The thesis put forward a feasible method for the communication between teachers and students in the process of hospital personnel training based on comprehension.This approach named‘dialogue’,can adjust the conflict between teachers and students including‘the conflicts between teaching and studying’,‘distraction of teachers’and‘halfhearted students’,etc.Applying‘dialogue’method to resolve conflicts provided a new angle for better understanding of relationship between teachers and students.

Objective To retrospectively analyze the elderly patients with inoperable locally advanced squamous cell lung cancer,and determine prognostic factors.Methods According to eligibility criterion,162 cases of elderly patients with inoperable locally advanced squamous cell lung cancer were selected from January 1,2010 to January 1,2015 in Shanxi Tumor Hospital.Related prognostic factors were carried on univariate and multivariate analysis with Kaplan-Meier approach and Cox regression,respectively.Results The median age of 162 patients was 73.6 years old.The overall median survival time was 19.4 months.The 1-year survival rate was 71.0％,and the 2-year survival rate was 35.9％.In univariate analysis with Kaplan-Meier analysis method:age (x2 =7.94,P =0.005),Eastern Cooperative Oncology Group (ECOG) score (x2 =42.12,P =0.000),chemotherapy combined with radiotherapy or not (x2 =14.99,P =0.000) were prognostic factors that influenced survival.Cox regression analysis showed that ECOG score (HR =0.30,95％ CI:0.19-0.46,P =0.000) and N stage (HR =0.65,95％ CI:0.44-0.95,P =0.026) were independent prognostic factors.Conclusion ECOG score and N stage are independent prognostic factors of the elderly patients with inoperable locally advanced squamous cell lung cancer.

Objective To study morphological structural changes for different segment umbilical vessels of fetus in patients with pregnancy induced hypertension (PIH) ,and explore relationship between PIH and umbilical vessels .Methods Totally 36 umbilical cords from fetus of pregnant women without and with PIH (17 cases ,19 controls) were collected ,and take umbilical cord of placen‐tal ,middle ,and fetal segment to routine dehydration ,embedding ,section and stain .In the cases 9 women had mild preeclampsia ,6 had severe preeclampsia and 4 had eclampsia .Microscope images were obtained by digital microscope ,and lumen diameter ,wall thickness and wall‐luminal ratio of different segment umbilical vein and arteries were tested by computer image analysis software . The test results were analyzed and compared .Results From the placental end to the fetal end ,the lumen diameter and wall‐luminal ratio gradually decreased ,and wall thickness gradually increased in the umbilical vein and arteries (P<0 .05) .Compared to normal pregnant women ,the lumen diameter and wall‐luminal ratio decreased ,and wall thickness increased in patients with PIH ,and the a‐bove changes aggravated by disease severity (P<0 .05) .Conclusion PIH is associated with structural changes in the umbilical ves‐sels .These changes are more predominant in the vein than in the artery and most obvious in the fetal end .

By the traditional Chinese medicine obtaining-pulse equipment coupled with pressure living like flexibility transducer and B-ultrasound scarching unit,collecting demic radial artery signal on cunkou,with the key link of four pulse tracings attributes in term of "position","rate","shape" and "force",each detecting indexes were analyzed synchronically with press pulse wave and ultrasound vas dynamic state changing trendgraph.According to the time lock analysis of electrocardiogram marking method and radial artery pulse wave,the theory approach of pulse tracings digitization were undertaken,and the scores of four attributes on pulse tracings were determined as well.

OBJECTIVE: This study was conducted to evaluate the percutaneous absorption of aconitine and mesaconitine in extracts of Radix Aconitum kusnezoffii. METHODS: The extracts of Radix Aconitum kusnezoffii were collected by using Franz diffusion cells after permeation through the skin of rats. Then rate constants of skin permeation of aconitine and mesaconitine were determined by high-performance liquid chromatography (HPLC). RESULTS: Under the condition that the concentrations of azone and propylene glycol were both 4%, the cumulative doses of skin permeation (Q) of mesaconitine and aconitine in the extracts of Radix Aconitum kusnezoffii (600 mg/ml) for 24 hours were 165.819 and 487.747 microg/cm(2) respectively, and their rate constants of skin permeation were 18.391 and 78.805 microg.cm(-2).h(-1) respectively. CONCLUSION: The aconitine and mesaconitine in the extracts of Radix Aconitum kusnezoffii can penetrate well through the skin of rats. Propylene glycol and azone can promote this penetration effects. The formula of skin permeation of mesaconitine and aconitine is in accordance with Higuchi equation and there is a linear relationship between Q and t(1/2).

ObjectiveTo investigate the expression of hypoxia inducible factor 1 (HIF-1α) in rats' retinae during the embryonic and earlier postnatal period.MethodsThe retinal expression patterns of HIF-1α protein and mRNA of embryonic day 12 (E12), E16, E20, and postnatal day 1(P1) and P5 rats were determined by immunohistochemical staining and reverse transcription polymerase chain reaction (RT-PCR).ResultsHIF-1α protein was detected in the neural epithelial layer and the pigment epithelial layer at all those 5 timepoints, with higher expression in the ganglion cell layer and the inner plexiform layer, and seems limited to the ganglion cell layer when retina became more mature. Embryonic rat retina had higher expression of HIF-1α protein and mRNA than postnatal retina, the difference was significant (P<0. 01). ConclusionThe expression of HIF-1α in rats' retinae differs from embryonic to earlier postnatal stages.

Objective To investigate the significance of Th 17 cells, Treg cells and Th17/Treg cell-associated cytokines in the development of tuberculous pleurisy through detecting the expressions of Th 17 cells and Treg cells (CD4+CD25+Foxp3+) in CD4+T cells, analyzing concentrations of IL-17, IL-23, IL-6 and TGF-βin serum of patients with tuberculous pleurisy and healthy controls and measuring levels of IL -17, IL-23, IL-6 and TGF-βin hydrothorax of patients with tuberculous pleurisy .Methods Flow cytometry was used to detect expressions of Th 17 and Treg cells in peripheral blood of patients with tuberculous pleurisy and healthy controls.ELISA method was performed for quantitative detection of concentrations of IL -17, IL-23, IL-6 and TGF-βin serum and hydrothorax .Differences and correlations between the above measured data were analyzed by the statistical software SPSS 17.0.Results Compared with the healthy control group , the expressions of Th17 cells in peripheral blood of the patients were significantly increased (1.02%±0.20%vs.0.89%±0.13%, P=0.002<0.05), while the expressions of Treg cells were significantly decreased (4.64%±0.77%vs.5.10%±0.90%, P=0.000<0.05).Correspondingly, the ratio of Th17/Treg cells (0.25±0.07) in the patients were significantly higher than that in the healthy controls (0.17±0.05, P=0.000<0.05).Concentrations of IL-17, IL-23 and IL-6 in peripheral blood and in hydrothorax of the pa-tients were (17.49±3.94) ng/L, (90.42±23.06) ng/L, (4.54±1.02) ng/L and (26.13±5.98) ng/L, (122.26±31.71) ng/L, (5.31±0.74) ng/L respectively, which were remarkably higher than the levels of IL-17 (14.45±3.81) ng/L, IL-23 (77.55±20.26) ng/L and IL-6 (4.26±0.91) ng/L in control group. In tuberculous pleurisy group , concentrations of IL-17, IL-23 and IL-6 in hydrothorax were significantly higher than those in peripheral blood with P values of 0.000, 0.000 and 0.003.There was no difference be-tween IL-6 levels in peripheral blood from patients and IL-6 levels in peripheral blood from the healthy con-trols, P=0.274.In comparison with the control group , TGF-βlevels in peripheral blood and in hydrothorax of the patients were significantly decreased (3.95 ng/L±0.79 ng/L, 3.12 ng/L±0.77 ng/L vs.3.32 ng/L ±0.80 ng/L) .In tuberculous pleurisy patients , the expression of Th17 cells in peripheral blood was nega-tively correlated with Treg cells in peripheral blood (r=-0.684, P=0.000<0.05), but was positively relat-ed to the levels of IL-17, IL-23 and IL-6 (r=0.479, 0.441, 0.326, P=0.013, 0.015, 0.017).TGF-βlevel had significantly positive correlations with Treg cells in the peripheral blood of the patients (r=0.297, P=0.024), but no significant correlation with Th17 cells was found (r=0.091, P=0.659).Conclusion Th17/Treg cell-associated cytokines might regulate the expressions of Th 17 and Treg cells and inflammatory reaction.Changes of Th17 cells, Treg cells and related cytokines might be important immunopathological mechanisms for tuberculous pleurisy .

Objective: High tibial osteotomy treated medial compartment serious osteoarthritis of the knee with varus deformity,and relieving arthritic pain,correcting deformity and normal femoraltibial axial alignment.Methods:From May 1992 to February 1998,18 cases(21 knees) were operated on,We chose fit patients and planed osteotomy angle.Results:All cases were followed up for an average 3.2 years,according to Coventry's rating system,81% of the whole series had a good or excellent results.Conclusion:It increases the medial joint space width and corrects femoraltibial axial alignment,allows for healing of the articular cartilage.Satisfactory results were obtained.

BACKGROUND: Transplantation of bone marrow mesenchymal stem cells (MSCs) improves functional recovery after spinal cord injury (SCl), but the mechanisms involved remain unclear.OBJECTIVE: To observe the effects of MSCs transplantation on the expression of brain-derived neurotrophic factors (BDNF) in rats after SCl.DESIGN, TIME AND SETTING: Randomized, controlled, animal experiment. The study was performed at the Laboratory of Neuroanatomy, China Medical University from April to July 2003.MATERIALS: A total of 64 SD rats, aged 3 months, of either gender, weighing 250-300 g, were used. Of them, 4 were randomly selected to isolate and culture MSCs, and the remaining were used to establish SCl models.METHODS: The 60 rats were randomly divided into 3 groups. Seven days after SCl, MSCs group (n=24) was transplanted with 5 μL culture solution containing 1×109/L MSCs to the injury site using micro-injection; PBS group (n=24) was transplanted with 5μ L PBS, and the blank control group (n=12) with 5μ L normal saline.MAIN OUTCOME MEASURES: The rats were sacrificed at 7, 14, and 28 days post-surgery. MSCs morphology was observed and the expression of BDNF at the lesion areas was examined by immunohistochemistry,RESULTS: All 60 rats were included in the final analysis. After ten subcultures, the cell proliferative capacity was reduced, and cell body turned to flat; the MSCs protiferation and morphous could be maintained by adding basic fibroblast growth factor.Transplantation of MSCs enhanced the expression of BDNF compared with PBS and blank control groups at 7, 14, and 28 days post-surgery (P ＜ 0.05); white no significant difference was found between PBS and blank control groups (P ＞ 0.05).

Objective To investigate the relationship between serum cystatin C (Cys C) level and the occurrence of in-stent restenosis after coronary drug-eluting stent implantation.Methods A retrospective analysis of coronary drug-eluting stent implantation was curried out in 592 patients.All patients were from Shengjing Hospital of China Medical University by coronary angiography,and were divided into restenosis group (142 cases) and non restenosis group (450 cases).The Cys C levels before and after surgery and follow-up angiography were analyzed.The biochemical indicators,and transcatheter arterial restenosis were analyzed.Results Either before or after operation and follow-up angiography,serum cystatin C levels were higher in restenosis group patients than that in non restenosis group [before operation:(1.622 ± 1.063) mg/L vs (1.369 ± 0.860) mg/L;after the operation:(1.769 ± 1.062) mg/L vs (1.458 ± 0.883) mg/L;review:(1.924 ± 1.085) mg/L vs (1.440 ± 0.874) mg/L;P ＜ 0.05].Multivariate COX regression analysis showed that serum cystatin C level was an independent risk factor of in-stent restenosis in drugeluting area (P ＜ 0.05).Conclusions The serum cystatin C level is closely related to in-stent restenosis in drug-eluting stents area.High level of serum cystatin C is an independent risk factor of in-stent restenosis after drug-eluting stents implantation.