To study the significance of the pathological changes of axon and myelin sheath in injured brainstem.The neurofilament and myelin basic protein was demonstrated immunohistochemically,and the pathological changes of axons and myelin sheathes in human brainstem following trauma were observed.In the injured brainstem,irregular swelling and disconnecting axons could be found as early as 0 5h after injury, while pathological changes in myelin sheaths such as tortuous change,partial peeling off from axon and intermittent disappearance could be observed at 19～22h after injury.However,in the normal brainstem,there were no evident changes in axons and myelin sheaths.Pathological changes of axon and myelin sheath in brainstem would occur after trauma,which could be used for postmortem diagnosis of brainstem injury.

Objective To strengthen the control of blood quality, ensure the safety of blood for clinical use and effectively contain the occurrence of transfusion transmitted disease. Methods Using the method of random sample survey, appraisal was made once again of the blood for clinical use in the blood stations of 14 cities(regions) of Hunan Province in 1997～2001, blood that had passed reexamination by relevant blood collecting and supplying institutions. The appraisal, conducted in the proportion of 10% of the yearly use of blood, focused on 5 indexes, including HBsAg, Anti HCV, Anti HIV, RPR, and ALT. Results 6 211 blood samples were checked, with the total positive rate being 7.89‰. Among theses, the positive rate of samples sent for testing was 7.78‰, the positive rate of samples collected and tested on the spot was 9.35‰, the positive rate of HBsAg was 2.59‰, the positive rate of Anti HCV was 3.86‰, the positive rate of Anti HIV after primary screening was 0.64‰(ascertained to be negative through Western Blot testing), the rate of ALT≥25 IU was 0.81‰, and the testing of syphilis was all negative. Conclusion Serious problems remain to be solved with regard to the safety of blood for clinical use.

Objective To compare the clinical efficacy of different surgical treatment on cholesteatoma otitis media and analy‐sis its differences .Methods Totally 100 cases of patients with cholesteatoma otitis media in hospital were divided into two groups , 50 cacse in each group ,the control group used open mastoidectomy for treatment ,the experimental group used complete bi‐style mastoidectomy ,and the postoperative clinical efficacy were observed .Results The experimental group patients after radical mas‐toidectomy complete bi‐style treatment ,air conduction hearing threshold (26 .89 ± 7 .23)dBHL and gas bone conduction (12 .54 ± 3 .78)dBHL were significantly lower than after open radical mastoidectomy treatment of patients in the control group (41 .38 ± 10 .56)dBHL and gas bone conduction (22 .57 ± 5 .96)dBHL(P<0 .05);after different surgical treatment ,the cholesteatoma otitis media total efficiency (92 .00% ) of experimental group was significantly higher than control group (64 .00% ) ( P< 0 .05 ) . Conclusion The complete bi‐style mastoidectomy is the treatment of cholesteatoma otitis media ,which can effectively repair dam‐aged eardrum ,restore patient hearing to the maximum extent ,help to restore patient′s disease and improve the quality of life of pa‐tients .

This article summarizes some methods in teaching physical chemistry,such as inspiring students’ interests and improving teacher’s teaching level. Then,how to enhance the teaching quality of physical chemistry is discussed.

Objective To study the effect of schistosomiasis transmission interruption model based on intensive agriculture in hilly endemic areas,so as to provide the reference for the similar endemic areas. Methods Based on the development of in-tensive agriculture in Guanghan City,a comprehensive demonstration area of schistosomiasis control with measures such as new rural construction,hardening ditches,the adjustment of industrial structure and water remediation measures was constructed. Ji-nhua,Shiguan and Hongyan villages were chosen as the evaluation sites to comparatively analyze the indexes of intensive agri-culture and schistosomiasis control effects. Results Compared with the demonstration area before construction,in 2014,the harden rates of ditches and village roads were increased by 49.57％and 39.33％respectively;and the proportion of agricultural machinery increased by 25％. The positive rate of serological tests of schistosomiasis was decreased by 81.74％. The Oncomela-nia hupensis snail area was decreased from 2.44 hm2(2007)to 0(2014). The awareness rate of schistosomiasis control knowl-edge and correct behavior rate of the residents were increased from 51.28％ and 90.85％ to 91.29％ and 97.69％ respectively. The experience of the demonstration area ensured the entire Guanghan District achieved the schistosomiasis transmission inter-ruption criterion at the end of 2014. Conclusions The schistosomiasis control model of intensive agriculture combined with oth-er comprehensive measures has a good effect on interrupting the endemic of schistosomiasis,and it can realize the sustainable development of the agricultural economy and schistosomiasis control.

The authors have made an investigation on the conditions of the internet access,the platform for network-aided teaching,the teaching resource and the teaching effect for physical chemistry among 127 pharmacy students of 2008 enrollment.Based on the results of the investigation,an analysis on the current situation and problems of network-aided teaching for this course was performed and recommendations were put forward accordingly.

The aim of this study was to clarify characteristics of cardiovascular malformation in patients associated with tetralogy of Fallot (TOF) by using dual-source computed tomography (DSCT) angiography. We retrospectively analyzed DSCT angiography of 99 consecutive patients with TOF. In addition to typical CT features of TOF in all patients, the DSCT angiography showed 27 cases (27.27%) of atrial septal defect, 14 cases (14.14%) of patents ductus arteriosus, 11 cases (11.11%) of bicuspid pulmonary valve, 18 cases (18.18%) of congenital coronary artery malformation, 22 cases (22.22%) of right aortic arch, 12 cases (12.12%) of persistent left superior vena cava, 8 cases (8.08%) of retro-aortic innominate vein and 9 cases (9.09%) of pulmonary venous anomalous. DSCT is capable of displaying anatomical characteristics of cardiovascular malformation in patients with TOF.
Angiography ; Heart Defects, Congenital ; diagnosis ; Humans ; Retrospective Studies ; Tetralogy of Fallot ; diagnosis ; Tomography, X-Ray Computed

Objective To explore the effectiveness of our self-designed 3D printing relay template in the treatment of malunion of irregular intra-articular ankle fractures.Methods From October 2013 to October 2015,our self-designed 3D printing relay template was used in 14 patients with severe malunion of intra-articular ankle fracture to assist their intra-articular osteotomy.They were 10 males and 4 females,with an average age of 40.5 years (from 34 to 59 years).Thin slice CT scan was preformed preoperatively for all the ankles involved.The computer fictitious tibial and fibular models for location and osteotomy navigation templates were acquired from the data of CT scan after processing,design and reconstruction by software.After the navigation templates which fit the size of solid ankle were printed by a 3D printer,they were sterilized and reserved.The guide plates were used in turn during operation.The irregular malunited bone blocks in the posterior malleolus were completely resected along the osteotomy template.After fracture reduction,the bone blocks were stabilized with internal fixation.Fracture union time was recorded.Scores of visual analogue scale (VAS),American Orthopaedic Foot and Ankle Society (AOFAS) and the short form-36 (SF-36),ankle ROM and complications were also recorded at the final follow-ups.Results The 14 patients obtained an average follow-up of 28.6 months (from 14 to 35 months).Bony union was achieved after an average of 3.7months (from 3 to 6 months).At the final follow-ups,on average,VAS score (2.2 ± O.8),AOFAS ankle and hindfoot score (81.1 ± 6.8),SF-36 score (82.5 ± 5.2),dorsal extension (27.5 ° ± 2.5°),and plantar flexion (24.2° ±6.3°) were significantly improved compared with the preoperative values (6.3 ± 1.8,43.1 ± 12.0,37.6 ± 9.9,14.1° ± 3.8° and 14.4° ± 3.9°,respectively) (P ＜ 0.05).No implant failure,soft tissue complications or post-traumatic arthritis occurred during the follow-up.Conclusion Since our self-designed 3D printing relay templates for osteotomy can accurately position the fracture lines of the distal tibia via limited incision and invasion,they help a lot in precise osteotomy and anatomical reduction of malunited intra-articular ankle fracture,preventing incidence of traumatic arthritis.

Aim To observe the effect of pyrimidine dithiocarbamate (PDTC) on the variance of disc morphology and the expressions of TNF-α, MMP-9 in the cervical disc in cervical dynamic equilibrium rat models, and to investigate the roles of PDTC in the process of intervertebral disc degeneration and the mechanism involved.Methods Fifty-four SD rats were divided into three groups randomly, then the dynamic equilibrium rat model was established by cutting the nuchal superficial and deep muscle of the rats.The dynamic equilibrium rats with PDTC solution intraperitoneal injection after operations were defined as PDTC group (group A), the models with saline intraperitoneal injection after operations as saline group (group B), the rats of fake operation with saline intraperitoneal injection as blank group (group C), and the animals were sacrificed in batches 10 weeks, 12 weeks, 16 weeks respectively after operation.The C5, C6 vertebrae and C5/6 discs were harvested, and the disc morphology was observed.TNF-α, MMP-9 mRNA expressions were detected by q-PCR and protein expression was observed by Western blot.Results Compared with the saline group, the morphology of disc in PDTC group was destructed slightly and fiber ring arranged orderly.TNF-α, MMP-9 gene and protein expressions had no obvious changes (P>0.05) in blank group (group C) at each time point.The expressions of IL-6, MMP-9 mRNA increased with time in group B, but the amount increased fast firstly, and slow lately, reaching peak in 12 weeks.The expression of TNF-α, MMP-9 protein became steady in group B from 10 weeks compared with other time points(P>0.05).TNF-α, MMP-9 genes and proteins expression decreased obviously in PDTC group (group A) compared with saline group (group B) (P<0.01) at each time point, but higher than blank group C(P<0.01) at each time point.Conclusions TNF-α and MMP-9 are important inflammatory factors involved in rat cervical disc degeneration, PDTC relieves the degeneration of rat cervical disc by reducing the expression of TNF-α and MMP-9 via disturbing the NF-κB signal pathway probably, and PDTC may become potential medicine for disc degeneration.

For the safety problems of internal medicine intravenous infusion,we carry out meticulous management,establish quality control system of intravenous infusion safety management,and formulate quality control plan.We collect and analyse the potential unsafety factors in the various departments of internal medicine.We have revised the intravenous infusion system and procedures,formulated standards for safety inspection of intravenous fluids,and standardized the admission system for nurses.We carry out training on intravenous infusion related knowledge for nursing staff,carry out meticulous management of venous transfusion links,and actively carry out learning and communication.All these measures have greatly enhanced the safety awareness of the nursing staff.The safety index of intravenous infusion for liver diseases was preliminarily summarized.The use rate of the safe indwelling needle was increased from 30.60％ to 92.30％,the rate of appropriate rate of drop speed increased from 68.45％ to 93.20％,the three sign standard rate rose from 75.20％ to 95.10％,and the patient's satisfaction with infusion increased from 85.60％ to 96.82％.Meticulous management can improve the safety of the internal medicine intravenous infusion as a whole.