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 understand the status of Ascaris eggs pollution in soil at national monitoring spots of soil-transmit-ted nematodiasis,so as to provide the evidence for making countermeasures and evaluating the control effect. Methods Ten households were selected from each of the 22 national monitoring spots annually according to the National Surveillance Program of Soil-Transmitted Nematodiasis(Trial),and the soil samples from vegetable gardens,toilet periphery,courtyards and kitchens were collected and examined by using the modified floatation test with saturated sodium nitrate. Fertilized or unfertilized eggs as well as live or dead fertilized eggs were discriminated and identified. In addition,a SWOT analysis of monitoring of Ascaris eggs pollution in the soil of rural China was carried out. Results A total of 1 090 households were monitored in 22 monitoring spots from 2006 to 2010. The total detection rate of Ascaris eggs in the soil was 30.73%,and the detection rates of fertilized,unfertilized and live fertilized eggs were 13.21%,26.42%and 20.28%,respectively. The total detection rates of Ascaris eggs in the vegetable garden,toilet periphery,courtyard and kitchen were 16.51%,13.49%,14.22% and 10.73% respectively. The SWOT analysis demonstrated that the monitoring work had both advantages and disadvantages,and was faced with opportunities as well as threats. Conclusion The pollution status of Ascaris eggs in the soil is still quite severe at some national monitoring spots,and the counter-measures such as implementing hazard-free treatment of stool,improving water supply and sanitation and reforming environment should be taken to protect people from being infected.

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.

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.

The nonlinear wavelet method is used to detect ECG signal. The ECG signal disrupted by high-frequency noise is decomposed with a dyadic Daubechies wavelet according to Mallat algorithm. The principle of the nonlinear wavelet detection method is discussed. Along with the Lipschitz criterion, it is applied to denoising the disrupted ECG signal. The ECG signal is effectively recovered while denoised.

In allusion to high labor intensity, low working efficiency and high error rate in hospital laboratory, a detection system of the enzyme-linked analyzer based on Multiscan EX instrument is developed. Being easy to operate, the detection system proves effective in enhancing working efficiency. It deserves popularizing because of its comprehensive applications to the detection.