As the structure of shoulder joint is complex, proper method s should be adopted to treat the injured shoulder joint according to the type an d position of the trauma. Conservative treatment has been widely used to treat t he slightly displaced or stable fractures (including those of the proximal humer us, clavicle and shoulder blade), and most of the fresh dislocations of shoulder joint and acromioclavicular joint if the injuries are not serious. As for the o bvious unstable shoulder fractures, recurrent dislocation of shoulder joint, sev ere dislocation of acromioclavicular joint, dislocation of shoulder joint accomp anied with fracture, and rotator cuff tear, an operation should usually be the r ight choice. In either conservative or operative treatment, earlier systematic f unctional rehabilitation should be widely used in order to achieve satisfactory functional recovery of should joint.

OBJECTIVE:To explore the effects of olmesartan medoxomil on blood pressure variability(BPV)and vascular en-dothelial function of patients with mild and moderate essential hypertension. METHODS:Sixty patients with mild and moderate es-sential hypertension were included in study group,and other 60 healthy volunteers were included in control group. Study group was given olmesartan medoxomil 20 mg orally,qd,for 4 weeks,followed by same dose if their SBP≤140 mmHg and DBP<90 mmHg till 12th weekend;those patients with SBP>140 mmHg or DBP≥90 mmHg received double dose till 12th weekend. Aver-age blood pressure,BPV,FMD and NMD of study group were measured before and after treatment as well as the changes in se-rum concentrations of NO and ET,and then compared with control group. RESULTS:Compared with before treatment,average blood pressure,BPV and ET level of study groups were decreased significantly after treatment,serum level of NO was increased significantly,while FMD and NMD were improved significantly,with statistical significance (P<0.05);there was no statistical significance,compared with control group (P>0.05). There were 3 cases of mild diarrhea and 2 cases of mild dry cough,and they relieved after medication withont speical treatment. CONCLUSIONS:Olmesartan medoxomil can play a good effect on de-creasing blood pressure and is tolerable. It can also improve the vascular endothelial function.

Objective: To build a relationship model of perceived academic self-efficacy, learning stress, and learning burnout of high school students. Methods: 674 high school students were surveyed with Learning Stress Scale of High School Students, The Perceived Academic Self -efficacy Scale, Scale of Learning Burnout of High School Students. Results: Learning stress had a direct effect on a low level of learning efficacy, perceived alienation to teacher and physical exhaustion (The direct effect value were -0.22,0.12,0.27). At the same time, perceived basic ability and perceived control partially mediated the impact of learning stress on the low level of learning efficacy, perceived alienation to teacher and physical exhaustion (the mediated effect value were -0.155 and-0.264, 0.066 and 0.299, 0.089 and 0.233). Perceived basic ability and perceived control fully mediated the relationship between learning stress and emotional exhaustion (the mediated effect value were 0.033 and 0.387). Conclusion: The students with a higher level of stress reported suffering more learning burnout than those with a lower level of stress, and vice versa.

Objective To study the effects of glucosamine sulfate on nitric oxide(NO)production induced by interleukin(IL)-1β in human osteoarthritis chondrocytes(HOC),and explore the possible mechanism.Methods Chondrocytes were harvested from 10 osteoarthritis patients undergoing total knee replacement(TKR)operation.Human recombinant IL-1β(5 μg/L)and glucosamine sulfate GS in different concentrations(0.2 mmol/L,2.0 mmol/L,20.0 mmol/L)were administrated into cell culture medium for 24 h.The content of NO was detected by enzyme-linked immunosorbent assay(ELISA).The mRNA and protein expression of inductive nitric oxide synthetase(iNOS)were measured by RT-PCR and Western blot,respectively.Results Stimulation of HOC with IL-1β enhanced production of NO and expressions of iNOS mRNA and protein(t=-14.81,-45.38,all P＜0.01).Pretreatment with 2.0 and 20.0 mmol/L GS showed a dose-dependent inhibition of IL-1β induced NO production(F=12.43,P＜0.05)and the expression levels ofiNOSmRNA(F=142.28,P＜0.05)and protein(F=78.08,P＜0.01).20.0 mmol/L GS alone did not influence NO production(t =-0.17,P＞ 0.05).Conclusions GS may inhibit the synthesis of NO induced by IL-1β in HOC through down-regulate mRNA and protein expressions of iNOS.

Objective To evaluate the result of open rotator cuff repair and to identify potential preoperative or intraoperative factors that could affect the outcome.Methods 43 cases(44 shoulders)with rotator cuff tear who undergone open repair surgery between May 1987 and October 2002 were retrospectively studied.There were 31 shoulders ruptured in supraspinatus, 9 shoulders in supraspinatus and infraspinatus,3 shoulders in supraspinatus and subscapulafis and 1 in supraspinatus, infraspinatus and subscapularis.And there were 13 shoulders torn with small size, 18 shoulders with middle size, 10 shoulders with large size and 3 shoulders with massive size.Ruptured rotator cuff was repaired with tendon to bone suture in 25 shoulders,with tendon to tendon suture in 7 shoulders, and combined suture in 11 shoulders.One shoulder was repaired by deltoid transfer.After an average 88.2-month-long follow-up(from 52 to 250 months),we evaluate the postoperative shoulder function with University of California at Los Angeles(UCLA)score.The patient's subject satisfaction was assayed by visual analogue scale (VAS).The risk factors as age, sex,dominant side, trauma history,preoperative duration and tear size were analyzed.Results The average UCLA score was 11.5±2.8 preoperatively and 29.7±5.3 at follow-up, with 36 shoulders reaching excellent or good and 2 shoulders ranking poor.According to VAS,the subject satisfaction rate was as high as 89%,being positively related to UCLA score significantly(r=0.72,P＜0.01).Preoperative duration(r=-0.332,P=0.028)and tear size(r=-0.404,P=-0.007)was negatively relative with surgical results.Age,sex,dominant side,trauma history had no effect on prognosis.Conclusion Open rotator cuff repair could acquire satisfying outcome.Preoperative duration and tear size was negatively relative with surgical results.

Homeobox gene Six1,as a transcription factor has been proved to participate in most malignant tumors.Its overexpression is associated with the genesis and development of breast cancer intimately.Overexpression of Six1 in mammary cells is sufficient to induce activation of stem cells.Similarly,Six1-overexpressed tumors could activate the TGF-β pathway and Wnt/β-catenin pathway,lead to malignant transformation by inducing epithelial-mesenchymal transition and mammary tumorigenesis.Research on the role of sixl will improve understanding the mechanisms of breast cancer initiation and development.

Objective:Mechanical ventilation has been the regular equipment or the therapy equipment in the hospital. In order to establish a safe condition of using ventilator, not only standard operations are required, but also high quality of ventilators should be ensured. This article will introduce a kind of ventilator detection system made in Switzerland, especially the portable device which supports the technology to detect ventilator at any time and every place. These detection equipments provide the protection of high risk medical equipment. Methods: According to the requirement of mechanical ventilation detection and the instruction of imtmedical ventilator detection system, the application methods of imtmedical detection system were introduced. Results: Compared the difference with other ventilator detectors, the priority, portability, stability and accuracy of the Citrex H4 detection were understood. Conclusion:The Citrex H4 ventilator detector is satisfactory for quality testing of ventilator, ion evaluate can make the output performance parameters more accurate and the quality higher.of the ventilators.

Objective:To investigate the protective effect of pine pollen on lipopolysaccharide (LPS)-induced learning and memory impairments in mice and the underlying mechanism.Methods:Sixty mice were randomly divided into four groups ( n = 15/group): normal control, model, low-dose pine pollen (500 mg/kg) and high-dose pine pollen (1 000 mg/kg). Mouse models of learning and memory impairment were established by lateral ventricle injection of LPS. The learning and memory abilities of mice were determined by the Morris water maze test. Superoxide dismutase (SOD) activity and glutathione (GSH) and malondialdehyde (MDA) levels in the hippocampus of mice were measured. Interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), dopamine (DA), and norepinephrine (NE) levels in the hippocampus were also determined. Results:The latency in the passive avoidance test in the model group was significantly shorter than that in the normal control group [(134.80 ± 33.89) s vs. (282.20 ± 17.43) s, t = 4.23, P < 0.01]. The number of errors in the model group was significantly higher than that in the normal control group [(4.00 ± 1.58) vs. (1.20 ± 1.30) times, t = 2.85, P < 0.01]. The latency in the passive avoidance test in the low-dose pine pollen (500 mg/kg) and high-dose pine pollen (1000 mg/kg) groups was significantly longer than that in the normal control group [(189.40 ± 27.21) s or (213.40 ± 21.26) s vs. (134.80 ± 33.89) s, t = 3.21, 4.38, all P < 0.05]. The number of errors in the low-dose pine pollen (500 mg/kg) and high-dose pine pollen (1 000 mg/kg) groups was significantly lower than that in the normal control group [(1.60 ± 1.44) times or (1.40 ± 1.44) times vs. (4.00 ± 1.58) times, t = 5.12, 6.42, both P < 0.05]. SOD activity and GSH, DA and NE levels in the hippocampus in the model group were significantly decreased compared with the normal control group [SOD: (7.59 ± 1.77) kU/g vs. (39.90 ± 6.37) kU/g; GSH: (3.49 ± 0.13) mmol/g vs. (6.37 ± 0.14) mmol/g; DA: (418.42 ± 2.57) ng/L vs. (586.37 ± 3.64) ng/L; NE: (187.20 ± 5.41) ng/L vs. (298.42 ± 2.32) ng/L, t = 3.67, 8.23, 2.23, 3.65, all P < 0.05]. MDA, IL-6 and TNF-α levels in the hippocampus in the normal control group were significantly higher than those in the model group [MDA: (8.79 ± 0.82) mmol/g vs. (2.62 ± 0.16) mmol/g, IL-6: (48.07 ± 5.56) ng/L vs. (18.76 ± 1.42) ng/L, TNF-α: (87.20 ± 4.31) ng/L vs. (22.42 ± 3.39) ng/L, t = 7.45, 2.67, 4.35, P < 0.05 or P < 0.01]. SOD activity, GSH, DA and NE levels in the hippocampus in the low-dose pine pollen (500 mg/kg) and high-dose pine pollen (1 000 mg/kg) groups were significantly higher than those in the model group [SOD: (18.80 ± 2.39) kU/g, (28.70 ± 2.36) kU/g vs. (7.59 ± 1.77) kU/g, GSH: (5.04 ± 0.36) mmol/g, (5.45 ± 0.17) mmol/g vs. (3.49 ± 0.13) mmol/g, DA: (488.37 ± 3.46) ng/L, (506.29 ± 5.72) ng/L vs. (418.42 ± 2.57) ng/L, NE: (225.65 ± 3.72) ng/L, (239.76 ± 5.58) ng/L vs. (187.20 ± 5.41) ng/L, t = 4.56 or 6.71, t = 4.65 or 5.32, t = 4.73 or 6.72, t = 3.84 or 5.63, P < 0.05 or P < 0.01]. MDA, IL-6 and TNF-α levels in the hippocampus in the low-dose pine pollen (500 mg/kg) and high-dose pine pollen (1 000 mg/kg) groups were significantly lower than those in the model group [MDA: (5.72 ± 0.47) mmol/g, (3.77 ± 0.23) mmol /g vs. (8.79 ± 0.82) mmol/g, IL-6: (28.42 ± 3.54) ng/L, (23.43 ± 5.62) ng/L vs. (48.07 ± 5.56) ng/L, TNF-α: (48.87 ± 4.82) ng/L, (39.65 ± 6.69) ng/L vs. (87.20 ± 4.31) ng/L, t = 6.31 or 7.28, t = 3.46 or 6.31, t = 4.28 or 3.57, P < 0.05 or P < 0.01]. Conclusion:Pine pollen can improve LPS-induced learning and memory impairments possibly through up-regulating the levels of monoamine neurotransmitters DA and NE and inhibiting the levels of oxidative stress and inflammatory reaction in the hippocampus of mice.

Objective:Now the mechanical ventilation has become the essential emergency or therapy equipment in the all sizes of hospitals. However with the widely application of ventilators, they are still the kind of high risk of medical instruments. In order to reduce various equipment failures, an overall management strategy based on traceability of two-dimension code is constructed in this article, which will provide a new direction for medical equipment management.Methods: Using the popular application of WiFi network and creating the only identified two-dimension code, the overall management strategy is established for the ventilators.Results: The centralized and decentralized management model is adopted in the preservation of ventilators. And all the operators of ventilators will be supported technology service about equipment failures and setting parameters by the respiratory department and engineering department. In addition to this, the two departments should organize the staff to learn the operation of ventilators in the hospital. All of those compose the structure of overall management.Conclusion: With the management of this method, the efficiency of ventilators is improved, and the rate of machine failures is dropped. The difficulty about technology service caused by space can be solved in time. Finally, the professional ability of the staff in hospital will be improved with the communication among the different departments.

To investigate the clinical efficacy of massage manipulation reposition for treatment of child hip-joint semiluxation, sixty-seven cases of child hip-joint semiluxation were treated by massage manipulation reposition. Sixty-two cases were cured and 5 cases improved. The total effective rate was 100%. Massage manipulation reposition is an effective method for treating child hip-joint semiluxation.