In clinical practice,we have adopted the methods such as intensifying the knowledge of preclinical medicine,learning to collect case history,training medical check-up,understanding the significance of auxiliary examination and encouraging the students to form the clinical thinking ability,and thus achieved satisfactory effect and obtained the positive opinion of students.

Objective To explore the clinical application of function-preserving pancreatic surgery for treating pancreatic neuroendocrine neoplasms (pNENs).Methods Twenty-eight patients with pNENs treated by the function-preserving pancreatic surgery at Anhui Province Hospital from January 2002 to December 2015 were analyzed retrospectively.Results Among the 28 patients, enucleation surgery was performed in 18 cases, distal pancreatectomy was performed in 8 cases, and middle pancreatectomy was performed in 2 patients.Total average operation time was (197±68) min, and the blood loss was (106±99) ml.The postoperative pancreatic fistula was observed in 7 patients, seroperitoneum was in 4 patients, incisional infection was in 1 patient, pulmonary infection was in 2 patients, and all the patients were cured by conservative treatment.There was no death during perioperative period.The postoperative hospital stay was (13±6)d.Analysis of pathological examination and clinical symptoms showed that 24 cases were diagnosed as functional pNENs (including 23 with insulinoma and 1 with gastrinoma), and 4 cases were as non-functional pNENs.The tumor grade G1 was categorized in 19 cases, G2 was in 9 cases.The TNM was I stage in all patients.There were no vascular or nerve invasion or lymph node metastasis.The follow-up period ranged from 4 to 144 months.2 patients were lost, and other patients were all alive.No diabetes or hypoglycemia occurred.Conclusions The function-preserving surgery for pNENs was safe and feasible, especially for well-differentiated functional pNENs.

As a new laboratory test for evaluation of endogenous pain inhibition,conditioned pain modulation (CPM) deficiency means dysfunction of endogenous pain inhibitory systems and higher incidence of chronic pain.Age,psychological factors and physical activity all seem to influence the individual CPM effect.A standard CPM testing way has an important role in comparison between different researches.

To evaluate the role of nitric oxide in local function of endometrium, the pattern of expression of endothelial and inducible nitric oxide synthases in the human endometrium at proliferative and secretory phases and decidua was studied by using immunocytochemistry. Results showed: (1) At the proliferative phase, the eNOS immunostaining was confined to vascular endothelial, whereas the iNOS was not detected in any composition of endometrium. (2) At the secretory phase, surface epithelium and grandular epithelium showed positive staining for both eNOS and iNOS. The stroma remained uniformly negative throughout the menstrual cycle. (3) In the decidua, the expression of both isoforms was increased, while moderate iNOS immunoreactivity was observed in decidualized stromal cells. It was demonstrated that the expression of eNOS and iNOS was elevated at the secretory phase and in decidua, indicating the increased production of NO at these phases. The increasing of NO might take part in implantation through dilating the vessels and relaxing the smooth muscles and in menstration through promoting apoptosis.

To evaluate the role of nitric oxide in the embryo implantation in mice, three experiments were carried out using the mice implantation model. In the experimentⅠand experimentⅡ, NG-nitro-L-arginine methyl ester (L-NAME), the non-specific NOS inhibitor, was administered intraperitoneally at doses of 0.5 mg-5 mg on the day 3 of pregnancy and at dose of 3 mg on different days of pregnancy (day 1-6) . In the experiment Ⅲ, L-aragnine, a donor of NO, was co-administered with L-NAME to evaluate the effect of L-aragnine on L-NAME, and the embryo development was assessed. In all these three experiments, the endometrium was histologically examined. Results showed compared with the control groups intraperitoneal administration of a dose of L-NAME between 1 and 5 mg on the day 3 of pregnancy led to the decrease in the number of implantation sites (P<0.05), and 4 to 5 mg of L-NAME caused inhibition of implantation completely. L-NAME resulted in failure of pregnancy when administrated at 3 mg between day 3 and 5 of pregnancy. The characteristic vascular permeability changes and decidualization in the endometrium were significantly attenuated and embryo growth was retarded. The L-NAME-mediated effects were significantly reversed when L-aragnine was co-administered with L-NAME. This study demonstrated that NO promoted the implantation in mice through regulating the permeability and decidulization of endometrium and the development of embryo.

Making dental impressions and models is a part of daily routine work for dental nurses in the orthodontic department in China. This paper analyzes the common problems encountered in the process of making dental impressions and models, and emphasizes the importance of quality control and supervision during this process. A method of combining real-time monitoring and periodic inspection based on nurse-doctor cooperation was put forward to ensure the quality of dental impressions and models. Firstly, the nurses should be well trained with the instruction of doctors before on duty; Secondly, the head nurse should be responsible for implementing real-time monitoring and periodic inspections to find the problems and take measures in time. Also, the doctors should check the dental impressions and models in time, especially for those models with special demands, and help the nurses to improve their skills constantly.

BACKGROUND: Tissue engineering has a promising prospect in corneal transplantation. Scaffolds are always restricting the development of tissue-engineered cornea. OBJECTIVE: To analyze application of different seed cells and scaffolds, and to summarize the progress of tissue-engineered cornea in recent years.METHODS: First author searched literature from CNKI (2000/2010-10) and PubMed database (2000/2010-10). The key words are tissue engineering, corneal transplantation in Chinese or English. A total of 223 literatures were seized by computers, according to the inclusion criteria, papers concerning the advance, application and reconstruction of tissue-engineered cornea were analyzed. Finally, 33 papers were included for further analysis. The present study was to analyze the seed cells, scaffolds, organ building and clinical applications of tissue-engineered cornea and investigate the development direction in the future. RESULTS AND CONCLUSION: The results show that seed cells and scaffolds are the focus of the studies now. Corneal transplantation has a high success rate in organ transplantation since the immune privilege of eye and avascular cornea, and it will be able to be a tissue engineering organ that can be largely built, easy to transplant. Reconstruction of cornea has reached first base, but every kind of scaffold has certain drawbacks, so the next goal is to find an ideal scaffold material.

Objective To discuss the perioperative nursing method for patients receiving colorec-tal tumor surgery under peritoneoscope. Methods Using the nursing procedure, through appraisal of patients' health situation→listing the nursing diagnosis or the nursing questions→formulation of nursing plan→ implementation of nursing plan→appraisal of the expected effect, combination of the surgical nursing's characteristic, to practice the idea of "the perfect person health and concern", cooperation with medical and nursing team, we provided a complete treatment and nursing plan for 38 patients receiving colorectal tumor surgery under peritoneoscope. Results 38 patients made satisfactory results with no surgery complications. The average in-hospital time was 9 days. Conclusions This technology has slight wound,light hemorrhage,slight draw-off, less pain, short exposure time of intestine, fast recovery of intestine function and early food intake. Systematic and intact perioperative nursing can improve the nursing quality and the success rate and reduce the complications so that the patients can live through the surgery safely.

Objective To observe changes of plasma thrombinogen segment 1+2(FI+2)and D-dimer(D-D)in multiple trauma patients and exphlore their relations with traumatic disseminated intra-vascular coagulation(DIC). Methods A total of 66 multiple trauma patients were divided into minor injury group(ISS＜16 points,21 patients)and severe multiple trauma group(ISS≥16 points,45 pa-tients).Then.severe multiple trauma group were divided into DIC group(12 patients)and non-DIC group(33 patients).Another 10 healthy pemons were served as control group.Venous blood was collect-ed once in the control group and that collected from other groups at days 1,3 and 7 after injury.The F1 +2 concentrarion was detetrained with ELISA.and the D-D concentration was measured by automated la-tex enhanced immunoassay. Results The F1+2 and D-D levels in the minor injury group and sever multiple trauma group were both higher than that of the control group.In the meantime.the F1+2 and D-D levels in severe injury group were remarkably higher than that in the minor injury group.The plasma F1 +2 and D-D levels were elevated continuously in traumatic DIC group and remarkably higher than that in the non.DIC group.in which the plasma F1+2 and D-D levels gradually declined.Plasma F1+2 and D-D levels had significantly positive correlations at days 1,3 and 7 after injury. Conclusions Hiigher levels of F1+2 and D.D at acute stage is not only relevant to the injury severity,but also closely to the occurrence of traumatic DIC after injury.Detection of plasma F1+2 and D-D levels may play an impor-taut role in early prediction of DIC.

The incidence of invasive candida infection in critically ill patients is rising year by year. It's clinical manifestation lacks specificity which is easy to result in missed diagnosis or misdiagnosis.Tradi-tional diagnosis methods need very long time and have low positive rate,which are easy to delay treatment,so early diagnosis is particularly important.1 ,3-β-D-glucan,mannan and antibodies,anti-enolase antibodies,can-dida score and colonization index may be helpful to make early diagnosis.