In clinical practice,we have adopted the methods such as intensifying the knowledge of preclinical medicine,learning to collect case history,training medical check-up,understanding the significance of auxiliary examination and encouraging the students to form the clinical thinking ability,and thus achieved satisfactory effect and obtained the positive opinion of students.

Objective To investigate the expression of inflanmatory cytokines such as interlukin-1β (IL-1 β),interlukin-6 (IL-6),tumor necrosis factor-α (TNF-α) and intercelluar adhesion molecule-1 (ICAM-1),and explore their relationships with neuronal function score after fluid percussion brain injury in rats.Methods The experimental models were established in 48 adult rats.The water content of edematous brain and the expression of IL-Iβ,IL-6,TNF-α and ICAM-1 were measured with dry-wet measure,immunohistochemistry at 6 h,12 h,24 h,3 d,7 d after operation respectively.Results Compared with animals of shame operation (SO) group,neuronal function score decreased in TBI group from 6h (3.78±0.84),reached to the lowest level at 24h (2.65±0.32),and gradually increased at 3d (4.75±0.71).IL-6,IL-1β,TNF-α and ICAM-limmunoreactive expression increased from 6h,reached its maxmum at 24h,lasted to 3th day,and began to decrease at 7d.The linear regression analysis indicated that expression of IL-1β,IL-6,TNF-α and ICAM-1 had negative correlations with change of neuronal function score(r=-0.912,r=-0.892,r=-0.794,r=-0.887 respectively,P＜0.05).Conclusion IL-6,IL-1β,TNF-α and ICAM-1 expression is upregulated following fluid percussion injury in rats,and shows negative correlations with neuronal function score.The possible mechanisms is that inflammatory cytokines are involved in nerve function impairment by inducing secondary brain injury.

Objective To prepare the mB7-1-GPI-anchored Lewis vaccine and investigate its antitumor effects. Methods mB7-1-GPI was incorporated on Lewis tumor cells and mB7-1-GPI-anchoring tumor vaccine was prepared. The anti-tumor immunity induced by the prepared mB7-1-GPI-anchored Lewis tumor cell vaccine in tumor-bearing mice was observed. Results Flow cytometric analysis showed that mB7-1-GPI were positively expressed on the surface of Lewis tumor cells. After Lewis tumor cells incubated with mB7-1-GPI, the positive rate (PR) of mB7-1 antigen was 95.8% (0h), 93.6% (4h), 91.1% (8h) and the fluorescence intensity (FI) was 11.2(0h), 10. 6(4h), 9. 8(8h). The IL-2 and IFN-γ production of splenic lymphocytes + lewis cells was (25.9 ± 1.4) pg/ml, (56. 0± 3. 5 ) pg/ml. The IL-2 and IFN-γ production of splenic lymphocytes + lewis/mB7-1-GPI was ( 871.3 ± 10. 4 ) pg/ml, ( 1329. 0 ± 11.9 ) pg/ml. In 25 days, the mean diameter of tumor of Lewis/mB7-1 -GPI was shorter than Lewis( 1.4 ± 0. 21 )cm & ( 2. 5 ± 0. 27 )cm , P ＜ 0. 05 ). Lewis tumor cell-bearing C57BL/6 mice treated with Lewis/mB7-1-GPI vaccine survived much longer than mice treated with Lewis vaccine ( 75.2 ± 2. 0 ) d & (40. 2 ± 2. 0 ) d ( P ＜ 0. 05 ). Conclusion The Lewis tumor vaccine prepared with mB7-1-GPI fusion protein significantly inhibited the tumor growth in Lewis bearing mice. It represented an useful new strategy for attaching immunological factor onto tumor cell surfaces without genetic manipulation.

Objective To study the effects of breast conserving surgery for early stage breast cancer. Methods The record of 38 patients with 0-IIa-stage breast cancer who received breast conserving surgery from Jan. 2005 to Feb.2010 was reviewed. The short-term effect was analyzed and the cosmetic effect was evaluated according to Rose standard. Results All patients recovered well and they were all satisfied with the shape of their breasts. No complication occurred. During the follow-up, no local recurrence and distant metastasis occurred. Conclusion Satisfactory clinical and cosmetic effect can be achieved by breast-conserving surgery in patients with early stage breast cancer.

Objective To review and summarize the experiences of mitral valve replacement in the children aged less than five years.Methods Twelve patients with moderate to severe mitral valve regurgitation (MR) or/and severe mitral valve stenosis (MS) were retrospectively study from January 2008 to December 2011,all of them suffered from severe heart failure and underwent mechanical mitral valve replacement.There were 9 males and 3 females.They aged from 4 to 58 months [mean (26.2 ± 18.1) months] and weighted from 5.6 to 13.0 kg [mean (9.6 ± 3.8) kg].Three patients underwent unsuccessful mitral valve repair before mitral valve replacement.17 to 23 mm aortic bileaflet mechanical prosthesis were reverse directional implanted in nine patients and 25 to 27 mm mitral bileaflet mechanical prosthesis were implanted in three patients.Results One patient died,the operative mortality rate was 8.3％.2 patients were complicated by cardiac arrhythmia and 2 patients complicated by mild hemolysis,all recovered after symptomatic treatment.The heart function of servived 11 patients improved significantly,none of them were complicated by haemorrhage or thromboembolic.Conclusion Severe mitral valve lesion injure heart function significantly for the young children and timely surgical intervention is the only option.Mitral valve replacement is the ultimate option for the patients failed in mitral valve annuloplasty.The introduction of aortic bileaflet mechanical prosthesis which smaller size is available and reverse directional implantation resolve the difficulty of prosthesis-patient mismatch essentially,most children with a small prosthesis has to redo mitral valve replacement with a larger size prosthesis.The compliance of permanent anticoagulation of young children is favourable and more intensively follow-up is essential to avoid the incidence of bleeding and thromboembolic.

Objective To investigate the angiographic manifestation of the proper esophageal artery (PEA),the hish risk factom for the presence of the anomalous PEA in hemoptysis and to evaluate the safety of transcatheter aaefial embolization(TAE) of the PEA using gelatin sponge(GS).Methods Selective esophageal arteriography WSS performed in forty-three patients with hemoptysis,including 15 cases of pulmonary tuberculosis,18 cases of bmnchiectasis,7 cases of posttuberculous bronchiectasis and three cases of lung cancer. One case experienced failure of bronchial arterial embolization. The angiographic manifestation of the PEAs Was studied.The complications of the procedure and clinical results were observed in the patients who underwent TAE using GS.Results Thirty-nine PEAs were catheterized selectively in 37 patients(86.0%).Eighteen anomalous PEAs(46.2%)were catheterized selectively in 17 patients (45.9%).The anomalous PEAs showed tortuosity,dilatation,hyperplasia,shunting with pulmonary artery and anastomosis with the bronchial artery.All lesions involved basal segment of inferior pulmonary lobar. Bronchiectasis Was the most frequent disease for PEA abnormality. No complications occurred and satisfactory curative effect Was achieved with TAE of the anomalous PEAs.Conclusions It is necessary to perform selective proper esophageal arteriography when the lesion involves basal segment of inferior pulmonary lobar in hemoptysis.Supplemental TAE of the anomalous PEA using GS is safe and valuable in the management of hemoptysis.

Objective To evaluate the efficiency of our self-designed enriched filtrator of stem cells in screening and collecting enriched human bone marrow stem cells (BMSCs) for rapid construction of bioactive materials.Methods Bone marrow blood from 32 patients was circulated in our self-designed enriched filtratorand filtered through beta-tricalcium phosphate(β-TCP).The numbers of BMSCs were counted pre-and post-filtration to assess the enrichment efficiency.The numbers of nucleated cells,red blood cells and platelets were compared pre-and post-filtration to assess the effects of the enriched filtrator of stem cells on blood cells.Bacteriological examinations were performed to test the safety of the device.Scanning electron microscopy was carried out to observe the adhesion of BMSCs on β-TCP.Results There was a significant difference between the pre-fihration colony number of BMSCs cultured (232.8 ± 128.6/mL) and the post-filtration one (37.8 ± 34.9/mL) (t =10.743,P ＜ 0.001).The efficiency of BMSCs enrichment of the device was 85.6％ ±8.4％ (from 63.8％ to 97.1％).There were no significant differences between pre-filtration and post-filtration in the numbers of nucleated cells [(16.8 ± 5.4) × 109/mL versus (16.3 ±5.0) ×l09/mL],red blood cells [(3.9±0.6) ×1012/mL versus (3.8±0.6) ×1012/mL] and platelets [(120.4 ± 54.6) × 109/mL versus (123.0 ± 51.8) × 109/mL] (P ＞ 0.05).All the bacteriological examinations of the bone marrow samples were negative.After in vitro osteogenic induction culture,formation of numerous BMSCs colonies was observed on the β-TCP by scanning electron microscopy.Conclusion Since our self-designed enriched filtrator can efficiently collect enriched BMSCs and combine them with β-TCP simultaneously,the device is capable of rapid and safe construction of bioactive materials.

For investigating the epidemiology and genetic characteristics of enterovirus 71 (EV71) in Fujian from 2010 to 2015,we analyzed the surveillance data of EV71 and sequenced VP1 genes of 72 EV71 strains randomly picked from the past 6 years.The overall infection rate was gradually down and one incidence peak (from May to July) was observed each year.Major infectious population were focused on Xiamen,Fuzhou,Nanping and Quanzhou,the ages ranged from one to three years old.Scattered children were the most infected ones.The proportion of EV71 in the severe case was higher than in the HMFD(χ2 =732.064 5,P＜0.000 1).EV71 circulated from 2010 to 2015 in Fujian Province was belonged to subgenotype C4a in consistent with vaccine strain (H07).Compared with the VP1 of vaccine strains,the divergence of complete VP1 nucleotide sequence was gradually expanding as time distance increased,but the sequence of amino acid was not found obvious difference.Variations in 4 key immune epitopes of amino acid had not appeared a regular pattern in year and not consistent with the trend of proportion of EV71 in HMFD.As a result,we considered the epidemiology characteristics of EV71 in Fujian was obvious,72 strains still belonged to C4a subgenotype and had no outstanding antigenic drift or mutation.Extensive epidemiology surveillance and genetic characteristic are needed for the application of EV71 vaccine.

Objective To investigate two enteral nutrition injection methods on prognosis of patients with acute cerebral infarction (ACI) induced pseudobulbar palsy patients. Methods A total of 86 patients of ACI accompanied with dysphagia were randomly divided into the feeding pump group (n=43) and the traditional nasal feeding group (n=43). Nutritional support for both groups lasted at least more than 14 d through the feeding tube. In the first and fourteenth day data of both groups concerned with body mass index (BMI), triceps skin fold (TSF), upper arm muscle circumference of triceps (MAMC), heamoglobin (Hb), serum prealbumin (Alb), alanine transaminase(ALT), aspartate aminotransferase (AST), blood urea nitrogen (BUN), creatinine (Cr), incidence of complications, neuro-function score NIHSS and the swallowing function evaluation were collected and analyzed. Results Nutritional index Hb and Alb was (132.6±10.1) g/L and (38.2±1.4) g/L in the group of the feeding pump group, and significantly higher than (122.2±13.2) g/L and (36.3±1.5) g/L in the traditional nasal feeding group in the fourteenth day, the difference was significant (t=12.86, 12.37, P<0.05). The NHISS score was 5.2±1.0 in the feeding pump group, significantly lower than 8.9±1.1 of the traditional nasal feeding group, the difference was significant (t=-26.37, P < 0.05). The improved rate of swallowing function was 81.4% (35/43) in the feeding pump group, significantly higher than 60.5%(26/43) of the traditional nasal feeding group, the difference was significant (χ2=4.568, P < 0.05). Conclusions The use of enteral feeding pump at early stage for ACI patients with pseudobulbar palsy can improve the nutritional status, acute neurological function, swallowing function and lower the incidence of complications which is beneficial for early recovery and short-term prognosis.

To study the biological characteristics and mutations of influenza A(H1N1)pdm09 virus isolated from one case of pneumonia of unknown etiology (PUE),which would provide references for clinical treatment and disease control,the throat swab specimen from the PUE case was isolated in the Madin-Darby Canine Kidney (MDCK) cells,and then the antigenicity,pathogenicity and drug resistance of influenza A (H1N1) pdm09 virus were analyzed after sequencing.As a result,one influenza virus strain was isolated from the specimen and named as A/FujianGulou/SWL64/2016(H1N1).The similarities of nucleotide sequences and amino acids sequences compared with the vaccine strain A/California/07/2009 (H1N1) were 96.9％-98.9％ and 96.7％-99.5％,respectively.Eighteen amino acids had mutated in the HA and 4 mutations,K163Q,S185T,S203T and D222N,were involved in 3 different epitopes,which indicated that the antigenic drift had occurred in the influenza virus.The D222N mutation associated with receptor binding site made the virus infect lower respiratory tract more easily.The virus was still amantadine-resistance and oseltamivir-sensitive.In conclusion,the influenza A (H1N1) pdm09 virus in this study have occurred antigenic drift and has the molecular characterization of causing severe pneumonia,so further surveillance should be performed to prevent and control the influenza epidemic.