and results related to the low contrast resolution, spatial resolution,uniformity and image noise were compared with the CBCT using the treatment planning system. The comparison of image quality and long-term stability and volume precision was analyzed. Results Spatial resolution was no differences observed between FBCT and CBCT ( 6 lp/cm: 6 lp/cm , T = 18. 00 , P＞ 0. 05 ) .Low contrast resolution was, on average, 1. 65％ and 1. 74％ for both CBCTFull-Fan and CBCTHalf-Fan , and 1. 03％ for the FBCT ( T =6. 00, P ＜ 0. 05). Uniformity was, on average, 0. 005 and 0. 033 for both, and 0. 003 for the FBCT ( T=6. 00 , P ＜0. 05). In terms of image noise, the FBCT images were superior to the CBCT (T=30. 00, P＜O. 05). In valid scan range of the CBCT, reconstructed precision was high. There was no significant time trend in the image quality. Conclusions The image quality of kilovoltage CBCT is inferior to the conventional CT. However, tumor and soft tissues are visible in the CBCT images. The image stability and reconstructed precision is satisfying.

Objective To investigate the clinical value of neutrophil-lymphocyte ratio (NLR) in postmenopausal patients with type 2 diabetes mellitus (T2DM). Methods A total of 128 newly diagnosed T2DM female patients were randomly recruited from the Zhujiang Hospital of Southern Medical University from March to September 2015. According to the physiological state, the patients were divided into menopausal group (n=66) and non-menopausal group (n=62). Fifty-six healthy females were chosen as the control group. The values of blood pressure, blood lipid, fasting plasma glucose (FPG), fasting insulin (FINS) and white blood count (WBC), neutrophil count, percentage of neutrophils,lymphocytes count, and percentage of lymphocytes were detected and compared between three groups. The NLR and the HOMA insulin resistance index (HOMA-IR) were calculated. Results Age, systolic blood pressure (SBP), triglyceride (TG), FINS, percentage of neutrophil, NLR, HOMA-IR were significantly higher in menopause group than those of control group and non-menopause group (P<0.05). There were no significant differences in diastolic blood pressure (DBP) and FPG between menopause group and non-menopause group, but both were significantly higher than those of control group (P < 0.05). There were no significant differences in total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), WBC and HbA1c between three groups (P>0.05). There was no linear correlation between NLR and HOMA-IR (rs=0.015, P > 0.05), HbA1c (r=0.030, P > 0.05). Conclusion NLR is of a certain significance in the assessment of inflammatory status and IR levels in postmenopausal women with T2DM, which may be related to the changes of autonomic nervous system.