According to clinical manifestations, 122 cases of subacute and chronic severe viral hepatitis confirmed by pathologic examination, were divided into two types. The severe jaundice-ascites(SJ-A) type accounted for 93 cases (76.2%) and the subfulminant hepatic failure (SFHF) type 29 cases (23.8%), with a ratio of 3.2 : 1. For SFHF type, hepatic encephalopathy was the first prominent feature and ascites might or might not appeared later. Therefore, this type was most easily misdiagnosed as fulminant hepatitis. In comparison with SJ-A type, the average elevation of serum bilirubin was lower and the average depression of prothrombin activivty more remarkable in SFHF type, suggesting that the degree of hepatic necrosis was more severer and the progress to hepatic failure more rapid. The mortality of SFHF type (93.1%) was markedly higher than that of SJ A type (62.4%) (x2 = 7.488, P

Objective To study the effects of IFN ?,TNF ?,IL 1 and dexamethasone on the expression of intercellular adhesion molecule 1(ICAM 1) of primary cultured human hepatocyte. Methods ICAM 1 expression of primary cultured human hepatocyte was induced in vitro by IFN ?,TNF ? and IL 1, measuring by cellular enzyme linked immunosorbent assay(ELISA). The effect of dexamethasone on human hepatocyte ICAM 1 expression was observed by adding dexamethasone into the cultured human hepatocytes prior to cytokine stimulation. Results The levels of ICAM 1 expression were significantly lower in unstimulated human hepatocytes than in human hepatocytes induced by IFN ?,TNF ? and IL 1. There were relations among the levels of ICAM 1 expression and cytokine concentration as well as induced period of time. Dexamethasone could partly inhibit the ICAM 1 expression on human hepatocytes induced by TNF ?,IL 1 and IFN ?.The inhibition rates were 40.3%?5.9%,38.1%?4.8%, and 37.6%?6.7%, respectively.Conclusions Enhanced ICAM 1 expression of primary cultured human hepatocyte may be induced in vitro by IFN ?,TNF ? and IL 1, which may be partly inhibited by dexamethasone.

This study is based on the requirements of the construction of applied undergraduate colleges and development of excellent doctor education training pilot project of the ministry of education. The situation of higher medical education and the requirement of health career development are analyzed. The medical talents training mode of three oriented which is taking the post competency of medical students as the frame is constructed. This paper expounds the background proposed by training mode from the internal drive, external drive and project boosting. With the national education policy as the basis, the theoretical basis of the international advanced education teaching idea, theory and standard is explained. The connotation of the training mode is revealed by the humanistic quality education, professional quality training and physical and psychological quality cultivating. The evaluation strategy of clinical medical per-sonnel training standards, index system, the implementation approach and evaluation methods which have certain feasibility and timeliness is established.

Objective to summarize the clinical experience and results of 50 cases of mitral valve surgery via right anterolateral mini-thoracotomy technique. Methods Patients of mitral valve diseases who accepted such less invasive technique with cap lamp between October 2008 and February 2010 were reviewed.Out of a total 50 cases,38 rheumatic cases underwent mitral valve replacement,12 degenerative cases underwent mitral valvuloplasty,22 cases underwent associated tricuspid valvuloplasty.Preoperative transthoracic echocardiography(TTE) manifest mean left ventricular ejection fraction(LVEF) was 57.3±6.0%.According to NYHA classification,32 patients were in NYHA class II while the other 18 in class III. Diagnosis was identified according to history, physical examination, ECG as well as TTE. There was no statistical difference with regard to age, body weight, cradiothoracic ratio,size of left atrium,size of left ventricle and LVEF comparing with homochronous mitral valve surgeries via median sternotomy.All the patients adopted single lumen trachea cannula and were positioned on his/her back with a 20-30 elevation of the right side, the right arm was suspended over the head. Cardiopulmonary bypass was established between the femoral artery and bicaval venous cannulation. A 6-8cm incision was created in the right submammary fold and the right chest cavity was entered through the fourth intercostalspace.In addition,two other ports were necessary with one positioned at the cross-point of right medioclavicular line and second intercostalspace for placing long myocardial perfusion needles and superior vena cava blocking belt and the other positioned at the cross-point of right midaxillary line and fourth intercostalspace for placing special aortic clamp as well as inferior vena cava blocking belt. Surgeons should wearing headlamps to obtain a clear operation field. The procedures were then performed through an interatrial septum or interatrial groove incision.Result None of the 50 patients turned into median sternotomy during surgeries, there was no case of prolonged intubation, failure of important organs, hemoglobinuria or death,4 cases appeared hypoxemia during surgeries because of high-frequency ventilation with low tidal volume and all Improved after being treated. One case was complicated by active bleeding of intercostal arteries and recovered uneventfully after secondary hemostasis. Comparing with a group made up of 50 patients of the same period who underwent traditional mitral valve surgery through median sternotomy, there was no statistical difference regarding total operation time(130-206,152.0±42.6min:120-190,145.6±50.4min),the mean bypass time(58-147,75.1±20.3min:56-140,72.0±19.3min),the cross-clamp time (29-71,42.9±16.5min: 27-66,41.7±14.7min),mean parallel cycle time(18-60,28.5±12.8min:21-50,29.5±12.0min)(P>0.05). Tracheal intubation time was similar for both groups.(3.5-12,5.2±2.8h:4-14,5.5±2.6h)(P>0.05).The drainage volume of the mini-invasive group was significantly less when comparing with traditional group and all removed their chest tubes on 1st postoperative day.The mean volume were 40-600(105±40)ml and 150-1000 (300±80) ml, respectively(P<0.05). Volume of blood transfusion was also significantly less than traditional group(200±50ml:300±100ml)(P<0.05).TTE before discharged manifest all mitral valve prosthesis had good function, no paravalvular leak was detected, mitral regurgitation and tricuspid regurgitation following valvuloplasty was mild.Conclusion On-pump mini-invasive mitral valve surgery via right submammary thoracotomy which entered the right chest cavity through the fourth intercostalspace together with the using of headlamps can provide a clear operation field. The operating procedure is simple, more important, it is less invasive, less draining and has shorter mean hospital stay and hidden incision. The operation is safety and early postoperative result of this new procedure is satisfactory.

BACKGROUND: Recombinant human erythropoietin (rhEPO) is a glycoprotein. Recent studies have demonstrated that rhEPO regulates many functional activities of neural cells. OBJECTIVE: To investigate the effects of different concentrations of rhEPO on proliferation of neural stem cells (NSCs) cultured in vitro. METHODS: Newborn Sprague-Dawley rat NSCs were harvested and cultured with serum-free culture medium containing different concentrations (5, 50, 500 U/mL) of rhEPO and 20 μg/L basic fibroblast growth factors (5, 50, and 500 U/mL rhEPO groups) and serum-free culture medium only containing 20 μg/L basic fibroblast growth factors (control group). After 7 days of culture, the cloning efficiency of NSCs was calculated. After 10 days of culture, neuron specific enolase (NSE)-and glial fibrillary acidic protein (GFAP)-immunoreactive cells were quantified. RESULTS AND CONCLUSION: In the rhEPO groups, cells proliferated rapidly, and the number of NSC microspheres was greater, in particular in the 50 U/mL rhEPO group, compared with the control group. NSCs grew faster in the 50 U/mL rhEPO group than in the control group. The number of NSE-and GFAP-immunoreactive cells was greater in the 50 U/mL rhEPO group than in the control group (P<0.01). These findings suggest that rhEPO promotes the in vitro culture and proliferation of NSCs, in particular 50 U/mL rhEPO.

Objective To investigate the clinicopathological characteristics, diagnosis and treatment of huge adrenal tumor.Methods Retrospectively analysed the clinical data of the 2 patients with huge adrenal tumor more than 10 cm in diameter, who were admitted in our hospital from September 2013 to January 2015.Clinical manifestations, treatment and prognosis were evaluated.Results Two patients were both suspected of adrenocortical carcinomas.Case 1 was a 28-year-old female.Laparoscopic surgery was performed at first but was conversed to open palliative adrenalectomy due to tumor rupture and bleeding.The postoperative pathology was adrenocortical carcinoma.The patient died of gastrointestinal bleeding caused by tumor metastasis 10 months later.Case 2 was a 39-year-old female, who underwent laparoscopic adrenolectomy with tumor excision completely.The postoperative pathology showed neoplasm of malignant potential, and no tumor recurred in 15 months follow-up.ConclusionsOpen surgery should be the priority if the diameter of adrenal tumor is more than 10 cm and diagnosis as suspicious of malignancy.Huge adrenocortical carcinoma is related to poor therapeutic response,and multimodality therapy may improve the prognosis.

Objective To understand the infection status and variation tendercy of Enterobius vermicularis infection among children at national monitoring spots of soil-transmitted nematodosis from 2006 to 2010,and master the epidemic regularity,so as to provide the evidence for making control strategy and evaluating the control effect. Methods A total of 22 national monitor-ing spots of soil-transmitted nematodosis were established according to the National Surveillance Program of Soil-Transmitted Ne-matodiasis(Trial),and the children aged 3-12 years were examined through adhesive cellophane anal swabs,then the infec-tion rates of children with different ages,genders,nationalities and education levels were analyzed. In addition,the advantage, disadvantage,opportunity and threat of the monitoring work were analyzed by SWOT analysis. Results A total of 17 068 chil-dren were examined in 22 monitoring spots from 2006 to 2010,and 1 363 of them were found being infected with E. vermicu-laris,the average infection rate was 7.99%,and the infection rates of male and female children were 7.39%and 8.70%,respec-tivel;the average infection rates in each year were 10.01%,9.68%,7.41%,6.96%and 6.57%,respectively. From 2006 to 2009,the infection rates of E. vermicularis in children in Fujian Province was the highest,which were 56.15%,53.42%, 37.82%and 49.53%,respectively,but in 2010,the infection rate in Guangdong Province(46.06%)was the highest. The fur-ther analysis demonstrated that the female children,3-6 age group,Li nationality and children at kindergarten stage had relative-ly high infection rates. The SWOT analysis showed that the advantage of E. vermicularis monitoring in China was its wide cover-age and continuity,and the disadvantage was the relatively small investment from the government,the opportunity was that the national monitoring spot could drive the monitoring work at the provincial,county and other levels,and the threat was that the work was paid less and less attention to in recent years. Conclusion Though the infection rate of E. vermicularis in children at national monitoring spots of soil-transmitted nematodosis has been decreased year by year,high-endemic areas still exist,and thus the work on enterobiasis control and prevention still needs to be strengthened.

Objective To compare the effects of thoracoscopic 2 hole and 3 hole for congenital pulmonary bulla resection.Methods 38 cases of congenital pulmonary bulla patients,both in the VATS downlink congenital pulmonary bulla resection.According to the number of holes,thoracoscopic operation were divided into the two groups. To observe the use of group 19 cases of 2 holes,19 cases 3 holes were adopted in the control group.Pull the chest tube operation time,operation time of the two groups were compared after.and the average hospitalization time after opera-tion,postoperative analgesia drug application.Results The observation group operation time,operation time,pulling the chest tube after operation the average hospitalization time, analgesic drug application rate respectively were (46.89 ±9.11)min,(3.95 ±0.85) d,(7.37 ±1.34) d,21.1%,The control group were (66.05 ±12.09) min, (4.37 ±0.98)d,(7.32 ±1.57)d,52.6%.There were statistically significant differences in rate of the two groups in operation time,analgesic drug application.(t=-5.516,χ2 =4.071,P<0.05);38 cases were cured,followed up for 3-24 months,no recurrence occurred in 1 cases.Conclusion Video assisted thoracic descending congenital pulmona-ry bulla resection,the 2 hole 3 hole more than minimally invasive,short operation time,postoperative analgesic use rate is low.

Wavelet transform(WT) is a powerful technique in signal separation and can improve the signal-to-noise ratio by separating the white noise and useful signal.The method in the paper introduces the concepts of Wavelet transform.According to the analysis of Wavelet coefficients between the noise and signal at different levels,the appropriate filter is realized.The patch clamp experiment results demonstrate the feasibility of the method.

Objective Effect of psychological intervention on functional rehabilitation of femoral supracondylar fractures.Methods 84 type C fracture patients according to AO criteria for the diagnosis were collected,and randomly divided into intervention group(n=42)and control group(n=42)according to patient sex,age,fracture condition,cultural degree balanced matching principle.The control group was given conventional treatment and fracture features of health guidance,the intervention group in addition to conventional treatment and rehabilitation guidance.Comprehensive mental intervention applied 4 times on postoperative 3 days,the 2nd,3rd,4th week.Self-anxiety scale and self-depression scale were used before operation and 6th month after operation.Results The anxiety and depression scores in two groups before intervention showed no significant difference P>0.05).6 months after the operation,the anxiety score(41.6±9.4 vs 48.7±8.5)and depression score(40.6±7.6 vs 47.4±9.2)in intervention group apparently decreased than that in control group(P<0.01).Function restoration of knee joint in different effect showed better than control group(u=-2.0591,P<0.05).Conclusion Psychological intervention can effectively promote the functional recovery of patients with femoral supracondylar fractures and promote anxiety and depression mood.