Objective To explore the immunologic regulation of the bifidobacterium adolescence cell wall(BCW) on function of macrophage in mice and tumor inhibition of BCW on human transitional cell carcinoma of bladder(BTCC) outside of body.Methods BCW wereinjected into abdomen of KM mice,the level of IL-1,IL12 and TNF-?which produced by macrophage was determined by ELISA reagent box.The role of tumor inhibition was determined by MTT method.Results The level of IL-1,IL12 and TNF-?of BCW injection group was higher than of control group(P

By analyzing data from a questionnaire survey on bilingual teaching, we evalueted the results of bilingual teaching for seven-year medical students and the main problems of bilingual teaching and solutions accordingly. An uneven English level on the part of teachers and students and imperfect materials etc. affect the overall results of bilingual teaching. Therefore persistent efforts need to be made in enhancing the teachers' English level, improving teaching methods and compiling proper textbooks so as to genuinely improve the bilingual teaching program.

OBJECTIVE:To analyze the blood concentration monitoring data of 4 commonly used antiepileptic drugs(AEDs, sodium phenytoin,carbamazepine,sodium valproic acid,oxcarbazepine)in order to provide reference for rational use of drugs in the clinic. METHODS:415 patients underwent 4 AEDs blood concentration monitoring were selected from our hospital during 2014-2015,and the results of blood concentration monitoring were analyzed statistically. RESULTS:There were 680 cases of AE-Ds blood concentration monitoring in total. The main objects of serum concentration monitoring were young and middle-aged(range from 19 to 60),involving 449 cases in total(66.03%). 360 cases were in the normal range(52.94%). Among 361 patients receiving single drug therapy,the rates of serum concentration in the normal range were 80.77%for carbamazepine,which was higher than oth-er 3 AEDs(30.00% for sodium phenytoin,47.40% for sodium valproic acid and 40.38% for oxcarbazepine),with statistical signifi-cance(P<0.05). Among 54 patients receiving combination therapy,the serum concentration monitoring data of 67.65%patients treat-ed with double-combination therapy and 100%patients treated with triple-combination therapy deviated from normal range. CONCLU-SIONS:The rate of AEDs blood concentration reaching the normal range are in low level in our hospital. It’s necessary to strengthen medication education for patients to improve the compliance of patients;clinical efficacy of AEDs is evaluated on the basis of blood concentration monitoring and clinical symptom,and combination therapy should be avoided as much as possible.

Objective To evaluate the clinical outcomes of different flaps for repairing the soft tissue defects of heels.Methods A total of 26 patients with soft tissue defects around the heel treated modified propeller perforator flap,medialis pedis flap,or anterolateral thigh flap from March 2012 to June 2016 were analyzed retrospectively.There included 19 males and 7 females,aged 4-64 years (mean,38.1 years).There were 9 patients with posterior heel defect,3 with weight-bearing defect,6 with posterior medial defect and 8 with posterolateral defect.The wound areas were from 6.0 cm × 4.0 cm to 12.0 cm × 9.5 cm,while the flap areas were from 7.0 cm × 5.0 cm to 13.5 cm × 10.5 cm.According to the principle of flap selection,the pedicled skin flap instead of free skin flap was selected in order to minimize damage to the donor site area.Modified propeller perforator flap was applied in 13 patients,medialis pedis flap in 3 patients and anterolateral thigh flap in 14 patients.The flap donor site was directly sutured in 23 patients and a simultaneous skin graft was applied in 3 patients.The survival rate,appearance,texture and feeling recovery of flaps,complications,walking ability,and the status of donor sites were compared.Besides,postoperative functions of all cases were estimated according to foot scoring scale of American Orthopaedic Foot and Ankle Society (AOFAS).Results All flaps survived well in 26 patients.The wounds of flaps and flap donor sites were healed at Ⅰ stage.A total of 24 patients were followed up for 12-36 months (average 16 months).The appearance,color and texture of the flaps were good.There was no ulcer in flaps or flap donor sites.The protective feeling of flaps was recovered and the feeling of distinguishing two points was 6-13 mm.Modified propeller perforator flap donor site was directly sutured,the wound of which showed a linear healing.There was no fat deformity or obvious scar formation around ankle.The skin graft of the medialis pedis flap donor site was healed well,without scar hyperplasia,rupture,or deformity of arch.The anterolateral thigh flap was healed linearly without scar,and the anterolateral skin felt slightly depressed.The muscle strength of the four biceps femoris muscle was 4.According to AOFAS score,the feet's functions were evaluated as excellent in 5,good in 16,fair in 4,and poor in 1,with excellence rate of 81％.Conclusions For different soft tissue defects of the heels,propeller perforators flap,medial plantar flap or anterolateral thigh flap can not only attain appearance reconstruction of the defects and good functional recovery,but also minimize the injury of flap donor site.

Objective To summarize the experience of treating the end stage of liver disease complicated with renal failure using combined liver-kidney transplantation.Methods The clinical data of 28 cases receiving combined liver-kidney transplantation were retrospectively analyzed, including the inclusion criteria of surgical indications, modus operandi, protocol of immunosuppression and the prognosis post-operation.Results Among these 28 cases in our study, 22 cases suffered from liver and renal failure, accounting for 78.6%; 4 cases were diagnosed as having hepatorenal syndrome, accounting for 14.3%; and 1 case had hyperoxaluria and polycystic liver with polycystic kidney. As for the modus operandi we used, piggy-back procedure was adopted for 4 patients and classic procedure without bypass was used for the rest. Donor kidneys were all put in the right iliac fossa. During the follow-up period of 5 months to 7 years, one-and 3-year survival rate of the recipients was 92.9% and 78.3% respectively. Among these 28 recipients, 4 cases had the graft renal dysfunction early post-operation: One died and 3 recovered through consecutive therapy. One case received re-transplantation of the liver 3 months after the first due to the relevant complications and then recovered. During this period, no impact on the renal function occurred. Eleven cases had pulmonary infection post-operation, and 1 died. No acute rejection occurred.Conclusion Combined liver-kidney transplantation is the effective treatment to the patients with end stage liver disease complicated with renal dysfunction. Suitable case selection and perfect operation timing were the key points to the success of combined liver-kidney transplantation.

ObjectiveTo study the teasibility ot using the recipient cystic duct for biliary reconstruction in living donor liver transplantation.MethodsBetween January 2008 and September 2011,5 patients underwent living donor liver transplantation with biliary reconstruction.The recipient 's cystic duct was anastomosed with one branch of the donor's bile duct,and other donor's bile ducts were anastomosed with hepatic duct or right hepatic duct.After transplantation,the recipients were followed up with liver function test.Radioscopy was preceded at 2nd week and 3rd month after transplantation.ResultsTwo weeks after transplantation,cholangiography through the tubes showed no leakage or stricture at intrahepatic and extrahepatic bile ducts. Three patients recovered well without any hepatic dysfunction,and cholangiography showed well at 3rd month after operation.One patient had normal hepatic function after operation,and had not yet taken cholangiography.One patient recovered smoothly early,but after 3 months the cystic duct was tortuous with anastomotic stricture.The liver function was normal,and T tube was withdrawn.But 9 months later,hepatic dysfunction appeared,and the middle of the lumen was slightly narrowed in MRCP.Tacrolimus was replaced by Sirolimus,and the liver function returned to normal.ConclusionBiliary reconstruction using the cystic duct is feasible and safe for living donor liver transplantation.

Objective To study the significance of HSP47 gene in keloid formation after in vivo study with RNAi technology and the recombinant HSP4 7 siRNA against heat shock protein 47 to keloid in a nude mice model.Methods We injected RNAi mixture into the keloid of a nude mice model in experimental group and PBS water(0.25 ml)into control group at the 16th days after establishing the models.After interference we observed the specimens and harvested specimens at 7th days for biochemical and pathological analysis.Results The expression of HSP47 mRNA reduced obviously and the collagen content also reduced in the experimental group.The rusults had statistical significance.Conclusion We can suppress the expression of HSP47 gene and then reduce the production of collagen after in vivo interfering experiment with HSP4 7 siRNA in keloid nude mice models using RNAi technique.This study cornfirms the mechanism that HSP47 promotes the keloid formation,which provides a new target to treat keloid.

Objective In order to know first aid awareness and training needs of non-medical college students in Shiyan city,and to provide the basis for an efficient first-aid training.Methods A total of 1063 non-medical colleges in Shiyan city were surveyed by random sampling method.Results 64.61％ of students awared of their own lack of knowledge of first aid,only 3.8 ％ feel rich;based on the first aid knowledge they obtained at present,46.92 ％ did not hesitate to rescue the stranger.After receiving systematic training,the rate rise to 78.9 ％,68.09 ％ of students worried about their lack of first aid skills were the biggest obstacle for them to implement of rescue;98.3％ of the students asked to undergo first aid training,92.27％ of students like approach first aid skills was hands-on model.33.03％ of students believe that medical schools were the best institutions to undertake emergency training,23.46％ of students chose the hospital.Conclusion Non-medical college students in Shiyan city have a bad awareness for firstaid knowledge and a strong desire for training.It is necessary that relevant departments will formulate targeted training programs to improve college students' first-aid response and improve regional emergency level.

Objective To detect the mutation frequency of EML4-ALK fusion gene in lung cancer patients, and to inves-tigate the distribution of mutation character for EML4-ALK fusion gene in Ⅰ stage lung cancer patients and clinical features as well as provide a reference for the individual treatment of lung cancer .Methods 256 fresh tumor tissue specimens of lung cancer patients were screened from the specimen bank of our hospital and all the patients had accepted the surgical treatment from February 2013 to December 2014.Total RNA was extracted and then be transcribed into cDNA, the amplification-refrac-tory mutation system(ARMS) was used to detect mutation of EML4-ALK fusion gene.The results according to the positive con-trol, negative control and RNA quality control for EML4-ALK fusion type were analyzed.Results During the 256 patients ofⅠ stage lung cancer, there were 17 patients(6.64%) had mutations in EML4-ALK fusion gene.In lung adenocarcinoma mu-tation rate(16/207, 7.73%) was higher than that of lung squamous cell mutation rate(1/39, 2.56%), lung adeno-squamous mutation rate(0/4, 0) and large cell carcinoma(0/5, 0) of the mutation rate;young lung cancer patients( <63 years) of the mutation rate(14/139, 10.07%) was significantly higher than the high age of lung cancer patients(≥63 years old) mutation rate(3/117, 2.56%), P =0.009.EML4-ALK fusion with tumor invasion and visceral pleura group incidence (9/80, 11. 25%) was significantly higher than that of non-invasive and visceral pleura group incidence rate(8/176, 4.55%), P =0.045.Conclusion The occurence of EML4-ALK fusion correlates with patients’ age as well as whether visceral pleura is in-vaded, type 1 EML4-ALK fusion was detected more in phase I lung cancer patients.

Purpose To explore the image quality, radiation dose and diagnostic accuracy of double flash scanning mode in patients with coronary artery stent. Materials and Methods Sixty-three patients with coronary stents underwent CT coronary artery imaging using conventional coronary artery angiography as the gold standard. Double flash mode was used in patients with heart rate ≤ 70 beats per minute. Spiral scanning was used in patients with heart rate between 70-100 beats per minute. The image quality, vascular CT value, noise, SNR and CNR were compared. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy were determined, and the radiation dose was calculated. Results There were 59 stents in Double flash group (57 were diagnostic) and 58 stents in spiral group (all diagnostic). There was no statistically significant difference in image quality, CT value, noise, SNR or CNR for the first scan between two groups (P>0.05). Image quality for the second scan in Double flash group showed statistical difference with the first scan and spiral group (P<0.05). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of Double flash and spiral group were 90.0%, 89.8%, 64.3%, 97.8%, 89.8% and 83.3%, 95.7%, 83.3%, 95.7% 93.1%, respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy for stents with diameter ≥ 3.0 mm were significantly higher than stents with diameter <3.0 mm. The radiation doses of Double flash group were significantly lower than the spiral group (P<0.05). Conclusion Double Flash mode scanning provides good image quality and diagnostic accuracy with lower radiation dose in patients with coronary artery stents. Imaging of stents with diameter ≥ 3.0 mm is superior to stents with diameter <3.0 mm.