Objective To investigate the histological detection and pleural effusion Mycobacterium tuberculosis and adenosine deaminase(ADA) activity assay value of tuberculous pleurisy.Methods 30 patients with tuberculous pleurisy were chosen as the research object,and selected another non-tuberculous pleurisy caused by pleural effusion in 30 patients as controls,patients received pleural puncture,take detect pleural effusion and pleural biopsy.Results A biopsy to confirm the diagnosis of tuberculous pleurisy in 18 cases,compared to 60.0 percent.Six cases of patients with pleural tissue biopsy again,a ratio of 20.0％.Pleural histopathology diagnosis was 80.0％.Patients with tuberculous pleurisy pleural effusion ADA average activity was (71.3 ± 16.2),which was significantly higher than that of the control [(19.3 ± 10.8)] (t =23.42,P ＜ 0.05).ADA-positive patients with tuberculous pleurisy was 86.7％,which was significantly higher than 3.3％ of the confrol group (x2 =14.64,P ＜ 0.05).Patients with tuberculous pleurisy pleural effusion TB-PCR positive rate was 6 6.7 ％,significantly higher than the 2 0.0 ％ (x2 =8.6 5,P ＜0.05).Application and histopathological examination of pleural effusion TB-PCR and ADA joint detection,diagnosis of tuberculous pleurisy was 100.0％,significantly higher than that of various methods alone(x2 =4.36,5.87,4.16,all P ＜ 0.05).Conclusion Histopathological examination of pleural effusion TB-PCR and ADA joint detection can improve diagnostic accuracy of tuberculous pleurisy.

Objective:To research the effects of HH singaling pathway on proliferation,apoptosis and CyclinD1 expression of breast cancer MDA-MB-231 cells by MDA-MB-231 cells treated with Cyclopamine,a HH singaling pathway inhibitor.Methods:MDA-MB-231 cells were treated with Cyclopamine.Cell proliferation was detected by MTT;Cell cycle distribution and apoptosis were analysed by flow cytometry(FCM).The mRNA levels of GLI1,CyclinD1 were measured by reverse transcription-polymerase chain reaction(RT-PCR);The protein level of CyclinD1 was detected by immunostaining of cell lines.Results:Compared with control group,Cyclopamine could significantly inhibit the proliferation of MDA-MB-231 cells in a dose-and time-dependent manner;By FCM the treatment of MDA-MB-231 cells with Cyclopamine induced a remarkable increase in the proportion of cells in the G0/G1 phase of the cell cycle and after 48 h the sub-G1 peak appeared.The mRNA levels of GLI1,CyclinD1 and the expression of CyclinD1 protein were reduced.Conclusion:The HH signaling pathway was activeted in MDA-MB-231 cells.HH signaling pathway inhibitor,Cyclopamine,could inhibit the proliferation,induce the apoptosis and reduce the expression of CyclinD1 in MDA-MB-231 cells.

Objective To evaluate the clinical effects of recombinant human epidermal growth factor (rhEGF) on wound healing of perianal absceess after operation.Methods 80 patients who received operation of perianal absceess were selected.The patients were randomly divided into the study group(n=40) and control group(n=40).All the patients underwent the treatment of anal abscess incision and drainage.The patients in the control group were disinfected routinely and treated by metronidazole,while the patients in the study group were treated by rhEGF after disinfection of saline.All patients were followed up for one month after surgery.The wound edema score,granulation growth and the healing time of the wound were recorded.Results One month after surgery,the wound edema score in the study group was less than that in the control group at any time.After 2 weeks and 4 weeks,the wound edema scores in the study group were (1.41±0.33)points,(0.54±0.11)points,which were significantly lower than (2.09±0.28)points,(1.37±0.16)points in the control group (t=9.937,27.036,all P<0.001).After 2 weeks and 4 weeks,the granulation growth scores in the study group were (1.71±0.38)points,(0.81±0.16)points,which were significantly lower than(2.16±0.38)points,(1.66±0.21)points in the control group (t=5.296,20.363,P<0.001).The healing time of the wound in the study group was (19.52±1.47)d,which was less than (25.49±1.75)d in the control group (t=16.521,P<0.05).Conclusion The rhEGF can distinctly promote wound healing and shorten the healing time of perianal absceess after operation,which is worthy of the clinical promotion.

BACKGROUND:Tamoxifen has been found to exert neuroprotection by reducing cerebral hemorrhage and edema surrounding the injured site of the spinal cord.
OBJECTIVE:To investigate the neuroprotective effect of tamoxifen on rat acute spinal cord injury and the underlying mechanism.
METHODS:Sixty Sprague-Dawley rats were equivalently randomized into five groups, and modeled into spinal cord injury at T10 level using modified Al en’s weight-drop method (70 g/cm), except those in sham operation group. At 30 minutes after modeling, al rats were given the intraperitoneal injection of 2.5, 5.0 and 10 mg/kg tamoxifen or same amount of normal saline, once daily. Basso, Beattie, Bresnahan (BBB) scores were recorded at 24, 48 and 72 hours after surgery. The injured spinal cord was removed at 72 hours to observe its edema. Meanwhile, the levels of interleukin-1β, interleukin-10 and tumor necrosis factor-α, as wel as Caspase-3 activity were detected by ELISA;the protein levels of nuclear factor-κB p65, phosphorylated I-κBαand Caspase-3 were detected by western blot assay.
RESULTS AND CONCLUSION:Compared with the model group, the hind limb function in the tamoxifen groups was significantly improved. Tamoxifen significantly decreased the water content in the rat spinal cord and inhibited spinal cord edema at 72 hours after surgery. ELISA results showed that tamoxifen significantly reduced the activity of interleukin-1β, interleukin-10, tumor necrosis factor-αand Caspase-3 (P<0.05). Western blot assay revealed that tamoxifen significantly downregulated the expression levels of nuclear factor-κB p65, phosphorylated I-κBαand Caspase-3. These results suggest that tamoxifen protects against spinal cord injury via suppressing inflammatory response and apoptosis-associated proteins.

Objective:Investigation on the characteristics of motorcycle accidentrelated fatalities,to provide the reliable information and reference data for the precaution and the reduction of the death rate of the traffic accident.Methods:Collect the information of the 145 people dead in the 135 cases of motorcycle accident which happened in the main urban zone of Chongqing city in 2004 examinated by the Chongqing Technical Authentication Center Of Road Traffic Accident,including the detailed process,time and place of accident as well as the means of transportation,the basic information,the injuries,and the main cause of death,which all were retrospectively analyzed.Results:Sex and age of the dead have the significant difference.In the aspect of the means of transportation,59.31% of the dead are drivers who under 40 ocuppy 79%,20% are passengers,20.69% are pedestrians who over 50 ocuppy 60%,instantly dead occupy 36.55% and dead after salvage occupy 63.45%.In the aspect of the cause of dying,craniocerebral injury occupy 65.52%,other injury or combined injury occupy 34.48% and 95.17% of the dead with the limbs injury which the ratio of the fracture of lower limb and the fracture of arm is 2.1:1.And the ratio of the second,third season and the first,fourth season is 1.64:1.Conclusion:The motorcycle accidents have the obvious features and the preventability.

Objective To provide references for enhancing the connection between the need of society and the training mode of in-service postgraduates who major in health service management by analyzing the existing and potential in-service postgraduates' potential trainingwishes andexpectations.Methods Questionnaire surveys,which involved basic information,motivations and aspirations on the advanced studies,understandings and suggestions on the cultivating mode,were conducted among in-service postgraduates(Grade 2010 through Grade 2012) who major in health service management in BUCM and staffs in the departments of corresponding postgraduates.Data including 128 validated questionnaires were analyzed using descriptive statistics in excel.Results The data indicated that further education was welcomed by 87 in-service postgraduates(85.3％ of the survey samples),who had astrong willing to further study.Specifically,the following tendencies were obtained:interdisciplinary training combining research and practice was approved by 71 in-service postgraduates (55.5％ of the samples); career-oriented talent training mode was accepted by 90 in-service postgraduates(70.2％ of the samples); 79 in-service postgraduates (61.7％ of the samples) believed courses should include both theory and practice educations; flexible educational system was welcomed by 77 in-service postgraduates(60.0％ of the samples) ; 61(47.7％) in-service postgraduates wished to attend class on week-ends while 45 (35.0％) wished to attend class in evenings; group instruction method was recommended by 73(57.0％) in-service postgraduates; 104(81.3％) believed double-tutors system should be applied to academic dissertation,and the academic dissertation could be all kinds of research papers such as investigation report,which was approved by 97 (75.6％) in-service postgraduates.Conclusions Through the above analysis,it can be validated that education on in-service postgraduates who major in health service management is worthy of further development.Finally,colleges and universities are suggested to optimize the training mode in four aspects including training objective,curriculum provi-sion,teaching methods and graduation thesis.

BACKGROUND:Nano-hydroxyapatite/polyamide 66 is a new nanobionic composite material and has good biocompatibility and bone conduction, but after implantation, whether the composite material can bind to vertebral bone interface and whether it is safe in clinical use stil need further studies. OBJECTIVE: To observe the ability of nano-hydroxyapatite/polyamide composite binding to the interface of artificial humeral head. METHODS: The rabbits were randomly divided into two groups: composite group was implanted with nano-hydroxyapatite/polyamide composites; control group implanted with autologous bone. After the replacement, rabbit bone marrow mesenchymal stem cels were subjected to primary culture, and then the cels were co-cultured with the composite material. RESULTS AND CONCLUSION:At 24 hours after culture, bone marrow mesenchymal stem cels grew wel on the composite materials. The cel adhesion rate was significantly higher in the composite group than the control group at 1 and 4 hours after culture (P < 0.05). After co-culture 4.5, 5.5, 6.5 hours, the absorbance value of cels in the composite group was higher than that in the control group (P < 0.05). At 24 weeks after replacement, changing ranges in the proportions of bone tissue and fibrous layers on the implant surface as wel as coverage rate in the composite group were the highest (P < 0.05). These findings indicate that the nano-hydroxyapatite/ polyamide composite implant has a certain binding capacity, which can make a good interface osseointegration.

Ventilator-induced lung injury is a serious complication of mechanical ventilation. At present a lot of researches have explored lung protective ventilation strategies to prevent and treat ventilator associated lung injury in adult. But researches on children are relatively rare. This article reviewed the pathophysiological mechanisms of pediatric ventilator-induced lung inju-ry and the clinical application of lung protective ventilation strategies in children.

The present review concluded remarkable globe clinical achievements in the field of critical care medicine during 2013.Briefly,new international sepsis management guideline,high frequency oscillatory ventilation,hydroxyethyl starch,immune-nutritional therapy,fecal transplantation and infection controlling became the highlighting topics.Additionally,it is also worthy to note the apparent disparity in the resuhs between meta-analyses suggesting a treatment advantage and following large-scale randomized trials that have failed to detect such differences in treatment outcomes.Nonetheless,we still expect the emerging of ongoing investigations may provide clarity in these area.

Objective]To study Xin'an physician Wang Xun diarrhea related theory of ideas in Cihangji, in order to more comprehensively understand diarrhea, to broaden the thinking, enhance the clinical curative effect. [Method] From the disease history, etiology and pathogenesis, syndrome differentiation and treatment,prescription drugs,and women,children with dysentery,make research on Wang's thought about diarrhea treatment. [Result] Wang's clinical diagnosis and treatment,well distinguished cold and heat; Not stick to the ancients,along seasons gas; Wang Xun created the prescription treatment of diarrhea for spring,summer,autumn,creation of winter season; on the pregnancy,postpartum woman and children with pox disease after the treatment of dysentery is summarized,with complete prescription. [Conclusion] Wang Xun Cihangji rich in content and syndrome differentiation of diarrhea, had experience,as today,treatment based on the thought of clinical diarrhea treatment still has important guiding significance.