Objective To evaluate the experience of replantation of severed finger tip and suggest a new method to replant the severed finger tip injury. Methods A total 25 cases of severed finger tip injuries on nail root level were retrospectively analysed.They were 18 males and 7 females,19～38 years old.The finger tips were completely cut down.The wound should be cleaned thoroughly under operative microscope and the cut ends of artery and nerve can be found on the wound.The important step was to dissect out all braches of the arch of the artery and ligate them but one small branch,so as to reduce the blood circulate into the finger tip.It was not necessary to joint the vein. Results Twenty-four fingers were survived,only one finger was necrosed.The course of 13 fingers were very prosperous.Twelve fingers had some cyanosis and 9 fingers turned red after a few punctures to release the venous blood and other 3 fingers should make a side incision torelease more venous blood.Then 2 fingers were survived and one finger was failured. Conclusion Only one artery should be anastomos for finger tip injury on nailroot level.No vein should be joint.But the branches of the artery arch should be ligated except one small branch.

Objective Infracardiac total anomalous pulmonary venous connection, a rare congenital cardiac defect, is associated with high mortality. A modification was designed for the procedure to reduce the post-operative obstruction in the pulmonary venous. Methods From September 2005 to December 2007, seven patients with infracardiac total anomalous pulmonary venous connection were treated with repair surgery through right side approach. The patients' age at operation was (70.57 ±44.67) days , the weight was (4.07 ±0.87) kg. Three patients had pulmonary venous obstruction, and 2 with small PFO. A modified right - side approach for repairing this defect was used. Results No death occurred after the operation. The postoperative complications included low cardiac output in 5 patients (71.43%), pulmonary hypertension crisis in 3patients ( 42.86% ) , mechanical ventilation for more than 7 days, which happened in 2 patients (28.58%) and pulmonary infection. All of the patients received follow-up. No residual shunt and pulmonary venous return obstruction were identified on echocardiogram(with a velocity from 1.2 m/s to 1.47 m/s). The heart function of patients was within the normal range(EF 0.70 -0.79, FS 0.32 -0.44). Conclusion The modified surgical procedure for the correction of infracardiac total anomalous pulmonary venous connection by right side approach was associated with favorite clinical outcomes, The post-operative outcomes depended on the size of anastomosis between the common vein and left atrium and the patency of the pulmonary venous return. Adequate size of anastomosis and maintenance of the spatial structures in adjacent regions were helpful in decreasing the adverse effect of postoperative obstruction.

Objective: To investigate the association between inflammatory cytokines and ventricular remodeling after acute myocardial infarction (AMI) in rats, and the effects of simvastain on inflammatory cytokines and ventricular remodeling after AMI thereof. Methods: After AMI was produced in female SD rats, the animals were divided into control group,simvastain group and sham-operated group. After transthoracic echocardiography, TNF-α, IL-6 and P Ⅲ NP of the serum and cardiac muscle were measured by radioimmunology technology. The comparative heart weight and infarct sizes were calculated.Results: Compared with the control group, the LVDd and LVDs decreased significantly (P ＜ 0.05), LVEF,LVFS and posterior wall thicking increased significantly (P ＜ 0.05) in simvastain group. The values of TNF-α, IL-6 and P Ⅲ NP increased significantly in simvastain and control group compared with those of sham-operated group(P ＜ 0.05 or P ＜ 0.01 ). The values ot TNF-α, IL-6 and pⅢ NP decreased significantly in simvastain group compared with those of the control group (P ＜ 0.05). The comparative heart weight and infarct size decreased significantly in simvastain group compared with those of the control group (P ＜ 0.05). Conclusion: Simvastain can ameliorate the ventricular remodeling and improve cardiac performance after AMI by restraining the overexpression of inflammatory cytokines.

Objective To review and evaluate the effect of one stage surgical correction of congenital heart disease with tracheal stenosis in infants.Methods Between August 2001 and December 2005,six infants with congenital heart disease with tracheal steno- sis were repaired at one stage operation.The age was 24 d～3 y[mean(13.16?12.03)months]and the weight was 4.2～10.0 kg [mean(7.98?2.03)kg].There were 3 patients with tetralogy of Fallot,1 with pulmonary atresia;2 with ventricular septal defect, 1 with coarctation of aorta;and 1 with pulmonary sling.The congenital heart disease were repaired underwent low temperature and car- diopulmonary bypass,and the tracheal stenosis were corrected simultancously.Results There was one death postoperative because of right and left branch stenosis.One patient with pulmonary sling died of granulation tissue on the patch 3 months after operation.All other 4 patients recovered uneventfully.These patients were followed up from 6 month to 4 years.There were no complications.CT scan shows that the tracheal anastomosis was patent without any stenosis.Conclusion One stage repair of congenital heart disease with tracheal stenosis in infants may have a satisfactory result.To deal with the tracheal stenosis is difficult,the operative methods de- pends on the length of stenosis.The principles of surgical methods consist of using autologous material,maintaining its contour and function of respiratory epithelium,and maintaining its growth.

Objective Aortic arch obstruction is a commonly associated malformation in the patients with Taussig-Bing anoma- ly.Herein,we reported our outcomes of single stage corrections in patients with the Taussig-Bing anomaly associated with aortic arch obstruction.Methods Between May,2000 and Dec,2006,12 patients with Taussig-Bing anomaly associated with aortic arch obstr- uction (5 patients associated with interrupted aortic arch) underwent arterial switch operation with baffling of the left ventricle to neo- aorta.The corrections of aortic arch obstruction included extended resection combined with end to end anastomosis to aortic arch or end to side anastomosis to ascending aorta.Results The hospital mortality rate was 25% (3/12).The ventilating time and ICU stay were (7.4?2.1) days and (11.7?4.6) days,respectively.No reoperation because of residual anomalies was required.Conclusion Tanssig-Bing anomaly,especially associated with aortic arch obstruction,is different from transposition of great artery.The opti- mized operative indications,techniques and the managements of aortic arch obstruction are discussed in the article.

Objective To investigate risk factors for the development of advanced schistosomiasis. Methods The case\|control study was designed with a match of 1∶1 and 1∶2. Healthy persons and chronic schistosomiasis patients were used as control. Each group was composed of 213 cases. Items investigated included: history of schistosomiasis and treatment, exposure to the contaminated water, social\|economical condition and nutritional status, other concomitant diseases. Cellular and humoral immunity, HBVMs and ABO blood groups were also detected. Statistical analysis was performed by 1∶1 and 1∶2 matched single and stepwise conditional logistic regression analysis with SAS software. Results By stepwise conditional logistic regression analysis, it was revealed that number of schistosomiasis examination(OR=1\^168-1\^311), interval from first infection to last treatment(OR=1\^142), interval from first infection to this investigation (OR=1\^089), \{HBsAg\++\}(OR=4\^683-10\^759), \{HBcAb\++\} (OR=2\^873), \{HBsAg\++\}+\{HBeAb\++\}+\{HBcAb\++\}(OR=7\^64) were risk factors of developing advanced schistosomiasis. The average living space and cellular immunity were lower in advanced schistosomiasis patients than others. No association was found between advanced schistosomiasis and ABO blood groups. Conclusion The development of advanced schistosomiasis is associated with repeated infections, and delayed or incomplete treatment. Combined infection with hepatitis B, poor socio\|economic conditions and impaired cellular immunity may increase the pathogenetic risk of schistosomiasis.

Objective: To apply and evaluate the effect of empowerment educational program on AIDS prevention and treatment among freshmen in one university. Methods: The method of two stage stratified sampling was used to select the experimental and control group. The traditional health education was implemented among the control group, and the empowerment education was implemented for the experimental group. The effect of the two groups was compared before and after intervention. Results: For experimental group, the awareness rate of AIDS(65.02%) ( χ 2=61.02， P <0.01) and the overall score of attitude and behavior(16.71± 2.53 )( t =-2.66， P <0.05) were significantly improved after intervention(82.96%，18.58±1.95). For the control group, there was significant difference in awareness rate of AIDS after intervention(67.70% vs 96.02%， χ 2=18.64, P <0.05), while there was no statistical difference in overall score of attitude and behavior after intervention(16.52±1.50 vs 17.16±1.57， t =-1.51, P =0.14). There was no significant difference in awareness rate between the two groups before intervention ( χ 2=0.36, P =0.55), but there was a statistical difference after intervention ( χ 2=20.42, P <0.01). There was statistical difference in attitude and behavior scores between the two groups after intervention ( P <0.05). Conclusion Empowerment educational program can improve the awareness rate of AIDS among college students, help to establish an objective attitude towards AIDS and infected patients, and to reduce high risk sexual behavior, also it is more effective compared to traditional education method.

BACKGROUND:The mechanism underlying Wal erian degeneration fol owing peripheral nerve injury is complex. Immune regulation on Wal erian degeneration is beneficial for early repair of perpheral nerve injury.
OBJECTIVE:To investigate the effects of Tol-like receptor 4 (TLR4) antagonist on Wal erian degeneration and axonal regeneration after early peripheral nerve injury in rats.
METHODS:Fifty male Wistar rats were recruited and randomly divided into treatment group (n=20), model group (n=20) and sham group (n=10). The right sciatic nerves of rats in treatment and model groups were cut and sutured end-to-end, while the sciatic nerves of rats in sham group were only exposed. In the treatment group rats were intravenously injected with 0.15 mg/kg TAK-242 via tail vein 1 hour preoperatively and 7 days postoperatively, and the rats in the other two groups were given intravenous injection of the same volume of normal saline. The sciatic nerves were removed at 24 hours, 3, 4 and 7 days after surgery.
RESULTS AND CONCLUSION:Real-time PCR indicated that the mRNA expressions of interleukin-1βand monocyte chemoattractant-1 were significantly increased in the model group compared with the sham group at 24 hours after surgery (both P<0.001), while the expressions were significantly decreased after TAK-242 injection (both P<0.001). Immunofluorescence showed that compared with the model group, down-regulated expression of CD68+and iba1+cel s appeared in the treatment group at 3 days after surgery (P<0.01, P<0.05). Luxol fast blue staining revealed that demyelination at the sciatic nerve stump appeared in both model and treatment groups at postoperative 7 days, but myelin debris clearance in the treatment group was significantly reduced compared with the model group (P<0.05). Hematoxylin-eosin staining showed that a lot of inflammatory cel s, Schwann cells and regenerated nerve fibers at the sciatic nerve stump were found in the model group, while there were few inflammatory cells, Schwann cel s and regenerated nerve fibers in the treatment group at 7 days after surgery. Immunohistochemistry found that the expression of growth-associated protein-43 in the treatment group was significantly lower than that in the model group at 4 days postoperatively (P<0.05). Besides, compared with the model group, a significantly decreased sciatic functional index was found in the treatment group at 20, 30 and 40 days after surgery (P<0.05). These results show that TLR4 antagonists delay early nerve regeneration in rats after sciatic nerve injury probably by inhibiting the TLR4 signaling pathway.

Objective: To determine health risk behaviors related to accidental injury of adolescent in Jiangxi province,and to provide a peference for taking targeted measures to prevent the occurence of adolescent’s risk behaviors. Methods: By using the cluster stratified sampling, students of grade one and grade two from 10 classes in 5 middle schools in Nanchang city and from 1 middle school in Wuyuan county were selected. Health risk behaviors were investigated through questionnaire survey and were compared within the two areas. Results: Regarding to safety, the rates of never or rarely wearing a helmet when riding a bicycle during the past 12 months, never or rarely wearing a seat belt, text or Email while driving a vehicle and in a physical fight were very high. In Wuyuan county, 35.2% of the students have ever tried cigarette smoking, 51.5% of the students have had at least one drink of alcohol, 4.0% of the students have ever had sexual intercourse, 32.7% of the students describe their weight as slightly or very overweight, 49.1% of the students trying to lose weight. After standardized, the rate of health risk behaviors in Nanchang city was higher than that in Wuyuan county. Conclusion here are more healthrisk behaviors found among middle school students in Nanchang than in Wuyuan county.The targeted measures should be taken to develop healthy behavior habits of the students to effectively reduce its occurence.

Objective: To analyze the relationship between daily behavior and self-perceived academic performance among students in Jiangxi, and to provide a scientific basis for developing health behavior among adolescents and children. Methods: By using stratified cluster sampling, 12 primary and secondary schools from six counties of Jiangxi Province were selected, and a total of 2 284 students were investigated with questions including breakfast consumption, number of days participating in sports activities (≥45 min) and the average screen time during the past 7 days. Regression analysis was carried out by using ordered multi-classification logistic. Results: Of the 2 284 students surveyed, 1 374(60.16%) perceived their academic performance as very good or good, 613 (26.84%) and 297(13.00%) perceived as moderate or poor. Primary school, having breakfast every day, not playing on mobile or computer during weekday was positively associated with higher self-perceived academic performance (OR=0.50, 0.57 and 0.64, respectively, P<0.05), no sports activities ≥45 min during the past 7 d was associated with poor(OR=1.57, P<0.01). Among the 2 284 students, 67.43% students ate breakfast every day in the past 7 d, 75.39% students did not play mobile phones or computers at school, 40.89% students did not participate in sports activities (≥45 min). Conclusion Breakfast skipping and insufficient physical exercise shows adverse effects, and no/limited screen time during weekdays shows positive effects on academic performance. Intervention of visky behaviors should to carried out from different perspectives to promote the develpment of the health habits among students.