Objective The proliferation and differentiation of neural stem cells in the subventricular zone(SVZ) and subgranular zone(SGZ) have been observed in normal old rats or treated by middle cerebral artery occluded(MCAO) and sham operation respectively. Methods Old rats were used to make models of middle cerebral artery occluded(MCAO).By BrdU pulse labeling and immunohistochemical single staining,the change of the number of BrdU positive cells was observed in SVZ and SGZ of normal rats or cerebral ischemia rats after MCAO 3d,7d,14d,21d,28d and sham operation respectively.By BrdU accumulating label and immunohistochemical double staining,BrdU/NeuN and BrdU/GFAP positive cells were determined in SVZ and SGZ of aged rats after MCAO 14d. Results BrdU positive cells were found in bilateral SVZ and SGZ of all groups above mentioned.Compared with normal and sham groups,BrdU positive cells of SVZ and SGZ in cerebral ischemia rats were strikingly increased.BrdU positive cells reached the peaks in SVZ at 7d and in SGZ at 14d after MCAO.At 14d after MCAO,BrdU/NeuN(0.98%) or BrdU/GFAP(12.56%) double labled cells were observed in SVZ,but no double labled cell was observed in SGZ.Conclusion The focal cerebral ischemia markedly stimulated proliferation of neural stem cells in SVZ and SGZ in old rats,and some proliferative cells in SVZ can differentiate into neurons or glial cells.

Basic surgical skills tralning which belongs to the basic course of surgery, is clini-cal basis for the medical students. The teaching practice of basic surgical skills tralning was explored by the Affiliated Hospital of Inner Mongolia Medical University, the theoretical teaching was combined with skills tralning practice, three kinds of means which contalned the model, animal tissues and or-gans in vitro and animal experiment were used to carry out systemic and standardized tralning. Finally, the basic surgical skills of postgraduate in surgery were improved, and the expected alm of teaching was achieved.

Objective To investigate the clinical features and therapy of fournier's gangrene.Methods The clinical data of 12 patients with fournier's gangrene who were treated at the Third Affiliated Hospital of Nanjing University of Chinese Medicine from January 2010 to February 2012 were retrospectively analyzed.Eleven patients had perianal abscess and 1 patient had perianal foreign body,most of the patients were presented with perianal pain,fever (＞ 38.5 ℃) and tachycardia.The mean interval between the onset of symptoms and admission to the hospital was 8 days (range,3-20 dyas).Seven patients were complicated with diabetes.Only 2 patients were administered hypoglycemic agents,but the effects were poor.Six patients were complicated with hypertension.One patient had the history of resection of sigmoid colon cancer 2 months before operation.Debridement and drainage were applied to all the patients after examination.Antimicrobial therapy applied to all the patients according to the results of drug sensitivity test.The incisions were washed by hydrogen peroxide solution postoperatively.Redebridement was applied if the disease was progressed.All patients were followed up via out-patient examination and phone call till June 2012.Results Results of clinical features:Perianal tissues necrotized,with the color of black.The scrotum or labia majora of 8 patients were invaded by the necrotic tissues.Results of laboratory test:the white blood cell count was (3.8-27.6) × 109/L,the white blood cell count of 6 patients was above 10 × 109/L,3 was above 20 × 109/L.The ratio of neutrophil granulocytes was 0.61-0.93.Four patients received single debridement,5 received redebridement,and 3 patients received debridement for more than 2 times.Two patients had sapremia and infectious shock,and they received treatment for 3 days and 4 days at the intensive care unit.Results of bacterial culture:6 patients were infected by the escherichia coli,4 by klebsiella pnenmoniae,and 1 by pseudomonas aeruginosa.The mean duration of hospital stay was (25± 14)days (range,1-49 days).All patients were followed up for 4-29 months,1 patient was discharged at postoperative day 2,and the prognosis of the 11 patients was good,no mortality was observed.Conclusions The clinical features of fournier's gangrene include severe pain and rapid spread of infections caused by necrosis of perianal subcutaneous tissues.Diabetes might be the risk factor of fournier's gangrene.Early diagnosis and prompt and aggressive surgical debridement are critical for improving survival.

Objective To investigate the optimal dose of remifentanil combined with dexmedetomidine for awake tracheal intubation.Methods 60 cases with difficult airway general anesthesia surgery from March 2014 to August 2016 in Jinhua People's Hospital were selected and divided into group R1,R2,R3,20 cases in each group.0.6μg/kg dexmedetomidine 10 minutes micro pump intravenously,Simultaneous target-controlled infusion effect of the chamber concentration of remifentanil.2.0ng/mL remifentanil in group R1,2.3ng/mL remifentanil in group R2,2.5ng/mL remifentanil in group R3.All patients underwent full surface anesthesia with 2％lidocaine under visual soft mirror guidance.The heart rate(HR),mean arterial pressure(MAP)and Ramsay sedation score at before anesthesia(T0),at the end of the administration(T1),intubation(T2),immediately after intubation(T3),tracheal catheter placement reaction score and record tracheal intubation during respiratory depression,cardiovascular adverse events,postoperative follow-up of tracheal intubation process satisfaction.Results MAP,HR and RR at T2,T3 in group R1 were significantly higher than those in group R2 and R3,the difference was statistically significant(P<0.05).The incidence of hypertension in the group R3 was significantly lower than that in group R1,while the incidence of respiratory depression and tachycardia was significantly higher than that in group R1,the difference was statistically significant(P<0.05),RSS score and satisfaction scores in group R3 were significantly higher than those in group R1,the reaction score in group R3 was significantly lower than the group R1,the difference was statistically significant(P<0.05).Within group comparison,the mean arterial pressure and heart rate and respiratory rate at T2 and T3 in group R1 was significantly higher than those at T1,heart rate was significantly faster than T1,the respiratory rate was significantly faster than T1,the difference was statistically significant(P<0.05),T2 and T3 in group R3 were significantly slower than those at T0,the difference was statistically significant(P<0.05).Conclusion Remifentanil combined with dexmedetomidine can be safely and effectively used for awake intubation under glidescope guiding in difficult airway patients.In the full airway surface anesthesia,dexmedetomidine micropump 0.6μg/kg simultaneous target transfusion effect of the concentration of remifentanil 2.3ng/mL is a more reasonable medication.

Objective To investigate the clinical effect of mini -plate and kuntscher pin fixation in the treatment of metacarpus and phalange fracture.Methods 113 FMB and FPB patients were divided into OSG (58 patients)and CTG(585patients)group according to random number table.Statistics of postoperative recovery and complications in the two groups were collected and analyzed after research.Results In 58 patients of OSG group,the total active bending from 2 -5 metacarpophalangeal joints to phalangeal joints of 28 cases(48.28%,χ2 =8.562,P =0.035 )were beyond 220°,19 cases (32.76%,χ2 =8.935,P =0.024)were between 180 -220°, 11 cases (51.72%,χ2 =9.365,P =0.012)were less than 180°.The total active bending fromthumb metacarpopha-langeal articulation to interphalangeal joint of 30 cases (51.72%,χ2 =9.365,P =0.012)were beyond 220°, 18 cases (31.03%,χ2 =8.747,P =0.009)were between 180 -220°,10 cases (17.24%,χ2 =8.932,P =0.041) were less than 180°(P <0.05).Conclusion AO Mini -plates surgical method has advantage of parking position accuracy,dissection stable fixation,functional recovery soon and less complication in the treatment of FMB and FPB patients,which is worthy of promotion.

Objective To explore the effect of RNA interference on the bionomics of Cathepsin L of hepatoma carcinoma cells. Methods In this study, the experimental group was the Cathepsin L RNA interference group. Control groups were the normal blank hepatoma carcinoma cell group (the blank group) and the Cathepsin LRNA interference blank group (the fluorescence control group). Observing times were ld,3d and 6d after RNA interference. Transfection efficiency in each group was observed. Expression of Cathepsin L of hepatoma cells was detected by immunofluorescence, RT-PCR and WB. Cell vigor was detected by MTT assay. Changes in the cell cycle and apoptosis were observed by flow cytometry. Transwell cabin was used to detect the changes of cell invasive power.Results In the experimental group, Cathepsin L mRNA level and protein level significantly decreased, the proliferation index significantly decreased and apoptosis index significantly increased. The invasive power also decreased. Conclusion RNAi interference can inhibit Cathepsin L expression, cell proliferation and cell invasive power efficiently.

In this study,we summarized airway management of a series of patients with inhalation injury caused by smoke from smoke pot based on grade classification,which were:establishment of a special team for these classified patients,classifying the patients into four sub-groups including extremely severe,severe,moderate and mild,establishment of a program for trachea management and relevant measures on these classified sub-groups.Key points of management on extremely severe patients were as follows:protective isolation,mechanical ventilation,nursing of extracorporeal membrane oxygenation and pneumothorax and mediastinal emphysema,prevention of tracheo-esophgeal fistula,nursing cooperation of fiberoptic bronchoscopy.Key points of management on severe patients were as follows:disinfection and isolation,rational oxygen therapy,sputum elimination management,observation of illness status,preparation of emergency treatment,prevention and nursing of complications.Key points of management on moderate patients were as follows:ventilation,oxygen uptake,aerosol inhalation,sputum elimination guidance,respiratory function training.For mild patients,there was no special management except ventilation,aerosol inhalation and regular pulmonary function examination.One patient died due to multiple organ failure complicated with massive hemoptysis,four patients recovered with airway scar proliferation and lung fibrosis,and fifty-five patients fully recovered.

Clinical neuroanatomy is a bridge between basic medicine and clinic. To resolve the deficiency existing in PBL teaching,we improved the basic teaching installation and teaching practice and evaluation system. The results indicated that we had gotten satisfactory effect by using teaching method of clinical neuroanatomy

Objective To investigate the molecular mechanism of epithelial-mesenchymal transition (EMT) induced by activated vascular endothelial growth factor receptor-1 ( VEGFR-I ) in cell line MHCC97-H.Methods MHCC97-H cells were cultured in DMEM with 1％ fetal bovine serum (control group),10 μmol/L PP2 (PP2 group),10 μmol/L PBS (PBS group),50 μmol/L VEGF-B (VEGF-B group),l0μmol/L PP2 and 50 μmol/L VEGF-B (PP2 +VEGF group),10 μmol/L PBS and 50 μmol/L VEGF-B (PBS + VEGF-B group),respectively.Protein expressions of epithelial marker E-cadherin,α-catenin and mesenchymal marker vimentin and N-cadherin were detected by Western blot.The expression sites of E-cadherin,α-catenin and mesenchymal marker vimentin and N-cadherin were detected by cell immunofluorescence.The ability of invasion and migration of cell line MHCC97-H were assessed by cell invasion and migration test.All data were analyzed by the t test.Results The expressions of E-cadherin,α-catenin,vimentin and N-cadherin were 3.23 +0.76,3.01 ±0.25,3.01 +0.22 and 2.63 +0.40 in the control group,4.18 +0.32,3.29 +0.11,4.85 +0.36 and 3.02 +0.52 in the PP2 group,2.83 +0.65,3.03 +0.27,1.37 ±0.24 and 2.98 ±0.36 in the PBS group,2.06 ±0.15,2.84 ±0.76,5.79 ± 0.38 and 5.54 ± 0.28 in the VEGF-B group,6.12 ± 0.08,5.45 ± 0.37,3.36 ± 0.42 and 3.26 ±0.13 in the PP2 + VEGF-B group and 1.36 ±0.54,1.26 ±0.45,4.05 ±0.17 and 1.05 ±0.33 in the PBS +VEGF-B group.There was a significant difference in the expressions of E-cadherin and α-catenin between the PP2 +VEGF-B group and the VEGF-B group (t =7.625,9.931,P ＜ 0.05 ).The expressions of vimentin and N-cadherin in the PP2 + VEGF-B group were significantly lower than those in the VEGF-B group (t =12.001,11.910,P ＜ 0.05).Six hours after the treatment with VEGF-B,the numbers of MHCC97-H migrated were 19 ± 1,5 ± 2and 16 ± 1 in the VEGF-B group,PP2 + VEGF-B group and PBS + VEGF-B group,respectively.The number of MHCC97-H cells migrated in the VEGF-B group was greater than that in the PP2 ± VEGF-B group ( t =13.566,P ＜ 0.05 ).The number of MHCC97-H cells passed through the Boyden chamber was 4 + 2,which was significantly less than 16 ± 1 of the VEGF-B group (t =12.350,P ＜0.05).Conclusion EMT induced by activated VEGFR-1 was mediated via c-Src kinase signal transduction in MHCC91-H cell line,and c-Src may be a potential target to interfere the invasion and migration of hepatic cancer cells.

Objective To establish cell models with different insulin sensitivity status and examine the expression of protein kinase B (PKB/Akt) in the same conditions. Methods 3T3-L1cells were cultured with different glucose concentrations (3.0, 5.5 and 50.0 mmol/L respectively).Insulin sensitivity, as presented by insulin-induced glucose transport rate in the cells, was tested by 3H-2-DG incorporation. PKB expression in cells was determined by RT-PCR. Results The insulin-induced glucose transport rate in 3T3-L1 cells was affected by different concentrations of glucose. The transport rate of 3H -2-DG in cells cultured in low glucose concentration was increased by 152% and 50% compared with high glucose concentration and control group, respectively. There was no difference in PKB mRNA expression among the three groups under the same conditions,whereas there was an obvious reduction of PKB expression in the three groups after the cells were treated with glucose and insulin. Conclusions 3T3-L1 cells cultured with different concentrations of glucose present the different insulin sensitivity status, but the difference of PKB mRNA expression has not been observed in the same condition.