Objective To explore the changes of alveolar morphology and alveolar epithelial cells in rats with hyperoxia-induced chronic lung diseases (CLD). Methods CLD model in neonatal rats was established by inhalation of high concentration oxygen(85%～90% ). Eighty neonatal rats were randomly exposed to hyperoxia (model group) and to room air (control group) (n =40 each). Radical alveolar counts and the alveolar septum thickness were used to evaluate alveolar development. The site and intensity of expression of SPC,AQP5 protein were detected by immunohistochemical staining,the dynamic expression of SPC mRNA,AQP5mRNA was detected by RT-PCR on day 1,3,7,14 and 21 after exposure. Results There were no significant differences about alveolar wall thickness and RAC between experimental groups and control group on day 1～3 ( P > 0. 05 ). But there was significant difference between the model group and the control groups on day 7 and 14 (P <0. 01 ). For model group,alveolar septum thickness peaked on day 21, the difference was significant compared with control group ( 10. 62±5.01 vs 3.62±0. 88, P < 0. 001 ), but RAC decreased to the lowest level, the difference was significant compared with control group ( 3.57±1.24 vs 10. 47±0. 88,P <0. 001 ). The expression of SPC decreased on day 3 manifestedly but increased on day 7 and the levels of SPC were higher than that in the control group. Experimental group showed gradual decrease in AQP5 expression as the lung impairment devastated. Conclusion Alveolar development was delayed and alveolar epithelial cell (AEC) was damaged in the neonatal CLD rats. The changes of SPC,AQP5 expression suggested AECI was severely damaged and failed in full recovery, meanwhile the quantity of AEC Ⅱ was increased but the ability of its differentiation and transformation was decreased.

Objective　To investigate clinical features of neonatal ventilator associated pneumonia.Methods　Retrospective analysis of clinical features was performed in twenty-two newborns with ventilator associated pneumonia.Results　Ventilator associated pneumonia were found in 22 ou t of 36 neonates with mechanical ventilation.Conclusion　The incidence of VAP is significantly increased if the time of mechanical ventilation in longer than 96 hours.

Objective To investigate the dynamic expression of mRNA and protein of surfactant protein C (SPC),E-cadherin (E-cad),N-cadherin (N-cad) and α-smooth muscle actin (α-SMA) and elucidate the significance of epithelial-mesenchymal transition (EMT) in a newborn rat model of Bronchopulmonary dysplasia (BPD).Methods A newborn rat model of BPD in hyperoxia was established,and a control group exposed to air was established.Lung tissue was collected on days 3,7,14,and 21,respectively.Alveolar development was evaluated by radical alveolar counts(RAC),including thickness of alveolar septum,ratio of alveolar and septa.Real-time PCR and Western-blot were used to detect levels of markers of epithelial cells (SPC,E-cad) and interstitial cells (N-cad,α-SMA) in AT2 and protein expression.Results On day 7,14,and 21,compared with the control group,RAC (7.38 ± 0.92,9.25 ± 0.70,9.88 ± 0.99) and alveolar area/pulmonary septal area ratios (A/S) (2.53 ± 0.02,3.34 ± 0.09,3.96 ± 0.13) were all higher in BPD group [RAC (5.88 ± 0.83,5.14 ± 0.83,4.38 ± 0.52) and A/S (1.88 ± 0.03,1.95 ± 0.03,1.89 ± 0.02)] (all P ＜ 0.05) ; the alveolar septum (8.53 ± 0.04,10.75 ± 0.46,13.55 ± 0.84) in BPD group were thicker than those (5.77 ± 0.09,4.40 ± 0.12,3.67 ± 0.18) in the control group (all P ＜ 0.01).The expressions of SPC and α-SMA in BPD group were significantly higher than those in the control group on day 14 and 21 (all P ＜ 0.05).The level of E-cad mRNA (2.43 ± 0.60,2.59 ± 0.48,3.37 ± 0.53) and protein (18.39 ± 1.77,18.29 ± 1.52,11.48 ± 1.72) for E-cad were higher in the control group than those (mRNA:1.48 ± 0.55,1.57 ± 0.48,1.12 ± 0.45 ;protein:9.50 ± 1.38,8.57 ± 1.06,8.22 ± 1.31) in BPD group was lower(P ＜ 0.05),while the level of N-cad was significantly higher(P ＜ 0.05) on day 7,14,and 21.Conclusions In the development of BPD,the markers of lung epithelial cells were down regulation,while the markers of interstitial cells were up-regulation,and these findings suggest that EMT from lung epithelial cells contributes to the occurrence of BPD.

BACKGROUND:Coronary artery stents can be used in clinical treatment of various lesions due to coronary artery stenosis, and different types of drug-eluting stents and bare metal stents can be used surgicaly. However, there are some differences in the therapeutic efficacy and safety among the stents made in different manufacturers. OBJECTIVE:To explore the safety of biodegradable sirolimus eluting stents from different manufacturers in the treatment of coronary artery stenosis. METHODS:Totaly 193 patients with coronary artery stenosis were enroled, including 116 males and 80 females, aged 37-81 years old. These patients were equaly divided into two groups and respectively treated with Firebird stent (MicroPort) and Partner stent (LOOP INC). Patients were folowed up for 12 months, and the restenosis rate,incidence of acute myocardial infarction, rate of coronary artery bypass graft or secondary percutaneous coronary artery interventional therapy, and mortality rate were compared between two groups. RESULTS AND CONCLUSION:After 12 months of folowed-up, there was no difference in the restenosis rate, incidence of acute myocardial infarction, rate of coronary artery bypass graft or secondary percutaneous coronary artery interventional therapy, and mortality rate between two groups (P> 0.05). During the folow-up, no adverse reaction occurred in both two groups. These findings indicate that different brands of biodegradable sirolimus eluting stents can obtain good outcomes in the treatment of coronary artery stenosis, have no adverse reaction, and exhibit a certain degree of security.

Objective To provide anatomic data for operation of inserting the electron cochlear in young children. Methods Fourteen heads,28 sides specimens of young children of 1to-5-year old were dissected,through posterior tympanum approach,via mastoidectomy,posterior tympanoto to enter posterior tympanum.The related anatomy structures of the location of the electron cochlear inserted into the proper sites were observed and measured under surgical microscope. Results The round window was seated in superior part of the round window niche.The pyramidal eminence,tendo musculi stapedius,incudostapedial joint,base of stapes,cochleariform process,round window niche and promontorium tympani were all visible from different directions.The posterior arch of stapes was situated in the prozone of scala.Scala was situated in the posteroinferior scala vestibuli.The distance from the middle point of the anterior border of the round window niche to the inferior wall was(1.49?0.42)mm,to the posterior wall of the Scala tympani(0.90?0.31)mm,to the basal tissue(1.49?0.41)mm,to the pyramidal eminence(3.28?0.55)mm,to the lateral semicircular canal(7.41?0.90)mm,to the inferior margin of the base of stapes(3.09?0.53)mm.Conclusion It is considered that the location of the insertion should be at the middle point of anterior border of the round window niche anterior from 0.90mm to 1.49mm,deorsum from 0mm to 1.49mm.When the round window niche is not found,the location of the insertion has to be at the middle point of the inferior margin of the base of stapes deorsum 3mm.

Objective To study the anastomotic relationships of perforators in each zone of the poste-rior leg and design perforating flaps for clinic. Methods Six fresh cadavers underwent a whole body, intra-arterial injection of a lead oxide and gelatine preparation. The posterior part of leg is divided into upper, mid-die and below equal parts, Observe topography of the perforating branches in every district by layer, and mea-sured their location, diameter, course, branches and anastomosis pattern. Radiographs of tissue specimens were digitally analyzed. Results There were 13 perforators that diameter≥ 0.5 mm, the average external diameter was 0.8 mm. The areas of each perforator supplied was average 38 cm2. Perforators from popliteal artery was identified an area 4 cm wide, around the intersection of two lines, a line drawn between the medial and lateral epicondyles of the femurs, and the midline of posterior leg. The areas of the every perforator sup-plied was 55 cm2. These vessels were large in diameter and create multiple true anastomoses with the perfora-tors from the posterior tibial artery or fibular artery. Perforating branches were small in the below part, a long perforator chain comprised of two to three perforators accompanies the Achilles tendon. Conclusion The perforator flaps deviced by perforators from the posterior leg may be transplanted to the lower limbs and the other part of the body. The perforators located in the middle zone of the leg are larger. Free posterior tibial or peroneal perforator-based flaps are reliable, relatively large, and have thin flaps. The upper and lower zones were the larger donor site for the proximal or distally pedicled perforator flap harvest.

ObjectiveTo study the anatomic characteristic of the attachment of medial patellofemoral ligament and its function in patellar stability. MethodsThirty adult cadaver knees were used for anatomic study, and the attachments of medial patellofemoral ligament were observed and measured. Results The femoral attachment of medial patellofemoral ligament was anchored to the bone between the medial femoral epicondyle and the adductor tubercle. The fibers here were thin and narrow, and became thick and wide to the anterior. The patellar attachment was in the superior two-thirds of the medial margin of the patella. The fiber here were the thickest and the widest. Conclusion The anatomic characteristic of the attachment of medial patellofemoral ligament was revealed, providing anatomical bases for surgery.

Objective To evaluate the effect of 3D printing models applied to Medical Imaging Di-agnosis Undergraduate Teaching. Methods Students in the year 2012/2013 of Shanghai Jiao Tong Univer-sity School of Medicine stomatology specialty were chosen for this study, including 38 students in the exper-imental group (2013) and 40 students in the control group (2012). All of them were taught by the same group of teachers, including 28 core curriculum hours and 5 practice class hours. 3D printing technology with PPT was applied to the experimental group in the medical imaging diagnostic teaching, and conventional teaching including PPT and usual models in the control group. Medical students were given a test about cardiovascular system and tasked with completion of drawing hand and foot bones. Students in experimental group were also asked to complete a questionnaire about their experience. Results The questionnaire showed that 3D printing teaching molds with PPT was of great significance to improve the students interest in learning imaging anatomy, to meet the vast majority of students' learning requirements, and to achieve satis-factory results. The average scores of the circulatory system test in the experimental group were higher than that of the control group [(8.32 ±2.352) vs. (6.15 ±1.284), P<0.05)]. Students in experimental group per-formed better than students in the control group on the Locomotor system test [(6.81 ±1.347] vs. (3.84 ± 0.985), P<0.01]. Conclusions 3D printing mold combined with PPT teaching method can promote the med-ical imaging anatomy structure, learning effect and teaching quality, and has practical value in the under-graduate teaching of medical imaging diagnosis.

Objective To study the value of using endoscopy iodine staining combined detecting the expression of p53, survivin and telomerase in the diagnosis of early esophageal carcinoma and precancerous lesions. Methods Three hundred patients who received routine gastrescopy and had high risk of esophageal carcinoma were examined by the iodine dyeing on their esophageal mucosa with 2. 5% Lugol solu-tion. Multiple biopsies were taken from the unstained or light-stained areas when their diameters were over 5mm for pathology diagnosis. The expression of p53, survivin and telomerase were detected by immunohistochemical staining. Results With the Lugol staining method, the incidences of light, moderate and high grade dysplasia and early esophageal carcinoma were 16. 3% ,9. 7% ,3.7% and 4. 3% respectively. The expression of p53, survivin and telomerase were related and the unstained were related to the expression of p53, survivin and telomerase in dysplasia and early esophageal carcinoma. Using endoscopy iodine staining combined testing p53, survivin and telomerase showed sensitiv-ity of 100%, specificity of 92. 3% and accuracy of 91.8% to diagnose of early esophageal carcinoma and high grade dysplasia. Conclusion Lugol solution chromoendscopy combined assay of p53, survivin and telomersse might be useful in the diagnosing early esophageal carcino-ma and precancerous lesion.

Objective To determine the prognostic value of standardized uptake value(SUV)of fluorodeoxyglucose(FDG)by positron emission tomography and computed tomography(PET-CT)in nonsmall cell lung cancer(NSCLC).Methods Forty-eight patients(39 male,9 female)with stage ⅢNSCLC were reviewed.All patients had at least two repeated FDG PET-CT scans either before and after therapy and the maximum standardized uptake value(SUVmax)of the primary lung lesion was calculated. Resuits Of the 45 eligible patients,after a median follow-up of 22.5 months(rang,13 to 35 months),24 patients had local and regional recurrenee or metastasis and 21 remain disease-free.The mean SUVmax of patients who had local recurrence or metastasis before and after treatment was 12.30±3.17 and 5.35±2.29,respectively.The mean SUVmax of patients who had no loeal recurrence or metastasis before and after treatment was 8.46±3.00 and 2.82±0.63,respectively.Significant differences(tbefore=4.15,Pbefore＜0.01;Pafter=4.88,Pafter＜0.01)in SUVmax were observed either before and after treatment.However,the percent change of SUVmax between pretreatment and post-treatment were not significiantly different(t=1.99,P＞0.05).Using the SUVbefore of 9.0 yielded 92% sensitivity,62% specificity,73% positive predictive value and 87%negaffve Dredictive value in predicting regional recurrence or metastasis. While using the SUVafter of 4.3 yielded 71% sensitivity,100% specificity,100% positive predictive valne and 72% negative Dredictive value. Conclusions PET-CT may have the potientials to predict response to therapy and the SUVmax is a significant predictor for recurrent or metastasis in patients of NSCLC.