Objective To investigate the effects of somatostatin(SST)or vasoaetive intestinal peptide (VIP)on the expression of MAdCAM-1 in the intestinal muecosa of rats with multiple organ dysfunction syndrome (MODS)and its significance of prevention and treatment of MODS.Method Thirty six Wistar male rats were randomly divided into 6 groups(6 rats in each group),including control group,VIP group 1 and SST group1 (rats treated with VIP and SST respectively),MODS group(rats with MODS),VIP group 2 and SST group 2(NODS rats treated with VIP and SST respectively).The rat model of MODS(system inflammatory response syndrome,＞2 or-gans dysfunction)was established by occlusion of superior mesenteric arteries.0.2 ρmol·g-1 h -11 VIP or SST by intravenous injection combined with 0.25 ρmol/g VIP or SST by intraperitoneal injection were injected into rats.In each group,intestinal lymphocytes from rats labeled with 51 Cr were infused into rat veins and were quantified with γcounter in GALT.The expression of MAdCAM-1 in the intestinal mucosa was measured by western blot.Inflam-mation in the intestinal mucosa was evaluated with histological sections.Student's t test was used to assess differ-ence between the experiment group and the control group.Results In VIP group l and SST group 1,the peak values of MAdCAM-1 expression in diffusive lymphatic tissue of small intestinal were 157.67±2.52 and 154.33±3.22.and those in Peyer patches were 136.00±1.00 and 137.00±1.00.There were no significant difference when compared with control group(165.33±1.53,152.67±2.31,P＞0.05).The percentage of 51 Cr-lympho-cytes in diffusive lymphatic tissue of small intestine(1.04%±0.59%,1.01%±0.83%)showed no significant difference from control group(1.07%±0.61%,P＞0.05),and those in Peyer patches(1.83%±0.90%,1.56%±0.64%)were significantly less than control group(3.85%±2.02%,P＜0.05).In VIP group 2 and SST group 2,the peak values of MAdCAM-1 expression in diffusive lymphatic tissue of small intestinal(158.00±2.65,154.33±1.53)and Peyer patches(156.33±1.53.151.33±2.31)were significantly less than MODS group(175.33±2.52,173.00±2.65,P＜0.05).The percentage of 51 Cr-lymphocytes in diffusive lymphafic tissue of small intestine(1.58%±0.42%,1.45%±0.26%)and Peyer patches(2.14%±1.49%,0.81%±0.35%)were significantly less than MODS group(3.23%±1.69%,5.04%±1.23%,P＜0.05)and the se-vere histopathological danlage in intestine was relieved.Conclusions VIP or SST reduced intestinal lymphoeytes homing to GALT in rats with MODS through suppressing the expression of MAdCAM-1,and attenuated the inflam-matory injure in the intestinal mucosa.

Objective To observe the results of bone bolt crews in treatment of the haplo-detached distal tibiofibular joint.Methods The haplo-detached distal tibiofibular joint were fixed with bone bolt in 7 patients.Their outcomes were evaevaluated according to Mast and Teipner criteria and X-ray.Results All 7 patients were followed up from 12 to 36 months.All were assessed as good,and no fair or poor cases were found.Conclusion Bone bolt fixation was believed to be a good method to treat the haplo-detached distal tibiofibular joint with simple operation,beared shear force and control of brew tightress and was helpful in weight loading and functional exercises in the earlier period after operation,so bone bolt fixation was good in practical value in clinc.

Objective To investigate the significance of clinical nursing pathway in perioperative period of children with hypospadia.Methods 63 cases of hypospadia children patients were randomly divided into the control group (30 cases)and the experimental group (33 cases).The traditional nursing method was used in the control group,while the clinical nursing pathway was used in the experimental group.Results The hospital stay,hospital charges and complications of the experimental group were less than the control group.The satisfaction degree of the experimental group was higher than the control group.There was significant difference.Conclusions Clinical nursing pathway is a safe and effective nursing model.It can shorten hospital stay,reduce hospital charges,decrease complications,and improve patients' satisfaction degree.

Objective To observe the changes in endothelin(ET), nitric oxide(NO) and C-reactive protein(CRP) before and after the rosiglitazone therapy in patients with impaired glucose tolerance(IGT). Methods 72 IGT patients were divided randomly into 2 groups: rosiglitazone group(n=45) and placebo group(n=27). 15 weeks later, the efficacy of rosiglitazone was compared. Results The levels of ET, CRP were decreased and NO increased significantly in rosiglitazone group compared with those before treatment (ET 54.8±10.0 pg/ml vs 72.8±24.3 pg/ml, P<0.01;CRP 4.58±0.38 mg/L vs 5.99± 0.85mg/L, P<0.01 ; NO 41.0±10.0 μmol/L. vs 31.3±9.0 μmol/L, P<0. 01)). However, the levels of ET,CRP and NO in placebo group did not change singnificantly (P>0. 05). Conclusions Rosiglitazone can singnificantly improve ET, NO, CRP level in IGT patients, which means an additional effect of rosiglitazone on the correlation of inflammation and endothelial disturbance.

Objective To study the clinical features of patients with intracranial ependymal tumour, and explore the prognostic factors which have.a significant association with the outcome. Methods Eighty-three patients with histologically proven ependymal tumour were retrospectively reviewed. The tumour location, the patients' age, the histological features, imaging characteristics, surgical management and adjuvant therapy were studied. Results In 83 cases of intracranial ependymal tumour,41 cases were infratentorial and 42 cases were supratentorial ependymal tumour, 37 patients age ≤15 years, while 46patients age ＞ 15 years. Fifty-eight patients ( 69.9% ) and 25 patients (30.1% ) had low (WHO Ⅰ - Ⅱ ) and high-grade (WHOⅢ) tumors respectively. Sixty-reven (80.7%) patients had gross total resection and 16patients ( 19.3% ) had subtotal resection. The 5-year survival rate was 81.9%( 68/83 ). The factors that were found to have a statistical significance association with the outcome were the extent of the resection and the pathologic characteristics. Conclusions Gross total resection of these tumors results in a good long-term outcome. Reoperation should be considered, if feasible, to remove residual malignant tissue. Anaplastic ependymomas carries a much poorer prognosis. Radiotherapy may play an important role in their treatment.The role of chemotherapy appears limited but can be attempted, especially in the very young, in order to avoid the deleterious effect of radiotherapy.

Objective　To evaluate the safety of biopsy of the prostate guided by transrectal ultrasound.Methods　Three hundred and seventeen patients suspected to have prostate cancer were examined and 208 patients were followed up.Results　One hundred and eighty-one patients followed up did not feel severe pain during the biopsy of the prostate. Clinical manifestations induded 12 cases of hematuria,4 dases of hematospermia,1 case of fever, 2 cases of pollakisuria and urodymia,2 cases of uroschesis,which disappeared after corresponding treatment.Conclusions　Biopsies of the prostate guided by transrectal ultrasound is advantageous in diagnosis of prostatic carcinoma.

In February 2008 the Xiamen Municipal Government reorganized the health service in Xiamen City to create a"Xiamen Model"for community health service.The community health service centers were divided into two parts:the public health service was directly undertaken by the loal government,and the medical service was affiliated to one of the tertiary hospitals.Both were financed by govemment budget,but operated separately.A recent survey showed that the "Xiamen model" promoted the vertical integration of Xiamen medical resources.increased the service efficiency,reduced the medical and drug cost,and improved the satisfaction of local residents.Nevertheless,there were still some problems;the tertiary hospital should change its service pattern and enhance general practice in the community,the finance compensating mechanism need to be improved.

As the techruque of molecular biology developed, the research of aplastic anemia turns to the cytogenetical level. Scientists focused on irwestigating the relationship between the mutation of gene or chromosome and the curative effect of aplastic anemia.The results show that abnormality of particular chrromosome or gene will cause different outcome . On the other hand, the first line therapy of aplastic anemia is still IST or HSCT according to the different situation.The antibody special for T cell is still in studying, and the effect shows well .Through the typing diagnosis consummated, the treating method developed, the survival rate of the patient with apLastic anemia will be advanced.

Objective To probe into the nursing experience of reasonable cooperation between op-eration room nurses and anesthesiologists. Methods Strengthening preoperative propaganda and psy-chological education,paying attention to the temperature and humidity in operation room,assisting the anesthesiologists to arrange patients'body position,giving cooperation of infusion and transfusion,actively involving in rescue work.Results Surgery patients got good care,anesthesia and surgery went along smoothly. Conclusions Smooth coordination between operation room nurses and anesthesiologists has great significance on the smooth going and satisfactory results of operation.

ObjectiveTo improve the compliance behavior of discharged patients with chronic obsturctive pulmonary disease(COPD)by health education of telephone visit.Methods240 COPD patients were divided randomly into the experimental group and the control group with 120 cases in each group.The experimental group accepted telephone visit regularly for six months after 1 week since discharged from hospital and the control group did not receive any intervention.Six months later,the compliance behavior and the readmission of two groups were compared.ResultsThe results indicated that the compliance behavior of the experimental group was significantly better than that of the control group (P<0.01).ConclusionsConducting the health education of telephone visit can strengthen the patients' compliance behavior,postpone the process of disease,prevent complications,lighten economic burden and improve their life quality.