China ; History, 20th Century ; History, 21st Century ; Pathology ; education ; history

Objective To explore the influencing factor of amount of bleeding after selective cesarean delivery,and to provide theoretical basis to prevent postpartum hemorrhage in clinic.Methods A total of 300 delivery women,who received selective cesarean delivery because of social factors,was included this research.The amount of bleeding after selective cesarean delivery was determined by volumetric method and weight method.The related factor of amount of bleeding after selective cesarean delivery was analyzed by single-factor and multiple regression method.Results The result of single-factor and multiple regression method showed that the amount of bleeding after selective cesarean delivery was related to uterine dysplasia,uterine contraction fatigue,cervical score,placenta previa,placental adhesion/implant and neonatal weight(Test value =9.263,9.845,3.447,7.234,5.765,3.627,all P ＜ 0.01),but not related to age,body weight,gestational duration,gravidity times,production time,abortion history,premature rupture of membrane (all P ＞ 0.05).Conclusion Conclusion Uterine dysplasia,uterine contraction fatigue,cervical score,placenta previa,placental adhesion/implant and neonatal weight were the related factors of amount of bleeding after selective cesarean delivery,and should be predicted intensely to reduce the incidence of postpartum hemorrhage.

Objective To introduce the new nomenclature scheme of the International Working Group (1995) on hepatic nodules, and summarize the imaging features of various hepatic nodules in light of their pathological characteristics, and evaluate the diagnostic values of various imaging facilities.Methods Ultrasound, computed tomography(CT), magnetic resonance imaging(MRI), and angiographic CT were reviewed and introduced.Results Many of these types of hepatic nodules play a role in the de novo and stepwise carcinogenesis of hepatocellular carcinoma(HCC) in the following steps: regenerative nodule, low grade dysplastic nodule, high grade dysplastic nodule, small HCC, and large HCC. Accompanying such transformations, there are significant alterations in the blood supply and perfusion of these hepatic nodules.Conclusion Modern state of the art medical imaging facilities can not only delineate and depict these hepatic nodules, but also provide important clues for the characterization of focal hepatic lesions in most cases, thus facilitating the early detection, diagnosis and management of HCC in its early stage.

In order to explore the teaching methods of biochemistry experiment teaching,Biochemistry department of Wannan medical college adopts PBL and case-based teaching contrast to lecture based learning in exerimental course,to evaluate teaching effect by analyzing questionnaire survey associated examination results.It is shown that PBL and case-based teaching can get good teaching effect.

Objective To investigate the effects of continuous passive motion (CPM) protocols on outcomes of total knee arthroplasty. Methods Seventy-two patients who underwent total knee arthroplasty were divided into 2 groups and treated with different CPM protocols: group 1 with CPM from 0 degree to 40 degrees and increased by 10 degrees per day, while group 2 with CPM from 90 degrees to 50 degrees (early flexion) and gradually progressed to full extension over a 4-day period. The CPM was administered twice a day for 1 hour over a 7-day period. All the patients participated in the same postoperative physiotherapy program. Results Group 2 (the early flexion group) had significantly more range of motion than group 1. Conclusion The early flexion can help achieve favorable functional gain after total knee arthroplasty.

Objective To evaluate the result of short-segment pedicle screw instrumentation plus pedicle screws inserted into the injury level for treatment of thoracolumbar burst fracture.Methods Fifty-six cases of thoracolumbar burst fracture treated from June 2008 to June 2011 were reviewed.There were 40 males and 16 females at mean age of 32.8 years (range,25-60 years).Twenty-four cases were injured from traffic accidents,19 cases from fall from the height,and 13 cases from fall of heavy objects.Fractured segments were T11 in 6 cases,T12 in 14 cases,L1 in 16 cases,L2 in 12 cases,L3in 5 cases,and L4 in 3 cases.Thirty cases underwent short-segment pedicle screw fixation through the level above the fracture to level below the fracture (Group A).Apart from this,26 cases were treated with additional transpedicular fixation at the fractured level (Group B).Anterior vertebral height ratio,sagittal Cobb' s angle,neurologic performance as evaluated by American Spinal Injury Association (ASIA) scale were assessed before operation,one week after operation,and one year after operation.Results Anterior vertebral height ratio and Cobb' s angle revealed no significant differences between the two groups before operation and one week after operation.At postoperative one year,anterior vertebral height ratio and sagittal Cobb' s angle were (87.2 ± 6.9)％ and (7.6 ± 3.2)°in Group A with significant differences from (93.3 5.7)％ and (5.7 ± 1.9) ° in Group B (P ＜ 0.05),but there was no statistical difference in ASIA scale of neurologic performance.Conclusion Short-segment pedicle screw instrumentation with stabilization at the level of fracture is an effective treatment for thoracolumbar burst fracture.

Objective To introduce the technique of three dimensional portal venography of multi detector row spiral CT and its clinical application in the evaluation of the portosystemic collateral shunts of liver cirrhosis. Methods All relevant literatures were retrospectively reviewed on the application of two dimensional and three dimensional reconstruction techniques such as MIP, SSD, VRT of multi detector row spiral CT to demonstrate the collateral vessels of liver cirrhosis.Results The distribution, pathway and anatomy of portosystemic collateral vessels were well shown by multi detector row spiral CT portal venography. Conclusion Multi detector row spiral CT portal venography provides excellent depiction of the anatomic characteristics of the collateral shunts and enables the continuous tracing of vascular structures, thus it is very helpful in the imaging evaluation of the collateral vessels of liver cirrhosis.

Objective: To investigate the concentrations of secreted protein acidic and rich in cysteine(SPARC) in the serum and urine of patients with IgA nephropathy and its expression in the kidney tissues. Methods: The concentrations of SPARC, tumor necrosis factor-a (TNF-a),interleukin 1β (IL-1β), and interleukin 6 (IL-6) in the serum and urine were measured with enzyme-linked immunosorbent assay(ELISA). The contents of SPARC protein in the culture medium of human mesangial cell (HMC) and human renal tubular epithelial cell (HKC), which had been treated with IL-6, were determined by ELISA. The expression and distribution of SPARC in IgA nephropathy and normal kidney tissues were observed by immunohistochemistry assay. Results: The concentrations of SPARC in serum and urine of IgA nephropathy patients were higher than those of the normal control subjects ([2.43±±1.22] μg/ml vs [0.69±0.21] 2μg/ml, [7.73±2.81] μg/ml vs [1.17±1.03]ρg/ml, P<0.01). The serum levels of TNF-α, IL-1β and IL-6 in IgA nephropathy group were significantly higher than those in the control group (P< 0.05); the urinary levels of TNF-α and IL-6 in IgA nephropathy group were also higher than those in the controls (P<0.01). SPARC protein secreted by HKC was higher than that by HMC (P<0.01). SPARC was weakly positive in normal distal cortical tubules. SPARC protein expression in tubular epithelial cells of IgA nephropathy patients was obviously higher than that of the normal controls. Conclusion: The secretion of SPARC by renal tubular epithelial cells is increased in patients with IgA nephropathy, which results in elevation of serum SPARC and may have a protective feedback inhibitory effect on HMC proliferation.

Objective To investigate the influence of multi-drug resistant mycobacterium strain tuberculosis (MDR-TB) on the clinical outcomes and its countermeasures in the treatment of bone and joint tuberculosis. Methods From December 1993 to June 1999, 250 revised cases were admitted in our hospital, which were 143 males and 107 females aging from 2 to 72 years with an average of 25.44 years. The most of lesions were located at spine, then the hip, knee and small joints. The specimens were harvested via need biopsy or operation from the lesion. Specimens were examined by Bactec TB 460 to identify tuberculosis mycobacterium and non tuberculosis mycobacterium strain, and drugs-sensibility test to INH(0.2 ?g/ml), SM (6.0 ?g/ml), RFP (2.0 ?g/ml) and EMB (7.5 ?g/ml) respectively. Results Of 250 patients, Mycobacterium were positive in 48 by Bactec measurement, which were tuberculosis mycobacterium strain in 46 with 18.4% positive rate, and non tuberculosis mycobacterium strain in 2(1 mycobacterium avium intracellulare complex, the other unkown). Of the 46 positive specimens, 27 were sensitive to all of 4 drugs(58.7%), however, 3 were resistant to 1 drug(6.5%), 1 was resistant to 2 drugs(2.1%), 4 were resistant to 3 drugs (8.7%), and 11 were resistant to 4 drugs(24%). In 11 patients resistant to 4 drugs and 2 patients with non tuberculosis mycobacterium strain, 8 were complicated with sinuses after the first operation, in which 7 healed after 2 to 3 re-operations and 1 died of secondary infection. 1 M. avium intracellulare complex and 1 unidentified mycobacterium were multi-drug resistant strains( INH,RFP, SM, EMB) and found with poor clinical results.Conclusion Those cases with MDR-TB in lesions can influence the curative effect of bone and joint tuberculosis significantly. Based on the drug-sensibility, the chemotherapy regimen should be modified and individualized, and requires several operations to cure.

Objective To investigate the spectrum of spiral CT imaging findings of blunt liver trauma.Methods Clinical data of 17 patients with blunt liver trauma were retrospectively collected. All patients underwent standardized spiral CT examination of the upper abdomen, which include plain scan, arterial phase and portal venous phase acquisition. The morphology, density and integrity of liver parenchyma and intrahepatic venous structures were carefully observed, as well as regions of porta hepatis, peritoneal cavity and retroperitoneal space.Results Twelve cases (70.6%) developed hepatic parenchymal laceration. There were 9 cases (52.9%) of traumatic hematoma, among which 5 were intraparenchymal and 4 were subcapsular. One case (5.9%) showed active bleeding within an intrahepatic hematoma, while two cases (11.8%) had injury (laceration) of hepatic veins. There were 7 patients (41.2%) who demonstrated the so-called “halo sign” around the intrahepatic portal branches. Thirteen patients were associated with peritoneal fluid (blood) collection, 3 with hematoma or hemorrhage of the right adrenal gland, 8 with plural effusion and 3 cases with rib fractures of right lower chest. Conclusion CT imaging findings of blunt liver trauma include parenchymal laceration, intraparenchymal and /or subcapsular hematomas, active hemorrhage, and tear of hepatic veins. Plain CT scan and contrast-enhanced dual-phase acquisition is very important for the comprehensive evaluation of patients with blunt liver trauma.