ObjectiveTo explore the weaning method of mechanical ventilation in the treatment of acute severe respiratory failure caused by organophosphate poisoning.MethodsThe clinical features and weaning situation of 51 patients with acute severe respiratory failure caused by organophosphate poisoning by the treatment of mechanical ventilation were retrospectively analyzed.ResultsIn 51 cases,45 cases were cured,the survival rate was 88.2％ and 6 cases died,the fatality rate 11.8％.Conclusion Early ventilator to rescue and choose opportunity for weaning could directly impact on the qualitv of life of patients,and improve outcomes,and reduce mortality.

Objective:To explore the application value of clopidogrel in patients with non ST segment elevation myo‐cardial infarction (NSTEMI) during emergency percutaneous coronary intervention (PCI) .Methods :A total of 168 NSTEMI patients treated in our hospital from Jan 2012 to Feb 2013 were randomly divided into clopidogrel group (n=84) and ticlopidine group (n=84) ,both groups received PCI .Therapeutic effect were observed and compared be‐tween two groups .Results:Compared with ticlopidine group , there were significant rise in percentage of TIMI blood flow grade 3 (88.1% vs .91.7% ) ,white blood cell counting [ (4.0 ± 2.9) 109/L vs .(7.2 ± 2.3) 109/L] and platelet counting [ (101 ± 35) 109/L vs .(141 ± 39) 109/L] ,and significant reduction in percentage of mild bleeding (40.5% vs .19.0% ) in clopidogrel group after operation 28d , P< 0.05 or < 0.01 ;compared with ticlopidine group , there were significant reductions in incidence rates of cardiovascular events (60.7% vs . 27.4% ) and adverse reactions (14.3% vs .10.8% ) in clopidogrel group after six‐month follow‐up ( P<0.05 both) .Conclusion:Clopi‐dogrel possesses satisfying therapeutic effect and high safety in patients with non ST segment elevation myocardial in ‐ farction during emergency percutaneous coronary intervention ,which is worth extension .

Objective:To study the effect of recombined TNF ? combined with induction of apoptosis and its relation with expression of bcl 2 in SW480 human colon cancer cells.Methods:The inhibitive effect of 5 Fu and TNF ? was measured by MTT.Apoptosis of colon cancer cells was studied by TUNEL.The expression of bcl 2 gene was determined by immunohistochemical analysis.Results:After SW480 colon cancer cells were treated with combination in various concentration of 5 Fu and 3 000 U/mL of TNF ? for 48 h,MTT assay revealed a significant decrease of relative viability in compasrison to the control.When SW480 colon cancer cells were treated with 3 000 U/mL of TNF ? and 125 ug/mL of 5 Fu in combination for 48 h,TUNEL method showed the number of nick end positive cells was significantly increased in comparison to the control.The expression level of bcl 2 gene lowered significantly than that of the control group.Conclusion:These results confirmed that combined TNF ? and 5 Fu could synergistically induce apoptosis in SW480 cells and decrease the expression level of bcl 2 gene.

Objective To study the method, advantage and shortcoming of mini-laparoscopic treatment for indirect inguinal hemia in children. Methods 136 cases with indirect inguinal hernia(right:75cases,left:44 cases,bilateral:17 cases) had been treated by high ligation with mini-laparoscopy. Results The mean operation time was 10 mmin for unilateral hernia and 23 mmin for bilateral hernia. Among 119 cases with unilateral hernia,38 cases had been found with contralateral latent hernia. The mean of postoperative inhospital stay were about 1 ～ 2 day(s). All patients had been followed-up for 3 ～ 12 months,there were only 2 cases recurrence found but no complications was detected.Conclusion Mini-laparoscopic high ligation for indirect inguinal hernia in children is a single, safe, satisfactory, effective,and minimally invasive surgical method.

AIM:To establish a quality standard for Anshen Wendan Pill(Rhizoma Pinelliae Praeparata,Pericarpium Citri reticulatae,Poria,Radix et Rhizoma Ginseng,etc.). METHODS:Pericarpium Citri Reticulatae,Fructus Schisandrae Chinensis,Radix et Rhizoma Ginseng,and Radix et Rhizoma Glycyrrhizae were identified by TLC,and the contents of schisandrin and hesperidin were determined by HPLC. The content of cinnabaris was determined by titration. RESULTS:Pericarpium Citri reticulatae,Fructus Schisandrae Chinensis,Radix et Rhizoma Ginseng,and Radix et Rhizoma Glycyrrhizae could be identified by TLC. The calibration curve of schisandrin was linear in the range of 0.017-0.52 ?g with the correlation coefficient of 1.000 0(n=5).The average recovery of schisandrin was 99.83%(RSD=0.86%,n=6). The calibration curve of hesperidin was linear in the range 0.506 -2.53 ?g,with the correlation coefficient of 1.000 0(n=5).The average recovery hesperidin was 100.43%(RSD=1.39%,n=6). The average recovery of cinnabaris was 98.30%(RSD=1.06%,n=6). CONCLUSION :The methods are simple,accurate and reproducible. They are suitable for the quality control of Anshen Wendan Pill.

Objective: To construct an angiopoietin-like protein 2(ANGPTL2) expression vector and obtain ANGPTL2 over-expression endothelial cell strains.Methods: Plasmid phrGFP-C was used to amplify hrGFP protein coding sequence by polymerase chain reaction.The amplified sequence was cloned into the A multiple cloning sites of pIRES to construct plasmid pIRES-hrGFP.Complementary oligonucleotides containing the recognition sequence of BamH I,Sal I,Xba I and SSe8387 I were synthesized,annealed and cloned into a BamH I site on the backbone of plasmid pIRES-hrGFP to obtain vector pIRES-hrGFP-MS.ANGPTL2 cDNA was cloned by RT-PCR while human renal RNA was used as the templet and then inserted into the B multiple cloning sites of the vector pIRES-hrGFP-MS.The newly constructed ANGPTL2 expression vector pIRES-hrGFP-MS-ANGPTL2 was linearized by Xba I and introduced into human umbilical vein endothelial cells.ANGPTL2 over-expressed endothelial clones were screened out by G418 selection and identified by the expression levels of both hrGFP and ANGPTL2 genes in these cell clones.Results: The ANGPTL2 expression vector pIRES-hrGFP-MS-ANGPTL2 was constructed successfully and two ANGPTL2 over-expression endothelial strains were obtained.The cells displayed a significantly extended appearance quite different from that of the control cells.Conclusion: The successful construction of the ANGPTL2 expression vector pIRES-hrGFP-MS-ANGPTL2 and the obtainment of two ANGPTL2 over-expression HUVEC strains have paved the way for further investigation into the function of ANGPTL2 and its possible role in diabetic nephropathy.

Objective To explore the application of mini-laparoscopy in the diagnosis and management of nonpalpable undescended testis in children.Methods 38 cases of impalpabal testes(46 testicular) had been operated by mini-laparoscopy in children with cryptorchidism.Results 38 children with nonpalpable undescended testis (46 testicular) had been operated by mini-laparoscope.Results After laparoscopic exploration,inguinal probe and postoperative pathology,it had been confirmed that 2 testicular were absent,34 testicular were found in high inguinal location,10 testicular were located in intraperitoneal cavity.In addition to the absent testicular,the rest had been performed with mini-laparoscope:one period descent fixation 41 testes,Fowler-Stephens (F-S) installment orchiopexy three testes.Follow-up with side testicular atrophy 2,including one period orchiopexy a testis,F-S installment fixation a testicular; Testicular rebound 1,who had been operated with one phase of testicular descent fixtion.Conclusion For inguinal failed to find the testicular,children with cryptorchidism should be done by laparoscopy because of its positioning accuracy,and most children can do a period drop fixed,but for those really intraperitoneal more exalted person,stage surgery should be needed.Its overall treatment effect is satisfactory and is worth popularizing.

Objective: ANGPTL2 is a newly found angiogenesis-associated protein.In the previous studies,we found that the renal expression of ANGPTL2 is involved in the development of diabetic nephropathy,but failed to reveal the exact distribution and synthesis of renal ANGPTL2.This study aimed to analyze the expression of the ANGPTL2 gene in the glomerulus and tubules in the kidney of db/db mice with diabetic nephropathy and to determine the cells responsible for the synthesis of renal ANGPTL2.Methods: Glomerulus and tubules were microdissected from the renal tissue of diabetic db/db mice and the expression of ANGPTL2 mRNA was analyzed by RT-PCR.The distribution and synthesis of ANGPTL2 in the kidney of the db/db mice were determined by immunohistochemistry,dual-labeling immunofluorescence and immunoelectron microscopy.Results: Significantly increased expression of ANGPTL2 mRNA was found in the glomeruli but not in the tubules of the diabetic db/db mice,as compared with the controls.Immunohistochemistry revealed that the ANGPTL2 protein was distributed in a podocyte-like pattern;dual-labeling immunofluorescence analysis showed colocalization of ANGPTL2 with WT1(Wilms' tumor 1,a marker of podocyte) staining,suggesting that renal ANGPTL2 was expressed specifically by podocytes,which was confirmed by immunoelectron microscopy.Conclusion: ANGPTL2 is specifically expressed by podocytes in diabetic nephropathy mice.

BACKGROUND: Skin flap of nutrient vessel of antebrachial cutaneous nerve is beneficial for repairing injury of distal tissue of hand; thus, it is important for comprehending the correlation of blood supply between distal nutrient vessel of basilic vein and medial cutaneous nerve of bone, skin and forearm to design distal pedicled flap of nutrient vessel of antebrachial cutaneous nerve on clinic. OBJECTIVE: To investigate distally arterial perforating branch of ulnar margin of forearm and provide anatomical bases for designing distal pedicled flap of nutrient vessel in basilic vein of ulnar margin of forearm. DESIGN: Simple sample study. SETTING: Researching Center of Clinical Anatomy, Military Institute of Orthopaedics, Fuzhou General Hospital of Nanjing Military Area Command of PLA. MATERIALS: The experiment was carried out at the Researching Center of Clinical Anatomy, Military Institute of Orthopaedics, Fuzhou General Hospital of Nanjing Military Area Command of PLA from May to October 2004. Thirty upper limbs of adult cadavers perfused with red latex through arteries were provided by Researching Center of Clinical Anatomy, Military Institute of Orthopaedics, Fuzhou General Hospitalof Nanjing Military Area Command of PLA. METHODS: Samples of lateral upper limbs of 30 adults were dissected as the pivot point of styloid process of ulna with microscope. MAIN OUTCOME MEASURES: ① Sources of distally arterial perfo- rating branch of ulnar margin of forearm; ② nutrient vessel between perfo- rating branch and basilic vein; ③ correlation of blood supply between nutrient vessel and medial cutaneous nerve of bone, skin and forearm; ④ superficial and deep communicating branch of basilic vein. RESULTS: ① Sources of distally arterial perforating branch of ulnar margin of forearm, which was derived from 5-9 cutaneous branches ulnar artery with external diameter of (0.7±0.3) mm, 1-3 upper cutaneous branches ulnar artery with the external diameter of (0.6±0.3) mm, 6.0- 16.0 mm above styloid process of ulna, 2-3 cutaneous perforating branches anterior interosseous artery and 1-3 posterior interosseous artery with external diameter of 0.4-1.2 mm, middle and inferior segment of periosteum of ulnar and skins in corresponding areas. ② Arterial perforating branches mentioned above started at cutaneous branches, fascia branches, periosteum branches, basilic vein and nutrient vessel branches of cutaneous nerve to form vascular chains of basilic vein and cutaneous nerve stem and vascular nets of deep, superficial fascia and periosteum. CONCLUSION: Nutrient vessel of basilic vein is derived from distally arterial perforating branch of ulnar margin of forearm, and this is homophylic with that of medial cutaneous nerve of bone, skin and forearm. Both of them are anatomical basis to design distal pedicled flap of nutrient vessel in basilic vein. Rotational point of distal pedicled flap can reach wrist joint. The compound flap can be applied to repair to injury of distal tissue of hand.

Objective To investigate the position competency of residents in the first year and to search for the standardizing training which aims at advancing position competencies. Method Twenty residents of the first year and 40 of superior doctors were taken as research targets. Question-naires including 8 aspects (basic ability, occupational spirit, communication skills, medical knowl-edge, team work, public health, information and management, and academic research) were con-ducted and were scored namelessly. The scores of items in one kind of ability were summed up to serve as the total score of this ability. The mean score of one kind of ability and the mean score of 8 kinds of abilities of residents and superior doctors was calculated. SPSS 17.0 was adopted to make statistical analysis. t-test was adopted to test the difference between the score from residents and superior doctors with P<0.05 representing statistics significance. Results The scores of 8 kinds of abilities were much lower than full scores. The scores of basic ability, occupational spirit, and team work from residents (78.5, 87.4, 41.9) were higher than those from superior doctors (72.6, 80.5, 39.5), with statistical significances (P=0.020, 0.013, 0.045). Conclusions Residents are lack of position competency and awareness, which demonstrates the gap between the training model and the demand of work. It is sug-gested that we should design the training system and evaluation methods based on doctors' compe-tences, add training for comprehensive ability and evaluate abilities of all aspects. An excellent hu-manity education should be built and quality cultivation should be taken attention to. Objective and measurable indices should be developed to increase residents' knowledge.