Objective To observe the effect of interferon combined with kenacort in the treatment of scars. Methods According to random number table,287 patients with scars were randomly divided into treatment group and control group.The treatment group(145 cases) was treated with injection of the mixture of interferon and kenacort. The control group(142 cases) was applied with contratubex.The effect and adverse reaction of the two groups were compared.Results The total effective rate of the treatment group was 95.86%,which was higher than 64.08% of the control group,the difference was statistically significant(χ2 =45.52,P<0.01).The incidence rate of adverse reaction of the two groups had no statistically significant difference(χ2 =1.25,P>0.05).Conclusion These find-ings may shed some light on the clinical application of combined injection therapy on scar treatment,given that the closed dynamic method of injecting interferon combined with kenacort significantly improved scar healing.

Objective: To determine the expression of Fas ligand (FasL) in the patients with esophageal carcinoma and its clinic significance. Methods: The expression of FasL was measured by immunohistochemical technique in 30 patients with esophageal cancer. The numbers of tumor infiltrationg (TIL) were accounted by immunohistochemically stained CD45. Results: 76.6% of specimen expressed FasL. The difference of FasL expression was significant between each TNM stage. There was a negative correlation between the number of TIL and the expression of FasL. Conclusion: The expression of FasL in esophageal carcinoma may correlate with its invasion and metastasis.

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Clinical practice is an important step in medical education. However,its effect is now becoming worse and worse because of the influence of employment difficulties,post-grad-uate entrance exam and medical environment. It is hard to resolve these problems by simply education method. These problems are very common in management and can be found in prejob training,employee loyalty and quality management,respectively. It is a new approach to improve clinical practice education by enhancing teachers'management ability.

BACKGROUND: Bone marrow mesenchymal stem cells (BMSCs) as a genetic carrier are beneficial to keep a genetic stability of exogenous gene. BMSCs can transfer human vascular endothelial growth factor (hVEGF) gene into the myocardial infarcted area. It is possible to obtain a cooperation of gene and cell therapy. OBJECTIVE: To investigate the angiogenesis at myocardial infarcted area of rats undergoing the transplantation of BMSCs transfected with hVEGF gene and in vivo expression of VEGF gene. DESIGN, TIME AND SETTING: A randomized control experiment was performed at the Institute of Paediatrics of Hunan Children's Hospital and Central Laboratory of Xiangya Second Hospital of Central South University from 2004 to 2007. MATERIALS: Male clean inbred strain Wistar rats were selected in the study. Rat models of myocardial infarction were established by ligation of coronary artery. METHODS: BMSCs were harvested from rats by density gradient centrifugation and adherent culture. Plasmid PeDNA3. 1-hVEGF 165 were transfected at 80%-90% cell confluence. Rat models of myocardial infarction, constructed by ligation of the left anterior descending coronary artery, were randomly divided into 4 groups. 2 weeks after the ligation,BMSCs transfected with hVEGF gene were injected into rat models in the combination group at the myocardial infarction zone. BMSCs were injected into cell group. Liposome-pcDNA3.1-VEGF165 DNA compound was injected into gene group. Culture medium was injected into control group. MAIN OUTCOME MEASURES: Capillary density and VEGF gene expression in the myocardial infarcted area of rats in each group four weeks after injection. RESULTS: Capillary density was the highest at rat myocardial infarcted area in the combination and gene groups, followed by the cell group (P=0.001, 0.029) and the control group (P=0.028).Reverse transcriptase-polymerase chain reaction (RT-PCR) showed that the hVEGF165 gene was expressed in the combination, gene, cell and control groups from higher level to lower level in order. CONCLUSION: BMSCs as the vector of VEGF gene are beneficial to its stable expression.Transplantation of BMSCs transfected with hVEGF gene is helpful for angiogenesis at myocardial infarcted area of rats. Its outcome is better than gene or cell therapy alone.

Objective:To investigate the cardiovascular protection effect of cilazapril in hemodialystic patients|(HD). Methods:Thirty HD with hypertension and left ventricular hypertrophy patients were randomly divided into two groups.Group A(n=20) cilazapril 2.5 mg～5 mg,group B(n=10) as control. After six mouths,the left ventricular mass and function were monitored by color Doppler cardiography. Results:BP was decreased in both group.LVDd,IVS,LVPWD and LVMI were decreased in cilazapril group. Conclusion:Cilazapril is not only effective and safe in treatment of hypertension,reversed the ventricular hypertrophy and improved the diastolic function in HD patients also.

Objective To investigate the value of roentgen stereophotogrammetric analysis (RSA) in assessing early migration of femoral implant after total hip arthroplasty (THA) with modular prostheses.Methods From May 2009 to April 2010,37 patients underwent THA with modular prostheses inour hospital,including 25 males and 12 females,aged from 58 to 72 years (average,60.23±5.64 years).There were 32 cases of degenerative osteoarthritis,3 cases of femoral neck fracture and 2 cases of developmental dysplasia of the hip.The Harris hip score and RSA were used to assess the clinical results and the migration of femoral implant at 3,6,12,24 months postoperatively,respectively.Results The average Harris hip score improved from preoperative 26.36 ±10.56 to 78.24±12.72,84.51±16.05,86.72±9.34,and 87.55±8.97 at 3,6,12,and 24 months after operation,respectively,and the differences between pre-and post-operative Harris score were significant.There was no prosthetic revision,and slight thigh pain occurred in 3 patients.According to RSA,the degree of initial migration of femoral implant had large individual differences,and the initial migration was higher from 3 to 6 months after operation.Clinical and biological stabilization was achieved in 36 patients,while progressive migration was found in 1 patient.There was a positive correlation between the distal migration and posterior migration within 24 months after operation (r=0.3,P=0.01).The distal migration and posterior migration/rotation mainly occurred within 3 months after operation.There was no correlation between prosthetic size/offset and degree of migration of implant.Conclusion RSA provides an objective reference for assessing the migration of femoral implant after THA with modular prostheses,which is a reliable method to evaluate early implant stability.

Objective To study the feasibility and safety of limb remote ischemic preconditioning (RIPC) in infants and explore the protective effect on myecardium ischemia reperfusion injury for infants undergoing cardiac operation under cardiopulmonary bypass. Methods 60 infants weight less than 7 kilograms with ventricular septal defect were enrolled into the study. 30 of them (RIPC group) were ischemic preconditioned two times (24 hours and 1 hour preoperatively) by three cycles of iscbemia (5 minutes for each) and reperfusion on the left upper arm using a blood pressure cuff. Serum lactate dehydrogenase (LDH), creatine kinase (CK) and its isoenzyme (CK-MB), and tro-ponin I (TnI) ; malondialdehyde (MDA) and superoxide dismutase (SOD) was preoperatively detected. The expression of heat shock pro-tein 70 (HSP 70) in cardiomyocytes was determined by western blot analysis. The surgical outcome including limb movement and sensory function was also recorded. Results No limb disability or sensory disturbance or no other surgical complications was found in all infants. LDH, CK, TnI at the beginning of operation in RIPC group was higher than those in control group. After operation, leakage of heart enzymes were attenuated in RIPC group, and the serum concentration of enzymes were lower than those in the control group. The RIPC group had low coronary sinus venous concentration of MDA but high SOD. The expression of HSP70 was upregulated in cardiomyocytes of RIPC group. Conclusion The limb RIPC can be done easily and safety in infants, and BIPC can reduce the leakage of myocardial enzymes and upregu-late the expression of HSP, which possess protective effect on myocardial IRI.

Telephone follow-up is one of the important ways to follow up patients. High-quality follow-up can benefit both doctors and patients. However, clinical research-related follow-up is often faced with problems such as time-consuming, laborious and poor patient compliance. The authors belong to a team that has been committed to the study of patient-reported outcomes for a long time. The team has carried out long-term follow-up of symptoms, daily function and postoperative complications of more than 1 000 patients after lung cancer surgery, and accumulated certain experience. In this paper, the experience of telephone follow-up was summarized and discussed with relevant literatures from the aspects of clarifying the purpose of clinical research follow-up, understanding the needs of patients in follow-up, and using follow-up skills.