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.

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.

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 .

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 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.

Anatomic structure in craniofacial region is very complicated and orthognathic surgery is difficultly performed.Therefore,it is necessary to generate virtual surgical model from CT scan data before operation on personal computer in order to make surgery more accurate.This technique has been increasingly interested in the field of orthognathic surgery both at home and abroad.The sample was scanned with thin-layer CT.CT image data (336 layer,1.0 mm slice thickness) were analyzed with the Mimics software.Simultaneously,three-dimensional model and virtual surgery of the facial cranium were established.The digitized virtual surgical platform of facial cranium was preliminarily created,and three common surgical methods in maxillofacial surgery,i.e.,LeFort Ⅰ osteotomy,mandibular angle osteotomy,and genioplasty,for maxillofacial surgery were simulated.The results showed that the digitized virtual surgical platform of facial cranium could be generated with the Mimics software on personal computer,which provides convenient and quick methods for research,teaching,and clinical surgery.More importantly,it creates theoretical basis for virtual surgical platform which can be widely used on personal computer.

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 .

Objective To study the expression levels of microRNA (miR)-16 and miR-146a in rat lungs of decompres-sion sickness (DCS) caused by fast buoyancy ascent escape or diving .Methods At 0.5 h after fast buoyancy ascent es-cape or diving, the pathological changes in rat lungs and expression levels of miR-16,and miR-146a were detected by re-verse transcription-quantitive polymerase chain reaction and compared with normal control group .Results The pathological characteristics of lungs in two DCS groups were tissue damage .At 0.5 h after DCS caused by fast buoyancy ascent escape , the lung tissue expression levels of miR-16 and miR-146a did not significantly change compared with normal control and diving DCS groups ,but the rat lung tissue expression level of miR-146 a in diving DCS group was obviously increased , com-pared with normal control group .Conclusion miR-146a may play a role in post-transcriptional regulation in the process of diving DCS .