Objective To evaluate efficacy and safety of two methods for gas-filled and liquid-filled balloon of Swan-Ganz catheter to locate the bronchus of pulmonary air leakage. Methods All of 38 cases with pneumothorax were randomly divided into two groups. Group A : the bronchus of pulmonary air leakage were detected by injecting gas into balloon of Swan-Ganz catheter. Group B: the bronchus of pulmonary air leakage were detected by injecting physiological saline into balloon of Swan-Ganz catheter. Results The locating success rate in Group A was 89. 5% (17/19) and Group B was 94. 7% (18/19) ( P＞0. 05). The mean time of locating in Group A was (13. 3 ±4. 1) min and Group B was (9. 6 ±3. 2) min( P ＜0. 05).In Group A, the dislocation rate was 47.4% and adjacent bronchial compression rate was 68.4% , and was respectively higher than Group B 21. 1% and 26. 3% ( P ＜ 0. 05). Patients in both groups were well tolerated without any obvious adverse effects. Conclusion It is a more simple, quicker, the same safe and effective to locate the broken bronchus of pneumothorax by injecting physiological saline into balloon of Swan-Ganz catheter.

Objective To study the location and significance of leptin and leptin receptor in rat submanibular gland. Methods Submandibular gland from SD rats were observed by hematoxylin-eosin, leptin and leptin receptor immunohistochemical staining. Result The granular convoluted tube and striated duct were leptin and leptin receptor positive. The density of positive cells in granular convoluted tube were much high than those of in striated duct. The acini were negative.Conclusion leptin and leptin receptor were widly expressed in granular convoluted tube and striated duct. These results might indicate that submandibular gland participated in adjusting the balance of energy.;

Objective To evaluate the hearing effects in hearing impaired children using FM system .Methods The FM listening evaluation for children questionnaire was used to evaluate 27 cases with sensorineural hearing loss who were fitted hearing aids or cochlear implants ,or using FM system .The auditory skills of the patients were evaluated in four kinds of listening environments :quiet ,noise ,auditory only and distance by this questionnaire . Each question required a subjective score based on the child's response .The higher the scores the better the results . The age range of the participants was 3 .48~5 .50 .On an average ,their experience of using hearing instruments was 2 .56 ± 0 .97 years .Results With local microphones only ,the total score was 67 .55% ;in quiet situation ,the score was 85 .33% ;in noise ,the score was 60 .54% ;with visual only ,the score was 69 .58% and in distance ,the score was 69 .5% .With frequency modulated + microphone ,the total score was 84 .35% ,in quiet situation ,the score was 94 .89% ,in noise ,the score was 81 .35% ,with visual only ,the score was 83 .56% ,and in distance ,and the score was 83 .29% .The score of the subjects with hearing instruments only in quiet was significant higher than those of in noise and long distance without eye clue situation(F=49 .53 ,P<0 .05) .The score of the subjects was significant improved after using FM system (P<0 .05) .The score of the subjects with hearing instruments and FM system in quiet was also significant higher than those of in noise ,long distance ,without eye clue situation(F=24 . 80 ,P<0 .05) .Conclusion FM system could improve the listening experience in hearing impaired children in a com‐plex environment .However ,processes and programs for preschool hearing impaired children should be further standardized and improved when fitting FM system ,as findings of variability in questionnaire performance .

Objective To prepare recombinant plasminogen activator(Pla) protein in E.coli BL21 cells that can be used in studying interactions between Yersinia pestis proteins and immunologic diagnosis of plague.Methods The pla gene was amplified by PCR and cloned into the pET28a expression vector.E.coli BL21 competent cells were transformed with the recombinant vectors, and isopropyl-β-D-thiogalactopyranoside ( IPTG) was added to induce expression of Pla protein. The expressed protein was detected by SDS-PAGE electrophoresis.The inclusion bodies of Pla protein were denatured in 8 mol/L urea, and then refolded using gradient urea solutions.The purified protein was identified by SDS-PAGE electrophoresis and Western blot.Results and Conclusion The constructed expression vector was demonstrated to be correct through agarose gel electrophoresis and sequencing.The recombinant Pla protein was accumulated as an inclusion body in E.coli, and the overexpression product was mainly a target protein, the yield of which was very high.SDS-PAGE purity of the bioactive Pla protein was obtained by denaturing and refolding the inclusion bodies.This study provides a simple and quick method for highly efficient preparation of biologically active Pla protein.

Education of evidence-based medicine in clinical research is important in enhancing primary hospital clinical research capacity and quality.Dongyang People's Hospital of Zhejiang Province has carried out evidence-based medicine education and training,and greatly improved the performance of clinical research and development of scientific researchers.

Due to the insufficient education of medical ethics and tending to medical moral educa-tion, the residents lack the ability to make ethical decisions. Therefore, we applied Four Topics method in the clinical ethics training of residents. The clinical ethics training was divided into three stages, and each stage had different training content and objectives. Dongyang People's Hospital adopted the form of lectures and panel discussions. During the group discussion, the group leader was in charge of case preparation, which came from clinical practice, and then all members applied the Four Topics method to analyze and discuss the ethical conflicts, and make the ethical decision. Through this process, residents' ability to solve ethical problems in clinical practice was enhanced.

Clinical thinking of Clinicians in Dongyang People's Hospital is gradually shifting from ‘empirical medicine’ to ‘evidence-based medicine’ after popularizing of evidence-based medicine, training core members and implementing multi-layered, multi-channeled, comprehensive and sustainable resident doctor training mode with clear steps and purposes within three years. This paper discussed on reasonable clinical practice of evidence-based medicine in primary hospital and provided realistic basis for the further development and improvement of training of evidence-based medicine in primary hospital.

Objective To establish a simple and quick loop-mediated isothermal amplification (LAMP)method for detection of Yersinia pestis.Methods LAMP Primers were designed based on the specific sequence 3a in Y.pestis chromosome.LAMP reaction results were detected using turbidity meter or visual method.The specificity of the constructed method was evaluated by detecting Y.pestis and its closely-related bacteria.The different dilution DNA template was detected with LAMP and PCR to evaluate the sensitivity of the method.Results Thirty strains of bacteria closely related to Y.pestis were detected by the constructed LAMP,and all the results were negative,indicating that the method had a very high specificity.The detection sensitivity of this LAMP assay was 20 pg of DNA per reaction,which was ten-fold that of the regular PCR.The detection reaction was completed in 25 min.Conclusion This LAMP method is quick,sensitive, specific and simple,which is expecked to become an effective method for rapid detection of Y.pestis on the scene.

OBJECTIVETo establish animal models for research of orthodontic tooth under rapid movement through distraction osteogenesis of the periodontal ligament, and to approach the rules of bone formation and the relationship between new bone formation and angiogenesis.

METHODS48 rats of which the right maxillary first molars were removed were randomly divided into experimental and orthodontic control group. The orthodontic model was established according to traditional method, and the stretch device was installed in the experimental group after reducing the second molar's mesial bone resistance. Four animals in each group were randomly selected to be killed at 6 time points (at day 0, 3, 5, 10, 20, and 30). After specimens were obtained, immunohistochemical staining was done. The expression of vascular endothelial growth factor (VEGF) and osteocalcin (OC) were investigated.

RESULTSIn the experimental group, VEGF was mainly expressed in vascular endothelial cells, fibroblasts, osteoblasts, osteoclasts, and bone cells. The positive expression of VEGF gradually increased, the peak appeared at day 10 on the tension side, and the other side was at day 5. OC-positive signals were seen in the extracellular matrix of periodontal ligament and osteoblastic cells, and its peak appeared at day 10 on both tension and pressure side. The expression of VEGF and OC were similar in orthodontic control group, but the level was lower.

CONCLUSIONVEGF and OC involve in the remodeling of periodontal tissues and play an important role during periodontal ligament distraction osteogenesis. Angiogenesis is earlier than bone formation, or both appear simultaneously.

Animals ; Molar ; Osteoblasts ; Osteocalcin ; Osteoclasts ; Osteogenesis ; Osteogenesis, Distraction ; Periodontal Ligament ; Rats ; Vascular Endothelial Growth Factor A

Objective To investigate the expressions of carbohydrate antigen 19-9(CA19-9), carbohydrate antigen 15-3(CA15-3) and carbohydrate antigen 125(CA125) and their clinical significance in papillary thyroid carcinoma (PTC). Methods The expressions of CA19-9, CA15-3 and CA125 were detected by immunohistochemical MaxVision method in 80 cases of PTC and 80 cases of benign thyroid lesions (BTL), including 34 cases of nodular goiter, 26 cases of Hashimoto's thyroiditis and 20 cases of follicular adenoma. The relationship between expressions of CA19-9, CA15-3 and CA125 and the clinical pathological characteristics were analyzed. Results The expression rates of CA19-9, CA15-3 and CA125 in 80 cases of PTC were 85%, 100%and 43.8%respectively, compared with BTL, the difference was statistically significant (P < 0.01). There was no significant correlation between expressions of CA19-9, CA15-3 and CA125 and age, gender, number and diameter of tumor nodules, lymph node metastasis, and TNM staging (P > 0.05). The sensitivity of CA19-9, CA15-3 and CA125 in the differential diagnosis of PTC and BTL were 85%, 100% and 43.8% respectively, and the specificity were 91.3%, 36.3%and 91.3%, respectively. Conclusion The expressions of CA19-9, CA153 and CA125 are helpful for the differential diagnosis of PTC and BTL.