[Objective]To evaluate the factors causing loosening of instrumentation and the progressive deformities after treating thoracolumbar bemivertebra with segmental instrumentation,and analyze the outcomes and strategies of reversion.[Method]A retrospective study was made in 7 cases with loosening of instrumentation and the progressive deformities secondary to operation on thoracolumbar hemivertebra in our hospital.There were 3 males and 4 females,with age range of 1.8~13 years.Preoperative mean Cobb's angles of scoliosis was 34.1?,and kyphosis was 40.2?.All cases were treated with posterior reversion.[Result]The failure factors of primary surgery were resulted from:failure of single hemivertebra resection(4 cases),shortage of segments fixation and bone graft(5 cases),unsatisfactory selection of instrumentation(2 cases),failure of manipulation in young children(2 cases),segment fixation without fusion(1 case).Postoperative mean Cobb's angle of scoliosis was 12.6?,with correction rate of 63.0%,and kyphosis was 17.3?,with correction rate of 56.9%.The revision cases were followed up for 18 to 28 months and showed that all patients got satisfactory cosmetic correction and fine fusion.No neurological complication or infection occurred,no implant failure were verified at the final radiographic evaluation.[Conclusion]The reasons for postoperative loosening of instrumentation and the progressive deformities includs:free from hemivertebrectomy,inappropriate segments fixation and bone graft,unsatisfactory selection of instrumentation,impropermanipulation in young children,fixation without fusion.If the above-mentioned five reasons of reversion strategies have been considered and avoided,the clinical results will be satisfactory.

AIM: To explore the surgical methods and clinical effects on young patients with congenital lower eyelid entropion.
METHODS: There were 27 patients ( 45 cases ) who suffered congenital lower eyelid entropion accepted the modified blepharosphincterectomy. The clinical effects and complications were evaluated.
RESULTS: After followed up for 6mo, 42 eyes were fully recovered, 3 eyes were unsuccessful and the cure rate was 93%, 5 eyes suffered minor lower eyelid skin folds, none had lower eyelid retraction and ectropion.CONCLUSION: Modified blepharosphincterectomy is an ideal cosmetic surgical treatment for young patients with congenital lower eyelid entropion. It is an effective surgical treatment with fewer complications.

Objective To study the correlation between organizational commitment of nurses and their intention to drop out. Methods Toally 304 contract nurses were recruited in this investigation. The questionnaires including demographic data, scale of organizational commitment and intention to drop out scale were used. Results The score of intention to drop out was 16.94 ± 2.16. The score on organizational commitment was 71.19 ± 6.65. There was a positive correlation between intention to drop out and organizational commitment among the contract nurses. Conclusions Improving contract nurses′organizational commitment can be an effective mean to reduce contract nurses′intention to drop out. It is an important means to promote the development of the nurse team and provide a reference for the scientific development of nursing.

AIM: To investigate the refractive distribution and analysis risk factors for aircrew ametropia.
METHODS: The number of 49 cases with ametropia from 1031 aircrew during May 2013 to May 2014 were reviewed. Various types of refraction composition, age, type, position, time of flight with the subjective assessment of aircrew were analyzed and compared.
RESULTS:Of 49 cases, 43 cases (88%) were myopia, 6 cases ( 12%) were hypermetropia. , Detection rates were higher in age over 50 years aircrew and flight time more than 3000h. Detection rates were lower in self-conscious symptom heavy aircrew, fighter aircrew and good habit of using eyes.
CONCLUSION: The myopia incidence in aircrew with age >50 years and long flight time is higher, than that of fighter pilots and good habit of using eyes. We should pay attention to the increasing late-onset myopia of aviators and habit of using eyes, work intensity and time of using eyes about aircrew.

Objective: Cellular proliferate inhibition, senescence or apoptosis are induced by telomere shortening through the activation of P53 pathway, but so far, little is known of the mechanism. This study aimed to clarify the molecular regulation of P53 through telomere pathway by the investigation of molecular interaction between P53 and the main telomere associated protein telomeric repeat binding protein 1(TRBP1) in vitro. Methods: Glutathione S-transferase (GST) alone and 4 different human P53-GST fusion proteins were expressed in E. coli. and purified through glutathione Sepharose TM 4B by affinity chromatography, P53s were wild type P53 (1-393), N terminal truncated form P53 2C (95-393), C terminal truncated form P53 N5 (2-293) and single amino acid mutant P53 R175H (175 arginine to histidine). Glutathione Sepharose TM 4B, purified GST alone and P53 fusions were mixed with human breast cancer cell line MCF-7 cellular protein extracts through in vitro binding assay-pull down, the molecular interaction between P53 and TRBP1 were detected by Western blot. Results: SDS-PAGE and Coomassie brilliant blue staining showed that the molecular weights of all the purified proteins were as expected and purities were over 90%. Western blot of TRBP1 showed that both wild type P53 and P53 R175H could bind to TRBP1 of MCF-7 cells, and their binding capacities are similar, whereas GST alone and Glutathione Sepharose TM 4B beads couldn’t. Compared with both of them, the interaction between P53 2C and TRBP1 enhanced dramatically, but between P53 N5 and TRBP1 reduced significantly.Conclusion: P53 can interact with TRBP1 directly and in vitro, C terminus of P53 (293-393) is the structural domain of their interaction. This C terminus domain dependent interaction between P53 and TRBP1 may be related to the cellular activities induced by telomere dynamic changing.

To obtain a most appropriate method for the evaluation of the three basic skills of clinical doctors,we designed an objective structured clinical examination(OSCE) model with standardized patients and applied it to the "three-basic" examinations among 50 doctors from various clinical departments.The results showed that this model provided a new way for the effective,objective and reliable evaluation of doctors' clinical knowledge and skills.

OBJECTIVE:To observe the clinical efficacy of Hepatocyte growth-promoting factors(PHGF) combined with Wuji baifeng pills for liver cirrhosis. METHODS:A total of 97 patients with liver cirrhosis were randomly assigned to either control group(n=32,conventional therapy) or treatment group(n=65,PHGF plus Wuji baifeng pills in addition to routine treatment).The course of treatment was 3 months for both groups. Clinical data including cardinal symptoms and signs,hepatic function,blood clotting function,hepatic fibrosis parameters,the inner-diameter of the portal vein and splenic vein(PVD,SVD),spleen thickness(SPT) measured by the color Doppler ultrasonography were monitored before and after treatment. RESULTS:After treatment,the symptoms and signs of the treatment group had better improvement than in the control group,with a markedly higher total effective rate than in the control group(84.62% vs.59.38%,P

AIM: To understand the relationship between pentanucleotide repeat(PNR) polymorphism of the apolipoprotein(a) gene and lipoprotein natures of normal Han population. METHODS: The serum levels of TG, TC, LDL-C,HDL-C, apo AI, apo B and Lp(a) were measured and the polymorphism of the apo(a) PNR was studied by using PCR-SSCP in 153 random normal individuals in Hubei Han population respectively. RESULTS: The relative frequencies of apo(a) PNR allele were significantly different from western population. The apo(a) gene which copy number of PNR is 5 was associated with high Lp(a) levels. No marked differences in the levels of TG, TC,LDL-C, HDL-C, apo AI and apo B were found among the various genotype groups of apo(a) PNR in Hubei Han. CONCLUSION: The data of lipids and PNR polymorphism of the apo(a) gene from healthy Hubei Han were obtained. The apo(a) allele with 5(TTTTA)-repeats may be related to high serum Lp(a) levels in the Hubei Han population.

Objective To investigate the effect of dexmedetomidine on postoperative renal function of patients with rheumatic heart disease following valvular heart surgery. Methods Fifty patients following valvular heart surgery were randomized into experimental group and control group,with 25 cases in each group. The patients in experimental group receiveddexmedetomidine 0.5 μg/kg infusion 15min before induction, and then 0.5 μg/(kg·h) infused to the end of surgery, while those in control group received the same amount of saline in the same way. Blood from central venous was collected before surgery, at the end of surgery, 24 h and 48 h after surgery in order to detect Src, BUN and Cys C and the length of ICU duration was also recorded. Results Src and Cys C of the patients in both groups obviously elevated 24h after surgery when compared with pre-operation , while BUN elevated at both 24 h and 48 h after surgery(P < 0.05). Compared with those in control group, Src, BUN and Cys C were lower in experimental group ( P < 0 . 05 ) , and the length of ICU duration was shorter (P < 0.05). Conclusion Dexmedetomidine could improve the postoperative renal function after valvular heart surgery and lead to a better prognosis.

Objective To investigate the changes of gastrin(GAS) and somatostatin(SS) in diabetic gastroparesis (DGP). Methods Totally 103 patients were divided into normal control group (n =17),simple gastroparesis(GP) group (n =30),simple diabetes mellitus(DM) group (n =23) and diabetes mellitus complicated with gastroparesis (DGP) group (n =33). Radioimmunity and RT-PCR were performed to detect the serum GAS and SS levels and the mRNA expression in the gastric mucosa tissue of 4 groups. Results There were significant differences in the serum levels and protein expression of GAS and SS between simple gastroparesis group,simple diabetes mellitus group, DGP group and the normal control group(P< 0.05). The differences between DGP group and normal control group was the most significant (P< 0.01), the differences between DGP group and the simple gastroparesis group or simple diabetes mellitus group were significant (P< 0.05). Contusion The increase of GAS and decrease of SS may play an important role in the occurrence and development of DGP.