ObjectiveTo evaluate the influence of different surgical technique on the pup and　adult rats after the rupture of upper trunk and middle trunk so as to find the best way of surgical therapy.MethodsFrom January 2010 to June of 2010, forty-eight Sprague-Dawley male rats were divided into two　groups of 24 each, i.e., pup groups at the age of 7 days postnatal (P7)and one adult (3 months old)group.After C5-7 injured,each group was subdivided into three equally:group A (repair C5-7),B(repair C5,6),and C (no reinnervation performed).In the 3rd month postoperatively,the following tests were performed to estimate the recovery of each group:(1)Compared the rate of carpoptosis of each group.(2)Compared the regenerated nerve traversing rate of the radial nerve in each group.(3)HE stain to compared the cross-sectional area recovery rate.(4)The MyoD1 and Myogenin of the affected extensor of forearm were measured by Western blot.Results(1) The ethology test:there were no carpoptosis in group of adult A and pup A; the carpoptosis rate of pup B and pup C were higher than that of adult A(P ＜ 0.05) ;the carpoptosis rate of pup A was lower than that of B and C(P ＜ 0.05); there was no difference between carpoptosis rate of adult A and B,but they were both lower than C(P ＜ 0.05).(2) Histological test of radial nerves:The percentage of myelinated both higher than C (P ＜ 0.05).(3) Western blot:The protein level of MyoD1 and Myogenin in radial nerve fiber in experimental side of pup A,B and C descended progressively (P ＜ 0.05).There was no difference between adult A and B,but they were both higher than C (P ＜ 0.05).(4) Histological test of the extensor digitorium:There was no difference between cross-sectional area recovery rate of adult A and B,but they were pup A,B and C increased progressively (P ＜ 0.05).There was no difference between protein level of MyoD1 and Myogenin in adult A and B,but they were both lower than C (P ＜ 0.05),ConclusionIn adult rats, there is no difference between the recovery of wrist extensor of the two surgical procedure after the C5-7 injured. The restoration of C5-7 but not C5,6 can do more good to the recovery of wrist extensor in pup rats.It's important to repaire the C7 by nerve graft after injury of C5-7 in newborn.

Objective To compare the clinical effectiveness of incision-thread-drawing procedure and incision and drainage procedure in the treatment of perianal abscess.Methods Clinical data collected from 110 patients with perianal abscess were retrospectively analyzed.Forty-six cases were treated with incision-thread-drawing procedure(therapy group) and 64 with incision and drainage procedure(control group).Results Recurrence rate and incidence of anal fistula were 4%(2/46) and 4%(2/46) in therapy group,respectively,significantly lower than those in control group(19% and 23%,P

Objective To investigate the efficacy of the clinical pathway in geriatric orthope-dics clinical teaching. Methods From March 2010 to December 2011, 80 clinical undergraduates, who practiced in the Department of Orthopedics in the Second Affiliated Hospital of Chongqing Medi-cal University, were equally randomized divided into two groups. One group was taught by the con-ventional methods and the other group was taught by the clinical pathway teaching. After the teaching, the theoretical exam and operational skill test were performed among students in both groups. SPSS 17.0 software was employed and the scores before and after the teaching and scores between two groups was analyzed by paired t-test(inspection level α=0.05). Results There was no significant difference in average scores between two groups before teaching(theoretical exam: P=0.81, operating skill test:P=0.65) while significant increases were observed in scores of theoretical exam and operational skill test after teaching (theoretical exam and operating skill test: P<0.05) and clinical pathway teaching group had higher scores than conventional teaching group (theoretical exam and operating skill test:P=0.02 and P=0.01). Conclusions Better effects can be achieved by clinical pathway approach re-garding geriatric orthopedics teaching.

ObjectiveTo explore the effects of the serum of traditional Chinese medicine Nao Yi An on glutamate induced cell death in cultured hippocampal neurons of rat and the underlying mechanisms. MethodsHippocampal neurons were cultured. The excitatory amino acid induced toxicity on cultured neurons was investigated. The viability of injured neurons was determined with the measurement of Lactate dehydrogenase (LDH) activity. Mitogen activated protein kinase (MAPK) were determined by immunoprecipitation /kinase assays /western blot detection.ResultsThe serum of Nao Yi-An raised cell viability. The serum of Nao Yi-An upregulated the expression of extracellular regulated protein kinases(ERK) and downregulated the expression of c-Jun N terminal kinase/stress activited protein kinase(JNK) in cultured neurons. The serum of Nao Yi-An induced upregulation of ERK and its anti death action were prevented with the specific ERKs inhibitor PD98059. Conclusions Activation of ERK signaling together with inhibition of JNK signaling by Chinese medicine Nao Yi-An appears to be an important mechanism for its survival effects on cultured hippocampal neurons.

Objective To evaluate the value of bypass graft in the treatment of critical lower limb ischemia with distal single outflow artery.Methods Forty-nine lower limbs in 42 patients with single outflow artery were collected and underwent arterial bypass graft.The operation methods included femoropopliteal artificial graft to single outflow artery with autograftand popliteal artery to calf vessel and so on.The results were analyzed finally.Results All of 42 patients,postoperative grafts occlusion occured in 1 case,the occlusion rate was 2.4％(1/42) and the success rate was 97.6％(41/42),1 case died of respiratory failure 4 d postoperatively,the mortality was 2.4％(1/42).The patency rate of graft was 100.0％(41/41) on discharge.Healing rate of foot ulcer was 33.3％ (11/33).Conclusions It's difficult to reconstruct blood flow for critical ischemic limb with single outflow artery,but good result is still expected by distal lower limb bypass graft.Distal bypass can provide a better nutritional support for the healing of foot ulcer and result in a lower limb salvage or lowering of amputation level.

Objective To study the effects on inhibit tumor growth and enhance immune function of Ganoderma lucidum polysaccharide(GLP)combined with low-dose cisplatin in tumor-bearing mice.Methods 2 × 106 Lewis cells in 0.1 mL PBS were injected subcutaneously into the flanks of healthy female BALB/c nude mice (5～6 weeks old).When the tumor volume reached 100 mm3,mice were randomly assigned to 4 groups,control group (Oral gavage of 0.5 ml PBS and intraperitoneal injection of 0.5 ml),GLP group (gavage once every two days,40 mg/kg GLP in 0.5 ml),cisplatin group (intraperitoneal injection once every two days,2 mg/kg cisplatin in 0.5 ml) and the combination group (such as the above dose of cisplatin and GLP).After the treatment regimen was complete,the mice were sacrificed,and the tumors were removed,photographed,weighed,and prepared for histological analysis.The immune cells in spleen and peripheral blood were analyzed by flow cytometry.Results GLP can effectively increase anti-tumor effect of the small dose cisplatin,improve the survival of tumor-bearing mice,promote Th cells convert to Th1 in peripheral blood,increased the expression of CD 11c + on DC cell surface (GLP group 4.59％ VS the control group 1.06％,the combined group 7.21％ VS the cisplatin group 2.8％).Conclusion GLP can improve the immune function of tumor-bearing mice,had synergistic anti-tumor growth with low dose cisplatin,moreover,reduce renal toxic effects of cisplatin.

Objective To investigate the clinical characteristic,diagnosis and treatment of familial adenomatous polyposis (FAP).Methods According to family history of the proband,we surveyed the pedigree and retrospectively analyzed the clinical characteristics of 10 FAP patients in 3 generations of the family.Result Among all 10 cases,3 died of colorectal cancer including two of whom had history of intestinal obstruction.Seven people of the third generation were all diagnosed as FAP.Among them,only 2 patients had clinical symptoms.Colonoscopy was done in all 7 patients before 35 years old.However,none of them had polyps or evidence of cancer.Surgical operation was performed on 1 patient and high frequency electric cutting under endoscopy was performed on 6 patients.Conclusions The early clinical manifestations of FAP are nonspecific.Pedigree investigation and colonoscopy screening for high-risk population are important to find early asymptomatic FAP patients.

Objective To investigate the prevalence and the transmission of oqxAB gene in clinical strains of Escherichia coli and Klebsiella pneumoniae .Methods Nonduplicate clinical isolates of E.coli (n=72)and K .pneumoniae (n=49)were col-lected.The oqxAB gene was amplified by PCR.The product was sequenced.Plasmid conjugation experiments were done in oqxAB-positive E.coli and K.pneumoniae strains to detemine whether oqxAB gene is located in plasmid.The MICs and mu-tant prevention concentrations (MPCs)for ciprofloxacin were determined in transconjugants with oqxAB gene by agar dilution method.Results The oqxA,oqxB and oqxAB were identified in 15,4,and 7 of the 72 strains of Escherichia coli and 4,1,and 34 of the 49 strains of K.pneumoniae,respectively.The oqxAB gene was positive in 2 (2/16)ciprofloxacin sensitive and 5 (5/56)ciprofloxacin resistant E.coli strains,in 8 (8/14)ciprofloxacin sensitive and 26 (26/35)ciprofloxacin resistant K. pneumoniae strains,respectively.The E.coli and K.pneumoniae strains with or without oqxAB did not show different sus-ceptibility to ciprofloxacin.The oqxA and oqxB sequences from E.coli and K.pneumoniae showed 99% similarity to the se-quences of GeneBank accession number AB601773.1 and accession number FJ975561.1,respectively.The oqxAB gene was successfully transferred in 4 of the 5 oqxAB-positive E.coli strains.The MIC of ciprofloxacin was 0.25-0.5 mg/L against the transconjugants,31-62 times higher than the MICs for the recipient strains.The MPC of ciprofloxacin was 8-16 mg/L against the transconjugants,32 times higher than that for recipient strain J53.The oqxAB gene were not transferred in K. pneumoniae. When the MIC of ciprofloxacin was ≤0.062 5 mg/L,the MPC of ciprofloxacin was 0.25-0.5 mg/L for K.pneumoniae strains with or without oqxAB.When MIC was 0.25-0.5 mg/L,the MPC of ciprofloxacin was 2-16 mg/L for K .pneumoniae strains with or without oqxAB .Conclusions oqxAB gene is present in E .coli and K .pneumoni-ae .The oqxAB gene spreads through plasmid in E .coli.The nonsiginificant difference of oqxAB prevalence between ciproflox-acin sensitive and ciprofloxacin resistant strains indicates that oqxAB gene may mediate low level resistance to ciprofloxacin in E.coli.The E.coli transconjugants of oqxAB gene can produce high level resistance under the selection pressure of ciproflox-acin.The high level resistance in K .pneumoniae under selection pressure of ciprofloxacin is not associated with oqxAB gene, but related to the ciprofloxacin MIC against these strains.

Hospital entrustment will incur cultural conflicts,which calls for cultural integration as the best means to ease such frictions and conflicts between two hospitals of cultural difference.Renmin Hospital of Wuhan University (Hubei general hospital)directly hosted Hanchuan people's hospital,and implemented the president responsibility system under the leadership of the management committee.By means of cultural integration to reshape Hanchuan hospital culture,Hubei general hospital has rebuilt the latter's culture.Such reshaping features the following:development as the core,scientific management as the breakthrough,employees as the center,technology upgrade as the basis,and patients service as the direction.Cultural integration has furthered development of the hospital entrusted,and turned frictions and conflicts into infiltration and integration.As a result,Hanchuan hospital is upgraded in general in terms of management and service quality.

Objective To study the expression of vimentin in the tongue mucosa carcinogenesis and to explore its significance in the invasion and metastasis of tongue squamous cell carcinoma .Methods The occurrence of tongue squamous cell carcinoma in rat was induced by means of 4NQO water solution ,and 56 cases in total were collected in the cancerous process ,including normal tongue mucosa ,epithelial hyperplasia ,mild dysplasia ,moderate dysplasia ,severe dysplasia and the tongue tissue specimen of squa‐mous cell carcinoma .The immunohistochemistry was used to evaluate protein expression and real‐time fluorescent quantitative PCR method was used to obtain the expression quantity of mRNA .Results In immunohistochemistry ,with the increase of degree of rat tongue mucosa dysplasia ,the positive rate of vimentin expression increases obviously .The difference between groups was statistical‐ly significant (χ2 =10 .685 ,P<0 .05) .Lesion groups compared with normal group ,their mRNA expression differences all hold sta‐tistical significance(P<0 .05);Mild dysplasia ,moderate dysplasia ,severe dysplasia and squamous cell carcinoma groups were com‐pared with epithelial hyperplasia group .The difference between squamous cell carcinoma group and epithelial hyperplasia group was statistically significant (P<0 .05) .mRNA expression of epithelial hyperplasia ,mild dysplasia ,moderate dysplasia and severe dys‐plasia were respectively 1 .22 times ,1 .28 times ,1 .29 times and 1 .42 times of that of the normal group .Conclusion During rat tongue carcinogenesis induced by 4NQO ,the expression of vimentin was increased with the increase of the degree of pathological change ,which is closely related to the invasion of tumor and could be regarded as a predictor of tongue squamous cell carcinoma .