Objective To compare microsurgery through small skull window hematoma puncture and external drainage in the treatment and clinical effect of basal ganglia hemorrhage.Methods 92 cases of hypertensive basal ganglia hemorrhage were randomly divided into the two groups,46 cases in each group,A group was used microsurgery through small skull window hematoma,group B by puncture drainage.Operation time,complications and serum S100 protein of two groups were compared.Results Two groups were successfully completed operation,operation time, amount of bleeding,the time of hospitalization in A group were (125.3 ±29.1)min,(84.3 ±11.4)mL,(14.2 ± 2.7)d,B group were (70.5 ±5.4)min,(39.6 ±9.6)mL,(8.1 ±1.9)d,A group were significantly higher than that of group B (t =3.724,8.162.2.996,P <0.05,P <0.01 ).A,B two groups had respectively 11 cases,3 cases of respiratory tract infection,A group was significantly higher than that of group B (χ2 =9.12,P <0.05 ).0 case, 3 cases occurred in rebleeding in group A and B,respectively,0 cases,2 cases occurred cerebral hernia in group A and B,respectively,rebleeding,cerebral hernia in group B was significantly higher than that in group A (χ2 =4.76, 4.18,all P <0.05).1 patient because of recurrent cerebral hemorrhage was dead after operation in group B,group A after operation in patients with good treatment in three months according to ADL classification rate was 93.5%,B group after operation in patients with good treatment in three months according to ADL classification rate was 82.6%, the difference was statistically significant (χ2 =5.06,P <0.05).After 1D,7d,14d in serum of S100 beta protein in group A were (3.17 ±0.62)μg/L,(1.52 ±0.41)μg/L,(1.26 ±0.33)μg/L;group B beta protein of serum S100 were (2.38 ±0.52)μg/L,(2.09 ±0.53)μg/L,(1.31 ±0.34)μg/L.1d beta protein of serum S100 in group A was significantly higher than group B (t =2.812,P <0.05);postoperative serum 7d S100 beta protein in group A was lower than that in group B (t =2.620,P <0.05);there was no significant difference between two groups of 14d serum S100 beta protein differences between postoperative (t =1.082,P >0.05).Conclusion Small window craniotomy and puncture drainage micro hematoma surgery treatment of cerebral hemorrhage in basal ganglia and each has advan-tages and disadvantages,we should adopt different treatments according to the patient's condition.

Objective To construct human-mouse hybrid Fab phage antibody libraries and to select target Fab genes. Methods With Fd repertoire genes of PBMC from hepatoma patients and the chemeric light chain gene of cFab-HAb18, two hybrid Fab phage antibody libraries(pComb3 and pComb3X) were constructed. The GST fusion and non-fusion HAb18GE were used as antigens to select the target antibodies with the optimized strategies of amplifying and screening. Results When pComb3 displaying library was cultivated at 37℃, the target fragments could not be cut out with the restriction endonucleases from most clones of the library, which was an indication of “recombinant-deletion”. But no “recombinant-deletion” was found in pComb3X displaying library. Because of the serious cross-reaction, the phage-display Fab ELISA could not be used for the selection of positive clones. But positive clones could be identified in the supernatant of lysate with ELISA afterbeing induced by IPTG. Conclusion Through the construction of HuMFab phage antibody libraries and the optimization of screening strategies, we get the desired HuMFab genes for subsequent research.

There was significant difference in teaching atmosphere between teaching hospitals directly and indirectly under medical university.To improve medical students'general quality,some measures were carried out in our teaching hospital indirectly under medical university,such as strengthening the exchanging with teaching hospital directly under medical university,improving the teaching management system,strengthening the key teaching members training and teaching quality control,and improving student performent training.

Objective To explore the clinical value of the ten-point scale in the early diagnosis of fat embolism syndrome.Methods The data of 129 patients with fat embolism syndrome diagnosed by Gurd criteria admitted from January 1993 to February 2012 were analyzed retrospectively.At the same time,another 97 patients with single or multiple long bone fracture and/or pelvic fracture without fat embolism admitted from July 2005 to February 2012 were enrolled as control group.Patients were excluded if they had any of the following diseases:simple brain trauma,thoracic injury,spine fracture,hemorrhagic shock and the complications of cardiopulmonary cerebral resuscitation (CPCR).The patients of two groups were comparable in respect of clinical setting.The clinical data were analyzed and scored by the ten-point scale.The x2 test were applied to statistical works.Results Among all the clinical characteristics,the incidence of increased D-dimer was the highest (74.1％) in early fat embolism syndrome,followed by the progressive decrease in hemoglobin (63.6％) and hypoxemia (57.4％),and the occurrence of dyspnea was the lowest (17.8％).The percentage of total scores over ten points in patients with fat embolism syndrome group was higher than that in those without fat embolism syndrome (x2 =202.6,P ＜ 0.01).The sensitivity of tenpoint scale was 96.12％ and the specificity was 99.8％.Conclusions Ten-point scale could be used to make early diagnosis of fat embolism syndrome,thereby reducing the occurrence of misdiagnosis and misseddiagnosis.

lsartan could reduce the release of p-selectin.Conclusions Valsartan could relieve myocardial ischemia reperfusion injury of rat, which may be through reducing p-seleetin of plasma.

ObjectiveTo a nalyze the morphologic features of SMMC-7721 cannibalistic cells that induced by triazole Schiff base derivative(LH-37) in vitro. Methods The SMMC-7721 cells (1×10~4/ml)were cultured in the medium containing of 1×10~(-5) mol/L LH-37 for 24h,48h.The character of cells was detected by Papanicolaou and Wright′s Staining. Immunohistochemical method was used to observe the cleaved Caspase-3 positive cells. The ultrastructure of cannibalism cells was observed by JEM 100CX-II transmission electronic microscope. Results Microscopic analysis demonstrated the complete internalization of one cell within another. We noted that some cannibalistic cells in small aggregates appeared to be inside of large vacuoles, suggesting that they were internalized within a neighboring cell. The proportion of cannibalistic cells were increased after SMMC-7721 cells were cultured in the presence of LH-37 for 48 hours. The proportion of the cannibalistic cells in control and LH-37 group was 0.47% and 5.23% respectively . Many internalized cells were positive for cleaved caspase-3 staining . Ultrastructural analysis of engulfed cells from 24 hours exhibited evidence of live-cell internalization consistent with cannibalism, The most common fate for internalized cells was death after treatment with LH-37 for 48 hours, as evidenced by nuclear degradation and the eventual disappearance of some cells within the enveloping cell . Conclusion The data presented indicate that LH-37 can lead to an increase of cannibalism in human hepatocarcinoma cell in vitro.

Objective To study the value of chest radiograph and thin-section computed tomography (CT) in diagnosis bronchiolitis obliterans in children, and to determine clinical view of obliterative bronchilitis in children. Methods We identified 12 infants, 10 boys, and 2 girls (age range, 5 month to 11 years) with clinical confirmation of bronchiolitis obliterans. Three cases were after Steven-Johnson syndrome, 8 were post-infection(2 adenovirus, 2 measles and 1 Pseudomonas aeruginosa infection, 3 cases were unknown etiology infection) ; The symptoms lasted for at least 6 weeks. One case had lung ventilation nuclear scan. We evaluated individual bronchscopy, pulmonary function test, chest radiograph and thin-section CT features and their characteristic appearance. Results All cases had typical clinical characteristics and pulmonary function testing results that were consistent with nonreversible small airways obstruction. One case had lung ventilation nuclear scan illustrated absent and reduced ventilation of the right lower lobe. Nine cases who underwent bronchoscopy were chronic endobronchial inflammation. Three children had transbronchial biopsy and 1 patient who underwent open pulmonary biopsies were uncertain of histological diagnosis. Chest radiography showed hyperinflation in 8 cases; peribronchial thickening in 6 cases; consolidation/atelectasia in 6 cases; unilateral hyperlucency of a small/normal-sized lung in 4 cases. Thin-section CT/HRCT features included: mosaic perfusion pattern, decreased lung attenuation in 11 cases, pulmonary vascular attenuation in 10 cases; bronchial dilatation in 7 cases; bronchial wall thickening in 9 cases; unilateral hyperlucency of a small/normal-sized lung in 5 cases; consolidation in 6 cases; nodular in 3 cases; mucoid impaction in 5 cases. Conclusions In our study, correct diagnoses of bronchiolitis obliterans in children were made more special with thin-section CT than with chest radiographs. The diagnosis of BO in children can be based on the characteristic clinical situation, pulmonary function, indicating minimally reversible airways obstruction and characteristic thin-section CT findings.

Objective: To select anti-HAb18G (hepatoma associated antigen) human Fd fragments with guided selection of L chain of chimeric Fab-HAb18. Methods: The human Fd repertories genes were amplified by RT-PCR from PBMC of hepatoma patients, and cloned into the vector pComb3X with chimeric L chain to construct the human-mouse hybrid Fab phage library. HAblSGE, extracellular region of HAblSG, was used as antigen to screen. The positive clones was obtained by ELISA and FCM with p Ⅲ-fusion Fab antibody. The DNA sequences were analyzed. Results: A human-mouse Fab antibody library were constructed with 2?107 PFU. After 6 rounds panning, 7 positive clones were obtained with ELISA and FCM. And sequences of 2 clones with better affinity were same. The CHI belonged to the IgG2 class as the parent Fd, and the variable region belonged to VH3 family. Conclusions: Through the construction of the HuMFab phage antibody library and chemeric L chain-guided selection, we get the available human Fd fragments for subsequent research.

OBJECTIVE To explore the incidence rate,pathogen distribution and characteristics of drug resistance of ventilator-associated pneumonia(VAP) patients due to acute lung injury and acute respiratory distress syndrome(ALI/ARDS) after severe injury,and analyze impact factors on VAP.METHODS All 183 cases with ALI/ARDS after severe injury from Jan 2004 to Mar 2008,were admiitted and given mechanic ventilation over 48 hours in our ICU and EICU.RESULTS VAP was found in 98 cases,accounted for 53.56%.Among them,42 were early-onset VAP and the other 56 were late-onset VAP.Altogether 276 pathogens were isolated,and most of them were Pseudomonas aeruginosa,Staphylococci aureus,Klebsiella pneumoniae,Acinetobacter baumannii and Escherichia coli.In 41 cases only one pathogen was isolated,the other 57 cases were with two or above pathogens.The revealed important risk factors were coma,prolonged mechanical ventilation,tracheotomy,antiacid treatment,use of antimicrobial agents and low albumin.CONCLUSIONS The incidence rate of VAP due to ALI/ARDS is high,and most of the isolated pathogens are drug resistant.Mixed infections are found commonly in these cases.

The possibility of rats mesenchymal stem cells (MSCs) modified with murine hyperpolarization-activated cyclic nucleotide-gated 2 (mHCN2) gene as biological pacemakers in vitro was studied. The cultured MSCs were transfected with pIRES2-EGFP plasmid carrying enhanced green fluorescent protein (EGFP) gene and mHCN2 gene. The identification using restriction enzyme and sequencing indicated that the mHCN2 gene was inserted to the pIRES2-EGFP. Green fluorescence could be seen in MSCs after transfection for 24-48 h. The expression of mHCN2 mRNA and protein in the transfected cells was detected by RT-PCR and Western blot, and the quantity of mHCN2 mRNA and protein expression in transfected MSCs was 5.31 times and 7.55 times higher than that of the non-transfected MSCs respectively (P<0.05, P<0.05). I(HCN2) was recorded by whole-cell patch clamp method. The effect of Cs(+), a specific blocker of pacemaker current, was measured after perfusion by patch clamp. The results of inward current indicated that there was no inward current recording in non-transfected MSCs and a large voltage-dependent inward and Cs(+)-sensitive current activated on hyperpolarizations presented in the transfected MSCs. I(HCN2) was fully activated around -140 mV with an activation threshold of -60 mV. The midpoint (V(50)) was -95.1+/-0.9 mV (n=9). The study demonstrates that mHCN2 mRNA and protein can be expressed and the currents of HCN2 channels can be detected in genetically modified MSCs. The gene-modified MSCs present a novel method for pacemaker genes into the heart or other electrical syncytia.