Objective To investigate the effect of recombinant human growth hormone on the PingPang Racket flap survival.Methods Every two PingPang Racket flaps were designed on the both sides of 40 adult SD rats's back.The pedicle size was 1.0 cm × 1.0 cm,while the flap size was 3.0 cm in diameter circular.Longitudinal axis of flap was perpendicular to the center line of the rats back,to which the distance from proximal pedicle was about 1 cm.The flaps on the left side served as Ⅰ group,and the other side served as Ⅱ group,which were subdivided into Ⅰa and Ⅰb,Ⅱa and Ⅱb,respectively.And there were 20 rats in each subgroup.On the flap surfaces in group Ⅰ,it was 6 uniform injection poinsts,subcutaneously injecting with rhGF (the dose was 0.1IU · Kg-1 · d-1) for 7 days from the beginning of operation,that were designed.It goes the same way to the group Ⅱ,while normal saline was instead of rhGF.In subgroup Ⅰa and Ⅱa,the flaps were generally observed every day.The percentage of the flap survival area was determinated 7 days after operation.In subgroup Ⅰb and Ⅱb,specimens were collected at the distal end of flap at intraoperative(before injecting rhGF)and 1 st,3rd,5th,7th day after operation.Immunohistochemistry and enzyme-linked immunosorbent were applied to examine the expression of TGF-β1 and CD34,and the microvessel density of the flaps was calculated.Results According to the 7 days' observation after the surgery,the flap survival area percentage of subgroup Ⅰa was (97.00 + 2.12) ％,which was significantly higher (P ＜ 0.05) than that of subgroup Ⅱ a,whose was (81.00 +3.43)％.On 1st,3rd,5th and 7th day postoperatively,the expression of TGF-β1,CD34 in both subgroup Ⅰb and Ⅱb were elevated and reached peak on the 5th day.Content of GF-β1 and CD34 in Ⅰb were 1571.40 ± 13.32 pg/ml and 60.40 ±0.32 pg/ml,respectively,and in Ⅱb were 691.43 ± 11.06 pg/ml and 20.43 ± 0.06 pg/ml.At the same point of time,the expression of TGF-β1,CD34 were significant higher in Ⅰb subgroup than that in Ⅱb (P ＜ 0.05).In subgroup Ⅰb and Ⅱb,the number of microvessels increased on postoperative 1 st,3rd,5th and 7th day,especially on 3rd,5th and tended to be stable at 7th day.At the same point of time,the number of microvessels in Ⅰb was always higher than that in Ⅱb (P ＜ 0.05).Conclusion Subcutaneous injection of rhGH on flaps can enhance the expression of TGF-β1,CD34,promote microvascular generation of the flap tissue directly or indirectly,and also improve the survival of PingPang Racket flaps.

Objective To Investigate the concentration of VILIP-1 and NR2 peptide in the serum of patients with ischemic stroke , and to explore their clinic value in early diagnostic of ischemic stroke patients.Methods The levels of VILIP-1 and NR2 peptide were examined by ELISA ( enzyme linked immunosorbent assay ,ELISA) with suspicious TIA ( defined as a neurological deficit that resolved within 24 hours) or acute ischemic stroke patients ( within 72 hours of onset of symptoms ) 340 cases,102 healthy controls,98 patients with vascular risk factors and 35 patients with hemorrhagic stroke.Among all the groups , VILIP-1 and NR2 peptide level were analyzed using the nonparametric Wilcoxon test.Diagnostic performance were analyzed among the groups with the two biomarkers independently and combinedly .Results Serum levels of VILIP-1 and NR2 peptide in patients with ischemic stroke (IS) were 9.80 (1.90-14.22) μg/L, 14.40 (5.60-27.91) μg/L respectively,which was higher than that of the healthy control group [VILIP-1:0.02 (0.01-0.09),NR2:0.33 (0.02-1.15),χ2 were 5.61 and 9.54,P<0.001],the group with vascular risk factors [VILIP-1:0.03 (0.02-0.16),NR2:0.27 (0.01-1.54),χ2 were 6.74 and 10.62,P<0.001], the group of patients non-stoke [VILIP-1:0.04 (0.03-0.19),NR2:0.53 (0.45-1.21),χ2 were 3.78 and 7.63, P <0.001 ].The levels of VILIP-1 and NR2 peptide was significantly increased in IS patients presenting within 3 h of symptom onset.When differentiating IS from patients with hemorrhagic stroke ,NR2 had a AUC of 0.934,showing a strong distinguishing effectiveness.Differentiating IS from healthy controls , patients with vascular risk factors and non-stroke patients,the AUC of combination of VILIP-1 and NR2 was 0.974,which was higher than the AUC of either VILIP-1(0.849) or NR2(0.862) alone(P <0.05). Conclusions VILIP-1 and NR2 peptide are very sensitive and specific biomarkers to the early diagnosis of IS.The combination of VILIP-1 and NR2 peptide has higher value of clinical applications than one of them independently.

Objective To explore the risk factors of hyponatremia in postoperative patients with aneurysm and analyze the clinical characterstics in order to provide reference for clinic.Methods Participants included 120 patients who treated by aneurysm occlusion.Detailed recorded the patient's history and basic information.The patients with hyponatremia were in case group,and other patients were in control group.The risk factors of hyponatremia were analyzed.Results Forty-five patients (37.5％) occurred hyponatremia after operation.The level of natrium was (125.2 ± 10.1) mmol/L,the average time of appear hyponatremia was (8.2 ± 0.8) d,15 patients were in the first peak(postoperative 1-3 d),25 patients were in the second peak (postoperative 8-9 d),5 patients occurred hyponatremia at other time.Thirty-nine patients were internal carotid artery aneurysms,6 patients were vertebrobasilar artery aneurysms.Single factor analysis showed that the age,preoperative GCS scores,history of hypertension and diabetes,emergency operation,the size of arterial aneurysms,medium-sized aneurysm of artery between two groups had significant difference [(48.7 ± 8.4) years vs.(54.7 ± 8.4) years,(14.4 ± 3.1) scores vs.(10.3 ± 3.4)scores,26.7％ (20/75) vs.60.0％ (27/45),33.3％ (25/75) vs.62.2％ (28/45),32.0％ (24/75) vs.62.2％(28/45),(0.9 ±0.3) cm vs.(1.4 ±0.4) cm,24.0％(18/75) vs.42.2％(19/45),P ＜ 0.01 or ＜ 0.05].Multifactors regression analysis showed that preoperative GCS scores,emergency operation were the independent risk factors of hyponatremia (P＜ 0.05).Conclusions Postoperative 1-3 d and 8-9 d are the peak stage of hyponatremia.Different treatment should be adopted according the peak stage.Lower scores of preoperative GCS and emergency operation are the independent risk factors of hyponatremia.Clinical work need to pay more attention to the risk factors,appropriate treatment and prevention.

ObjectiveTo investigate the role of electroencephalogram (EEG) examination in the prognosis evaluation of patients with severe craniocerebral injury.MethodsFifty-seven patients with severe craniocerebral injury were selected as study subjects and their clinical data were analyzed retrospectively.All the patients got EEG examination,and the relationships between EEG grading and Glasgow coma scale (GCS) score,the prognosis of outcome were analyzed.ResultsThe EEG of 57 patients within 24 h after hospitalization were all abnormal.There was significantly negative correlation between EEG grading and GCS score (r =-0.742,P ＜0.05).EEG grading was significantly positively correlated with the prognosis of outcome (r =0.730,P＜ 0.05).ConclusionsEEG examination and EEG grading can evaluate the prognosis of patients with severe craniocerebral injury.It provides reference for clinical treatments.

Objective To investigate the influence of different interventional treatment timing on the prognosis of patients with intracranial aneurysms. Methods One hundred and thirty-eight patients with ruptured intracranial aneurysms were divided into group A (Ⅰ- Ⅲ grade) with 109 cases and group B ( Ⅳ- Ⅴ grade) with 29 cases according to Hunt-Hess grade when admitted. All patients received interventional treatment, the operation period was divided into early, middle and late stage according to the different time from disease time to operation, then compared the good rate, cerebral vasospasm and hydrocephalus incidence of patients underwent surgery at different period. Results The good rate at different period in group A were respectively 69.7% (23/33),58.8% (10/17) and 61.0% (36/59),which and the cerebral vasospasm and hydrocephalus incidence of patients underwent surgery at different period in group A had no significant difference(P > 0.05). The good rate of patients received surgical treatment at early stage in group B was 46.2%(6/13), which was significantly superior to late stage (0), the difference was statistically significant (P < 0.05), while the cerebral vasospasm and hydrocephalus incidence of patients underwent surgery at different period in group B had no significant difference(P> 0.05). Conclusion The prognosis of patients with Hunt-Hess grade Ⅰ - Ⅲ grade undergoing interventional treatment at early, middle and late stage can be satisfactory, while grade Ⅳ - Ⅴ grade patients should receive interventional treatment at early stage.

To analyze the epidemiological characteristics of human infection with avian influenza A(H7N9) virus from 2013 to 2016 in Xiaoshan,China,we collected the epidemiological data of human A(H7N9) cases as well as the results of environmental monitoring and analyzed it by case study,descriptive epidemiological method,and statistical analysis.Results showed that a total of 22 cases were confirmed,including 12 deaths.All the cases occurred in winter and spring,and most of them had been exposed to live poultry,and with the underlying condition of chronic diseases.Chi-square test showed that the ratio of cases with chronic diseases in death group was higher (P=0.01).The environmental monitoring result showed there were distinctive seasonal differences of positive rate with peaks in winter and spring and nadirs in autumn and summer.Positive rates for the samples from external environmental monitoring were consistent with the distribution of the case onset.Due to rise of environmental monitoring positive rate,we should be alert to the occurrence of new cases,especially in rural areas where live poultry fairs still exist and among people with occupational exposure.We should further improve ability to prevent and control this disease.

BACKGROUND:Lumbar spinal stenosis is clinical repaired with decompression, bone fusion and internal fixation, and different internal fixation materials can be chosen during the surgery. OBJECTIVE:To explore the influence of polyetheretherketone (PEEK) pedicle screw fixation combined with interbody fusion on the bone fusion rate of patients with lumbar spinal stenosis. METHODS:A retrospective analysis was performed in 63 cases of lumbar spinal stenosis undergoing decompression and interbody fusion. These patients were divided into control group (titanium internal fixation system,n=31) and experimental group (PEEK pedicle internal fixation system,n=32) according the internal fixation materials folowed by posterior spinal decompression with interbody fusion. The Oswestry dysfunction index scores before and 4, 12, 24 weeks postoperatively and bone fusion rates at 4, 12, 24 weeks postoperatively were compared between the two groups. RESULTS AND CONCLUSION:Oswestry dysfunction index scores showed a gradual decline in both two groups before and 4, 12 and 24 weeks after treatment, but there was no difference at different time (P > 0.05). At 4 and 24 weeks after treatment, there was no difference in the bone fusion rates between the two groups (P > 0.05), but at 12 weeks after treatment, the bone fusion rate in the experimental group was better than that in the control group (P < 0.05). During the surgery, no infection and other adverse events occurred in the two groups. These results indicate that both PEEK and titanium internal fixation systems for lumbar tube stenosis have obtained good results, but PEEK material has a better role in the bone fusion at 4-12 weeks after internal fixation.

Purpose To investigate the effects of chemotactic factor CCR4 on the abi1ity of pro1iferation,ce11 cyc1e,invasion,and mi-gration of human ga11b1adder cancer ce11. Methods Western b1ot was used to detect the expression 1eve1 of CCR4 in ga11b1adder carci-noma ce11s. Ga11b1adder carcinoma ce11s was infected by means of s1ow virus,the CCR4 gene si1encing was conducted using siRNA-CCR4 interference techno1ogy. Ga11b1adder carcinoma ce11s GBC-SD were divided into three groups( GBC-SD,GBC-SD/CCR4-RNAi and GBC-SD/contro1). CCL17,a 1igand of CCR4,was used to act on these three groups of ce11s. CCK8 method was used to detect the ce11 pro1iferation abi1ity of three groups. F1ow cytometry was used to test ce11 cyc1e. Tanswe11 assay was app1ied to detect ce11 migration and invasion abi1ity. Western b1ot was performed to detect the expression of its corresponding 1igands CCL17 and CCL22 proteins. Re-sults CCR4 gene si1ence did not inf1uence ce11 cyc1e and pro1iferation of ga11b1adder ce11 GBC-SD,but can significant1y inhibit GBC-SD ce11 invasion and movement abi1ity,CCR4 gene si1ence had no inf1uence on the expression of CCL17 and CCL22 gene in tumor ce11s. Conclusion Ga11b1adder carcinoma ce11s GBC-SD express chemokine receptor CCR4,chemokine receptor CCR4 can promote the invasion and metastasis of GBC-SD ce11s.

Objective To study the status quo of nursing human resource configuration and structure of neonatology department in China's economically developed areas.Methods Using judgment sampling and multi-stage stratified sampling,investigations were conducted by the self-designed questionnaire in letter in 2012.Results In 2012,both the bed nurse ratio(1:0.79) and doctor nurse ratio (1: 1.22) met the Health Ministry's standards (1:0.58-0.61 and 1: 2) respectively.Age distribution of neonatology nursing staff was from 25 to 34 years old (55％).The distribution of wordng experience was average.Nurses with junior college degree as the main body took up 48％,with primary title as the main body 66％,and the appointment system accounted for 42％.The nursing personnel with young ages,senior skilled,higher education degree,and advanced titles were concentrated in Grade Ⅲ-A hospitals and public hospitals of women and children.In terms of distribution equity,two Gini coefficients of geographical and population distribution were both less than 0.35 and near zero,which indicated relatively perfect equity.Conclusions The stock and per capita of neonatology nursing human resources in China's economically developed areas were insufficient in the long run and showed imbalanced allocation among hospitals with different levels.The allocation structure failed to meet the needs of nursing disciplinary development.

Objective To investigate the feasibility and safety of retroperitoneal laparoendoscopic single-site (LESS) donor nephrectomy using home-made single-port device.Methods From January 2011 to June 2012,11 consecutive LESS left donor nephrectomies using home-made single-port device with conventional laparoscopic instrument were performed through retroperitoneal access in our center.Results The procedures were completed and no complications occurred in all donors.Mean operative time was 149.5 min.Estimated blood loss was 30-350 ml.Warm ischemia time was 2-4 min.The urine output was prompt in all cases.Recipient graft function was normal within 2 weeks.Donor hospital stay was 5-6 days after operation.Conclusion LESS donor nephrectomy using home-made single-port device in our initial experience is feasible and safe.It is also cost-effective and minimally invasive with conventional laparoscopic donor nephrectomy.This technique is a good option for living donor nephrectomy.