Objective To investigate the effect of PDCA circulation method in training of neonatal resuscitation from asphyxia.Methods Fifty medical staff in the department of pediatrics were trained on neonatal resuscitation from asphyxia with the PDCA circulation method.The performances in the examination after training were compared with those before training.Result The performances in the post-training examination were significantly better than that in the pre-training examination(P<0.01). Conclusion PDCA circulation method used for the training of neonatal resuscitation from asphyxia is effective in improving the theoretical knowledge as well as the practical manipulation.

Objective To study the correlation between ?-fibrinogen gene variation (-455G/A) and plasma fibrinogen level and cerebral infarction.Methods 86 hypertension patients with cerebral infarction(infarction group),85 hypertension patients without cerebral infarction(hypertension group) and 90 healthy people(control group) were enrolled in this trial. The polymorphism of ?-fibrinogen gene-455G/A located at the start of transcription from all subjects was analyzed by polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP) technique. Plasma fibrinogen level was measured with prothrombin time (PT) assay.Results The fibrinogen level in infarction group(4.82?0.26 g/L) was significantly higher than that in control group(4.37?0.19 g/L)( P 0.05).The A-455 allele frequency in infarction group was significantly higher than those in control group and hypertension group (all P 0.05). Conclusion Plasma fibrinogen level is affected by the ?-fibrinogen gene -455G/A polymorphism. The fibrinogen A-455 allele may be an independent risk factor of cerebral infarction.

10?m cytochalasin D (CD) was used to treat cardiocytes from adult human atrium and adult rat atrium and ventricle in long-term primary cultures. Durations of treatment were 0.5, 1, 6, 12, 24 and 48h. In some cultures, the medium containing CD was removed at the planned time to be replaced with the medium without CD.These dishes were then cultured for an additional 48h. Control cultures were exposed to dimethyl sulfoxide (DMSO), the vehicle used to dissolve CD. All cultured cells were first stained with rhodamine-labelled phalloidin to show F-actin and then stained with fluoreseein-labelled antitubulin to show microtubles. The freshly isolated and rounded cardiocytes did not respond to CD, while the spreading cells responded apparently. The actin filament bundles in the peripheral zone of spreading cells were cut into segments. Most segments were gathered into aggregates and granules. Some aggregates were lodged on the inner aspect of the sarcolemma. Small vacuoles were seen between the myofibrils or somewhere along the course of the myofibrils. The CD response from the atrial spreading cells, especially the human atrial spreading cells, were more obvious than that from the rat ventricular cells. Cells exposed to CD and then cultured in normal medium for 48h did not return to normal. Microtubules were not directly affected by CD, but in places where vacuolization occured they made way for vacuoles. All the control cultures made no response to DMSO. The above-mentioned results suggest that different sensitivity to CD existed in cultured adult cardiocytes between different species and that a difference also existed in the contractile machinery between the atrial culturing cells and ventricular cultureing cells of the same species.

Objective To evaluate the outcomes of distraction osteogenesis with mini external fixation in management of metacarpophalangeal bone defects after hand trauma.Methods From June 2010 to December 2015,16 patients with metacarpophalangeal bone defects after hand trauma received distraction osteogenesis at our department.They were 11 men and 5 women,from 20 to 45 years of age (average,32.5 years).There were altogether 20 bone defects:8 cases had single metacarpal bone defect,2 unilateral second and third metacarpal bone defects and 6 phalangeal shortening after repair of digital stump (involving thumb in 4 cases,index finger in one and index and middle fingers in one).The metacarpophalangeal bone defects averaged 1.8 cm (from 1.0 to 3.1 cm).Under the fluoroscopic guide,4 or 6 mini half-pins in one line were directly drilled into the dorsal aspect of the involved metacarpophalangeal bone before the Orthofix fixator was mounted.The proximal (18 digits) or distal (2 digits) osteotomy between the second and third pinholes was performed via the dorsal approach,The external fixator and pins were removed without anesthesia after callus maturation.Results Average follow-up period was 12.2 months (range,from 9 to 26 months).All the metacarpal bone defects were reconstructed and all the phalangeal shortenings were lengthened;the bony callus was completely calcified at the lengthened part.The mean lengthening was 1.9 cm (from 1.0 to 3.1 cm);the percentage of lengthening ranged from 26％ to 51％ (average,34％).The bone lengthening index (time cost by average 1 cm) was 70.9 d/cm (from 60.0 to 87.1 d/cm).According to the Tentative Assessment Criteria for Upper Extremity Function by Hand Surgery Society,Chinese Medical Association,the total activity of motion (TAM) was excellent in 13 cases,good in 4,fair in 2,and poor in one,yielding an excellent to good rate of 85.0％.Conclusion Distraction lengthening using mini external fixation is a valid option with a minor rate of complications which allows for early functional exercise to help restore the appearance and function of the affected fingers.

Objective To assess the efficacy and pathological change of fertility-sparing treatment with progestin for endometrial carcinoma (EC) of stage Ⅰ a and complex atypical hyperplasia (CAH) and to observe the prognosis of the treatment.Methods Nine EC patients of stage Ⅰ a and 21 CAH patients aged under 40 years who desired childbearing and retaining their fertility were enrolled into this study.All patients were given a daily oral high-dose of progestin with duration of treatment ranging from 6 to 9 months.Diagnostic curettage was performed every 3 months as a modality for seeing the histologic change of neoplastic tissues and endometrial tissue.A careful and long-term follow-up is necessary for patients with complete response (CR).Results During the first period of fertility-sparing management,according to histologic change,5 EC patients and 18 CAH patients showed CR with no evidence of endometrial adenocarcinoma or hyperplasia,2 EC patients and 2 CAH patients showed partial response with a regression to complex or simple hyperplasia without atypia,2 EC patients and 1 CAH patient showed stable disease or progressive disease.Accordingly,a total of 26 patients showed CR (26 of 30 patients).The median time to CR was 6 months (range,3 to 21 months) of progestin treatment.The median follow-up time was 55.5 months (range,24 to 104 months) and all patients were alive.During follow-up,among the 26 patients with CR,3 of 6 EC patients achieved CR recurred disease after a median time interval of 10 months (range,6 to 51 months),7 of 20 CAH patients achieved CR had recurrent disease after a median time interval of 12 months (range,6 to 55 months).Four of 7 CAH with recurrent disease achieved CR to progestin retreatment.Eight of 26 patients achieved CR continued a further 3 or 6 months of consolidation therapy,3 of them had recurrent disease,the remaining 18 stopped progesterone treatment after CR and 7 patients had recurrent disease; there was no significant statistical difference between the two groups (P=1.000).EC patients succeeded in 4 pregnancies,CAH patients succeeded in 10 pregnancies,they gave birth to 16 healthy babies in all.Conclusions EC of stage Ⅰ a and CAH had slow progression of symptoms.Progestin treatment in EC of stage Ⅰ a and CAH patients was effective.A careful and long-term follow-up is required because of the substantial high rate of recurrence.Progestin re-treatment in most patients with recurrent endometrial cancer is effective and safe.

AIM To study the protective and mechanism of Tfa (total flavone of the flowers of Abelmoschl Manihot L. Medic). METHODS The rats were injected Iso and then the T wave movement value observed. The rats anterior descenging bracnch of left artery were occluded for 48 hours the results of CPK, LDH and disscoate fatty acid of serum and infarct area of myocardium observed. RESULTS Tfa 100,200 mg?kg -1 ,ip depressed the T wave rise by injection of Iso in rats. Tfa 100 mg?kg -1 ?d -1 ?3,ip inhibited the serum CPK and LDH disscoate fatty acid in myocardium induced by coronary artery occluded in rats;also markedly depressed the infarct area in myocardial infarct rats. Tfa 0 03 mg?kg -1 ?d -1 ?3,ip obviously reduced the MDA contents,increased SOD and GSHPx activities in the mitochondria in mice. CONCLUSION Tfa shows a protective effect against myocardial injury. The mechanism may be via against oxygen free radicals and lipid peroxidation,also stabilize the mitochondria function.

Teaching of medical ethics is important in making up intems'diathesis.Recognition of the relatinship between doctor and patient is an important way for promoting their socialization and specialization since it is the basic relationship which interns face during clinical practising.Only by properly dealingwith the relationship can interns take to strengthen medical ethics study and culture medical moral consciously.

Objective To detect the changes of cell proliferation and IFN-γsusceptibility of human pancreatic can-cer cells after suppressor of cytokine signaling-1 (SOCS1) gene silencing, and to explore the SOCS1 as the target of anti-tu-mor therapy through enhancing the function of IFN-γ. Methods Western blot assay, PCR and real-time PCR were used to verify the down regulation of SOCS1 in human pancreatic cancer cell (PANC1) after transfection;subsequently, PANC1 was stimulated with IFN-γ. Western blot assay was also used to detect the expression of signal transducers and activators of tran-scription (STAT)1 and phosphorylation STAT(pSTAT)1;and the change of IFN-γsusceptibility was detected by MTT assay. Real-time PCR was used to detect the mRNA of interferon regulatory factor-1(IRF-1). Flow cytometry was used to detect the cell cycle. Results The expression levels of SOCS1 mRNA and protein were significantly decreased in small hairpin SCOS1 (shSOCS1) transfected PANC1 cells. After the silence of SOCS1, the expression levels of IRF-1 and pSTAT1 in-creased significantly (P<0.05), and the median inhibitory concentration(IC50)of IFN-γfor PANC1 cells decreased signifi-cantly (P<0.01). The cell count of shSOCS1 cells dropped significantly compared with that of control group after the SOCS1 silencing for 72 hours (P<0.05). The cell cycle arrest was promoted at the G0/G1 phase, but the percentage of cells in S phase and G2/M decreased compared to that of control groups (P<0.05). Conclusion After the inhibition of SOCS1 gene expression, the proliferation ability of human pancreatic cancer cell line PANC1 decreased, and the sensitivity of PANC1 cells to IFN-γwas enhanced.