BACKGROUND: Researches suggest that ginseng saponin (GS) has protective effect on central nerve, but the effect on spinal nerves is reported rarely.OBJECTIVE: To investigate the relationship between effect of GS on spinal nerve and level of nitrogen monoxide (NO) and its mechanism.DESIGN: Randomized controlled animal study.SETTING: Military Hyperbaric Oxygen Center of Navy General Hospital of Chinese PLA.MATERIALS: The experiment was completed at Clinical Anatomy Institute (National Key Laboratory) of the First Military Medical University of Chinese PLA in 2000. Forty SD foetus rats with 15-day conception were selected.METHODS: Study Ⅰ: Embryo-spinal nerve cells of SD rats were separated, extracted and modeled with DMEM/F12 culture medium. On the fourth day of inoculated culture, axon of spinal nerve (simulation of peripheral nerve injury) was damaged with scarification method in injury group, but that in non-injury group was not treated. 150 μL cell culture medium and 100 mg/L Griess solution were mixed at 0, 0.5 1, 1.5, 2, 2.5, and 3 hours after injury respectively. Absorbency (A) was assayed with Σ960 (λ=570 nm) enzyme-linked immunoadsordent assay (ELISA) symbolic device 10 min-utes after reaction at room temperature. Study Ⅱ: Embryo-spinal nerve cells of SD rats were separated and extracted. Those in the experimental group were treated with GS + DMEM/F12 culture medium, but with DMEM/F12 culture medium in the control group. A value was assayed with the same method.MAIN OUTCOME MEASURES:① Relationship between injury of spinal neurons and level of NO;② Relationship between protective effect of GS and level of NO.RESULTS:① Relationship between injury of spinal neurons and level of NO: In the injury group, NO secretion was increased after injury of spinal neurons, reached peak 2 hours later, and decreased 3 hours later. There was significant difference as compared 0.5 hour with 0 hour (P ＜ 0.01),and also there was significant difference as compared 2 hourswith 0 hour (P ＜ 0.01).② Relationship between protective effect of GS and level of NO: In the control group, A value was increased with time passing, reached peak 2 hours later, and decreased 3 hours later; but A value in the experimental group was not changed generally. There was significant difference between the two groups at 2-hour point (P ＜ 0.01).CONCLUSION: NO liberation is increased after peripheral nerve injury.GS can inhibit NO liberation so as to protect peripheral nerve.

Objective To analyze the related factors and the independent risk factors of death in patients with multiple injuries. Methods Data of 651 patients with multiple injuries treated in our hospital from June 2012 to June 2015 were retrospectively analyzed. According to the outcomes, patients were divided into effective group (n=608) and death group (n=43). Data of gender, age, cause of injury, the primary diseases related with the trauma, ISS score, number of trauma, time from injury to the treatment and the body parts of injury were compared between two groups. Logistic regression analysis was used to analyze the risk factors of death in multiple trauma patients. Results The proportion of patients≥60 years old, ISS score≥16 points, the number of trauma≥4, a major brain injury and time of trauma to the treatment ≥3 h were higher in death group than those of effective group (P<0.05). The independent risk factors for emergency death in multiple injuries included patients≥60 years old, major brain injury, ISS score ≥16 points and time of trauma to the treatment ≥ 3 h. The cause of death in patients with craniocerebral trauma (cerebral laceration) accounted for up to 27.91%(n=12), intracranial hematoma accounted for 20.93% (n=9), and traumatic hemothorax accounted for 11.63% (n=5). Conclusion The related factors and independent risk factors should be paid attention to doctors in emergency department, and the emergency plan should be made to reduce the death rate of emergency patients with multiple injuries.

Objective To Compare the postoperative recovery of continence after 3D and 2D laparoscopic radical prostatectomy.Methods A retrospective analysis of 72 patients underwent radical prostatectomy in our department from January 2013 to December 2015,including 38 cases underwent 3D laparoscopic radical prostatectomy,3D group's mean age was (64.2 ± 6.0)years,mean of preoperative PSA was (14.5±7.6)ng/ml,Gleason score (13 cases≤6,17 cases =7,8 cases ≥8),the mean prostate volume (41.4 ±9.1) ml,the classification of clinical stage in 3D group included 2 cases in cT1,26 cases in cT2,9 cases in cT3a,1 cases in cT3b,mean body mass index was (22.8 ± 2.2) kg/m2,mean of MUL (membranous urethral length) was (15.6 ±2.6) mm;34 cases in the 2D group,3D group's mean age was (61.9 ±6.6)years,mean of preoperative PSA was (16.7 ±6.8) ng/ml,Gleason score (10 cases≤6,18 cases =7,6 cases ≥8),the mean prostate volume (42.1 ± 10.6) ml,the classification of clinical stage in 3D group included 1 cases in cT1,28 cases in cT2,5 cases in cT3a,mean body mass index was (21.7 ± 1.9) kg/m2,mean of MUL(membranous urethral length) was (15.5 ± 2.5) mm.All patients got a good function of micturition and urinary continence before the surgery.We compared surgical time,bladder neckurethral anastomosis time and blood loss in two groups.Membranous urethral length(MUL) were measured on preoperative and postoperative magnetic resonance imaging (MRI).Postoperative continence rate was analyzed at 2 weeks,4 weeks,8 weeks,12 weeks,24 weeks and 36 weeks after the remove of the catheter.Results All the operations were completed successfully by the same surgeon and none was transferred to open surgery.The age,PSA value,Gleason score,prostate volume,TNM stage,BMI (body mass index)and other relevant aspects of the clinical data showed no significant difference (P ＞ 0.05).The time of bladder neck-urethral anastomosis is less than the 2D group [(12.9 ± 1.7) min and (15.7 ±2.6) min,P =0.021],MUL loss in the 3D laparoscopic surgery group is less than that of 2D laparoscopic [(0.5 ±0.1) ml vs.(0.6±0.2) ml,P =0.044],the two groups in operative time [(162.7 ± 17.1) min vs.(175.7 ± 15.7) min,P =0.802],intraoperative blood loss[(191.1 ± 31.6) ml vs.(211.8 ±43.2) ml,P =0.021],intraoperative blood transfusion rate [5.2％ (2/38) vs.8.8％ (3/34),P =0.662],postoperative incidence of urine leakage [7.9％ (3/38) vs.14.7％ (5/34),P =0.463],postoperative the MUL [(15.1 ± 2.6) mm vs.(15.0 ± 2.6) mm,P =0.767),there was no statistically significant differen.All patients were followed up for urinary function at least 36 months.The continence rate between two groups at 8 weeks (60.5％ vs.35.3％),12 weeks (73.7％ vs.47.1％) got significantly difference.Conclusions Compared with 2D laparoscopic,3D laparoscopic may help early postoperative recovery of urinary continence after laparoscopic radical prostatectomy.

Objective Coronary heart disease (CHD) is a multifactorial disease. This meta-analysis was performed to evaluate the relationship between angiotensinogen gene polymorphisms and CHD in the Chinese population. Methods We searched literature in pubmed (1990-2010.8) and CNKI (1990-2010.8) for all the relevant studies on 2 angiotensinogen polymorphisms (M235T and T174M) and risk of CHD. The meta-analysis software Stata 10.0 was used for ascertaining heterogeneity among individual studies and for combining all the studies. Furthermore,Egger's test and sensitivity analysis were performed to insure authenticity of the outcome.Results Ten associations studies on 2 angiotensinogen polymorphisms (M235T and T174M) were included in this meta-analysis. In a combined analysis, the summary per-allele odds ratio for CHD of the M235T polymorphism was 1.374 (95% confidence interval, 1.019 to 1.852) and T174M polymorphism was 4.089 (95% confidence interval, 1.697 to 9.851). Conclusions The M235T polymorphism had weak but statistically significant association with CHD while the T174M polymorphism was more strongly associated with a CHD risk in Chinese population, but further confirmation studies are needed.

Objective To assess the effect of ambient air SO2 on mortality of respiratory diseases. Methods Based on the ecological theory, after the adjustment of seasons, temperature, humidity and air pressure, the observed individuals were divided into eight groups. The association between SO2 exposure and mortality rate of respiratory diseases was analyzed using Poisson regression and local auto-regression method. Results SO2 concentration increased by 0.05 mg/m3, the mortality of respiratory diseases increased by 5.90% (95%CI: 2.26%-9.68%) in all groups, in children by 10.23% (95%CI: 2.07%-19.04%), in young-middle-male group by 1.10% (95%CI: -9.51%-12.96%), in young female group by 9.58% (95%CI: -2.57%-23.23%), in young group by 10.23% (95%CI: 2.07%-19.04%), in aged male group by 5.26%(95%CI: 0.01%-10.78%), in aged female group by 8.07% (95%CI: 3.45%-12.89%) and in aged group by 4.66% (95%CI: 1.44%-7.99%) respectively. Conclusion SO2 exposure is found to be associated with the increase of mortality of respiratory diseases, especially in children, aged people and elderly females.

Objective To evaluate the diagnostic value of multi-slice spiral CT urography(MSCTU)in pyelic and uretal disease.Methods 46 cases of pyelic and ureter disease with integrated clinical data were collected in two years,all cases were undergone multi-slice spiral CT contrast-enhanced scanning,the excretory-phase images were transferred to the workstation and shaded volume rendering(SVR),maximun intensity projection(MIP),multiplanar reconstruction(MPR)and curved planar reconstruction(CPR)were performed.Results In 46 cases,16 pyelic and ureteral calculus,12 congenital deformitions(including pelviureteric duplication malformations,retrocaval ureters,ureteropelvic junction stenosis,supern-umerary kidneys),5 inflammatory stenosis,7 primary pyelic and ureteral cancer,4 ureters were involved by bladder cancer and 2 compressive lesion were found.Conclusion MSCTU has obvious advantage in the diagnosis of pyelic and uretal disease.

Leptomeningeal metastasis (LM),with a high omission rate in diagnosis in approximately 5 ％～8 ％ of all patients, is increasingly recognized as a lethality complication. The diagnosis of LM remains challenges,but commonly can be established by CSF cytology or by definitive neuroimaging. Although a combination of focal radiotherapy,intrathecal chemotherapy,and systemic chemotherapy may be necessary to achieve optimal treatment of patients, but prognosis is unacceptable and therapy remains palliative in most patients.

In this paper, we review the ultrafiltration application in the preparation of Chinese medicine injections, suggesting that ultrafiltration process possesses some features: raising the clarity of Chinese medicine injection, removing impurity and pyrogen, retaining more active components and having partial decoloration. We also discuss some variant effect factors on ultrafiltration.

To evaluate the effect of problem-based learning (PBL) in internal medicine teaching for residency training of general medicine.Fifty two residents of general medicine were divided randomly into PBL teaching and traditional teaching groups with 26 in each.The evaluation was conducted in combination of examination scores and questionnaire survey in both groups.In questionnaire survey the residents of PBL group responded positively about the use of PBL in teaching, and rated themselves as having much better competencies in problem solving and self-directed learning.The scores of case analysis examination in PBL group were higher than those in traditional teaching group ( 73.7 ± 4.1 vs.71.1 ± 4.8, P ＜ 0.05 ).The results suggest that the application of PBL has better effect than traditional teaching in residency training of general medicine.

Objective To summarize the modernization of information demand of clinical teaching and management of nursing interns, evaluate the effect of development of the nursing intern teaching management information platform in the clinical effect. Methods Through literature retrieval, inductive method, on the basis of the needs analysis of nursing interns, clinical teachers, Nursing Education Center personnel a total of 41 people were divided into 5 groups with 5-7 people each. Brainstorming method was used to build the initial module and design the questionnaire and the interview outline. The clinical teaching teacher questionnaire was investigated in 101 part and in-depth interviews. Results The recovery of 100 valid questionnaires, the effective questionnaire 99.0%(100/101) and in-depth interviews with 15 excellent clinical teachers, the final 7 first level indices and 55 two level indices; finally running test platform development and 6 months, again the clinical teacher interviews, trial platform had a satisfactory result. Conclusion The nursing intern teaching management information platform is helpful to improve the teaching quality of nursing interns and management efficiency.