To study the effect of hyperbaric oxygen (HBO) on cellular proliferative nuclear antigen (PCNA) in spinal cord after its injury (SCI), we observed the pathological changes and the expression change in PCNA in spinal cord after the injured rats were treated with HBO. The results showed that there were hemorrhage, edema, vacuolation of nerve cells in spinal cord, disorder and fragmentation in nerve fibers after injury. PCNA was strongly positively expressed in neurons. The results in 0.1MPa HBO group were similar to that of non-treatment group, while in 0.25MPa HBO group, edema was abolished, the cellular vacuolation was lessened, the morphology of nerve cells recovered, the structural configuration appeared normal, and the degree of PCNA expression was decreased compared with the injury group. These results suggested that PCNA could serve as a cellular proliferative index; HBO could prevent or alleviate the pathological changes of SCI, and could effectively promote the repair of the injury of the spinal cord.

Objective To explore the clinical curative effect of early enteral nutritional support for acute se-vere organophosphorus pesticide poisoning.Methods 56 cases with acute severe organophosphorus pesticide poison-ing were selected and divided into group A and group B in accordance with the random number table.Both groups were given conventional emergency treatment.Enteral nutrition support with nutrition pump was applied for 30 cases of group A in 48 -72hours,while group B in 72h -5d.The time of consciousness recovery,CHE increase to normal 60%,the incidence rate of intermediate syndrome,gastrointestinal complications of abdominal pain,abdominal disten-sion,vomiting,reflux,diarrhea,VAP,MODS of the two groups of patients were compared.Results The time of con-sciousness recovery (3.6 ±0.8)d in group A was lower than that of group B(4.1 ±0.6)d (t=2.612,P<0.01), the CHE increase to normal 60%(5.5 ±1.3)d in group A was lower than that of group B(6.3 ±1.1)d(t=2.464, P<0.05),the incidence rate of intermediate syndrome(3.3%)in group A was lower than that of group B(38.5%) (χ2 =4.691,P<0.05),the VAP of 13.3% in group A was lower than that of group B(46.2%)(χ2 =7.352,P<0.01),the MODS of 13.3% in group A was lower than 38.5% of group B(χ2 =4.691,P<0.05),the duration in ICU of (8.0 ±1.2)d in group A was lower than (12.0 ±2.4)d of group B(t=7.705,P<0.01).There was no sig-nificant difference of gastrointestinal complications between the two groups (P >0.05 ).There was no significant difference of gastrointestinal complications between the two groups (P>0.05).Conclusion Early enteral nutritional support is effective and safe for acute severe organophosphorus pesticide poisoning and worthy of promotion.

Purpose To study the clinicopathological features, immunophenotype and differential diagnosis of proximal epithelioid sarcoma (PES).Methods The clinical, radiological and pathological features were reviewed in 6 cases of PES.Results The patients consisted of five males and one female with ages ranging from 32 to 74 years (mean 56 years). Clinically, the tumor mass were progressively-growing solitary nodules with the fuctional disorder and pain. The sites of the tumor involvement were buttock (1 case), thigh (2 cases), iliac spine (1 case), lumbar spine (1 case) and anterior sacrum (1 case). Histologically, the tumors were mainly consisted of epithelioid cells with round or oval nuclei, prominent nucleoli and eosinophilic cytoplasm, some tumor cells appeared rhabdoid features. Immunohistochemically, the tumor cells were positive for vimentin (6/6), CK (5/6), EMA (6/6),β-catenin (6/6), CD99 (5/6), and CD34 (4/6), but negative for S-100 protein, HMB 45, CD 117 and CD 31.Conclusion PES is a distinctive moderate grade malignant tumor with prominent epithelioid and rhabdoid cells appearance.The differential diagnoses include the tumors that have similar cellular appearance with PES, and immunohistochemical staining is useful for diagnosis and differential diagnosis.

Objective To explore the diagnostic value of bronchofiberscopic washing cytology (BWC) and bronchoalveolar lavage fluid (BALF) ThinPrep cytology test (TCT) in the diagnosis of lung cancer.Methods Three hundred and eighty-five lung cancer patients who completed the BWC and BALF TCT were selected.The sensitivity was compared between the conventional smear and the two TCT methods.The sensitivity and accuracy of BWC and BALF TCT in the diagnosis of lung cancer were analyzed.Results The sensitivity of TCT was 76.1％ (293/385) in the diagnosis of lung cancer,and conventional smear was 54.8％ (211/385).The sensitivity of TCT was significantly higher than that of conventional smear (P ＜ 0.05).In the diagnosis of central lung cancer,the sensitivity of BWC TCT and BALF TCT was 74.4％ (131/176) and 70.5％ (124/176),and there was no statistical difference (P ＞ 0.05).In the diagnosis of peripheral lung cancer,the sensitivity of BALF TCT and BWC TCT was 83.3％ (174/209) and 44.0％ (92/209),and there was statistical difference (P ＜ 0.05).In BWC TCT,the accuracy of TCT and histology in squamous cancer was 92.7％ (127/137),in adenocarcinoma was 92.6％ (151/163),in small cell cancer was 96.8％ (61/63),and total accuracy was 91.9％ (354/385).In BALF TCT,the accuracy of TCT and histology in squamous cancer was 92.0％ (126/137),in adenocarcinoma was 94.5％ (154/163),and in small cancer was 98.4％ (62/63),and total accuracy was 92.7％ (357/385).Conclusions TCT has more diagnostic value in lung cancer.BWC and BALF TCT show different sensitivity in the diagnosis of lung cancer of different kinds.BWC TCT combination with BALF TCT is helpful to improve the diagnosis of lung cancer.

Objective Platelet aggregation, activation induced by bubbles is the main cause of decompression sick-ness.Clopidogrel(Clo) can decrease platelet aggregation through inhibiting the bind of fibrinogen and ADP .This study is designed to find if Clopidogrel can paly a protective role in decompression sickness and explore the intervention mechanism . Methods Totally 111 male SD rats divided into 3 groups:normal control group (n=20), decompression sickness(DCS) group(n=46), and DCS+Clo(Clopidogrel)treated decompression sickness (DCS+Clo)group(n=45).The rats in DCS and DCS+Clo group were placed in chamber and compressed to 1.5 MPa at speed of 2t/4 , the time of compression and res-idence was 4.5 min totally, then decompressed to surface at a speed of 3 m/s.The mortality and behavioral of rats were ob-served within 30 min post decompression .The pathology and the wet/dry ratio of lung , WBC and platelet counts in periph-eral blood, the expression of activated platelets , and immunohistochemical detection of lung tissue CD 41 expression were also been tested .Results We found Clo reduces the DCS mortality risk ( mortality rate:11/45 in DCS+Clo group vs 28/46 in DCS group, P<0.01).Clo reduced the lung injury, the wet/dry ratio of lung, the accumulation of platelet and leu-kocyte in lung , the WBC counts and activated platelets in peripheral blood .Conclusion Clo can play a protective role in decompression sickness through reducing post-decompression platelet consumption and activation , decreasing the activation of leukocytes .

BACKGROUND:Using three dimensional (3D) reconstruction techniques,any part of body is accessible to visual observation.However,reports concerning 3D reconstruction of craniofacial vascularity based on PC are few in China.OBJECTIVE:To explore the method and the application values of reconstructing a digital 3D model of craniofacial vascularity based on the data of CT strengthening scanning.METHODS:CT strengthening scan images from a healthy volunteer in DICOM format were imported into Mimics 10.01 software and craniofacial blood vessels were reconstructed with the technique of thresholding,editing and 3D region growing.RESULTS AND CONCLUSION:The 3D digital model of craniofacial blood vessels was obtained.This model could be zoomed and rotated randomly and displayed the spatial positions and adjacent relationships of different anatomical structures,also the reconstructed structures could be measured in 3D space.The 3D digital model of craniofacial blood vessels can be reconstructed conveniently and quickly with Mimics software on PC,and also it can bring morphological reference to human anatomy teaching,clinical neurosurgery,oral and maxillofacial surgery,as well as image diagnosis,and will be helpful to generate a virtual plateform in craniofacial surgery.

To meet the challenge of the clinical teaching,the"Regulations on the Management of Clinical Teaching Practice in Medical Education"has been made and implemented, which establish the definitude responsibilities,rights and profit relations among doctors,students and the patients. Related organizations and persons should fully realize its normative significance,implementation obstacles and deepen the study of clinical teaching research,thus facilitating the enhancement of the teaching effect,and building a harmonious triangular relationship among the concerned parties.

Objective To investigate the effect of N-acetylcysteine ( NAC) on lung and heart injury of rats with a fast floating escape induced decompression sickness .Methods Eighty male Sprague-Dawley rats were randomly and evenly divided into four groups:control group and three NAC prevention groups .The NAC groups were treated with different doses of NAC(250, 500 or 1000 mg/kg)by intraperitoneal injection 1 h before entrance.In the control group, rats were given an equal volume of saline1h before entrance.The air was pressurized at the 2t/7 exponential rate to 1.5 MPa which was maintained for 4 min and then uniformly decompressed to atmospheric pressure .The extravehicular survival and pathological changes in the lung and heart tissue were detected 0.5 h after rat egress.Results The survival rate of rats treated with NAC 500 mg/kg(90%) was significantly higher than that of those treated with saline (65%)alone (P<0.05).There was large break and fusion in the structure of pulmonary alveolus of control group besides obvious erythrocyte exudation , cardiac muscle fibers edema ,and obvious denaturation and break .Conclusion NAC can play a protective role in rats with a fast floating escape induced decompression sickness by mitigating the injury to and inflammation of lung and heart tissue .

Objective To investigate the effect of PPAR-δ on the lung injury of rats induced by hyperbaric oxygen (HBO2) exposure.Methods Sixty male Sprague-Dawley rats were randomly divided into six groups:air+vehicle, air+GW0742, and air+GSK0660, HBO2 +vehicle, HBO2 +GW0742, HBO2 +GSK0660.Lung injury was induced in rats by HBO2exposure (2.3 ATA, 100%O2, 8 h).Rats were injected with vehicle[10%DMSO in 0.3 ml NaCl 0.9%(v/v)] or GW0742 (0.3 mg/kg, ip) or GSK0660 (1 mg/kg, ip) at 1, 6 and 12 hours before either air or oxygen exposure .Protein levels in the bronchoalveolar lavage fluid ( BALF) , wet/dry ratio of the lung and the pathological changes in the lung tissue were detected 30 min after rats′egress.Results and Conclusion For the HBO2 +GW0742 group, the protein levels in BALF, the wet/dry ratio of the lung and the pathological changes in lung tissues all significantly decreased compared with those of the air group .These changes in HBO 2 +GSK0660 group tended to increase the level of lung injury .PPAR-δhas a protective effect on pulmonary oxygen toxicity induced by HBO 2 .

27 rabbits were divided into normal group(n = 4),control group (n = 5), silybin group (n = 6), hyperbaric oxygen (HBO) group (n = 6), and HBO combined with silybin group (n = 6). Circulation of hindlimb was interrupted completely for 6 h and reperfused for 1 h. Malondialdehyde (MDA) and superoxide dismutase(SOD) in plasma from ischemic-reperfused injured limb were measured. Adenosine triphosphate (ATP) and creatine phosphate (CP) in samples taken from anterior tibial muscle were determined. Ultrastructural changes of injured muscle were observed. The results showed that HBO combined with silybin treatment had a favourable effect on ischemic and reperfused injured limb muscle with reduction of the lipid peroxidated injury, increase of the SOD activity and the high energy phosphate compounds (ATP and CP), and a promoting recovery of injured muscle cells. HBO and silybin had a synergistic action. It suggests that HBO combined with silybin is an effective method for treatment of ischemic and reperfused injured limb.