[Objective]To evaluate the effect of post-operative rehabilitative nursing of patients repaired with acellular nerve allograft.[Method]From April 2003 to April 2006,39 inpatients with peripheral nerve defect were subjected to receive acellular nerve allograft in order to repair nerve defect.The patients were rehabilitated with special nursing after being operated and discharged.Among of them,21 patients were followed up over 6 months,the effect of treatment was analyzed.[Result]Among 21 patients,16 people had excellent and good effect of treatment and the efficient rate was 71.4%.[Conclusion]Post-operative rehabili tative nursing is important and effective for rehabilitation patients of peripheral nerve injuries repaired with acellular nerve allograft.

Objective To exploration the value of color Doppler ultrasounographhy(CDU) in the diagnosis of breast mass. Methods The clinical data of 600 cases of breast tumor treated in our hospital in recent 3 years were retrospectively analysed, all patients were examined with CDU before operation. Results CDU found breast small tumor in 163 cases(27.2%) which couldn’t detected by hands, found multiple masses in 307 cases(51.2%);and suspected malignancy in 75 cases,of the 75 cases,malignancies were comfirmed by pathological examination in 72 cases(96.0%).Conclusions CDU can find small breast mass which can not be detected by hands,and can determin the mass is a tumor or not.CDU can also find early stage of breast cancer.CDU is non-traumatic,rasily to be perfomed and repeated.CDU can improve the preoperative diagnosis rate of breast mass.

BACKGROUND:How to control the orderly formation of colage in skin repair and scarring process is worthy of attention. OBJECTIVE: To investigate the effect of basic fibroblast growth factor (bFGF) combined with insulin-like growth factor 1 (IGF-1) on the proliferation and colagen synthesis of rat bone marrow mesenchymal stem celsin vitro. METHODS:Rat bone marrow mesenchymal stem cels were isolated and cultured to induce adipogenic differentiation assessed by oil red O staining and osteogenic differentiation identified by alizarin red stainingin vitro. Passage 3 cels were cultured in the medium containing bFGF, IGF-1, combination of them or the control fluid, respectively. MTT assay was used to detect cel proliferation at 12, 24, 48, 72 and 96 hours of culture. The expression of type I colagen and type III colagen were detected by RT-PCR and western blot after 10 days of incubation. RESULTS AND CONCLUSION:Compared with the control group, bFGF or IGF-1 alone significantly promoted the proliferation of bone marrow mesenchymal stem cels, and inhibited the expression of type I colagen and type III colagen. After combined use of bFGF and IGF-1, the proliferation of bone marrow mesenchymal stem cels was improved more significantly, and the expression of type I colagen and type III colagen returned to normal levels. These findings indicate that the combination of IGF-1 and bFGF can promote proliferation of bone marrow mesenchymal stem cels and restrain the expression of type I colagen and type III colagen, which may be helpful for control and repair of scar formation during wound healing.

Objective To evaluate the interventional of bare-handed core muscle strength training and the sling exercise therapy (SET) on low back pain.Methods The soldiers of an Air Force Station who suffered from low back pain participated in the study.One hundred and forty-four patients were equally divided into three groups: the core muscle strength group (using core muscle strength training and the general physical therapy), the SET group (using SET and general physical therapy), and the control group (using the general physical therapy).All the groups were tested for 6 weeks.Questionnaires were distributed to the three groups before intervention, two weeks, four weeks and six weeks after intervention in order to find out about the degree of LBP, lumbar function and activity of these cases.Changes in the lumbar muscle strength were observed.Results The number of the patients who completed the test included 43 cases in the bare-handed core muscle strength group, 43 cases in the SET group and 44 cases in the control group, respectively, the VAS scores were 3.25, the Roland scores were 5.83,the FFD scores were 8.58 of the bare-handed core muscle strength group;the VAS scores were 3.30, the Roland scores were 5.93,the FFD scores were 8.10 of the SET group;the VAS scores were 2.41, the Roland scores were 3.03,the FFD scores were 7.40 of the control group.The LBP intervention efficiency of the three groups was 90.90%, 85.13% and 46.82%, respectively.There was no significant difference in indexes between the test groups(P>0.05).But compared with the control group,there was significant difference(P<0.05).Conclusion The bare-handed core muscle strength training and SET have obvious effects on LBP cases.According to their own infrastructure and facilities, military health care organizations in different environments can intervene in LBP cases with the bare-handed core muscle strength training or SET to alleviate the pain effectively.

Objective: To acquire the expression of E2F3 protein and mRNA in bladder transitional cell carcinoma (BTCC) tissue and normal bladder epithelial tissue, and the relationship between E2F3 expression and the biological behaviors of BTCC thereof. Methods: Immunohistochemistry was used to detect the expression of E2F3 in BTCC(n = 64) and normal bladder mucosa(n = 10). Immunohistochemistry result was analysed by Image-pro Plus software and the expression result was indicated by integrated optical density (IOD). The expression of E2F3 mRNA was investigated using RT-PCR analysis in fresh bladder tumor tissues and normal bladder mucosa. Results: The expression rate of E2F3 in BTCC (32.8%) was higher than that of normal bladder mucosa(P < 0.01). The expression rate of E2F3 was strongly correlated with the pathological grade and clinical stage (P < 0.05;P < 0.01). Immunohistochemistry result indicated that the IOD of E2F3 was significantly higher in BTCC than that of normal bladder mucosa (P < 0.01). The expression level of E2F3 was strongly correlated with pathological grade (P < 0.01). Conclusion: E2F3 was the diagnostic and prognostic index of BTCC, and provided theory basis about the gene target therapy in BTCC.

Objective: To construct siRNA plasmid expression vector in order to knockdown E2F-3 activity. Methods: Sixty-four base-pair oligos for hairpin RNA expression, which targeted E2F-3 gene, were chemically synthesized and annealed. The pRNAT-U6.1/Neo vector was linearized with Bam HI and HindⅢ. Finally, the annealed oligos were inserted into the lined pRNAT-U6.1/Neo to construct RNAi plasmid(pRNAT-U6.1-E2F-3/Neo). The reconstructed RNAi plasmids were i-dentified by electrophoresis after digestion with BamHI and Hind Ⅲ, and were confirmed by sequencing analysis. Results: The recombinant pRNAT-U6.1-E2F-3/Neo vector was identified by polymerase chain reaction, and confirmed by sequencing analysis. The results demonstrated that 64 bp had been inserted into the expected site. Furthermore, the insertion sequence was exactly correct and no mutation site was found. Conclusion: The pRNAT-U6.1-E2F-3/Neo RNAi system was constructed successfully. This will facilitate the study of E2F-3 in bladder cancer cell lines.

Objective To compare the efficacy of flurbiprofen axetil combined with fentanyl administered using different modes for postoperative analgesia.Methods This was a prospective,multicenter,randomized,double-blind,control,parallel-group study.ASA Ⅰ or Ⅱ patients,aged 14-91 yr,weighing 35-95 kg,scheduled for orthopedic,thoracic or hepatobiliary surgery under general anesthesia from January 2010 to October 2010,were randomly divided into A,B and C groups.The three groups received patient-controlled intravenous analgesia (PCIA) after surgery.In group A,flurbiprofen axetil 100 mg was injected immediately after the end of surgery and then PCIA was performed with fentanyl 1.0 mg in 100 ml of normal saline.In group B,PCIA was performed with flurbiprofen axetil 200 mg and fentanyl 0.6 mg in 100 ml of normal saline.In group C,flurbiprofen axetil 100 mg was injected immediately after the end of surgery and then PCIA was performed with flurbiprofen axetil 200 mg and fentanyl 0.6 mg in 100 ml of normal saline.The PCA pump was set up with a 2 ml bolus dose,a 10 min lockout interval and background infusion at a rate of 2 ml/h.VAS scores at rest and during activity and sedation score were recorded at the end of surgery and 4,8 and 24 h after surgery.The effective analgesia,excessive sedation,nausea and vomiting,dizziness,somnolence and respiratory depression were recorded within 24 h after surgery.Samples from the PCIA bump were taken to do microbe culture experiment at 24 and 48 h after surgery.Results Two thousand five hundred and ninety-six cases completed this trial (875 cases in group A,946 cases in group B and 775 cases in group C).Compared with group A,VAS scores at rest and during activity at the end of surgery and 4,8 and 24 h after surgery and sedation score were significantly decreased in group B,VAS scores at rest and during activity were significantly decreased at the end of surgery and 4 and 8 h after surgery and sedation scores were significantly increased at 4 and 8 h after surgery in group C,the rate of effective analgesia was increased in groups B and C,the incidence of excessive sedation was decreased in group B,while increased in group C,the incidence of postoperative nausea and vomiting was significantly decreased in groups B and C,and the incidence of postoperative dizziness was significantly decreased in group C (P ＜ 0.05).Compared with group B,no significant change was found in the VAS scores at rest and during activity,rate of effective analgesia,and incidences of nausea and vomiting,and somnolence (P ＞ 0.05),sedation scores were significantly increased at the end of operation and 4 and 8 h after surgery,the incidence of excessive sedation was increased,and the incidence of postoperative dizziness was decreased in group C (P ＜ 0.05).Neither bacterium nor fungus was found in the PCIA pump samples.Conclusion PCIA with flurbiprofen axetil 200 mg and fentanyl 0.6 mg (background infusion at a rate of 2 ml/h,2 ml bolus dose,10 min lockout interval) provides better efficacy and the occurrence of sides effects is low for the patients undergoing moderate or major operations.

Objective To explore the correlation and role of E2F3 gene,miR-17-5p and miR-20a in the cell lines of transitional cell carcinoma of bladder. Methods The plasmids of pcDNA3.1-HA-E2F3 and pAAV-siRNA-E2F3 were used to overexpress and knockdown E2F3.The mimics of miR-17-5p,miR-20a and their anti-miRNA oligonucleotides were used to overexpress and screen miR-17-5p and miR-20a.The expression levels of E2F3 gene,miR-17-5p and miR-20a were detected by quantitative real-time PCR,and E2F3 protein were detected by Western blot. Results When E2F3 was overexpressed,the 2- △△Ct of miR-17-5p and miR-20a were 2.26 ± 0.30 and 4.04 ± 0.51,it was statistically significant to compared with control (P ＜ 0.05) ; when E2F3 was knockdown,the 2 △△Ct of miR-17-5p and miR-20a were 0.49 ± 0.02and 0.65 ± 0.04 (P ＜ 0.05) ; when miR-17-5p and miR-20a were overexpressed simultaneously,the level of E2F3 mRNA was significantly decreased,the average E2F3 protein gray scale was 55.31 ± 7.89,the control was 103.67 ± 13.61 (P ＜ 0.05 ) ; when miR-17-5p and miR-20a were knockdown simultaneously,the E2F3 mRNA was significantly increased,the E2F3 protein gray scale was 295.68 ± 19.25,the control was 103.67 ± 13.61 ( P ＜ 0.05 ). Conclusions miR-17-5p and miR-20a could be up-regulated by E2F3 gene,and the E2F3 gene could be down-regulated by miR-17-5p and miR-20a.The regulatory feedback loop of E2F3 gene,miR-17-5p and miR-20a exists in transitional cell carcinoma of bladder. The loop maybe plays a key role in the development of bladder cancer.

This study retrospectively reviewed 9 cases of complicated hepatic cystic hydatidosis with intrabiliary rupture who were surgically treated with pericystectomy in combination with Roux-en-Y hepaticojejunostomy in our hospital from 2004 to 2010. The clinical features, results of laboratory tests, B-mode ultrasonography and CT, post-operative recovery, days of hospital stay after the operation and post-operative complications were statistically analyzed and the patients were followed up. The subjects in our series included 7 males and 2 females, whose average age was 50.78±7.58 years. Before operation, 9 patients suffered from pain of the right upper quadrant and jaundice, which, in 4 cases (44.45%), were accompanied with fever and chills. Preoperative B-mode ultrosonography and CT showed that all the 9 patients had single hydatid cyst, with their diameter being 9.33±1.58 cm on average. The lesions involved segments V, VI in 6 cases, and segment IV in 3 cases. By WHO classification, 7 cases were classified as CE3 and 2 cases as CE4. They all had choledochectasia. The subjects underwent the surgery uneventfully. Intraoperatively, 2-4 biliary fistula orifices were found, with the average of the orifice being (0.79±0.20) cm. After the operation, one patient developed incision infection, one had pulmonary infection and one suffered from reflux cholangitis. No anastomotic leaks or peri-operative deaths took place and follow-up revealed no recurrence and implantative metastasis. We are led to conclude that pericystectomy in combination with Roux-en-Y hepaticojejunostomy can achieve satisfactory results for the treatment of complicated hepatic cystic hydatidosis with intrabiliary rupture.

Objective To sudy the changes in mTOR signaling pathway in childhood aplastic anemia(AA) by detecting the expression levels of the molecules of mTOR signaling pathway in T cells,and to explore immunologoical pathogenesis of AA in children from T cell intracellular signal transduction pathway.Methods Peripheral blood samples were collected from 16 newly diagnosed severe AA(SAA) patients and 8 patiens treated with effective immunosuppressive therapy,and the findings were compared with those of 17 healthy children (normal controls) and CEM cells (positive controls).The expressions of p-Akt,p-TSC2,p-mTORC1,p-4EBP1,p-p70S6K in CD3 + T cells in peripheral blood were detected by flow cytometry(FCM).Results 1.The expressions of p-Akt,p-TSC2,p-mTORC1,p-4EBP1,pp70S6K of the newly diagnosed SAA group were higher than those of the normal control group (P ＜ 0.05),but were lower than the postive control group (CEM group) (P ＜ 0.05).The mean fluorescence intensity (MFI) of p-Akt of three groups was 8.04 ± 3.78,2.59 ± 1.01 and 20.23 ± 8.98 respectively ;p-TSC2 was 49.73 ± 19.49,16.10 ± 8.04 and 101.05 ± 29.78 respectively ; p-mTOR was 13.90 ± 9.32,2.92 ± 1.09 and 34.3 ± 19.03 ;p-4EBP1 was 142.69 ± 53.36,26.91 ± 13.70,256.01 ± 53.79 ; p-p70S6 K were 17.67 ± 10.48,3.69 ± 2.22,31.73 ± 12.85 respectively.2.The expressions of p-Akt,p-TSC2,p-mTORC1,p-4EBP1,p-p70S6K of the effective treatment groups were lower than those of the newly diagnosed SAA group (P ＜ 0.05) ; the expressions of p-Akt,p-TSC2,p-mTORC1,p-p70S6K were similar to those of the normal control group(P ＞ 0.05),but the expressions of p-4EBP1 were higher(P ＜ 0.05).The MFI was followed by 3.28 ± 1.27,16.50 ± 10.91,3.54 ± 1.66,74.89 ± 49.69 and 4.21 ± 1.69.Conclusions 1.The expressions of p-Akt,p-TSC2,p-mTORC1,p-4EBP1,p-p70S6K were increased in the newly diagnosed SAA patients,the mTOR signaling pathway was activated in SAA patients.2.The expressions of p-Akt,p-TSC2,p-mTORC1,p4EBP1,p-p70S6K were lower than those of the newly diagnosed SAA patients.The degree of activation of mTOR signaling pathway was associated with disease status.The signaling pathways may be involved in the T cells of AA of the immune abnormalities.