Objective To investigate the clinical curative effect of ladder-type decompression in preventing acute encephalocele in the operation of severe craniocerebral trauma.Methods The clinical data of 178 patients after operation of severe craniocerebral trauma were retrospectively analyzed.The patients were divided into routine decompression group (75 cases) and ladder-type decompression group (103 cases).The former was treated by routine decompression,and the latter was treated by ladder-type decompression.The efficacy was compared and analyzed.Results The incidence of acute encephalocele and delayed hematoma in ladder-type decompression group were 27.18％ (28/103) and 12.62％ (13/103),in routine decompression group were 54.67％ (41/75) and 26.67％ (20/75),and the differences between two groups were statistically significant (P ＜ 0.01 or ＜ 0.05).Three months after discharge,21 cases were lost in ladder-type decompression group and 15 cases were lost in routine decompression group.Recovery rate and death rate in ladder-type decompression group were 29.27％ (24/82) and 36.59％ (30/82),in routine decompression group were 15.00％ (9/60) and 55.00％ (33/60),and the differences were statistically significant (P＜ 0.05).Conclusion Ladder-type decompression can effectively reduce the incidence of acute encephaloceie via the steady release of intracranial pressure,which has positive significance in the improvement of the treatment and prognosis of severe craniocerebral injury.

In order to meet the needs of social development for public health talents and optimize the curriculum system and teaching content of preventive medicine, the course of "Health Emergency" should be set up. It integrates the related content in many courses, and there are 20 hours for theory and 18 hours for experiment or practice. The course takes the emergency response as the cutting point focuses on the projects with high demand of the industry improves the platform and expands the content of emergency skill training through the extracurricular activities and special lectures. Combining theory with practice, this paper explores teaching reform measures that are conducive to improving students' core competence in public health.

OBJECTIVETo investigate the reversing effect of icaritin on multidrug resistance of multiple myeloma cell lines KM3/BTZ and its underlying mechanism.

METHODSKM3/BTZ cells were established by a gradually ascending gradient induction of bortezomib (BTZ). The sensitivities of KM3 and KM3/BTZ cells to 7 chemotherapeutic drugs, the inhibition and reversal effects of icaritin on proliferation and drug-resistance of KM3/BTZ cells were analyzed by MTT. The apoptosis was analyzed by flow cytometry, and the expression of Par-4, HSP27 and P-gp were detected by Western blot.

RESULTSKM3/BTZ cells were not only resistant to BTZ, but also to other 6 chemotherapeutic drugs. The resistance index (RI) to BTZ was 17.84, and higher than that of other chemotherapeutic drugs. Icaritin inhibited the proliferation and induced the apoptosis of KM3/BTZ cells. The ICvalue of BTZ decreased from 0.345 µg/ml to 0.149 µg/ml, and the reversal index was 2.38 (P<0.05). The expression of Par-4 protein increased in a concentration-dependent manner, while the expression of HSP27 and P-gp were down-regulated.

CONCLUSIONIcaritin can inhibit cell proliferation and induce apoptosis of KM3/BTZ cells, moreover, can effectively reverse the multidrug resistance of KM3/BTZ cells. The mechanism may be related with down-regulation of HSP27 and P-gp expression, and up-regulation of Par-4 expression.