China ; History, 20th Century ; History, 21st Century ; Pathology ; education ; history

Objective To explore the influencing factor of amount of bleeding after selective cesarean delivery,and to provide theoretical basis to prevent postpartum hemorrhage in clinic.Methods A total of 300 delivery women,who received selective cesarean delivery because of social factors,was included this research.The amount of bleeding after selective cesarean delivery was determined by volumetric method and weight method.The related factor of amount of bleeding after selective cesarean delivery was analyzed by single-factor and multiple regression method.Results The result of single-factor and multiple regression method showed that the amount of bleeding after selective cesarean delivery was related to uterine dysplasia,uterine contraction fatigue,cervical score,placenta previa,placental adhesion/implant and neonatal weight(Test value =9.263,9.845,3.447,7.234,5.765,3.627,all P ＜ 0.01),but not related to age,body weight,gestational duration,gravidity times,production time,abortion history,premature rupture of membrane (all P ＞ 0.05).Conclusion Conclusion Uterine dysplasia,uterine contraction fatigue,cervical score,placenta previa,placental adhesion/implant and neonatal weight were the related factors of amount of bleeding after selective cesarean delivery,and should be predicted intensely to reduce the incidence of postpartum hemorrhage.

In order to explore the teaching methods of biochemistry experiment teaching,Biochemistry department of Wannan medical college adopts PBL and case-based teaching contrast to lecture based learning in exerimental course,to evaluate teaching effect by analyzing questionnaire survey associated examination results.It is shown that PBL and case-based teaching can get good teaching effect.

Objective To investigate the effects of continuous passive motion (CPM) protocols on outcomes of total knee arthroplasty. Methods Seventy-two patients who underwent total knee arthroplasty were divided into 2 groups and treated with different CPM protocols: group 1 with CPM from 0 degree to 40 degrees and increased by 10 degrees per day, while group 2 with CPM from 90 degrees to 50 degrees (early flexion) and gradually progressed to full extension over a 4-day period. The CPM was administered twice a day for 1 hour over a 7-day period. All the patients participated in the same postoperative physiotherapy program. Results Group 2 (the early flexion group) had significantly more range of motion than group 1. Conclusion The early flexion can help achieve favorable functional gain after total knee arthroplasty.

Objective To evaluate the result of short-segment pedicle screw instrumentation plus pedicle screws inserted into the injury level for treatment of thoracolumbar burst fracture.Methods Fifty-six cases of thoracolumbar burst fracture treated from June 2008 to June 2011 were reviewed.There were 40 males and 16 females at mean age of 32.8 years (range,25-60 years).Twenty-four cases were injured from traffic accidents,19 cases from fall from the height,and 13 cases from fall of heavy objects.Fractured segments were T11 in 6 cases,T12 in 14 cases,L1 in 16 cases,L2 in 12 cases,L3in 5 cases,and L4 in 3 cases.Thirty cases underwent short-segment pedicle screw fixation through the level above the fracture to level below the fracture (Group A).Apart from this,26 cases were treated with additional transpedicular fixation at the fractured level (Group B).Anterior vertebral height ratio,sagittal Cobb' s angle,neurologic performance as evaluated by American Spinal Injury Association (ASIA) scale were assessed before operation,one week after operation,and one year after operation.Results Anterior vertebral height ratio and Cobb' s angle revealed no significant differences between the two groups before operation and one week after operation.At postoperative one year,anterior vertebral height ratio and sagittal Cobb' s angle were (87.2 ± 6.9)％ and (7.6 ± 3.2)°in Group A with significant differences from (93.3 5.7)％ and (5.7 ± 1.9) ° in Group B (P ＜ 0.05),but there was no statistical difference in ASIA scale of neurologic performance.Conclusion Short-segment pedicle screw instrumentation with stabilization at the level of fracture is an effective treatment for thoracolumbar burst fracture.

Objective To introduce the technique of three dimensional portal venography of multi detector row spiral CT and its clinical application in the evaluation of the portosystemic collateral shunts of liver cirrhosis. Methods All relevant literatures were retrospectively reviewed on the application of two dimensional and three dimensional reconstruction techniques such as MIP, SSD, VRT of multi detector row spiral CT to demonstrate the collateral vessels of liver cirrhosis.Results The distribution, pathway and anatomy of portosystemic collateral vessels were well shown by multi detector row spiral CT portal venography. Conclusion Multi detector row spiral CT portal venography provides excellent depiction of the anatomic characteristics of the collateral shunts and enables the continuous tracing of vascular structures, thus it is very helpful in the imaging evaluation of the collateral vessels of liver cirrhosis.

Objective To introduce the new nomenclature scheme of the International Working Group (1995) on hepatic nodules, and summarize the imaging features of various hepatic nodules in light of their pathological characteristics, and evaluate the diagnostic values of various imaging facilities.Methods Ultrasound, computed tomography(CT), magnetic resonance imaging(MRI), and angiographic CT were reviewed and introduced.Results Many of these types of hepatic nodules play a role in the de novo and stepwise carcinogenesis of hepatocellular carcinoma(HCC) in the following steps: regenerative nodule, low grade dysplastic nodule, high grade dysplastic nodule, small HCC, and large HCC. Accompanying such transformations, there are significant alterations in the blood supply and perfusion of these hepatic nodules.Conclusion Modern state of the art medical imaging facilities can not only delineate and depict these hepatic nodules, but also provide important clues for the characterization of focal hepatic lesions in most cases, thus facilitating the early detection, diagnosis and management of HCC in its early stage.

Objective: To investigate the concentrations of secreted protein acidic and rich in cysteine(SPARC) in the serum and urine of patients with IgA nephropathy and its expression in the kidney tissues. Methods: The concentrations of SPARC, tumor necrosis factor-a (TNF-a),interleukin 1β (IL-1β), and interleukin 6 (IL-6) in the serum and urine were measured with enzyme-linked immunosorbent assay(ELISA). The contents of SPARC protein in the culture medium of human mesangial cell (HMC) and human renal tubular epithelial cell (HKC), which had been treated with IL-6, were determined by ELISA. The expression and distribution of SPARC in IgA nephropathy and normal kidney tissues were observed by immunohistochemistry assay. Results: The concentrations of SPARC in serum and urine of IgA nephropathy patients were higher than those of the normal control subjects ([2.43±±1.22] μg/ml vs [0.69±0.21] 2μg/ml, [7.73±2.81] μg/ml vs [1.17±1.03]ρg/ml, P<0.01). The serum levels of TNF-α, IL-1β and IL-6 in IgA nephropathy group were significantly higher than those in the control group (P< 0.05); the urinary levels of TNF-α and IL-6 in IgA nephropathy group were also higher than those in the controls (P<0.01). SPARC protein secreted by HKC was higher than that by HMC (P<0.01). SPARC was weakly positive in normal distal cortical tubules. SPARC protein expression in tubular epithelial cells of IgA nephropathy patients was obviously higher than that of the normal controls. Conclusion: The secretion of SPARC by renal tubular epithelial cells is increased in patients with IgA nephropathy, which results in elevation of serum SPARC and may have a protective feedback inhibitory effect on HMC proliferation.

Objective To summarize the principle and application of functional MR imaging of pancreatic carcinoma and chronic mass-forming type pancreatitis.Methods Articles about diffusion-weighted imaging(DWI),magnetic resonance spectrum imaging(MRSI) and dynamic contrast-enhanced MR imaging of pancreatic carcinoma and chronic pancreatitis were reviewed and analyzed.Results Functional MR imaging could reflected the differences in molecules diffusion,metabolism and tissue perfusion between pancreatic carcinoma and chronic pancreatitis.Conclusion As a non-invasive protocol,functional MR imaging can provide useful information in differential diagnosis between chronic mass-forming type pancreatitis and pancreatic carcinoma.

Objective To investigate the value of MR diffusion-weighted imaging (DWI) in differentiating pancreatic carcinoma from chronic focal pancreatitis on 3.0 T MR system. Methods Thirteen patients with proved pancreatic carcinoma, 7 patients with confirmed chronic focal pancreatitis, and 14 healthy volunteers, were included in this study. MR examination including the routine abdomen scanning protocol and DWI was performed for both patients and volunteers. The SE-EPI sequence and ASSET technique were used for DWI. The b values of 400, 600, 800 and 1 000 s/mm2 were selected to acquire the DWI. The corresponding apparent diffusion coefficient (ADC) values were measured in each designated region of interest and statistically analyzed. Results ①DWI of the healthy volunteers showed intermediate signals of pancreas. ②DWI of pancreatic tumor masses showed homogenous high signal intensity relative to the surrounding pancreatic tissue with clear boundary. Under different b values, the tumor ADC values were (1.63?0.235)?10-3 mm2/s, (1.42?0.126)?10-3 mm2/s, (1.36?0.170)?10-3 mm2/s and (1.26?0.178)?10-3 mm2/s respectively, which were significantly lower than those of non-tumor region (2.11?0.444)?10-3 mm2/s, (1.83?0.230)?10-3 mm2/s, (1.81?0.426)?10-3 mm2/s, (1.60?0.230)?10-3 mm2/s and of the normal pancreas (1.85?0.350)?10-3 mm2/s, (1.69?0.290)?10-3 mm2/s, (1.67?0.268)?10-3 mm2/s, (1.42?0.221)?10-3 mm2/s, P