The article summarizes the questions of clinical practicing in obstetrics and gynecology through clinical teaching in person,and find out some measures to improve teaching quality of clinical practicing.

Child, Preschool ; Coronary Aneurysm ; etiology ; therapy ; Humans ; Infant ; Male ; Mucocutaneous Lymph Node Syndrome ; complications ; therapy ; Thrombosis ; complications ; therapy ; Urokinase-Type Plasminogen Activator ; therapeutic use

ObjectiveTo deter mine the sustained attention function of the patients with mild Alzheimer's disease(AD) and mild cognitive impairment(MCI).Methods10 patients with MCI, 10 with mild AD and other 10 healthy elderly controls were tested with Continuous Performance Task(CPT) aimed to assess sustained attention. ResultsCompared with the normal controls, the mild AD patients reacted very more slowly(P<0.001), missed more targets(P<0.05), while that the MCI patients did was as well as the control group. ConclusionThe mild AD patients shows impairment in sustained attention function, but the MCI patients shows a preserved ability of sustained attention function.

Objective To investigate the effect of meridian-warming and unblocking acupuncture and moxibustion on the quality of life in patients with osteoporotic vertebral body compression fractures. Method Two hundred and eighty patients meeting the criteria of osteoporotic vertebral body compression fractures were enrolled and randomly allocated to treatment and control groups. The treatment group received meridian-warming and unblocking acupuncture and moxibustion and the control group, complex treatment of Western medicine. The Visual Analogue Scale (0-10 marks) score and the SF-36 score were recorded before and after treatment. The clinical therapeutic effects were evaluated. Result The pain score was decreased, the SF-36 score was increased and the clinical therapeutic effect was improved more in the treatment group than in the control group (P<0.05). Conclusion Meridian-warming and unblocking acupuncture and moxibustion helps to relieve the pain and improve the quality of life in osteoporosis patients.

Objective To observe the effect of microprismatic needle scalpel(MPNS) on headache induced by compression of greater occipital nerve or lesser occipital nerve.Methods 95 patients with headache induced by compression of occipital nerve were divided into the treatment group (50 cases, treated with MPNS) and control group (45 cases, treated with carbamazepine).Results In the treatment group, 42 cases were cured, 6 cases were effective, 2 cases were ineffective; while, those in the control group were 16 cases, 21 cases and 8 cases respectively. There was a significant difference between two groups ( P<0.01).Conclusion MPNS has an obvious effect on headache induced by compression of occipital nerves.

ObjectiveTo explore the relationship between thermography patterns and the clinical features of thalamus hemorrhage in the recovery period. MethodsTwo hands skin temperature of 32 patients with thalamus hemorrhage were measured with infrared heat radiation imaging 1 month after the stroke. Results21(66%) of 32 patients showed different imaging patterns between the affected limbs and the healthy sides. Of the 25 palsy patients, 18 (72%) showed abnormal images, just 3 of 7(42.6%) patients with normal muscle force showed abnormal images, and the difference was significanct(P<0.05). There was no relation between sensory disorder and imaging pattern. Patients with hematom lager than 10 millilitre showed more abnormal images than those with hematom under 10 millilitre(P<0.05). Patients with a course within 3 months had a tendency to show hot pattern, while those with a course beyond 3 month showed cold pattern. Conclusion There are certain relations between thermograpy patterns and the symptoms, signs of thalamus hemorrhage.

OBJECTIVETo study the effects of Citalopram on the mRNA expression of bax and bel-2 in frontal cortical neurons and on cell apoptosis of rats after stress.

METHODSTwenty-four healthy male SD rats were randomly divided into three groups (n = 8). The control group did no receive any treatment, the stress group was subject to stress and given normal saline and experimental group was given Citalopram irrigation stomach after stress. Rats were forced to swim to establish chronic stress model (15 min/d, 4 weeks), bax, bcl-2 mRNA expression were tested by in situ hybridization technique (ISH), TUNEL assay was used to determine cell apoptosis, Nikon image analysis software were used to measure the number of positive cells in each index.

RESULTSCompared with the control group, the stress group showed a larger number of bax mRNA expressing cells( P < 0.01), a smaller number of bcl-2 mRNA expressing cells (P < 0.01), and the staining intensity of positive cells was significantly reduced( P < 0.01). Compared with the stress group, the experiment group showed more reduced number of bax mRNA positive cells( P < 0.01) and significantly increased bcl-2 mRNA positive cells( P < 0.05), a small amount of positive cells were found, compared with that in the stress group, nuclear condensation in the experimental group was reduced significantly and the staining was obviously weaker( P < 0.01).

CONCLUSIONCitalopram significantly antagonizes bax mRNA and potentiatesbcl-2 mRNA protein expression and inhibits apoptosis of rat prefrontal cortical neurons caused by chronic stress, which might be one possible mechanism of Citalopram for prevention and treatment of psychosis caused by chronic stress.

Animals ; Apoptosis ; Citalopram ; pharmacology ; Male ; Neurons ; drug effects ; metabolism ; Prefrontal Cortex ; cytology ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; RNA, Messenger ; Rats ; Rats, Sprague-Dawley ; Stress, Physiological ; bcl-2-Associated X Protein ; metabolism

OBJECTIVETo investigate the clinical effect of anastomosis of superficial veins for improving the drainage of perforator propeller flaps.

METHODSFrom Sept. 2011 to Dec. 2012, 11 cases with soft tissue defects and chronic ulcer wound at extremities were treated with adjacent perforator propeller flaps, which were pedicled by the peroneal artery(5 cases), or the lateral supramalleolar artery(3 cases), or the ulnar artery (2 cases), or the posterior interrosseous artery (1 case). The wound size ranged from from 3.0 cm x 2. 5 cm to 11. 0 cm x 4. 0 cm, and the falps size ranged from 6 cm x 3 cm to 21 em x 5 cm. One superficial vein in all the flaps was anastomosed with superficial vein in the recipient area. The blood supply of the flaps were recorded after operation 1 - 3 months after operation, the fluency of anastomosed vein was detected by color Doppler ultrasound. Flap swelling evaluations were performed in early 3 months and later 3 - 6 months, and the results were classified into 4 grading degrees. 6 months later, Questionnaire of the flap aesthetic satisfactory was performed for seven patients during follow-up period.

RESULTS9 flaps survived completely, two flaps had partial marginal skin necrosis in the distal end, which were both managed with surgical debridement, and both wounds healed in two months. 9 cases were followed up for more than 12 - 19 months. The early rsults of flap swelling evaluations were: I degree 0 case, II degree 8 cases, III degree 3 cases, IV degree 0 case, and the later results were: I degree 7 cases, II degree 4 cases, III degree 0 case, IV degree 0 case. The flaps had ideal appearance, good contour, and high aesthetic satisfactory (100%). The mean flap survival area rate of veins anastomosed was (98. 6 ± 9. 7) %.

CONCLUSIONSPerforator propeller flaps with anastomosis of superficial veins can improve the flap venous drainage, avoid transient venous venous congestion, so as to increase the flap survival. It is an effective way for improving the vein drainage.

Anastomosis, Surgical ; methods ; Debridement ; Extremities ; blood supply ; Graft Survival ; Humans ; Leg Ulcer ; pathology ; surgery ; Perforator Flap ; transplantation ; Regional Blood Flow ; Tibial Arteries ; Ulnar Artery ; Ultrasonography, Doppler, Color ; Veins ; surgery

Objective To investigate the methods and clinical effects of flow-through posterior interrosseous artery flaps for reconstructing digital wounds combined with artery injury.Methods From December 2011 to September 2013,11 patients with traumatic digital defect combined with artery injury were repaired with flow-through posterior interrosseous artery flaps.Flap aesthetic satisfaction was assessed using questionnaires; flaps were tested for pain and touch sensation,temperature perception,and two-point discrimination; finger activity was detect using the total active movement (TAM) ratio of the injured and uninjured side.Results All flaps and injured fingers survived.Wounds healed by the first intension.Nine patients were followed up for 12-24 months.Two-point discrimination of the flaps recovered at postoperative 6 months and averaged (9.7 ± 2.1) mm at postoperative 12 months,with S3 +grade in sensation evaluation.TAM ratio of the injured and uninjured side was 0.85 ±0.17.All patients expressed the satisfaction to flap appearance.Conclusions Flow-through posterior interrosseous artery flaps are safe and effective to cover digital wounds and restore blood circulation.The technique improves the clinical application of perforator flaps.

Objective To investigate the methods and results of lateral leg propeller pedicled flaps based on multi-perforators for coverage of soft-tissue defects on the foot and ankle.Methods From May,2012 to June,2013,8 patients with soft-tissue defects were treated,including 5 cases by trauma,2 cases by chronic unlcers,1 case by infection on the foot and ankle with exposed osseous and tendinous.Lateral leg propeller pedicled flaps based on multi-perforators were elevated and rotated with the angle from 150° to 180° for coverage of soft-tissue de-fects.Flap size ranged from 15.0 cm × 7.0 cm to 23.0 cm × 9.0 cm.Skin graft was applied to cover the donor sites.After the operation,the blood supplies of flaps were observed severely over 10 days.Questionnaire of the flap aesthetic satisfactory and AOFAS evaluation were performed in 7 patients during fellowed-up periods.Results Seven flaps were all survived well,1 flap had partial marginal skin necrosis on the distal,which was managed with surgical debridement,and wound healed in 1 month.Seven patients had a mean of 10.7 months' fellowed-up periods.The flaps had like-like appearance,good contour,and high aesthetic satisfactor (100％).The mean AOFAS score was 90.5.Conclusion Lateral leg propeller pedicled flaps based on multi-perforators can supply the blood of the larger volume of tissue,which can be safely sustained to repair distal and larger defects on the foot and ankle.