Objective To compare the effects of methylprednisolone and dexamethasone individually combined with tropisetron on the prevention of postoperative nausea and vomiting (PONV) of high risk in patients with thyroid surgery.Methods One hundred and sixty patients of high risk of postoperative nausea and vomiting scheduled for radical operation of thyroid with general anesthesia were randomly divided into four groups with 40 cases each.Four groups of the patients were intravenously injected methylprednisolone 40 mg plus tropisetron 5 mg at the end of the operations (group MT),dexamethasone 7.5 mg before anesthesia induction,and tropisetron 5 mg at the end of the operations (group DT),tropisetron 5 mg at the end of the operations (group T),and normal saline (group C).Incidence and severity of nausea,vomiting and adverse reactions were recorded during 24 hours after end of the operations.Results Compared to group DT,the incidences of PONV during the 0 ～ 2 h and 2 ～ 6 h,and the visual analogue scale (VAS) of PONV at 2 h after the operations in group MT were significantly lower (P ＜ 0.05).Compared to group C,the incidences of PONV and VAS score during the 0 ～ 24 h after the operations in group MT and group DT were significantly lower (P ＜0.05),the incidences of PONV during the 2 ～6 h and 6 ～ 12 h after the operations,and VAS score of PONV at 6 h and 12 h after the operations in group T were significantly lower (P ＜0.05).Compared to group C,incidences of headache in group MT and group DT were significantly lower (P ＜ 0.05),and incidence of swim in group T was also significantly lower (P ＜ 0.05).Incidence of adverse reactions in group MT and group DT were no significant difference.Conclusions Preventive effect of methylprednisolone combined with tropisetron for PONV in high-risk patients within 6 hours after thyroid surgery was significantly better than that of dexamethasone combined with tropisetron.

In order to meet the requirements of medical teaching contents and curriculum system reform, we adopt the experience ofHarvard University School of Medicine to integrate Biochemistry and Cell Biology into a new one—— "Chemistry and Biology of theCell". We have carried out the integration of the two courses three times. In this new course, repeated contents have been reduced, thelinkage of the two courses has been increased, and the burden of students was lightened,which makes students contact the clinic earlierand enables to improve the students' ability to solve problems.

Objective To investigate the single-nucleotide polymorphisms of PTPN22 gene rs2476601 ,rs3811021 and rs2488457 in patients with primary immune thrombocytopenia(ITP) .Methods Totally 100 patients with ITP and 100 cases as con-trol from Department of Hematology ,the Affiliated Baiyun Hospital of Guiyang Medical College and the Affiliated Hospital of Guiyang Medical College were collected .PTPN22 gene + 1858 loci (rs2476601) and 3′UTR region rs3811021 loci were detected by PCR-RFLP ,the promoter-1123 loci (rs2488457) were detected by PCR-SSP ,and the results were statistically analyzed .Results PTPN22 gene + 1858 locus in ITP patients and control group were all C allele ,T allele was detected ,and there was no single nucle-otide polymorphisms (R620W) exist .The frequency of PTPN22 gene rs3811021 locus TT ,CT ,CC three genotypes in ITP patients and control group had no significant difference(χ2 = 3 .686 ,P= 0 .158) .The frequency of T allele ,C allele in ITP patients and con-trol group had no significant difference(χ2 = 2 .828 ,P = 0 .093) .The frequency of PTPN22-1123 gene (rs2488457)GG ,GC ,CC three genotypes in ITP patients and control group had no significant difference(χ2 = 1 .802 ,P = 0 .406) .The frequency of C allele and G allele in ITP patients and control group had no significant difference(χ2 = 0 .003 ,P = 0 .954) .According to the gender fac-tors ,in females ,the genotype and allele frequency of SNP loci rs3811021 and rs2488457 in ITP patients and control group had no significant difference(P< 0 .05) ,so as in males(P < 0 .05) .Conclusion PTPN22 gene rs2476601 this SNP site does not exist in Guizhou Han population ,The addition of two SNP loci of PTPN22 gene (rs3811021 ,rs2488457) exists polymorphism ,but the two SNP loci has no sex difference ,the onset and ITP in Guizhou Han population had no significant correlation .

ObjectiveTo investigate the role of SAA in rheumatoid arthritis(RA) pathogenesis by analyzing the expression of serum amyloid protein A(SAA) in serum,synovial fluid and synovial membrane in patients with RA.MethodsSAA levels in the serum and synovial fluid in each group were detected.Sera SAA was tested by Western blotting,while the expression of SAA in RA and osteoarthritis(OA) synovium was detected by immunohistochemistry.Comparisons between groups were performed by t-tests or KruskaWallis test.ResultsThe serum levels of SAA were significantly higher in RA [(318±132) μg/L] than those in OA [(127±47) μg/L] and healey controls [(127±41) μg/L,P＜0.01].In RA,the SAA levels in the synovial fluid [ (571±473) μg/L ] were significantly higher when compared to those in O A [ (129±33) μg/L](t=2.46,P=0.04).Western blotting results showed that SAA bands were found in the serum samples of each group,and higher expression of SAA were seen in RA.Pathology study had showed that SAA was observed mainly in endothelial cells,synovial fibroblasts,macrophages and perivascular areas in RA synovium.In OA,SAA was observed in perivascular areas and synovial fibroblasts.ConclusionIn RA,SAA levels in both serum and synovial fluid are significantly higher than those in the controls.High expression of SAA in RA synovium can be observed.Our results suggest that SAA may play a role in inflammation reaction and joint destruction of RA.

Objective To assess the distribution of vaginal microflora in healthy women and investigate their cognition of lower reproductive tract infection-related knowledge as well as personal hygiene habits and character of behavior in seeking medical treatment. Methods Total of 1660 healthy women who had physical check-ups at the Medical Center of Renji Hospital were selected and received gynecologic examination, as well as routine examination, pH examination and bacterial culture of the vaginal discharge. In addition, 860 of them were randomly selected for questionnaire survey, in which reproductive tract infection -related knowledge and personal hygiene habits as well as behavior in seeking medical treatment were involved. Results Among the 1660 eensused women, vaginal average pH was 4. 16±0.21. The positive rate of Candida in vaginal discharge routine examination was 3.86% (64/1660), which was lower than that in aerobes culture 7.71% (128/1660). Candida alhicans was the most populous species 78.9% (101/128) ,followed by 7.8% (10/128) and 7.0% (9/128) for the Candida glabrata and Candida krusei respectively. The most populous species of vaginal microflora were hemolytic streptococcus A (63.80%, 1059/1660), Staphylococcus epidermidis (14.28%, 237/1660), and Enterococcus faecalis (D) group ( 11.44%, 190/1660). The questionnaire survey showed that 88.4% (760/860) of 860 women took active treatment when feeling unwell, 92.1% (792/860) of them had good hygiene practices, and only 21.2% (182/860) had the habit of vaginal douching. In addition, 50.0% (430/860) of them had the desire to obtain reproductive health knowledge through out-patient consultation. Conclusions Vulvovaginal Candida disease ranks the first in all types of vaginitis, among which, Candida albicans is the most populous species followed by the Candida glabrata and Candida krusei. Hemolytic streptococcus A and Staphylococcus epidermidis are the most common species of vaginal mieroflora in healthy women. The censused women have high awareness of reproductive health care and pay mueh attention to common gynecologic diseases such as lower reproductive tract infection. Nevertheless, we should strengthen the public education of reproductive health-related knowledge.

Objective To evaluate myocardial apoptosis with 99Tcm-C2A-GST myocardial imaging using the recombined C2A domain of Synaptotagmin Ⅰ by gene engineering. Methods ( 1 ) The C2A gene was inserted into the prokaryotic glutathione S-transferate (GST) fusion protein expression plasmid pGEX-6P-1. The recombinant plasmid was transformed into E. coli BL21. C2A-GST fusion protein was purified after BL21 was induced with isopropyl-β-D-1-thiogalactopyranoside (IPTG). (2)The activity of fusion protein was identified by cell binding test with fluorescein-5-isothiocyanate (FITC)-C2A-GST. (3) The C2A-GST fusion protein was labeled with 99Tcm using 2-iminothiophene hydrocoride method. Radiochemical purity was determined with thin layer chromatography. (4)99Tcm-C2A-GST (7.4 MBq) was injected to ischemia-reperfusion rat models through tail vein. The image was acquired with SPECT at 1 h after injection, and then hearts were removed, rinsed with saline and dyed with triphenyl tetrazolium coride (TTC). The ischemic myocardium was separated from the viable myocardium and was weighted. Its radioactivity was measured by gamma counting. The difference of uptake of radiotracer between ischemic myocardium and normal myocardium was compared using percentage activity of injected dose per gram of tissue ( % ID/g) with standard deviation. SPSS 12.0 and t-test were used for data analysis. Results ( 1 ) C2A-GST fusion protein wassuccessfully expressed and its relative molecular weight was 3.8 × 104. (2) FITC-C2A-GST binding to apoptotic cells could be observed by fluorescent microscopy. (3) The radiochemical purity of 99Tcm-C2A-GST was (98.90 ±0.43)%. (4)The imaging studies showed that there was focal uptake of radioactivity in the ischemic myocardium. In vitro uptake of 99Tcm-C2A-GST was (2.41 ±0.32) % ID/g by the ischemic myocardium, however 99Tcm-C2A-GST-N-hydroxysuccinimide (C2A-GST-NHS) was (0. 82 ± 0. 24) % ID/g. There was statistically significant difference between those two groups (t = 10. 6, P ＜0.01 ). Conclusion The C2A domain of Synaptotagmin Ⅰ expressed by gene engineering can be used as the tracer for noninvasive detection of ischemic myocardium in the ischemia-reperfusion rat model.

Objective To evaluate the clinical effect of laparoscope and open surgery for treatment of gynecological diseases. Methods 620 female patients with gynecological diseases were divided into two groups randomly (Group A: n = 310, Group B: n = 310). Group A was treated by laparoscopic surgery, Group B was treated by open abdominal surgery. The clinical effects of laparoscope and open abdominal surgery were compared between the two groups. Results Group A had better results in intraoperative blood loss, recovery time of intestine and stomach function, get out of bed time and hospitalization time than that in group B, there were significant difference (P < 0.01). The gastrointestinal reaction rate after operation, the anodyne utilization, the complication incidence rate was 9.7 %, 5.2 %, 3.9 % respectively, it is lower than that in group B; and wound healing was better in group A than group B, with statistical difference (P < 0.01). There was no significant difference in operation time between the two groups (P > 0.05). Conclusions Laparoscopic surgery has better effects for treatment of gynecological diseases than open abdominal surgery.

Objective:To study the effectiveness of inferior pole fracture of patella treating by the new tension band.Methods:From Dec.2011 to Dec.2013, 21 patients with inferior pole fracture of patella were treated with the new tension band which consisted of cannulated screw, titanium cable and shims. There were 21 patients[10 males, 11 females, the average age was 54 years(21 to 79)],of whom,all were“fell on knees”.Results:The average operation time was 89 min (57-197 min),the follow-up visits were done from 7-31 months ( average 18 months) , the bone healing time was from 8-12 weeks (average 10.5 weeks).The post operation assessment was done by Bostman score, from 20 -30 (average 27),10 excellent,and 11 good.No complication occurred.Conclusion:The new tension band is the effective treatment for inferior pole fracture of patella.The internal fixation is reliable, it is simple to operate, and patients can take exercises as early as possible.Therefore, the new tension band has a bet-ter clinical value.

BACKGROUND:For patients in intensive care unit (ICU), mechanical ventilation is an effective treatment to survive from acute illness and improve survival rates. However, long periods of bed rest and restricted physical activity can result in side effects. This study aimed to investigate the feasibility of early rehabilitation therapy in patients with mechanical ventilation. METHODS:A randomized controlled trial was carried out. Sixty patients, with tracheal intubation or tracheostomy more than 48 hours and less than 72 hours, were admitted to the ICU of the Affiliated Hospital of Medical College, Qingdao University, from May 2010 to May 2012. These patients were randomly divided into a rehabilitation group and a control group. In the rehabilitation group, rehabilitation therapy was performed twice daily, and the training time and intensity were adjusted according to the condition of the patients. Early rehabilitation therapy included heading up actively, transferring from the supine position to sitting position, sitting at the edge of the bed, sitting in chair, transferring from sitting to standing, and ambulating bedside. The patient's body mass index, days to first out of bed, duration of mechanical ventilation, length of ICU stay, APACHE Ⅱ score, highest FiO2, lowest PaO2/FiO2 and hospital mortality of patients were all compared between the rehabilitation group and the control group. The differences between the two groups were compared using Student's t test. RESULTS:There was no significant difference in body mass index, APACHE Ⅱ score, highest FiO2, lowest PaO2/FiO2 and hospital mortality between the rehabilitation group and the control group (P>0.05). Patients in the rehabilitation group had shorter days to first out of bed (3.8±1.2 d vs. 7.3±2.8 d; P=0.00), duration of mechanical ventilation (5.6±2.1 d vs. 12.7±4.1 d; P=0.005) and length of ICU stay (12.7±4.1 d vs. 15.2±4.5 d; P=0.01) compared with the control group. CONCLUSION:Early rehabilitation therapy was feasible and effective in improving the outcomes of patients with mechanical ventilation.

Objective:To evaluate the curative effects of Masquelet technique and 3D printing in repair of Cierny-Mader type Ⅳ long bone osteomyelitis.Methods:A retrospective study was conducted of the 8 patients who had been treated at Department of Orthopaedics, The Third Affiliated Hospital to Peking University for Cierny-Mader type Ⅳ osteomyelitis of the lower extremity from June 2017 to December 2019. They were 6 males and 2 females, aged from 27 to 79 years (average, 54.6 years). The defects involved femoral shaft in 5 cases, femoral metaphysis in one, tibia shaft in one, and tibial metaphysis in one. The defect lengths ranged from 7.7 to 15.5 cm, averaging 10.2 cm. Stage one was local infection control and temporary stability reconstruction using Masquelet technique, stage two design and 3D printing of the prosthesis and stable pattern design, and stage three prosthesis implantation and rehabilitation. The ranges of motion of the knee and ankle were recoded postoperatively and the functions evaluated using the Johner-Wruhs scores.Results:The average follow-up time for the 8 patients was 12.6 months (from 6 to 18 months). The total treatment time from the first admission to the last discharge ranged from 62 to 125 days (average, 91.0 days), the time for stage one from 13 to 57 days (average, 28.7 days), that for stage two from 30 to 87 days(average, 48.3 d), and that for stage three from 28 to 84 days (average, 63.0 days). The infection was controlled and there was no recurrence, implant loosening or breakage. Seven patients were capable of full weight-bearing at 14.7 days (from 4 to 42 days) after surgery. One patient recovered full weight-bearing 6 months after surgery due to severe osteoporosis. Fine functional recovery was achieved in the 8 patients, with a range of motion from 0° to 100° for the knee and a range from 35° dorsal flexion to 40° toe flexion for the ankle. The Johner-Wruhs scores at the last follow-up showed 2 excellent, 5 good and one moderate cases.Conclusion:In repair of Cierny-Mader type Ⅳ long bone osteomyelitis, Masquelet technique and 3D printing can shorten the treatment process and allow for early recovery.