Problems such as detached knowing and doing , utilitarian tendency , moral practice ability is weak and so forth are now existing in the medical college students'moral practice in the new period .There are not only medical students'personal factors , but also school and social factors .Therefore , it should excavate potential , build good medical students moral practice platform , innovative form of moral practice , motivate medical students to par-ticipate in the moral practice enthusiasm , strengthen the construction of management system , ensuring the medical students moral practice into effect .

[Objective]To evaluate the cytocompatibility of chitosan-alginate scaffolds through in vitro cytoxicity experiment,cell-material co-culture experiment and in vivo implantation test.[Method]Chitosan-alginate scaffolds with longitudinal,paralleled multi-channels were produced via freeze-drying. Bone marrow derived stromal cells (BMSCs) were cultivated with the leach liquor. The cytotoxicity of scaffold was analyzed using MTT assay after 1,3 and 5 days of culture.Scanning electron microscopy was conducted after 3,5 and 7 days of BMSCs culture on the chitosan-alginate scaffold in vitro. Immunofluorescence detection was performed after implanting BMSCs and chitosan-alginate scaffolds in vitro in acute hemi-transaction spinal cord injury.[Result]The cytotoxicity of chitosan-alginate scaffold was in grade 0-1. Scanning electron microscopic observation indicated that the cells adhered to and grew on the surface of scaffold,arranging in a directional manner after 3 days of co-culture. NF200 and NSE fluorescence detection proved that a great many BMSCs were survival in the scaffold after 6 weeks,and that some transplanted cells differentiated into neuron-like cells.[Conclusion]Chitosan-alginate scaffold has a satisfactory cytocompatibility and may be an ideal tissue engineering scaffold material.

Objective To investigate the biomechanical properties of the posterior tibial anatomic plate. Methods A total of 25 fresh frozen adult tibial top and matching femur specimens were randomly divided into four groups. One specimen was used as normal control ( N group), and the remaining 24specimens were with Schatzker Ⅵ tibial plateau fracture and accompanied by rear split and backward fracture displacement. The lateral margin of the tibia was fixed with a L-type plate, and the medial margin was fixed with the same plate after remodeling. The 24 specimens were divided into three groups, eight specimens per group. The posterior margin of the tibia was fixed by posterior tibial anatomic plate ( Group A), T-type plate ( Group B) or straight reconstruction plate ( Group C). The strength, stiffness, torsional biomechanics and failure load performance of the plates in each group were evaluated. Results The strength and stiffness of test groups was superior to that of Group N ( P ＞ 0.05 ), and the torsional biomechanics of test groups was close to that of Group N ( P ＞ 0.05 ). The posterior tibial anatomic plate was superior to T-type plate and straight reconstruction plate in aspects of strength, stiffness, torsional biomechanics and failure load performance ( P ＜ 0.05 ). Conclusions Posterior tibial anatomic plate has excellent biomechanical properties, and it is superior to other materials in treating posterior tibial plateau fracture and restoring the stability of the knee.

Objective To compare the therapeutic effect of aerobic exercise training of different intensity on hypertension. Methods Sixty hypertensive patients were randomly allocated to 2 groups and treated with aerobic exercise training at 20% or 60% of maximal intensity. Not only were the relevanl parameters of exercise capacity measured by the use of treadmill exercise test,but also was ambulatory blood pressure monitored and the quality of life recorded before and after the therapy. Results There was nc significant difference of the decrement in any parameter of ambulatory blood pressure between the two groups ( P>0. 05).There was a significant difference of the increment of general health, vitality, emotion and mentality between the two groups after treatment with group A better than group B(P <0. 05). Conclusions Aerobic exercise training at 20% and 60% of the maximal intensity has similar ambulatory blood pressure, but the quality of life is significantly better after aerobic exercise training at 20% of the maximal intensity.

Objective To investigate the EUS elastographic patterns of normal pancreas and focal pancreatic lesions, and its value for characterizing and differentiating between benign and malignant pancreatic tissues. Methods Between January and June 2009, 6 patients with normal pancreas and 9 patients with focal pancreatic lesions were enrolled. Real-time elastography was carried out during the conventional EUS examination. The elastographic images were scored with 1 to 5 based on the elastographic pattern. Results Nine focal pancreatic lesions were finally diagnosed as pancreatic cancer (n = 4), cyst-adenocarcinoma (n =1), cyst-adenoma (n = 2) and focal pancreatitis (n = 2), respectively. Pancreatic cancers were scored as 3(n = 1) and 4 (n = 3). Cyst-adenocarcinoma was scored as 5 and cyst-adenomas were scored both as 2,while focal pancreatitis were scored as 2 and 3, respectively. Elastographic pattern was scored as 1 (n = 5)and 2 (n = 1) in 6 normal pancreas. When scores 1 and 2 were assigned to benign lesion and 3 to 5 to malignancy, the overall diagnostic accuracy of EUS elastography for focal pancreatic lesions was 88. 9%(8/9). Conclusion There are apparent differences in elastographic patterns between benign and malignant pancreatic tissues. EUS elastography is a promising method that allows characterization and differentiation of benignancy and malignancy.

Objective: To analyze influencing factors of percutaneous coronary intervention (PCI) on therapeutic effect in patients with coronary chronic total occlusions (CTO). Methods: Clinical data, lesion features and PCI therapeutic results of 65 patients with 72 CTO lesions, who received PCI in our hospital from Jan 2010 to Dec 2012, were retrospectively analyzed. Results: PCI success rate of CTO lesion was 91.67% (66/72); compared with patients with CTO occlusion 3~12 months, there was significant decrease in PCI success rate (97.78% vs. 81.48%) in those with CTO occlusion >12 months; compared with patients with occlusion length ≤15mm, there was significant decrease in PCI success rate (97.96% vs. 78.26%) in those with occlusion length >15mm; compared with patients with mouse tail-like broken ends, there was significant decrease in PCI success rate (96.55% vs. 71.43%) in those with knife cut-like broken ends, P<0.05 all; PCI failed in six lesions, in which four because guidewire failed to pass through lesions and two because balloon failed to pass through lesions; incidence rate of complications was 7.69% during PCI, there were no major adverse cardiovascular events during admission in all patients; symptoms relieving rate of angina pectoris was 90.16% after PCI. Conclusion: Success rate of percutaneous coronary intervention is related to lesion features, CTO occlusion duration etc.

BACKGROUND:Neural stem cels can repair the damaged brain tissues with potentials of proliferation and differentiation, which become one of the important directions for treating cerebral palsy. OBJECTIVE:To observe the clinical effect and safety of neural stem cel transplantation on the treatment of cerebral palsy in children. METHODS:Neural stem cels were isolated from human embryonic brain and identified by immunofluorescence staining, which were transplanted intravenously into 26 children with cerebral palsy. Children's motor functions were evaluated by gross motor function measure scale and Peabody development motor scale-fine motor scale before treatment, and 3 and 6 months after treatment. Routine blood test and liver-kidney function were detected before and after treatment. Clinical adverse reactions in children with cerebral palsy were monitored. RESULTS AND CONCLUSION:The lost cases were not found during 6 months of folow-up. Specific proteins of neural stem cels were al positive in this study. At 3 and 6 months after transplantation, the A, B, C functional area scores and total score on the gross motor function measure scale were obviously increased (P < 0.05,P < 0.01), but the C and D functional area scores were not remarkably elevated (P > 0.05). At 3 months after transplantation, the fine motor quotient, grasping subtest and visual-motor integration were not remarkably increased (P > 0.05); these scores, however, were elevated after 6 months with statistical significance (P < 0.05, P < 0.01). The results of routine blood test and liver-kidney function in 26 children were in normal range, and there were no serious adverse reactions during the cel transplantation. Therefore, neural stem cel transplantation has high safety and good curative effects to improve the motor function of children with severe cerebral palsy, especialy for gross motors.

Although previous publications suggest the 2009 pandemic influenza A(H1N1)virus was reassorted from swine viruses of North America and Eurasia, the immediate ancestry still remains elusive due to the big evolutionary distance between the 2009 H1N1 virus and the previously isolated strains. Since the unveiling of the2009 H1N1 influenza, great deal of interest has been drawn to influenza, consequently a large number of influenza virus sequences have been deposited into the public sequence databases. Blast analysis demonstrated that the recently submitted 2007 South Dakota avian influenza virus strains and other North American avian strains contained genetic segments very closely related to the 2009 H1N1 virus, which suggests these avian influenza viruses are very close relatives of the 2009 H1N1 virus. Phylogenetic analyses also indicate that the2009 H1N1 viruses are associated with both avian and swine influenza viruses circulating in North America. Since the migrating wild birds are preferable to pigs as the carrier to spread the influenza viruses across vast distances, it is very likely that birds played an important role in the inter-continental evolution of the 2009 H1N1virus. It is essential to understand the evolutionary route of the emerging influenza virus in order to find a way to prevent further emerging cases. This study suggests the close relationship between 2009 pandemic virus and the North America avian viruses and underscores enhanced surveillance of influenza in birds for understanding the evolution of the 2009 pandemic influenza.

Over the past decade, syndromic surveillance, as supplementation of disease surveillance, has provided possibility of early alert in a real-time way for detection of emerging infectious diseases and outbreaks of widespread infectious diseases, resulting in improvement in sensitivity of outbreak detection and public health alert capacity. This tool has been highly valued and widely used in the world, and effective implementation has been observed in China. Upon abundant literature search, the authors reviewed the progress and advance of syndromic surveillance in early alert of emerging infectious diseases and outbreaks, and analyzed the problem met in the current situation in China when implementing syndromic surveillance in local facilities, which are high cost, lack of medical information platform, lack of real-time digital alert system and lack of a comprehensive information exchange platform. The authors suggested that syndromic surveillance should be implemented considering the local situation and performed in a more effective way in the current situation. Syndromic surveillance has to be integrated into the conventional public health surveillance systems and advanced laboratory networks. Digital information system is urgently needed to achieve real-time alert.
China ; Communicable Diseases, Emerging ; Disease Outbreaks ; Humans ; Population Surveillance

Objective:To evaluate the correlation between Card 9 gene polymorphism and acute pancreatitis(AP).Methods:70 AP patients and 70 healthy subjects from Shanghai Songjiang District Central Hospital from June 2019 to February 2020 were enrolled. TaqMan probe method was used to assay genotype distributions of the Card 9 polymorphisms rs10870077, rs4077515, rs10781499, rs141992399, rs139265120. Real-time quantitative PCR was used to determine the level of Card 9 mRNA, electrochemiluminescence immunoassay was applied to assay IL-6 and procalcitonin, and nephelometry was performed to measure the C-reactive protein(CRP).Results:Compared with the control group, the genotype and allele frequency of Card 9 gene rs10870077 C>G were significantly elevated in AP patients with statistically significant difference (31.4% vs 50.0%, P<0.05). There was no statistically significant difference on the allele frequency of Card 9 rs4077515AG and rs10781499AG, especially on rs141992399 C>G and rs139265120 A>G. C>Gpolymorphism in Card 9 rs10870077 resulted in an obvious increase of serum Card 9 mRNA expression in AP patients from 3.90±1.96 to 6.20±2.82, and the difference was statistically significant ( P<0.05), but there was no statistically significant difference on the Card 9 mRNA between AP patients with Card 9 rs4077515AG and rs10781499AG and the controls. IL level in AP patients with Card 9 rs10870077CG was greatly higher than that in those with Card 9 rs10870077 CC and GG [(614.7±1531.8 ng/L vs (372.5±1127.9)and (385.5±598.7)ng/L]. But compared with GG genotype, CRP level was obviously decreased [(34.84±50.64)mg/L vs (55.30±87.02)mg/L], and the procalcitonin was obviously increased [(1.98±4.70)μg/L vs (0.77±1.12)μg/L], and all the differences were statistically significant (all P value<0.05). Conclusions:Card 9 rs10870077 C>G mutation could upregulate the expression of Card 9 mRNA and increase IL-6 level, which may be a high risk for the occurrence of AP patients.