This article analyzes and summaries the problems and difficulties existing in the first-aid medicine's clinical teaching.Combined with his own teaching experience,the author has made some exploration on the teaching time,the way of teaching and inspection form,which has got a good teaching effect.It provids the reference and development for the clinical teaching of first-aid medicine.

Objective To construct the eukaryotic expression plasmid of pEGFPC1uPAR gene and explore the effect on the proliferation and invasion ability of Pam 212 cells. Methods The human uPAR cDNA was cloned by PCR, and inserted into the eukaryotic expression plasmid pEGFPC1. After identification of sequencing, the reconstructive plasmid was transformed transiently into Pam 212 cells, then the cell growth and the invasion ability were evaluated. Results The reconstructive plasmid of pEGFPC1uPAR was validated by sequencing. The reconstructive plasmid can promote the growth of Pam 212 cells and enhance the invasion ability. Conclusion The pEGFPC1uPAR plasmid was constructed successfully and uPAR was confirmed to promote the growth and the invasion ability of Pam 212 cells, which lay the foundation for further studies of uPAR in vivo.

OBJECTIVETo establish and evaluate a hypercoagulable animal model for the assessment of anticoagulants.

METHODSForty mice, thirty-two rats, and twenty-four rabbits were randomly and equally divided into control group (saline) and three ellagic acid (EA)-treated groups (low, middle, and high doses). In the mice, bleeding time (BT) was estimated with tail transaction, and clotting time (CT) with template method. Prothrombin time (PT) and the activated partial thromboplastin time (APTT) in rats and rabbits were measured by means of Quick's one-stage assay and modified APTT assay respectively. In addition, thrombin activity was estimated in rats with PT assay using a hemagglutination analyzer. The circulating platelet aggregates were detected in rabbits through platelet counting and presented as the circulating platelet aggregate ratio (CPAR).

RESULTSEA shortened BT and CT in mice, PT and APTT in rats, and increased thrombin activity and CPAR, all in a dose-dependent manner. EA also brought reduction of PT and APTT in rabbits in dose- and time-dependent manners.

CONCLUSIONEA could induce hypercoagulable state through activating coagulation system and platelets in mice, rats, and rabbits.

Animals ; Anticoagulants ; therapeutic use ; Blood Coagulation Disorders ; chemically induced ; drug therapy ; Drug Evaluation, Preclinical ; Ellagic Acid ; adverse effects ; Female ; Male ; Mice ; Mice, Inbred ICR ; Models, Animal ; Platelet Aggregation ; drug effects ; Prothrombin Time ; Rabbits ; Rats ; Rats, Sprague-Dawley

Objective To investigate the effect of progressive decompression elasticity socks therapy on life quality of the lower extremity deep vein thrombosis patients.Methods 50 qualified patients were divided into 2 groups receiving respectively compression therapy or not.Analysis and comparison were made based on results of SF36 questionnaire.Results There were no demographic differences between the two groups.Average follow-up time was (5.6 ± 2.4) months,the cronbach α coefficient was 0.8652 in compression therapy group,there was significant improvement on every evaluated stage and in every dimension after standard treatments (P ＜ 0.01),while in control group,only 4 dimensions (PF,RP,RE,BP) improved (P ＜ 0.05),there were statistical differences on every dimension between the two groups (P ＜ 0.01).Conclusions Progressive decompression elasticity socks therapy helps make the recovery of patients of acute deep vein thrombosis of the lower extremities.

ObjectiveTo investigate the effect of neuregulin1β (NRG1β) on the learning memory abilities and the neuronal apoptosis and the expressions of nuclear factor kappa B (NFκB) in experimental Alzheimer's disease model in rats induced with beta-amyloid protein1-40 (Aβ1-40) injection.To explore the mechanisms of NRG in improving the capabilities of learning and memory.MethodsThirty adult healthy male wistar rats were randomly divided into control group (n =10),model group (n =10) and treated group (n =10).Alzheimer's disease models were established by stereotactically injecting Aβ1-40 into the left lateral ventricle,and treated by injecting NRG1β(0.3 μg · kg-1 ) into the right lateral ventricle.The learning and memory abilities of rats were evaluated with Y-electric maze before the experiment and 7 days after making Alzheimer's disease models and 14 days after treatment.HE staining was used to observe the structure of hippocampal neurons.The neuronal apoptosis of hippocampus was investigated by TUNEL assay.The expressions of NFκB in hippocampal neurons were determined with immunohistochemistry technique.ResultsCompared with control group (57.50 ± 1.58,7.20 ±1.03 ),the model group rats ( 59.50 ± 2.79,7.50 ± 1.08 ) showed low cognitive ability ( t =20.36,5.28,P ＜0.05 ),the hippocampal pyramidal cells of rats in the model group were sparse and disturbed pyramidal cells,noticeable neuron loss.The number of neuronal apoptosis and the expressions of NFκB increased significantly than those in control group (P＜0.05).Compared with model group (79.10 ±4.12,4.40 ±0.69),NRG1β strikingly improved cognitive ability ( 67.70 ± 4.90,5.80 ± 0.63 ) and normal cell structure ( t =5.63,4.69,P ＜ 0.05 ).The expressions of NFκB (25.90 ± 6.67 ) reduced while the number of neuronal apoptosis ( 23.50 ± 3.89 ) decreased markablely than those ( 41.10 ±7.95,29.30 ± 7.24) in model group(t =4.63,2.23,P ＜ 0.05).ConclusionNRG1β might decrease the neuronal apoptosis by inhibiting NFκB expressions,so that to improve the learning and memory abilities of experimental dementia rats.

Objective To study CT and MRI appearance of transient hepatic attenuation difference (THAI)) .to reveal the cause of THAD),and to avoid false positive and misdiagnosis.Methods 10 cases appearing THAD in CT and 5 cases appearing THAI) in MRI were reviewed and all were processed with plain scan and dy- namic contrast with CT or MRI.Results 7 cases appeared transienl hypertransfusion of CT,4 cases appeared tran- sient hypertransfusion of MRI;3 cases appeared transient Hypoperfusion of CT,1 case appeared transient hypoperfu- sion of MRI.Conclusion The appearance of THAD in CT and MRI,was related to the quick-scan with CT and MRI only sufficient comprehension of the characteristics of blood supply in normal physiology and pathology of liver, combined with plain scan,could make correct decision possible in the final diagnosis when it occurred regional perfu- sion difference in liver.

Objective To evaluate the characteristics and clinical application value of Dual Source CT(DSCT),3.0T MR and DSA in the diagnosis of intracranial aneurysm.Methods The imaging characteristics of DSCT,3.0T MR and DSA in 102 patients of in-tracranial aneurysm were analyzed retrospectively.Results The cerebral DSA were performed in 102 patients,and the sensitivity and accuracy of DSA were 100%.60 patients were detected by DSCT/CTA,and the sensitivity and accuracy of DSCT/CTA were 93.1% and 97.2% respectively.52 patients were detected by 3.0T MR/MRA,and the sensitivity and accuracy of 3.0T MR/MRA were 89.1% and 92.7% respectively.10 patients were detected simultaneously by CT and MR.The diagnostic sensitivity and accu-racy of these three methods had no significant difference(P >0.05).Conclusion The sensitivity and accuracy of DSCT,3.0T MR and DSA in the diagnosis of intracranial aneurysm are high and had no significant difference,each had its characteristic.Reasonable application of the three methods produces higher clinical value.

Objective To analyze the curative effect of minimally invasive incision combined with plate fixation for calcaneal fractures.Methods Retrospectively analyzed the clinical data of 30 cases(30 feet) of calcaneal fractures who were treated with minimal incision(sinus tarsi approach combined with posterior lateral incision) from August 2014 to August 2015.Minimally invasive incision combined with plate fixation were performed for the treatment.X-rays were taken in the regular follow-up,B(o)hler and Gissane angle as well as the complications were measured.The final curative effect was comprehensively assessed according to the ankle hind foot score of American Aryhopaedic Foot and Ankle Society(AOFAS).Results All cases were followed up for an average of 14.5 months (from 12 to 16 months), and all fractures healed with no complication such as incision infection or poor healing.The average B(o)hler angle was improved from preoperative(13.42°±4.2°) to (29.3°±3.8°) at the last follow-up with a significant difference(t=-20.424,P=0.000),and the average Gissane angle was significantly improved from preoperative(97.8°±9.7°) to (123.6°±6.5°) at the last follow-up (t=-17.5,P=0.000).The outcomes were evaluated with AOFAS,resulting in an excellent and good rate of 83.3%.Conclusion Treatment of calcaneal fractures with minimal incision has the advantages of less trauma,lower incision complication rate,stronger reduction and fixation,which can achieve satisfactory outcomes.

Objective To investigate the value of 99Tcm-methoxyisobutylisonitrile (MIBI) scintigraphy in assessing the preoperative chemotherapy response and multidrug resistance of osteosarcoma.Methods From January 2007 to October 2008, 12 patients (female:4, male:8; mean age:16.3 years,range:8-27 years) underwent early (10min) and delayed (120 min) 99Tcm-MIBI scintigraphy before and after preoperative chemotherapy.Seven cases had osteosarcoma at the distal femurs, 2 at the proximal tibias, 2 at the upper end of humerus and 1 at the fibula.The tumor-to-background ratio (T/B) and washout rate (WR) were calculated.Tumor necrosis was classified according to Huvos criterion after limb salvage surgery.Immunohistochemical staining for P-glycoprotein(gp) was examined.Spearman correlation analysis and t-test were performed.Results According to Huvos criterion, 7 patients were classified as good responders with more than 90% of tumor cell necrosis and 5 as poor responders with less than 90% of tumor cell necrosis.R value (ratio of early phase T/B after and before chemotherapy) was significantly lower in good responders than that in poor responders (0.473 ± 0.21 vs 0.998 ± 0.06, t= 5.342, P= 0.000 ).R value was significantly correlated with the degree of tumor cell necrosis ( rs=- 0.87, P= 0.000 ).WR was significantly higher in patients with positive P-gp expression than that in patients with negative P-gp expression ((38.36 ±18.64)% vs (6.40±5.87)%, t= -3.278, P=0.008).There was significant correlation between the WR and P-gp expression (rs = 0.91, P= 0.001 ).Conclusion 99Tcm-MIBI scintigraphy is a feasible non-invasive technique to assess the chemotherapy response and to detect P-gp expression of osteosarcoma.

OBJECTIVESTo study the morphological feature of complicated thoracolumbar fractures and the fixation technology of injured vertebra.

METHODSFrom January 2005 to December 2007, 61 patients with type B and C thoracolumbar fractures according to AO classification were treated. There were 53 males and 8 females, with a mean age of 33.2 years (range, 9 to 65 years). Based on ASIA grading system of neurologic deficit, Grade A was found in 41 cases, grade B in 5 cases, Grade C in 5 cases, Grade D in 6 cases and Grade E in 4 cases. The injured vertebra located at thoracic region in 13, thoracolumbar in 39 and lumbar in 9 cases. The patients were divided into two groups: 32 cases with pedicle screws in the injured vertebra and 29 cases without pedicle screw in the injured vertebra. The analyses on the morphological features of injured vertebra were performed, and comparisons were carried out on the outcome regarding the reduction and correction of the injured vertebra, and the difference of Denis scale in pain domain and work status domain, between the two groups.

RESULTSAll the patients were followed up for an average of 3 years (range, 1.5 to 4.5 years). There were significance statistical difference in the correction loss of Cobb angle, sagittal index, correction of dislocation index, and the Denis pain scale between the two groups (P < 0.05). A better outcome was observed in the injured vertebra fixation group than the injured vertebra non-fixation group.

CONCLUSIONSInserting pedicle screws in the injured vertebra is effective and useful in the correction of complicated thoracolumbar fractures. It improves biomechanical stability of the spine after the operation.

Adolescent ; Adult ; Aged ; Bone Screws ; Child ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; methods ; Humans ; Lumbar Vertebrae ; injuries ; Male ; Middle Aged ; Retrospective Studies ; Spinal Fractures ; surgery ; Thoracic Vertebrae ; injuries ; Treatment Outcome ; Young Adult