Objective To study proloning the surviving time limit of servered skeletal muscle through intermittent ischemia Methods We use canine gracilis as experimental object to observe its changes by"4C" (colour,capillary bleeding,contractility and consistency of muscle),succinic,dehydrogenase and electron microscope Result (1) At normal temperature the ischemic time limit of skeletal muscle was 7 hours (2) At low temperature (4℃),the surviving time limit of skeletal muscle was 15 hours.(3) However, intermittent ischemia, the surviving time limit of skeletal muscle was 25 hours. Conclusion Intermittent ischemia can prolong the surviving time limit of skeletal muscle obviously So, intermittent ischemia may be used as a new better method of servered limb perservation

Objective To explore the effect of direct observation of procedural skills (DOPS) in teaching acupuncture manipulation skills. Methods Sophomores of acupuncture and Tuina spe-ciality were divided into two groups based on their classes, 36 students in experimental group and 31 in control group. In experimental group, DOPS on filiform needling was done twice in the middle and at the end of the semester respectively. In control group, DOPS was done once at the end of semester. The final exam's DOPS score and satisfaction degree of teachers and students concerning the results of the assessment in two groups were compared by independent samples t-test. P<0.05 indicates signifi-cant differences. The teaching effect of DOPS was also evaluated by questionnaire survey of students in experimental group. Results The total score of DOPS (4.26 ±0.24), scores of needle insertion (4.18±0.42), and scores of reinforcing and reducing method (4.03±0.28) in experimental group were higher than those in control group ((4.14±0.25), (4.00±0.29) and (3.87±0.37), P<0.05). The teachers' satisfaction (8.38±0.51) and students' satisfaction (8.47±1.03) concerning the results of the assessment in experimental group were higher than those in control group ((8.05±0.78) and (7.94±1.15), P<0.05). More than 80% of students in experimental group supported the saying of‘DOPS promoting students' skills training and enhancing the ability of handwork ’ . Conclusions DOPS can be used as an effective teaching and examination method and can improve students' skills of acupuncture manipulation.

A total of 267 patients with pressure ulcer were randomly divided into treatment and control groups.All of them underwent traditional debridement.The wounds in treatment group were spreaded with traditional Chinese medicine.According to the results of bacteria culture and drug sensitivity,antimicrobial agents were selected in control group.The observation indices of two groups included pain grade,swelling grade,ulcer area and skin temperature difference.Then the variations of observation indices before and after treatment were examined.In treatment and control groups,the different values of pain grade before and after treatment were 2.1 ± 0.9 and 1.2 ± 0.7,swelling grade 1.3 ± 0.6 and 0.7 ± 0.5,ulcer area 4.7 ± 3.1 and 2.4 ± 2.5 and skin temperature difference 0.12 ± 0.05 and 0.22 ± 0.10 respectively.Treatment group was superior to control group and there was statistical significance (P ＜ 0.05).The effective rates were 95.6％ and 65.4％ and the number of cured patients 86 and 33 cases respectively.And there was statistical significance (P ＜ 0.05).

Objective To investigate the mechanism by which epidermal growth factor (EGF) accelerates the growth of estrogen-negative breast cancer cell line MDA-MB-435S. Methods Under the effect of EGF cyclin D_1 was measured by Western blot and cell-cycle was assayed by FCM. Results EGF enhanced cyclin D_1 expression. Protein kinase C (PKC) inhibitor Go6976 blocked cyclin D_1 over-expression caused by EGF. In EGF group G_0/G_1 was 69.36%, phase S was 22.77% and PI was 0.31. Differences were all significant compared with control (P

Filiform needle acupuncture technique is the core content of needling and moxibustion method. The examination and assessment of filiform needle manipulation are the most important measure for testing the effect of filiform needle acupuncture technique teaching. The establishment of a scientific examination and assessment system of filiform needle manipulation should involve comprehensive examination and assessment contents, definite and detailed evaluation rules and quantified scoring criteria to make the examination and assessment system be able to comprehensively and objectively assess the students' skills of filiform needle manipulation to achieve the purpose of improving the quality of filiform needle acupuncture technique teaching.

Objective To explore the effect of flipped classroom in teaching auricular needling method. Methods Sophomores of acupuncture and Tuina speciality were divided into two groups based on classes, with 33 students in experimental group and 30 in control group. In teaching auricular needling method, experimental group adopted flipped classroom by online resources and classroom activities, while control group adopted traditional classroom such as teaching, watching video, demonstration. Post-test score of two groups were compared by independent samples t-test. The teaching effect of flipped classroom was evaluated by questionnaire survey of students in experimental group. Results The total score of auricular needling (88.4±13.91), score of location (55.40±7.34), and score of application (32.00±10.31) in experi-mental group were significantly higher than those in con-trol group (71.48±15.93, 47.55±12.23 and 23.94± 11.97) (P<0.05). Students' satisfaction concerning the flipped classroom in experimental group was up to 90%. Conclusion Flipped classroom can be used in teaching auricular needling method, which can improve teaching quality and promote improvement of students' self-study and communication skills.

Objective To study the effects of ePTFE-covered stents versus bare stents on portal hemodynamics in portal hypertensive patients receiving TIPS. Methods Sixty patients with portal hypertension underwent TIPS with 8 mm diameter bare stents and ePTFE-covered stent from April 2007 to April 2009. The clinical outcomes were observed after TIPS, and the hemodynamics of potal vein system were studied before and after TIPS and during the follow up using direct portography and color Doppler ultrasound technique. Results TIPS procedures were successful in all patients without major complications. The follow-up of patients with bare stents were (8 ± 4) months and follow-up of ePTFEcovered stents group were (6 ± 4) months. Immediately after the TIPS the portosystemic pressure gradient of the two groups decreased by 60% and 58%, respectively(t =0.79, P >0.05). During the follow-up,portosystemic pressure gradient of bare stents group increased gradually, while that in ePTFE-covered stents group maintained low portosystemic pressure gradient (13.2 ± 1.2) mm Hg vs. (9. 5 ± 2. 9) mm Hg, P =0. 015. The blood velocity and volume of venous return of potal vein system were significantly higher in ePTFE-covered stents group than in bare stents group during the follow-up using color Doppler ultrasound method. The blood velocity and volume of the shunts were significantly higher in covered stents group than in bare stents group after 1 year, (125 ±20) cm/s vs. (88 ±13) cm/s, and (1816 ±380) ml/min vs.(1074 ±239) ml/min, respectively P<0. 01. Conclusions In TIPS patients with ePTFE-covered stents high blood velocity and low portosystemic pressure gradient sustained in contrast with those using bare stents.

Objective To study the profile of peripheral blood cortisol concentration in patients with hepatitis B virus (HBV)-related acute on chronic liver failure (ACLF) and its association with disease severity and predictive value on prognosis.Methods Forty-five patients with HBV-related ACLF,including 15 patients in early-stage,15 in medium stage and 15 in end-stage; and 15 patients with severe chronic hepatitis B (CHB) were also enrolled.Peripheral blood cortisol concentration was tested by chemiluminesence immunoassay.SPSS version 18.0 was used to compare peripheral blood cortisol concentration among different groups and analyze its correlation with prothrombin activity (PTA),total bilirubin (TBil),albumin (Alb),alanine aminotransferase (ALT),aspartate aminotransferase (AST),HBV DNA,international normalized ratio (INR) and model for end-stage liver disease (MELD) scores.The independent risk factors of prognosis in patients with HBV-related ACLF were determined by performing Logistic regression analysis.Results The concentrations of peripheral blood cortisol in severe CHB group,early stage ACLF group,medium stage ACLF group and end-stage ACLF group were (595.6±114.0),(496.0±87.2),(303.9±81.1),and (183.8±71.8) nmol/L,respectively.A decreasing trend was observed and the differences among groups were statistically significant (F =63.93,P ＜ 0.01).Peripheral blood cortisol concentration were significantly different among subgroups of patients with MELD＜30,followed by 30-40 and ＞40(F 9.01,P＜0.01).Peripheral blood cortisol concentration in patients with ACLF was positively correlated with PTA level (r=0.83,P＜0.01),and inversely correlated with TBil (r =-0.34,P＜0.05),MELDscore (r =-0.60,P＜0.01),AST/ALT (r =-0.35,P＜0.05),and INR (r=-0.59,P＜0.01).Association with Alb,ALT,AST and HBV DNA was not observed.According to multivariate Logistic regression analysis,MELD score,cortisol level,Alb and total cholesterol were independent risk factors of prognosis for patients with ACLF.Serum cortisol concentration in survival group of HBV-related ACLF was higher than that in death group,while the death group exhibited a gradually decreasing trend.Conclusions The peripheral blood cortisol concentration decreases in patients with HBV-related ACLF,which is related to the degree of liver dysfunction,disease severity and prognosis of patients.Moreover,the lower level of cortisol concentration indicates poor short-term prognosis in patients with HBV related ACLF.

BACKGROUND:The rate of tuberculosis infection was high in patients after renal transplantation. Clinical manifestation is not typical, which brings inconvenience to diagnose.
OBJECTIVE:To summarize the diagnosis and therapeutic methods of tuberculosis infection after al ograft renal transplantation.
METHODS:Relevant diagnosis and therapeutic method of 13 patients with tuberculosis infection after renal transplantation were retrospectively analyzed in the Department of Organ Transplantation, Zhujiang Hospital of Southern Medical University from January 2010 to October 2013.
RESULTS AND CONCLUSION:The onset time was 4-120 months after operation;62%(8/13) patients within 18 months after transplantation. Patients affected long-period fever, mainly low-grade fever. Four cases were identified according to the history, imaging data in combination with positive pathogenic diagnosis. Five cases were identified according to the history, imaging data combined with lung biopsy histopathology. The remaining four cases were identified according to the history, imaging data with experimental effective anti tuberculosis treatment. Early pulmonary symptom was not obvious. Chest CT was helpful in early diagnosis and differential diagnosis. Al patients fol owed early, law, ful , right amount, combined with principles of anti-tuberculosis treatment, and treatment usual y lasted for 6-10 months. They were given combined anti-tuberculosis infection drugs, adjustment of immunosuppressive agents and five-ester capsule for liver protection therapy. Thirteen patients were alive, no deaths. Two cases with early infection without timely treatment suffered from acute rejection, leading to loss of graft function and returned to hemodialysis. The others were cured and left hospital. Renal function was normal after 6-month fol ow-up (serum creatinine). Results indicated that after renal transplantation, patients with pulmonary tuberculosis should be early detected, early diagnosed and early treated. CT guided biopsy can be used as an effective and feasible means for diagnosis and identification of smear negative pulmonary tuberculosis after renal transplantation. Adjustment of immune scheme, anti-tuberculosis treatment and five-ester capsule significantly reduced calcineurin inhibitor dose, and lessened their adverse reactions.

After removal of unilateral molars in the rats,the changes in the articularcartilage and articular disc of the temporomandibular joint and HRP uptake of thelining cells of synovial membrane were observed with light,transmission and scanningmicroscopy.The HRP uptake activity of the lining cells was lowered and degenerative chan-ges were presented in ths articular cartilages following the removal of the molars.It is suggested that the temporomandibular joint is intimately integrated with theocclusion of the upper and lower teeth.Defect of the teeth on one side mayinduce occlusion disorders.These will certainly cause some changes of the structureand function of the temporomandibular joint.