Objective To study the relation along p53, p21 protein, p21 gene and their clinical significances in 40 gastric comparing with normal gastric tissues.Methods In this study, the p53 and p21 protein were investigated in 40 gastric carcinomas using IHC(Immunohistochemistry). At the same time, the possible presence of p21 gene mutation was also analyzed by silver staining PCR-SSCP method.Results The abnormal expression of p53 and p21 protein occurs only in gastric carcinoma; The expression of p53 protein and p21 is not related to the clinico pathological features. There was relationship between the expression of p53 protein and p21 protein. In 40 cases of gastric carcinoma, single strand conformational polymorphism of PCR product for p21 gene in tumor tissue shows no altered band or mobility shifting.Conclusion The abnormal expression of p53 and p21 protein occurs only in gastric carcinoma and is not related to the clinicopathological features. The expression of p21 protein is related to that of p53 protein. The mutation of p21 gene was not found in all of 40 tumor specimens. This suggests that p21 alteration in gastric carcinoma is caused through the inactivation of p53 protein rather than through intragenic mutation of the p21 gene itself.Using drugs which can stimulate p21 gene is a new method to cure gastric cancer with mutation-p53 protein.

Objective To investigate the diagnosis and treatment of primary hyperparathyroidism ( PHPT) initially with urinary calculus .Methods The clinical data of 26 patients who diagnosed as PHPT ini-tially with urinary calculus were retrospectively reviewed .Results There were 22 cases with bilateral urinary calculus and 4 cases with unilateral relapsed urinary calculus .Ultrasonography , CT and radionuclide were helpful to determine the location of the neoplasia .24 cases underwent percutaneous nephroscope or ureteroscopy pneu-matic ballistic lithotripsy , 2 cases discharged ureteral calculi by themselves .All patients were performed surgical treatment of PHPT , which was confirmed by intraoperative frozen pathology and postoperative pathological exami -nation.There was great improvement of clinical symptoms after surgical procedures .The preoperative serum calci-um, urine calcium and parathyroid hormone elevated , while serum phosphate decreased .The postoperative indi-cators were just the opposite .The difference had statistical significance ( P<0.05 ) .Conclusions Laboratory investigations and imaging studies are very important to diagnose PHPT initially with urinary calculus .The para-thyroid surgery can remarkably reduce the calculus recurrence and improve renal function .

Cultivating Clinical thinking ability is an important tache of clinical medical education. Teachers'guidance, the charateristics that suit teaching, the organic combination of the active methods which can mobilize clinical medical interns' learning enthusiasm, such as problem-based learning, and humanity education are effective approaches to enhancing interns' clinical thinking ability.

Based on the applicability analysis of various medical logistics systems, the design and research of medical logistics system based on automated guided vehicle ( AGV) are discussed in depth in such aspects as requirement analysis, system architecture and the function of the upper software platform. According to the implementation environment of specific projects, the relationship between the professional lines is coordinated and the building information modeling technology is used to assist in the professional cooperative work of the building structure. The establishment of medical logistics system based on AGV can effectively make up for the deficiency of other mainstream logistics methods, achieve efficient and speedy logistics, and further improve the quality of hospital service.

Objective:To perform trans-peritoneal laparoscopic adrenalectomy via a single incision in treatment of adrenal tumors,and to discuss its clinical outcome and safety.Methods:Single incision trans-peritoneal laparoscopic adrenalectomy was used in treatment of three patients with adrenal tumors.The incision was made 3 cm below the costal margin of anterior axillary line; three Tocars were placed in the cut.The instruments used included single port access,CUSA,Hem-o-lok,etc..Results:The three operations were all successful,and there were no conversion to open procedure or a need for extra Ttrocars.The operating time periods were 75,116,and 135 min,with a mean of (108.7?30.7)min.The perioperative blood losses were 10,20,and 30 ml,with a mean of (20?10)ml.The gastric canal and ureteral catheter were withdrew one day after operation,and the drainage tube was withdrew 3 d after operation.The mean postoperative hospital stay was 4 d.Conclusion:Single incision trans-peritoneal laparoscopic adrenalectomy has the advantage of little trauma,less blood loss,satisfactory safety,and prompt postoperative recovery,but is difficult to manage.

Objective To study the influence of foot progression angle on tibial shock during running. Methods The normal, toe-in and toe-out gait of fifteen healthy adults was tested during running trials on a treadmill. The differences in tibial shock (impact peak, average loading rate, instantaneous loading rate and maximum tibia acceleration) for runners at different foot progression angles were analyzed to explore the influence of foot progression angle on tibial shock. The changes in sagittal plane trunk angle, strike pattern, stride frequency and step width of runners under three gaits were also compared to explore its possible causes. Results Compared with normal gait, the maximum tibial acceleration of toe-in and toe-out gait was increased by 19.3% and 24.5%, impact peak was increased by 7.6%, average loading rate was increased by 7.9% and 9.5%, instantaneous loading rate was increased by 3.9% and 10-.9%, with significant statistic differences. No significant changes were found in sagittal plane trunk angle, strike pattern, stride frequency and step width. Conclusions Foot progression angle might be an another gait parameter which affected tibial shock during running in addition to other related known gait parameters such as sagittal plane trunk angle, strike pattern, stride frequency and step width，which would provide an important reference for prevention of tibial stress fracture.