Objective To explore the chronic effect of low levels of 2,3,7,8-tetrachlorodibenzo-p-dioxin(TCDD) exposure on the protein expression profile in the serum of rats and to get the further understanding of the molecular mechanism of TCDD toxicity.Methods Thirty-two male SD rats were randomly divided into three TCDD exposed groups treated with TCDD at the doses of 875,350 and 140 ng /kg by gavage,once a week,for 29 consecutive weeks respectively and one control group treated with single corn oil.The proteins in the serum were separated and analyzed by two-dimensional gel electrophoresis and mass spectrometry,the histopathological examination of livers was performed at the same time.Results TCDD induced significant fatty degeneration and necrosis in the livers.Several interesting volume-altered protein spots were identified.Among these proteins,Bal-647 was down-regulated,apolipoprotein E was up-regulated by TCDD and fetuin-like protein was only expressed in the group of 875 ng/kg.Conclusion The differentially expressed proteins may contribute to a better understanding of the toxicity induced by TCDD and may be used as the biomarkers of effect for TCDD exposure.

Objective:To explore the clinical value of PUFA in the treatment of cancer cachexia,meta-analysis and systematic evaluation of literature was applied.Methods:According to the inclusion criteria,PubMed/MEDLINE,EMBASE and the Cochrane Central Register of Controlled TriMs for randomized controlled trims that compared PUFA treatments with placebo or no treatment in cancer cachexia were searched.Outcomes of interest were effects on weight,appetite,the level of CRP and IL-6,the composition of lean body mass and the quality of life.Results:Finally,16 articles were included in the analysis,which reported appetite (6 papers),C-reactive protein (9 papers),IL-6 (5 papers),lean tissue weight (7 papers) and quality of life assessment (7 papers),respectively.Conclusion:PUFAs for the treatment of cancer cachexia plays an irreplaceable role.The body weight,appetite,inflammation index and quality of life can be significantly improved,and the patients can tolerated the addition of PUFA during the treatment.

Objective To compare the clinical outcomes of modified and traditional posterior lumbar interbody fusion (PLIF) in treatment of lumbar spinal stenosis.Methods A retrospective review was made on 47 patients who sustained monosegmental L4.5 stenosis due to lumbar degenerative revise and characterized by typical intermittent claudication and single or both limb numbness and pain.The patients were randomly allocated to Group A and Group B using the lottery method.Group A (n =24) consisted of 10 males and 14 females at mean age of 52 years (range,47-66 years) and the course of disease averaged 13 months (range,9-23 months).Group B (n =23) contained 8 males and 15 females at mean age of 53 years (range,49-67 years) and the course of disease averaged 11.5 months (range,6-22months).Modified PLIF including spinous process replantation combined with canal H-shaped bone grafting for posterior column reconstruction and interbody fusion was performed in Group A.Traditional PLIF,namely posterior spinal decompression and interbody fusion,was performed in Group B.Waist function rehabilitation after surgery of the patients in the two groups was assessed using the Oswestry disability index (ODI) and postoperative results were analyzed.Results There were no significant differences between Groups A and B regarding the operation time [(1 90 ± 15.66) min vs (170 ± 11.32) min] and intraoperative blood loss [(980 ± 35.58) ml vs (879 ± 21.25) ml] (P ＞ 0.05).Mean period of follow-up was 20 months (range,12-28 months).Postoperative results in Group A were graded as excellent in 19cases,good in three,fair in two and poor in zero,with excellence rate of 88％.While in Group B,the results were excellent in 13 cases,good in four,fair in four and poor in two,with excellence rate of 74％(P ＜ 0.05).ODI score and symptom improvement rate after operation were better in Group A than in Group B (P ＜ 0.05).Conclusion The modified PLIF including spinous process replantation combined with canal H-shaped bone grafting for posterior column reconstruction is relatively an ideal surgical technique for treatment of lumbar spinal stenosis and deserves wide promotion.

ObjectiveTo investigate the feasibility of preventing tendon adhesion by using bFGF/ vitamin C composite biodegradable membrane.MethodsSixty Newzerland rabbits were divided into experimental and control groups randomly.After the animal model was established, the tendon autografts were encapsulated with the bFGF/vitamin C composite biodegradable membrane in experimental group, while no tendon autografts encapsulation in control.Three weeks after surgery, regular HE staining and AgNO3 staining were performed to observe the fibroblast nuclei and vitamin C.The quantity of collagen fibrils was measured by Luzex-F Image Analyzer.Eight weeks after surgery, the peritendinous adhesion and the maximum tensile load were analyzed.Results At 3 weeks after surgery, the numbers of vitamin C granules, fibroblast nuclei and collagen fibrils in the experimental group were significantly more than those in the control group(t = 11.78 ,P ＜0.001) .At 8 weeks after surgery, the peritendinous adhesion in the experimental group was significantly slighter than that in the control group(Z =3.922,P ＜0.005) ,and the maximum tensile load in the experimental group was significantly higher than that in the control group (t = 8.39, P ＜ 0.001) .ConclusionbFGF/vitamin C composite biodegradable membrane can stimulate the proliferation of fibroblasts and synthesis of collagen fibrils,improve the biomechanical property of tendon autografts and prevent the tendon adhesion.

The principal investigator responsibility system has been progressively under implementation at some of the domestic medical universities. However, since there are big differences between military medical universities and civilian ones in terms of organizational structures, tasks to be committed, functions and personnel systems, military medical universities have to consider own characteristics and well handle the following four pairs of relations in the process of implementing principal investigator responsibility system: the relation between the subject groups and the teaching and research sections, the relation between the subject research and the discipline construction, the relation between the subject research and the personnel training, and the relation between the collective assessment and the individual assessment in the process of performance assessment.

Objective To explore the methods and clinical effects of dimple plasty with syringe needle guiding.Methods From February 2008 to May 2012,36 dimple plasties in 21 patients were performed with using a syringe needle guiding the absorbable suture,including 15 cases in bilateral side and 6 cases in unilateral side.There were 4 cases in unilaterally right side and 2 cases in unilaterally left side.Two patients with inborn dimple in unilateral side received the dimple plasty in the other side for facial symmetry.Results 34 dimples in 21 patients were satisfied with the results.Two dimples were re-operated after three months because of disappearance.There were scleromas in 2 cases,which was disappeared by hot compress in three months.There were no hemotoma and infection in 21 patients.Conclusions The procedure of dimple plasty under syringe neddle guiding is safe,reusable and effective.It is a minimally invasive surgery and the patients are satisfied with the dynamic results after operation.

Objective To explore the effect of secondary brain injury(SBI) in high-risk factors and brain malignant encephaiocele during surgical operation for severe traumatic brain injury. Methods Carried on the grouping graduation to 112 patients with severe traumatic brain injury according to SBI's high-risk factors:non-high-risk factors group (pure group) 23 cases, high-risk factors group (SBI group) 89 cases, 1 level of high-risk factors group had 27 cases, 2 level of high-risk factors group had 28 cases, 3 level of high-risk factors group had 34 cases. Results Carried on the comprehensive therapy regarding the above patients, the brain malignant encephalocele rate in the SBI group and the pure group was 59.55% (53/89) and 13.04%(3/23) respectively, there was significant statistics differences in the two groups,1 level and 2 level of high-risk factors group of brain malignant encephalocele rate was 40.74% (11/27) and 53.57% (15/28) respectively, the difference was not obvious statistics significance, 2 level and 3 level of high-risk factors group of brain malignant eneephalocele rate was 53.57%(15/28) and 79.41%(27/34) respectively, the difference was obvious statistics significance. Conclusions The SBI's high-risk factors are the important factors affecting severe craniocerebral injury encephalocele. Taking adequate pre-operative assessment, carrying a comprehensive treatment on the patients combine with high-risk factors of SBI can greatly reduced the incidence of brain malignant encephalocele during surgical operation if the high-risk factors of SBI is controlled.

Objective To analyze the clinical effects of arthroscopic en masse repair with footprint ending shift using double-row suture-bridge technique for delaminated rotator cuff tears under tension.Methods A total of 58 patients with delaminated rotator cuff tears under tension from August 2013 to August 2016 who underwent arthroscopic en masse repair using doublerow suture-bridge technique were retrospectively analyzed.There were 33 males and 25 females with a mean age of 53.0±7.8 years (range 39-74) with 24 patients left side involved and 34 right side.They were divided into 2 groups to receive en masse repair either footprint ending shift or on the footprint.There were 28 patients with footprint ending shift and 30 patients on the footprint.Clinical effects were evaluated by University of California Los Angeles (UCLA) score,American Shoulder and Elbow Surgeons (ASES) score,visual analogue scale (VAS),Constant-Murley score and shoulder range of motion at preoperatively and postoperatively.Results The average follow-up duration was 23.2±0.8 months (range 21-24).The two groups were compatible with no significant difference in age,gender,tear size,follow-up duration,preoperative function and range of motion of the shoulder joint (P＞0.05).At the last follow up,the UCLA,ASES,VAS,Constant-Murley scores and shoulder range of motion in the group footprint ending shift were respectively 32.4±2.5,12.8±0.9,1.0±1.1,93.4±5.6,158.3°±9.3°,58.9°±5.0° with significantly differences compared with preoperative scores (P ＜ 0.05).The postoperative value in the group on footprint were respectively 31.6±2.9,12.8±0.9,0.7 ± 1.2,91.3±7.1,156.1°± 10.7°,59.6°±4.6° with significantly differences compared with the preoperative scores (P ＜ 0.05).There were no significant difference between the two groups (P ＞ 0.05).The operation duration in the group footprint ending shift was 100.9±6.0 min,while that in the group on footprint was 106.6±6.1 min.There was significantly difference in the operation duration between two groups (t=-3.600,P=0.001).Conclusion Arthroscopic en masse repair using double-row suture-bridge technique can successfully treat delaminated rotator cuff tears under tension.Compared with arthroscopic en masse repair on footprint using double-row suture-bridge technique,the footprint ending shift is easier and time saving without significant difference in function of the shoulder joint and the range of motion in repair of delaminated rotator cuff tear under tension.

Objective The multiple malformation of upper eyelid,including the excessive width of fold line,sunken and/or multiple folded upper eyelid are the common complications after blepharoplasty.The aim of this study was to investigate the clinical effect of orbital septum fat redistribution on correcting these deformities.Methods From September 2015 to September 2017,38 patients with multiple malformations of upper eyelid were treated.The incision of upper eyelid and the excessive skin was designed and resected.After completely relieving the scar adhesion zones,we set the lateral orbital septum fat free and transposed it to the inner side of orbital septum or superior border of tarsus with suturing fixation.Then we routinely completed the double eyelid operation.Results Thirty-eight patients with multiple malformations of upper eyelid were treated successfully.The patients were followed up for 6 months to one year,and the results were totally satisfactory.The operation was not performed again.Conclusions The orbital septum fat redistribution can successfully correct the multi ple malformation of upper eyelid.It should become a regular procedure in blepharoplasty.

Objective: To analyze the heart rate changes and risk factors, as a result of high altitude. Methods: Retrospective analysis of echocardiographic data of plateau workers at a railway maintenance company from 2006 to 2013. The survival curve method was used to analyze the abnormal rate of the heart. Kaplan-Meier method and Cox proportional hazards regression model were used to analyze the influencing factors. Results: In the first occurrence of cardiac abnormalities, the main types of abnormalities were right atrium enlargement (53.47%) , right ventricle enlargement (17.36%) , and tricuspid regurgitation (16.67%) . Cox regression analysis showed that workplace altitude and first physical examination age are two influencing factors of cardiac abnormalities, and their relative risk was 1.661 and 1.039. At high altitudes (3 600~4 000 m) , nearly 40% of workers heart has not changed. But this adaptation does not observed in the ultra-high altitudes (≥4 000 m) . Conclusion There are individual differences in human adaptability to high altitude. We should take more stringent measures of health care for older people and those who work at more than 4000m. And we should abide by the rotation system for railways that are suitable for the plateau.