Objective To quantitate platelet GPIIb/IIIa occupancy and to evaluate the performance of the method, and investigate GPIIb/IIIa occupancy for the patients with leukemia.Methods GPIIb/IIIa occupancy was quantified by flow cytometry (FCM) and the method was evaluated according to guidelines published by NCCLS and ICSH; meanwhile,GPIIb/IIIa occupancy for 13 healthy donors and 16 patients with acute leukemia was investigated.Results The results demonstrated coefficients of variation (CV) for within-batch, between-batch and overall imprecision were

BACKGROUND:There is often space between implant and bone during immediate implantation.Whether biological membrane is needed to guide bone regeneration remains poorly understood.OBJECTIVE:To createdifferent sizes of space between femurand implantsindogs and to observe the effects of biological membrane on bone regeneration capacity of bone defects surrounding implants.DESIGN,TIME AND SETTING:A self-control animal experiment was performed at the Laboratory Animal Center,Norman Bethune College of Medicine,Jilin University and School of Stomatology,Jilin University between March and December 2005.MATERIALS:BLB hydroxyapatite-coated implant was provided by Beijing Leiden Biomaterial Co.,Ltd.,China;BME-10X collagen membrane was purchased from Fujian Better Biotechnology Co..Ltd.,China.METHODS:BLB implants were installed in the bilateral proximal femoral bone to create standard gradient bone defects with horizontal width 3 mm.vertical depth 5 mm,and horizontal lengths of 0,1,2,3,and 4 mm Bone defects on the left femur were sutured directly and those on the right femur were covered with biological membrane prior to suture.All animals were sacrificed at 3 months after surgery.Specimens containing implants were harvested to prepare tissue blocks for radiological observation.MAIN OUTCOME MEASURES:The quantity,color,and texture of newly formed bone surrounding implants were observed from the surface and profile levels.The implant-bone integration and new bone formation were also examined by soft X-ray photography.RESULTS:Grossobservation results revealed that when the horizontal length of bone defect was 3 mm or less,there was no significant differenee in bone density between the newly formed bone and the host bone no matter whether biological membrane existed or not;when the horizontal length of bone defect was 4 mm the bone density was better when biological membranes were used than not.Soft X-ray photography results revealed that when the horizontal length ofbone defect was 3 mm or less.no significant difference in bone density and bone trabecular morphology and orientating was found between newly formed bone and host bone no matter whether biological membrane was used or not;in the 4-mm-length bone defect areas.implants contacted with newly formed bone directly,but the calcified degree ofnewly formed bone was poor,bone trabecula was thin,and bone trabecular course was irregular,nevertheless,the calcified degree of newly formed bone was better under the condition of being with biological membrane than without biological membrane.CONCLUSION:Biological membrane exhibits strong capacity to promote the regeneration and repair of bone defect tissue with a horizontal length of 3 mm or less,and plays an important role in repatr of large sizes of bone detect

Objective To discuss the application effect of LVIS stent-assisted coil embolization in intracranial wide-neck small aneurysms.Methods The clinical data of 32 patients with intracranial wide-neck small aneurysms treated with stent-assisted coil embolization were analyzed retrospectively and evaluated.Results In 32 cases,the embolization grade was Raymond Ⅰ in 23 cases,Raymond grade Ⅱ in 7 cases,and Raymond Ⅲ in 2 cases.The successful embolization rate was 93.8%.No aneurysm was ruptured during embolization.One patient had thrombotic event in the surgery,but the occluded artery was recanalized after the treatment of immediate thrombolysis.Disorder of contralateral limb's activity and confusion were appeared in two patients after surgery.The symptoms improved by giving clopidogrel,aspirin and increasing the dosage of nimodipine.All the survival patients recovered well after 6 months of follow-up.No recurrence of aneurysm was confirmed by DSA and parent artery was patent.Conclusion Lvis stent is simple to be operated and has various models,suitable for most intracranial aneurysms,showing good performance.It suits embolization therapy in intracranial wide-neck small aneurysms,but the strong thrombosis should be valued.

ObjectiveTo explore the role of autofluorescence bronchoscopy in lung cancer operation and the meaning of choice lung cancer operation mode.MethodsTo retrospectively analyze 32 non-small cell lung cancer patients.Before lung cancer operation,white light bronchoscopy (WLB) and autofluorescence bronchoscopy (AFB) had been done routinely.Compared the different invasive tumor conditions by WLB and AFB,operation modes were decided by the edge of the tumor which were proved by biopsy pathology.ResultsIn 32 cases,19 cases underwent pulmonary lobectomy.One case underwent carinal resection and reconstruction.8 cases underwent sleeve lobectomy.4 cases underwent other therapy because of tumor airway metastasis.In 8 cases which underwent sleeve lobectomy,3 ca ses were found by WLB and AFB together,5 cases were found only by AFB.In 4 cases who had no operation chance,2 cases were found by WLB and AFB together,2 cases were only by AFB.The sensitivity for the detection of bronchial premalignant lesions was extremelyhigher withthe addition of AFB than WLBalone ( P ＜ 0.05 ).ConclusionAutofluorescence bronchoscopy is a safe and efficient technique which could improve the sensitivity of diagnosis in lung cancer than WLB.It is important to select operation mode.

Objective To discuss the application of early time window modified stereotaxic aspiration in converting operation therapy on the specified acute epidural hematoma.Methods 21 patients with the specified acute epidural hematoma were treated with early time window modified stereotaxic aspiration drainage,using YL-1 hematoma puncture needle with silica gel ventricular drainage tube.Results The successful rate of puncture was 100％.Hematoma was completely cleared in 19 cases.A small amount of epidural effusion was remained in 2 cases.1 case had concomitant rebleeding during the puncture,and shifted to craniotomy.Conclusion Early time window modified stereotaxic aspiration drainage is a minimally invasive,safe and effective treatment on the specified acute epidural hematoma when mastering the indications,timing and skills of puncture.

Objective To strengthen the ability of clinical thinking and the ability to solve practical clinical problems for medical students.Methods Medical undergraduates studying in affiliated hospitals of Tongji university from 2005 to 2010 were enrolled The clinical thinking training and assessment in clinical teaching were enhanced by introducing problem-based learning,case-based learning and by strengthening the role of interns in clinical work and emphasizing clinical thinking ability assessment during various kinds of clinical skills examinations.Meanwhile,the teaching management and supervision were improved.The awareness and ability of clinical teachers to train students′ clinical thinking were aroused and cultivated through teaching staff training so as to ensure that clinical thinking training and assessment were involved in the whole process of clinical teaching.Results The students' abilities of self-study,scientific thinking and oral expression were improved.The passing rates of our graduates in national general medical practitioner test were increasing yearly from 2006 to 2008.Conclusion Strengthening clinical thinking ability training during clinical teaching plays an active role in improving clinical skills in medical students.

BACKGROUND: Digit amputation coupled with neighboring composite skin loss frequently occurs. Conventional treatment for this lesion is somewhat less desirable in that it either results in shortened or lost fingers as well as delayed skin resurfacing. Therefore, the curative effect is not satisfactory.OBJECTIVE: To observe free forearm venous flap for soft-tissue reconstruction in digit amputation accompanied with neighboring soft tissue loss and postoperative rehabilitation and its effect on functional recovery.DESIGN: Before-and-after controlled observational trial based on the patients.SETTING: Department of orthopedics of a university hospital.PARTICIPANTS: Totally 11 patients, 8 males and 3 females aged 20 to 45years, who were treated between October 2000 and May 2004 in the Department of Orthopedics, Third Affiliated Hospital of Sun Yat-sen University,for digit amputations accompanied with composite skin flaps avulsed in dorsal fingers or hand, were recruited.METHODS: Eleven free venous flaps measuring 1. 5 cm × 1.0 cm to 5 cm × 6. 5 cm from anteromedial ipsilateral forearms were elevated and transferred to the defected sites either antegradely or retrogradely with respect to the nature of the defects. Microvascular anastomosis was performed at both ends of the flaps to the wounds in an end-to-end fashion. Digit replantations in 13 digits were performed simultaneously at one stage. The donor sites were closed primarily by direct suturing or skin grafting. After operation, early rehabilitation was initiated under professional guidance.RESULTS: Complete healing was achieved in 9 out of 11 venous flaps and 12 out of 13 replanted digits. After one-year follow-up, finger motion function in seven cases was satisfactory; however, all the flaps presented diminished sensation.CONCLUSION: The free venous flap from anteromedial forearm is an alternative flap for soft-tissue reconstruction in digit amputation. Easy access,ideal thickness, and good pliability are the advantages of the flap whereas limited sensory recovery is the main shortcoming.

Objective To investigate the diagnostic value of transbronchial needle aspiration (TBNA) and transbronchial biopsy(TBB) in central lung cancer.Methods Retrospectively analyzed the diagnostic data of 150 patients with central lung cancer who underwent TBNA followed by TBB in our hospital from January 2011 to October 2012.Results Among 150 patients with central lung cancer,33 cases had intracavity mass.Thirtythree cases (100％) were confirmed by TBB and 32 cases (97.0％) confirmed by TBNA.There was no statistically significant difference between the diagnosis of TBB and TBNA(P =0.90).There were 26 cases with simple stenosis,among which 1 case(3.9％) confirmed by TBB and 26 cases(100％) confirmed by TBNA.And there was statistically significant difference was observed between the diagnosis by TBB and TBNA (P =0.01) Sixteen cases belonged to the lumen external pressure type with 2 cases(12.5％) were confirmed by TBB and 16 cases(100％) confirmed by TBNA.And there was statistically significant difference was observed between the diagnosis by TBB and TBNA (P =0.02).Forty-seven cases had luminal stenosis combined with mucosal diffuse lesions with 25 cases(53.2％) confirmed by TBB and 40 cases(85.1％) confirmed by TBNA.And there was statistical difference was observed between the diagnosis of TBB and TBNA(P =0.04).Twenty-eight cases had mixed type central lung cancer with 27 cases(96.4％) confirmed by TBB and 28 cases(100％) confirmed by TBNA.No statistically significant difference was observed between the diagnosis of TBB and TBNA (P =0.87).Conclusion According to endoscopic performance of central lung cancer,accurate and reasonable choice of biopsy method can minimize inspection costs on the basis of maintaining positive rate of diagnosis in order to achieve optimal titer.

Objective To detect the level of plasma microRNA-1 (miR-1) in acute myocardial infarction (AMI) and compare the diagnostic values of it with that of cardiac troponin T (cTnT).Methods During 2011-05 to 2012-05,there were fifty-six plasma samples taken from patients with AMI and twenty-eight plasma specimens got from non-AMI controls were analyzed.The expression of plasma miR-1 was measured by quantitative reverse transcription-polymerase chain reaction (qRT-PCR),and the level of plasma cTnT was measured by using electrochemiluminescence-based methods on the Elecsys 2010 Immunoassay Analyzer.Then,the SPSS 16.0 was used for the statistical analysis.Data were presented as means ± standard deviation unless otherwise described.The differences about clinical characteristics between AMI patients and controls were tested using Student' s t-test or Fisher' s exact test.The Mann-Whitney test was conducted to compare the expression of microRNAs between the AMI patients and controls.The comparison of microRNAs expression between different intervals of AMI patients was done using Wilcoxon signed rank test.The receiver operating characteristic (ROC) curve was established to discriminate AMI patients from controls.Results The expression of plasma miR-1 was significantly increased in AMI patients (P ＜ 0.01) compared with healthy controls.The contents of the plasma miR-1 in AMI patients fell down nearly to the normal level at 14 days (P ＞ 0.05).There was no relevance between the expression of plasma miR-1 and the clinical characteristics of the study population (P ＞ 0.05).Moreover,ROC curve analyses demonstrated that miR-1 had the specificity and sensitivity for the diagnosis of early AMI,but was not superior to cTnT.Conclusions Our results showed that plasma miR-1 had the capacity in early diagnosis of early AMI,and can be biomarker for AMI,however,miR-1 is not superior to cTnT for the diagnosis of AMI.

Objective To explore labeling efficiency and appropriate conditions of Superpara magnetic iron exide nanopaticles (SPIO) nanoparticles for Bone marrow stromal cells(BMSCs). Methods BMSCs were aquired from skeletally mature dogs via iliac crest aspiration and separated by adherent cell cytopheresis.BMSCs were cultured and incubated with SPIO at different concentrations in vitro. The labeling efficiency of BMSCs with different labeling concentrations SPIO nanoparticles as well as detection of characteristics and signal attenuation rules were evaluated by MRI at 1.5T in vitro. Results BMSCs were efficiently labeled by SPIOin vitro and has no alterations to viability and proliferation profiles at this labeling concentration. BMSCs loaded with SPIO can be detected by MRI at certainly cell quantity in vitro(5 × 104). The quantity of SPIO in cells gradually reduced as cell culture time prolonged, with no statistically significant changes in cell death(P＞ 0.05). Conclusion The results demonstrated the potential application of SPIO as a wonderful cell tracer in vitro.