The score of the final test papers of rehabilitation medicine among the fiveyear prgram clinical students of Grade 2005 in our university were analyzed,which showed that the test paper had the degree of difficulty and discrimination was good,which reflected the students’real level.And at the same time we found that students could not to make good use of learning to analyze and work out a solution. Therefore,we should pay attention to the combination between teaching and clinical practice,increase student’chance of learning on the job, and properly append such subjects as application, synthetic and evaluation in the test papers.

Objective To assess the ability of interleukin-1 beta (IL-1?) antibody and tumor necrosis factor alpha (TNF?) antibody to prevent postoperative abdominal adhesion formation in mice.Methods 60 BALB/c mice were randomly divided into four groups: normal saline group(n=15), anti-IL-1? group(n=15), anti-TNF? group(n=15),and anti-IL-1? combined with anti-TNF? group(n=15). After an identical peritoneal injury operation, mice were treated using intraperitoneally with either normal saline or corresponding antibody at the time of abdominal closure. The mice were killed 20 days after operation, the abdominal incisions and the development of intra-abdominal adhesions were observed. Adhesion scoring was based on an overall assessment of the extent,location, and type of adhesion.Results Anti-IL-1? combined with anti-TNF? group had significantly lower adhesion scores (0 84?0 19) than that in other groups(P

Objective To explore the clinical manifestations, pathogenic mechanisms and treatment of Mirizzi syndrome.Method 65 patients with Mirizzi syndrome were analysed retrospectively.Results According to Csendes typing, patients with Mirizzi syndrome included type Ⅰ in 18 patients(27 6%), type Ⅱ in 25 patients (38 4%), type Ⅲ in 13 patients(20 0%), type Ⅳin 9 patients(13 8%), all patients were healed by corresponding operation and perioperative management.Conclusions Good outcome of Mirizzi syndrome patients can be achieved by accurate diagnosis,exact operation and active perioperative management.

Objective To investigate the efficacy of Yiqing capsules and Cefaclortablets in the treatment of simplex anaphylactoid purpura. Methods In this randomized,simple-blind, controlled study, all of 191 simplex anaphylactoid purpura patients,the throat secretion Group A βhemolytic streptococci antigen test was positive ,92 patients of control group were treated Cefaclor tablets and regular treatment,99 patients of test group were Yiqing capsules and Cefaclor tablets. Results After 10 days treatment,the clinical efficacy of the test group and the control group were 91.9% ,75.0% ,the test group was obviously higher than that of the control group(P ＜ 0.01), and the negative rate of the throat secretion Group A βhemolytic Streptococci antigen test of the test group was higher than that of control group, (P ＜0.01). the commencements of response of the test group was earlier than that of the control group(P ＜0. 01) ,the frequencies of recurrence of the test group were lower than that of the control group (P ＜ 0. 05).Conclusion Yiqing capsules combined cefaclor in treatment of simplex allergic purpura could improve efficacy, and reduce the treatment time.

Objective To evaluate the clinical value of laparoscopic nephrectomy. Methods Laparoscopic nephrectomy was used in 26 cases (transperitoneal approach in 19 cases and retroperitoneal approach in 6 cases), including 8 cases of radical resection of renal cancer, 7 cases of total resection of kidney and ureter (2 cases of carcinoma of renal pelvis and 5 cases of carcinoma of ureter ), 6 cases of non-functioning or atrophic kidney and 5 cases of living donor nephrectomy. Results All the operations were accomplished successfully. The operative time was 120 min ～ 250 min (mean, 190 min) and the intraoperative blood loss was 50 ml ～ 200 ml (mean, 130 ml). No blood transfusion was needed and no operative complications occurred. Follow-up for a mean of 16 months in 8 cases of renal cancer and 20 months in 7 cases of total resection of kidney and ureter revealed no recurrence or metastasis except for 1 case of local recurrence of ureteral carcinoma. Conclusions The laparoscopic nephrectomy has the advantages of minimal invasion, less blood loss and rapid recovery.

Objective To investigate the preventive effects of phytosterol on lipid metabolic disturbance of rats fed with high-fat diet. Methods Forty male SD rats were randomly divided into control group (fed with basic diet), high-fat model group (fed with high-fat diet), low phytosterol group( fed with high-fat diet and 100 mg/kg phytosterol) and high phytosterol group( fed with high-fat diet and 200 mg/kg phytosterol). Body weight, serum lipid, liver fat and body fat were measured at the end of experiment (6 weeks later). Results At the end of experiment, the body weight, contents of liver fat and body fat and serum TC, TG and LDL-C levels were significantly higher in high-fat model group, low phytosterol group and high phytosterol group than those in control group (P <0.05), while serum HDL-C levels in these three groups were significantly lower than that in control group (P < 0.05). Compared with high-fat model group, the body weight gain and content of body fat of high phytosterol group were significantly lower (P <0.05). The contents of liver fat and serum TC, TG and LDL-C levels in low phytosterol group and high phytosterol group were significantly lower than those of high-fat model group (P < 0.05). Conclusion Phytosterol could prevent lipid metabolic disturbance of rats fed with high-fat diet. High dose phytosterol has the potential to reduce the body weight gain and contents of body fat of rats fed with high-fat diet.

Objective To explore the clinical effect of transjugular intrahepatic portosystemic shunt (TIPS) and percutaneous transhepatic variceal embolization (PTVE) on the treatment of cirrhosis with esophageal gastric varices bleeding. Methods The data of 61 patients of liver cirrhosis combined with esophageal gastric varices bleeding who underwent the interventional treatment were included in the retrospective analysis. Patients were divided into two groups, PTVE treatment group (n=42), and TIPS treatment group (n=19). The success rate of clinical treatment, the rebleeding rate, the alleviation of varicose veins, the incidence of hepatic encephalopathy, survival rate and liver function parameters were compared between two groups. Results Two groups of surgery were successful. The portal vein pressure decreased obviously in TIPS group. The rebleeding rate was higher in PTVE group (78.6%) than that in TIPS group (63.2%). The total alleviation rate of esophageal gastric varices was significantly lower in PTVE group (50.0%) than that in TIPS group (89.5%, P<0.05). The incidence rates of hepatic encephalopathy were 14.3% and 26.3% for PTVE group and TIPS group respectively. The two-year cumulative survival rates of PTVE group and TIPS group were 95.2% and 89.5% respectively, and there was no statistically significant difference between two groups. After surgery, the liver function parameters were not significantly different from those determined before the treatment in PTVE group. At 1 month and 3 months after TIPS, the liver functions were declined obviously. At 6 and 12 months after the treatment, the liver functions were not significantly different from those determined before the treatment in PTVE group. Conclusion The surgery of TIPS is safe and ideal interventional treatment for cirrhosis with esophageal gastric varices bleeding, which has the lower rebleeding rate, better esophageal gastric varices alleviation rate and long term less influence in liver function.

Objective To investigate the clinical effects of laparoscopic sleeve gastrectomy with duodenaljejunal bypass (LSG + DJB) for the treatment of type 2 diabetes mellitus.Methods The clinical data of 17 patients with type 2 diabetes mellitus who underwent LSG + DJB at the Xijing Hospital of the Fourth Military Medical University from March 2013 to February 2014 were retrospectively analyzed.The fasting blood glucose,postprandial 2-hour blood glucose,glycosylated hemoglobin (HbA1c) and body mass index (BMI) in 17 patients before operation were (9.2 ± 0.6) mmol/L,(14.4 ± 2.2) mmol/L,8.3％ ± 1.2％ and (29.4 ± 2.2) kg/m2,respectively.All the patients received LSG + DJB and were followed up by outpatient examination up to March 2015.The pre-and post-operative 12-month fasting blood glucose,postprandial 2-hour blood glucose,HbA1 c and BMI in 17 patients were compared.Measurement data with normal distribution were presented as-x ± s and analyzed by the t test.Results All the 17 patients received successful laparoscopic LSG + DJB without conversion to open surgery.The operation time,volume of intraoperative blood loss and recovery time of postoperative gastrointestinal function were (141 ±53)minutes,40 mL and 2.5 days.Of 3 patients with postoperative complications,1 patient with anastomotic leakage at postoperative day 5 received reoperation by laparoscopic Roux-en-Y gastric bypass,1 patient with digestive tract obstruction at postoperative day 10 released obstruction by reoperation and 1 patient with left subphrenic abscess and leakage at the upper of the stomach at postoperative week 2 was cured by the symptomatic treatment.The duration of hospital stay was 5.2 days.All the patients were followed up for a median time of 16 months (range,13-24 months).The postoperative 12-month fasting blood glucose,postprandial 2-hour blood glucose,HbA1c and BMI in 17 patients were (5.5 ± 0.7)mmol/L,(8.8 ± 1.7)mmol/L,5.1％ ± 0.7％ and (24.7 ± 2.3)kg/m2,which were significantly different from preoperative indicators (t =19.96,10.52,12.06,31.99,P ＜ 0.05).During the follow-up,no anastomotic ulcer and stenosis,dumping syndrome and severe malnutrition were occurred.Conclusion LSG + DJB is safe and feasible for the treatment of type 2 diabetes mellitus,with a good short-term hypoglycemic effect.

Objective To investigate the protective effects of soybean isoflavone(SI) on genetic toxicity induced by di-n-butul phthalate(DBP) in mice.Method(1) Micronucleus test:40 male 7 w old Kunming mice were randomized into 4 groups:High and low dose SI intervention groups,DBP model group,and solvent control group.SI intervention groups were given different doses of SI(50,100mg/kg) for 30 d,meanwhile,the DBP group and solvent group were given 0.5% sodium carboxymethyl cellulose.Then all groups were treated by 0.5g/kg DBP for 5d except solvent group.Mice were sacrificed 6 hour after last treatment,and then counting micronucleated cells in bone marrow.(2) Sperm malformation test:40 male 6w old Kunming mice were grouped and treated the same as micronucleus test.Mice were sacrificed at 35 day after the first treatment,and then sperm quantity,motility,viability and abnormality rate were calculated.Result Micronucleus rate and sperm abnormality rate of SI intervention group were lower than DBP model group,while sperm motility and viability were higher than DBP model group.Conclusion SI can relieve the genetic toxicity induced by DBP in mice.

Objective To construct a RhoA-siRNA expression vector and determine its role on the malig-nant behavior of HepG2 cells.Methods A RhoA-siRNA DNA fragment was synthesized and cloned into the expression vector of pGenesil-1.The constructed Rhon-siRNA DNA plasmid was stably transfected into HerG2 cells by lipofectamine,and then HepG2 cells were divided into the HepG2/RhoA-siRNA group (HepG2 cells were transfected with pGenesil-1-RhoA-siRNA),HepG2/control group(HepG2 cells were transfected with control plasmid) and HepG2 group (without plasmid transfection).The inbibitory effect of RhoA-siRNA on RhoA protein expression was shown by Western blot.The proliferation,migration,growth potentiality and cell cycle of transfected HepG2 cells were evaluated by MTT assay,wounded healing,the plate cloning formation test and flow cytometry,respectively.All data were analyzed by one-way analysis of variance (ANOVA) and chi-square test.Results The expression of RhoA protein in the HepG2/RhoA-siRNA group was,significantly decreased compared with that in the other two groups (F=178.19,P<0.05).Scratched cells were healed within 48 hours in the HepG2/control group and HepG2 group,but not in the HepG2/RhoA-siRNA group.The clone formation rates in the HepG2/RhoA-siRNA group,HepG2 group and HepG2/control group were 39%±3%,67%±5%and 70%±6%,respectively,with a significant difference among the three groups(χ2=33.34,38.69,P<0.05).Flow cytometry showed that the number of cells transfected with RhoA-siRNA was highest in the G0/G1 phase and lowest in the S phase(F=70.46,76.57.P<0.05).Conclusion The RhoA-siRNA expression vector can effectively suppress the proliferation and migration of HepG2 cells,which may provide a novel gene therapy for hepatocellular carcinoma.