Objective To evaluate the comprehensive clinical ability of new nurses in hospital of traditional Chinese medicine by the application of obstructive structured clinical examination.Methods New nurses of Nanjing hospital of traditional Chinese medicine (TCM) of the grade 2012 and 2013 were assessed.The examination consisted of four parts including standard patient station,the capacity of the case,the basic nursing skills of medicine and TCM.The scores of the theoretical knowledges and nursing skills were assessed.Results The average score of the nurses was (76.32±6.31)points,complying to the normal distribution;The degree of difficulty of the examination was 0.70-0.85 and the degree of distinguish was 0.28-0.48;The score of the theoretical test was lower than that of nursing skills and there was significant difference between them (P＜0.05).Conclusions The design of the examination is reasonable and the clinical ability of new nurses majored in TCM can be well assessed.

Objective To evaluate effect of en bloc resection of malignant sacral tumor involving partial sacrum and ipsilateral sacroiliac joint with reservation of contralateral sacral foramina.Methods Between February 2005 and July 2010,16 patients with malignant sacral tumor involving partial sacrum and ipsilateral sacroiliac joint underwent hemi-sacrectomy and functional reconstruction.The operation achieved en bloc resection of tumor with reservation of contralateral sacral foramina.There were 10 males and 6 females,aged from 17 to 70 years (average,37.9 years).There were 5 cases of chondrosarcoma,3 cases of Ewing's sarcoma,2 cases of malignant schwannoma,2 cases of osteosarcoma,1 case of malignant giant cell tumor of bone,1 case of lymphoma and 2 cases of metastatic tumor.Results The surgical time ranged from 4 to 11.5 hours (average,6.5 hours).The average blood loss was 3600 ml (range,1500 to 5500 ml).Five patients underwent type Ⅰ resection,while 11 patients underwent type Ⅱ resection.All patients were followed up for 21 to 59 months (average,34.4 months).Three months after operation,13 patients had difficulty with ankle plantar flexion,while sphincter function was more or less reserved in 16 patients.Four patients (25％)had wound healing complications,which was cured after debridement and drainage.Local recurrence occurred in 7 patients.There were 5 cases of local recurrence among 6 patients who had intralesional margin;4 recurrence lesions located in the sacrum and 1 in soft tissue.Eight patients (50.0％) survived without tumor,2 patients (12.5％)survived with tumor,and 6 patients (37.5％) died of tumor.Conclusion The en bloc resection of tumor involving partial sacrum and ipsilateral sacroiliac joint with reservation of contralateral sacral foramina was feasible and had better outcome compared with total sacrectomy.

Objective To evaluate the functional outcomes of different limb salvage procedures in patients with bone and soft tissue sarcomas of the shoulder girdle.Methods From July 2001 to July 2008,16 patients with limb salvage for sarcomas of shoulder girdle were respectively analyzed,including 11 males and 5 females with an average age of 38.4 years (range,17-67).Localizations of the tumors were 8 in the scapula(including 4 chondrosarcomas,1 Ewing sarcoma,and 3 metastases),5 soft tissues of the shoulder girdie(including 2 synoviosarcomas,1 fibrosarcoma,1 hemangioperieytoma,and 1 well-differentiated liposarcoma),and 3 proximal humerus (including 1 osteosarcoma and 2 metastases).Twelve patients were treated with classical Tikhoff-Linberg procedures,and 4 with improved procedures.Results The mean surgical time duration was 3 hours.The mean blood loss was 1600 ml.The mean follow-up time was 40 months.Major complications included 2 cases of delayed wound healing,and 1 ulnar nerve injury.One patient had local recurrence and died of pulmonary metastases 18 months after second operation of interscapulothoracal amputation.The patient with fibrosarcoma also died of pulmonary metastases 23 months later.One patient with synoviosarcoma was alive with pulmonary metastases in 9 months.Four of 5 patients with carcinoma metastases died during 11 to 23 months later.The 5-year cumulative survival rate was 34.6%.Functions were preserved in the whole hand and elbow.The MSTS functional score of the patients receiving classical Tikhoff-Linberg procedures was 14.7,while improved Tikhoff-Linberg procedures was 19.5.Conclusion The Tikhoff-Linberg procedure not only provides a wide resection of tumors in the shoulder girdle but also preserve the whole hand and elbow functions.The shoulder function was poor in patients receiving classical Tikhoff-Linberg procedures.

Background and purpose: Alveolar soft part sarcoma (ASPS) is a rare malignant neoplasm characterized by slow growth and indolent behavior, and most of the patients had metastases in diagnoses. This study was to define clinical features and assess prognostic factors of ASTS. Methods: Between January 2003 and December 2008, there were 15 patients with ASTS who received treatment and were followed up in the Department of Orthopedic Ontology of Peking University People's Hospital. We retrospectively analyzed the clinical factors of the disease related to prognosis: gender, age, tumor size, primary tumor site, metastatic sites, local recurrence, the roles of postoperative radiotherapy and postoperative chemotherapy. Resnlts: At a follow-up from 7 to 76 months, only 2 patients had local recurrences after excision, but there was a high incidence of pulmonary metastases. Only 6 patients achieved disease free survival, 5 patients died of metastases or other complications. The five-year overall survival rates was 41.7%, and the median survival time was 42.0 months. Univariate analysis and Cox regression analysis revealed that tumor size, tumor primary site and metastases at diagnoses were prognostic factors, but not gender and age, Conclusion: Alveolar soft part sarcoma is a high grade malignant soft tissue neoplasm with frequent metastases to lung, bone or brain. Tumor size, primary tumor site and metastases at diagnoses are some of the prognostic factors. Chemotherapy or radiotherapy after surgery have no benefit to the survival in our analysis. Further prospective studies are needed to clarify the best strategy for the treatment of ASPS.

Objective To identify prognostic factors and imply the appropriate management of pulmonary metastases from osteosarcoma. Methods Data were obtained retrospectively from 99 osteosarcoma patients with pulmonary metastases who received systemic treatments and followed up in Department of Orthopedic Oncology of Peking University People's Hospital from January 2000 to July 2008. The mean followup time was 24.45 months (range, 13-91 months). The average age of the patients at diagnosis was 20.39 years (range, 7-68 years); the male female ratio was 65:34. All the patients had undergone resection of tumors, and 93 of them had received neoadjuvant chemotherapy. Pulmonary metastases were found in 16 patients at diagnosis of osteosarcoma, in 47 patients during chemotherapy and 36 patients after the whole treatment. The age of patients, the number of pulmonary metastases, the time of appearance of pulmonary metastases,extrapulmonary metastases, the response of primary tumor to chemotherapy and management of pulmonary metastases were analyzed. Results The interval between the diagnosis of osteosarcoma and pulmonary metastases ranged from 0 to 74 months with the mean time of 9.05 months. The 1-year, 2- and 5-year cumulative survival rates were 87.4%, 56.8% and 23.4% respectively in the study, with the median survival time of 25 months. Univariate analysis showed the significant factors included the time of appearance and the management of pulmonary metastases. Cox regression analysis revealed that the time of appearance of pulmonary metastases was the only prognostic factor. There was no significant difference between age, number of pulmonary metastases, extrapulmonary metastases and response of primary tumor to chemotherapy.Conclusion Characteristics related to the time of appearance of pulmonary metastases and surgical management especially as pulmonary resection appear to be more predictive of a successful outcome.

AIM: Bone morphogenetic protein (BMP) as polyphenic morphogen can induce the formation of bone and cartilage. This study investigates the effect of BMP on articular cartilage regeneration after periosteal graft. METHODS: Experiments were performed at the Animal Laboratory (absl-3) of Weifang People's Hospital from September 2006 to January 2007. Sixteen New Zealand white rabbits (32 knees) (2.5-3.0 kg) were divided into experimental and control groups randomly, each 8 rabbits (16 knees). The 3.5 mm in diameter of full-thickness articular cartilage defect was made on femoral intercondylar fossa in all rabbits, and 3.5 mm in diameter of periosteum was cut out from the anteromedial part of the upper tibial bone. In the experimental group, the cartilage defect was covered with periosteum, into which 20 ?g BMP and 20% Pluronic were injected. In the control group, the cartilage defect was covered with periosteum, into which the same dosages of 9 g/L saline and 20% Pluronic were injected. All the rabbits were sacrificed in 4, 8 and 12 weeks postoperatively. Motion of joint, conjunction of repair tissue and perienchyma were examined macroscopically. Haematoxylin-eosin staining and toluidine blue staining were used to observe the characteristics of repair tissues. Histological scores on samples in each group were measured by Wakitani score standard at different time points with light microscope. Ultramicrostructure of transplanted tissues was observed with scanning electron microscopy (SEM). RESULTS: Sixteen rabbits were included in the final analysis. Macroscopic observation: 4 weeks after the surgery, the defect was covered with tissue like cartage in the experimental group, and with periosteum in the control group. 8 weeks after the surgery, the surface of the defect was smooth, with boundary unclear in the experimental group. In the control group, the outcome was the opposite. In 12 weeks, cartilage had formed in the experimental group, and tissue like cartilage began to happen in control one. Histological observation: 4 weeks after the surgery, the defect was filled with cells and matrix with abundant proliferation of periosteal cambium layer in the experimental group, and slight proliferation in the control group. 8 weeks after the surgery, the periosteum in the experimental group became fibrocartilage with little hyaline cartilage. Just little fibrocartilage with on hyaline one was detected in the control group. In 12 weeks, the repair tissue in the experimental group approached to normal cartilage. Just fibrous tissue with little fibrocartilage was detected in the control group. Regenerative repair of cartilage defect was better in the experimental group than in the control group (P

Objective To investigate the effect of sodium fluoride(NaF) on proliferation, differentiation and the mRNA expression of osteoprotegerin (OPG) and receptor activator of nuclear factor κβ ligand (RAN KL) of mouse osteoblasts. Methods Osteoblasts were isolated from calvarias of Kunming mice born in 1 - 2 d and cultured. Various concentrations of NaF(0, 10-8, 10-7, 10-6, 10-5, 10-4, 10-3mol/L) were added to the culture medium, the proliferation and activity of alkaline phosphatase(ALP) was determined after 72 h or 120 h. The expression of OPG mRNA and RANKL mRNA was analyzed by semi-quantification RT-PCR. Difference among groups was analyzed by One-Way AN0VA. Difference between two groups was analyzed by LSD-t test. Results There was significant difference in cell proliferation among groups after 72 h(F = 13.806, P < 0.05). Compared with control group(0.434 ± 0.010) , the proliferation was significantly induced in 10-7 - 10-4 mol/L groups treated osteoblasts (0.448 ± 0.010, 0.453 ± 0.013, 0.454 ± 0.016, 0.449 ± 0.018, all P< 0.05), and was significantly suppressed in 10-3 mol/L group(0.401 ± 0.009, P < 0.05). There was statistic difference in the activity of ALP among groups(F = 9.021, P < 0.05). Compared with control group (1.677 ± 0.682), the activity of ALP significantly increased in 10-7 - 10-5 mol/L groups[ (2.447 ± 0.756) × 106, (2603 ± 0.183) × 106, (2.687 ± 0.886) × 106 U/L, P < 0.05 or P < 0.01 ] and significantly decreased in 10-4 mol/L group[ (1.479 ± 0.366) × 106 U/L, P < 0.05 ]. There was significant difference in the expression of OPG mRNA among groups(F = 11.299, P< 0.05). Compared with control group (1.000 ± 0.000), the expression of OPG mRNA was significantly increased in 10-7 - 10-4 mol/L groups( 1.058 ± 0.027, 1.053 ± 0.026, 1.088 ± 0.055, 1.069 ± 0.008, P < 0.05 or P < 0.01) , while significantly decreased in 10-3 mol/L group (0.941 ± 0.029, P< 0.05). There was no difference in RANKL mRNA expression among groups (F= 1.311, P> 0.05). The ratio of RANKL/OPG decreased with increasing doses of fluoride and increased in 10-4, 10-3 mol/L groups, but there was no difference between groups(F = 1.376, P> 0.05). Conclusions A biphasic pattern of proliferation and differentiation has been induced in mouse osteoblasts, which manifests stimulation effect in low doses and suppression in higher doses. Low doses of sodium fluoride suppress differentiation and maturation of osteoblasts by increasing expression of OPG mRNA, while high doses of sodium fluoride enhance differentiation and maturation of osteoblasts by decreasing expression of OPG mRNA.

Mitochondrial dysfunction plays an important role in the process of PD, DJ-1 participates in regulating the function of mitochondria,which has an effect on the protection of mitochon-dria. DJ-1 mutations can lead to the decrease of the activity of mitochondrial complex Ⅰ, the decrease of mitochondrial mem-brane potential and then mitochondrial fragmention and mitoph-agy, and then further damage neurons and trigger PD. This re-view presents the role of DJ-1 in regulating the function of the mitochondria in the pathogenesis of Parkinson's disease(PD).

Adult ; Agriculture ; Female ; Humans ; Lung ; physiology ; Male ; Middle Aged ; Plastics ; Respiratory Function Tests ; Surveys and Questionnaires

ObjectiveTo explore the characteristics of noncompaction ventricular myocardium under ultrasonic cardiography. Methods8 patients, 1 with non-symptom and other 7 with various cardiac dysfunctions and arrhythmias, accepted ultrasonic cardiography. ResultsNumerous ventricular trabeculae and deep intertrabecular recesses, as well as left ventricular dilatations were found under ultrasonic cardiography.ConclusionNoncompaction ventricular myocardium can be diagnosed with ultrasonic cardiography reliablely.