This paper has introduced the application of multimedia technique binding interconnection network in surgery medical teaching.The level of teaching and administration in surgery medical teaching have been highly raised by making manufacture medical multimedia courseware,setting up the routes of Chinese-English languages information query and internal-international academic communication,building up the systems of surgery medical test,daily administration and learning in Web.

Objective To evaluate the safety and immunogenicity of Shigella flexneri 2a conjugate vaccine.Methods A random and double blind study were carried out to compare the safety sero conversion rates and geometric mean titer(GMT)increase of Shigella flexneri 2a conjugate vaccine with phosphate-buffered saline used as control.Results The results showed that no severe systemic and local reaction rates occurred in trial group,which were not statistically significant compared with the control group.The seroconversion rate of both two weeks and twelve weeks after two doses(increased by 4 folds) were 86.27% and 79.74%;for GMT were 1∶361.83 and 1∶326.21 and increased averagely 1.08 and 0.98 times,which showed significant difference with those of the control group.Conclusion Shigella flexneri 2a conjugate vaccine was safe and its immunogenicity was good in group over 2 years old.Trialregistration National food drugs surveillance administrative bureau,"Medicine Clinical Experiment Written directive from a superior"2003L03808 number.

Objective To investigate the effects and mechanisms of all-trans retinoic acid(ATRA)on the proliferation and cell cycle of lung carcinoma cell line A549.Methods The A549 cells were treated with ATRA at the dosages of 5,10,50 ?mol/L for 1-7 d.The proliferation of A549 was assessed by MTT method and cell cycle was analyzed by flow cytometry.The expressions of CDK4,Rb and p-ERK1/2 were assessed by Western blotting.CyclinD1 mRNA was analyzed by SYBR-PCR amplification.Results ATRA obviously inhibited the proliferation of A549 cells,and the cell cycle was arrested in G0/G1 phase.The expression of p-ERK1/2 protein and CyclinD1 mRNA on A549 cells were decreased.Conclusion ATRA might inhibit the proliferation of A549 cells through down-regulating p-ERK1/2 protein and CyclinD1 mRNA.

To investigate the expressions and changes of serum soluble intercellular adhesion molecule-1 (sICAM-1) in lung cancer patients before and after operation and the roles of sICAM-1 in differential diagnosis, metastatic potential, and prognosis. Methods From 2002 to 2003, a total of 17 samples of lung carcinoma tissues and sera were studied. The other 11 non-cancer patients were employed as the controls. Cell surface sICAM-1 levels were analyzed by immunohistochemistry method and ELISA. Results The serum sICAM-1 concentration in the cancer patients was (432.0?124.4) ng/ml. In the controls, however, the serum concentration of sICAM-1 was (262.3?77.7) ng/ml. In patients with lung cancer, the serum concentration of sICAM-1 was significantly higher than that of the controls (P0.05). Conclusion The serum sICAM-1 concentrations in lung cancer patients may play an important role in staging and may also serve as a useful indicator of advanced disease.

Objective To compare the curative effect of anti-relfux plastic stent and common plastic stent in treatment of malignant biliary obstruction.Method 22 cases of anti-reflux biliary plastic stent implantation and 30 cases of common bile duct stent implantation from March 2013 to April 2016 were selected as study subject, then compare the operation time, one-time success rate, postoperative pancreatitis, cholangitis, patency, differences in survival situation.Result There was no significant difference between the two groups in the aspects of the operation time, one-time success rate of recent cholangitis after surgery, postoperative pancreatitis (P > 0.05), but there was significant difference between the three aspects of long term patency, cholangitis, survival period (P < 0.05).Conclusion The anti-relfux biliary stent has good long-term curative effect in treatment of malignant biliary obstruction, which worth of further exploration and research.

Research on osteoporosis diagnosis has always been a critical isuue in the field of international academia and medicine. Recent progress in quantitative ultrasound (QUS) has suggested that ultrasound, due to its obvious advantages, be considered as an effective and noninvasive tool for assessment of bone status and diagnosis of osteoporosis. This paper presents the principle and recent development in the ultrasonic assessment of bone status and osteoporosis including assessment with through-transmission and backscattering measurement, and also introduces the latest progress in ultrasonic axial transmission technique.Limitations of current research are discussed and suggestions are proposed for future research.

This study was aimed to optimize the ethanol extraction technology ofXiao-Xu-Ming (XXM) decoction. The extraction rates of paeoniflorin, ferulic acid, tetrandrine and yield extract were used as comprehensive evaluation indexes. The amount of ethanol, extraction times, extraction time and concentration of ethanol were selected as factors. The orthogonal design was used to optimize ethanol reflux extraction technology of XXM decoction. The results showed that the optimum extraction conditions were as follows: refluxing extracted 3 times with 10 folds, 70% ethanol, 1.5 h for each time. It was concluded that the optimized extraction process was objective, practical, reasonable and stable, which provided experimental basis for industrial production of XXM decoction.

Objective To investigate the risk factors related to mortality in human avian influenza A (H7N9)cases in Hangzhou.Methods The clinical and epidemiological data of 61 H7N9 patients whose diagnoses were confirmed by laboratory tests between 1st March,2013 and 2nd March,2014 in Hangzhou were collected.Descriptive analysis and univariate analysis were used to analyze the demographic,clinical and epidemiological characteristics and treatment outcomes.Patients were classified into improvement group and death group according to treatment outcomes,and risk factors for death were explored.Chi square test and t test were used for statistical analysis.Results A total of 61 patients were included in this study,among which 20(32.8%)patients died.The ratio of men to women for death attributed to H7N9 infection was three to one.The mean age of patients in death group was (63.6 ±3.8)years,which was older than that in improvement group ([55 .4±2.2]years,t =1 .97,P =0.05 ).The univariate analysis showed that the risk factors of mortality included over 60 years (χ2 =5 .16,P =0.02;OR =3.65 ,95 %CI :1 .19-11 .13 ),low education level (χ2 = 5 .42,P =0.02;OR =4.20,95 %CI :1 .24 - 14.00 ), chronic diseases (χ2 =4.67,P =0.03;OR=3.81 ,95 %CI :1 .12-12.69),bad hand hygiene (χ2 =4.05 , P =0.04;OR=4.67,95 %CI :1 .04 -11 .56 ),C-reactive protein (CRP)≥120 mg/L (χ2 =4.04,P =0.04;OR=6.00,95 %CI :1 .04-35 .33),increased initial neutrophil count (χ2 =3.90,P =0.05 ;OR=4.58,95 %CI :1 .01 -34.22)and decreased initial lymphocyte count (χ2 =7.12,P =0.01 ;OR =7.53, 95 %CI :1 .63 - 24.51 ).Conclusion Over 60 years,low education level,chronic diseases,bad hand hygiene,CRP≥ 120 mg/L,increased initial neutrophil count and decreased initial lymphocyte count are identified as risk factors for death in H7N9 cases in Hangzhou.

Objective To develop and validate a mortality risk prediction model for patients infected with avian influenza A H 7N9 virus.Methods A stratified and random sampling method was adopted for selection of subjects .A total of 102 patients infected with avian influenza A H7N9 virus, who were admitted to the designated hospitals in Zhejiang Province during March 2013 and March 2015, were enrolled.Standard questionnaires were used to collect data about demographic , epidemiologic and clinical characteristics , and the data were retrospectively reviewed . Univariate analysis and stepwise logistic regression analysis were used to identify the mortality risk factors of patients infected with avian influenza A H7N9 virus, and nomogram was applied to develop the risk prediction model .The accuracy of the prediction model was assessed using Concordance index (C-index) and receiver operating characteristic (ROC) curve. Results Stepwise multiple logistic regression analysis showed that age ≥60 years (χ2 =3.98, OR=2.99, 95%CI:1.05-9.21, P<0.05), increased initial neutrophil count (χ2 =6.66,OR=5.06, 95%CI:1.56-18.83, P<0.05), C-reactive protein≥120mg/L (χ2 =8.63, OR=5.15, 95%CI:1.79-16.31, P<0. 01), poor hand hygiene (χ2 =6.83, OR =10.29, 95%CI:2.18-81.49, P <0.01) and 5 days of incubation period or shorter (χ2 =7.23, OR=4.75, 95%CI:1.59-15.80, P<0.01) were independent risk factors for mortality of patients .Based on the above study , a risk prediction model of nomogram was developed.Poor hand hygiene (grade A, 100.0 points) ranked on the top of all risk factors, followed by C-reactive protein≥120 mg/L (grade B, 76.5 points), increased initial neutrophil count (grade C, 70.5 points), 5 days of incubation period or shorter (grade D, 62.0 points) and age ≥60 years (grade E, 51.0 points).The C-index and the area under the curve were 0.833 and 0.817 for the nomogram model , respectively;and the nomogram model fitted well .Conclusion Nomogram model can effectively predict and estimate the risk of death for patients infected with avian influenza A H 7N9 virus.