OBJECTIVEThis study aims to investigate the temporal pattern of expression of vascular endothelial growth factor (VEGF) and new bone formation during midpalatal suture expansion osteogenesis for rapid maxillary expansion.

METHODSA total of44 New Zealand white rabbits were randomly assigned to 11 groups, namely, five experimental groups, five control groups, and one control 0 group. A Haas appliance was used for the rapid expansion of the midpalatal suture; rapid expansion was set for 2 weeks and fixed for 4 weeks. The tissue of the maxillary midpalatal suture was harvested on the day of installing rapid expansion (control 0 group), on weeks 1 and 2 for rapid expansion, and on weeks 1, 2, and 4 for fixed (experimental group and control group, respectively). The immunohistochemical method was used to detect distribution and expression of VEGF, and new bone formation was observed with periodic acid-Schiff.

RESULTSHigher VEGF expressions are observed after midpalatal suture distraction osteogenesis. Positive staining for VEGF is mainly noted in the vascular endothelial cells, and the active osteoblasts are at the edge of a newborn trabecular bone. A weak VEGF expression is detected among cells in the control group. The VEGF expression of the experimental group is higher than that of the control group in rapid expansion weeks 1 and 2 and in fixed weeks 1 and 2. The expression of VEGF in the experimental group increases significantly and peaks at fixed week 1, and then gradually decreases. The amount of newly formed bone in the experimental groups is always higher than that in the control group; moreover, it increases significantly and peaks at fixed week 2, and then gradually decreases.

CONCLUSIONThe mechanical strain created by rapid maxillary expansion generates a sequence of VEGF cellular events that lead to increased vascularization and subsequent new bone formation.

This paper focused on the role conflicts owing to the multiple identity of roles and professional limi -tations in the dispute processing personnel , analyzed the probability in the medical processes and results , appeal of the patients and pattern of medical dispute processing , and made the conclusion that the medical dispute processing personnel is volunteers promoting social harmony and a practitioner of new medical model from the social perspec -tive and should carry forward the dedication , fraternity, mutual assistance and progressive spirit , the concept of the biological -psychology -social medical model to analyze the loss of patients in dispute and appeal , truly safe-guard the health rights and interests of patients , and give some advices to perfect the role ethics dispute processing .

OBJECTIVE To investigate the effective methods for nosocomial infection(NI) management and to adapt the new needs of quality-control in modern hospital.METHODS Under the circumstance to start using the ward building and reconstructing the outpatient building,by applying reasonable flow of work,making practicable rules and regulations,depending on new management mode of total cost-quality-effect and supervision-control-administration,to improve our NI management level in all directions in practice.RESULTS The reorganization towards NI management of all the staff had been boost,the rules and regulations of NI management had been carried out and NI had been controlled effectively.CONCLUSIONS Essential facilities are the matericl basis of NI management.Modernized management methods and process management are very meaningful to elevate the NI management level,and to ensure the quality of medical service.

Objective:To evaluate the linearity change of hard tissue of the juvenile of Class II division 1 with mandible functional retrusion by IMGA. Methods: The pre- and post- treatment cephalometric of 12 juvenile patients with IMGA were analyzed in Pancherz analysis to compare the dental position and the skeletal change. Results: After treatment, as far as OLp plane, the statistical changes were significance by pg/OLp,mi/OLp,ii/OLp, co/OLp +pg/OLp,is/OLp -ii/OLp,ms/OLp -mi/OLp,is/OLp-ss/OLp(P0.05), respectively. Conclusion: The IMGA is effective on the treatment of the juvenile patients of Class II division 1 with mandible retrusion of facial hypodivergency.

Objective To investigate some water soluble vitamin nutrition status of old people in Shangqiu and explore the improving ways. Methods A dietary survey was carried out and urinary VB1, VB2 and VC were test-ed. Results The intakes of VB1 ,VB2 and VC were much lower than the recommended amounts. Conclusion The intakes of VB1 ,VB2 and VC were seriously deficient in old people and preventive measures should be taken such as intaking fresh vegitable, fruits and coarse food grain.

Objective To introduce ramified anterolateral femoral flaps pedicled with different musculocutaneous branches used for primary repair of soft-tissue defects at different regions of extremities. Methods From January 2008 to April 2009, 15 patients, 10 males and 5 females, were treated with an-terolateral thigh flaps for their soft-tissue defects at limbs which involved 4 hands, 6 feet and 5 legs and an-kles. Different shapes of anterolateral thigh flap were designed according to clinical anatomy and particular conditions of blood vessels and musculocutaneous branches in different cases. The flaps were ramified into 2 independent free flaps to repair 2 independent defects. The maximum distance between 2 defects was 8 cm. The area of defect ranged from 3.0 cm×3.5 cm to 8.0 cm×11.5 cm, and the flap area from 5.0 cm×5.0 cm to 9.0 cm×15.0 cm. Results According to clinical anatomy, the presence of sarco-cutaneous branches was 100%. The source blood vessel of the flaps was quadriceps artery of femur. The 15 patients were followed up from 3 to 8 months. The tissue grafts all survived and the flaps primarily healed at the recipient site. Revisions were done 3 weeks to 3 months after the primary operation to thin down the clumsy skin flaps in 6 cases, The shape and texture of the flaps were satisfactory. Conclusion Ramified anterolateral femoral flaps pedicled with different musculocutaneous branches provide an ideal way of repairing severe and complex soft-tissue defects at extremities.

Objective To find the differences of bladder and urethra dysfunction between sacral spinal cord injury and Thoracolumbar spinal cord injury.Methods According to the criteria of inclusion and exclusion, we collected 30 patients in the study group.There were 22 males and 8 females, aged 17 -74 ( mean, 47 ) years, with duration between 7 - 36 ( mean, 18) months.There were nineteen cases of thoracolumbar spinal cord injury and 11 cases of sacral spinal cord injury in the study group.We conducted a retrospective analysis of the urodynamic data of the 30 patients in the group.They were divided into a sacral spinal cord injury group and a thoracolumbar spinal cord injury group according to the location of the site of injury.The urodynamic findings of the two groups were comparable.SPSS 16.0 was used to compare the differences between the groups by ANOVA/rank sum test.Results We measured the free flow rate parameters between thoracolumbar and sacral spinal cord injury groups.The maximum free flow rate was ( 13.0 ±5.1 ) vs ( 13.0 ±5.8) ml/s, the free flow rate at 2 s was (6.5 ±5.1 ) vs (6.9 ±6.4) ml/s, the mean free flow rate was (5.4± 2.4) vs ( 3.4 ± 0.5 ) ml/s, urine output volume was ( 279.1 ±131.1 ) vs (450.0 ± 26.6) ml and the residual urine volume was (209.5 ± 180.7 ) vs (434.0 ± 215.0) ml.The residual urine volume and urine output volume of sacral the spinal cord injury group was higher than the thoracic spinal cord injury group (P ＜ 0.05).We also measured the the cystometric parameters.The maximum urinary flow rate was (16.0±23.3) vs (7.1 ±3.3) ml/s, average flow rate was (4.6 ±2.3) vs (3.9 ± 2.3) ml/s, the flow rate after voiding 2 s was (4.6 ± 3.1 ) vs (2.2 ± 3.2) ml/s, urine output volume was (268.4 ± 113.9) vs ( 129.0 ± 97.9) ml, detrusor pressure of maximum flow rate was (58.8 ± 22.0) vs (56.5 ± 14.5) cm H2 O, flow rate of maximum detrusor pressure was (4.8 ± 2.0) vs (4.8 ± 4.4) ml/s,the maximum detrusor pressure was (68.0 ± 31.0) vs (54.6 ± 20.2) cm H2O and the average pressure of voiding period was (47.4 ±20.0) vs (42.6 ± 13.9) cm H2O.The urine output volume of the thoracolumbar spinal cord injury group was lower than sacral spinal cord injury group ( P ＜ 0.05 ).There were no significant differences in bladder sensation and coordination of bladder/urethra between the thoracolumbar spinal cord injury group and the sacral spinal cord injury group (P ＞ 0.05).The incidence of low compliance bladder in the thoracolumbar spinal cord injury patients (4/11) was higher than the sacral spinal injury group, the incidence of high compliance bladder in the sacral spinal cord injury patients (11/19) was higherthan the thoracolumbar group.Conclusions The urodynamics' difference between the sacral spinal cord injury group and thoracolumbar spinal cord injury group was observed in bladder compliance and bladder detrusor contractility changes.Relatively, the incidence of decreased detrusor contractility and high compliance bladder in sacral spinal cord injury patients was higher, and the cidence of detrusor hyperreflexia and low compliance bladder in thoracolumbar spinal cord injury patients was higher.

An ultra high performance liquid chromatography-photodiode array detection-tandem quadrupole mass spectrometry ( UPLC-PAD-MS/MS) method was developed for the determination of total 13 flavonols and flavonol glycosides in red onion which including 6 quercetin and its glycosides, 4 isorhamnetin and its glycosides, 3 Kaempferol and its glycosides. The chromatographic separation was carried out by used a UPLC HSS T3 column and eluted under gradient with mobile phases of acetonitrile and water both contained 0 . 1%formic acid at a flow rate of 0. 3 mL/min. The results showed that the major flavonols and flavonol glycosides in red onion were quercetin-4’-glucoside, quercetin-3, 4’-diglucoside, quercetin and Isorhamnetin-4’-glucoside. The amounts and distributions of flavonols and flavonol glycosides among different parts of red onion were different. For the same amount of dry materials, the content ratio of total flavonols and flavonol glycosides in the outer two layers, the third layer and the inner layer was 60. 3:33. 0:6. 7, the amount of quercitin and its glycosides accounts above 92. 1% of total flavonols and flavonol glycosides for each part. In the outer two layers, the amount of flavonol monoglycosides are the highest, in the third layer, the amount of flavonol aglycones were the highest, but in the inner layer, the amount of flavonol diglycosides were the highest. Small amounts of Kaempferol and its glycosides were found in red onion, and mostly were found in outer layers. This method is simple, fast, accurate and convenient, and can be used to analyze flavonols and flavonol glycosides in onion product.

Objective To investigate the application of stroke volume variation (SVV) in directing management of elderly septic shock patients. Methods Patients who were diagnosed with elderly septic shock and supported with mechanical ventilation were in?cluded (n=28). They were divided into control group (n=13) and SVV group (n=15). Volume recovery was directed by CVP (central ve?nous pressure ) in control group and by SVV and CO (cardiac output) in SVV guoup respectively. Blood lactate, oxidation index, CVP , MVP, NT-proBNP, time of recovery, the length relying on mechanical ventilation and Vigileo parameters were compared after volume resuscition. During the period of treatment, the incidence of acute left ventricle dysfunction within 24 hours, MODS within 28 days and mortality rates of all causes were compared between these two groups. Changes in SVV, cardiac output (CO) and systemic vascular re?sistance (SVR) in SVV group before and after resustation were recorded. Results Blood lactate acid and NT-proBNP were significant?ly lower in SVV group compared with those in control group whereas oxidation index in SVV group were significantly higher than that of control group. The time of resuscitation and the duration relying on mechanical ventilation were shorter in SVV group than those in control group. On the contrary, the incidence of acute left ventricle dysfunction,MODS and all mortality rates were not significantly different between these two groups. There were significant differences between hemodynamic variables such as SVV, CO in SVV group before and after resuscitation. Conclusion SVV may direct volume resuscitation more effective in elderly septic shock than CVP does.

Objective To analyze the relationship between bladder trabeculation degrees and the urodynamic findings in patients with benign prostatic hyperplasia (BPH). Methods A total of 358 patients with BPH were included.Based upon the urethrocystoscopy, the bladder trabeculation degree was divided into 4 grades:Grade 0-no bladder trabeculation;Grade 1-mild to moderate;Grade 2-severe;Grade 3-severe with formation of pseudo-diverticula.We analyzed the relationship between the bladder trabeculation found by fiber urethrocystoscopy and the urodynamic findings such as maximum flow rate (Qmax),P Qmax.Watte factor,compliance and residual urine volume.For statistical analysis AVOVA (analysis of variance) and Spearman correlation were used. Results In the 358 cases,the bladder trabeculation degrees were as follows:Grade 0,21 cases;Grade 1,228 cases;Grade 2,82 cases and Grade 3,27 cases.A significant correlation was found between bladder trabeculation and the urodynamic findings.As the degree of bladder trabeculation increased,Qmax decreased (Grades 0 to 3:11.50?1.13,10.28? 2.29,9.80?0.98,7.36?1.37 ml/s,respectively;F=22.43,P