The article analyzed the problems of the improper orientation of the teaching objective, the imperfect coursesystem, the excessive shifting of the teaching approaches and the reverse effect of the test system. It also put forward thesolutions such as working out the syllabus fit for all the colleges and universities, giving free rein to the extracurricularactivities, and strengthening teachers' training and improving the test system ect.[

Objective To investigate the value of mammotome minimally invasive puncture drainage in the treatment of breast abscess.Methods 53 patients with the breast abscess were divided into minimally invasive group (27 cases)and open group(26 cases)according to the principle of completely random.The patients in the minimally invasive group were treated with mammotome minimally invasive puncture drainage under the ultrasound guidance.The patients in the open group underwent conventional breast abscess incision and drainage.All the patients were treated with systemic anti -infection and symptomatic treatment.Then,we collated and analyzed the statistical data from the operation time,postoperative pain time,pain degree,number of dressing,healing time,postoperative breast feeding and breast appearance aspects.Results There was no significant difference in operation time between the two groups.In the minimally invasive group,the time of pain,the degree of pain,the time of dressing change,the healing time,the proportion of nursing and the appearance of the breast were (2.6 ±0.8)d,(2.1 ±0.2)min,(7.3 ±0.6)times, (1 8.0 ±0.1 )d,81 .5%,(3.5 ±0.2)points respectively.Those in the open group were (5.2 ±0.2)d,(3.3 ± 0.3)min,(28.0 ±0.2)times,(30.0 ±0.8)d,26.9%,(2.1 ±0.2)points respectively.The differences between the two groups were statistically significant(t =-3.38,-5.1 2,-5.61 ,-5.39,χ2 =32.25,t =-6.1 2,all P <0.05). Conclusion Minimally invasive treatment is a good method in the treatment of breast abscess,and deserved to be promoted clinically.

Objective To investigate the clinical application value of ductoscopic flushing in the treatment of early lactation acute mastitis.Methods 52 patients with early acute mammitis were divided into observation group (27 cases)and control group(25 cases)according to the principle of completely random.In the observation group, the patients were checked under the intervention of mammary duct firstly,and then the disease regions of the breast were flushed using ductoscope.In the control group,the patients were treated with artificial breast -milk.The two groups were all treated with the same antibiotics.The curative effect of the two groups was observed,and the statistical analysis was performed.Results In the observation group,the mass extinction time,pain relief time,pyretolysis time, hemogram recovery time,contralateral continued breast -feeding proportion,the proportion of abscess formation,the proportion of back -milk,the proportion of ipsilateral quadrant recurrence were (3.5 ±1.2)h,(5.0 ±0.9)h, (1.0 ±0.1)d,(1.0 ±0.3)d,92.6%,7.4%,7.4%,0.0% respectively,those in the control group were (24.0 ± 3.2)h,(2.0 ±2.1)h,(2.0 ±0.2)d,(3.0 ±0.3)d,88.0%,12.0%,12.0%,8.0% respectively.The differences between the two groups were statistically significant(t =1.72,0.36,0.43,0.72,χ2 =1.83,2.02,1.56,0.34,all P <0.05).Conclusion Ductoscopic flushing has good effect in the treatment of early lactation acute mastitis,and it is worthy of clinical promotion.

Objective To investigate the clinical application and effecacy of ulnar-sided thumb ladder progressive flap in repairing grade Ⅰ and Ⅱ thumb oblique wound.Methods Between October 2009 and October 2013,ulnar-sided thumb ladder progressive flap with double blood supply was transferred to cover the grade Ⅰ and Ⅱ thumb oblique wound in 24 patients (12 males and 12 females).Mean age was 30 years (range,10-40 years).Mechanism of injury was machine twist injury in 8 patients,machine cutting injury in 6,sharp weapon injury in 6 and injury by a heavy object in 4.Twelve patients had grade Ⅰ defect and twelve patients grade Ⅱ defect.Flap ranged in size from 1.0 cm ×3.0 cm to 1.5 cm × 3.5 cm.Flap advancement distance was 1.5-2.5 cm.Donor area was sutured directly.Wound healing and color,swelling and temperature of the flap were observed after operation.Finger function was assessed with the upper limb function evaluation standard set up by hand surgery branch of Chinese Medical Association.Results Postoperatively,the flap survived and the fingertip had protective sensation.The wound healed by first intention.Two patients developed distal interphalangeal joint stiffness,and restored to normal after rehabilitation.All patients were followed up for 1-36 months (mean,20 months).Finger color,temperature,texture and pulp were restored.Finger function recovered satisfactorily,with excellent results in 22 patients and good results in 2 patients.Conclusion The procedure is easy and reliable,has affirmative effect and achieves maximal preservation of finger length and function.

Objective To investigate the clinical effect of inherent artery dorsal perforator flaps of thumb radial palmar for coverage of ipsilateral thumb degree Ⅰ and Ⅱ oblique defect of the fingertip.Methods The study included 6 males and 6 females,aged 10-40 years (mean 30 years),with thumb fingertip Ⅰ and Ⅱ degree defect treated between October 2009 and October 2013.Injury resulted from machinery cutting injury in 4 patients,machinery twist injury in 3,cutting by sharp weapons in 3,and crush injury in 2.There were 6 patients with Ⅰ degree defect and 6 patients with Ⅱ degree defect.Defects were all oblique involving more in the radial side rather than in the ulnar side and reconstructed with thumb radial palmar artery perforator flaps.Flap ranged in size from 1 cm × 2 cm to 1.5 cm × 2.5 cm.Donor site was covered with skin grafts.Observation indexes were wound healing condition,flap color,flap swelling degree,and flap temperature.Finger function was measured with upper extremity scoring system formulated by Hand Surgery Branch of Chinese Medical Association.Results All flaps survived and achieved good protective sensation.Wound healed primarily.Color,temperature and texture of the flap returned to almost normal.Moderate swelling of the flaps was detected and subsided around one week.All patients were followed up for 1-36 months (mean 20 months).At the final follow-up,two-point discrimination was 9-11 mm (mean 10 mm).Two patients developed distal interphalangeal joint stiffness and recovered after rehabilitation exercise.Finger function was rated as excellent in 10 cases and good in 2.Conclusion Inherent artery dorsal perforator flap of thumb radial palmar has affirmative effect and allows maximum preservation of finger length and function when applied to repair ipsilateral thumb degree Ⅰ and Ⅱ oblique defect of the fingertip.

AIM　To investigate the poteintation of vincristine-induecd apoptosis by tetrandrine, neferine and dauricine isolated from Chinese medicinal plants in the human mammary MCF-7 multidrug resistant cells. METHODS　The apoptotic cells were detected by fluorescent staining of a combination of Hoechst 33342 and propidium iodide (PI), flow cytometry and agarose electrophoresis. RESULTS　The apoptotic cells induced by vincristine alone accounted for about 10% of all the cancer cells, while the percentage of apoptotic cells induced by a combination of vincristine with tetrandrine, neferine, or dauricine was found to be significantly higher than that by vincristine alone, and their reversal effects were positively correlated with the drug concentration and the exposure time. In addition, tetrandrine was shown to be the most potent in the reversal efficacy among the three compounds to be tested for apoptosis in vitro. CONCLUSION　Tetrandrine, neferine and dauricine showed obvious potenitiation of vincristine-induced apoptosis in the human mammary MCF-7 multidrug-resistant cells.

Objective: To evaluate the consistency of transesophageal echocardiography (TEE) and pulmonary artery catheter (PAC) method in monitoring cardiac volume load and cardiac hemodynamic indexes.Methods: A total of 45 patients undergoing coronary artery bypass grafting in our hospital were selected.The right ventricular end-diastolic volume (RVEDV), right ventricular end-systolic volume (RVESV) and right ventricular ejection fraction (RVEF) were monitored during surgery by TEE and PAC respectively.Consistency of monitored data was compared between two methods.Results: Both TEE and PAC indicated that compared with baseline level, after loading, there were significant rise in RVEDV [TEE: (38±6)ml vs.(51±9ml), PAC: (153±17)ml vs.(188±19)ml], RVESV [TEE: (19±4)ml vs.(33±5)ml, PAC: (92±16)ml vs.(110±23)ml], P<0.01 all, but there was no significant change in RVEF, P>0.05.Before therapy, RVEDV, RVESV and RVEF monitored by PAC and TEE showed significant positive correlation, and all relevant coefficients were >0.8 (r=0.844, 0.862, 0.916, P<0.01 all);after therapy, correlation of RVEDV and RVESV significantly reduced to <0.6 (r=0.552, 0.579, P<0.05 both), but RVEF correlation remained >0.8 (r=0.892, P<0.01).Conclusion: In clinical monitor, the consistency of TEE and PAC is high,the former is non-traumatic,and is more convenient for clinical use.

CD4+CD25+ Regulatory T cells (Treg) have been found to down-regulate immune activation in HIV-1 infection. However, whether the depletion of Treg benefits to the disease status of HIV infection remains undefined. To address this issue, we enumerated the Treg absolute counts and frequency in 75 antiviral-na(i)ve HIV-1-infected individuals in this study. It was found that HIV-infected patients displayed a significant decline in Treg absolute counts but a significant increase in Treg frequency. In addition, with disease progression indicated by CD4 T-cell absolute counts, circulating Treg frequency gradually increased; while Treg absolute counts were gradually decreased, suggesting that the alteration of Treg number closely correlated with disease progression in HIV infection.Functional analysis further showed that Treg efficiently inhibit both CD4 and CD8 T cell proliferation in vitro. Thus, our findings indicates that Treg actively participate in pathogenesis of chronic HIV infection,influencing the disease progression.

Objective:To summarize the experience of ambulance medical support in the 19th Hangzhou Asian Games, and provide reference for the ambulance medical support work of large-scale sports events in the future.Methods:According to the actual situation of the Asian Games, the objectives of the medical support were determined according to the principles of highlighting the key points and overall consideration. All kinds of ambulances were allocated according to the principles of combining dynamic and static and regional linkage. The ambulance support was divided into the event side and the city side,with the regional security vehicle as the supplement of the event side and the guarantee of the city side, the implementation of "one pavilion one policy", "one game one policy", "one place one policy" and "one vehicle one plan", and the interconnection of medical points (rooms), designated hospitals, management and command personnel and ambulances were realized through the Asian Games Intelligent Emergency Medical Support Syetem (EMSS).Results:Between September 16, 2023, 08:00, and October 9, 2023, 08:00, a total of 207 ambulances were deployed during the 19th Hangzhou Asian Games. Of these, 88 (42.5%) were at competition venues, 11 (5.3%) at training venues, 30 (14.5%) at non-competition venues, and 78 (37.7%) were regional support vehicles. Among them, 20 venue ambulances participated in regional support tasks during idle times. Ambulances transported patients from event sites 345 times, with the highest number of transports occurring at competition venues (187 times) and the fewest in the assisting city of Huzhou (6 times). The highest ambulance utilization rate was 70.5% at competition venues, while training venues, non-competition venues, and regional support ambulances had utilization rates of 45.5%, 53.3%, and 42.3%, respectively. The median age of transported individuals was 26 (21, 36), with a majority being male (59.1%). Athletes comprised 52.5% of transports, while staff and spectators accounted for 39.7% and 7.8%, respectively. Joint injuries were the most common condition among transported individuals, totaling 58 cases (16.8%). Regional support ambulances participated in 75 transfers and replacements, with 17 (22.7%) transfers and 58 (77.3%) replacements.Conclusions:This study confirms the feasibility and efficiency of the Asian Games' ambulance support plan, highlighting the crucial role of EMSS. The study suggests the need to strengthen medical support for staff, in addition to athletes.

OBJECTIVETo observe the effect of Cinnabaris on mouse embryos after pregnant mice were treated by Cinnabaris in different periods of pregnancy.

METHODTwo separate experiments were performed: First, Cinnabaris was orally given into pregnant mice at the doses of 0.08, 0.4, 4.0 g x kg(-1) from D6 to D19 after pregnancy; Second, Cinnabaris was orally given into mice at the same doses mentioned above from D14 prior to pregnancy until D19 after pregnancy. All animals were sacrificed on D 20 of pregnancy by caesarean section. The numbers of survival, dead and absorbed fetuses were calculated and the survival fetus weight was measured. The survival fetuses were treated by two methods: One third survival fetuses were fixed and stained by Bouin solution for organ examination and the remaining two thirds fetuses were stained for skeleton examination.

RESULTNo obvious embryo toxicity was observed in the first experiment at Cinnabaris dose levels of 0.08, 0.4, or 4 g x kg(-1) x d(-1). There was no significant effect on embryonic development and the numbers of the survival, dead and absorbed fetus. No obvious malformations on appearance, organ, and skeleton examination of fetuses were found. The second experiment showed that the rates of abortion and absorbed fetus in 0.4, 4 g x kg(-1) x d(-1) Cinnabaris group were higher but without statistical significance compared with control group. Appearance and organ examination of Cinnabaris groups fetus showed no obvious malformation, but skeleton malformation was found in 0.4, 4 g x kg(-1) x d(-1) groups (the rates of skeleton malformation were 46.7% and 77.8%, respectively).

CONCLUSIONNo obvious embryonic development toxicity was observed when Cinnabaris was orally given in intermediate and late pregnant period, but the embryos in the early stage of pregnancy was more sensitive to Cinnabaris. When Cinnabaris was given prior to pregnancy until the whole period of pregnancy, it may be harmful for the fetuses at above the dose level 0.08 g x kg(-1) x d(-1) (equivalent to 5 times clinical intake dose), both in a dose-dependent manner.

Animals ; Drugs, Chinese Herbal ; toxicity ; Embryo, Mammalian ; Embryonic Development ; drug effects ; Female ; Fetal Development ; drug effects ; Mice ; Mice, Inbred ICR ; Models, Animal ; Pregnancy