The case teaching method was applied in the course of Clinical Rehabilitation. The key factors included the case design, operation and assessment in its working program. In the teaching of Clinical Rehabilitation, the use of the case teaching method can stimulate the interest of studence and enhance the effect of teaching.

OBJECTIVETo study the effects of transcutaneous electrical nerve stimulation on multimodal analgesia after total knee arthroplasty.

METHODSSixty patients diagnosed as knee osteoarthritis and suffered unilateral total knee arthroplasty in the department of orthopedics, Zhejiang Traditional Chinese Medicine Hospital from March 2009 to May 2012 were randomly divided into control group and test group, 30 cases in each group. All the patients received celecoxib preoperatively, knee periarticular injection with the drug mixture intraoperatively, and celecoxib and morphine sulfate controlled-release tablets postoperatively. The patients in the test group were also treated with transcutaneous electrical nerve stimulation each day after operation. All the patients started doing functional exercises at 24 h after operation. Postoperative visual analogue scales(VAS), passive and active range of motion of knee joint,and complications were recorded.

RESULTSThe VAS scores of test group during postoperative 24 h to 1 week were 3.39 +/- 0.69, 2.79 +/- 0.51, 2.16 +/- 0.52, and 1.07 +/- 0.57 separately,which were lower than 3.80 +/- 0.86, 3.22 +/- 0.58, 2.53 +/- 0.54 and 1.38 +/- 0.52 in the control group. The passive and active range of knee joint motion in the test group during postoperative 24 h to 2 weeks were (30.67 +/- 3.65) degrees, (39.17 +/- 3.96) degrees, (47.83 +/- 4.86) degrees, (93.67 +/- 7.30) degrees, (107.67 +/- 7.51) degrees and (29.83 +/- 5.33) degrees, (78.33 +/- 8.24) degrees, (95.17 +/- 5.94) degrees respectively,which were higher than (28.67 +/- 3.92) degrees, (36.83 +/- 4.25) degrees, (45.17 +/- 5.17) degrees, (89.83 +/- 7.25) degrees, (103.17 +/- 7.37) degrees and (24.17 +/- 10.26) degrees, (73.83 +/- 9.07) degrees, (91.33 +/- 7.42) degrees in the control group. In the test group, 19 patients had ring-shaped haemostasis impression to some extent in the skin of knee joint to different degree, and 5 patients had blister formation.

CONCLUSIONIt is meaningful to apply transcutaneous electrical nerve stimulation for treating multimodal analgesia after total knee arthroplasty,which can not only relieve patients' postoperative pain, and also promote the rehabilitation of knee function as far as possible.

Aged ; Aged, 80 and over ; Analgesia ; Arthroplasty, Replacement, Knee ; adverse effects ; Female ; Humans ; Knee Joint ; surgery ; Male ; Middle Aged ; Pain, Postoperative ; etiology ; therapy ; Transcutaneous Electric Nerve Stimulation ; Treatment Outcome

Actins ; metabolism ; Adenocarcinoma ; pathology ; Adult ; Diagnosis, Differential ; Endometriosis ; pathology ; Epithelium ; pathology ; Female ; Gastrointestinal Stromal Tumors ; pathology ; Hamartoma ; metabolism ; pathology ; Humans ; Muscle, Smooth ; pathology ; Stomach Diseases ; metabolism ; pathology

AIM: To investigate the effect of ecdysterone (EDS) on H9c2 cardiomyocytes after oxidative stress.METHODS:H9c2 cells were cultured in vitro and divided into control group, high dose (2 μmol/L) of EDS group, middle dose (1.5 μmol/L) of EDS group, low dose (1 μmol/L) of EDS group, and H2O2 group.H9c2 cardio-myocytes in H 2 O2 group and high , middle and low doses of EDS groups were exposed to H 2 O2 for 6 h to establish the model of oxidative stress.The viability of the H9c2 cells was detected by CCK-8 assay.The apoptosis of H9c2 cells was analyzed by flow cytometry.The levels of lactate dehydogenase (LDH) and creatine kinase-MB (CK-MB) in the culture medium, and the levels of superoxide dismutase (SOD) and malondialdehyde (MDA) in the H9c2 cells were measured by colorime-try.The generation of reactive oxygen species (ROS) and the mitochondrial membrane potential were evaluated by flow cy-tometry and confocal laser scanning microscopy .The protein levels of Bax , Bcl-2 and cleaved caspase-3 in the H9c2 cells were determined by Western blot .RESULTS:Ecdysterone at the selected concentrations had no effect on the viability of H9c2 cells.Compared with control group, the levels of LDH, CK-MB, ROS and MDA, and the apoptotic rates of the H9c2 cells were significantly increased after treated with H 2 O2 , but were decreased by EDS treatment in a dose-dependent man-ner.The levels of SOD and mitochondrial membrane potential of the H 9c2 cells in H2 O2 group were reduced significantly compared with control group , but high, middle and low doses of EDS treatments up-regulated the levels of SOD and mito-chondrial membrane potential in H 2 O2-treated H9c2 cells.The protein levels of Bax and cleaved caspase-3 in the H9c2 cells in H2 O2 group showed significant elevation in comparison with control group , and the protein expression of Bcl-2 de-clined in H2 O2 group compared with control group , but high, middle and low doses of ecdysterone treatments down-regula-ted the protein levels of Bax , cleaved caspase-3 and up-regulated the expression of Bcl-2 in H2 O2-treated H9c2 cells. CONCLUSION:Ecdysterone attenuates the effect of H 2O2-induced oxidative stress on H9c2 cardiomyocytes.The mecha-nism may be involved in scavenging oxidative stress products , increasing antioxidant enzyme activity and improving mito-chondrial function .

AIM: To construct random eight-peptide library for the study on atherosclerosis and restenosis. METHODS and RESULTS: Random oligodeoxynucleotides encoded eight peptides were synthesized and amplified by polymerase chain reaction(PCR). The product was cloned into phage surface display vector fUSE5 in Sfi I site and electroporated into competent MC1061. The library was identified through PCR, hybridization, DNA sequencing and affinity biopanning of streptavidin. Because the upstream primer is complementary to part vector clone site sequences and part exogenous gene sequences, and the other one complementary to pIII gene of vector, thus only clones inserted exogenous gene could be amplified easily. Additionally we used the probe oligodeoxynucleotide complementary to vector clone site sequences to identify clones which were not inserted exogeneous genes. Furthermore, two hybridizing positive clones were sequenced. Their sequences are consistent with two oligodeoxynucleotide probe sequences. As a result, 2.1?108 special clones were obtained. Affinity biopanning proved that the libraries could be amplified steadily. CONCLUSION: The eight-peptide library is reliable.

Aim According to various target sites of HLA-E mRNA,to design and synthesize 3 pieces of HLA-E siRNA chain,to compare quantitatively their efficiency of silencing gene in BEL-7402 with HLA-E(+)in order to select the dominant siRNA.Methods The hepatocarcinomal BEL-7402 cells,induced by 5×10~5 IU·L~(-1) IFN-γ,expressed HLA-E(+) and was pured by flow cytometry selecting as target cells for research.3 pieces of specific siRNA(A,B,C group)were designed and chemically synthesized,then the concentration of which(0.1 mmol·L~(-1))was respectively transfected through Lipofectamin 2000 into target cells.After 48 h,the gene silent effect on HLA-E gene in A,B and C groups was quantitatively observed by cytoimmunofluorence,flow cytometery,Western blot and real-time PCR,as well as on NK cytotoxicity to target cells tested by NK killing rate.Results Compared with those of control or non-specific siRNA group,HLA-E antigen,protein product,HLA-E mRNA and HLA-E molecule on cell surface were statistically down-regulated in A,B,and C group(P<0.01),whose were silenced more (above 90%) in B or C group than in A group (P<0.01).The NK killing rate in A,B and C groups was dominantly improved(P<0.01),which in B or C group was higher than in A group (P<0.01).Conclusion The targeted siRNA can specifically and high-efficiently silence HLA-E expression in hepatocarcinomal cells,and may keep them from immunoescape through non-classic HLAⅠ pathway to imply new strategy for hepatocarcinomal gene-immunotherapy.

Carcinoma, Non-Small-Cell Lung ; genetics ; metabolism ; pathology ; DNA Mutational Analysis ; DNA, Neoplasm ; genetics ; isolation & purification ; Genes, erbB-1 ; Humans ; Lung Neoplasms ; genetics ; metabolism ; pathology ; Mutation ; Paraffin Embedding ; methods ; Polymerase Chain Reaction ; methods ; Real-Time Polymerase Chain Reaction ; methods ; Receptor, Epidermal Growth Factor ; genetics

Adenocarcinoma ; drug therapy ; genetics ; metabolism ; pathology ; surgery ; Adenocarcinoma, Bronchiolo-Alveolar ; drug therapy ; genetics ; metabolism ; pathology ; surgery ; Adenocarcinoma, Papillary ; metabolism ; pathology ; Cadherins ; metabolism ; Diagnosis, Differential ; Genes, erbB-1 ; genetics ; Humans ; Lung Neoplasms ; drug therapy ; genetics ; metabolism ; pathology ; surgery ; Lymphatic Metastasis ; Mucin-1 ; metabolism ; Mutation ; Neoplasm Invasiveness ; beta Catenin ; metabolism

Adolescent ; Humans ; Kearns-Sayre Syndrome ; Male

Acid Anhydride Hydrolases ; metabolism ; Apoptosis ; Biomarkers, Tumor ; metabolism ; Caspases ; metabolism ; Cell Adhesion Molecules ; metabolism ; Chromosome Deletion ; Drug Delivery Systems ; GPI-Linked Proteins ; metabolism ; Humans ; Hyaluronoglucosaminidase ; metabolism ; In Situ Hybridization, Fluorescence ; methods ; Lung Neoplasms ; diagnosis ; drug therapy ; genetics ; metabolism ; Neoplasm Proteins ; metabolism ; Neoplasm Staging ; Receptor, Epidermal Growth Factor ; metabolism ; Vascular Endothelial Growth Factor A ; metabolism