ObjectiveTo selected the safe dosage of intrathecal injection of sufentanil for preemptive analgesia in lower limb orthopaedic surgery.MethodsSelected 96 patients who ASA classification Ⅰ - Ⅱ grades undergoing elective lower limb orthopaedic surgery with subarachnoid epidural block down,they were divided into six groups by random number table and double blind method,each group of 16 cases.Group Ⅰ,Ⅱ,Ⅲ,Ⅳ,Ⅴ,Ⅵ received 0.05,0.10,0.15,0.20,0.25,0 μ g/kg of intrathecal sufentanil and 2.5 ml of 0.5％ levobupivacaine.Observed and recorded the duration of block level of pain to T10,visual analog score (VAS)postoperative at 2,4,6,8,12,24,48 h,and side effects.ResultsThe duration of block level of pain to T10 of group Ⅰ,Ⅱ,Ⅲ,Ⅳ,Ⅴ,Ⅵ was (245.6 ± 34.2),(259.3 ± 36.7),(268.9 ± 37.8),(286.6 ± 38.8),(287.7 ± 39.1 ),(228.6 ± 31.4) min.There was no significant difference between group Ⅳ and group Ⅴ (P ＞ 0.05 ),the differences of other groups were statistically significant (P ＜ 0.05 ).Compared with group Ⅴ,VAS of group Ⅲ and group Ⅳ at 6,8,12,24,48 h after operation was not statistically significant (P ＞ 0.05),and they were lower than the other three groups(P ＜ 0.05 ).There were no respiratory depression occurred after operation in group Ⅰ,Ⅱ,Ⅲ,Ⅳ,Ⅵ,4 cases occurred in group Ⅴ.ConclusionThe best of effective dose of intrathecal injection of sufentanil for preemptive analgesia in lower limb orthopaedic surgery is 0.20 μ g/kg.

Objective To evaluate the information of head injury caused by the major earthquake of Wenehuan and the diagnostic value of muhi-slice spiral CT(MSCT). Methods A total of 1557 earthquake victims were hospitalized, of which head CT scan was performed in 292 eases, and abnormalities were found in 225 of them. The composition, type of injury and MSCT findings of head injury were retrospectively analyzed. Results CT abnormalities were found in 225 victims, including 66 cases of skull fracture,50 eases of cerebral contusion and laceration, 55 eases of intracranial hematoma, 16 cases of subaraehnoid hemorrhage, 16 eases of subdural collection of fluid,20 eases of foreign substance of scalp,and 2 eases of traumatic cerebral infarction. Operation was performed in 22 of them. Conclusion The incidence of head injury in earthquake was high, and most of them were not severe. The examination of MSCT was rapid, MPR and 3D images can clearly show the lesion of craniocerebral trauma. MSCT can provide more valuable information for clinical therapy in craniecerebral trauma caused by earthquake.

BACKGROUND: With the rapid development of modern society, psychological problems in college students have been paid high attention by educatienal organizations of psychological health in China. OBJECTIVE: To probe into the influencing factors of psychological problems in college students. DESIGH: Cluster sampling 1∶2 paired observation, case-control study. SETTING: Medical College of Wuhan Polytechnic University. PARTICTPANTS: 1 200 sophomores with the age ranged 19-20 years were selected from Wuhan Polytecnic University by cluster sampling at June 2001, and 145 students with the scores of more than 3 factors greater than 3 points were screened by Symptom Checklist 90 (SCL-90) (including 9 factors of somatization, compulsion, interpersonal sensitivity, depression, anxiety, hostility, phobia, paranoid and schizophrenia. The higher the grade was, the severer the symptom was) to be the psychological problem group. Subjects were selected to be the normal controls at the ratio of 1∶2 with those in the psychological problem group, whose classes, specialties and ages (the difference was less than 2 years) were similar to those of the enrolled patients. 290 students normal in the indexes of SCL-90 were taken as the matched group. Of all subjects in both experiment groups, there were 173 males and 262 females with an average age of 19.2 years. METHODS: ① The subjects in the two experiment groups were investigated of the psychological health by SCL-90 as well as the personality characteristics and Eysenck Personality Questionnaire (EPQ) (For Adult). The EPQ statistic software designed by the Institute for Juvenile and Children, Tongji Medical College of Huazhong University of Science and Technology was adopted to acquire the E score (introversion, extroversion), N score (nervousness), P score (psychoticism), L score (conceal) and quantity form quadrant of E-N coordinate picture, so as to define the tendencies of characters. ② The psychological problem was considered to be the dependent variable, while all relevant factors (The influencing factors of psychological problem included the understanding from parents, relationship with family members, desire for learning, personality characteristics, over-high P score, over-high/low E score, over-high/low N score) were taken as the independent variable. Single-factor Logistic regression analysis was conducted at 1:2. ③ Based on 1:2 single-factor Logistic regression analysis, the variances were selected from factors of P ＜ 0.01 together with the Logistic regression models of multifactor at 1:2 by stepwise regression method.MAIN OUTCOME MEASURES: ① Comparison in the SCL-90 score between the psychological problem group and the normai control group. ② Single-factor and multivariate analysis of the relevant factors of psychological problems. RESULTS: A total of 435 enrolled students were involved in the analysis of results. ① The average score of somatization, compulsion, interpersonal sensitivity, depression, anxiety, hostility, phobia, paranoid and schizophrenia in students of the psychological problem group was higher than that in the normal control group (t=-13.39, 29.64, 27.09, 26.04, 19.52, 18.13, 14.15, 18.61, 22.41, P＜ 0.01). ② Nine factors were selected in the single factor analysis after the Logistic regression analysis, including 6 protective factors of understanding from parents, relationship with family members, desire for learning, personality characteristics, E ＞ 61.5, N ＜ 38.5, while he other 3 factors (P ＞ 61.5, E ＜ 38.5, N ＞ 61.5) were risk factors. The multivariate analysis showed that factors of relationship with family members, desire for learning as well as personality characteristics were protective factors, while it was a risk factor when N ＞ 61.5.CONCLUSION: The psychological problems in college students relate to the relationship with family members,understanding from the parents, desire for learning as well as the character trait and personality characteristics.

Objective To observe the value of virtual tough tissue imaging quantification (VTIQ) in differential diagnosis of thyroid imaging reporting and data system(TI-RADS) 4 thyroid nodules.Methods A total of 185 patients with 192 TI-RADS 4 nodules were included in this study.The nodules were divided into three groups according to the maximum size as follows:Group Ⅰ,the maximum size≤0.6 cm;Group Ⅱ,0.6 cm＜ the maximum size≤ 1.0 cm;Group Ⅲ,the maximum size ＞ 1.0 cm.Shear wave velocities (SWV) of nodules were measured by means of VTIQ technique.With pathological diagnosis as the gold standard,SWV value of benign and malignant nodules were analyzed and ROC curve was drawn to assess the diagnostic efficiency.Results By the ROC curve test,at SWV cut-off values of 2.44 m/s for group Ⅰ and group Ⅱ,2.49 m/s for group Ⅲ,the sensitivity were 79.0 ％,76.0 ％,88.6％,specificity were 88.6％,89.5 ％,93.7 ％,accuracy were 83.5 ％,81.8 ％,90.1％,Youden index were 0.68,0.66,0.82,respectively.Conclusions VTIQ can reflect the hardness of TI-RADS 4 nodules,the value of the differential diagnosis of such nodules is high,convenient,noninvasive and not limited by the size of nodules.

This study is to investigate the inhibitory effect of lidamycin (LDM) and its combination with methotrexate (MTX) on lung metastasis of fibrosarcoma by bioluminescence imaging in athymic mice. A stable luciferase transfected HT-1080 cell line was constructed and the capability to establish experimental lung metastasis in athymic mice was confirmed. The optical imaging system was applied to evaluate the formation of lung metastasis in vivo. In addition, metastatic nodules were counted for the evaluation of inhibition rates. As shown, the fluorescent intensity of luciferase-transfected HT-1080 cells was colinear with the cell population and the minimal detected cell population was 100 cells/well. Optical imaging showed that the fluorescent intensity of treated group was apparently lower than that of the control. The inhibition rates of lung metastasis by LDM alone at 0.025 mg x kg(-1) and 0.05 mg x kg(-1) were 53.9% and 75.9%, respectively, while that of MTX alone at 0.5 mg x kg(-1) was 70.2%. The combination of LDM at 0.025 mg x kg(-1) and MTX at 0.5 mg x kg(-1) showed an inhibition rate of 88.7%. The coefficient of drug interaction (CDI) was 0.82. The results herein demonstrated that LDM alone had strong anti-metastasis effect on human fibrosarcoma HT-1080 and the inhibition efficacy is strengthened when combined with MTX.

Objective To analyze the related immune parameters in liver transplantation recipients to help guide adjusting future immunosuppressants.Methods Fifty-three tolerant recipients after liver transplantation were included in this study.They had normal liver functions and took only one immunosuppressive drug.They were divided into the 3 ～5 years tolerance group (3Y group,n =21) (including 5 years) after transplantation,and the 5 ～ 11 years tolerance group (5Y group,n =32).Another 15 liver transplantation recipients who had twice or more recurrent acute rejections were enrolled as the RJ group and 32 age-matched healthy donors served as the HC group.The natural killer (NK) cells,B cells,memory T cells,regulatory T cells (Tregs) and the subsets were detected by flow cytometry.The plasma TGF-β level was evaluated using ELISA.Results The percentages of NK cells (3Y group 19.00 ± 0.09,5Y group 20.00 ±0.09,HC group 14.00 ±0.07,RJ group 9.00 ±0.03) and total Tregs within the CD4+ cells (3Y group 6.26 ±2.33,5Y group 4.80 ±2.21,HC group 3.04 ± 1.25,RJ group 1.09 ±0.81) in the 3Y,5Y and HC groups were significantly higher than those in the RJ group (P ＜ 0.05).The proportions of resting Tregs (3Y group 0.23 ±0.07,5Y group 0.16 ±0.02,HC group 0.07 ±0.02,RJ group 0.05 ±0.01),active Tregs (3Y group 0.56 ± 0.11,5Y group 0.42 ± 0.15,HC group 0.08 ± 0.02,RJ group 0.05 ± 0.01) and non-suppressive Tregs (3Y group 3.51 ±0.80,5Y group 3.71 ±0.41,HC group 1.44 ±0.14,RJ group 2.15 ± 0.62) increased significantly in the tolerant recipients after liver transplantation when compared with those in the HC and RJ groups (all P ＜ 0.05).No significant differences on B cells,memory T cells and TGF-β level were detected among in four groups.Conclusions The NK cells,total Tregs,resting Tregs,active Tregs and non-suppressive Tregs increased significantly in the tolerant recipients after liver transplantation.These might serve as potential biomarkers for immune tolerance.

Objective To carry out the current status of internal quality control by statistical analysis of the Internal Quality Control (IQC)data of homocysteine in 2014 March.Methods Web-based External Quality Assessment (EQA)system was used to collect IQC data of homocysteine from 292 EQA participant laboratories nationwide.The data include thecoefficient of variation (CV)of IQC data under control in March 2014 and long-term cumulative data.Acceptable rates of CVs of two-lot internal quality controls in homocysteine were calculated according to 5 criteria,that were 1/3TEa,1/4TEa and the speci-fications based on biological variation including the minimal,appropriate and optimal allowable imprecision.The instrument the participant laboratories used were sorted into 6 groups and the passing rate of each group were calculated by the 5 crite-ria.Results 292 laboratories reported the data of level 1 IQC for homocysteine,106 of which reported the data of level 2 IQC.The passing rate was different according to different criteria.The passing rate had few difference by the criteria of 1/3TEa and the minimal allowable imprecision based on biological variation,which were from 63.36% to 76.42%.It was also true for 1/4TEa and the appropriate allowable imprecision based on biological variation,which were from 34.25% to 57.55. The passing rate was only 10.62%~16.98% by the criteria of appropriate allowable imprecision based on biological varia-tion.Statistical results showed that instruments the participant mainly used were HITACHI (77/292),Olympus (61/292), Roche (19/292),Beckman (14/292),Abbott (10/292)and Simens (10/292).The passing rates of all the instrument group had few difference except Simens group.Conclusion Most of the laboratories could meet the criteria of 1/3TEa and the min-imal allowable imprecision based on biological variation.But less than half of the laboratories could meet the criteria of 1/4TEa and the appropriate and optimal allowable imprecision based on biological variation.The precision performance of ho-mocysteine among laboratories needs further improvement.

Objectives To study the effect of VIM in Enterovirus 71 (EV71) infection of (human brain microvascular endothelial cells (HBMEC) and elaborating the mechanism of EV71 infection in the nervous system. Methods Knocked out the VIM by CRISPR technology , the differences in EV71 absorption , replication , release between wild VIM and VIM knocked-out (VIM-KO) HBMEC were detected by fluorescence quantitative PCR. Results 4 ℃ absorption experiment conformed that EV71 adsorption in VIM- KO is 40% less than in the normal HBMEC. After EV71 infect HBMEC for 48 h (48 h p. i.), the quantitative PCR result showed intracellular viral RNA in VIM-KO was only 1/12 of that in the normal HBMEC. Also the extracellular viral RNA was quantified, and the number of cells in VIM-KO had been reduced 1.4 times compared with the normal HBMEC. Conclusions Once VIM knocking out, EV71 attachment has been obviously reduced. Meanwhile, the level of viral RNA replication and release are decreased compared with the normal HBMEC. VIM may be an attachment receptor of EV71 in HBMEC , when the virus invades HBMEC with the binding of VIM. Moreover , VIM plays an important role in the replication and release of EV71.

Objective To investigate and analyze the current situation of reference intervals and decision limits of reticulocyte count in China.Methods The information related to upper/lower limits,decision limits,data resources,method principles, instruments and reagents of reticulocyte count in 2014 was collected via the external quality assessment software system based on website.The participants were divided according to their methods and instruments.The SPSS 1 9.0 was used for conducting the data analysis and statistics of results for each group.Results There were 276 laboratories submitting the val-id results.The major resources for reference intervals came from national guide to clinical laboratory procedures (53.99%), instructions of instrument manufacturers (16.30%),textbook (9.78%),instructions of reagents manufacturers (9.06%) and others.The major resources for decision limits were national guide to clinical laboratory procedures (56.06%),instruc-tions of instrument manufacturers (16.67%),textbook (7.58),instructions of reagents manufacturers (7.58%)and others. The medians and averages of upper/lower limits and decision limits among subgroups were close,whereas the P2.5 and P97.5 were significant discrepancies.Only 45.65% and 48.48% of participant laboratories had verified reference intervals and deci-sion limits before clinic use.The lower limits and decision limits among subgroups had nostatistical difference (P>0.05), where as the upper limits of different instrument groups had significant differences (P<0.001).Conclusion The current situation of reference intervals and decision limits of reticulocyte count is unsatisfactory.It is certain to establish a uniformed reference interval and decision limits for reticulocyte count,which provides a reference for the standardization of reticulocyte count testing.

Objective To investigate the clinical treatment efficacy of mutabilis coated nasal ointment to postoperative nasal septal reconstruction.Methods After surgical reconstruction,116 cases were divided into the treatment group and control group ac-cording to random method,58 cases in each group.The treatment group was given mutabilis coated nasal ointment combine with physiological seawater nasal care device;the control group was only given physiological seawater nasal care device in the same time. The effects were observed for 6 months.Results The total effective rate of treatment group was higher than the control group (98.28%),the two groups had significant difference(P <0.05).Postoperative follow-up,the bleeding rate in the treatment group have no significant difference compared with the control group(P >0.05);the incidence of infection and cavity stricture in the treat-ment group were significantly lower than the control group(P <0.05).Conclusion The application of mutabilis coated nasal oint-ment can promote the wound healing of nasal cavity,but also can prevent the operation adhesion,and shorten repair time,so as to improve the clinical effect of operation.