Large numbers of Plasmodium chabaudi gametocytes can be produced in the splene-ctomized Wistar rats 3-4 days after the intravenous inoculation of high parasitaemia mouse blood. On the 8-9th day, the number of gametocytes reduced greatly. The level of gametocytaemia was related to the time of splenectomy and the amount of the infected blood inoculated. The gametocytes in the rat were normal in their ability of exflagellation and their infectivity to anophelines.

Objective To observe and research the influence of vaginal delivery and cesarean section by two kinds of mode of delivery on maternal infant outcome of re-pregnancy after cesarean section.Methods 258 patients with re-pregnancy after cesarean section were selected,they were divided into vaginal delivery group(73 cases) and cesarean section group(185 cases) according to the different delivery mode.The maternal puerperal infection rate,24h postpartum hemorrhage volume,days,cost of hospitalization,lochia time and neonatal in hospital of both two groups were compared.Results The success rate of vaginal delivery was 69.52％,the rate of cesarean section was 71.71％.In vaginal delivery group,maternal puerperal infection rate,24 h postpartum hemorrhage volume,length of hospital stay,cost of hospitalization,lochia time were 1.73 ％,(201.54 ± 107.54) mL,(3.41 ± 0.09) d,(1 540.12 ±117.21),(21.36 ± 13.12) d,which were significantly better than the second cesarean section group [8.11％,(354.64 ± 215.54) mL,(7.45 ± 0.32) d,(4 932.62 ± 786.35),(27.11 ± 17.04) d],the differences were statistically significant (x2 =4.08,t =4.75,7.24,8.91,3.98,all P ＜ 0.05).Delivery of two kinds of mode of delivery of the newborn had no significant differences in birth weight,Apgar score,the rate of infection,intracranial hemorrhage rate and the asphyxia rate(t =0.15,0.09,0.46,0.00,x2 =0.03,all P＞0.05).Conclusion Re-pregnancy after cesarean section is not the choice of cesarean section delivery clinical indications of operation,when the pregnant women with indications of trial production,in strict monitoring downlink vaginal delivery.

Objective To investigate the therapeutic effects of continuous regional arterial infusion using protease-inhibitor and antibiotic in severe acute pancreatitis.Methods Nafamostat Mesilate(NM) and Tienam were infused 2~7 days in succesion through the arterial coeliac trunk after femoral artery puncture in 19 cases with severe acute pancreatitis.Results The mortality was 21.1% and the effective rate was 78.9%.Conclusion This treatment for severe acute pancreatitis,the death rate has not been obviously improved,but it is effective for infection.

OBJECTIVE:To systematically review the relationship of clinical efficacy between XPD Lys751Gln (A/C),XPD Asp312Asn(G/A)and platinum-based chemotherapy in patients with advanced non-small cell lung cancer(NSCLC),and provide evidence-based reference for clinical treatment. METHODS:Retrieved from PubMed, Cochrane Library, EMBase, Medline, CJFD,VIP database and WanFang database,studies about the effects of XPD Lys751Gln and XPD Asp312Asn polymorphism on ef-fectiveness,clinical outcomes and adverse drug reaction of platinum-based chemotherapy in advanced NSCLC patients were collect-ed,and Meta-analysis was performed by using Rev Man 5.3 software. RESULTS:Totally 30 studies were included,involving 5 028 patients. Genetic testing showed that XPD Lys751Gln divided into mutant gene (Lys/Gln + Gln/ Gln) and wild-type gene (Lys/Lys),while XPD Asp312Asn divided into mutant gene (Asp/Asn + Asn/Asn) and wild-type gene (Asp/Asp). Results of Me-ta-analysis showed,the progression-free survival (PFS) of Lys/Gln+Gln/Gln patients with platinum in XPD Lys751Gln polymor-phism was obviously lower than Lys/Lys patients [OR=-1.12,95%CI(-1.73,-0.50),P<0.001],while there was no significant difference in the chemotherapy effectiveness and total survival period. The effective rate of Asp/Asn+Asn/Asn patients for platinum in XPD Asp312Asn polymorphism was lower than Asp/Asp patients [OR=0.80,95%CI(0.68,0.96),P=0.02],while there was no significant difference in the total survival period and PFS. Meanwhile,the incidence of Ⅲ-Ⅳ level gastrointestinal adverse reac-tions of Lys/Gln+Gln/Gln with platinum in XPD Lys751Gln polymorphism was higher than Lys/Lys patients [OR=0.43,95%CI (0.20,0.94),P=0.03],and there was no significant difference in Ⅲ-Ⅳ level blood system adverse reactions. CONCLUSIONS:XPD Lys751Gln polymorphism may be associated with PFS and Ⅲ-Ⅳ level gastrointestinal adverse reactions for advanced NSCLC patients with platinum-based chemotherapy,while XPD Asp312Asn polymorphism may have effect on platinum-based chemotherapy,both of them may be as estimate the chemotherapy effect and prognosis detection index of platinum-based chemo-therapy.

Objective: To observe the difference in clinical efficacy between acupuncture with point selection based on syndrome differentiation along the meridians and acupuncture at non-meridian and non-acupoint points for functional dyspepsia (FD). Methods: A total of 74 FD patients were randomized into an observation group and a control group, with 37 cases in each group. Both groups received acupuncture treatment. Zusanli (ST 36) and Neiguan (PC 6) were selected in the observation group, with Taichong (LR 3) and Neiting (ST 44) added for excess syndrome, and Gongsun (SP 4) and Yinlingquan (SP 9) added for deficiency syndrome. Four non-meridian and non-acupoint points were selected in the control group. The treatments in both groups were performed once a day with a 2-day break after 5 consecutive treatments, which constituted one treatment course. A total of 4 courses were performed. The scores of Nepean dyspepsia index (NDI) and Leeds dyspepsia questionnaire (LDQ) were recorded before and after treatment, and during follow-up (8, 12, 16, 20 and 24 weeks after recruitment) to assess the clinical efficacy. Results: The NDI scores in the two groups after treatment and at each time point during follow-up were higher than those before treatment (all P<0.05), and the LDQ scores were lower than those before treatment (all P<0.05). The NDI scores after treatment and at each time point during follow-up in the observation group were higher than those in the control group (all P<0.01); the total LDQ score and scores of upper abdominal pain, postprandial satiety and upper abdominal burning sensation after treatment and at each time point during follow-up in the observation group were significantly lower than those in the control group (P<0.01 or P<0.05).. Conclusion: Acupuncture with point selection based on syndrome differentiation along the meridians has a better curative effect than acupuncture at non meridian and non-acupoint points in the treatment of FD.

Objectives To study the significance of using kappa value in surgical clinical teaching.Methods The interns in Department of General Surgery were included,and were divided into routine teaching group and targeted teaching group randomly. Kappa statistic was used to compare the consistency of physical examination.Results The results showed that Morris's point tenderness was grasped more efficiently in targeted teaching than routine teaching group.Conclusion With the help of kappa value teachers can find the teaching items more correlated with training and give students targeted teaching so as to improve the teaching effect.

Objective To analyze inhibitory effect on Wistar rattish hepatoma by endostatin, angiostatin,hyper-liquid hpiodol and a combination of these agents. Methods The rattish hepatoma models were randomly divided into 8 groups, including control group, lipiodol group, endostatin gene group, angiostatin gene group, endostaitin gene and angiostatin gene group, endostatin gene and lipiodol group, angiostatin gene and lipiodol group and endostatin gene, angiostatin gene and lipiodol group. Following treatment on Wistar rots with these agents or a combination of these agents, we measured the changes in tumor volume growth rate, metastases quantity rote, rattish life span, micmvessel density (MVD) value, apoptotic index(AI), vascular endothelial growth factor. Single factor variance test and Chi-square test were used for statistics. Results On the sixth day after treatment, the tumor volume growth rate of all the therapy groups were smaller than the control group. The therapeutic effect of the above mentioned two genes in combination with lipiodol was the best and the tumor volume growth rate was the smallest. On the eighteenth day after treatment, the numbers of pulmonary metastasis were(37.2±7.2)、(26.2±5.0)、(25.5±4.7)、 (26.2±3.9)、(14.9±2.6)、(19.1.4-2.8)、(20.2±2.7)and(6.1±1.2); the life span was(23.3± 4.4),(35.2±4.9),(28.2±3.6), (29.4±3.4), (38.3±6.7),(37.7±5.8), (36.4±5.5) and (59.8±9.4)days for each group respectively. The difference of the numbers of pulmonary metastases between the therapeutic groups and the control group was statistically significant(P<0.O1). The difference of the life span between the control group and the single gane group was not statistically significant, but the difference of the life span between the control group and the combination groups is statistically significant. MVD[(63.4±8.7)strip/high power field] in the lipiodol group was higher than the other therapeutic groups. However, the difference of MVD between the lipiodol group and the control group was not statistically significant. The apoptotie indexes in all the therapeutic groups were higher than the control group [(4.2±1.6)% ], the index in the two genes in combination with lipiodol group was the highest[ (19.6± 2.4)%]. The expression rate of VEGF in the control group was the highest(100%)and the rate in the two genes in combination with lipiodol group was the lowest(12.5%). Conclusions The inhibitory effect on Wistar rattish hepatoma of a combination of the above-mentioned two genes and lipiodol via transhepatic artery infusion is obviously superior to that of each individual agents.

BACKGROUND: The assessment of chronic nerve root injury is mainly depend on indirect evidences of imaging results.OBJECTIVE: This study is designed to find out the relationship between the degrees of the pathological changes of nerve roots and motor evoked potential (MEP) changes due to chronic compression.DESIGN: A self-controlled trial with animals as subjects.SETTING: Spine Surgery Department of the Second Clinical Hospital of Jinan University.MATERIALS: The trial was completed in the Spinal Surgery Department of the Second Clinical Hospital of Jinan University from October 2001 to May 2003. The subjects were 30 healthy cats of either gender weighing 3 to 5 kg.INTERVENTIONS: The compression model was established by wedging a Ⅴ-shape bone flap into the right intervertebral foramens between C7, C8 and T1 vertebrae. The left foramens served as controls. The cats underwent CT examination on the 2nd, 4th, 8th and 12th postoperative week to show the foramen changes. Six randomly selected cats underwent magnetic stimulation MEP each time on the 2nd, 4th, 8th, 12th and 24th week. The injuries to the compressed nerve roots were assessed according to Mackinnon Standard and they were compared with the MEP wave.MAIN OUTCOME MEASURES: Whether the superficial magnetic stimulated MEP monitoring result was in correspondence with the pathological changes of the chronically compressed nerve roots.RESULTS: The MEP did not show any abnormal changes for Grade Ⅰ injury prolonged to 9.6- 10. 2 ms. There was almost no evoke potential at all stimulation points for grade Ⅴ nerve root injury.CONCLUSION: That the injured nerve root presents dysesthesia and normal MEP results suggests grade Ⅰ injury. Prolonged latency including prolonged F wave suggests grade Ⅱ injury. And additional amplitude decrease together with widened and unclassifiable waves implies the injury be grade Ⅲ. The prominent features of grade Ⅳ nerve injury is much more decreased amplitudes and more prolonged latency. For grade Ⅴ injury there is always disappearance of whole MEP or some potential components. The superficial magnetic stimulated MEP monitoring results are in correspondence with the pathological changes of the nerve roots due to chronic compression, which means MEP monitoring results could serve as the quantitative indication to pathological changes of nerve injury.

OBJECTIVETo investigate the technique and its effect of combined nasolabial flap and free auricular composite flap for full-thickness nasal alar defect.

METHODSFrom March 2010 to March 2013, 9 patients with full-thickness nasal alar defects were treated with combined nasolabial flaps and free auricular composite flaps. Composite auricular flap was used as inner lining and cartilage framework. The nasolabial flap at the same side was used as outer lining.

RESULTSAll the patients were followed up for 6-18 months (average, 12 months). All the 9 composite auricular flaps survived completely. Epidermal necrosis happened at the distal end of 1 nasolabial flap. Alar rim was almost normal and symmetric nose was achieved in 6 cases. The arc and the thickness of the alar rim was not enough in 3 cases, resulting in asymmetric appearance.

CONCLUSIONSThe survival area of auricular composite flap can be enlarged with nasolabial flap. The auricular helix edge can be reserved to reconstruct nasal alar rim with smooth and natural arc. Large full-thickness nasal alar defedts can be reconstructed with combined nasolabial flaps and free auricular composite flaps.

Adult ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Rhinoplasty ; methods ; Skin Transplantation ; methods ; Surgical Flaps ; Young Adult

Objective To understand the status and features of nursing care adverse events and to offer scientific basis for improving patient safety management of nursing at high altitude area. Methods Data such as categories, causes, time distribution and other factors of nursing care adverse events were collected from January 2013 to August 2014 in the People′s Hospital of Tibet Autonomous Region were analyzed. Results Over the study period, 50 adverse events were recorded and the most common types were tube emersion(26%,13/50), pressure sores(14%,7/50) and scald(12%,6/50) respectively. The proportions of different severity of adverse events were hidden events (48%,24/50), events without bad consequence(36%,18/50), adverse events(14%,7/50) and warning events(2%,1/50) respectively. The ineffective communication, inadequate assessment, and not abiding by the rules accounted for 70%(35/50) of the causes of adverse events. 7:00-10:59 and 19:00-22:59 period was the high incidence of adverse events, respectively accounted for 32%(16/50) and 26%(13/50). Conclusions The management of nursing adverse events at high altitude area need to consider the geographical characteristics,besides, to guarantee the implementation of the system,reduce the bed / nurse ratio, improve the comprehensive quality of nurses and other measures can be taken to reduce the occurrence of adverse events.