ObjectiveTo study the diagnostic method of microcirculation disturbance of patients with chronic hepatitis B (CHB).Methods81 patients with CHB and 5 normal volunteer were observed.Hypoxia-induciable factor was detected by immunohistochemistry stain,TXB2 and 6-Keto-PGF1α were detected by chemiluminescence and HA was detected by RIA,ultrastructure of liver was observed by transmission electron microscope (TEM).ResultsAccompany with the pathological changes of liver in patients with CHB,the strength and range of expression of HIF-1 α enhanced,HA and TXB2 of serum rised gradually( all P ＜ 0.05 ),but 6-Keto-PGF1α of blood plasma fell- off.The electron microscope showed that erythrocyte aggregation,stenosis and blockage of sinus hepaticus turned obviously,collagen fibers deposition and basal membrane formation aggravated gradually.ConclusionAssociated detec tion with HIF-1 α、HA 、TXB2 and 6-Keto-PGF1 α can reflect the condition of microcirculation of liver perfectly.

[Objective]To analyze the MRI and CT characteristics of the pathological changes of ligamentum flavum.[Method]Clinical data of MRI and CT characteristics of 48 cases of lagamentum flavum pathological changes were analyzed and compared retrospectively.[Result]MRI showed"\"signal in sagital position and"V"signal from the vertebral canal in stalk postition.CT showed two sides of soft tissue signal of vertebral canal and some part presented bone substance density.[Conclusion]The MRI,CT images of the ligamentum flavum pathological changes have both advantages and disadvantages.It would benefit the clinical therapy only with the combination of them.

Objective To investigate the clinical value of serum pepsinogen(PG)Ⅰ,Ⅱ and gastrin-17(G-17)levels in early di-agnosis for atrophic gastritis and gastric cancer.Methods The study was performed on a case-control trial,and 430 subjects were recruited.Each of them underwent endoscopy biopsies before serum tests were performed.These patients were further divided into three groups based on endoscopic and histological findings:160 non-atrophic gastritis group,118 atrophic gastri-tis group and 152 gastric cancer group.Serum samples of PGⅠ,PGⅡ and G-17 were analyzed by enzyme-linked immunosor-bent assay(ELSIA),and calculated the values of PGⅠ/PGⅡratio.Results Compared with the non-atrophic gastritis group, serum PGⅠ and G-1 7 values in atrophic gastritis and serum PGⅠ,PGⅡ,PGⅠ/PGⅡratio and G-1 7 values in gastric cancer group decreased significantly (P<0.05);compared with the atrophic gastritis group,serum PGⅠ and G-17 values in gastric cancer group decreased significantly (P<0.05).By using receiver operating characteristic curves (ROC),the cut-off points of PGⅠ84.706μg/L,PGⅡ 10.873μg/L,PGⅠ/PGⅡ ratio 11.008 and G-178.265 pg/L in atrophic gastritis group,PGⅠ65.145μg/L,PGⅡ 10.089μg/L,PGⅠ/PGⅡ ratio 6.375 and G-17 4.971 pg/L in gastric cancer group.Conclusion Low serum PGⅠ,PGⅡ,PGⅠ/PGⅡ ratio and G-1 7 values are biomarkers of atrophic gastritis and gastric cancer and valuable for the early diagnosis of gastric cancer.

[Objective]To investigate the clinical use of spiral CT with 3D Reconstruction for fractures of the tri-ankle joint.[Method]Fifty-six cases of tri-ankle joint fractures treated in our hospital from 1999 to 2004 were studied respectively.The ankle joint X-ray and spiral CT with 3D reconstruction were taken for all the cases preoperatively.The results were analyzed and compared with finding in operation .Scanning parameters of spiral CT were: 2 to 5mm collimation,3 to 5mm table speed and 1.5 to 3mm reconstruction interval.[Result]Fractures were demonstrated definitely by spiral CT in all the cases.Analyses of the results showed the superiority of spiral CT with 3D reconstruction in the fracture classification.Exact assessment of fragments and total agreement of the preoperative results were compared with findings in operation.[Conclusion]Operative treatment and rehabilitation may provide satisfactory fracture reduction and clinical results for ankle joint fracture.Well-timed treatment,correct fracture pattern estimation,proper internal fixation and rehabilitation are important to achieve better long term results.

Objective To study the effects of IFN-?on expression of B7 molecules in human lung adenocarcinoma cell line cultured in vitro.Methods Human lung adenocarcinoma SPC-A-1 cells were incubated in the medium with IFN-?respectively.Cell proliferation effect was measured by MTT assay;apoptosis was detected with flow cytometry assay;expression of B7-1 and B7-2 mRNA was determined by RT-PCR.Results Compared with those of control group,MTT shows that IFN-?could reduce the SPC-A-1 cell proliferation.FCM shows the apoptosis rate in the IFN-? group was significantly higher,but there is no different changes in each concentration group.Compared with the control group,expression of B7-1 and B7-2 significantly increased in the IFN-?group,and the expression was not correlated with the concentration of IFN-?in each control group.Conclusion IFN-?can inhibit cell proliferation and induce apoptosis in SPC-A-1 cell line.IFN-?markedly enhance the expression of B7-1 and B7-2 in SPC-A-1 line.The apoptosis may be mediated by up-expression of gene B7-1 and B7-2.

Objective:To explore a new way of nursing teaching round-making compatible with the nursing students at junior college,and to establish and improve the standards for its assessment.Methods:We performed a new mode of nursing teaching ward round jointly organized by nursing teachers of the school and clinical supervisors of the hospital among student nurses of Grade 2006 on four different subjects respectively,by going through the following four steps: establishing the subject,working out the plan,making the ward round and assessing the quality.Results:The average score on the quality assessment of the four subjects by teachers and students was 93.78.Conclusion:The new mode of nursing teaching ward round jointly organized by the school and hospital can make the best of nursing faculty resources,give full play to nursing students'potential and optimize this activity and facilitate the teaching of clinical nursing.

Objective: To explore an integral training mode for student nurses in large modern general hospitals.Methods: Integral nursing training was conducted in our hospital among 610 student nurses from universities and postsecondary specialized colleges.Results: All the student nurses considered the integral training to be helpful for the promotion of their professional nursing competence.Conclusion: The professional competence-oriented integral nursing training can optimize the teaching quality of clinical nursing and help enhance the professional competence and comprehensive qualities of student nurses.

Limb-shaking transient ischemic attack (TIA), a rare manifestation, is commonly caused by severe stenosis or occlusion of an extracranial internal carotid artery. Such patients are usually treated with surgical revascularization or anti-platelet therapy. We present a 56-year-old woman with 6 months’ episodic attacks starting with mouth skewed to the right and a sensation of ‘weakness’ involving predominantly her left arm, and at times, also involved the left leg. This was immediately followed by rhythmic jerky movements of the left arm and at times, also involved the left leg. Magnetic resonance angiography revealed severe stenosis of M1 segment of the right middle cerebral artery. The patient’s symptoms were signifi cantly improved by treatment with anti-platelet drugs and nimodipine.

Objective To determine if fetal stem cells can enter the maternal circulation during pregnancy and re-pair the injuries of maternal heart.Methods C57 female mice at the age of 6-8 weeks were randomly assigned to three groups:sham control, surgery without pregnancy, and surgery with pregnancy ( n=8,eath group) .The control sham group was developed by opening and closing of the chest.The other two groups underwent heart surgery.The myocardial infarc-tion ( MI) model was induced by ligation of the left anterior descending coronary artery.Half of the surgical mice mated with e-GFP transgenic male mice, and another half group was not.Electrocardiogram ( ECG) and echocardiographic images were recorded at pre-operation, post-operation and postpartum.The collected data were used to evaluate the heart function. The GFP expression was detected by immunohistochemistry and q-PCR.Results When compared with the sham group, both the ischemia surgery groups with and without pregnancy, the ECG ST segment was significantly increased.This meas-urement indicated that the myocardial ischemia surgery was successful, and no significant difference in the ST segments be-tween two ischemia surgery groups was found.However, when ECG was measured in the surgical mice after postpartum, their myocardial ischemia was dramatically improved when compared with that of the ischemia surgery only mice.Echocar-diographic images also indicated that both the surgery groups had myocardial ischemia, however, no significant difference was observed in the pregnant mice before and after postpartum.The order of the cardiac function indexes from high to low was the sham group, surgery with pregnancy group, and surgery with no pregnancy group;in particular, the cardiac func-tion of pregnancy group was significantly enhanced compared with that of the surgery with no pregnancy group (P<0.05). More importantly, both immunofluorescence and q-PCR results showed that the embryonic stem cell translocation through circulation system with GFP expression in the heart of pregnancy group, while negative in other two groups.Conclusions Embryonic stem cells can be transferred into the maternal circulation of pregnant mice, and play a role in the repairing of their cardiac injuries.

Objective To evaluate the feasibility and safety of endoscopic thyroidectomy via anterior chest and breast for the treatment of patients with papillary thyroid carcinoma ( PTC ).Methods Endoscopic thyroidectomy was performed in 85 PTC patients between March 2006 and March 2010. Diagnosis was based on intraoprative frozen section. There were 83 females and 2 males, age averaged at 36. 3 years. Sixty three of 85 cases were diagnosed preoperatively as thyroid carcinoma and US revealed ipsilateral cervical lymph node enlargement suspective of metastasis in 12 cases. Endoscopic thyroidectomy plus selective neck dissection was performed. Results This procedure was carried out successfully in 84patients. There were 51 cases of papillary thyroid microcarcinomas(<1. 0 cm) , 28 cases between 1. 0 cm and<2. 0 cm, and 5 cases with the diameter between 2. 0 cm and 3. 0 cm. Total thyroidectomy, ispilateral lebectomy and ispilateral lebectomy plus contralateral subtotal lobetomy were performed in 4, 6, 74 cases,respectively. Central compartment dissection was performed in all of the 84 cases and ipsilateral neck dissection was also performed in 12 cases that were suspected metastatic lateral neck lymph nodes. The mean operative time was (113. 3 ±46. 5) minutes. No significant blood loss occurred. The mean number of lymph nodes yield in the central compartment and lateral compartment were 6. 5 (range 2 to 14) and 19. 2 (range 9 to 26 ), respectively. Forty-four cases ( 44/84, 52. 4% ) had metastatic lymph nodes in central compartment, while 11 cases (11/12,91.1% ) in lateral compartment. Six patients (6/84,7.14%) had transient vocal cord palsy and recovered after 1-2 months. Postoperative transient hypocalcaemia occurred in 4 cases (4. 8% ) , and there were no other major complications. The average postoperative hospital stay was 3. 7 days (range 3 to 6). No evidence of residual or recurrent disease was found at follow-up. The cosmetic results of this procedure were excellent. Conclusions The anterior chest and breast approach of endoscopic thyroidectomy is feasible and safe and cosmetic worthwhile for selected cases of PTC.