Objective To discuss two simulation studies on the closed and open peritoneum in abdomenal operations. Meth-ods We selected 120 domestic female rabbits from animal laboratory of Qi Qi Ha’er Medical College at random and divided them into four groups(according to whether the peritoneum was open or not,the degree of peritoneum defect at the right side of incision and the existence of peritoneum hemorrhagic focus ),with 30 cases in each group. Group Ⅰ: no peritoneum suture and making a defect of 4cm?3cm at the right side of the incision; Group Ⅱ: no peritoneum suture and making a defect of 4cm?3cm at the right side of the incision,with a hemorrhagic focus at peritoneum defect;Group Ⅲ: with peritoneum suture; Group Ⅳ:with dense and compact peritoneum suture.And then we analyzed postoperative peritoneum healing progress. Results Observeations of the incision infection by the naked eye were that one case was identified in group Ⅰ,Ⅲ and Ⅳ;and a significant difference of occurrence rate was identified between the fallowing groups: groupⅠandⅡ(P

BACKGROUND: As indicated by clinical research, if cerebral infarction could be effectively treated at early stage, especially normal specific therapy provided within 6 hours or even earlier after attack, the prognosis would be significantly better than delayed therapy. However, it is still unclear that whether the changes of cellular apoptosis-inducing or -inhibiting indicators could be used as criteria in the judgment of prognosis.OBJECTIVE: To test the content of cell apoptotic factor and to investigate the prognosis in hospitalized patients with cerebral infarction who received treatment at different time for further verification of the therapeutic timing for the disease.DESIGN: A same term randomized controlled study based on patients.SETTING: Department of neurology of a general hospital of a military area command of Chinese PLA.PARTICIPANTS: Totally 144 male patients admitted in the Second Department of Neurology, General Hospital of Jinan Military Area Command of Chinese PLA between 2000 and 2002 were divided into four groups including 6 hours, 24 hours, 72 hours and 96 hours group according to different time of therapy provided.METHODS: Oral administration of 400 mg Lumbrokinase, 2 tablets of heparin sodium, 60 mg of nimodipine, and 100 mg of vitamin E, three times a day. 150 mL of normal saline(NS) containing 52.5 mg of Ginkgo biloba L extractive(Jin Na Duo) and 150 mL of NS containing 10 mL of Cerebroprotein Hydeolysate were used through intravenous drop once a day. Ten days were set as one therapeutic course and 2 courses were given. 200 g/L of mannite was given to dehydrate for patients with large area infarction(＞ 7 cm2) . Platelet membrane Fas, Apo2.7 and Bcl-2 percentage and prognostic assessment were tested in patients of four groups before and after therapy.MAIN OUTCOME MEASURES: Peripheral platelet membrane Fas,Apo2.7 and Bcl-2 percentage in patients of different group and prognosis evaluation.RESULTS: Percentage of platelet membrane Fas, Apo2.7 and Bcl-2 of 6 hours group was significantly higher or lower after therapy than before therapy ( P ＜ 0.05 ), and moreover, the difference with other groups was significant( P ＜ 0.05), As revealed in the analysis of prognosis, the effectiveness of patients who received therapy within 6 hours was significantly better than that of 96 hours group and the mortality reduced significantly.CONCLUSION: Normal hospitalizing therapy provided within 6 hours after attack could surely improve the prognosis and reduce the disability rate, and the abnormity and extent in Fas, Apo2.7 and Bcl-2 are closely correlated with prognosis.

Objective To investigate and analyze the postoperative progression of ossification of the patients with ossification of the posterior longitudinal ligament (OPLL) on cervical spine. Methods From Jaunary 2001 to December 2007, 95 postoperative patients with cervical OPLL were followed and analyzed retrospectively. There are 72 males, 23 females, with the average age of 56.3 years (range, 40-73years). The follow-up time was from 1 to 6 years, average 3.1 years. Among them 36 patients were performed with anterior cervical corpectomy, fusion with titanium mesh and fixed with cervical plates, others treated with posterior cervical laminectomy and fixation. 2 of the 95 cases were performed anterior and posterior combined operation. Clinical data, X-rays, CT and MR images and progression of ossification, were measured and analyzed in details .The relationships between the progression of ossification and relative factors, as gender, age, C3 ossified involved, T-OPLL, OPLL-type, time of follow-up, surgical approach, Japanese Orthopaedic Association (JOA) scores and improvement rate of JOA scores, were analyzed. Results Progression of ossification in 39 cases among the 95 followed postoperative OPLL patients, 28 men and 11 women, average age 55.9 years, range 41-71 years. The age of progressed patients included 12 cases of ≤49 years, 12of 50-59 years, 12 of 60-69 years and 3 of ≥70 years. 35 patients were operated by posterior approach and only 4 treated with anterior operation. According to the standard of the progression of ossification that 2 mm in the length or/and thickness, there are 4 cases progressed only in length, 2 only in thickness, other 33 patients both the length and thickness. Progression of length is from 2mm to 20mm (average 7.74±4.71). But thickness is progressed from 2 mm to 6 mm (average 2.67±1.51). From 1 to 3 years follow-up time it appeard as a downtrend about the progression of ossification. But it may appear an uptrend from the 4th year. JOA score and improvement rate of the JOA score were almost improved to the high-point in three years. And according to the statistic data there are obvious relationship between progression of ossification with age, surgical approach and C3 ossified involved. Conclusion There is a high rate of postoperative ossification progression in cervical OPLL patients. Cervical OPLL patients with C3 ossification involved, performed with posterior laminectomy and those young at surgery may have higher rate of progression of the ossification. The JOA score and improvement rate of the JOA score were little influenced by the progression of the OPLL during the short and intermediate-term follow-up.

Objective To investigate the apoptosis induced by adenovirus mediated PML growth suppressor in SGC-7901 gastric cancer cells. Methods Human full-length PML cDNA was cloned into shuttle plasmid pSGCMV, the constructed plasmid containing PML gene was co-transfected into 293 cells together with backbone plasmid pPE3 to obtain recombinant adenovirus Ad-pml. Ad-pml was used to infect SGC-7901 cells. The expression of p53 and bcl-2 in SGC-7901 cells and qualitative, quantitative index of cell apoptosis were detected with MTT, flow cytometry and immunohistochemical method. Results The growth of SGC-7901 cells was inhibited and the apoptosis rate was increased by adenovirus mediated PML in a MOI- dependent manner. The expression of p53 protein was increased and that of bcl-2 protein was unchanged in SGC-7901 cells after treated with adenovirus mediated PML. Conclusions Adenovirus mediated PML exerts its cytotoxic effect on SGC-7901 cells by inducing apoptosis. The increase of p53 protein expression is the mechanism inducing gastric cancer cell apoptosis.

Objective To evaluate the assessment index system of internal medicine, and to analyze the factors of practical effects on internal medicine. Methods The assessment index system of clinical skills was developed by expert group based on the clinical syllabus and objectives. Internal medicine index system was divided into four items such as history-taking, physical examination, hos-pital records and case questions. 49 five-year clinical interns who took internal medicine exams were researched. Reliability, validity, discrimination, difficulty were used to analyze the quality of assess-ment index system. Gender, teaching hospital and the preparation of postgraduate examination were used to explore the influencing factors of practical effects with independent t-test and Wilcoxon signed rank tests. Results The reliability, discrimination, difficulty of the assessment index system were 0.50, 0.15 and 0.85, respectively. The removing item coefficient of history collection, physical ex-amination, hospital records, case questions were 0.38, 0.26, 0.47 and 0.53, separately, and the discrimination were 0.18, 0.17,0.27 and 0.37, separately, and the difficulty were 0.87, 0.89, 0.79, and 0.78, respectively. The scores of assessment index system of girls were higher than those of the boys(P<0.05). Moreover, the girls scored higher in history collection and physical examination, compared with the boys(P<0.05). The discrepancy scores were not statistically significant among teaching hospitals (P>0.05). The students who prepared the postgraduate examination scored lower than the others(P<0.05). Conclusions The assessment index system of internal medicine is reason-able and reliable, but the assessment of case questions still needs to be standardized. Teaching hospi-tals have little effect on internship while gender and the preparation for postgraduate examination influence practice effects in internal medicine.

Objective To observe the therapeutically effect of kangnao liquid on Pi3k mRNA and Aktm RNA ex-pressions in rats with focal cerebral ischemia-reperfusion (I/R) injury. Methods 180 male SD rats were randomly divided into 6 groups:sham operated group, model group, three kangnao liquid groups (high-dose, medium-dose and low-dose) and nimodipine group. Rats in kangnao liquid groups were administrated with kangnao liquid of 24 g/(kg · d), 12 g/(kg · d) and 6 g/(kg · d), orally once a day. Rats in nimodipine group were given nimodipine 1 mg/(kg · d). Rats in model group and sham group were treated with the same volume of distilled water for 7 days. The animal model of middle cerebral artery occlusion (MCAO) was established by a monofilament method from right internal carotid artery. The neurological evaluation was per-formed 24 h after reperfusion. The in situ hybridization was used to investigate the expression levels of Pi3k mRNA and Akt mRNA in rats on 12 h, 24 h, 48 h, 72 h and 168 h after ischemia for 2 h. Results Compared with model group, neurological functions were improved significantly in kangnao liquid groups. The expression levels of Pi3k mRNA and Akt mRNA were al-so significantly higher in kangnao liquid groups than those of model group. The expression levels of Pi3k mRNA and Akt mRNA were significantly higher in nimodipine group than those of model group, but which were lower compared with those of high-dose and medium-dose kangnao liquid groups. Conclusion Kangnao liquid can protect nerve cells by enhancing the expressions of Pi3k mRNA and Akt mRNA in rats with cerebral ischemia-reprefusion injury.

Objective: To study the effect of enteral nutrition in the treatment of heart failure with hyponatremia.Methods: Forty patients sufferd from heart failure with hyponatremia were divided into two groups at random: control group(n=20) with regular therapy and treatment group(n=20) with enteral nutrtion on the base of regular therapy.Time intervals from hyponatremia to normal natremia of the two groups were compared.Results: Time interval from hyponatremia to normal in the treatment group was 5.30?1.82 days,and that in the control group was(8.85?2.44) days.Conclusion: The treatment with enteral nutrition can significantly shorten the clinical treatment time in heart failure with hyponatremia.

Objective To evaluate the value of transvaginal color Doppler sonography(TVCD)in the conservative treatment of early tubal pregnancy(TP).Methods Fifty cases of early TP were examined by TVCD before medical treatment,including the size of TP mass,blood flows graded according to Alder,hemodynamics parameters.All data were ananlized and compared with therapeutic results.Results Fortyfive cases were treated successfully(45/50),and 5 failed.According to TVCD,TP masses flow were graded from O to Ⅲ.In the successful group,4 cases were graded 0,21 Ⅰ,16 Ⅱ and 4Ⅲ,blood flow signals were measured in 41 cases,the mean velocity was(5.452±4.327)cm/s,PI(1.597±0.696),RI 0.680±0.107.In the failure group,all TP masses flow were graded Ⅲ,the mean velocity was(16.774±9.855)cm/s,PI 0.95 1±0.193,RI 0.567±0.034.Conclusions In the medical treatment of early TP,TVCD findings associated with the treatment outcome closely,it plays an important role in assessing conservative treatment of early TP.

Objective To explore the feasibility,efficacy and safety of endoscopic retrograde cholangio?pancreatography ( ERCP ) drainage during peroperation of hilar cholangiocarcinoma for alleviate jaun?dice. Methods Nineteen cases patients with hilar cholangiocarcinoma who were treated with ERCP in the First Affiliated Hospital of Xi'an Jiao Tong University from January 2013 to December 2013,the drainage way,efficient rate,complication rate,and surgical situation were retrospective analyzed. Results Bilateral endoscopic drain?age was one?time achieved in all 19 patients. Among them,Eendoscopic nasobiliary drainage( ENBD) for unilat?eral bilateral drainage was 4 cases,ENBD and plastic stent for unilateral( left or right) drainage was 9 cases,EN?BD and plastic stent for bilateral drainage was 6 cases. The drainage efficiency rate was 89. 5% ( 17/19) . Serum alanine aminotransferase(ALT),total bilirubin(TBIL),direct bilirubin(DBIL),alkaline phosphatase(ALP) and Prothrombin time (PT) were significantly decreased after 7days post?ERCP((208. 4±47. 7) U/L vs. (90. 3 ±31. 57) U/L,(421. 7±85. 9) μmol/L vs. (150. 1±49. 7) μmol/L,(294. 6±30. 6) μmol/L vs. (95. 4±23. 2)μmol/L,(853. 1±133. 7) U/L vs. (600. 0±116. 4) U/L,(17. 7±1. 8) s vs. (13. 8±1. 0) s;P=0. 000,0. 001, 0. 000,0. 001,0. 004) . There were 6 cases occurred ERCP postoperative complications,including 2 cases of hy?peramylasemia, 1 case of pancreatitis, 3 cases of cholangitis. Seven cases of hilar cholangiocarcinoma patients were received hilar radical surgery by combination caudate lobectomy of the left or right hepatectomy,no postop?erative cholangitis was occurred. Conclusion ERCP biliary drainage is an important means to ensure the perio?perative safety and efficacy of hilar cholangiocarcinoma.

OBJECTIVE:To evaluate the efficacy and safety of new agent zaleplon in treatment of insomnia.METHODS:A randomized,double-blind,controlled and dosage-adjusted clinical trial was conducted.The subjects had been treated with zaleplon5～10mg/d and zopicolone7.5～15mg/d for14days,respectively.RESULTS:The scores of sleep dysfunction rating scale at endpoint were significantly reduced as compared with the baseline in both groups(P