The learning passion,apprehension and master of probation knowledge and practice capacity of probationers have improved greatly by applying the teaching method of stage-separated to echelon teaching on the basis of the cognitive law and focusing on clinical operation practice.Meanwhile,this method has effectively improved clinical probation teaching quality of orthopedics.

ObjectiveTo observe the spinal cord pathological change and hindlimbs motor function of rats after decompression on chronic spinal cord injury.Methods 30 Wistar rats were divided randomly into conrol group ( n =5 ),compression group ( n =5 ) and decompression group ( n =20 ),then the decompression group was subdivided into 4 parts as 1 week,2 weeks,4 weeks,6 weeks after decompression.Decompression was made after 30 days of chronic spinal cord copression injury,rats'motor function was detected by inclined plate experiment,the histopathological change,Nissl body and neural cells apoptosis in different spinal cord sections were assessed by the stainings of HE,Nissl and TUNEL.ResultsCompared with control group,the behavior testing showed all rats in compression group presented with weakness of muscle power in their hindlimbs (P ＜ 0.01 ),but the hindlimbs motor functions recovered from the first week after decompression and the difference had statistical significance compared with the compression group(P＜ 0.01 ).Then the rats hindlimbs functions recovered gradually later on.The staining of HE,Nissl and TUNEL showed that the injured spinal cord section performed no improvement at the first 2 weeks after decompression,the neural apoptosis index(24.31 ± 4.73 )％ decreased until the forth week after decompression(P＜0.05).The spinal cord segments closed to the injured part recovered in early stage.At 1 week after decompression,lots of Nissl bodys were observed in spinal anterior horn,the neural apoptosis index in the 2 sections closed to the injured part were ( 15.21 ± 4.81 ) ％ and ( 16.21 ± 3.98 ) ％,which declined observably compared with compression group(P ＜ 0.05 ).ConclusionAfter decompression on chronic spinal cord injury,the recovery of rats'hindlimbs motor function in early stage is probably benefited by the functional compensation of the spinal cord segments closed to the injured section.

Objective To study the anti-inflammatory, antipyretic and analgesic effects of Rhizoma Zingiberis alcoholic Extract (RZE) and to explore its in-vitro antibacterial actions. Methods Auricular swelling method in mice, typhoid and paratyphoid vaccines-induced fever in rabbits and bodytwisting test in mice were used respectively to observe the anti-inflammatory, antipyretic and analgesic effects of RZE. Results RZE could inhibit xylene-induced auricular swelling and bodytwisting response reaction induced by acetic acid in mice; RZE also reduce the vaccines-induced fever in rabbits. MIC of RZE for 8 bacterial strains ranged 13.5 mg/mL to 432 mg/mL. Conclusion RZE has a significant anti-inflammatory, antipyretic and analgesic effects and exert in-vitro antibacterial action.

Objective To compare the effect of breathing oxygen or air on respiratory function training for chronic obstructive pulmonary disease (COPD). Methods 32 patients with stable COPD, pulmonary function Ⅱ～Ⅳ, were divided into 2 groups: oxygen (10males and 6 females and air (12 males and 4 females). All the patients participated in a standardized pulmonary rehabilitation program. They were assessed with St. George respiratory questionnaire, pulmonary function test, 6-minute walking distance, cardiopulmonary exercise test and Borg scale, maximal oxygen consumption (VO2max) before and after training. Results After 8 weeks of pulmonary rehabilitation, the VO2max in oxygen group increased compared with that of the air. Conclusion Supplying oxygen during training can increase the tolerance of COPD patients.

: Objective To investigate the effects of exercise therapy on activity of daily living (ADL), perception of dyspnea and quality of life (QOL) in stable patients with chronic obstructive pulmonary disease (COPD). Methods 40 COPD stable patients accepted treadmill exercise for 8 weeks. 6-min walk test (6MWT), the parameters of cardiopulmonary exercise test, ADL, perception of dyspnea (Borg Scale), and St. George's respiratory questionnaire (SGRQ) were measured before and after exercise. Results ADLs in different levels (P<0.05), especially in higher level (P<0.01), were significantly improved in all patients after exercise. Perception of dyspnea (Borg Scale) was also improved significantly (P<0.01). There was positive correlation between ADL and QOL （r=0.455, P<0.01), but negative between dyspnea and QOL （r=-0.412,P<0.05). Conclusion Exercise therapy can improve the ADL and perception of dyspnea in daily activities in patients with COPD, as well as QOL.

Objective To conduct item analysis on Work Attitude Scale(Wa) and to develop a short-versioned scale.Methods Wa and Symptom Checklist 90(SCL-90) were administered to 3767 recruits,item analysis of Wa was conducted and short version of Wa was developed based on the results of item analysis,Cronbach' s αcoefficient of the original scale and the short-versioned scale was calculated,criterion validity of the original scale and the short-versioned scale was analyzed using SCL-90 as the validity criterion.For other samples,16 Personality Factor Questionnaire (16PF),Eysenck Personality Questionnaire ( EPQ),and Self-Rating Anxiety Scale (SAS) were tested while the short-versioned scale was tested at the same time,criterion validity of the short-versioned Wa was analyzed using 16PF,EPQ,and SAS as the validity criterion.Results Difficulty of the original scale was from 0.03 to 0.87,27 items' difficulty was less than 0.20 or greater than.Discrimination index was from 0.04 to 0.56,22 items' discrimination index was less than 0.30.Correlation coefficient of the item score and the total score is from 0.02 to 0.52,18 items' correlation coefficient was less than 0.30.The short-versioned scale was made up of the 18 items with better quality.Cronbach' s α coefficient of the original scale and the short-versioned scale was 0.778 and 0.789,respectively.Both the total score of the original scale and the short-versioned scale were significantly correlated with the scores of SCL-90,and all the correlation coefficient were above 0.40.The correlation coefficient between the score of the short-versioned scale and that of the original scale was 0.934.The correlation coefficient between the score of the short-versioned scale and 16PF,EPQ,SAS was significant.Conclusion The short-versioned scale has a higher reliability and good validity.

Objective To study the change of estrogen in patients with pulmonary artery hypertension (PAH) secondary to congenital heart disease (CHD). Methods A total of 144 patients with CHD including 36 patients with normal pulmonary arterial pressure as control group, and 108 with PAH were investigated as PAH group. Their pulmonary artery pressure was measured by right heart catheterization and the serum concentrations of estradiol, progesterone, prolactin and follicle stimulating hormone (FSH) were detected by chemiluminescence immunoassay. Results The serum concentrations of estradiol, progesterone, prolactin and FSH in PAH group were significantly higher than those in control group (P<0.05). Multiple regression analysis showed that the concentrations of estradiol, progesterone and prolactin were not correlated with the site of shunt but significantly correlated with physiologic factor including sex, age and menstrual cycle, and the level of mean pulmonary arterial pressure. The correlation coefficient of mean pulmonary arterial pressure to them was 0.607,0.531 and 0.518 respectively. The concentration of FSH was positively correlated with the prolactin and estradiol with a related coefficient of 0.917 (P=0.012) and 0.759 (P= 0.000). Conclusion The estrogen plays an important role in modification of the pulmonary arterial pressure in patients with CHD and PAH.

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Objective:To find a short, neutralizing antibody-inducible, ORF2-encoded protein by means of comparing the immunogenicity of pN472-C617 and pN477-C613 which represent amino acids 472-617 and 477-613 of HEV ORF2-encoded protein of hepatitis E virus(HEV) genotype 4, respectively.Methods:The two recombinant proteins were expressed, purified, and then used to immunize BALB/c mice. Anti-HEV titers in the immune sera were detected by ELISA. Anti-HEV neutralizing activity was tested by a PCR-based in vitro neutralization assay.Results:Both of the two recombinant proteins were efficiently expressed in E.coli in soluble forms. The purified proteins induced mice to develop high levels of anti-HEV specific antibodies. However, only the immune sera obtained from the mice immunized with pN472-C617 showed the neutralizing activity to the homologous HEV strain by preventing the virus from absorption on PLC/PRF/5 cells surfaces and replication in the cells. The immune sera against pN477-C613, which was truncated five amino acids from both N- and C-terminal of pN472-C617, had no HEV neutralizing activity.Conclusion:The pN472-C617 is the shortest neutralizing antibody-inducible ORF2-encoded protein of HEV reported in literatures so far. It may be considered as a potential candidate for a novel HEV subunit vaccine in our future study.

Objective The poor sleep quality of epileptic patients may be partly due to the occurrence epileptiform discharges (EDs).We observed the number of interictal discharges in each sleep stage and explored the associations between EDs and sleep phases in epilepsy patients.Methods Two hundred and forty epileptic patients and 213 healthy volunteers were enrolled in the current study.For all subjects,video-electroencephalogram monitoring and 24 h-night polysomnography were conducted to detect EDs and analyze the sleep structures.Results EDs were detected in 88.7％ (213/240) of epilepsy patients with the most frequent cases from the temporal lobe.The EDs detected during waking,sleeping,or both waking and non-rapid eye movement (NREM) sleep stage accounted for 20.6％ (44/213),40.4％ (86/213),and 38.9％ (83/213) of the total patients,respectively.The total sleep time and time spent in REM were similar between the epileptic patients and healthy volunteers.However,epileptic patients spent a significantly longer mean sleep time in NREM Ⅰ-Ⅱ ((304 ±39) min versus (225 ±29) min,t =3.51,P =0.000) and less in NREM Ⅲ-Ⅳ ((49 ± 7) min versus (133 ± 17) min,t =2.30,P =0.000) than healthy volunteers.Furthermore,asymmetric sleep spindles and fragmentary sleep structure as well as high inversion frequency were found in epilepsy patients,respectively.Conclusion Combination of long-term video electroencephalogram with polysomnography is a useful method to analyze associations between EDs and the sleep-wake cycle.This strategy can also help identify the nature of sleep disorders in epileptic patients,which may improve the treatment efficacy.