ObjectiveTo investigate the prevention and management of the hemorrhage during laparoscopic cholecystectomy( LC), and improve success ratio. MethodsThe medical data of 420 cases with LC from May 2003 to 2009, September were analyzed retrospectively, including total number, hemorrhage site and ways of prevention and management. Results417 cases experienced successful C,with success ratio 99.3%. 49 cases ( 11.7% ) had hemorrhage, and in 46 cases(93. 9% ), it was stopped by laparoscope or hemostasis by compression,3 cases were rescued by operation. All hemorrhage sites included 15 cases(30. 6% ) in triangle de Calot,26 cases(53. 1% ) in gallbladder bed, and 8 cases ( 16.3% ) in incision. ConclusionA reliable opetration and appropriate hemostasis are critical of the successful operation and prevention of complications after LC.

Objective To explore the effect of bone marrow stromal cells (BMSC) transferred by Nell-1 gene combined with biomaterial fibrin glue (FG) to enhance segmental bone defect healing in dog mandible. Methods Nell-1 gene vector was reconstructed in retroviral vector and then transfected BMSC. The protein of Nell-1 gene in transferred cells was determined by immunohistochemistry. Segmental defects were created surgically in the dog’s mandible. The defect was repaired with BMSC transfected by Nell-1 retroviral granules in presence of FG,untransfected BMSC in combination with FG,and FG alone. The control group was left untreated. The defect-repairing capability for each treatment were assessed by gross observation,radiography,and histology at 8th week and 16th week. Results Cells transfected by Nell-1 retroviral granules expressed abundant Nell-1 mRNA and protein in the cytoplasm. Positive results were not found in those cells that were not transferred. The use of BMSC transferred by Nell-1 retroviral granules combined with FG materials exhibited the strongest defect-repairing ability. Gross observation,radiographical and histomorphometric analyses revealed a significantly greater total area of bone formation,increased amount of the new bone in the defects than in those treated with the untransfected BMSC. Conclusion Nell-1 gene transfection may be used to promote the osteogenic ability of BMSC.

Objective: To investigate the effect of hypertension on the process of carotid atherosclerotic lesions in patients with type 2 diabetes mellitus using ultrasound techniques. Methods: A total of 203 consecutive type 2 diabetic patients with hypertension were enrolled into the study. The patients were grouped according to the increased systolic blood pressure for 5 mm Hg as an observation unit. The hemodynamic parameters of intracranial and extracranial arteries in each group were measured by using color Doppler flow imaging (CDFI) and transcranial Doppler ultrasound (TCD) to identify the extent of vascular lesions. The correlations of systolic and diastolic blood pressure, age, hypertension, duration of diabetes with the detection rate of common carotid intimal medial thickness (CCA-IMT), carotid and intracranial arterial stenosis were analyzed. Results: Circled digit oneThe CCA-IMT in 203 patients was 0.62-1.36 mm (mean 1.04 ± 0.14 mm). The detection rate of intracranial arterial stenosis was 52.7%, in which the detection rate of stenosis rate ≥ 50% was 21.2%; the detection rate of extracranial carotid artery stenosis was 28.1%, in which the detection rate of stenosis rate ≥ 50% was 14.8%. The total detection rate of intracranial arterial stenosis and the detection rate of stenosis rate ≥ 50% were higher than extracranial carotid artery, in which there were significant differences in total detection rate of stenosis (P < 0.01), and there were no significant differences in the detection rate of stenosis rate & 50% (P > 0.05). Circled digit twoMultiple stepwise regression analysis showed that there was a linear relationship between the CCA-IMT and systolic blood pressure and age. For each increase of 5 mm Hg in systolic blood pressure, the CCA-IMT would increase 0.015 mm; for each increase of 1 year of age, the CCA-IMT would increase 0.008 mm. Circled digit threeThe total detection rate of intracranial artery stenosis showed a linear relationship with age. For each increase of 1 year of age, the total detection rate of stenosis increased 2.8%; the detection rate of ≥ 50% stenosis showed a linear relationship with systolic blood pressure. For each increase of 5 mm Hg in systolic blood pressure, the detection rate of stenosis increased 2%. Conclusion: the CCA-IMT increases with the increased blood pressure in hypertensive patients with type 2 diabetes. The progression of intracranial arterial stenosis in patients with diabetes mellitus promoted by hypertension is more apparent than carotid artery.

Objective:To find out the existing pattern of HPV16 in tongue cancer cell and to analyze itsrole in carcinogenesis of tongue cancer. Methods :Southern blot hybridization was used to detect the HPV16sequence and its existing condition in 20 cases of fresh human tongue cancers. Results:HPV16 DNA se-quence in 5 cases of 20 tongue cancers was detected. And HPV16 DNA existed in tongue cancer cell in non-integration pattern. Conclusion:HPV16 was involved in carcinogenesis of tongue cancer through interactionof HPV gene products rather than its integration with genome of target cell.

Objective To investigate the effects of fracture displacement and operation method on perioperative blood loss of femoral neck fractures. Methods From December 2013 to October 2014, 130 cases (58 males and 72 females, aged from 18 to 91 years, with an average age of 71.1±12.9 years) with femoral neck fractures were retrospectively analyzed for the periopera?tive blood loss. The degree of displacement was described according to Garden's grades. According to the degree of fracture dis?placement, the patients were divided into two groups:GardenⅠ-Ⅱgroup and Garden Ⅲ-Ⅳgroup, and patients' preoperative hidden blood loss was compared between two groups. According to the degree of fracture displacement and the method of opera?tion, the patients were divided into four groups:Group 1 indicates the group in which patients received cannulated screws fixation for Garden gradeⅠ-Ⅱ;Group 2 in which patients received hemiarthroplasty for Garden gradeⅠ-Ⅱ;Group 3 in which patients received cannulated screws fixation for Garden grade Ⅲ-Ⅳ; Group 4 in which patients received hemiarthroplasty for Garden grade Ⅲ-Ⅳ; and variation in the following four parameters was analyzed: the dominant blood loss, postoperative hidden blood loss, total hidden blood loss, total blood loss in the four different groups. Results For the Garden gradeⅢ-Ⅳfemoral neck frac?ture group, the preoperative hidden blood loss was significantly higher than that of the Garden gradeⅠ-Ⅱfemoral neck fracture group (t=2.267, P=0.001). The dominant blood loss volume, postoperative hidden blood loss volume, total hidden blood loss vol?ume and total blood loss volume of hemiarthroplasty groups (402.1 ± 36.8 ml, 641.3 ± 53.2 ml, 880.7 ± 61.7 ml, 1 246.1 ± 76.7 ml) were higher than those of the cannulated screws fixation group (45.8±34.9 ml, 301.9±50.6 ml, 436.6±58.6 ml, 478.5±72.9 ml). Conclusion The perioperative hidden blood loss is mainly related with the degree of fracture displacement, the greater the de?gree of fracture displacement, the more the preoperative hidden blood loss. While the dominant blood loss volume, postoperative hidden blood loss volume, total hidden blood loss volume and total blood loss volume are mainly related to the method of operation, the blood loss in which patients received hemiarthroplasty should be increased significantly.

With the development of internet technology, medical education is facing great challenge based on diversified-development information features. Our study discussed the experience of applying website, WeChat and so on to inspire the teaching interaction. By this way, it not only en-riches the content of course but also reforms the teaching method which makes the teaching form more flexible and interesting. Moreover, we prospect the advantage of the new information-based products in the endocrinology course. Through the above discussion, we think using internet technology reasonably can not only break the traditional teaching modes of endocrine, but also play a positive role in promot-ing the reform of endocrine teaching.

Traditional recombination technology of bacteria chromosome and its limitation were introduced. The definition of Red recombination technology is put forward: a method of homologous recombination between foreign linear DNA and the target gene in chromosomes mediated by ? phage Red system. The linear DNA referred here is general PCR product or oligonucleotide, which has a 36~50bp homologous sequence with the target gene in chromosome at both flanking. Red recombination technology leaves out the in vitro DNA restriction enzyme digestion and link process, which makes the knockout and alternation of target gene in bacteria chromosome relatively easier, and becomes an effective method to exploring genes and constructing new strains gradually. The gene inactivation and alternation method aiming at bacteria chromosome applied to Red recombination system was summarized by the structure element, action mechanism, and strategy of recombination, advantage and developing prospect. The Red system includes three genes: bet (aka?), exo and gam (aka ?). Exo is a 5′→3′ exonuclease, which degrades the 5′ ends of linear DNA molecules. Bet is a single-stranded DNA binding protein that binds to the single stranded 3′ ends generated by Exo and promotes annealing to complementary DNA. Gam binds to the host RecBCD complex and inhibits its exonuclease activity. Red recombination system may be constructed in such plasmids as pKD20 and pKD46 or in chromosome of bacteria. Most bacteria are not readily transformable with linear DNA because of the presence of intracellular exonucleases that degrade linear DNA. But when bacteria cells are transformed with pKD20 or pKD46 plasmid, or integrated with a detective ? prophage, Red recombination enzymes may be expressed in host cells, which make linear DNA with 36~50bp extensions that are homologous to both flanking of target genes transform E.coli readily and knock-out or alternate target gene. The Red recombination method is not only useful in chromosomal gene inactivation in E.coli, but also in other bacteria or virus, such as Salmonella, Shigella flexneri and virus HaSNPV. With the proceeding research, Red system will be applied for more and more purposes, and contribute a lot for gene improvement and gene function investigation in the coming Postgenome Era.

This article elaborated the connotation and characteristics of research-oriented hospital as well as its inner connection with the development of key disciplines , based on the system dynamics model data analysis of the National TCM Clinical Research Base . It gave suggestions in increasing discipline input , strengthening personnel training , and improving achievement output to research-oriented hospital construction in order to promote the construction of research-oriented hospitals .

This article took the research work of 16 national clinical research base construction units as its background in order to dig the connotation of health service efficiency . Through data envelopment analysis , a comprehensive exposition was given on the inputs and outputs relation of medical and health service efficiency in order to propose appropriate policy recommendations. The study was guided by the scientific development concept in order to gradually improve the efficiency of health services and achieve a comprehensive , coordinat-ed and sustainable development of the hospital .

OBJECTIVETo investigate the changes of the cardiac hemodynamics after acute high altitude exposure in healthy young males and the relationship with acute mountain sickness(AMS).

METHODSLeft ventricular function and oxyhemoglobin saturation (SaO2), heart rate (HR), blood pressure (BP) were measured in 218 healthy young males before and after high altitude exposure within 24 h respectively. According to the lake louise score criteria, the subjects were divided into two groups: acute mountain sickness group (AMS group) and non acute mountain sickness group (non-AMS group).

RESULTSHR, diastolic blood pressure (DBP), mean arterial pressure (MAP), left ventricular ejection fraction (LVEF), stroke volume (SV), stroke index (SI) cardiac output (CO), cardiac index (CI) were significantly increased upon acute high altitude exposure (P < 0.05). Whereas SaO2 and end-systolic volume (ESV) were significantly decreased (P < 0.05). In addition, HR, systolic blood pressure (SBP) and MAP in AMS group were significantly higher than those in non-AMS group (P < 0.05). But stroke index (SI) and end-diastolic volume (EDV) in AMS group were significantly lower than those in non-AMS group (P < 0.05).

CONCLUSIONCardiac function in healthy young males upon acute high altitude exposure was enhanced. EDV, HR and SI might become the indexes of predicting the acute mountain sickness in the future.