Objective To investigate the effect of extracorporeal shock wave (ESW) on physically or hormonally induced femoral head necrosis of rabbits, and to study the underlying mechanism. Methods Twenty two Japanese rabbits were randomly divided into two groups: group A and group B. Different methods were used for each group to establish the model of bilateral femoral head necrosis: freezing for group A and hormone injection for group B. The right hind limbs of all rabbits were used as the treatment side treated with ESW while the left hind limbs as control without any treatment. The rabbits were sacrificed at 2, 4, 8 weeks, respectively, after the treatment. X ray, pathological and electron microscope examinations were adopted to observe the changes of the femoral head. Results At the 8th week after ESW treatment, X ray imaging showed less severe cave in on the femoral head of the control side than that of the treatment side in both groups. The empty lacunae ratio, the number of the osteoblast and the blood vessels were significantly different between the treatment and the control sides, but not between the two groups. Conclusion ESW is an effective treatment for the physically and the hormonally induced femoral head necrosis. The mechanism may include recanalization of the blocked vessel and promotion of the osteoblast growth.

Objectives To study the clinical significance of the early diagnosis on colorectal cancer and the value of monitoring precancerous lesions of p53 gene examination. Methods Histological specimens of tumor from 110 patients with colorectal neoplasms were collected under the endoscopy, another 10 normal intestinal mucosa tissues with benign enteropathy as a control group. By PCR-SSCP methods, examined p53 exon 5～8 of mutation circumstance, made pathological section at the same time, and combine to track the observation. Results 24 patients p53 gene mutation were detected out in 78 cases colorectal cancers,counted up 32 4%, among 17 patients were moderate,low differentiation, 3 patients of them were mucinous adenocarcinoma.There are 6 patients p53 gene mutation in 36 cases colorectal adenoma,counted up 16 7%, among them an patient of Ⅱ～Ⅲ class atypical hyperplasia adenoma occurrence canceration in the next 10 months.There was no p53 gene mutation in normal intestinal mucosa tissue.Conclusions p53 gene examination combinated with pathological examination could monitor precancerous lesions and early diagnosis of the colorectal cancer.

Chimeric antigen receptor (Car) T cells, not only have the characteristics of strong specific recognition of tu-mor antigens, but also have destruction and high affinity advantages, thus receiving more attention. Although it has played a lot of advantages in anti-tumor, it still has some shortcomings, which needs to be further optimized to improve the safety of its clinical application. In this study, The cell structure and biological function, treatment process, application development and application risk of Car T cells are reviewed, which provide references for further clinical immunotherapy of Car T.

Objective To understand oral submucous fibrous (OSF) because the hair cause of disease and the quantitative corresponding measures,do a good job in OSF prevention and control work.Methods The quantitative cluster sampling,according to the diagnostic criteria of the development of the Pindborg,yuhu in Xiangtan city of different types of 57 units of 11 046 people to chew areca cause OSF epidemiological investigation.Results OSF 335 diagnosis example,the prevalence rate of 30.33‰,4 cases were oral cancer,oral cancer coexist rate was 11.94‰; All OSF patients had a history of betel nut,no chewing betel nut (containing the cigarette,wine,and spicy aficionados) were not found in patients with OSF; Of OSF prevalence in the chewing hobby was no differences in sex and age in the crowd; OSF prevalence of high and low with length of fixed number of year of average chewing betel nut dose and chewing betel nuts were closely related(r =0.28828,P ＜ 0.01) ; OSF prevalence was different from eating betel nut additive that had a very significant difference.Different hobbies compatibility with standardized test,7 incidence group had 6 group without significant difference,but people only eat chili can (in the control group,1 329) and outsiders no OSF patients (control group,698).Conclusions Survey results confirm that chewing betel nut is the main factor of Xiangtan people of OSF,and OSF carcinoma prevalence is lower than abroad.

Objective To evaluate the effects of celebrity role models on the teaching of rehabilitation medicine. Methods The teaching program of rehabilitation medicine based on the effect of celebrity role models was designed and given to the college students of Capital Medical University School of Rehabilitation Medicine. The students in grades 2014 (group A) and 2015 (group B) were taught by the same teachers with celebrity and general roles, respectively. The learning attitude, immediate test following the teaching and the final exam were carried out to determine the teaching effects. Results The incidence of using mobile phones was higher in group B than in group A (χ2=8.22, P<0.05), and there was no significant difference in the incidence of doze between 2 groups (χ2=2.59, P>0.05). Nobody left early in the class. The scores of the evaluated chapters and the total score in the immediate test were higher in group A than in group B (t>2.048, P<0.05). However, there was no significant difference about those in the final exam (t<1.591, P>0.05). Conclusion The teaching program of rehabili-tation medicine based on the effect of celebrity role models could improve the short-term teaching effect.

Objective To discuss the epidemiological situation of Streptococcus pyogens infection and drug sensitivity results in children in Meilong area in Shanghai,China,and provided scientific pathogen information for clinic infection control and treatment.Methods This was a retrospective study.The group A Streptococcus pyogens strains which were isolated from a total of 1 069 throat swab samples of pediatrics patients between May 2014 and April 2015,the strains were used the method of molecular biology for emm type and MLST and PFGE,part of the strains were used the Kirby-Bauer method for drug sensitivity test.To analyze the infection characteristics,epidemic tendency and drug sensitivity of GAS in different seasons and different age groups.Results A total of 274 S.pyogens strains were detected,the positive rate was 25.63％,the main types of emm were emm1(38.83％)and emm12(52.75％),the others were 8.42％.The main types of MLST were ST-28,ST-36,ST-49.emm types were closely related with MLST and PFGE clust.Among them,emm1/ST28,emm12/ST36,emm75/ST49 were related to each other,the same emm types were mostly the same cluster of PFGE.During this study,the patients were 3-13 years old,and the high infection age were 6-11 years old.The prevalent infection time were May 2014 and June 2014 and between Novemer 2014 to January 2015 and April 2015.The sensitivity rate of beta-lactamase drugs such as penicillin and ampicillin and levofloxacin,vancomycin and linezolid were 100％,the resistance rate of clindamycin and erythromycin and tetracycline were more than 95％.Conclusion The most popular genotype of GAS was emm12,the main age of infected patients were 6-11 years old,and the epidemic season were winter-spring and early summer in Meilong area,Shanghai,China,and beta-lactamase drugs were the first choice for GAS infection.

ObjectiveTo evaluate the effect of labor analgesia and the outcome of maternals and neonatals by applying the vitamin B6- folic acid mixture to combined with spinal-epidural analgesia(CSEA) in nulliparous women at latency.MethodsAll the 112 full-term nulliparous parturients were selected and divided into the treated group and controlled group.Nulliparous women in two groups received CSEA,with which the additional vitamin - folic acid mixture was used only in treatment group.The contrast between the analgesic effect in groups,and alalgesic effect-acting period,fentanyl Apgar score and newborn usage were compared between groups also.ResultsThe analgesic effect-acting period and fentanyl dosage in the treated group were significantly decreased.There was significant difference between the 2 ( P ＜ 0.05 ).ConclusionsIt could be effective applying vitamin B6- folic acid mixture at latency in nulliparous women based on CSEA,which could shorten the lumbar hemp effect-acting period and reduce fentanyl narcotic drugs dosage.

Discharge planning is the basis of continuous medical service. It could shorten the length of hospital stay, improve bed occu-pancy, reduce readmission rate, save medical costs, and improve the quality of life. It's considered to be important and supplemented by rele-vant policies and regulations to promote development in the United States, the United Kingdom, Canada, Australia and other developed countries. In China, even though Hong Kong and Taiwan have issued discharge planning policies, the mainland is still at the stage of explora-tion. Discharge planning in Chinese mainland has problems like restricted objectives, imperfect content, un-optimized process, unestablished professionals and organizations and so on. Standardized discharge planning guide still needs further research. As the health service system including hospitals, public health institutions and primary health institutions coverd urban and rural gradually, and the new pattern of grad-ing diagnosis and treatment established, it's necessary to analyze the necessity, importance, obstacles and measures of discharge planning in China.

With the social development and the transformation of medical model, providing patients with continuous services and seam-less transfer between different medical institutions, namely continuity care, is inevitable. Discharge planning take patients as the center and patient's needs as the guidance. Patients and their families should actively take part in the plan. Through multi-disciplinary and multi-institu-tional cooperation, patients can continue to enjoy health services after discharge. Discharge planning is the basis of continuous medical ser-vice. This article summrized the background and situation of discharge planning in the United States, Canada, Brazil, the United Kingdom, Ireland, Australia, Japan, India, South Africa, and Hong Kong, Taiwan and mainland in China. When heavy medical burden, aging, im-balence between supply and demand occurred, discharge planning could be helpful to make rational use of medical resources, save medical costs, guarantee the quality of medical service continuity, avoid the occurrence of adverse events after discharge and improve the patients' function and quality of life. This article reviewed group members, time, institutions and process of discharge planning in order to provide ev-idence-based basis for the development of discharge planning in China.

Objective To select an ideal Parkinson ’ s disease ( PD) animal model with metabolic abnormalities for subsequent experimental studies .Methods A total of 62 Sprague-Dawley male rats were randomly divided into four groups:damaged medial forebrain bundle ( MFB) model group, damaged medial forebrain bundle ( MFB) sham group, damaged Striatum model group and damaged Striatum sham group .After detecting the rotation experiment , successful model rats of two groups were selected to detect the changes of food intake , body weight , blood glucose and intra-abdominal adipose tissue.Results It was easier to produce a PD model by destroying MFB than striatum .Compared with sham-operated rats, MFB model rats showed significant abnormality both in reduction of body weight [(218.1 ±13.99) g vs (252.7 ±10.1)g, P<0.05] and high blood glucose appeared at 15min and 30min after introperitoneal glucose tolerance test ( IPGTT) .Their perirenal white adipose tissue was significantly reduced ( both left and right side ) .Striatum model rats only appeared decreased food intake [(13.95 ±0.25)g vs (20.23 ±0.86)g, P<0.001] and impaired glucose regulation at 15min, 30min and 60min after IPGTT.Their body weight and adipose tissue did not change significantly .Conclusion No matter in the success rate or metabolism-related indicators , MFB damaged rat model of PD is more suitable to study PD patients with abnormal lipid metabolism compared with Striatum rat model .