Objective To evaluate the effect of injection duration on bruising and pain after the subcutaneous injection of heparin.Methods The relevant randomized controlled trials,quasi-randomized controlled trials about subcutaneous heparin injection duration of ≥30 s and ≤ 10 s were searched in the databases of CNKI,CBM,VIP Database for Chinese Technical Periodicals,PubMed,Highwire,ScienceDirect,Chinese Cochrane Library,Wanfang database and Google.The quality of RCTs was assessed and Metaanalysis was conducted by RevMan 5.0 Software.Results Twelve RCTs involving 1 986 injections were included.The results of Meta-analysis showed that:There was significant difference between the two groups in the occurrence of bruising.The injection duration of 30 s was much better to prevent bruising.Statistical differences existed in pain intensity between the two groups.Conclusions Prolonging the injection duration to 30 s may reduce the occurrence of subcutaneous bruising.There is no enough evidence to draw a conclusion on pain intensity.Adequately,the current study is limited to a small sample,powered and high quality randomized controlled trials are still needed to be conducted.

Objective:To study the effect of Mg 2+ on glutamate and energy metabolites during focal cerebral ischemia and reperfusion in rats. Methods: Twelve male Wistar rats were divided into 2 groups(n=6):magnesium sulfate(100 mg/kg, i.p.) group and saline group.Cerebral ischemia was produced by occlusion of middle cerebral artery with a nylon thread for 60 min and followed by 60 min reperfusion.Microdialysis probes were stereotaxically implanted into the cortex; dialysates were collected every 15 min to determine the concentrations of glucose, lactic acid and glutamate. Results: There was a dynamic decrease of glucose and an increase of lactic acid and glutamate during ischemia and reperfusion in saline group.Glucose decreased slightly in magnesium sulfate group during ischemia and recovered to normal rapidly during reperfusion. The lactic acid levels in magnesium sulfate group were lower than that in saline group during early stage of ischemia(0-15 min) and reperfusion.There were significant attenuation in the elevation of glutamate during ischemia and reperfusion when magnesium sulfate was administered and recovered to normal after 30 min of reperfusion. Conclusion: The preservation of cellular energy metabolism,the decrease of lactacidosis and attenuation of glutamate level during ischemia and reperfusion may contribute to the neuroprotective effects of Mg 2+ .

Objective To analyse the mutation of pathogenic gene TSC2 in tuberous sclerosis complex (TSC). Methods Using polymerase chain reaction-single strand conformation polymorphism(PCR-SSCP), all the 41 exons of TSC2 gene were analyzed in 4 TSC cases(include 1 suspect case) from one family and 1 sporadic TSC case ,and compared with the kin familial controls and kinless normal controls. Results Missense mutation on exon33 1346S→P (4037T→C) of TSC2 was found in 4 familial cases, and no mutation of TSC2 gene was found in the sporadic case and all the health controls. Conclusion Missense mutation on exon33 (1346S→P,4037T→C)is a new discovery in TSC2 gene of patients with TSC.

Objective To investigate the effects of early core muscles and manual respiratory function training on stroke patients with dysphagia. Methods From June, 2015 to January, 2016, 60 stroke patients with dysphagia were divided equally into control group and obser-vation group randomly. Both groups accepted routine swallowing function training, electrical stimulation and respiratory function training, while the observation group accepted core muscles training and manual respiratory function training, for four weeks. They were evaluated with Standardized Swallowing Assessment (SSA), forced vital capacity (FVC), maximum ventilatory volume (MVV) and the maximum ex-piratory time before and after treatment. Results All the indices improved in both groups after treatment (P<0.001), and improved more in the observation group than in the control group (P<0.001). Conclusion Core muscles and manual respiratory function training at early stage can obviously improve swallowing and respiratory function of stroke patients with dysphagia.

Modern medical staff are facing the challenge to survive in competitions and develop through cooperation.Thus it is of great importance for the future medical staff,that is,medical students to cultivate and enhance their teamwork for future demand.Cultivating approaches mainly include creating a collaborative environment,carrying out cooperative scientific research,creating teamwork in the curriculum,and launching community service activities.

BACKGROUND: The expression of main histocompatibility antigen in cornea of rats is similar to that of human. It is verified in early experiments that penetrating corneal transplantation in rats is more repetition and reliability, and the operation difficulty is lower than that in mice.OBJECTIVE: To establish rat model of penetrating corneal transplantation and analyze the reasons of complications during model preparation and the corresponding managements and probe into the method for improving the success rate of rat model of corneal transplantation.DESIGN: Randomized controlled experiment was designed.SETTING: Department of Ophthalmology , Union Hospital, Tongji Medical College, Huazhong University of Science and Technology.MATERIALS: The experiment was performed in Department of Ophthalmology in Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from March to May 2004. Seventysix outbred female Wistar rats of two months old were employed and randomized into experimental group and control group with 38 rats in each,without eye disease, of clean grade, body mass varied from 180 to 200 g and their right eyes were taken as acceptors. Thirty-eight SD female rats were employed and their both eyes were taken as donors. All of the animals were provided from Experimental Animal Center of Tongji Medical College of Huazhong University of Science and Technology.METHODS: Central penetrating corneal transplantation in situ was adopted and the model was established on the right eye of Wistar rat. Ten minutes before operation, tropicamide eye drops was administrated twice to amplify adequately the pupil of the right eye up to 4.0 mm. According to body mass, general anesthesia was done with abdominal injection of 3.0 mL/kg chloral hydrateand dicaine eye drops was applied twice 5 minutes before the operation with 0.1 volume fraction. Routine sterilization was done on the head of rat, the eyes kept in horizontal level and respiration kept smooth. The clip in dental-ophthalmology department was used to fix the posterior of the operated eye and make it to be semiluxated. The ring driller 3.5 mm in diameter was used to collect corneas of both eyes in SD rat as the implant tissue and place in culture dish with endothelial part upward, covered with methyl cellulose of 20 g/L mass weight concentration. The ring driller, 3.0 mm in diameter was used to collect the cornea of the right eye in Wistar rat to be the graft foreman, and the implant tissue was sutured into the graft foreman on the right eye of Wistar rat with 10-0nylon thread intermittently. Eight stitches were done in corneal transplantation in the experimental group and 6 stitches in the control group. After operation, ofloxacin eye drops was administrated and the operated eye was covered with plaster. Corneal rejection was observed and the evaluation was done in 3 items, named, turbidity, edema and neogenetic vessel. The total score of 3 items was taken as the rejection index on the day. Rejection was determined if the rejection index on the day ≥5 or corneal turbidity reached the 3nd grade. x2 and Fisher definite probability methods were used for statistical examination.plant tissue and corneal rejection.RESULTS: Of 76 Wistar rat acceptors, 5 rats were dropped out, among which, 1 rat was died accidentally after operation in the experimental group, 2 rats were died accidentally after operation in the control and 2 rats were injured cornea on the operated eyes due to fighting. But by supcomplications after corneal transplantation: In the experimental group, the number with anterior adhesion of sclera, non-round pupil; limited wound healing and non-formation of anterior chamber was lower than that in the implant tissue and corneal rejection: the survival time of corneal implant tissue was similar basically in both experimental group and the control [(8.9±2.3), (8.6±2.3) days, P ＞ 0.05]. Rejection presented in both groups in 16 days after corneal transplantation and the incidence of rejection was 100%.CONCLUSION: With stitches maintained and without intervention, the acute rejection is similar in rat corneal transplantation and human corneal transplantation. It is explained in the experiment that 8 stitches in corneal transplantation in which the rat implant tissue of 3.5 mm matches graft foreman of 3.0 mm can reduce the complications of rat corneal transplantation and becomes a satisfactory animal model of corneal transplantation.Skillful microscopic operation techniques, satisfactory operation instruments and adequate amplilfied pupil can reduce to the most extent the postoperation complications in rats.

Objective To assess the value of C-reactive protein(CRP) for the prognosis of acute pulmonary embolism (PE). Methods 56 acute pulmonary embolism patients, confirmed by spiral computed tomography (sCT), magnetic resonance imaging(MRI), or pulmonary angiography (CTPA). CRP as well as electrocardiogram (ECG), echocardiography(UCG), blood gas analysis, were taken after admission. Results Among these patients,24 cases with higher CRP(≥10 mg/L),were diagnosed as massive (50.0%), sub-massive PE(45.8%), mini-massive (4.2%) or died(25.0%). 24 cases (100.0%) showed right heart dysfunction and 24 cases showed pulmonary hy-pertension on UCG, right ventricular 20 (83.8%) on ECG, 22 cases (91.7%) showed hypoxemia. 8 cases (33.3%) had syncope,and 9 cases (37.5%) had cardiogenic shock. CRP was lower than 10 mg/L in 32 patients, among whom,3 cases (9.4%) were with massive PE,6 cases (18.8%) were with sub-massive PE,23(71.8%) were with small PE,1 cases(6.3%) died. 13 (40.6%) had right heart dysfunction and 16(50.6%) had pulmona-ry hypertension on UCG, right ventricular on ECG in 15 cases (46.9%), hypoxemia in 11 cases (34.4%), syncope in 2 cases (6.3%), cardiogenic shock in 4 cases (12.5%). The occurrence of massive PE, mortality (P<0.01) and sub-massive PE (P<0.05)were statistically different between the groups with higher CRP and the groups with lower CRP. The ratio of right heart dysfunction, pulmonary hypertension, right ventricular overloading, hypoxemia had statistical significance (P<0.01). There was statistical significance in the occurrence of syncope, cardiogenic shock (P<0.05). Conclusions CRP can be used as a parameter for PE, and can be used to stratify risk levels for severi-ty and assess the effectiveness of treatment.

Objective To assess the efficacy of itopride on treatment of patients with functional dyspepsia (FD) overlapping constipation-predominant irritable bowel syndrome (C-IBS). Methods Patients who met criteria for FD and FD overlapping C-IBS were randomly assigned into FD treatment group (group A), FD control group (group B), FD overlapping C-IBS treatment group (group C) and FD overlapping C-IBS control group (group D). The patients in group A and group C received 100 mg of itopride 3 times daily for 8 weeks. Dyspeptic symptoms including abdominal pain, bloating, early satiety and constipation, were evaluated before and after treatment. Ultrasonic monitoring of gastric emptying function was performed in group A and group C before and two weeks after treatment.ResultsThe symptoms of FD were relieved in both group A and group C (P<0.05), while better results were shown in group C. The significant improvement of constipation was seen in group A and group C. Besides, after medication, gastric emptying was improved in group A and group C in comparison with group B and group D. Conclusion Itopride is an effective therapeutic option in the treatmentping of patients with overlapping of FD and C-IBS.

Objective To study on the changes of the DNT cells and T lymphocyte subtype in children with infectious mononucleosis (IM) and its clinical significance.Methods The flow cytometry (FCM) was used to detected the DNT cells and other T lymphocyte subtype in 48 cases of IM.Results The study showed that DNT cells( 9.39 ± 4.89 )% were greatly increased in comparison with normal controls (NC) (4.26 ± 1.68)% ( P ＜0.01 ).CD4 cells(21.45 ±9.87)% were decreased ( P ＜0.01 ) and CD8 cells increased in comparison with NC (32.43 ± 5.07) % ( P ＜ 0.01 ).Conclusion DNT cells and T lymphocyte subtype can be used to evaluate the immune function of children with infectious mononucleosis (IM) and provide guidance for adoptive immunotherapy.

New type medical talents are in great need in the fierce international competition in medical field.Logic quality is acquired by accumulation,not born to be.Modern medicine sets higher requirement for medical talents in the aspects of logic quality including receiving and processing information,ability of expression and collaboration,forecasting and innovation.Therefore,only through diligent learning,training and repeated practice can enhance the logic quality of medical talents,and develop into winners in the increasingly fiercer international competition in medical field.