Objectives To investigate the effect of tumor necrosis factor ? on skeletal muscle ischemia reperfusion injury (SMIR). Methods Twenty four healthy male Sprague Dawley rats were divided into three groups. Group A underwent anesthesia and external jugular vein cannulation only. Group B underwent 4 hours of left hind limb ischemia followed by 4 hour reperfusion. Group C ischemia and reperfusion were treated with anti TNF ? monoclonal antibody (2?mg/kg). ResultsSMIR significantly increased the transcription of TNF ? mRNA in monocyte. The increased TNF ? raised significantly the level of MDA(9 9?1 8 vs. 5 5?0 4)?CK(122?24 vs. 49?11)?NO(270?98 vs. 128?46) in plasma and MPO(skeletal muscle 4 27?0 53 vs. 1 28?0 19, lung 2 61? 0 12 vs. 0 57?0 02) in tissues respectively( P

Through developing resident standardization training,we established programs of resident standardization training,defined training aims,standardized training items,and established guarantee system,evaluation system,quality-monitoring system and encouragement system,which guaranteed the quality of residency training,and acquired satisfactory effects.

Through approaching the mixed ability training of clinical post-graduates, the following conclusions were drawn: necessity to take turns in the clinical specialties, establishment of its program, the details and contents were pointed out, meanwhile, it is necessary to guarantee progression of the plan and its training effects, and to improve the cultivation quality.

Objective To observe the ultrastructure and absorption function of colon mucosa in rat with ultra-short bowel syndrome. Methods Totally 30 SD rats were randomly divided into three groups: ultra-short bowel group (90%-95% of the intestine was surgically resected, n = 10), sham group (n = 10), and normal control group (n = 10). All animals were given with enteral nutrition. Scanning electron microscopy was performed 21 days later to observe the morphology of mucosal surface, and transmission electron microscopy was performed to observe the ultrastructural changes of intestinal epithelial cells. The absorption of colon to water, carbohydrates, and amino acid determined after 3 hours of closed perfusion of the colon with D-xylose solution and 15N-glycine on the continuous cycle of colon. Results As shown by the transmission electron microscopy, compared with the normal control group, rats in the ultra-short bowel group showed significantly decreased goblet cells on colonic mucosl surface, increased epithelial cells, longer and denser microvillus, increased area of membrane surface, increased number of cell-cell junctions, increased number of desmosome, tight junction, and gap junctions, higher development of endoplasmic reticulum and dictyosome, and increased number of mitochondria. As shown in the screening electron microscopy, compared with the normal rats, rats in the ultra-short bowl group had significantly deeper colon folds, thicker mucous membrane, increased number of bay openings, and longer and denser microvillus-like structures inside bays. The capability of water absorption was signicatnly higher in the ultra-short bowl group than in the sham group and normal control group (P = 0. 000) . The absorption rates of xylose and 15 N-glycine were also significantly higher in the ultra-short bowl group than in the control group (P ＜ 0. 01). Conclusions The absorption capability can be compensatively increased in rats with ultra-short bowel syndrome. Decreased apoptosis of colon mucosa cells, increased absorption cells, hyperplasia of microvilli, increased area of the membrane surface,and increased number of mitochondria may constitute its material and energy bases.

By using electron microscopy, the paranodal region and axo-glial junction were examined in optic nerves of rats aged 14 days. The paranodal region was characterized in longitudinal sections by the sequential termination of the myelin lamellae, beginning proximally with the innermost and ending, at the Ranvier node, with the outermost lamella. The termination of each lamella was accom- panied by a separation of the major dense line of the compact myelin and the consequent formation of a "loop" of glial cytoplasm. Each paranodal loop inde- nted the axonal surface as it became junctionally apposed to the axolemma. The periaxonal extracellular space, 10-20nm in width in the internodal region and reduced at the paranodal junction to approximately 3nm, forming an axo-glial junction, which was thought to be held together by dense structure. The parano- dal junction seems to serve strong adhesion between the apposed axonal and glial membranes. Conduction of the nerve impulses in myelinated axons was saltatory. Axons and sheath cells probably maintain vital communication with one another, presumably at the paranodal junctional complex. This communication was viewed as vital to the stability and maintenance of myelin. We found some clear vesi- cles in axoplasm near the Ranvier node and speculated that there were endocyto- sis and exocytosis in paranodal region. This was a direct morphological evidence supporting metabolic coupling between axons and sheeth cells.

Objective: To review the efficacy of nutrition support and operation in management of chylothorax.Methods: 6 patients underwent conservative way(fat-free enteral nutrition+PN+ somatostatin) and 3 patients then received the operation.Results: 3 patients were cured with only conservative way,but 3 others were cured under operation.Conclusion:The conservative way(fat-free enteral nutrition+PN+ somatostatin) is a effective method in patients with chylothoral,and the operation is needed in some patients.

Objective To overcome the disadvantages of the traditional auscultating method and design the electro-auscultating visual system integrating the monitoring and recording functions.Methods The portable system consisted of the module pre-gathering and electro-auscultating heart-sound signal,the circuit of A/D converting and MCU,as well as the device of signal LCD-displaying in real-time and the USB mass storage device.Results Portable electro-auscultating system was realized,which integrated the functions of watching,monitoring and recording.Conclusion The portable system is more convenient for clinical doctors to get correct information from patients,benefiting to the clinical pathology-statistics and profound development of the related data.

Objective To investigate the variation of lymphocyte subgroup,lymphocyte and C-reaction protein in patients with acute and chronic Brucellosis,for auxiliary reference in differential diagnosis of acute and chronic Brucellosis.Methods All the blood samples were come from clinical laboratory of Heilongjiang Agricultural Reclamation Bureau General Hospital,which including 35 acute patients(acute group),62 chronic patients(chronic group) and 30 healthy people(control group).Flow cytometric method was used to determine the T lymphocyte subgroup(CD3+,CD19+,CD3+/CD4+,CD3+/CD8+) and the lymphocyte.Application of rate scattering turbidimetric method was used for determination of C-reactive protein.Results Percentages of CD3+ cells in acute and chronic groups were increased compared with that of control group(％:74.71 ± 6.79,70.61 ± 8.99 vs.65.00 ±7.50; F =12.40,P ＜ 0.05),and the acute group was higher than the chronic group(P＜ 0.05).Percentages of CD19+,CD3+/CD4+ cells in acute and chronic groups were decreased compared with that of control group(CD19+,％:7.79 ± 3.93,9.94 ± 4.53 vs.11.50 ± 3.25; CD3+/CD4+,％:30.56 ± 6.38,35.56 ± 8.22 vs.39.00 ± 4.00; F=18.62,13.03,all P＜ 0.05),and the acute group was lower than the chronic group (P＜ 0.05).Percentage of CD3+/CD8+ cells in the acute group was higher than those of the chronic and control groups(％:4.06 ± 8.35,29.50 ± 7.25 vs.28.72 ± 8.30; F =12.06,P ＜ 0.05).The lymphocyte counts in acute and chronic groups were higher than that of the control group(％:34.29 ± 10.91,39.12 ± 12.08 vs.30.84 ± 6.45; F=13.78,P ＜ 0.05),but the acute group was lower than the chronic group(P ＜ 0.05).C-reactive protein levels in acute and chronic groups were increased compared with that of the control group(mg/L:27.43,15.87 vs.0.60; H =19.42,P ＜ 0.05),and the acute group was higher than the chronic group(P ＜ 0.05).C-reactive protein positive rates in acute and chronic groups were increased compared with that of the control group(65.7％,61.3％ vs.3.3％; x2=27.54,23.16,all P ＜ 0.01).The difference between groups was statistically significant(x2 =9.94,P ＜ 0.01).Conclusion Lymphocyte subgroup,lymphocyte and C-reactive protein are changed differently in patients with acute and chronic Brucellosis which have a certain reference value in differential diagnosis and treatment of acute and chronic Brucellosis.

Objective To observe and compare the different forces between doctors and nurses used visible laryngoscope endotracheal intubation applied to the oropharyngeal organization. Methods 10 nurses (to carry on laryngoscope intubation theory, and had certain study period practice) were chosen in group A and 10 clinical anaesthetize doctors (to be possible correctly used visible laryngoscopes) were chosen in group B, two groups used the visible laryngoscope on the same model person body inserted the tube, computer monitor software recorded results. Results The impulse force was (25.57±3.37) N·s and insert tube time was (25.3±3.3) s in group A which were higher than (16.47±2.99) N·s and (16.2±3.0) s in group B (t=2.550 and 2.207, P<0.05). The average forces in group A and group B were (0.87±0.62) N and (0.64±0.30) N, and peak forces were (3.05±0.95) N and (2.06±0.48) N, there was no remarkable difference between the two groups (P>0.05). Conclusions There is no statistics difference forces applied to the oropharyngeal organization between nurses and anaesthesiologists using visible laryngoscope intubation, and visible laryngoscope intubation technique is easy to learn and it is feasible by the nurse to master the technology and applied to anesthesia intubation care and emergency care.

Objective To investigate thyroid hormone nuclear receptor expression in peripheral blood mononuclear cells (PBMCs) and its relation with injury severity in patients with severe multiple trauma.Methods Twenty-eight patients with severe muhiple trauma and another 26 healthy subjects as control were enrolled in the study.At 2 days after injury,the levels of free triiodothyronine (FT3),free thyroxine (FT4) and thyroid-stimulating hormone (TSH) in peripheral venous blood were determined by using immunoradiometry,and the expressions of mRNA of the thyroid nuclear receptors (TRα and TRβ) in PBMCs were measured by using real-time RT-PCR.Results FT3 concentration in peripheral venous blood was significantly decreased in patients with severe multiple trauma versus healthy subjects.Concurrently,the expressions of TR mRNA (TRα and TRβ) were significantly decreased in PBMCs of patients with severe multiple trauma compared with healthy subjects (TRα mRNA:3.86 ±0.54 vs.5.24 ± 1.17,P ＜0.05;TRβ mRNA:9.86±2.27 vs.13.57 ±2.45,P ＜0.05).Pearson correlation analysis showed that FT3 concentration and the expression of TRβ mRNA correlated negatively with injury severity score (ISS) in patients with severe multiple trauma (r=-0.445,-0.496,P=0.018,0.007).Conclusions These data provide the evidence of a lowered activity of the thyroid signaling pathway in PBMC and a significantly negative correlation between FT3 concentration and the expression of TRβ mRNA in respect of injury severity in patients with severe multiple trauma.Additional investigations are needed to further determine the roles of the thyroid signaling pathway in adverse outcomes in the wake of severe multiple trauma.