Objective To evaluate the effect of different early nutrition support on nutritional status,immune function and stress condition in patients with severe craniocerebral trauma.Methods 90 postoperative patients with severe craniocerebral trauma were randomly divided into standard EN group,immune EN group and TPN group,30 cases in each group.Blood samples were obtained for measurement nutritional status,immune function and stress conditionin in patients before treatment and the first,seventh and twenty first day after surgery.Results Nutritional status,immune function and stress condition of patients in immune EN group improved significantly after seven days.Nutritional status,humoral immune function and stress condition of patients in standard EN group also improved.After 21days,nutritional status,humoral immune function and stress condition of patients in TPN group improved (P ＜ 0.05 or P ＜ 0.01).Conclusion Early immune EN nutrition support of patients with severe craniocerebral trauma can improve nutritional status,immune function and stress condition and maybe the best nutrition support method.

Objective To study the expression of metastasic suppressor gene( KAI1 / CD82)and cell adhesion molecules(CD44v6)in human laryngeal squamous cell carcinoma(LSCC),precancerous lesion,polyps,and normal mucosa. Methods Immunohistochemical technique( Envision)was used to detect the expression of KAI1 / CD82 protein and CD44v6 protein in 64 cases of LSCC,21 cases of laryngeal precancerous lesion(LPL),15 cases of polyp of larynx(LP)and 15 cases of normal laryngeal mucosa(NLM). Results The result turned out to be as follows:①KAI1 / CD82 protein was highly expressed in NLM and LP,and lowly expressed in LPL and LSCC,the positive rates of KAI1 / CD82 protein expression were 86. 67%(13 / 15),80. 00%(12 / 15),38. 10%(8 / 21)and 37. 50%(24 /64),respectively. There was statistically significant difference in NLM and LSCC. ② CD44v6 protein was lowly ex-pressed in NLM and LP and highly expressed in LPL and LSCC,the positive rates of CD44v6 protein expression were 26. 67%(4 / 15),33. 33%(5 / 15),80. 95%(17 / 21)and 75. 00%(48 / 64),respectively. There was statisti-cally significant difference in NLM and LSCC. Conclusion ① The down-regulation or deletion of KAI1 / CD82 and the up-regulation of CD44v6 are related to carcinogenesis,development of LSCC. ② The combined detection of KAI1 / CD82 and CD44v6 may provide clinical basis for the early diagnosis of LSCC.

BACKGROUND:Total knee arthroplasty solves a great pain for patients with severe knee joint disease, and its clinical curative effects have been general y accepted. In the clinic, the formulation of clinical analgesic program of the two surgeries in patients undergoing double knee prosthesis lacks of the support of evidence-based medicine.
OBJECTIVE:To compare the differences in pain during early stage of primary and secondary surgeries in bilateral total knee arthroplasty, and to provide evidence for clinical analgesic programs.
METHODS:A total of 87 patients receiving staged bilateral total knee arthroplasty from January 2009 to January 2013 were retrospectively analyzed. Visual analogue scale was compared at 24, 48 and 72 hours after first and second staged total knee arthroplasty, including seating and maximum flexion position. In addition, the difference in early pain score was compared between second and first total knee arthroplasty in different intervals (less than 6 months, 6-12 months, more than 12 months).
RESULTS AND CONCLUSION:The visual analogue scale scores at seating and maximum flexion position at 24 and 48 hours after second total knee arthroplasty were significantly higher than the first surgery. No significant difference in visual analogue scale scores was detected between 72-hour seating and maximum flexion position. Visual analogue scale scores were significantly higher in the interval of less than 6 months than in the 6-12 month group and more than 12 month group in the 24-hour seating and maximum flexion position after second total knee arthroplasty. No significant difference in visual analogue scale scores was detected between the 6-12 month group and more than 12 month group at seating and maximum flexion position. Results suggested that the pain of second surgery was obviously higher than the first surgery within 48 hours after staged bilateral total knee arthroplasty, and this can provide a clinical evidence to enhance the analgesic strategy in the second staged bilateral total knee arthroplasty. The interval between two surgeries also affected the early pain after second surgery. Considered the aspect of postoperative pain, it is better to suggest the interval between first and second surgeries in staged total knee arthroplasty should be more than 6 months. This can reduce pain after second surgery, elevate patient’s satisfaction and accelerate the speed of recovery.

Objective To study the clinical application of midazolam combined with remifentanil in spinal anesthesia.Methods80 cases of vertebral fractures in Jiaxing hospital, Zhejiang armed police corps from February 2014 to December 2016 were selected as the research object in this study.They were randomly divided into two groups: control group and experimental group, each group had a total of 40 cases.Patients in the control group were treated with midazolam anesthesia, the experimental group was treated with midazolam combined with remifentanil anesthesia.Comparative analysis of the experimental group and control group of patients with vital signs and anesthesia recovery time and anesthetic effect indicators.ResultsAfter the corresponding anesthesia, the respiratory frequency and heart rate of the experimental group were significantly higher than those of the control group, with statistical difference (P<0.05).There was no significant difference between the control group and the experimental group, no statistical significance.The recovery time, the time of open eyes and extubation time of the experimental group were significantly lower than those of the control group (P<0.05).The excellent rate of anesthesia in the experimental group was 95.0%, and the excellent rate of anesthesia in the control group was 75.0%.As a result, the excellent rate of anesthesia in the control group was significantly lower than that in the experimental group, the OAAS score of the experimental group was significantly higher than that of the control group, with statistical difference (P<0.05).ConclusionThe application of midazolam combined with remifentanil in anesthesia of spinal fracture surgery, anesthesia effect is good, the patient's recovery time is faster, with the clinical significance of further promotion and application.

Objective To explore the influence of aerobic exercise on plasma lipoprotein in overweight and obese PCOS women.Methods 12 obese and overweight patients with PCOS were selected.Before and after 12 weeks of aerobic exercise,the height,weight,BMI,WHR,body fat percentage and fasting blood samples of high-density lipoprotein(HDL),low density lipoprotein(VLDL),triglyceride and cholesterol levels were measured and detected.Results After 12 weeks of aerobic exercise,the BMI[(25.43±2.17)kg/cm2 vs.(22.27±1.57)kg/cm2,t=8.52],WHR[(0.864±0.021) vs.(0.831±0.019),t=2.99],fat rate[(33.76±5.36)% vs.(30.53±5.66)%,t=5.580],and triglyceride[(1.90±0.58)mmol/L vs.(0.95±0.51)mmol/L,t=7.400]were obviously decreased,the high-density lipoprotein cholesterol[(2.07±0.39)mmol/L vs.(3.31±0.48)mmol/L,t=3.352]was obviously increased,the differences were statistically significant (all P<0.05).Conclusion Obese and overweight PCOS women can lose weight through aerobic exercise,so as to adjust lipoprotein spectrum and improve health.

Taking the modern occupation education concept as the guide,oriented by adapting to the demand of occupation post,we established a new open education mechanism of medical occupation education to promote the reform of personnel training mode,curriculum and teaching content to explore the effective way of the sustainable development of local medical occupation education.

Objective To explore the effect ot atorvastatin on the levels of serum Interleukin-6 ( IL-6),Endothelin(ET) and MCP-1 in patients with acute cerebral infarction(ACI).Methods 100 patients with ACI were randomly divided into the atorvastatin therapy group(n =50) and the conventional therapy group(n =50).At the basic of conventional therapy,the atorvastatin therapy group was treated with Atorvastatin 20mg/d.Both groups were treated for 4 weeks.The levels of serum IL-6,ET and MCP-1 were measured and the scores of neurological deficit ( NDS ) were evaluated before and after treatment.A healthy control group which approximately matched the experimental group included 30 persons.Results The levels of serum IL-6,ET and MCP-1 in both two groups after 14d treatment were significantly lower than those before treatment(t =26.38,49.10,34.51,25.77,32.23,34.68,P ＜0.05),and the levels of serum IL-6,ET and MCP-1 in atorvastatin therapy group was significantly lower than that in conventional therapy group( t =10.10,13.18,23.85,P ＜0.05 ).NDS of both groups after treatment was lower than those before treatment(t =18.38,6.98,P ＜0.05 ),and the score of atorvastatin therapy group was significantly lower than that of conventional therapy group( t =12.00,P ＜ 0.05).Conclusion Atorvastatin could significantly decrease the levels of serum IL-6,ET and MCP-1,and it could promote the neurological fuction recovery in the patients with ACI.

BACKGROUND: Parkinson disease is a common degenerative disorder of nervous system. Transplantation of embryonic stem cell can alleviate the symptoms of Parkinson disease, but restricted technically and ethically. Compared with embryonic stem cell, the various characteristics of bone marrow derived-multipotent adult progenitor cells (MAPCs) enable them to become one the ideal sources of cells for cell transplantation.OBJECTIVE: To explore the hypothesis that MAPCs were able to enter the brain and reduce the neurological functional deficits in rats by injecting intravenously.DESTGN: A randomized controlled experiment.ETTING: Department of Neurology, Wuhan First Hospital.MATERIALS: The experiments were performed in the laboratory of Department of Neurology, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology from October 2003 to March 2005. Eighty healthy Sprague-Dawley (SD) rats of 180-200 g were provided by the experimental animal center of Tongji Medical College,Huazhong University of Science and Technology.METHODS: The rats were made into models of Parkinson disease, the bone marrow-derived MAPCs, which were in vitro purified, proliferated and treated with 5-bromo-2-deoxyuridine (BrdU), were injected via caudal vein. After three months,the immunohistochemical technique, reverse transcription-polymerase chain reaction (RT-PCR), electron microscopy and behavioral tests were used to identify the MAPCs or neuron-like cells derived from MAPCs in brain and their functions.MAIN OUTCOME MEASURES: ① Results of behavioral observation; ② Results of immunihistochemical staining.RESULTS: After implantation, MAPCs could survive and differentiate into neuron-like cells in substantia nigra and striatum. MAPCs-derived dopaminergic neurons caused gradual and sustained behavioral restoration of 6-hydroxydopamine (6-OHDA)-mediated motor asymmetry. The levels of dopamine beta-hydroxylase (DBH), nerve growth factor (NGF) or dopamine transporter (DAT) mRNA were up-regulated significantly. It was observed under electron microscope that immature synapse implicated MAPCs- derived neuron should play an important role in the reconstruction of neural circuitry.CONCLUSION: Transplanted bone marrow derived-MAPCs can spontaneously differentiate into dopaminergic neurons,and act the corresponding nerve function.

Objective　To study the relation between mental emotion of top senior middle school students and college entrance examination achievement. Method　Using 16PF,STI,TTI and SAS, this year's graduates were measured. Result　The liberal arts had a significant defference from the science departments in the personality of 16PF. Applying the methods of judgement and more factors, the Q1 (experiment F=8.76 P<0.01) and Q2 factors (independence F=8.23 P<0.01) had a positive correlation with college entrance examination achievement, a negative correlation with the M factor (fantasy F=4.88 P<0.01).Conclusion　The personality of experiment, flexibility of nervous process in temperament and that of time characteristic had a positive correlation with college entrance examination achievement .Independence of high scores fantasy of low scores and the flexibility of temperament helped to upgrade the scores of college entrance examination .The division into liberal arts and science departments of students should refer to their personality.

Chronic lung disease (CLD) of prematurity is the major cause of long-term disability of extremely low birth weight ( ELBW ) premature infants, and it is the most cost consumptive disease in neonatal intensive care unit graduates.Vitamin A plays an important role in the development of premature lung. Nevertheless, premature infants are prone to vitamin A deficiency.Oral supplementation of vitamin A does not alter the incidence of CLD in ELBW infants.Intramuscular administration of vitamin A reduced the incidence of CLD.The treatment is considered painful and this way is not routinely practiced.Vitamin A is systemically bioavailable after intratracheal administration with surfactant in an animal model of newborn respiratory distress.