Objective To explore the clinical value of video-assisted thoracoscopic mediastinal tumor resection.Methods The clinical data of 32 patients(observation group) who performed video-assisted thoracoscopic mediastinal tumor resection were retrospectively analyzed,compared them with 53 patients with mediastinal tumor who underwent traditional thoracotomy (control group).The clinical outcomes including operation time,intraoperative blood loss,chest drainage duration,postoperative hospital stay,postoperative complication and postoperative analgesia drug application were compared between two groups.Results No perioperative death was observed in two groups.There were no statistical difference in operation time between two groups [(121.9 ± 41.2) min vs.(141.7 ± 35.2) min] (P ＞ 0.05).The observation group was significantly better in the intraoperative blood loss [(116.0 ±53.2) ml],chest drainage duration [(5.2 ± 1.2) d],postoperative hospital stay [(8.5 ± 1.3) d],postoperative analgesia drug application [(0.8 ± 0.7) times],postoperative comolication (3 cases),than those of the control group [(147.2 ± 45.2) ml,(6.8 ± 2.2) d,(11.2 ± 2.4) d,(2.1 ± 0.9) times,15 cases].There were statistical differences between two groups (P ＜0.05).Conclusion Complete video-assisted thoracoscopic mediastinal tumor resection is a valuable way in the treatment of mediastinal tumor,rapidly recovery and less postoperative complication.

Objective To investigate the effects of autologous platelet-rich plasma in the treatment of refractory wound.Methods Fifteen cases with refactory wound ( 1 1 males and 4 females) involving six cases with diabetic ulcer,five with post-surgical ulcer wounds and four with pressure sore were enrolled into the study.The autologous platelet-rich gel was applied to the wounds after debridement and dressing change was done every week.The results of wound bacterial culture were regularly detected and the growth of granulation was observed.Skin graft or flap graft surgery was performed to close the wound when the wound condition was permitted.Results Of all,three patients had spontaneous healing after the change of dressing,four got healing after flap graft and eight attained healing after skin graft.There was no recurrence or sinus after treatment.Conclusion Autologous platelet-rich gel accelerates wound healing,improves wound condition,and raises success rate of surgical closure of the wound.

Objective:To investigate the change of petvic floor function in the third trimester of pregnancy and early postpartum.Methods :46 pregnant women in the third trimester in our hosprtal from July to October 2007 were randomly selected.In late pregnancy, 6 ～8 weeks and 12 ～14 weeks after delivery, the incidenca of stress urinary incontinence (SUI) and bladder neck mobility in different stage of puerperium was carried out.They were respectively given score, protectrve pad experiment, ultrasonic testing residual urine and peri-neum ultrasound examination.An anarysis on their.Results :The incidence of SUI that diagnosis by POP-Q or POP-Q combined with pat test was 47.83% ,39.13% respectively in late pregnancy group;21.74% ,15.22% in 6 ～8 weeks after delivery;17.24%.13.7g% in 12 ～14 weeks after delivery.The difference between late pregnancy group and 6～8 waeks after delivery group was statistical significance (P<0.05).There was no significantly difference between 6 ～8 weeks and 12 ～14 weeks after delivery groups(P>0.05).There was significant difference between 6 ～ 8 weeks and 12～14 weeks after delivery group while compared the bladder neck angle[(88.11± 13.36)° vs(82.17 ±10.28)°]with the bladder neck rotation angle[(21.67 ±10.64) ° vs (16.79±8.57) °].Conclusions :Pregnancy and delivery can damage the function of pelvic floor, which has certain rehabilitation after delivery.

Objective To discuss the relationship between pulse pressure and blood uric acid and the effect of simvastatin on pulse pressure and blood uric acid in aged primary hypertension (PH) patients with normal cholesterol.Methods Eighty-five patients with PH were divided into two groups randomly,routine group (using drugs only to lower blood pressure) and simvastatin group (simvastatin was added).Six months later,blood uric acid and pulse pressure was measured again.Results With the development of hypertension,there was statistical difference on pulse pressure and blood uric acid between hypertension grade 3 and grade 1 or grade 2 (P < 0.05).With the increase of pulse pressure,the trend of blood uric acid increase was distinct,and blood uric acid level was positively related with pulse pressure by correlation analyses(r = 0.87,P< 0.05).The pulse pressure and blood uric acid was decreased after treatment compared with that before treatment in simvastatin group (P < 0.05),but there was no significant difference before and dter treatment in routine group (P >0.05).There was significant difference after treatment between two groups (P< 0.05).Conclusions With the increasing of pulse pressure,there is a significant raise in blood uric acid.Blood uric acid is positively related with pulse pressure by correlation analyses.Simvastatin is a drug used to lower cholesterol,and it could also be used to reduce pulse pressure and blood uric acid in aged PH patients with normal cholesterol.

Objective To explore the effects of Xuan Yun Ning on the plasma endothelin in pafients with vertebrobasilar ischemia.Methods 60 cases of vertebrobasila ischemia were randomly recruited into a treatment group and a control group,with 30 cases in each group.The control group was treated with Nimodipin,and the treatment group was treated with Xuan Yun Ning plus Nimodipin.Another 30 healthy persons whose age is more than 40 years were recruited for a healthy control group without any treatment The alterations of plasma endothelin were measured by radiation immunological test in the treatment group,the control group,and the healthy control group.Results The elevated plasma endothelin was significantly decreased in treatment group than the control group and the healthy control group(P＜0.05).Conclusion Xuan Yun Ning improves the blood volume by lowering the level of plasma endothelin and thus treats patients with vertebrobasilar ischemia.

Objective To study the clinical significance of cardiac enzymes of acute cerebral infarction(CI). Method The cardiac enzymes were determined in 92 patients with CI within 48 hours. The cardiac enzymes of CI group and control group,consciousness disturbance group and consciousness group were compared. Results The cardiac enzymes of CI were evaluated than the control group (P

Thirty New Zealand albino rabbits of both sexes were used for the experi-ments which was (1) To observe the febrile response induced by microinjection of TNFinto the lateral ventricle; (2) To measure the PGE_2 & cAMP contents of the plasma andcerebrospinal fluid. The results showed that injection of TNF (50ng/each) into the lateralventricle did induce a definite raise of body temperature (T=0.79?0.14℃). The PGE_2concentration increased markedly in c. s. f. while that in plasma remain unchanged ascompared with the control. However cAMP lever in both, plasma and c. s. f. had nochange. These results suggested that (1) The injection of TNF into the lateral ventriclecaused a raise in PGE_2 synthesis in the brain while there was no alterations of PGE_2found in peripheral blood (2) The increase in PGE_2 didn't followed by an increase incAMP which indicated that the fever induced by TNF must have a different mechanismfrom that induced by leucocyte pyrogent (LP or In-1). PGE_2 might be involved in thefever inducing mechanism but these results don't support the hypothersis that the raiseof PGE_2 level may increase the cAMP content which in turn reduced the fever.

Osteochondral lesions of the talus are rare.The factors leading to them include trauma,chronic fatigue,family history,and idiopathic necrosis.The patients present with ankle pain,swelling,bruise,limited mobility and limp at an early stage while joint stiffness and walking and moving pain at a late stage.Normal check is likely to overlook them,resulting in delayed diagnosis and treatment.If an osteochondral lesion of the talus is suspected with negative X-ray manifestations,further radionuclide bone scan or MRI is indicated for definite diagnosis.As there is no blood supply to the talar cartilage which is relatively too small,it is difficult to treat osteochondral lesions of the talus.Early mild lesions can be treated by conservative therapy.If conservative treatment fails or the lesions deteriorate,surgery is required.This paper reviews the research progress in the treatment of osteochondral lesions of the talus.

Hypoxia-inducible factor-1 (HIF-1) is a key transciptional regulator of cellular and systemic oxygen homeostasis,composed of the two subunits,HIF-1α and HIF-1β.HIF-1α is an inducible subunit regulated by hypoxia,which is posttranslationally modified by various ways,including ubiquitination,phosphorylation,hydroxylation,acetylation and glycation,accordingly affecting its protein's stability,nuclear translocation and regulation of its target genes.Small ubiquitin-related modifier (SUMO) is an micromolecule protein participating in posttranslational modifications of proteins dynamicly in eukaryotic organism,which is similar in structure to ubiquitin.SUMOylation and deSUMOylation are involved in multiple regulations of biologic processes,such as signal transduction,transcriptional regulation,cell cycle processes and biological rhythm.SUMOylation is related to HIF-1α stability and transcription activity in hypoxia,providing a newthread to study self-regulation mechanism of HIF-1α for us.

Nationally and internationally,there is an growing emphasis on formative assessment for medical education.Teachers are enabled to apply the reflective teaching methods in their classes through careful theoretical trainings and practical guidance.By the application,shortcomings of students are found effectively,so that teachers can adjust their teaching plans and reach a higher teaching quality.