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 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 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 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 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 investigate the nutrition statuses of thiamine and riboflavin and their relationship with the antioxidant capacity and blood glucose and lipids levels in the middle-aged and elderly. Methods Totally 314 subjects aged above 40 years old from communities in Shanghai were enrolled. The 3-day survey of 24-hour's diet recall was made to evaluate the daily nutrient intakes using a nutrition assessment software provided by CDC China. Thiamine and riboflavin levels were detected by urine load test. Fasting blood glucose ( FBG), total choles-terol (TC), triglyceride (TG), superoxide dismutase (SOD) activity and malondialdehyde (MDA) were deter-mined by commercial kits. Results The average daily intakes of thiamine and riboflavin were (0. 82 + 0. 36) and (0. 91 +0.48) rag, respectively. The middle-aged and elderly whose intakes of thiamine and riboflavin reached recommended nutrient intake (RNI) level accounted for 11.8% and 17.2%, while those lower than 60% RNI ac-counted for 51.3% and 49. 4%, respectively. Urine load test showed the deficiency rates of thiamine and ribofla-vin were 65.0% and 58.6%, respectively. Compared with the normal group, plasma MDA, FBG, TC, and TG levels progressively increased and SOD activity decreased in insufficient and deficient groups; the plasma MDA, FBG, and TC levels were significantly different between normal group and thiamine deficient group ( P < 0. 05 ).The FBG and TC levels were negatively correlated with the status of thiamine ( r = - 0. 246, r = - 0. 154, P <0. 05). The MDA and TG levels were negatively correlated with the status of riboflavin ( r = - 0. 136, r =-0. 297, P <0. 05). Conclusions The nutrition statuses of thiamine and riboflavin are poor in the middle-aged and elderly in Shanghai. The nutritional statuses of thiamine and riboflavin are positively correlated with the antioxi- dant capacities and are negatively correlated with the level of FBG, TC, and TG.

Objective To study the relationship between trace elements and blood lipids and glucose in Shanghai adults. Methods Totally 245 subjects aged above 18 years from two communities in Shanghai were en-rolled into this study. Blood trace elements (Fe, Zn, Cu, Mg, Pb, Mn, and Cd) were examined with atom ab-serption spectrophotometry. Body mass index (BMI), waist hip rate (WHR), and blood pressure (SBP, DBP)were also determined. Results Compared with the normal control group, plasma Fe and Mn levels were signifi-cantly lower while Zn and Zn/Cu levels were significantly higher in hyperlipemia group (P <0.05 or P <0. 01 ) ;plasma Zn, Zn/Cu, and Mn levels were significantly lower while Cu and Pb levels were significantly higher in dia- betes mellitus group (P <0. 05 or P <0. 01 ) . A tendency of lower Mg and higher Cd levels were also found in both disease groups, but there were no statistical significance ( P >0. 05 ). Conclusions The metabolism of trace elements is abnormal in patients with hyperlipemia and diabetes mellitus. Intervention of these trace elements disor-der may be valuable in the prevention and treatment of these diseases.

Objective To improve the pancreaticoenterostomy technique and drainage in panereatieoduodenectomy, so as to prevent postoperative pancreatic leakage. Methods One hundred and thirty-eight panereaticoduodenectomy cases underwent parachute continuous running suture of pancreaticojejunostomy and extra drainage of the anastomotic stoma. Results The average time of the double-deck continuous invaginated pancreaticoenterostomy was 11 minutes, and there was no pancreaticoenterostomy leakage in all cases, lntraoperative blood loss was 353±61 ml, the average hospital stay was 19.2 days. Pulmonary infection developed in 6 cases, three cases suffered from postoperative upper gastrointestinal bleeding due to stress ulcer, two cases from functional delayed gastric emptying. All these complications were cured by conservative treatment, and there was no mortality in these series. Conclusions The parachute continuous running suture of pancreaticojejunostomy and extra drainage has the advantages of easy performance, saving time and less complications, and is an effective way in the prevention of panereatieojejunostomy leakage.

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.