Objective To evaluate the value and significance of testing megakaryocyte micronuclei in bone marrow smears for hematopathy diagnosis.Methods Bone marrow smears from a total of 863 cases of patients with hemopathy were collected from 2002 to 2009 at the second affiliated hospital of zhejiang university school of medicine.Smears from 25 healthy individuals were used as control.The bone marrow smears were subjected to Wright-Giemsa staining.The number of megakaryocytes, morphous and positive rate of megakaryocyte micronucleis were recorded by using low power lens and immersion objective.Statistical differences of positive rate in the different diseases, pathologic subtypes, total number and type of megakaryocyte were analyzed.Results The megakaryocyte micronucleis were round or oval with varying size, distributed in paranuclear or away from nuclear and even free in extracellular, which could be observed in large and medium megakaryocytes.The positive rate of megakaryocyte micronucleis was highest in myeloid leukemia, particularly in the subtype of M6, M2, M4 and M5b with dyshaematopoiesis.Megakaryocyte micronucleis could also be found in MA, infection and benzolism, but rarely observed in the lymphocytic leukemia.Conclution The detection of megakaryocyte micronuclei was related with its amount, size and type.There is significant difference of the postive rates of megakaryocyte micronuclei testing among the different hematopathies and pathologic subtypes.Megakaryocyte micronuclei testing should be valuable in the the diagnoses of hematopathy.

Objective To explore the relationship among emotional resilience,stress and school adjustment.Methods Adolescent life events check-list,adolescent emotional resilience scale and school adjustment scale of middle school students were conducted among 394 junior high school students.Results (1)The emotional resilience score and emotion recovery score of male junior high school students(46.07±8.56,24.43±5.80) were higher than that of female ones(44.39±8.39,23.27±5.37),and the differences were statistically significant(t=1.97,2.05,P＜0.05).The total score of emotional resilience(45.46±8.50,44.83±8.56) was not statistically related with whether they were the only children(t=0.68,P=0.50).The emotional resilience score and positive emotion score of rural junior high school students(44.04±8.53,20.63±5.35)were lower than that of urban ones (46.46± 8.34,22.15 ±4.72),and the differences were statistically significant(t=-2.86,-2.99,P＜0.01).The total score of emotional resilience (47.23±7.82,44.63±8.45,43.00±8.97) in different grades was statistically significant (F=8.86,P=0.00),and the first grade students were higher than the second and third year students.(2)Psychological stress was negatively related with emotional resilience and school adjustment(r=-0.23～-0.35,P＜0.01),and emotional resilience was positively correlated with school adjustment(r=0.12 ～ 0.29,P＜0.01).The relationship between stress and school adjustment were mediated by positive emotion and emotional recovery (the mediating effect were 11.11％,21.15％).Conclusion Frotional resilience plays a mediating role between psychological stress and school adjustment.

Objective To observe the effect of panax quinquefolium fruit saponin(PQFS) on hemodynamics and correlative indexes in the coronary artery ligated dogs.Methods The dogs were divided into five groups randomly(n=6): control group,gingkgo leaf tablet group(24 mg?kg~(-1)),24,12 and 6 mg?kg~(-1) PQFS groups.The myocardial infarction size(MIS)and the changes of the serum enzymes were determined by using the acute myocardial infarction models with the ligation of left anterior descending coronary artery of dogs.The parameters of hemodynamics and myocardial oxygen metabolism were measured in the anesthetic dogs with thoracotomy.(Results Compared) with control group,the myocardial blood flow was increased(P

Objective To study curative efficacy of dezocine in treatment of receiving laparoscopic appendectomy and its effects on white blood cell count and c reactive protein.Methods 90 patients of laparoscopic appendectomy who received therapy from January 2015 to October 2016 in our hospital were selected as research objects,according to random number table,those patients were divided into the observation group and the control group,45 cases in each group.The control group was treated with sufentanil, while the observation group was treated with dezocine.Then operation index, T0 (preoperative),T1(extubation),T2(after extubation) mean arterial pressure(MAP),heart rate(HR), respiration rate(RR),isual analogue scale/score ( VAS) , ramsay score ( RSS) , white blood cell count and c reactive protein of two groups after treatment were compared .Results After treatment, MAP,HR in the observation group were significantly lower than control group [(78.30 ±6.20)mmHg vs.(86.08 ±6.09)mmHg,(76.45 ±5.90)mmHg vs.(80.48 ±5.80)mmHg,(90.82 ±9.50)time/min vs.(96.73 ±9.83)time /min,(87.21 ±8.15)time /min vs.(93.59 ±9.90)time /min](P<0.05); VAS, RSS score were significantly lower than the control group[(2.60 ±0.70)score vs.(5.29 ±0.83)score,(3.53 ±0.92)score vs.(6.38 ± 1.21)score](P<0.05); White blood cell count, c reactive protein were significantly lower than the control group[(7.92 ±2.01) ×109/L vs.(14.98 ±2.11) ×109/L,(7.90 ±2.30)mg/L vs(12.46 ±3.10)mg/L](P<0.05).Conclusion Dezocine is well for receiving laparoscopic appendectomy, obvious analgesic effect, can significantly reduce the white blood cell count and c reactive protein.

AIM: To construct the shRNA targeting anterior gradient protein 2 (AGR2) gene for exploring the effect of AGR2 on the biological behavior of nasopharyngeal carcinoma (NPC) cells.METHODS: The expression of AGR2 at mRNA and protein levels in NPC cell lines 6-10B and 5-8F was detected by real-time PCR and Western blot.The pSR-GFP/Neo-AGR2-shRNA expression vector targeting AGR2 was constructed.Based on the interference targeting AGR2, the cell migration and motility were determined by Transwell migration and motility assays.RESULTS: The expression of AGR2 was increased in NPC cell line 5-8F compared with NPC cell line 6-10B (P <0.05).When the AGR2 expression in 5-8F cells was interfered, the cell migration, invasion and tumorigenicity were weakened.CONCLUSION: The expres-sion of AGR2 is up-regulated in NPC cell line 5-8F.pSR-GFP/Neo-CLU-shRNA successfully inhibits the expression of AGR2 in NPC cell line 5-8F.AGR2 inhibits the migration, invasion and tumorigenicity of 5-8F cells in vivo.

Objective To study the influences of ginsenoside Re on learning and memory abilities of natural apolexis rats and to probe its preliminary mechanism.Method Water maze test for old rats was used to observe the effect of ginsenoside Re on learning and memory,and electrophysiological technique to record the long-term potentiation(LTP)in basic synaptic transmission of the dentate gyrus in anesthetized rats.Results Ginsenoside Re can markedly counteract memory acquisition impairment in natural apolexis rats,and enhance the synaptic transmission in the dentate gyrus and form the LTP consequence.Conclusion Ginsenoside Re can improve the learning and memory obstacle in rats,the mechanism may correlate with its enhancing the basic synaptic transmission and promoting the magnitude of LTP of the dentate gyrus.

Standardized patient(SP) is playing an important role in medical education.Nevertheless this kind of medical education is not perfect.By use of analyzing the shortcomings in internal medicine education by SP.the effect of SP education will be greatly increased.

Objective To investigate the efficacy of dexmedetomidine-assisted topical anesthesia in patients undergoing bronchoalveolar lavage ( BAL). Methods Twenty-four ASA Ⅱ or Ⅲ patients in ICU, aged 24-64 yr, weighing 50-80 kg, scheduled for BAL, were randomly divided into 2 groups ( n = 12 each) : topical anesthesia group (group A) , topical anesthesia + dexmedetomidine group (group B) . In group A, 0.9% normal saline 5 ml was injected intravenously 30 min before operation, 2% lidocaine 5-10 ml was given via a tracheal tube or cannula 5 min before operation and then an increment of 2% lidocaine 5 ml was given using fibreoptic bronchoscope every 15-30 min as required (the total amount was within 20 ml) . In group B, dexmedetomidine 0.5-1.0 μg/kg was injected (time of injection≥ 10 min) followed by infusion at 0.1-0.5 μg·kg-1 ·h-1 and the topical anesthesia was performed as the method described in group A. The time of lavage, adverse reactions and adverse cardiovascular events were recorded. Blood samples were taken 20 min before lavage, 20 min after the start of lavage and 20 min after the end of lavage (T1-3 ) for determination of the concentrations of plasma catecholamine and serum cortisol. Results The incidences of adverse reactions and adverse cardiovascular events were significantly lower and the operation time was significantly shorter in group B than in group A ( P < 0.05). The concentrations of plasma catecholamine and serum cortisol were significantly higher at T2，3 in group A, while lower at T2，3 in group B than at T1 ( P < 0.05) . The concentrations of plasma catecholamine and serum cortisol were significantly lower in group B than in group A ( P < 0.05). Conclusion Dexmedetomidine-assisted topical anesthesia can be used safely and effectively in BAL.

Objective To establish and evaluate 3 kinds of minimally-invasive valve implantation model in vivo.Methods A novel tissue engineered heart valve(TEHV) manufactured by branched polyethylene glycol cross-linked acellular porcine valve and a minimally-invasive valve implantation system according to the design of Corevalve revalving system were adopted.After anesthesia,18 adult male goats were randomly divided into 3 groups: the ulrasound-directed orthotropic group (group A,n =6),angiography-directed orthotropic group (group B,n =6) and direct-released heterotopic group (group C,n =6),and all received minimally-invasive valve implantation orthotropically or heterotopically.4 weeks later,the valvular function was evaluated by CTA and/or echocardiography.Results All 3 kinds of caprine model were successfully constructed.The operation success rate of each group was A: 66.7％,B: 50.0％ and C: 100.0％,respectively(multiple x2 analysis,group A and B P ＞0.05; group A and C,group B and C,P ＜0.05).The operation-time of each group was A: (79 ± 18) min,B:(61 ±23) min,C: (45 ± 15) min(one-way ANOVA,P ＜0.05).The survival rate at4 weeks was A: 100％,B: 100％ and C: 83.3％ (multiple x2 analysis,P ＞ 0.05).Echocardiography and CTA proved the short-term function of implanted TEHV was satisfactory.Conclusion All 3 kinds of caprine valve implantation model can be established without cardiopulmonary bypass and blood transfusion.The devices and equipments required in group A is relatively simple,but the procedure cost longer time for it is hard to determine the right position by ultrasound.The application of angiography made the positioning much easier in group B while the procedure had to be performed in specific operation room with angiographic apparatus.Group C did rely on neither special equipments nor complex operation,but the valve leaflets cannot work normally,so this model was only suitable for testing in vivo characteristics such as biocompatiblities.