Objective To explore the pathogenesis of femoral head ischemic necrosis(FHIN),and to observe the clinical therapeutic effects of extracorporeal shock waves therapy(ESWT) for FHIN in soldiers.Methods With exclusion of the femoral head necrosis sAbsequent to femoral neck fracture,108 cases of FHIN in ARCO stage Ⅰ-Ⅲ period,induding 86 males and 22 females,with aged ranged from 17 to 25 years,were involved in the present study,and the treatment modality was chosen by patients voluntarily.In 50 patients,ESWT combined with drilling decompression procedure(ESWT group) was chosen,and 9-12kV(0.16-0.22mJ/mm2) of extracorporeal shock wave was applied on the second day after drilling decompression.X-ray and MRI of bilateral hip joints were taken and Harris hip score(HHS) was estimated at 6 and 12 months after treatment.58 patients chose the treatment of simple drilling decompression served as controls.The results of the two groups were analyzed by Student's paired t test.Results No aggravation of FHIN occurred in the two groups.The average ratio of necrosis zone in ESWT group was diminished by 22.9%,32.8% and 34.3%,respectively,in the stages of ARCO Ⅰ,Ⅱ and Ⅲ,and the improvement was better in ARCO Ⅱ and Ⅲ stages than that in control group(P

Objective To explore the clinical characteristics for patients with hemorrhagic transformation(HT) after acute cere‐bral infarction .Methods In this study ,retrospective analysis was performed for 48 patients HT ,which were classified as HI(n=45 ,93 .8% ) ,HI‐1(n=27) ,HI‐2(n=18);PH(n=3 ,6 .3% ) ,PH‐1(n=2) ,PH‐2(n=1) .PH‐2 admission NIHSS score was signifi‐cantly higher than other types of HT .CT scans and MRT were carried out ,infarction area were defined so that we could choose dif‐ferent treatments .Results The total cases with hemorrhage time within 1 -2 weeks after infarction was 28(58 .3% ) ,while 14 (29 .2% )occured within 1 week .The relationship between HT location and infarction area:25 cases(52 .1% ) occurred cerebral lobe infarction ,for which hemorrhage lesion was located in cortex and(or) subcortical;11 cases (22 .9% ) occurred deep brain parenchy‐ma infarction ,for which hemorrhagic lesion was located inside or on the edge of infarcts;8 cases were lobes and deep infarction ,3 cases were cerebellar infarction ,1 case was brain stem infarction ,all of the hemorrhagic lesion was inside the infarcts .The relation‐ship between HT and infarct size:31 cases(64 .6% ) occured secondary to large area acute cerebral infarction ,14 cases(29 .2% ) oc‐cured secondary to small area of cerebral infarction ,3 cases(6 .3% ) occured secondary to lacunar infarction .Hemorrhage of the HI patients was in the cortex and the subcortical white matter ,with shapes of deep brain dot ,patchy ,funicular or gyrus .Hematoma was formed in cerebral infarction for PH patients ,which mainly located in basal ganglia .Conclusion The HT occurrence is closely relat‐ed to the infarction area and size .Patients with Large area and cerebral lobe infarction have high opportunity for complication of HT .HT usually occurs within 1-2 weeks after cerebral infarction ,during which brain CT or MRI should be routinely reexamined .

Adult ; Axilla ; Breast Neoplasms ; pathology ; surgery ; Carcinoma, Ductal, Breast ; pathology ; secondary ; surgery ; Carcinoma, Intraductal, Noninfiltrating ; pathology ; secondary ; surgery ; False Negative Reactions ; Female ; Humans ; Lymph Node Excision ; Lymph Nodes ; pathology ; surgery ; Lymphatic Metastasis ; Mastectomy ; methods ; Reproducibility of Results ; Sentinel Lymph Node Biopsy ; methods ; Technetium Tc 99m Sulfur Colloid

Objective To explore the role of Schistosoma japonicum egg antigens in host immune response. Methods Female BALB/c mice aged 6-8 weeks were divided into two groups. The mice in the experiment group were administrated with 10 000 eggs of S.japonicum orally and injected with 200 ?g SEA via tail vein,once for a week. The mice in the control group were infected with PBS. The number of CD4+CD25+T cells was detected in a murine model treated by S. japonicum egg antigens,and the regulatory properties of CD4+CD25+ T cells were assessed while CD4+CD25+ T cells were cocultured with CD4+CD25-T cells. For the detection of murine TGF-? and IL-10,a DuoSet ELISA development kit was used. IL-4,IL-10 and IFN-? were detected by using flow cytometry. Results The number of CD4+CD25+T cells and the level of IL-10 increased in mice treated with S. japonicum egg antigens. CD4+CD25+T cells dramatically enhanced IL-10 production and decreased IFN-? production compared with the CD4+CD25-population. CD4+CD25+T cells suppressed the proliferation of CD4+T cells. Conclusion S. japonicum egg antigens downregulate the host immune response by inducing the production of CD4+CD25+ T cells and IL-10.

Objective To investigate the clinical application of the combined the anterior malleolus flap and anterior tibia flap. Methods Based on the dissection of the perforating branches of anterior tibial artery on the middle and inferior section, the combined the anterior malleolus flap and anterior tibia flap was designed to repair the necrotic skin of anterior foot for 5 patients. The sizes of the flaps ranged from 17 cm×10 cm-10 cm× 5 cm. And the area of the flap was from tibial tuberosity(upper bound) to the line between internal malleolus and external malleolus (lower bound), and from the median line of one side of leg to the other side. Results Postoperatively, all flaps survived, and the primary healing of transplanted skin in donor site was achieved. The texture of flaps were excellent, the phenomenon of abrasion did not happen, and the clinical therapeutic efficacy was satisfactory after a follow up of 2-24 months. Conclusion It's a good method that combined the anterior malleohls flap and anterior tibia flap, which not only could enlarge the area of the flap but also has reliable blood supply, in repair of large size skin defect of anterior foot.

BACKGROUND: Effect of nerve growth factor(NGF)on angiogenesis of regenerative perpheral nerve is still researched up to now.OBJECTIVE:To evaluate the dose-response relationship and mechanism of NGF on angiogenesis of regenerative sciatic nerve in rats.DESIGN:Randomized controlled animal study.SEFFING:Department of Neurology,the 324 Hospital of Chinese PLA;the Third Laboratory,Institute of Battle Surgery,Daping Hospital of the Third Military Medical University of Chinese PLA.MATERIALS:A total of 32 healthy adult Wistar rats weighing 200-250 g and of both genders were selected in this study.Silica gel conduit was provided by Shanghai Xinya Medical Rubber-goods Factory and NGF was provided by Sigma Company,USA.METHODS:The experiment was carried out in the Third Laboratory,Institute of Battle Surgery,Daping Hospital Affiliated to the Third Military Medical University of Chinese PLA from August 2003 to February 2005.Experimental grouping:All rats were randomly divided into 4 groups,including saline group,50,100 and 500 ng NGF groups with 8 rats in each group.Experimental intervention:Sciatic nerves were cut to establish defect of 10 mm in length,and then the defect was bridged with silica gel conduit in the left latter limb.After the bridging,rats in the saline group were perfused with 5 μL saline,and rats in the NGF groups were perfused with 2.5,5 and 25μL NGF(20 mg/L),respectively.Experimental evaluation:On the 30th day,immunohistochemical technique was used to detect the expressions of CD34,vWf,vascular endothelial growth factor(VEGF)and trkA in newborn vascular endothelial cells of regenerative sciatic nerve;meanwhile,their forms were performed with quantitative analysis.MAIN OUTCOME MEASURES:Pathological and immunohistochemical changes of nerve regeneration of rats in each group.RESULTS:All 32 rats were involved in the final analysis,①Results of pathological sections of nerve regeneration in rats:Distal end of sciatic nerve was completely bridged at 30 days after operation and thickness of sciatic nerve in silica gel conduit lined in 500 ng NGF group＞50 and 100 ng NGF group＞saline group.Numbers of fiber and regularity of arrangement of sciatic nerve were superior in NGF groups to those in saline group,In addition,angiogenesis was obviously observed at 30 days after operation.②Results of immunohistochemical staining:There were significant differences among three NGF groups as compared with saline group in the expressions of four antigens (P＜0.05).Expressions of four antigens were increased in 500 ng NGF group as compared with those in 100 and 50 ng NGF groups(CD34:94.2±6.4,74.2±10.9,77.0±11,0;vWf:116.2±20.0,72.0±13.1,68.0±9.7;TrkA:105.4±10.6,57.8±11.5,58.8±6.5;VEGF:89.0±3.0,48 6±7.4,35.2±2.9;P＜0.05 or P＜0.01).CONCLUSION: NGF can promote angiogenesis of the regenerative peripheral nerves and show a dose-response relationship,while its mechanism may be related to promoting expressions of TrkA and VEGF.

The medical law science interdisciplinary talents play an crucial role in solving medical service dispute and alleviating contradictory. Based on the questionnaire survey and the interview to the court and law offices as well as the analysis of the society's demand for the knowledge structure and ability of medicine law professionals, we proposed the construction of the training mode for medicine law professionals with the ability to adapt to the social demand.

Objective To study the effects of high matrix metalloproteinase 9 (MMP 9 ) on the biological behaviors of fibroblasts,in order to clarify the possible mechanisms in the wound healing of diabetic foot.Methods Establish the cell model of skin fibroblast with high expression of MMP 9 by high glucose (22.0 mmol/L) and high homocysteine (100 μmol/L) co-culture.Control group was incubated with normal glucose (5.5 mmol/L).Realtime PCR,ELISA and gelatin zymography were used to detect the MMP 9 mRNA,protein expression and activity of MMP 9.Flow cytometry,CCK-8,ELISA assay,scratch test and transwell were used to detect cell proliferation,viability,collagen (hydroxyproline) secretion,horizontal migration and vertical migration of cells.Results Data were expressed as (x- ± s).Differences were considered significant if their P value was ＜ 0.05.Results The expression of MMP 9 mRNA,protein levels and the activity of MMP 9 in high MMP 9 group were 6.05 folds,4.12 folds and 1.58 folds higher than those in control group (P ＜ 0.01,respectively).The proportion of S phase cells,proliferation index,cell viability,collagen (hydroxyproline) secretion,6 h horizontal migration rate and the number of vertical migration cells in high MMP9 group decreased by 29.8 ％,18.1％,23.3 ％,68.7 ％,45.0 ％ and 21.4 ％ than those in control group (P ＜ 0.01,respectively ). Conclusions Fibroblast with high expression of MMP 9 have decreased proliferation,activity,collagen secretion and reduced migration,which suggests that MMP 9 may inhibit the biological behaviors of fibroblasts.

Objective: To observe the influence of electroacupuncture with different frequencies on rats swimming endurance and sift out the optimal frequency parameter.Methods: Wistar rats were randomly allocated to control group, non-acupoint group and electroacupuncture with low frequency group (EA with 2 Hz group), electroacupuncture with medium frequency group (EA with 15 Hz group), and electroacupuncture with high frequency group (EA with 100 Hz group), acupoints Zusanli (ST 36) and Taichong (LR 3) were punctured and rats load swimming time was used as an index, and the change of swimming endurance time before and after acupuncture was observed. Results: After electro-acupuncture, swimming time was increased in 15 Hz and 100 Hz groups respectively, with the significant differences between before and after acupuncture (P＜0.05). There was also a significant difference in the percentage of increase in swimming time between 15 Hz group and other groups (P＜0.05).Conclusion: It is suggested that electroacupuncture at acupoints Zusanli (ST 36) and Taichong (LR 3) with a frequency of 15 Hz could enhance rats's swimming endurance, and 15 Hz might be an optimal frequency parameter during the electrical stimulation.

Objective To analysis the basic condition of the health resources in Chongqing ,and to explore the effect of the al‐location of health resources on doctor‐patient relationship .Methods Health statistics yearbook of Chongqing city was collected ,the fairness of the allocation of health resources in chongqing carried on the analysis and evaluation ,using the DEA model to analyze and evaluation the efficiency of the allocation of health resources in chongqing ,self‐designed questionnaire was used;hospitals ,doc‐tors and patients were investigated ,the descriptive and statistical analysis carried on .Results The distribution of health resources in Chongqing was inequitable on a regional .This inequitable distribution had been evaluated to the effect that ,as per the DEA mod‐el ,7 prefectures were effective with another 5 slightly effective and 26 as DEA ineffective .In the 8 hospitals that had been investiga‐ted ,the occurrence of medical disputes was undergoing a surge ,which indicates the tense relation between doctors and patients .Con‐clusion The total amount of health resources in Chongqing is fairly insufficient ,the high quality health resources are scarce .Unbal‐anced allocation of health resources and allocation inefficiency is the main reason for nervous doctor‐patient relationship and contra‐diction focus .