Using the average technique of the electronic computer, we recorded the somatosensory evoked Potentials (SEPs) by electrical stimulation of median nerve (MN) and posterior tibial nerve (PTN) in twenty-three normal subjects and twenty-five diabetic patients. The peak latencies of SEPs components were prolonged, and the afferent conduction velocities of MN and PTN were reduced in most patients. In some patients, the central conduction time (N13-N20 and P40-N80 conduction time) was prolonged. Besides, there was a significant change in the shape of triphasal potentials recorded from Erb's point.and popliteal fossa. These results suggest: there not only was abnormality of conductive function of peripheralnerves, but also, the conductive function of central nervous system might be involved in diabetes mellitus.

OBJECTIVE:To investigate the relationship between the perioperative application of antibiotics in caesarean opera-tion and neonatal hyperbilirubinemia,and to provide reference for reducing the incidence of neonatal hyperbilirubinemia. METH-ODS:264 cases of cesarean section women were randomly divided into control group and observation group,with 132 cases in each group. Control group was given antibiotics after operation,and observation group was given prophylactic application of antibi-otics before operation,and equivalent dose of intravenous injection after operation. Postoperative maximum and average tempera-ture,white blood cell(WBC),neutrophils(NEUT),complications and economic index were compared between 2 groups after op-eration. RESULTS:There was no statistically significant difference in postoperative maximum and average temperature,WBC count,NEUT proportion,wound infection and fever rate between 2 groups (P>0.05). The costs of medication,drug dosage per capita,hospital stay and the incidence of neonatal hyperbilirubinemia in observation group were significantly lower than in control group,with statistical significance (P<0.05). CONCLUSIONS:The perioperative standard use of antibiotics in caesarean opera-tion could effectively reduce the incidence of postoperative neonatal hyperbilirubinemia and hospitalization cost,and cut down treat-ment time. It also has a high economic value and worthy of promotion.

Objective To investigate the role of DRP1 and OPA1 in the process of apoptotic in hyperoxia induced lung injury of premature rats .Methods 48 premature Wistar rats were divided into control group in which rats were exposed tO 210 ml .L 1 oxy-en ,and hyperoxia group in which Rats were exposed to 950 mL .L 1 oxyen .The lung tissues of 2 groups were gained on the first day ,the second day and the seventh day with which that all mice were killed by cutting neck .Section of lungs were stained with hea-toxylin eosin to observe the pathological changes ,the protein expression in the lung cells which were linked with the change of plas-tosome ,then the premature rat lung tissue apoptosis in each group were evaluated .Results Compored with the contnx group ,the expression level of OPA1 in the hyperoxia group began to decrease on the first day and apparently decreased to the buttom line on the seventh day .On the other hand ,DRP1 in hyperoxia group began to increase on the first day ,while reached the summit on the seventh day .A few of TUNEL positive cells began to increase with time dependence .A lot of TUNEL positive cells could be found in hyperoxia group ,and the apoptotic index reached the peak on the 7 d .There is a significantly positive correlation between the cell apoptosis and the ratio change of DRP1 and OPA1 in high oxygen group(r=0 .725 ,P<0 .01) .Conclusion The classical pathologic characters of lung injury were found out in hyperoxia group ,and it changed obviously with time .

Objective To construct the evaluation index system of medical education for clinical departments in grade-three hospitals.Methods Questionnaire were answered by the clinical experts,medical education directors and VP for education in the grade-three hospitals.According to the principle of Delphi method,the survey included the basic situation of experts,the relative importance of each index and the degree of expert authority.SPSS 16.0 was used to analyze the data.Results The questionnaire recovery rate was 90％,with authority of the average value 0.88,and coordination coefficient 0.348.The coordination coefficient was tested by chi square test,P=0.000.Five first level indexes by the authoritative coefficient after correction (residency training,postgraduate education,academic education,continuing medical education,teaching for refresher doctors) of the weighted value (％) were 22、22、22、19 and 15 respectively.Conclusion The experts in this study represent strong and high enthusiasm and authority.After practical application,the index system is supposed to have practical application value.

The fetal inlfammatory response syndrome (FIRS) is a subclinical condition characterized by systemic acti-vation of the fetal innate immune system with a large number of pro-inlfammatory cytokines released. FIRS is the fetal coun-terpart of the systemic inlfammatory response syndrome (SIRS) described in adults. Intrauterine infection is the most common reason of FIRS. FIRS has been implicated as a cause of preterm labor, preterm white matter injury, bronchopulmonary dyspla-sia (BPD) and necrotizing enterocolitis (NEC).

Objective To evaluate mid-term clinical effects of laparoscopic intraperitoneal onlay mesh herniorrhaphy (IPOM) for adult inguinal hernia. Methods A retrospective analysis was made on 546 cases of inguinal hernia treated by IPOM (603 sides) between June 2002 to December 2004. We closed the hernia sac by the lift-insert method following with the implantation of the Prolene mesh with the help of a stapler. Results The operation was successfully completed in all the cases, except for 2 cases of conversions to open surgery because of difficulties in covering the defects. There were no intraoperative complications, and 5 cases of postoperative seroma which subsided after physical therapy. The operative time was 25~40 min (mean, 31 min), and the hospital stay was 36~72 h (mean, 46 h). Follow-up observations for 18~48 months (mean, 28 months) found 6 cases of recurrence, with the recurrence time at 30~45 months (mean,38.2 months). The racurrence rate was 0.995%. Conclusions Laparoscopic intraperitoneal onlay mesh herniorrhaphy a minimally invasive method with reliable outcomes, low recurrence rate, and rapid recovery.

The indirect pathway of the somatic afferent elements from trigeminal nerve (TGN) to nucleus tractus solitarii (NTS) was studied with the light and electron microscopic HRP transganglionic and retrograde tracing. After HRP was injected into NTS at the level of obex, the retrogradely labeled cells were mainly found in the interstitial nucleus buried in the spinal tract of TGN along caudal subnucleus. The interstitial nucleus was also the terminating area of the primary afferent fibers of lingual and inferior orbital nerves. Under electron microscope, it was found that the primary afferent terminals of lingual and inferior orbital nerves formed synapses on the dendrites of neurons in the interstitial nucleus. Moreover, in cellular architecture, the interstitial nucleus and the superficial laminae of the caudal nucleus of TGN were similar and continuous with each other. Hence, the pathway from the TGN to NTS via the interstitial nucleus is consisted of two neurons and the sensations transmitted through this pathway may be considered to be somatic. It is presumed that this pathway composed of two neurons might modulate the visceral afferent function in NTS when certain points in the skin area innervated by TGN were acupunctured.

Objective To explore the effect of transabdominal preperitoneal prosthetic(TAPP) repair combined with intraperitoneal onlay mesh(IPOM) on laparoscopic repair of inguinal hernia.Methods From January to December 2006,laparoscopic hernioplasty was performed on 30 adult patients with inguinal hernia.The hernia area was divided into two parts by the subperitoneal vessel across the area.The medial part was repaired by TAPP using polypropylene patch,and the lateral part was repaired by IPOM with Proceed patch.During to operation,an incision was made on the peritoneum along the subperitoneal vessel,and then the peritoneum was separated medially to expose an operative area(7.5 cm?6.5 cm),which was an avascular area with loose connective tissues and few vital nerves.Results All the operations were accomplished under epidural anesthesia.The operative time was 30-40 min(mean 35 min) for unilateral hernia,and 50-60 min(mean 55 min) for bilateral ones.The amount of blood loss during the operation was 1-5 ml.The patients could walk on the second day after the operation.They were discharged from the hospital 3-4 days after the operation,and were back to work in 2 weeks.During a 2-12-month follow-up(mean,9 months),no adhesive intestinal obstruction and local or systemic complications was observed.Conclusions The combined technique of IPOM and TAPP is a minimal invasive method with confirmed efficacy.By using this easily mastered method,the operative time is reduced,and the patients can recover quickly.

Objective: To study the effects of group counseling on depression and anxiety of patients with schizophrenia in their rehabilitation.Methods: Eighty patients with schizophrenia in rehabilitation stage were randomly divided into research group and control group. In research group, the patients received group counseling in addition to conventional medications. Before and after the counseling, their anxiety and depression were assessed by self-rating scale SAS and SDS. Results:The research group decreased much more in anxiety and depression than control (SAS:research group from 43.6?7.7 to 4.34?6.43, control from 44.0?6.2 to 41.8?5.6;SDS:research group from 44.2?6.8 to 36.3?7.2, control from 44.0?6.7 to 41.2?6.7, t=19.9、16.2,P

Ovarian neoplasms,composed predominantly or exclusively of small round cells with scant cytoplasm,is relatively rare.However,there is a wide range of differentiation,and pathologists often struggle to make a correct diagnosis because of its overlapping histological features.Perhaps the best known neoplasm of this kind is ovarian small cell carcinoma of the hypercalcemic type,which may be confused with a wide range of neoplasm from sex cord-stromal tumor to neoplasm in the family of small round blue cell tumor to various undifferentiated malignancies.Small cell carcinoma of the pulmonary type may also arise from the ovary,and this may be a component of a typical ovarian surface epithelial-stromal tumor.Other small cell neoplasm that may arise within the ovary or involve the ovary includes intra-abdominal desmoplastic small round cell tumor,metastatic small cell carcinoma,peripheral primitive neuroectodermal tumor,and endometrial stromal sarcoma.In this review,the morphologic features of some of these neoplasms are described,as well the value of immunohistochemistry and other ancillary techniques in establishing a diagnosis.