Objective To study the expression of matrix metalloproteinase(MMP) in chronic obstructive pulmonary disease (COPD) and its clinical significance. Methods 36 Wistar rats were randomly divided into three groups : the normal group (A), the model group (B) and the medicine treatment group (C). Rats in group B and C were passively smoked for 75 days to establish COPD model. Group B were administered Vit A 15 mg/ kg before smoking. 75 days later,the rats were killed. Group A were killed 25 days after equal volume of saline was dripped in trachea. The pathological changes of lung tissue were observed in each group. The expression of MMP was determined by immunohistochemistry and ELISA. Result The enzymatic activity and the expression of MMP-2 and MMP-9 were reciprocally different as compared among the tree groups(P <0.01). Conclusion MMP expression is increased in impaired lung tissues of COPD rats.

Objective To summarize and analyze the results of our university graduates' participation in the national medical licensing examination in order to investigate the clinical medical teaching reform.Methods There were 770 candidates who took the NMLE from 2011 to 2013.Excel 2007 was used to statistically analyze the total score,passing rate,average score and mastery rate for each subject,and average score and mastery rate at different cognitive level.Results In these three years,our candidates' total pass rate was higher than the national average total pass rate,respectively higher 17.11％,18.10％,17.82％;the pass rate of practical skills examination was also higher than the national average pass rate,respectively higher 7.30％ and 7.19％ and 5.90％;the pass rate of theory examination was higher than the national average pass rate,respectively higher 12.91％,12.97％ and 14.29％.The average score and mastery rate for each subject,the average score and mastery rate at different cognitive level were also all higher than those of the national average of medical colleges.Conclusions National medical licensure examination can be used as an important reference,through optimization of medical curriculum and teaching mode,optimization of clinical practice skills training system and optimization of clinical practical skill evaluation system etc.,to further improve the clinical medical personnel training mode.

Objective To compare the clinical effects of treating cervical prolapse of intervertebral disc by using Solis cage, titanium cage and autogenous iliac crest graft (AICG) combined with titanium plate. Methods 64 cases of cervical prolapse of intervertebral disc were analyzed retrospectively. All the patients were followed up for about one year. Group A is composed of 20 patients (30 intervertebral spaces) treated with microdiscectomy and Solis cage fusion;group B is composed of 21 patients(22 intervertebral spaces) treated with titanium cage and group C is involved of 23patients(28 intervertebral spaces) which were dealt with AICG combined with titanium plate. The differences in the to-tal X ray exposure time, time working on iliac bone, incidence of complications, fusion rate, incidence of JOA score recovery rate more than 50 % and rehabilitation time of the three groups are analyzed. Results All indexes from group A and B were more satisfactory than those from group C (P＜0. 05). The statistic analysis results of the incidence of complications of cervical part, rehabilitation time in group A are 5.0± 1.8, 5.1 ± 1.2; and that is 14.3±2.6, 7.5 ± 1.6and 26.1±6.2, 8.6±2.3 in group B and group C respectively. There is significant difference between group A and group B on the incidence of complications of cervical part and rehabilitation time (P＜0.05). Results of the incidence of JOA score recovery rate ＞ 50 % in group A(95.8 ± 3.2) was more satisfactory than that in group B(93.6 ± 2.9),while there was no statistical difference between group A and group B (P＞0.05). Conclusion The Solis cage is better in treating the cervical prolapse of intervertebral disc than other ways. Also, it makes the operation easier, rehabilitation time shorter, and it causes fewer complications.

Objective To evaluate the result of manipulative reduction and percutaneous cannulated screws fixation for the triplane fracture of the distal tibia in children. Methods From September 2004 to March 2009, 15 cases of triplane fracture of the distal tibia were treated with manipulative reduction and percutaneous cannulated screws fixation. This study included 9 boys with an average age of 13.2 years (range, 12-14 years) and 6 girls with an average age of 12.4 years (range, 11-14 years). Preoperative diagnoses were confirmed by the X-ray films or CT examination. If plain radiographs showed the fracture gap of epiphysis board and articular surface were greater than 2 mm after closed reduction, the operation was needed. Under "C"-arm X-ray machine, anatomical reduction was achieved by manipulative reduction according to the bone fracture type. The fractures were fixed by percutaneous cannulated screw. Postoperative CT scanning confirmed anatomical reduction. All patients had been immobilized with cast for 8 weeks. The ankle joint function and growth were evaluated by modified Weber protocol. Results All patients were followed up for 15 to 68 months with an average of 26 months. There were excellent in 13 cases, good in 2 cases. X-ray films showed all fractures were healed. There were not bone bridge and uneven articular surface, or rotating and shortening deformity. All patients could participate in the normal physical activities. The 2 cases with good outcome were related to weight-bearing too early. The main problem was that pain occurred in ankle joint with excess activity. Conclusion The method of manipulative reduction and percutaneous cannulated screw fixation is relatively reliable treatment for closed triplane fractures of the distal tibia.

Objective To investigate the influence of clinical results of early low frequency training for acute Achilles tendon rupture after anchors repair.Methods A total of 35 patients with acute Achilles tendon rupture were treated with early low frequency training after anchors repair,including 28 males and 7 females.Aged 18 to 37 years, mean 26 years old.Duration 2h to 5d from injury to therapy.All patients palpated the discontinuity of Achilles tendon, limitative activity of ankle plantar flexion,Thompson test was positive,and MRI examination was taken.Results 35 patients were followed up for 12 to 18 months,with an average follow -up of 14.5 months.According to the Amer-Lindholm score,excellent in 30 cases,good in 5 cases,the good rate was 100%.All the wounds were healed, without infection,dehiscence,sural nerve injury and re -rupture occurred.Conclusion Early low frequency training after anchors repair for acute Achilles tendon rupture is safe and reliable,patients can receive a better functional outcome.

Adolescent ; Adult ; Aged ; Antigens, CD ; biosynthesis ; Brain Neoplasms ; blood supply ; metabolism ; pathology ; Child ; Endoglin ; Female ; Glioma ; blood supply ; metabolism ; pathology ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit ; biosynthesis ; Immunohistochemistry ; Male ; Middle Aged ; Neovascularization, Pathologic ; metabolism ; pathology ; Receptors, Cell Surface ; biosynthesis ; Telomerase ; biosynthesis ; Young Adult

Air Pollutants ; toxicity ; China ; epidemiology ; Hospitals, Public ; Humans ; Patient Admission ; Respiratory Tract Diseases ; etiology ; physiopathology ; Temperature ; Weather

Drug abuse continues to be a serious public health threat worldwide. Most drug abuse prevention research has been conducted with predominantly American or European adolescent populations. Little is known about approaches that work best to prevent the initiation of Chinese adolescent drug use. For targeting risk factors of drug initiation in Chinese adolescents, a school-based health intervention program named "Cognition-Motivation-Emotional Intelligence-Resistance Skills" (CMER) was developed to enhance cognition upon drug use, to decrease motivation of drug use and to improve emotional adjusting and drug resistance skills in this study. A total of 798 students from 3 senior high schools in Wuhan, a city in central China, were assigned randomly to intervention and control groups. The intervention group received the CMER program in which knowledge, development of positive attitude and motivation towards drugs and training of peer resistance skills were basic elements. The immediate impact was compared by measuring the above mentioned elements prior to and three-month after the training session. Students from both groups were asked to complete a self-administered questionnaire. The questionnaire included demographic items, self-reported drug use behavior, cognition, attitude, and motivation associated with the initiation of drug use and resistance skills. Three months after the intervention, significant effects were found on "illegal substance use at least once" (P<0.05) between the intervention and control groups. Immediate effects of the intervention were also found on knowledge, motivation and peer resistance skills (P<0.05), but there was no clear evidence for any effects on attitude towards substance use (P>0.05). It was concluded that the CMER program, which significantly increased the knowledge of drugs and peer resistance skills, was effective in the drug abuse prevention in a sample of school students in Wuhan, China.

Objective:To investigate the whole genome characteristics of coxsackievirus A4 (CVA4) circulating in Qingdao city.Methods:Four CVA4 isolates circulating in Qingdao city during 2013 to 2015 were selected. Whole genome sequences of these strains were amplified by one-step reverse transcription-polymerase chain reaction (RT-PCR). Sequence alignment and phylogenetic analysis were performed using MEGA7.0 software package. Genetic recombination analysis was performed using similarity plots 3.5.1 software package.Results:Phylogenetic analysis showed that based on the sequences of the whole genome and P1, P2 and P3 regions, HS312/QD/CHN/2013 and HS605/QD/CHN/2014 strains together with the early domestic isolates belonged to the same clade, while FY218/QD/CHN/2015 strain and CV-A4/P1033/2013/China strain collected in Wenzhou in 2013 formed another clade in each phylogenetic tree. HS144/QD/CHN/2014 strain belonged to the same clade as HS312/QD/CHN/2014, HS605/QD/CHN/2014 and the early domestic CVA4 isolates in the phylogenetic tree based on the P1 region, but formed a separate clade in the phylogenetic trees based on the whole genome, P2 region and P3 region. Genetic recombination analysis revealed that there was genetic recombination between HS144/QD/CHN/2014 strain and the CVA2 strain of CV-A2/P373/2013/China isolated in mainland China in 2013 in the region of 2C-3D (5 081-7 301); FY218/QD/CHN/2015 and CV-A4/P1033/2013/China strains were highly homologous and recombination signal sequences were detected in the region of 2A-2B (3 821-4 161) between the two strains and the CVA2 strain of CV-A2/P373/2013/China.Conclusions:The CVA4 isolates circulating in Qingdao city presented obvious genetic diversity at the genome-wide level.

Objective To evaluate the success rate, safety and efficacy of endoscopic retrograde cholangiopancreatography (ERCP) after Billroth Ⅱ gastrectomy. Methods Data of 75 patients with biliary disease after Billroth Ⅱ gastrectomy, who underwent ERCP from January 2007 to November 2009, were retrospectively analyzed. Results In 75 patients, afferent loop intubation was achieved in 69 (92%) and selective cannulation of bile duct were successful in 68 (68/69, 98. 5%). Diagnostic procedures were carried out in 3 patients, and therapeutic in 65 others, which included EST plus stone removal and ENBD in 16, ERBD in 19, EMBE in 18 and EBD plus stone removal and ENBD in 12. Afferent loop perforation occurred in 1 patient (1.3%) and was treated surgically, and 2 acute pancreatitis (2. 6%) were treated conservatively.There was no complication of bleeding. Conclusion ERCP after Billroth Ⅱ gastrectomy is safe and efficiency for biliary disease.