Objective To investigate the histological changes and collagen phenotype of a semitendinosus autograft after reconstruction of posterior cruciate ligament(PCL) in rabbits. Methods Twenty skeletally mature New Zealand white rabbits were divided into two groups. In group 1, the PCL of the right knees of 18 mature New Zealand white rabbits were resected and immediaterly reconstructed with double-band semitendinosus antograft. Then the rabbits were respectively killed at 3, 6, 12, 26 and 52 weeks after the operation, to obtain the the semitendinosus autografts. Group 2 consisting of the other 2 rabbits was served as control group, and semitendinosus tendons and PCL were obtained. All specimens were staining with hematoxylin and eosin, toluidine blue and immunohistochemical methods of type Ⅰ, Ⅲ collagens to analyze the histological changes and collagen phenotype of a semitendinosus autograft, and compare those with normal semitendinosus tendons and PCL. Results Histological results demonstrated that there was obvious difference at the cell formation between normal semitendinosus tendon and PCL. After postoperative 52 weeks the graft was similar to the normal PCL, while the alignment of graft was still different from that of normal PCL through necrosis, cell growing in, collagen formation and remolding. Immunohistochemistry result demonstrated: the staining of type Ⅰ collagen in graft was low at first, then increased gradually; the staining of type Ⅲ collagen was low at first, increased quickly, then decreased, at 52 weeks it was present in local areas. But positive reactions for type Ⅰ collagen were localized in collagen fibers, and those for type Ⅲ collagen were localized in synovium in normal PCL. Conclusion The study showed the semitendinosus autograft was still different in cell formation from normal PCL at 52 weeks after PCL reconstruction with semitendinosus.

Objective to analyze the influence obstetric factors of the small for gestational age(SGA)in twins,so as to direct the clinical prenatal supervision in clinic. Methods A retrospective study of the SGA was performed,the general data of 1 514 patients admitted in obstetrics and gyne-cology of Shengjing Hospital during 2001 to 2014 were analyzed by Logistic regression analysis. Results the incidence of the SGA in twins was 10.89%. the protective factors were male fetus,assisted reproductive technology(ARt)and gestational diabetes mellitus(GDM). the risk factors were the female fetus and hypertensive disorders in pregnancy. Conclusion the gender of fetus,assisted reproductive technology(ARt),gestation-al diabetes mellitus(GDM),hypertensive disorder complicating pregnancy are the influential factors of the SGA in twins. We recommend a further pre-pregnancy and pregnancy care which is of significance for the prevention of SGA.

Traditionally the cultivation mechanisms of pathological postgraduates can not fully adapt to the demand of research and society in China,to some extent,which impedes the development of pathology.Combining our practical conditions with overseas experiences,we try to make the beneficial thinking and adjustment on the existing cultivation mechanisms.

Objective To know the nursing scientific research status in recent years,and to reveal the differences between Chinese nursing scientific researches and foreign nursing scientific researches,in order to promote the rapid development of nursing cause in China.Methods Five Chinese journals of nursing and four foreign nursing journals were analyzed covered China National Knowledge Infrastructure (CNKI),PubMed and Google data ranged from 2008 to 2013.By adopting bibliometrics method,regional distribution,the number of people participation,the cooperation between units,the source of financial funding,research content and nature of Chinese nursing research papers were analyzed,and also compared to research content and nature of foreign nursing journals.Results The amounts of published papers were 1 527 pieces.The geographical distribution of research papers were all spread over 28 provinces,autonomous regions sand municipalities directly under the central government,most of which was Guangdong province [12.64％ (193/1 527)];The majority of research papers were completed by single unit and more than five people,which about [68.4％(1 045/1 527)],[38.6％(589/1 527)],respectively;Provincial level of research papers were more than national level [81.4％(1 243/1 527) vs.18.6％(284/1 527)];The papers focused on the clinical nursing research [37.8％(577/1 527)] and clinical basic nursing research [34.6％(529/1 527)].Almost researches were descriptive research,while 40.7％(622/1527) of which were clinical analysis.Foreign nursing scientific researches paid more attention to psychological research and nursing profession which were related to humanities and investigation was major method used;Compared with the foreign nursing papers at the same time,the number of Chinese nursing research papers increased rapidly (P ＜ 0.05);Papers were completed more than five units rapidly increased compared with the pre-upgrade,as well as the national subjects,the difference was statistically significant (P ＜ 0.05).Conclusions The number of nursing research programs tended to increase year by year and the enthusiasm of nurses participating in scientific research was higher than before.Different units needed to further strengthen cooperation in scientific research.The research content and direction were diversity,which had not yet formed central tendency.The research method was still limited to descriptive studies,and the creativity of the research methods was needed,especially laboratory research.

Objective To evaluate the efficacy of modification and care improvement in endotracheal tubes (ETTs) to prevent ventilator associated pneumonia (VAP) in patients receiving mechanical ventilation (MV).Methods PubMed,China National Knowledge Infrastructure (CNKI) were searched,literature information was extracted and classified according to the inclusion criteria,the data were statistically analyzed.Results Totally 46 clinical research articles and 6 laboratory research articles were involved,the data showed that polyurethane (PU) cuff [23.809％ (35/147)],silver-coated ETTs [4.830％ (37/766)],subglottic drainage duct [19.492％ (759/3 894)],discontinuous subglottic drainage[13.603％ (256/1 882)] were associated with a decreased incidence of VAP compared with polyvinyl (PVC) cuff [40.179％ (45/112)],non-silver-coated ETTs [7.537％ (56/743)],conventional ETTs[45.733％ (1 088/2 379)],continuous subglottic drainage [25.000％ (503/2 012)],the differences in the incidence of VAP were statistically significant,respectively,P＜ 0.05.The incidence of VAP in cylindrical PU cuff was 25.000％ (8/32),the tapered PU cuff was 21.875％ (7/32),the difference in the incidence of VAP was not statistically significant.Conclusions The modification of the ETTs and the care improvement can effectively reduce the incidence of VAP.

Objective To study the effects of continuous passive motion(CPM)on tissue blood oxygen saturation(StO2)in the edge of wound after anterior cruciate ligament(ACL)reconstruction in rabbits.Methods Twenty male New Zealand rabbits,aged 8 months,received an ACL reconstruction by using double semitendinous tendon autograft in the right hind leg.The rabbits were randomly divided into 2 groups postoperatively,namely Cage activity group(n=10)and CPM group(n=10),treated with cage activity and activity by rabbit knee joint continuous passive motion apparatus respectively.On the following day after operation,a near-infrared optical device and ODISseyTM Tissue Oximeter were applied to measure the changes of tissue oxygen saturation(StO2)in the edge of the wound in each cycle(with flexion of 30?-110?)and various CPM speeds(2.35?/s,3.2?/s,and 8?/s),and the optimal CPM range and speed was thus selected for analyzing the changes of StO2 in local tissues of wounds with various angles of CPM in knee joint before the operation and on the 2nd,4th,6th,8th,10th,and 14th postoperative days.Results There was a significant difference with regard to StO2 between CPM group and Cage activity group(P0.05),however,a significant difference was observed among different time points(before the operation,and 2,4,6,8,10,14 days after the operation)(P

Objective To research for a new method of arthroscopic total meniscectomy with simple instru- ments. Methods One hundred and sixty nine cases were followed up for short period that had been operated on with a forward knife, a back cutting knife, a punch and a 30?scope from Nov. 1992. to Aug. 1998. Results The av- erage time of operation was 78 minutes. The operations had no injury to cartilage and ligament. It is necessary for only 7 .9 percent of patients to take analgesic intramuscularly after operation. Eight patients had a transient tourniquet paral- ysis. All of them could begin to work and exercise after postoperative 2 weeks. Conclusion As compared with the method introduced by David Sisk ,this method has the advantages of simple instruments, fewer ports and complications and minimal trauma Either lateral meniscus or medial meniscus can be cut off by the same method. This method is a safety and a better way to arthroscopic meniscectomy.

In oder to make the bone tunnel in optimal position, effective and firm fixation, early functional recov- ery and minimally operative injury we reported a new technique in reconstructive anterior cruciate ligament(ACL)using patellar tendon autograft fixed with interference screw. With the assistance of arthroscopy 74 patients with ACL rupture were treated between October 1997 and April 1999. The clinical results showed that the operative injury was minimal, fixed bone grafts were accurate and the reconstructed ACL was isometricity. The reconstructed ligament could be fixed biologically and firmly because of used patellor tendon autograft with bone grafts at two end. Clinical experience of ar- throscopic - assisted ACL reconstruction was summarized.

This paper explores subjective and objective reasons for missed diagnosis and diagnostic errors in health examination,aiming to improve mutual communication between patients and health staff,enhance people's consciousness in ethics,promote the medical concept which stresses preclinical prevention and early treatment for diseases,decrease the rate of missed diagnosis and diagnostic errors,and makes health examination profitable for both medical institutes and recipients.

OBJECTIVE:To prepare a nickel-titanium alloy stent coated by anti-tuberculotic isoniazid and study the dissolution of isoniazid in vitro.METHODS:The polyurethane which was used as film-former was mixed with isoniazid before being coated uniformly on the stent,then the stend was torrefied and dried so that the drug layer alloy stent was obtained.The content and accumulated dissolution in vitro of isoniazid from the stent was determined by ultraviolet spectrophotometry.RESULTS:The linear range of isoniazid was 5.0～30.0 ?g?mL-1(r=0.999 9)and its recovery rate was 99.67%(RSD=1.06%).A high accumluated dissolution rate of isoniazid was achieved,over 60% within the first 30 minutes,followed by a sustained dissolution in the following 8 h.CONCLUSION:The preparation method of the stent is simple and the quality is controllable.