Thirty-six patients with femoral neck fracture, including 23 male and 13 female with an average age of 78 years (range 70-89 years) underwent artificial hip replacement or dipolar femoral head replacement in Hebi Second People’s Hospital from May 2002 to October 2007. All patients completed the surgery procedure safely. Except 2 with incision infection, there were no serious complications occurred. The patients could get out of the bed 3-20 day after surgery (average 7 days); the length of stay in hospital averaged 22 days (range 16-27 days). Thirty-six patients were followed-up for 1-4 years. During the survival time, no prosthesis loosening, subsidence or joint ache was found. Twenty patients developed fever 2-5 days after surgery, and 2 cases developed regional inflammation. Functional evaluation results at the final follow-up for half a year show that 13 (36.1%) cases are excellent, 20 (55.6%) are good, and 3 (8.3%) are fine; the overall excellent and good rate is 91.7%.

Based on the research standpoint of internal needs,innovative research and management practice,the paper revealed and deeply discussed the 20 drivers behind the full play of medical doctor students' innovative behavior through the use of the method of questionnaire,expert in-depth interviews.

Facing the new problems under the background of new era,with the establishment of the market economy of our country and the improvment of the medical health system,how to solve medical health problems,how to strengthen the modernization management of state-owned hospital,and how to improve their comprehensive strength become the focus of the health research.With the internal and external environment analysis and the strategic management theory,this paper puts forward the development strategy and the support system of the children's hospital of Chongqing Medical University.

AIM: To investigate the effects of rat retinal ganglion cell (RGC) apoptosis on delayed rectifier K+currents (IK).METHODS:The retinas of 2~3 d newborn Sprague-Dawley rats were dissociated into cell suspension by trypsin digestion .The RGCs were cultured and divided into control group , pressure 0.5 h group, pressure 1 h group, pressure 1.5 h group and pressure 2 h group.The cells were cultured regularly for 6 d in control group , and the cells in other groups were cultured regularly for 6 d and gave pressure of 80 mmHg for 0.5 h, 1 h, 1.5 h and 2 h, respectively. The rhodamine 123 fluorescence from labeled RGC mitochondrion was detected by continuous wavelength multifunctional microplate detection instrument.The membrane capacitance (Cm) in different groups and IK in the pressure 1 h group were recorded from the RGCs by whole-cell patch-clamp technique .RESULTS:No difference of rhodamine 123 fluorescence in the RGC mitochondria between control group and pressure 0.5 h group was observed .Rhodamine 123 fluorescence in the other 3 groups was significantly lower than that in control group (P<0.05).No difference of the Cm between control group and pressure 0.5 h group was found, and the Cm in the other 3 groups was significantly lower than that in control group (P<0.05).The amplitudes of IK were higher than that in control group .At the test potential from -10 mV to 60 mV, the current density in pressure 1 h group was significantly higher than that in control group (P<0.05).The maximal conduc-tion ( Gmax ) in pressure 1 h group was significantly higher than that in control group .The voltage for IK channel half-activa-tion ( V1/2 ) in pressure 1 h group declined comparison with control group ( P<0.01 ) , and the k value had no significant difference between the 2 groups.CONCLUSION:Retinal ganglion cell apoptosis accompanies with delayed rectifier K +current enhancement .

This paper reviewed the basic concepts of creativity and systematic perspective on creativity and systematically analyzed the connotation of creativity in doctoral candidates,thus summarizing the advantages of the development of creativity in doctoral candidates:physiological function,intellectual quality,non-intellectual quality and professional innovation that may help to unleash creativity,knowledgeable,dedicated,and innovative supervisors and a correspondingly suitable environment,which is of great importance to the researches on unleashing the creativity in doctoral candidates and creating innovative results.

Objective To discuss the effect of different intension electrotherapy to rabbits'FERG,Methods Using the FERG as the target,to stimulate the TAIXI point with 0.2,0.8,2.0 and 4.0mA inrension eleetrotherapy,then observe the change of the rabbits'FERG during and after the stimulation.Results 0.8mA intension can lead to the delay of the FERG a-wave's latency obviously.The lower or higher.stimulation has little effect to the awave's latency.All kinds of stimulation to the b-wave's latency has little difference,but the effect to the amplitude has significant difference.While the stimulating intension below 2mA in 15 minutes,the b-wave's amplitude rise obviously with the intension's rising,but the amplitude will fall when the intension get to 4mA.Conclusion The effect of electrotherapy on the retina'function has osculation relationship with the electrotherapy intenmon,the best effect needs the most fitful intension of stimulation.

AIM　To study the structures of the epimerides of cycloclausenamide. METHODS　The structures of compound I, extracted from Clausena lansium (Lour.) Skeels, and synthesized compound III were determined by single crystal X-ray diffraction analysis. The stereo-structures of compound II and IV were also built up through Tripos force field based on crystal structures of compound I and III. RESULTS　The molecular formula and molecular weight were found to be C18H17O2N and 279.34 respectively. Compound I crystallized in monoclinic system, space group P21 with a=0.5928(1), b=1.5014(1), c=1.6190(1) nm, V=1.4410(3) nm3, Z=4, Dx=1.288 g*cm-3, Rf=0.075, Rw=0.073(w=1/σ2｜F｜), S=3.983; compound III crystallized in triclinic system, space group P1 with a=0.5667(1), b=1.2934(1), c=2.1119(1) nm, α=102.17(1), β=90.25(1), γ=102.65(2)°, V=1.4770(5) nm3, Z=4, Dx=1.224 g*cm-3, Rf=0.047, Rw=0.051(w=1/σ2｜F｜), S=0.467. CONCLUSION　These results showed that compound I and III both are cycloclausenamide except that the directions of the phenyl group on C6 are different. Cycloclausenamide can form 4 pairs of epimerides but the directions of the phenyl group does not affect their energy in free state.

Objective To investigate the effect of differential diagnosing female genital tract infection diseases by using leucorrhea microscopy method, bacteria pre-enzyme spectrum analysis method and the joint method. Methods Both leucorrhea microscopy method and bacteria pre-enzyme spectrum analysis method were respectively used to detect the vaginal discharges of 4130 women from our hospital outpatient service, and test results combined with clinical manifes-tations and treatment effect were also analyzed and compared summarily. Results 1976 patients were founded by using the leucorrhea microscopy method (detection rate and accuracy rate was 47.8%,71.6% respectively); 1302 cases were founded by using bacteria pre-enzyme spectrum analysis method (detection rate and accuracy rate was 31.5%, 58.1%respectively);2622 cases were detected by using the joint detection method (detection rate and accuracy rate was 63.5%, 91.1% respectively). Conclusion The joint method has the advantages of both leucorrhea microscopy method and bac-teria pre-enzyme spectrum analysis method, and can accurately identify five common kinds of female reproductive tract infection diseases with one sample for once.

Objective To explore the effect of sorafenib on HeLa cell proliferation by inducing cell apoptosis and autophagy and its impact on drug resistance.Methods The drug-resistant cell strains were constructed through in-termittent induction method,with concentrations of 0,2.5,5.0,7.5,10.0,15.0,20.0 μmol/L.HeLa cells were incubated with increasing concentrations of sorafenib with each concentration for 1 week.The drug-resistant cell strains with stable passages were collected.MTT assay was used to detect the effect of sorafenib on cell prolifer-ation.Cell cycle distribution was analyzed by flow cytometry.The change in the expression of drug-resistant and ap-optotic genes in the parents and drug-resistant cell strains under different drug concentrations was examined by semi-quantitative PCR.The changes of apoptotic related marker proteins LC3-Ⅰ and LC3-Ⅱ were detected by Westernblot.Results Stable drug-resistant strains were successfully obtained;Drug-treated cells were more blocked in the G1 phase.In drug-resistant cells,the expression of apoptosis suppressor gene Bcl-2 was significantly decreased and the apoptotic gene Bax as well as the drug-resistant genes were all significantly increased(P＜0.05).The LC3-Ⅱ/LC3-Ⅰ ratio of drug-resistant cells was significantly higher than that of parent cells(P＜0.05).Conclusions Sorafenib may block the cell cycle,suppress malignant cell proliferation and promote autophage.On one hand,autophagy participates in the development of cell drug resistance and promotes cell survival.On the other hand,drug-induced autophagy may activate some of apoptotic signaling pathway in drug-resistant cells and promote the reversal of cell drug resistance.

Objective: To evaluate image quality and radiation dosage of CT cerebral perfusion (CTP) imaging of 70 kV with different tube current and scanning passes and its diagnostic value for hyperacute cerebral infarction. Methods: A total of 190 patients with suspected hyperacute cerebral infarction in Lishui Central Hospital of Zhejiang Province from December 2017 to February 2019 were selected prospectively, and all patients were divided into 4 groups according to random number table and received non-contrast CT examination and dual-source CT cerebral perfusion imaging with 70 kV protocol simultaneously within 6 hours after the onset of symptoms: group A, 120 mA, 21 scanning time points; group B, 100 mA, 21 scanning time points; group C, 100 mA, 17 scanning time points; group D, 80 mA, 21 scanning time points. The values of perfusion parameters such as cerebral blood flow (CBF), crerbral blood volume (CBV), mean transit time (MTT), time to peak (TTP) were acquired. Image quality was evaluated and effective dose (ED) was recorded. The quantitative variables of image quality and radiation dosage were compared between four groups using one-way analysis of variance test. Results: There was no differences between groups on the CBF, CBV, MTT, TTP maps for all CTP values (P>0.05), and all images could meet the diagnostic requirements. The subjective image quality score of vessel sharpness and overall image quality of both internal carotid artery and middle cerebral artery and the degree of noise of internal carotid in artery in group A was higher than that in group D (P<0.05). The score of vessel sharpness of internal carotid in artery ingroup A was higher than those in both groups B and C (P<0.05). The scores of vessel sharpness of both internal carotid artery and middle cerebral artery internal carotid in artery ingroups B and C were higher than that in group A (P<0.05). The mean EDs of non-contrast CT in group A, B, C, D were 1.10, 2.11, 1.76, 1.42, 1.40 mSv; compared to group A, ED was reduced approximately 16.6% (0.35/2.11), 32.7% (0.69/2.11) and 33.6% (0.71/2.11), respectively (P<0.05). The diagnostic accuracy of low dose dual source CTP for detecting hyperacute cerebral infarction was 93.5% (172/184), while that of non-contrast CT was 52.2% (96/184);for detecting hyperacutelacunar cerebral infarction, it was 72.1% (31/43) and 16.3% (7/43) respectively (P<0.05). Conclusion Appropriate reduction of tube current (100 mA) and scanning passes (17 scanning time points) can reduce the radiation dosage and acquire comparable image quality for 70 kV protocol CTP. Compared with non-contrast CT, low dose dual-source CTP is more sensitive to hyperacute cerebral infarction, especially hyperacute lacunar cerebral infarction.