[Objective]To study Bone microdmage to osteoavascular epiphysis caput humeralis in teenagers of the guts outbreak mechanism and make a diagnosis and give treatment in early stage important point.[Method]The review was from 138 patients of the shoulder department ache with shoulder joint movable function obstacle that orthopedics out-patient service of 2004~2005.There was X-rays / CT,the blood bio-chemical 5 example among the teenager of the patients,it was observed by medium short-term curative effect.We was combined a related cultural heritage study,put forward to make a diagnosis and gave treatment to have the instruction meaning to the clinic of four expect to categorize a method,and to early,medium,later period the non-surgical operation treatment observation.[Result]In 138 patients,there were 5 teenager patients who were the epiphysis of head humeralis bone microdamage ON,through the function instauration was normal:Earlier period 2 cases of 1~4 weeks,middle period 2 cases of 5~8 weeks,the later period 1 case of 4~6 months.We choose the medicine of prescription with the independence,"Huo xue hua yu","Bu shen zhuanggu","Tong luo zhi tong" medicinal broth,the right amount internal use outside use,having already obtained good result.We have already observated the serious bone arthritis/canceration,resulting in serious result(in another report).[Conclusion]Once or more shoulder was bone microdamage lead the caput epiphysis humeralis occurrence ON of guts.We observe the sufferer whom had the clinical symptom,physical sign,according to the clinical performance,course of disease's long/short,imageology atc.The suggestion is divided into early,medium,night and most late four periods,for the convenience of the choice treatment measure.Because of various reason,long and non-healing cases might develop to the most later period of case,such as the avascular osteo arthritis/canceration.

Objective To compare gene expression profiles among hepatocellular carcinomas(HCC),cirrhotic liver tissue and normal liver and to analyze their biological information.Methods Total RNA was isolated from hepatocellular carcinomas,cirrhotic liver tissue and normal liver respectively,purified into mRNA by oligotex,and reverse-transcribed to synthetize two kinds of fluorescences(Cy3-dUTP,Cy5-dUTP) labeled cDNA probes.The targets were mixed together and hybridized with the genes on the genechip containing 4096 genes.The following comparisons were performed: hepatocellular carcinomas versus normal liver,cirrhotic liver versus normal liver.Genes that were differentially expressed between these groups were identified based on signal-to-noise ratios by using GenePix Pro3.0 software.Results 141 genes were found with close relation to HCCs,some of these genes were related to cell cycle and signal transduction,such as MCM7,YWHAH,among these,there are 23 genes whose expression tendency consistent with that of cirrhotic liver's.When compared with normal liver,there were 2 genes belong to metallothionein family downregulated in HCCs but upregulated in cirrhotic liver.Conclusion The inactivation of anticancer genes,the abnormality of metabolism related genes and the activation of cell proliferation cycle related genes may have a vital role in HCC.Research into these genes systematically may help to explore new markers of early diagnosisand to guide treatment proposal and to evaluate prognosis better.2007.27(1)

BACKGROUND: Neonatal hypoxic ischemic encephalopahty(NHIE) is a common neonatal disease, which could cause cerebral palsy, inferior intelligence and convulsion. At present, usual examinations for this disease are CT.MRI and single photon emission computed tomography(SPECT), etc.OBJECTIVE: To investigate the character of SPECT image of NHIE, and compared with CT and MRI as well to provide a theoretical gist for function surveillance and early intervention of NHIE.DESIGN: An observatory comparative study based on NHIE patients and normal neouates as control.SETTING: Department of nuclear medicine in a medical university hospital.PARTICIPANTS: Thirty neonates hospitalized in the Department of Pediatrics, Affiliated Hospital of Jining Medical College between September 1998 and October 2000 were selected as observation group with 23 males and 7 females. Another 10 normal neonates including 7 males and 3 females were randomly selected from same period into control group.METHODS: SPECT brain blood perfusion was conducted in the subjects of two groups and the results were compared with that of CT and MRI.MAIN OUTCOME MEASURES: ① comparison of SPECT brain blood image features between NHIE and normal neonates; ② comparison of SPECT images and CT, MRI results. RESULTS: In 22 NHIE cases who received SPECT, CT and MRI simultaneously, mild group had 7 cases, and positive cases of SPECT, CT or MRI was 7, 3 or 5; moderate group had 10 cases, and positive cases of three methods was 10, 8 or 9; severe group had 5 cases, the all of them were positive in all three examinations. The total positive detectable rate of SPECT, CT or MRI was 100, 72.73% or 86. 36%. There was no significant difference of sensitivity between SPECT and MRI in mild group, while there was significant difference between SPECT and CT(x2 = 3.95, P ＜ 0.05);there was no significant difference among three methods in either moderate group or severe group(x2 =0. 83, P ＞ 0.05).CONCLUSION: SPECT brain blood perfusion image is a quite sensitive method for the surveillance of NHIE, which can provide imageological reference for the evaluation of its prognosis and early intervention.

In order to train higher vocational nursing talents with strong theoretical knowledge,practical ability and humanistic quality,Kunming health Career Academy specially has developed clinical nursing comprehensive training course.Focusing on the training of students' occupation ability and the employment orientation,this course introduces multi-station concept,design and arrange the site teaching content,uses rich teaching methods and practices scientific and strict assessment,and especially it puts forward and implements intensive training t of site teaching before the practice of nursing students.Finally,the graduation test scores between the students who studied the course and the previous students who didn't are compared and analyzed.The result shows that the teaching of this course has obviously improved the theory,skill level and humanistic quality of nursing students in our hospital.

Objective:To evaluate visceral sensitivity,gut barrier function and autonomic nerve function (ANF) in patients with diarrhea-predominant irritable bowel syndrome (IBS-D),and to explore their roles in IBS-D pathophysiology.Methods:A total of 46 IBS-D patients (IBS-D group) were selected from the Department of Gastroenterology of China-Japan Friendship Hospital from October 2015 to March 2016,and 20 healthy volunteer were served as a control group (HC group).Clinical and psychological symptoms were evaluated by questionnaire,and visceral sensitivity to rectal balloon distention,gut barrier function and autonomic nerve function (ANF) were examined.The difference in the abovementioned indexes were compared between the 2 groups,and the correlations in the parameters were analyzed in the IBS-D group.Results:The scores of IBS symptom severity scale (IBS-SSS),Hamilton anxiety scale (HAMA),Hamilton depression scale (HAMD) and visceral sensitivity index (VSI) were significantly higher in the IBS-D group than those in the HC group (P＜0.01).In the visceral sensitivity test,maximum tolerable threshold in the IBS-D group was significantly decreased compared to that in the HC group (P＜0.01);there was no significant difference in first sensation threshold and defecating sensation threshold between the two groups (P＞0.05).As gut barrier function markers,the serum diamine oxidase (DAO) and d-lactate were significantly increased in the IBS-D group (P＜0.05).In ANF test,the total score and parasympathetic score as well as the proportion of abnormal scores in the IBS-D group were significantly higher than those in the HC group (P＜0.05).In IBS-D group,the HAMA,VSI and serum DAO were positively correlated with IBS-SSS (r=0.528,0.575,0.507;P＜0.01),while the 3 visceral sensitivity thresholds were negatively correlated with IBS-SSS (r=-0.636,-0.476,-0.697;P＜0.01);in addition to the IBS-SSS,the HAMA,HAMD,VSI and serum DAO were also significant negatively correlated with the visceral sensitivity thresholds (all P＜0.05);no significant correlations were found between the ANF and the other parameters.Conclusion:IBS-D patients show psychological symptoms,visceral hypersensitivity,impaired gut barrier function and abnormal ANF characterized by parasympathetic dysfunction;the former 3 factors are all associated with disease severity,and thus may play vital roles in IBS-D pathophysiology.

Background Choroidal neovascularization (CNV) is one of the primary causes leading to visual damage in many fundus diseases.Many evidences indicate that macrophage activation and monocyte chemoattractant protein-1 (MCP-1) play important roles in CNV.However, the dynamic expression of macrophage and MCP-1 in the initial stage of CNV is not clear.Objective This study was to investigate the dynamic changes of F4/80 and MCP-1 expressions in retina-choroid tissue with experimental CNV.Methods Laser-induced CNV models were monocularly established in 105 SPF 8-week-old male wild type C57BL/6 mice.The mice were sacrificed at 6,12,24, 48 and 72 hours after photocoagulation, respectively, and the retina-choroid tissue sections and choroidal flatmounts were prepared.The histopathological examination was carried out to observe the changes of morphology and structure as well as inflammatory response in CNV.The expression and distribution of F4/80 and MCP-1 protein in retinachoroid were detected by double immunofluorescence technique.The expression and distribution of F4/80 in choroid were examined by immunofluorescence.The relative expression levels of F4/80 mRNA and the content of MCP-1 protein in RPE-choroid complex were assayed using real-time quantitative PCR and ELISA,respectively.The use and care of the mice complied with the Regulation for the Administration of Affair Concerning Experimental Animals by Ethic Committee of Experimental Animals of Nanjing Medical University.Results The rupture of Bruch membrane, RPE, outer nuclear layer and choroid was exhibited under the optical microscope 6 hours after photocoagulation.Infiltration of inflammatory cells and tissue edema were seen as the lapse of photocoagulation time, and proliferation of vascular endothelial cells was found 72 hours after photocoagulation.F4/80 was expressed in photocoagulation area 6 hours later, and MCP-1 was expressed around the area.With the lapse of photocoagulation time,the expression intensity of MCP-1 weakened and that of F4/80 enhanced.The contents of MCP-1 protein in RPE-choroid complex were (31.25±4.73), (276.31 ±4.20), (331.95 ±5.86), (221.24±4.42), (179.89 ± 4.10) and (130.80 ± 5.90) pg/mg in the normal control group, photocoagulation 6-, 12-, 24-, 48-and 72-hour groups, respectively,with a significant difference among the groups (F=1 416.46 ,P＜0.01).The contents of MCP-1 protein peaked at 12 hours after photocoagulation and then gradually declined.The expression levels of MCP-1 protein in different time groups were higher than those in the normal control group (all at P＜0.01).A significant difference in F4/80 mRNA expression in RPE-choroid complex was also found among the groups (F =762.72, P＜0.01, and a gradually raising tendency was seen over time, showing evidently increase in comparison with the normal control group (all at P＜0.01).Conclusions Inflammatory response occurs in the early stage of experimental CNV.MCP-1 responds to the CNV at early stage,and the accumulation and activation of macrophage play an important role in the development of CNV.

Objective To investigate the correlation between dynamic changes in esophageal impedance and dilated intercellular space (DIS) of patients with acid-induced non erosive reflux disease (NERD).Methods From September 2013 to July 2014,a total of 35 patients with NERD and 20 healthy controls were selected and underwent 24 h multichannel intraluminal impedance and pH monitoring (MII-pH monitoring),acid perfusion test and gastroendoscopy examination.One piece of mucosa tissue was taken under gastroendoscope from the anterior and posterior walls at 2 cm above the dentate line of the esophagus.Intercellular space (ICS) of the esophageal epithelia cells was measured by software after hematoxylin and eosin staining.t test and variance analysis were performed for statistical analysis.Pearson correlation analysis was used for correlation analysis.Results Impedance baseline of distal esophagus and impedance recovery rate of patients with NERD were lower than those of healthy control group,which were (2 998±701) Ω vs (3 880±1 054) Ω and (30.1±14.0) Ω/min vs (53.0±14.5) Ω/min,and the differences were statistically significant (t=3.65,5.41;both P＜0.01).Compared with healthy control group,ICS of the esophageal epithelial cells was obviously wider (1.03 ± 0.20) μm vs (0.66±0.14) μm,and the difference was statistically significant (t=-6.57,P＜0.01).Impedance baseline of esophagus and impedance recovery rate of patients with positive acid perfusion test were lower than those of patients with negative acid perfusion test,which were (2 755±680) Ωvs (3 411±536) Ω and (25.4±13.0) Ω minvs (33.4±9.8) Ω /min,and the differences were statistically significant (t =2.99,2.03;both P＜0.05).The correlation between impedance recovery rate and ICS was negative (r=-0.70,P＜0.01).Conclusions Recurrent reflux induced injury and delayed mucosal headline may be the factors of impaired mucosal integrity in patients with NERD.The changes esophageal of impedance baseline to a certain extent reflected the degree of esophageal mucosal integrity impairment.

Objective To investigate the inhibitive effect of siRNA(small interfering RNA,siRNA) on the phosphodiesterase type 5(PDE5) in smooth muscle cells of human corpus cavernosum,and provide experimental groundwork for the gene therapy of erectile dysfunction (ED). Methods Small interfering RNAs targeting PDE5 gene were systhesized by using web design software provided by Ambion,there siRNAs and control siRNA were systhesized by Ambion. SiRNAs were transfected into smooth muscle cells of human corpus cavernosum by using siPORTTM Lipid reagent;down-regulation of PDE5 mRNA was detected by RT-PCR;the inhibitive effect of PDE5 was detected by Western Blotting. Results The results of RT-PCR indicated siRNA1、siRNA2 and siRNA3 made down-regulations of PDE5 mRNA expression in the transfected groups 58.2%、14.9% and 11.8%;the PDE5 expression decreased 70.5%、19.8% and 17.3%;however the expression did not have different in control siRNA and frank group. Conclusions The synthesized siRNAs in vitro were able to down-regulate the expression of PDE5.There were different capabilities of the specific siRNAs down-regulation.It was suggested that the siRNA technique provide not only an extremely powerful tool for the functional analysis of genome but also a new method for ED gene therapy.

Objective To compare the yield and speed of detection of Salmonella subsp, enterica serotypo Paratyphi A from the blood of patients with suspected paratyphoid fever A. Methods With the BacT/ALERT 3D system and paired aerobic and anaerobic bottles (AEB, ANB) that were each filled with 5 ml of blood, the blood culture of 13 500 suspected paratyphoid fever A patients were performed. Results A total of 4 060 isolates were detected. About 3 149 were detected from both AEB and ANB. Four hundred and sixty-one isolates were detected only from the AEB and 450 were only from the ANB. The detection rates of the AEB and ANB were all 26.7% (χ<'2>=0.023, P=0.880). The increased detection rate attributed to the additional blood volume in the AEB and ANB were 11.3% and 11.1%, respectively. The detection speed differed between the two medium formulations. The time to detection was (23.66±15.89) h and (25.48±16.92) h for3 149 isolates, respectively (t=7.007, P<0.01).The mean time to detection was 31.80±20. 97 for 461 isolates discovered with AEB and (33.45±20.72) h for 450 isolates discovered with ANB. Conclusion The blood volume is an important factor in determining the detection rate of blood culture. Although no statistical difference for positive rate was found between the AEB and ANB, more isolates was detected earlier in AEB.

Objective:To evaluate the six-degree setup errors of tumors of cervical vertebra, thoracic vertebra and lumbar vertebra by image guided radiotherapy. Methods:From May 2013 to June 2014, 30 patients with spinal malignant tumors(10 patients of cervical vertebra, thoracic vertebra and lumbar verte-bra respectively) were treated with Elekata Synergy accelerator(Elekta company,Sweden). Six-degree set up errors were corrected using HexaPODTM evoRT bed under image of on board cone beam computed tomography ( CBCT) guided. All the patients received kilovoltage CBCT before receiving radiotherapy and after correction. The acquired images were co-registered with planning CT with bone window. The data of 838 CT images were analyzed and the errors of translational directions X ( lateral ) , Y ( lngitudi-nal),Z(vertical)and rotational directions RX(pitch), RY(roll), RZ(yaw) were recorded. The data were compared by t-test using SPSS 13. 0. Results:The absolute translational setup errors in X, Y and Z axes of cervical vertebra before correction were (1. 71 ± 0. 10) mm, (1. 81 ± 0. 11) mm and (1. 94 ± 0. 09) mm respectively:(3. 17 ± 0. 19) mm, (4. 26 ± 0. 28) mm and (2. 18 ± 0. 12) mm for thoracic vertebra, and (2. 69 ± 0. 24) mm, (3. 33 ± 0. 26) mm and (2. 86 ± 0. 21) mm for lumbar vertebra. The residual setup errors in X, Y and Z axes of cervical vertebra were (0. 5 ± 2. 4) mm,(0. 01 ± 2. 4) mm and (2. 4 ± 1. 4) mm, respectively after correction;(1. 17 ± 0. 11) mm,(0. 26 ± 0. 30) mm and (0. 08 ± 0. 12) mm for thoracic vertebra and (1. 09 ± 0. 24) mm,(2. 03 ± 1. 26) mm and (0. 06 ± 0. 51) mm for lumbar vertebra. The t-test of paired data of set up errors before and after CBCT showed significant difference in three translational directions of cervical vertebra and thoracic vertebra, only Z (t= -3. 518,P<0. 001) for lumbar vertebra. The absolute rotational setup errors in RX,RY and RZ axes of cervical vertebra before correction were 0 . 67 ° ± 0 . 04 ° ,1 . 06 ° ± 0 . 06 ° and 0 . 78 ° ± 0 . 05 ° respec-tively. 0. 62° ± 0. 05°, 0. 75° ± 0. 06°, and 0. 84° ± 0. 06° for thoracic vertebra, 0. 59° ± 0. 06°, 0. 80° ± 0. 07°, and 0. 73° ± 0. 06°for lumbar vertebra. The rotational directions RX, RY and RZ axes of cervical vertebra were 0 . 27 ° ± 0 . 14 ° , 1 . 20 ° ± 0 . 04 ° and 0 . 28 ° ± 0 . 05 ° respectively;0 . 02 ° ± 0 . 20 ° , 0. 05° ± 0. 26°and 0. 64° ± 0. 16°for thoracic vertebra and 0. 09° ± 0. 26°, 0. 50° ± 0. 05°,and 0. 03° ± 0. 16°for lumbar vertebra. The t-test of paired data of set up errors before and after CBCT showed signifi-cant difference in three rotational directions of cervical vertebra and lumbar vertebra, only RY(t=7. 106, P<0. 001)for thoracic vertebra. All the patients acquired pain relief and there was no radiation-induced toxicity detected clinically during a median follow-up of 6 months. Conclusion:Six-degree set up errors of spine tumors were corrected effectively with HexaPODTM evoRT bed under CBCT image guided and its feasibility in day-to-day clinical practice has been demonstrated.