Clinical medicine is a practical discipline.Students combine theoretical knowledge with practical operation and develop clinical thinking at stage of clinical practice.From the perspective of education administration,a series of measures were carried out throughout the whole teaching in clinical internship in our university.Students were trained to gain the abilities of combing knowledge with practice,analyzing and solving issues individually and thinking logically and scientifically.Through years of research and practice,remarkable achievements were gained and both clinical skill and comprehensive quality of our students were greatly enhanced.

Objective To report the preliminary experiences in the treatment of old unstable thoracolumbar vertebral fractures by using anterior decompression, bone graft or titanium mesh and internal fixation with Z-plate system. Methods There were 23 cases (18 males and 5 females) with age range of 25-66 years (mean 41.7 years) as well as thoracolumbar vertebral fracture history for 1.2-28 years (mean 5.6 years). All cases complained of severe lower back pain, 17 of whom had slight neurological deficits (Frankel Grade D). Preoperative radiographic evaluation showed that all 23 cases had various degrees of kyphosis (25?-40?, averaged 34?), spinal cord compression and vertebral instability. Of 23 cases, 15 were treated with anterior decompression, full-thickness iliac crest autograft and internal fixation with Z-plate and the other 8 with titanium mesh instead of full-thickness iliac crest autograft. Results No severe complications happened during and after operation. The lower back pain and neurological deficits were improved or disappeared 2-3 months postoperatively. The average kyphotic correction degrees ranged from preoperative 34? to postoperative 12?. No patients' symptoms worsened during follow-up. In three cases with preoperative Frankel Grade D, the myodynamia recovered slightly but the Frankel Grade remained unchanged. The postoperative MRI examinations showed that vertebral canals were well decompressed. Conclusions Anterior decompression, autograft or titanium mesh and internal fixation with Z-plate are proved to be safe and effective techniques for clinical management of old thoracolumbar fractures, for they have advantages in effective decompression of neural structures, high healing rate of autograft and correction of kyphotic deformity.

Objective To evaluate the short-term results of ARCH plate in cerical expansive open-door laminoplasty(ELAP)for OPLL.Methods From June 2010 to September 2011,a total of 12 cases with OPLL underwent open-door ELAP by ARCH plate fixation and were followed up in our hospital.8 cases were males and 4 cases were female.The average age was 60.5 years.The neurological effect was evaluated by use Japanese Orthopedic Association(JOA)scoring criteria for cervical myelopathy.The ana-tomical effect was analyzed by compare roentgenogram and CT before and after surgery.Results The JOA scores were improved for 39% after the operation,while the saggital diameters of the cervical spinal canaldural after operation was enlarged for 82%(P<0.05).X-ray films and CT scan after operation that there was no occurrence of re-close of door,there was no occurrence of anchor loosing.Conclusion For OPLL,ELAP using ARCH plate fixation bring less occurrence of re-close of door,slight postoperative neck AS,and satisfactory clinical outcomes.

Amoxicillin ; adverse effects ; Anti-Bacterial Agents ; adverse effects ; Child ; Humans ; Male ; Renal Insufficiency ; chemically induced

Cell-Derived Microparticles ; Disease Progression ; Humans ; Leukemia ; pathology

The main objective of this research is to investigate the effects of astragaloside IV, calycosin separately glucoside, formononetin on oxidative stress in Chang Liver cells induced by H2O2. In the experiments, Chang Liver cells (a kind of normal human hepatocytes) were used as the research object, bifendate which has a clear hepatoprotective effect was used as the positive control drug, then the oxidative damage model of Chang Liver cells were established by H2O2. Cells were divided into six groups: blank control group, oxidative stress group, astragaloside IV group, calycosin separately glucoside group, formononetin group and positive control group. Then endogenous antioxidant system related indexes were detected by micro plate and colorimetric method; intracellular reactive oxygen species (ROS) were detected by DCFH-DA fluorescent probe; and the expressions of CYP2E1 were evaluated by liver microsomes, mRNA, and protein, respectively with spectrophotometry, Real-time PCR method, and Western blot technique. Results showed that H2O2 decreased antioxidant activity, and increased ROS level and expression of CYP2E1. The above oxidative stress status had been changed with protections of the three components of Astragalus membranaceus (compared with oxidative stress group, P < 0.05, P < 0.01), which taken as a whole had equivalent effects as the drug of positive control group( bifendate). Taken together, three Astragalus membranaceus ingredients all had significant or extremely significant inhibiting effects on oxidative damaged Chang Liver cells which were induced by H2O2, and the oxidative damage of Chang Liver cells had been relieved.
Astragalus membranaceus ; chemistry ; Cells, Cultured ; Cytochrome P-450 CYP2E1 ; metabolism ; Humans ; Isoflavones ; pharmacology ; Liver ; drug effects ; Oxidative Stress ; drug effects ; Reactive Oxygen Species ; metabolism ; Saponins ; pharmacology ; Triterpenes ; pharmacology

Objective To explore the immunosuppression effects,outcomes and clinical significance of mesenchymal stem cells (MSCs) transplantation in burn treatment by comparing the levels of WBC,C-reaction protein (CRP),interferon-γ(IFN-γ),interferon-o (TNF-α),interleukin-6 (IL-6),interleukin-10 (IL-10) between control burn models and models conducting MSCs transplantation.Methods After stripping Wharton's Jelly from the neonatal umbilical cord,MSCs was cultured and expanded.Burn models were constructed in male SD rats weighted at (200± 5) g,and randomly grouped for control and MSCs transplantation.The rats in transplantation group were injected subcutaneously with hUCMSCs (1.5× 106) at 24 h after burning.The content of WBC,CRP,IFN-γ,TNF-α,IL-6,IL-10 in blood samples at 0,1,2,3,5 and 7 d after burning were detected by enzyme-linked immunosorbent assay (ELISA).The ELISA results,the wound healing rate at 7,14,21 and 28 d,as well as wound healing time were compared and analyzed statistically by ANOVA between the two groups.Results WBC in control group increased significantly at 1 and 2 d,and CRP in control group increased substantially at 2 and 3 d.IFN-% IL-6 and IL-10 levels in serum showed increase on 5 d,and TNF-α arrived at its peak value at 7 d.By contrast,WBC,CRP,TNF-α,IL-6 and IL-10 of the MSCs transplantation group showed slightly increase after burning and the differences were convinced by statistical analysis,while IFN-γ showed little difference among the two groups.The MSCs transplantation group also showed significantly higher wound healing rate at 14,21,28 d and shorter wound healing time than that of the control.Conclusions MSCs transplantation can suppress the over-inflammatory response by significantly mediating the inflammatory cytokines as WBC,CRP,TNF-α,IL-6,IL-10 in burn.IFN-γseems not affected by MSCs transplantation.MSCs would be suitable to promote wound healing and repair in burn,which is achieved not only by differentiation and paracrine,but also by subtle immunoregulation.

Objective To explore the interventional treatment method for complex and refractory lymphatic malformation in children.Methods The clinical data of 78 cases with complex and refractory lymphatic malformation during January 2013 to January 2016 in our department were retrospectively analyzed.The lesions involved the neck in 28 cases,maxillofacial regions in 19 cases,the chest and armpit in 8 cases,the limb in 7 cases,the pelvic cavity and retroperitoneal space in 6 cases,the superior mediastinum in 3 cases,the hypogloeeis in 3 cases and scrotum or perineum region in 4 cases.All the children underwent ultrasound or MRI imaging studies preoperatively.The interventional procedures included:(1) Percutaneous puncture of the LM for sclerotherapy.The lesions were punctured with 20 G needle under the guidance of DSA or ultrasound and the correct positions were confirmed with angiography.The liquid of the lesions was extracted as far as possible.The dosage of sclerosing agents was adjusted according to the size of lesion.The dose of Laurolacrogol injection was 1/10—1/5 of the amount of the liquid in the lesions and the maximum of Laurolacrogol foam was ≤8 ml(20 mg).The dose of Pingyangmycin was ≤ 8 mg.(2) The drainage catheter placement and sclerotherapy.Percutaneous catheter drainage under ultrasound guidance or by surgery was conducted.The liquid in the lesions was drained by retaining the catheter for 1-4 weeks,and sclerotherapy was applied for several sessions during this period.(3) Treatment for one time a week,2 times a session.The interval of every two sessions was 4 weeks.The sclerosing agents included:Laurolacrogol Injection or Pingyangmycin for the lesions with high tension,Laurolacrogol foam for the lesions with low tension,Pingyangmycin for the microcystic lesions.Statistical analysis was conducted using SPSS20.0 software.Results A total of 208 sessions of sclerotherapy for 78 LM patients were performed and average session was (3.0±0.8).Nine patients used Lauromacrogol foam,23 patients used Lauromacrogol Injection,39 patients used pingyangmycin,while combined treatment was conducted in 7 patients.Laurolacrogol injection was used in 20 cases,Pingyangmycin in 29 cases and combination therapy in 5 cases for the high tension lesions in the neck,maxillofacial,chest and armpit.The low tension lesions of pelvic cavity and retroperitoneal space in 6 cases and of superior mediastinum in 3 cases were placed with draining catheters,and treated with sclerotherapy with Laurolacrogol foam.Three cases with hypogloeeis LM was neonates,who were treated with Laurolacrogol injection.The lesions on the limb and scrotum or perineum region were almost microcystic,were treated with Pingyangmycin in 9 cases and with combination therapy in 2 cases.The total curative rate was 97.4％ (76/78),total effective rate was 100％ (78/78).Imaging examinations showed that the cavities were closed or only a small amount of residual sclerotic lesions were present.Clinical examinations showed that the surface masses almost disappeared.The follow up period was 6 months to 2 years.There were no serious complication and adverse reactions occurred.Conclusions Interventional treatment is a safe,effective,and minimally invasive treatment for the complex and refractory lymphatic malformation.In order to receive the best treatment effect,we should use targeted therapy for different region and type of LM.

Objective To establish a dot blot hybridization technique for rapid detection of staphylococci and methicillin-resistant staphylococci.Methods Three pairs of primers were designed according to nuc gene of staphylococcus aureus,mecA gene of methicillin-resistance,tuf gene of staphylococci.Specific DNA probes were synthesized by polymerase chain reaction and labeled with biotin.The bacterial DNA inoculated on nitrocellulose filter was hybridized with these probes.The sensitivity and specificity were detected.Results The DNA probes with 270bp,310bp and 370bp were amplified by the three pairs of primers respectively.The probes were specific.Among 50 clinical isolates of staphylococcus aureus tuf and nuc gene were all positive and mecA gene in 22 isolates were positive.Positive rate of tuf,nuc and mecA gene in 30 staphylococcus epidermidis were 100%,0 and 30% (9/30) respectively.No hybridization in other non-staphylococci occurred.The established method could detect as low as 1ng of bacterial DNA.Conclusion The dot blot hybridization is of high value in rapid,effective identification of methicillin-resistant staphylococci.

The demand of hospital car in first-aid and patients carrying is urgent in paroxysmal epidemic,disaster and wartime.According to types and characteristics of civil-train,many methods are used to rapidly refit civil-train to hospital car,such as rapid taking down devices from civil-train,installing medical appliances and unloading the device in the civil-train and auxiliaries.Based on analysis and comparison,YZ25G hard-seat train is the best one to refit from civil-train to hospital car.