Objective To explore sympathetic skin response (SSR) in the region innervated only by the median or ulnar nerve. Methods Thirty healthy volunteers, ten patients with median nerve injury, ten patients with ulnar nerve injury and three patients with both median and ulnar nerve injury were involved in the study. SSR was elicited by electrical stimulation and the latency and amplitude of the SSR were recorded in the center of the palm and on the hypothenar, and the pulps of the index and little fingers. Results After median nerve injury the SSR of the index finger pulp disappeared, the SSR amplitude of the palmar center was reduced, while the SSR amplitude of the little finger pulp was normal. In contrast, after ulnar nerve injury the SSR of the little finger pulp disappeared,the SSR amplitude of the hypothenar was reduced, while the SSR of the index finger pulp was normal. When both nerves were injured, no SSR could be elicited anywhere on the palm. Conclusions The SSR of the palmar center and hypothenar are affected by both the median and ulnar nerves. The index and little finger pulps are sites for recording SSR which represent the SSR of the median and ulnar nerve distribution, respectively. Index and little finger pulps are ideal sites for detec t ing efferent functioning of sympathetic nerves from the median and ulnar nerve paths,respectively.

BACKGROUND: The etiology and pathogenesis of Tourette syndrome(TS)is still unacknowledged, and related studies on the relationship between TS and hypoironemia are unavailable. Since hypoironemia has been found existed in children with TS who showed better outcomes after receiving adjuvant ferralium, thereby this study was designed to investigate the relationship between TS and serum iron.OBJECTIVE: To study the relationship between TS and serum iron.SETTING: At a nursing science department of a university-affiliated hospital, pediatric department of a university affiliated hospital and sectional hospital.PARTICIPANTS: Between June 1997 and December 2000, 45 children with TS received treatment at pediatric clinic of Chenghai sectional people' s hospital, Shantou city, who accorded with the diagnostic standards of the second edition of Chinese Psychopathy Category and Diagnostic Standards,those who were confirmed as brain organic diseases by CT and MIR were excluded.METHODS: Serum iron, hemoglobin and the number of red blood cells were determined in 45 TS children and compared with that in 38 controls.MAIN OUTCOME MEASURES: Difference of the level of serum iron and the incidence of hypoironemia between two groups.RESULTS: The level of serum iron was(12.79 ±0.67) μmol/L in experimental group, obviously lower than(19.26 ± 5.38) μmol/L in control.group( P ＜ 0. 005), the incidence of hypoironemia was 42% significantly higher than13% of control group( P ＜ 0. 005).CONCLUSION: Quite a lot of children with TS have hypoironemia that might be one of the pathogenesis factors, the possible mechanism is, as the result of hypoironemia, decreased activity of monoamine oxidase led to abnormal monoamine neurotransmitter.

This paper mainly discusses how physician - patient disputes are included within scope of the media and become its"focus"of concern.It has revealed in my research that the dual interests of the media,the interests driving of the journalists,the strength of TV (or video) and the audiences are the inherent dynamisms which ehance the media let physician - patient disputes included in its vision.In other words,the physician - patient disputes become the"hot spot"of media attention with the help of the gatekeepers and the audiences.

Objective To investigate the expression of transforming growth factor ?_1(TGF?_1)in renal cortex from uninephrectomized diabetic rats. Methods Wistar rats were divided into uninephrectomized rats(group A), streptozotocin diabetic rat(group B). Blood glucose, serum insulin level and body weight, kidney weight, kidney weight/body weight as well as renal tissue protein contents were observed after 1, 4 weeks of streptozotocin injection. The expression of TGF?_1, precollagen 1?(Ⅳ) and fibronectin mRNA were measured by Northern blot analysis, and TGF?_1 protein by Western blot analysis in kidney cortex. In addition, ACE activities were determined by fluorimetric assay in plasma, kidney cortex and medulla. Results Group B demonstrated significantly elevated blood glucose and decreased serum insulin level. Kidney weight、kidney weight/body weight and renal tissue protein contents progressively increased despite total body weight loss. There was significant(P

Object To report the one arm external fixator with skeletal traction of calcanus in treatment of comminuted fractures of tibia and fibula. Method 186 cases of fractures of tibia and fibula were treated by the one arm external fixator with skeletal traction of calcaneus. 42 cases were open fractures, and 142 cases were closed fractures.185 cases were followed up. Results 183 cases of fracture united, and the average healing time was 6 months. By Johner Wrichs score 113 were rated as excellent, 69 good, 2 poor. The infection rate was 17.5%. Conclusion It is convenient and effective to use one arm external fixator with skeletal traction of calcaneus to treat comminuted tibia and fibula fractures.

Objective To investigate the relationship between the expression of CC chemokine ligand 5(CCL5)and S100 calcium binding protein A4 (S100A4)protein in breast cancer tissues with clinicopathological features and prognosis.Methods The expression of CCL5 and S100A4 in 40 cases of normal breast tissues and 120 cases of breast cancer were detected by immunohistochemistry,and the relationship between the degree of expres-sion and the clinicopathological features and prognosis of breast cancer was analyzed.Results The expression posi-tive rates of CCL5 and S100A4 in breast cancer tissues were 56.67% and 62.50% respectively,which were not expressed in normal breast tissues,and the differences were statistically significant (χ2CCL5 =39.403,P <0.01;χ2S100A4 =47.062,P <0.01).The expression of CCL5 in breast cancer tissues was statistically correlated with clinical staging(χ2 =10.141,P <0.01 ),pathological type (χ2 =5.769,P =0.017)and lymph node metastasis (χ2 =34.178,P <0.01),but not correlated with patients'age,tumor size,pathological grading(all P >0.05 ).And the expression of S100A4 was statistically correlated with clinical staging(χ2 =44.311,P <0.01)and lymph node metas-tasis(χ2 =14.843,P <0.01 ),but not correlated with patients'age,tumor size,pathological type and pathological grading(all P >0.05).The expression of CCL5 and S100A4 in breast cancer was positively correlated(r =0.301, P <0.01).CCL5 was positively correlated with the recurrence of breast cancer(OR =6.270,P <0.01),and S100A4 was not correlated with the recurrence of breast cancer(OR =1.103,P =0.768).Survival analysis showed that the disease -free survival time of patients with positive CCL5 expression was significantly shorter than the patients with negative CCL5 expression(χ2 =11.851,P <0.01 ),and the disease -free survival time of patients with positive S100A4 expression was significantly shorter than the patients with negative S100A4 expression(χ2 =5.433,P =0.021).The joint detection showed that the disease -free survival time in CCL5(+)+S100A4(+)group was sig-nificantly lower than that of CCL5(+)or S100A4(+)group(χ2 =15.341,P <0.01)and CCL5 (-)+S100A4 (-)group(χ2 =15.341,P <0.01).Conclusion The expression of CCL5 and S100A4 in breast cancer can reflect the metastasis and staging of breast cancer,which can be used to judge the clinical pathological characteristics and prognosis of breast cancer.

Biodiesel, a nontoxic,cleaning, renewable and biodegradable fuel, is expected as a substitute for conventional fossil diesel. There are three main approaches to produce biodiesel, alkali-catalysis processing, enzymatic-catalysis processing and supercritical processing. With the unique property of energy-saving and environment-friendly, enzymatic-catalysis appears a great potential for industrial application. The main bottleneck of this technology is high cost and low stability of the lipase, as well as the inactivation of lipase by methanol and so on. To settle the problem, several methods have been used including the fixed-bed bioreactor, enzyme immobilized processing, whole-cell biocatalyst, changing addition method of methanol, developing of novel acyl acceptor, enhancing methanol resistance of lipase. The main problems and the relative strategy research of the enzymatic-catalysis technology were sum up.

Objective To investigate the diagnostic significance of argyrophilic nuclear organizer regions(AgNORs) of peripheral T lymphocytes in elderly cancer patients. Methods AgNORs was examined using KL tumor image analysis system in 45 cases of health control,36 cases of elderly inflammatory patients,97 cases of elderly cancer patients and 30 cases of elderly tumor-cured patients. CD3,CD4,CD8,CD4/8 and NK were detected by flow cytometer in cancer patients. Results Compared with normal controls,inflammation and tumor-cured patients,AgNORs was decreased extremely in elderly patients with cancer. Moreover,AgNORs was decreased in tumor metastasis status. Conclusions In analyzed elderly cancer patient cases,the expression of AgNORs is significantly decreased. The AgNORs may serve as a marker for judgment of clinical treatment and supervisor.

Objective To investigate the causes and outcome of different treatment methods of iatrogenic rectovaginal fistula. Methods Clinical data of 52 patients with iatrogenic rectovaginal fistula were analyzed retrospectively. Results Twenty-two fistulae occurred after gynecological operation (42.3%), fourteen after obstetric injury (26.9%), thirteen after colorectal operation (25.0%) and three due to miscellaneous causes (5.8%). The fistulae were located in the lower rectum in 27 cases(51.9%), mid rectum in 10 cases(19.2%) and upper rectum in 15 cases(28.9%). They were treated by non-surgical treatment in 9 cases(17.3%), permanent diverting stoma(loop transverse colostomy) in 8 cases(15.4%), and surgical repair by various approaches in 35 cases(67.3%). The fistulae of all nine patients who received non-surgical treatment failed to heal. Eight patients who received permanent diverting stoma had symptomatic improvement without fistula healing. The overall cure rate of surgical repairs in 35 cases was 77.1%(27/35). The cure rates of trans-sphincteric (Mason′s operation), transanal, transabdominal, transperineal and transvaginal approaches were 100%(8/8), 100%(2/2), 83.3%(5/6), 0%(0/1) and 66.7%(12/18), respectively. The cure rate of Mason′s operation for the mid and lower rectovaginal fistulae was higher than that of transvaginal approach (100% vs 66.7%). Conclusions Iatrogenic rectovaginal fistula is caused by obstetric injury or injury of rectovaginal septum due to surgical mismanagement. Surgical repair is the only method that can cure rectovaginal fistulae. Mason′s operation is a favorable treatment method for the mid and lower (especially mid) rectovaginal fistulae.