[Objective]To compare the effects of continuous femoral nerve block(CFNB) and epidural analgesia(CEA) on rehabilitation after total knee arthroplasty(TKA) surgery. [Methods]Fifty patients undergoing unilateral TKA surgery were randomly divided into group CFNB(n=25) and group CEA(n=25).All patients were received unilateral spinal anesthesia with 0.5% dicaine and given analgesia with 0.2 % ropivacaine with 1ug/ml sufentanil.VAS pain scores during rest and continuous passive movement(CPM) at each time point was recorded.Other parameter such as the angle of initiative flections,blood loss at 6 h post operation,the concentration of serum hemoglobin at 24 h,48 h and side effect were recorded.[Results]The VAS pain scores during test had no significant difference between two groups.The VAS scores of CPM at 24 h and 48 h in group CFNB were obvious lower(3.68?0.93 and 3.93?0.78) than those in group CEA.The initiative flections were similar at 12 and 24 hours after operation.The concentration of hemoglobin at 6 h after operation was lower than that before operation.After reinfusion it was increased but did not reach the level before operation.The incidence of side effects was not noted in both groups.[Conclusion]After TKA surgery,the continuous femoral nerve block can provide better pain relief.No adverse impact on rehabilitation movement of operated legs or blood loss and has less side effect.Therefore,it should be considered an alternative analgesia method after TKA.

AIM:To investigate the influence of high-mobility group box 1 (HMGB1) on the proliferation of neural stem cells in peri-infarction cortex of focal cerebral ischemia/reperfusion model rats .METHODS: Male SD rats (n=48) were randomly divided into sham group , ischemia/reperfusion (I/R) group, RNA interference group and nega-tive interference group .The rat middle cerebral artery was blocked to establish focal cerebral I /R model ( ischemia for 1 h and reperfusion for 7 d).Lentivirus vector of HMGB1 shRNA was used to suppress the HMGB1 protein expression in the rat brain.The effect of RNA interference was evaluated by the methods of double-immunofluorescence labeling of HMGB 1/GFAP and Western blotting .The proliferation of neural stem cells in the peri-infarction cortex was assessed by double labe-ling of BrdU/nestin.RESULTS: The protein expression of HMGB1 in I/R group was much higher than those in sham group (P<0.05).RNA interference effectively inhibited the HMGB1 expression (P<0.05).Double labeled BrdU/nestin positive cells in I/R group were more than that in sham group (P<0.05).The double labeled BrdU/nestin positive cells were significantly decreased in RNA interference group (P<0.05).CONCLUSION:Focal cerebral ischemia/reperfusion injury promotes the proliferation of neural stem cells in peri-infarction cortex by increasing HMGB 1 protein level .

Objective To investigate the statistical.method for analyzing nurse job burnout Data. Methods Hotelling T2 test and multivariate analysis of variance(MANOVA)were used to analyze nurse job burnout datum. Results There was statistical significance between different cities,different ethnieities in the personal achievements,hut from three dimensions of the whole job burnout,there are no statistical sig-nificant differences among different cities, different ethnicities and different ages. Conclusions The use of Hotelling T2 test and multivariate analysis of variance to analyzing nurse job burnout data, not only ob-tain overall conclusion, and further use of single-variable analysis may also gain comparative results of each dimensions.

Objective To explore the expression and significance of CD44 gastric cancer stem cell biomarker positive circulating tumor cells (CTC ) in peripheral blood of patients with gastric cancer . Methods From March 2010 to December 2012 ,45 patients with gastric cancer and 20 healthy individuals were enrolled .Peripheral blood samples of all the subjects were collected .The expression of CTC and CD44 postive CTC were detected by density gradient centrifugation method and double immunofluorescent staining .Chi‐square test and t‐test were performed for statistical analysis .Results CTC in peripheral blood of healthy controls were not detected .Among 45 patients with gastric cancer ,CTC were detected in 27 patients and 19 of them were CD44‐positive .The difference in positive rate of CTC expression was statistically significant between two groups (χ2 =10 .986 , P<0 .05) .Among 27 CTC‐positive patients , 19 were proximal gastric cancer and 16 of them were CD44‐positive;16 patients had lymph node metastasis and 14 of them were CD44‐positive;13 patients had distant metastasis and 12 of them were CD44‐positive;14 patients had recurrence and 13 of them were CD44‐positive .The CD44 positive CTC was correlated with tumor location ,lymph node metastasis ,distant metastasis and recurrence (χ2=5 .891 ,5 .527 ,5 .787 and 7 .052 ,respectively ,all P<0 .05) .Furthermore ,in 13 patients with recurrence and CD44 positive CTC ,the recurrence time was (10 .54 ± 5 .55) months which was shorter than that of one patients with CD44 negative CTC (19 months) ,and the difference was statistically significant (t= -3 .654 , P=0 .004) .Conclusions CTC which express cancer stem cell marker may be associated with recurrence and metastasis of gastric cancer .It has more important clinical significance to detect this subtype of CTC .

Objective: To detect circulating tumor cells (CTCs) in patients with gastric cancer and evaluate the relationship among CTCs, clinico-pathological characteristics, and prognosis of gastric cancer. Methods: Peripheral blood samples (10 mL in EDTA) were obtained from 45 patients with gastric cancer. CTCs were detected using density-gradient centrifugation and immunofluo-rescence staining. The clinical significance of the two methods were also compared and investigated. Results:CTC-positive case was defined by the presence of at least one CK19 (+)-CTC per 10 mL of the sample. CTCs were found in 27 of the 45 patients with gastric cancer. The presence of CTCs was significantly correlated with lymph node metastasis, distant metastasis, and recurrence (P=0.007, 0.035, 0.035, respectively). However, CTCs were not significantly correlated with sex, age, tumor location, TNM staging, and tumor differentiation (P>0.05). Conclusion:CTCs were associated with poor prognosis of gastric cancer.

Objective To understand the prevalence and epidemiological features of clonorchiasis sinensis based on inpa-tients in Zhongshan City. Methods All of the 23 town hospitals in Zhongshan City were selected as the surveillance hospitals in 2016. Among the inpatients from those hospitals,those lived in the city longer than 6 months were selected as the surveillance subjects. The stool specimens of the subjects were collected and examined by the modified Kato-Katz thick smear method for the eggs of Clonorchis sinensis. The crude infection rates of C. sinensis of the subjects were standardized according to the age and sex compositions of the population in Zhongshan City,2016. Meanwhile,the infection rates of the subjects from different towns and those combined with related clinical diseases were analyzed. Results A total of 2667 people were included in the surveil-lance,among which 219 were tested as positives,with a crude infection rate of 8.21％. For the positives,the male accounted for 81.74％(179/219),and their age ranged from 4 to 89 years with the mean value of(62.20±13.80)years. After standardization by age and sex composition,the infection rate was 3.62％for the whole population,the rates of the male and the female were 5.46％and 1.53％,respectively,and the former was 3.57 times as high as the latter. Both the infection rates of the male and the female rose as the age increasing(χ2 male=99.91,χ2 female=16.51,both P<0.01). The standardized infection rates among the subjects in different towns ranged from 0 to 10.40％,and the rates in the north towns were higher than those in the south towns. The standardized rate was 9.22％for the subjects combined with gallstone,3.40％for those not combined with gallstone,and the former was 2.71 times as high as that of the latter. Conclusion The people aged 30 years and above,with gallstone or living in towns with high C. sinensis infection rates are the key population for prevention and control of clonorchiasis in Zhongshan City.

Objective To investigate clinical significance of Homer expression in peripheral blood leukocytes of patients with ischemic stroke (IS).Methods It was a retrospecive study.The gene expression levels of Homer were measured by RT-qPCR.266 patientscollected in Zhongnan Hospital from September 2015 to June 2016were divided into 5 groups:large-artery atherosclerosis (LAA,100 cases),cardioembolism (CE,42 cases),small vessel occlusion (SVO,68 cases),stroke of other demonstrated etiology (SOE,23 cases) and stroke of undemonstrated etiology (SUE,33 cases).Meanwhile,age and sex matched 126 healthy controls were also collected.IS diagnostic criteria for cerebral infarctionwas in accordance with the guideline for acute ischemic stroke in China in 2010.The levels of Homers in subgroups were compared by Oneway ANOVA.The area under curve (AUC) and 95％ confidence interval (CI) were calculated using ROC analyses.The odds ratio (OR) and 95％ CI were calculated using the multivariate logistic regression analyses.Results The levels of Homer1 [2.01 ± 0.15] and Homer2 [1.81 ± 0.31] in LAA patients were significantly higher than othergroups [Homer1 CE:2.40 ± 0.34;SVO:2.38 ± 0.35;SOE:2.36 + 0.33;SUE:2.40 ± 0.30;control group:2.35 ± 0.28;Homer2 CE:2.09 ± 0.38;SVO:2.08 ± 0.30;SOE:2.09 ± 0.41;SUE:2.10 ± 0.34;control group:2.12 ± 0.31] (Homer1 CE:t =9.353,P＜0.001;SVO:t =9.258,P＜0.001;SOE:t =5.396,P＜0.001;SUE:t=9.644,P＜0.001;control group:t =11.882,P＜0.001;Homer2 CE:t =4.725,P＜0.001;SVO:t =5.545,P＜0.001;SOE:t=3.640,P ＜ 0.001;SUE:t =4.669,P ＜ 0.001);There was no significant difference in the expression of Homer1 (F =0.940,P =0.441) and Homer2 (F =0.336,P =0.854) between non-LAA groupsand healthy controls.There was no significant difference in the expression of Homer3among the groups (F =0.641,P =0.669).Multinomial logistic regression analyses revealed that,higher Homerl (adjusted OR =8.62,95％ CI:4.13-18.00,P＜0.001) and Homer2 (adjusted OR=2.42,95％ CI:1.75-3.36,P ＜ 0.001) levels showed significant associations with increased odds of having LAA stroke,compared with the controls.ROC curves showed that the AUC of the combination of Homer1 and Homer2 for differentiating LAA and controls was 0.896 (95％ CI:0.862-0.929,P ＜0.001) and the AUCfor differentiating LAAand non-LAA was 0.847 (95％ CI:0.800-0.894,P ＜ 0.001).Conclusion The expression of Homer1 and Homer2 in peripheral blood leukocytes could be used as novel biomarkers for LAA stroke.

Objective To analyze the results of the Objective Structured Clinical Examination(OSCE) of medical interns in Department of Gynecology and Obstetrics,and to assess the role of OSCE in clinical teaching and practice. MethodsAtolal of 104 medical interns of five-year education program in 2002 and seven-year education program in 2003 in School of Medicine had taken part in OSCE of gynecology and obstetrics.The OSCE consisted of six stations: gynecologic examination,obstetric examination,oral test,interrogation of standardized-patients(SP),drawing partogram,and non-stress test(NST) explanation.After gathering the data of each station,the software of SPSS 11.0 was used to make statistical analysis. Results The median scores were as follows: 92.0 for gynecologic examination,91.0 for obstetric examination,83.5 for oral test,80.0 for interrogation of SP,80.0 for drawing partogram,and 70.0 for NST explanation.There was no significant impact of familiarity to OSCE on the results of the test.The results showed that medical interns did good job in basic performance,but lack of clinical practice skills in some complicated practice of gynecology and obstetrics.Conclusion The grading system and stations setup of OSCE in Department of Gynecology and Obstetrics in Shanghai Sixth People's Hospital show objectivity and equity.The OSCE can be widely applied in the after-department examination and even graduation examination.

Trichoderma harziaiarum plays a role of antagonic ability to pathogenic micr obes and of inducing plant to produce a resistivity of disease. In this paper, afte r the rice was sprinkled by zymolytic liquid of Trichoderma harziaiarum, the changes on the activities and isoenzymes of polyphenol oxidase (PPO) and pe roxidase (POD) were investigated. The results indicated that Trichoderma harz iarum could increase the activities of PPO and POD and produce new pattern of isoe nzymes; the different concentration of zymotic liquid had a different effects on the PPO and POD that were caused by the liquid; the 50 times diluted liquid had a greatly positive relation to the POD activity; and the higher concentration o f the liquid had a tendency that made the PPO activity inhibition and then incre ase, which denoted that the liquid took a scheduled adjustment play of the PPO a ctivity.

The muttagenic H-13 strain which was injected by ionic beam and screened from Trichoderma hamzlaiarum, can promote the growth of rice remarkably. In the experiment, we use zymolytic liquid of H-13 strain sprinkle on the seedling of rice, and determine nitrate reductase activity and N, P, K content. The results suggest that the effect of promoting plant growth of the strain has a relation to the enhance of nitrate reductase activity and the increase of N, P and K absorption.