Some traditional Chinese medicine technologies,with strong safety, quick and significant effect, standerdized manipulation, simple operation and good prospect for promotion and application are selected in the research project for application and demonstration of rural health appropriate technology. Through the application of the project, we have new experience in medical teaching.

Objective To investigate the expression of Kuppel-like factor 2( KLF2 )after focal cerebral ischemia-reperfusion( I/R)injury in rats and the intervention effect of nuclear factor kappa B ( NF-κB)inhibitor. Methods Sixty healthy male SD rats were randomly divided into a sham operation group,an I/R group,and a NF-κB inhibitor group( n=20 in each group). A focal cerebral I/R model was induced by the intraluminal suture method,and NF-κB inhibitor( pyrrolidinedithio carbamate,PDTC)was given to intervene. The observation time points were 6,12,24,and 48 hours after I/R. Reverse transcription-polymerase chain reaction(PCR)and Western blot were used to measure KLF2 mRNA and protein expression in ischemic brain tissue. Enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of serum tumor necrosis factorα( TNF-α),and they were compared among groups. Results Compared with the sham operation group,the expression levels of KLF2 mRNA and protein in I/R group in the ischemic brain tissue at each time point were averagely decreased( the relative expression levels of KLF2 mRNA:0. 46 ± 0. 03 vs. 0. 82 ± 0. 04,0. 30 ± 0. 04 vs. 0. 78 ± 0. 05,0. 18 ± 0. 04 vs. 0. 76 ± 0. 02,0. 26 ± 0. 02 vs. 0. 81 ± 0. 04,respectively;the relative expression levels of KLF2 protein:0. 46 ± 0. 04 vs. 0. 80 ± 0. 02,0. 30 ± 0. 02 vs. 0. 79 ± 0. 02,0. 15 ± 0. 02 vs. 0. 77 ± 0. 01,0. 24 ± 0. 01 vs. 0. 79 ± 0. 02,respectively). They reached the lowest values at 24 hours after I/R,while the serum TNF-αlevels were increased. There were significant differences(all P<0. 05). After giving NF-κB inhibitor PDTC,the expression levels of KLF2 mRNA and protein at 6,12,24,and 48 hours after I/R were upregulated differently compared with the I/R group. The relative expression levels of KLF2 mRNA were 0. 61 ± 0. 04,0. 44 ± 0. 03,0. 34 ± 0. 02,and 0. 43 ± 0. 04, respectively. Those of KLF2 protein were 0. 60 ± 0. 02,0. 43 ± 0. 02,0. 33 ± 0. 01,and 0. 44 ± 0. 03, respectively,while the levels of TNF-αwere decreased. There were significant differences(all P<0. 05). There was a negative correlation between the KLF2 mRNA levels and the serum TNF-αlevels at each time point in the I/R group and the PDTC group( r= —0. 728 ,P<0. 05 ). Conclusions The expression levels of KLF2 mRNA in brain tissue are decreased after I/R,and it is negatively correlated with the serum TNF-α levels. It may be involved in the pathological process of I/R by NF-κB pathway mediated inflammatory reaction.

Objective Retrospectively evaluate the effect of Z-axis tube-current modulation technique with desired noise level to improve image quality (image noise level) and decrease radiation doses of MSCT (16-slice CT) in chest scanning. Methods Consecutive two hundred patients whose CT scan projection radiographs showed no significant abnormal were randomly divided into two groups by the examination order: Z-axis tube-current modulation (ZTCM) group (odd number, test group) and constant tube-current (CTC) group (even number, contrast group). The desired noise level of ZTCM group was 10HU and the machine automatically set the dynamic tube-current in scanning according to attenuated information of chest acquired in scan projection radiographs, the tubo-current of CTC group was set at 200mA, while the other scan parameters remained totally the same. The maximum tube-current value,CTDIvol, DLP and the tube-current of the slice at the maximum breast level of female patients were recorded respectively. The noise of image at upper lung, aorta arch, left atrium and bottom lung level were measured and compared. The qualities of Images were classified in three levels (excellent, good, poor) with double blind method. Results The mean value of maximum mA, CTDIvol, DLP and mA of the slice at the maximum breast level of ZTCM group were (178.5±125.6) mA, (10.5±3.8) mGy, (231.6±24.3)mGy/cm and (116.0±22.5) mA, those of CTC were 200.0 mA, 12.8 mGy, (274.7±18.4)mGy/cm and 200.0 mA, ZTCM group decreased by 10.8%, 19.9%, 15.7% and 42.0%,respectively, as compared with CTC group. The image quality at upper lung and bottom lung level in ZTCM group was improved significantly (P < 0.05) and the cases of excellent images in ZTCM group was significantly higher than that of CTC group (P < 0.05). Conclusion ZTCM technique not only contributes to more rational distribution of radiation doses but also realizes individuation, decreases the total radiation doses and improves image quality in chest CT scanning. It is valuable and promising in chest CT scan.

Objective To evaluate the efficacy of immediate and delayed postoperative removal of urethral catheters Methods Randomized controlled trials and quasi-experiment trails of immediate and delayed postoperative removal of urethral catheters were collected in the databases such as CENTRAL, PubMed, OVID, China National Knowledge Infrastructure (CNKI), China Biology Medicine disc (CBM), VIP, Wanfang Data, etc. Data were analyzed by RevMan 5.3 version.after heterogeneity analysis,pooled risk ratio (RR) with 95%confidence interval (95%CI) using both fixed and random effect models were estimated. Results Ten randomized controlled trials (RCTs) were included. The results of Meta-analysis indicated that immediate urinary catheter removal was associated with a lower incidence of urinary tract infections (RR=0.29, 95%CI 0.15 to 0.56, P=0.000 3), positive urinary culture (RR=0.31,95%CI 0.16 to 0.59, P=0.000 2) compared with the delayed removal group and seven studies recommended removal of the indwelling urinary catheter immediately after hysterectomy. While, there was a higher risk of re-catheterization (RR=4.56, 95%CI 2.93 to 7.08, P<0.01)in the immediate removal group. Seven studies recommended removal of the indwelling urinary catheter immediately after hysterectomy. Conclusions Removal of the indwelling urinary catheter immediately after hysterectomy was recommended.

Objective To investigate protective effects of thrombopoietin ( TPO) on cerebral model control in rats and associated signal transduction pathway. Methods Thread embolism was performed to generate cerebral ischemia-reperfusion rat model. Eighty male SD rats were randomly divided into sham operation group, model control group, TPO group, TPO and Janus kinase 2 ( JAK2 ) kinase inhibitor ( AG490 ) group. Before 30 min of ischemia-reperfusion, TPO group was given TPO (5 μg·kg-1) by intraperitoneal injection, TPO + AG490 group was given TPO (5 μg·kg-1) before 30 min of ischemia reperfusion, then given AG490 (8 μg·kg-1), and model control group were given the same dose of 0. 9% sodium chloride solution. The observation time points were 6, 12, 24, and 48 h after ischemia reperfusion. Immunohistochemical staining and Western blotting were used to measure the protein levels of Bcl-2, JAK2 and signal transducer & activator of transcription (STAT3). TdT-mediated dUTP nick end labeling (TUNEL) was used to detect apoptosis. Results Compared with model control group, the number of apoptotic cells were significantly reduced [(67. 50±9. 37) vs. (40. 20±7. 47)], the expression levels of Bcl-2, JAK2 and STAT3 protein were significantly increased [(35. 40±7. 39) vs. (78. 70±9. 75);(35. 68±6. 75) vs. (62.35±7.53); (25.40±9.45) vs.(55.36±9.69), respectively] 24 h after ischeia reperfusion in the TPO group (all P<0. 05). Compared with the TPO group, the Bcl-2, JAK2 and STAT3 protein levels were significantly decreased in TPO and AG490 group [(78. 70±9. 75) vs. (55. 40±9. 35);(62. 35±7. 53) vs. (40. 68±5. 89); (55. 36±9. 69) vs. (30. 40±9. 39), respetively], and the number of apoptotic cells was significantly increased [(40. 20±7. 47) vs. (55. 23±7. 65)] (all P<0. 05). Conclusion TPO can inhibit cell apoptosis after ischemia-reperfusion injury, the mechanism might be related to the activation of JAK2/STAT3 signal transduction pathway through raising the expression of Bcl-2 gene.

Objective To discuss the experience of medical care for the assurance of security of the'Shenzhou Ⅶ'astronauts at the landing venue in order to innovate a high efficient mobile ICU in medical helicopters.Method The data collected from over.as and domestics were reviewed and analyzed to find out the possible causes of accidental injuries to astronauts during acmspaec flight,and to pmpose a practicably and effectively prophylactic strategy and reasonable treatments for the astronauts with accidental injuries.Results Three,high efficient mobile ICU innovated could elqsure the safety ofthe astronauts.The ICUs with high efficiency were set up in the helicopters where the surgery Call he peormed for controlling the danlage.Fine armature made our work mole effective.Conclusions Practicably and effectively Plephylactic measurements and reasonable treatments are the essential aspect of the successfulness for the security of astronauts of manned aemspacecraft flights.The innovated medical care system in helicopters could realized the obligation of swift response and the duty offirst-md.

Objective:To investigate the efficacy of osteochondral fragment fixation using bioabsorbable pins for Hepple Ⅱ osteochondral lesions of the talus (OLT) in adolescents.Methods:Retrospective case analysis was used. The clinical data and follow-up results of 13 adolescent patients (13 feet) with Hepple Ⅱ OLT were all treated with osteochondral fragment fixation using bioabsorbable pins admitted to Shanghai Sixth People′s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2017 to December 2021 were retrospectively analyzed. There were 7 males and 6 females, with 13 right feet. The age was (14.85±2.23) years old, ranged from 12 to 18 years old. According to the American orthopedic foot and ankle society (AOFAS) ankle-hindfoot score, visual analogue scale (VAS) and SF-36 score before operation and at the last follow-up were used to evaluate the efficacy and function of the patients. Measurement data with normal distribution were represented as mean ± standard deviation( ± s), and the comparison between groups was conducted using the t-test; The mearsurement data with skewness distribution were expressed by M( Q1, Q3), and rank-sum test was used for inter-group comparison. Results:Thirteen adolescent patients (13 feet) with Hepple Ⅱ OLT underwent surgery successfully and were followed up for (25.54±9.95) months. All wounds healed by first intention, and no complications such as wound infection and delayed healing occurred. Preoperative AOFAS ankle-posterior foot score, VAS and SF-36 score were 58.62±3.55, 7.00 (6.50, 8.00) and 68.38±4.81, respectively. At the last follow-up, the scores were 97.38±2.73, 1.00 (0.00, 1.00), 91.15±4.28, respectively, and the results were significantly improved at the last follow-up, with the difference between the two groups statistically significant( P<0.05). Conclusion:Osteochondral fragment fixation using bioabsorbable pins which can promote cartilage repair, significantly improve symptoms, and achieve better clinical satisfaction with fewer complications, is a safe and effective surgical treatment option for Hepple Ⅱ OLT in adolescents with satisfactory short-term clinical outcomes.