Objective To investigate the influence of intrahepatic cholestasis of pregnancy (ICP) on the pulmonary morphologic changes of fetal rats.Methods Twenty pregnant SD rats at 15 days of gestations were randomly divided into ICP and control group.Rats in the ICP group were subcutaneously injected with 17-α-ethinylestradiol and progesterone for 5 consecutive days to establish the rat ICP model, and those of the control group received subcutaneous injection of sirasimeyu also for 5 days.The levels of serum alanine aminotransferases (ALT), aspartate transamlnase (AST), and total bile salt (TBA) were measured before and after the treatment, respectively.Maternal rats were sacrificed on 21 days of gestations and hysterotomies were performed immediately.Histopathologic changes of mammal rats' livers and fetal lungs were observed under light and electron microscopes.Results (1) The maternal serum levels of ALT, AST, and TBA showed no significant difference between the ICP and control group [ALT: (55 ± 15) vs (49 ±12) U/L; AST:(146±16)vs (145±20) U/L; TBA: (13±4) vs (14 ±4) μmol/L, P>0.05, respectively]before the ICP models were established, but higher levels were shown in the ICP group after [ALT: (94±12) vs (59±17) U/L; AST: (245±26) vs (163±27) U/L; TBA: (44±16) vs (17± 3) μmol/L, P <0.05, respectively].(2) The livers of maternal rats' in the ICP group were gloomy with blurred margins, however those of the control group were normal.Microscopic observed swollen and degenerated hepatocytes with narrowed hepatic sinusoid, dilated bile duct and necrosis of hepatocytes occasionally in the ICP group, while the morphology of hepatocytes and structures of lobuli hepatis in the control group were normal.(3) The fetal pulmonary tissues in the ICP group were dark, and normal in the control group.Histopathologic examination showed matured fetal pulmonary tissues with dilated and congested interstitial lung capillaries, thickened alveolar septum, mild focal inflammatory exudation and focal hemorrhage in alveolus.Furthermore, reduced microvilli, mitochondrion vacuolization, cytoplasm disintegration and increased lamellar body evacuation were observed in type Ⅱ pneumonocytes in ICP group under light and electron microscopes.While fetal pulmonary tissues of the control group did not show any significant lesions.Conclusions Rat model of ICP can be established with the combination of estrogen and progestin.Hyperbileacidemia in ICP rat may lead to pathological changes in fetal pulmonary tissues.

Objective To investigate the pulmonary morphologic changes and pulmonary surfactant protein A (SP-A) mRNA expression in fetal rats with maternal intrahepatic cholestasis of pregnancy (ICP).Methods Animal models of intrahepatic cholestasis of pregnancy were induced by 17-α-ethinylestradiol and progesterone.Histopathologic examination of the fetal lungs was performed under light and electronic microscopes.The expression of SP-A mRNA in the fetal lungs was measured by reverse transcription-polymerase chain reaction technique.Results (1) Compared with the control group,histopathologic examination showed that fetal pulmonary tissues had dilated and congested interstitial lung capillaries,thickened alveolar septum,mild focal inflammatory exudation and focal hemorrhage in alveolus.Furthermore,reduced microvilli,mitochondrion vacuolization,cytoplasm disintegration and increased lamellar body evacuation were observed in alveolar epithelial cell II in ICP group under light and electronic microscopes.(2) Expression of SP-A mRNA in fetal lungs of ICP group (0.71 + 0.10) was significantly lower than that in control group (1.00±0.27),t=3.093,P＜0.05.Conclusions Hyperbileacidemia in ICP maternal rat might lead to pathological changes in fetal pulmonary tissues.Low expression of SP-A mRNA might contribute to lesions of fetal lung with ICP.

Objective To know the sanitary status of waterworks for centralized water supply in Anhui province,and try to enhance the implementation Standards for Drinking Water Quality (GB 5749-2006).Methods From April to November in 2008,the hygienic status and water quality self-test capacity of the waterworks at city,county,enterprise and town levels were investigated.Results As for the source water,over 70% of waterworks were up to the Grade Ⅲ standard.In the hygienic management and water treatment process,the city level water workswere better.The rates of complete water treatment were 80.63%,73.78%,58.12% and 60.46%,respectively for different level water works.The rates of the water quality test equipments fulfilled were 77.77%,42.99%,38.18% and 13.77% respectively.For water quality test,the 119 waterworks only focused on the aesthetic,general chemical and microbiological indexes.The performance rates of toxicological indicators,disinfectants indicators,radioactive indicators and other indicators were 17.65%,26.68%,15.97% and 3.49%,respectively.Conclusion Hygienic management of waterworks of levels for centralized water supply in Anhui province needs to be strengthened,and the water treatment process needs to be improved,the capacity building for self-test of water quality in the waterworks needs to be enhanced.

Objective To discuss the efficacy and safety of transurethral plasmakinetic resection of the prostate(PKRP) for benign prostatic hyperplasia(BPH).Methods A British made Bipolar plasmakinetic resection system(Gyrus) was employed in this series.Started from the 6 o’clock point,the middle lobe of the prostate was resected,followed by the left and right lobes,which were resected down to the prostate capsule.And then the bladder neck was cut down.The apical tissues were resected to the anterior border of the seminal colliculus.After the operation,a F22 three-channel catheter was indwelled for 3 to 5 days after the operation,and a balloon was place in the bladder neck.Results The procedure was completed successfully in all of the cases with a mean operation time of(85.0?12.0) min,and a median blood loss 115.0 ml(30 to 650).Ten patients received blood transfusion during the operation(200 to 400 ml).No case showed transurethral resection syndrome or obturator nerve reflex.Fourteen patients developed inflammatory stricture of the anterior ureter and was then cured by dilating the urinary tract;15 cases showed transient urinary incontinence and was cured after pelvic floor muscle training for 1 to 3 weeks.Follow-up was available in the patients for 1 to 6 months,during which the mean Qmax of the patients significantly increased compared to that preoperation [from(7.6?2.4) ml/s to(22.6?3.4) ml/s,t=13.582,P=0.000),and the IPSS and life quality score markedly decreased [from 27.3?1.5 and 4.3?0.4 to 7.0?1.2 and 2.1?0.8;t=16.394 and 9.761,P=0.000 and 0.005,respectively] Conclusion PKRP is an effective and safe treatment for BPH.

Objective:To identify the normal position of the root tips of lower premolars, first and second molars, the distances through 3-D reconstruction in 100 cases of general population were measured. Methods: The three distances were measured from 100 cases over 17 years old, divided by gender: 1. The distance of Mandible of the Centre (M) under the jaw to the lower edge of the next point (L);2. The distance of Mandible of the Centre (M) and M points to the horizon at the same point of the buccal (O);3. The distance of Mandible of the Centre (M) and M to the point in the same horizontal line at the side of the tongue(I). Results: The second premolar root tip of the jaw bone under the margin of the thick wall, the wall thickness of tongue in cheek bone lateral side of the wall in the first and second molars, the lower edge of the mandible bone wall, the tongue side of the wall, cheek bone side walls were thicker through 3-D reconstruction measurement than in normal way.Cheek bone was much thicker than the tongue side of the wall. Conclusion: The way of identifying the normal lower in the second premolar and the first and second molar root tip through the three distances by 3-D reconstruction will give us lots of help, such as: Orthognathic operation of the mandible sagittal split SSRO, scaling of cysts, planting of a certain theoretical basis for scientific research and teaching to provide a realistic and practical method.

BACKGROUND:The treatment of infected nonunion is a difficult problem in orthopedic trauma, which needs to completely eliminate foci of osteomyelitis to control infection, repair soft tissue defect and close the wound, repairs bone defects to promote healing and protect limb function as much as possible. Autogenous micromorselized bone can be easily obtained and recombinant human bone morphogenetic protein-2 has variety of sources. Their mixed grafting mode is safe and reliable in repairing of bone defects, which are suitable for repair of infected nonunion. ＜br> OBJECTIVE:To study the operating method and clinical results of repairing infected nonunion using autogenous micromorselized bone grafting mixed with bone morphogenetic protein-2. ＜br> METHODS:Twenty-three cases underwent infected nonunion repair with autogenous micromorselized bone (l ium, long bone metaphyseal cancellous bone) mixed with bone morphogenetic protein-2, including 7 cases of femoral bone defect caused by osteomyelitis after debridement and external fixation and 16 cases of tibial bone infected nonunion. Eleven of 23 cases continued to use the external fixation because of scar contraction or poor conditions of soft tissue, and the other 12 cases switched to use internal fixation. X-tray was taken to evaluate the bone healing at the 1st, 3rd, 6th and 12th months after operation. The function of the affected extremity was assessed by Johner-Wruhs grade. ＜br> RESULTS AND CONCLUSION:Al of the cases were averagely fol owed up for 13.4 months. The bone defects and bone fracture healed in al cases without infection, and the wounds were al sealed. The excellent and good rate according to Johner-Wruhs grade was 95%. These findings indicate that the bone grafting mode of autogenous micromorselized bone mixed with bone morphogenetic protein-2 is characterized as variety of sources, high safety and reliable osteogenic ability in repair of bone defects.

OBJECTIVE To understand the epidemic condition on the resistant plasmids and their homology of the Staphylococcus aureus obtained from two hospitals in Gansu Province.METHODS The antibiotic sensitivity test,plasmid elimination,plasmid profile,and restriction endonuclease profile were used in analyzing the S.aureus resistant plasmids.RESULTS We isolated 15 strains of S.aureus from 196 samples in two different hospitals,the isolation rate was 7.7%.From them 86.7% isolates were resistant to the seven commonly used antibiotics in different degree.Only 13.3% strains were just resistant to one antimicrobial,the multi-resistant strains amounted for 46.7%.There were 12 isolates carried plasmids(80.0%).The results of plasmid elimination showed 11 strains carried resistant plasmids,and the one with 38 kb was a popular plasmid.The endonuclease profiles revealed that the same source strains had certain homology,there were similiar endonuclease profiles among strains in different wards.CONCLUSIONS The popular plasmids in different wards have certain homology,and they can be transferred among different strains of bacteria.

OBJECTIVE:To observe clinical efficacy and safety of Astragalus injection combined with neoadjuvant chemother-apy and three dimensional conformal radiotherapy in the treatment of colorectal cancer. METHODS:A total of 80 patients with me-dium and advanced colorectal cancer were selected from oncology department of our hospital during Jun. 2010 to Jun. 2014,and di-vided into observation group and control group according to random number table,with 40 cases in each group. Control group re-ceived neoadjuvant chemotherapy combined with three-dimensional conformal radiotherapy. Observation group was additionally giv-en Astragalus injection 10-20 mL added into 5％ Glucose injection 250-500 mL,ivgtt,qd,on the basis of control group. A treat-ment course lasted for 21 d,and both groups received 3 courses. Short-term efficacies as well as immune indexes [CD3+,CD4+, CD4+/CD8+ and NK cells] before and after treatment were observed in 2 groups. The occurrence of ADR and survival situation were compared between 2 groups. RESULTS:Clinical response rate of observation group was 87.5％,which was slightly higher than that of control group(77.5％),but there was no statistical significance(P>0.05). Before treatment,there was no statistical signifi-cance in immune index levels between 2 groups(P>0.05). After treatment,NK cells,CD3+,CD4+ and CD4+/CD8+ levels of con-trol group were decreased significantly,which was significantly lower than observation group,with statistical significance (P<0.05). There was no statistical significance in the incidence of ADR between 2 groups(P>0.05). Two-year survival rate of observa-tion group was significantly higher than that of control group;the recurrence rate and distant metastasis rate were significantly low-er than control group,with statistical significance(P<0.05). CONCLUSIONS:Astragalus injection not only can improve therapeu-tic efficacy of neoadjuvant chemotherapy in patients with colorectal cancer,balance inflammatory state,improve survival rate,re-duce recurrence rate and distant metastasis rate with good safety.

The authors attempted to sort out the training experience of higher education pedagogy in America , and truthfully recorded the understanding and experience of the higher medical elite education of America during visiting the University of Nebraska Medical Center .Combined with the current situation of high medical education in Chi-na, the formation and the embodiment of medical elite education mode of America has also been concretely ana -lyzed , which was expected to bring new enlightenment and reference for the development of high medical elite edu -cation mode and the medical teaching remodeling .

Objective : To investigate the characteristics of HIV/AIDS cases at ages of 15 to 24 years reported in Ningbo City from 2011 to 2021, so as to provide insights into AIDS control among adolescents. Methods : The epidemiological data regarding HIV/AIDS cases in Ningbo City from 2011 to 2021 were captured from the AIDS Comprehensive Prevention and Control Information System of Chinese Disease Prevention and Control Information System, and the temporal distribution, population distribution, and routes of infections and detection were descriptively analyzed. Results : A total of 1 218 HIV/AIDS cases at ages of 15 to 24 years were reported in Ningbo City from 2011 to 2021, accounting for 17.41% of totally reported cases, and the proportion of HIV/AIDS cases in total HIV/AIDS cases during the same year appeared a tendency towards a decline from 2011 to 2021 (χ2trend=17.170, P<0.001). There were 993 males (81.53%) and 225 females (18.47%), 123 students (10.10%) and 1 095 off-campus adolescents (89.90%), and 904 with non-local registered residence (74.22%). Sexual behavior was identified as the predominant route of HIV infections (97.45%), including 714 men who had sex with men (58.62%). There were 636 cases with passive testing (52.22%), 305 cases with active testing (25.04%) and 219 cases with diagnosis at sexually transmitted diseases clinics (17.98%). Conclusions Men, non-local registered residence and off-campus adolescents were predominant among HIV/AIDS cases at ages of 15 to 24 years in Ningbo City from 2011 to 2021, with men-men sexual behaviors as the predominant route of HIV infections.