In recent years, the medical graduates who take part in postgraduate examination have been increasing each year. The preparation for postgraduate examination affects the clinical practice, but not yet has a quantitative report. This article studied the students in general surgery, which were divided into postgraduate examination group and clinical practice group. By comparing the theoretical knowledge results and the clinical practice skills between the two groups we found that there was no difference between the two groups in the theoretical and operating skill when they were just in the department, and the operating results in the clinical practice group were better than the postgraduate examination group when they were out of the department.

ObjectiveTo discuss the effect of surgical treatment of varicose vein on primary chronic venous insufficiency(PCVI) in the lower extremities.MethodsBetween August 2007 and August 2008,128PCVIpatients underwenthighligationof the greatsaphenousveinandendovenous electrocoagulation of the varix superficial vein. Spectrum Doppler ultrasound was used to measure the superficial femoral vein blood flow hemodynamic information beneath the first pair of valve including quiet breathing condition and the Valsalva action (reflux time、caliber、reflux velocity). Reflux index (RI) was used as guide line.ResultsClinical sympotoms improved in 54 out of 60 mild PCVI cases, in 29 of 45 moderate PCVI patients, while only in 6 out 23 cases in whom severe preoperative clinical symptom with PCVI was present.The effective rate respectively was 90％, 64％, and 30％.The mild reflux index significantly improved than that before operation ( t = 21. 484, P = 0. 000 ), the moderate reflux index improved than that before operation ( t = 2. 173, P = 0. 035 ), while the serious reflux index were not statistically improved than that before operation( t = 1. 888, P = 0. 078 ). In all cases reflux index improved after the surgery ( x2 = 8. 266,P = 0. 004).ConclusionsMinimally invasive surgical treatment of varicose veins can improve the reflux of the deep vein in PCVI cases with mild to moderate clinical symptom.

It has been found by Ju('81)that HRP could be anterogradely transported forlong distances.Based on this fact the rate of anterograde transport was investigatedin the present study,and,at the same time,the rate of retrograde transport and thetime of disappearance of HRP from the labeled sites were observed.Twenty tworabbits,weighing 2～2.2 kg,were used.The HRP was injected into the lower lumbarspinal cord unilaterally.The animals were sacrificed after 12 hours to 7 days andwere processed with benzidine and o-dianisidine.The anterogade labeling in the dorsalaccessory olivary nucleus and the retrograde labeling in the red nucleus and thenucleus raphe pallidus were chosen for study.It was quite unexpected to find that the anterograde and retrograde labelingsparalled each other in time as well as in intensity.They appeared at the same timeand waxed and waned practically in full accord.Labeling of the brainstem firstappeared at 18 hour's survival,reached its peak at the 2nd day,and then graduallyfaded away till at the 7th day when only traces of labeling remained.In the casewhich showed the earliest labeling the distance between the injection site and theobex,which was at about the same level as the most densely labeled parts of thedorsal accessory olivary nucleus and nucleus raphe pallidus,was measured to be 265mm and the rate of transport,the same for anterograde and retrograde transports,was calculated to be more than 350mm per day.Counting from the time of theearliest labeling,HRP was found to remain at the labeled site for as long as 5～6 days.The period of net accumulation of HRP at the labeled sites was about 1 day.Thus,the best survival period would be roughly the time required for HRP to travel thefiber tract plus 1 day.Neurons of the red nucleus and the nucleus raphe pallidus differ greatly intheir morphology,physiology as well as biochemistry.The results in them however,were similar.This,in connection with observations on other nuclei,both anterogr-adely and retrogradely labeled,suggests that the rate of transport and the duration ofpreservation of HRP in the central nervous system are basically the same in differentneuronal systems.

HRP was injected into the right side of the cervical or lumbar enlargement ormidthoracic segment of adult cats.Retrogradely labeled cells in the red nucleuswere examined and their somatotopic localization was determined.1.The Rubro-spinal projection was mainly crossed with obvious somatotopiclocalization.The dorsal medial part of the red nucleus projected to the cervicalenlargement.The ventral lateral part of the red nucleus projected to the lumbarenlargement.The neurons between these two parts projected to the thoracic cord.2.In cervical and lumbar injected cases a few labeled cells were found also inthe ipsilateral red nucleus,suggesting a minor ipsilateral rubrospinal projection exist-ed.No ipsilateral labeling was found in the thoracic injection cases.3.The rubrospinal tract could at least project to as low as L 6 segment of thespinal cord.

The somatotopical projection from the lateral vestibular nucleus to differentlevels of the spinal cord in the cat was studied with the horseradish peroxidasemethod.It was found that in the lateral vestibular nucleus the cells projecting tothe cervical and lumbar segments of the cord were distributed over the entire ros-trocaudal extent,each with an area of concentration.The caudal and middle thirdsof the nucleus,especially its dorsolateral part,projected to the lumbar cord.Thecells projecting to the cervical cord were concentrated at the rostral-middle thirds ofthe nucleus and those to the thoracic cord were concentrated at the dorsal part ofthe caudal-middle thirds.The area projecting to the thoracic levels seemed tocoincide with that projecting to the lumbar levels.The cells projecting to thelumbar cord were largest in number,those to the cervical cord less and those to thethoracic cord least.

Objective To discuss the pathogeny,treatment and prophylactic measures of postcholecystectomy syndrome (PCS).Methods The clinical data of 150 patients with laparoscopic PCS in our department from October 2000 to March 2009 were analyzed.Results Etiological factors were found in 131 patients:one hundred and twelve cases were due to the reasons of biliary system,including bile duct residual stones after cystic resection,the injury bile duct stenosis,a long residual cystic canal,nipple benign stricture,bile duct tumor etc;Nineteen examples were due to other reasons,including gallbladder stone merger reflux gastritis,gastroduodenal ulcer,diverticulum beside duodenal nipple,and so on,which resulted in the symptoms un-release after cystic resection.Nineteen cases were not found organic lesion.In ones whose etiological factors were definite,117 cases were treated with different surgeries according to different etiological factors;another 33 cases were treated with conservative treatment.Total 145 cases were followed up,and 139 cases in them were cured or relieved at different degrees.Conclusion Careful preoperative examination,normalized operation avoiding damaging bile duct and leaving behind bile duct stones can effectively prevent laparoscopic PCS.

Objective To investigate the distribution of ompA gnne in 15 Chinese reference standard strains belonging to 15 serogroups of Leptospira interrogate, and to express recombinant OmpA ( rOmpA ) and to identify immunogenicity and immunoprotection of rOmpA. Methods Genomic DNAs from different leptospiral strains were extracted by phenol-chloroform method. Entire ompA gene fragments from the strains were amplified by PCR and then sequenced after T-A cloning. A prokaryotic expression system of ompA gene from L. interrogans strain 56601 was constructed, and the expression and yield of rOmpA were determined by SOS-PAGE plus Bio-Rad Agarose Image Analyser. Rabbits were immunized with rOmpA for obtaining antiserum, and immunodiffusion test was used to measure the antiserum's titer. Western blot assay was performed to determine the immunoreaetivity of rOmpA with the antiserum against rOmpA and antiserum against whole cell of L. interrogans strain 56601, while mi-croscopic agglutination test (MAT) was applied to detect the cross agglutination to the 15 L. interrogans strains. A leptospire adhering cell model and a leptospire infecting guinea pigs model were used to determine the adhesion-bloc-king effect of rOmpA antiserum and immunoprotection of rOmpA. Results All the 15 L. interrogans strains, but not L. biflexa strain Patoe Ⅰ , had sequence conserved ompA genes. The yield of rOmpA was approximate 20% of the total bacterial proteins, rOmpA could induce rabbits to produce antibody and immunodiffusion titer of the anti-serum was 1:4. Both antisera against rOmpA and against whole cell of L. interrogans strain 56601 were able to pro-duce positive Western blot signs to rOmpA, and the former offered 1 : 20-1 : 320 MAT titers to the 15 L. interrogans strains. 1: 10-1:160 dilutions of rOmpA antiserum could efficiently block L. interrogans strain 56601 adhering to J774A. 1 cells, and 100 μg and 200 μg rOmpA displayed 50.0% and 75.0% immunoprotective rates in the infee-ted guinea pigs. Conclusion ompA gene only exists in genomes of different pathogenic L. interrogans serogroups. rOmpA has relatively stronger antigenicity, cross immunoreactivity and certain immunoprotection, implying that this recombinant protein may be used as a candidate antigen for developing universal genetic engineering vaccine of L. interrogans.

Aim To investigate the effects of chloride channel blockers on the apoptosis of RIN-m? cells of pancreatic islet induced by H2O2.Methods The apoptotic model was made by H2O2 exposed for six hours with a concentration of 500 ?mol?L-1.The chloride channel blockers:DIDS,NPPB and NFA were administered to pretreat the samples respectively.The cell viability,morphological changes,and apoptosis rate were observed.Results Chloride channel blockers alone have no marked effects on the cell viability of RIN-m? cell.However,they elevated the cell viability of RIN-m?cell disposed of by H2O2.Compared to H2O2 group,the groups of DIDS +H2O2,NPPB+ H2O2 and NFA+H2O2 have significant difference in cell viability and apoptosis rate(P

The projection from the lower brain stem to the spinal cord was studied with HRP method by injecting HRP into the cervical and lumbar enlargements of the spinal cord of 10 cats.The follwing nuclei were found to have spinal projections:1) The reticular formation: Numerous retrogradely labeled cells were seen in the nuclei of gigantocellularis and medullae oblongatae centralis subnucleus ventralis, fewer in the nuclei pontis centralis caudalis and oralis. A few labeled neurons were also found in the nuclei of medullae oblongatae centralis subnucleus dorsalis, parvocellularis, paragigantocellularis laterlaris, paramedium reticularis subnucleus ventralis and cuneiformis. Most of them projected to the spinal gray matter ventral to the dorsal horn except the nuclei of medullae oblongatae centralis subnucleus dorsalis and parvocellularis which projected mainly to the dorsal horn.2) The raphe nuclei: Nuclei of raphe pallidus, magnus and obscurus projected to both the cervical and lumbar enlargements, while nucleus raphe dorsalis only to the gray matter ventral to the dorsal horn of the cervical enlargement.3) The gracile and medial cuneatus nuclei projected somatotopically to ipsilateral spinal cord.4) The cranial nuclei: The Edinger-Westphal nucleus, nuclei of nervi oculomotor principalis, tractus spinalis nervi trigemini and tractus solitarii and the nuclei vestibularis lateralis, medialis, superior and spinalis were found to project to spinal cord. There was somatotopic arrangement in the nucleus vestibularis lateralis.5) The nuclei of locus coeruleus, subcoeruleus, parabrachialis lateralis and medialis, neucleus retroambigualis and the Kolliker-Fuse nucleus projected bilaterally to the spinal cord.6) The red nucleus: Large amount of labeled cells were seen in the controlateral red nucleus. The ventrolateral part of the red nucleus projected to the cervical enlargement while the dorsornedial part to the lumbar enlargement.7) The superior colliculus and the griseum centrale mesencephali projected to the gray matter ventral to the dorsal horn of the cervical enlargement.

HRP was injected into C_6, C_7, L_5, L_6 or T_(5～7) spinal gray. The retrogradely labeled cells and anterogradly labeled terminal arborizations were traced in L_5 and T_5 in cervical injection cases, C_5 and T_5 in lumbar cases, and C_5, L_5 in thoracic cases.Large amount of labeled cell were consistently found in laminae Ⅶ (including the lateral horn of the thoracic cord) and Ⅷ, next numerous in lamina Ⅴ and Ⅹ region. Lamina Ⅰ was found labeled in the cervical and lumbar cord, but virtually not found in the thoracic cord. Labeled cells were few and inconsistent in laminae Ⅳ and Ⅵ. A few labeled lamina Ⅸ cells could be found in the thoracic cord, only occasionally in the lumbar cord, but could not be found in the cervical cord. Laminae Ⅱ and Ⅲ were free from labeled cells in all cases. The labeled terminal arborizations were more widespread and could be found in practically every lamina, being densest in region Ⅹ, laminae Ⅶ (including the lateral horn of the thoracic cord) and Ⅷ. In lumbar injection cases a prominent plexus of labeled terminal arborization could be seen in the ventrolateral part of the C_5 ventral horn. Corresponding plexus was not found in the lumbar cord in cervical injection cases.Some labeled terminal arborizations were found in close approximation to or overlapping with labeled cells or unlabeled motor neurons.These results imply that: (1) The occurance of labeled cells and labeled terminal arborizations in the lateral part of lamina Ⅶ (lateral horn) suggests that intersegmental connection is related to visceral activities as well as somatic ones. (2) Labeled cells were consistently found in region Ⅹ which was also the area of dense labeling of terminal arborization, suggesting that this region plays a remarkable role in intersegmental connection. (3) Long ascending bundle connects the lumbar enlargement with the ventrolateral part of the motor neurons directly. (4) The close approximation of labeled terminal arborization and labeled cells signifies direct intersegmental feedback circuit.