Hereditary hemolytic anemia(HHA)is a hereditary disorder with main clinical presentation of hemolysis and hemolytic anemia.It's the most common disease of hereditary disorders in the world.According to the pathogenic mechanism,the disorders can be divided into three groups:abnormalities of the red cell membrane,red cell enzyme disorders and hemoglobinopathies.The most common HHA are hereditary spherocytosis,G6PD deficiency and the thalassemias.The clinical presentation of HHA may be heterogeneity.No anemia may occur in the early stage or mild HHA.In order to detect HHA early,we should pay more attention to the morphology of red cell in the peripheral blood film.Recommendation of screening tests with high sensitivity and specificity will be improving the diagnosis of HHA.For correct diagnosis,the medical centres should establish red cell membrane protein electropheresis,direct quantitative assay of red cell enzyme,gene diagnosis and prenatal diagnosis of hemoglobinopathy.

Objective To determine the changes of gene expression profile in small intestinal allograft in rats after ischemic preconditioning(IPC),and to study the mechanism of graft protection of IPC.Methods Rats are randomly divided into 3 groups:sham operation(S group),small bowel transplant(SBT group)and IPC small bowel transplant group(ISBT group).Total RNAs was extracted from intestine of the 3 groups 1h after the intestine remored and cold preservation/reperfusion,and then purified to mRNA.mRNAs was then reversely transcribed to cDNA and to prepare hybridization probes.The mixed probes were hybridized to the cDNA microarray.After high-stringent washing,the fluorescent signals on cDNA microarray were scanned and analyzed.Results Among the 4 096 target genes,297 differentially expressed genes were identified between normal intestine and intestinal allograft in ISBT group;among those 84 genes which have been reported,including 18 genes expressing down and 66 genes expressing up regulation.Differentially expressing genes could be related to the protective effect of IPC.Conclusions The mechanisms of protective effect of IPC on cells of the graft are by modulation of genes related to cell adhesion,related to cellular energy and metabolism,and related to the signal transmission of the cells.

Objective To compare the curative effect and safety between ziprasidone injection and haloperidol injection in the treatment of acute agitation of schizophrenia .Methods Totally 86 patients with acute agitation of schizophrenia were divided into observational group(n=43)and control group(n=43) ,the study used a random ,single‐blinded and clinical controlled experiment . the observational group was given ziprasidone mesylate 10-20 mg every time by intramuscular injection and the amount was less than 40 mg every day ;control group was given haloperidol injection 5-10 mg every time by intramuscular injection and the amount was less than 30 mg every day .Drugs in the two groups could be repeated according to the state of illness after 4-6 hours ,and the daily injections were no more than 3 times and the course of treatment was 3 days .The Positive and Negative Symptoms Scale Ex‐cited Factor(PANSS‐EC)was used to evaluate the agitated symptoms before treatment and 2 ,6 ,24 ,48 ,72 hours after treatment ,the Positive and Negative Symptoms Scale(PANSS)and Clinical Global Impression Scale‐Severity of Illness(CGI‐SI)was used to evalu‐ate the curative effect ;extrapyramidal side adverse reaction(SAS) ,Treatment Emergent Symptoms Scale(TESS)and the related lab tests were employed to assess the adverse reaction .Results Comparing with the baseline ,PANSS‐EC score of observe group de‐creased significantly at 2 h after the treatment ;at other observation time‐points ,PANSS scores ,PANSS‐EC scores and CGI‐SI scores in the two groups both decreased significantly(P<0 .01);but with no significant difference between the two groups(P>0 .05) .There were no significant difference in the total effective rate between the two groups(P>0 .05) .There were no serious ad‐verse events in the two groups .incidences of adverse reactions of observe group were 37 .21% ,which were significantly lower than that of control group 53 .49% (P<0 .05) .Conclusion Effect of ziprasidone injection and haloperidol injection was comparable in the treating acute agitation of schizophrenia ,which could treat acute agitation of schizophrenia with low incidences and excellent se‐curity .

Objective To improve the surgical technique to establish a simple model of heterotopic segmental small bowel transplantation in rats. Methods The segmental intestine was harvested with "non-injury"technique and consisted of donor aortic segment with superior mesenteric artery and portal vein, after perfused in situ with lactated Ringer's solution, the graft was stored in 4℃ lactated Ringer's solution for about 1 h. The heterotopic segmental intestine transplantation was performed by end-to-side anastomosis of donor aorta to recipient aorta. The left kidney of the recipient was resected and the donor's portal vein was anastomosed to the recipient left renal vein by" cuff anastomosis". Results A total of 87 intestine transplantations were performed, 26 of them was regarded as formal experiment group.The average time for the arterial and venous anastomosis were 25～30min and 5 min.Among the 26 recipient rats,21 survived more than 3days.The average survival was 8.93?2.59 days, The longest survival was 14 days in this group. Conclusions It is indicated that the keys of success of small intestinal transplantation are as follows:the high quality graft,excellent anastomosis of blood vessels and adequate liquid supplement.

Objective　To investigate the role of splenomegaly and splenic macrophage(MΦ)in the occurrence of the hypersplenism of portal hypertension(PHT).Methods　The changes of the quantity of ACP in MΦ,the ulstrastructure of MΦ and the quantity of the blood cells phagocytized and destructed by MΦ in the spleen of PHT by the methods of immunohistochemistry and transmission electron microscope were observed and compared with the normal spleen.The correlation of spleen index,the quantity of ACP in MΦ and the peripheral blood cells counts were also studied.Results　Comparing with the normal spleen,the quantity of ACP in MΦ was increased,the surface folopodia of MΦ was increased and lengthened and the quantity of lysosome in MΦ and the quantity of erythrocytes and platelets phagocytized by MΦ were increased.Spleen index and the quantity of ACP in MΦ were negatively correlated with the peripheral blood cells counts,spleen index was positively correlated with the quantity of ACP in MΦ.Conclusion　The splenomegaly and splenic MΦ could play a vital role on the occurrence of the hypersplenism of PHT.

Objective To summarize the methods of operative treatment for complex proximal humeral fractures and its clinical results. Methods 40 cases with complex proximal humeral fractures underwent operation from December 1999 to February 2002. Of 40 cases, 29 were followed up with a mean of 25 months (11 to 40 months). Using Neer system, Constant-Murley rating system and questionnaire were adopted to classify the fractures and evaluated postoperative functions of the daily life and work. A deltoid-pectoral approach was used in all patients. The surgical neck fractures were fixed with the terminal threaded pin or modified Ender's nail. The tubercle fragments were sutured with non-absorbable Ethibond No.5 or "8" figure tension band wire. Results The average absolute Constant-Murley score was 81.7(54 to 96), the excellent and good rate was 65%(19/29), fair 24%(7/29), and poor 11%(3/29). The average forward elevation was 142.5?(60? to 180?). The average pain VAH score was 12(9 to 15). The humeral head avascular necrosis, detected by the follow-up X-ray film, was diagnosed if the humeral head was completely or partially absorbed or reduced. In three-part fractures, 71% cases were excellent or good results, no poor result, and 17% had humeral head necrosis; in four-part fractures, 58% cases were excellent or good results, 25% poor, and 67% were found with humeral head necrosis. The extent of the humeral head necrosis was one of main causes to the poor function for complex proximal humeral fractures. All of the fractures healed at 6 to 8 weeks postoperatively without delayed union and nonunion. Conclusion For complex proximal humeral fractures, a good clinical result can be obtained on condition of the anatomical reduction of the tubercle fragments, as well as the stable fixation of the surgical neck fracture with appropriate suture materials and proper post-operative rehabilitation. Satisfactory result is possible even while the humeral head avascular necrosis happened.

Objective To investigate the role of splenic macrophage(M) in the occurrence of hypersplenism in patients with portal hypertension(PHT). Methods The changes in the quantity, distribution, ultrastructure of M, the quantity acid phophatase in M ,and the quantity of M phagocytizing blood cells were determined by immunohistochemistry and transmission electron microscopy in the normal and PHT spleen. Results Compared with normal spleen, the cell density of the M in PHT spleen decreased;and the quantity of acid phophatase in M increased; the surface folopodia of M increased and lengthened;and the quantity of lysosome in M and the quantity of M phagocytizing blood cells increased. Conclusions The splenic M may play an important role in the occurrence of hypersplenism in PHT.

An analysis of the results of examination of diagnostics teaching in the middle of the semester of 2008 grade is made to discuss the pnoblems existing in teaching and learning so as to improve the teaching quality.

Objective To investigate the training of recruits′psychological stress and its relevant influencing factors ,so as to of‐fer scientific basis for the psychological training and psychological health education of recruits .Methods Questionnaire survey method was used and a total of 720 training of recruits in 2013 was sampled .The application of the stress response questionnaire (SRQ) ,eysenck personality questionnaire (EPQ) ,trait coping style questionnaire (TCSQ) ,symptom checklist (SCL‐90) were used to carry out the psychological test and analysis on these recruits .Results The total score of the SCL‐90 and the score of each factor were significantly lower than the norm of recruits in year of 2000(P<0 .01) .Compared with the norm of SCL‐90 of Chinese sol‐diers in 2004 ,the factor score of somatization ,anxiety and terror were significantly higher than those of domestic soldiers .However , the factor score of hostility and bigotry were significantly lower than those of domestic soldiers (P<0 .05) .The new soldiers who were the only child of the family and was born with urban registered permanent residence had more obvious psychological stress symptoms .The total score of psychological stress and each factor score of new soldiers with different educational level had no sig‐nificant difference (P>0 .05) .According to what was shown in the related analysis ,the SCL‐90 total score .SRQ total score had significant positive correlation with emotional stability and negative coping style(P<0 .01) ,but had significant negative correlation with introversion‐extroversion and waste score(P<0 .01) ,and the total score of SCL‐90 had significant positive correlation SRQ to‐tal score(P<0 .01) .It was shown in the regression analysis that factors had significant predictive effect on the psychological factors of new soldiers during the training period respectively were as follow :negative coping ,stability ,introversion‐extroversion ,psychoti‐cism and whether they are the only child or not .The decisive coefficient of 5 variables was R2 =0 .558 ,F=163 .65(P<0 .01) .Con‐clusion The overall mental health of 2013 recruits training are in good condition ,individual mental health status ,personality traits and coping style training of recruits psychological stress are significant predictors .