Objective To investigate role of reverse digital artery island flap combined with dig- ital nerve end to side anastomosis.Methods Reverse digital artery island flaps were used for recon- struction of 65 fingertip defects in 57cases,in which the restoration of the flap sense was attained via dig- ital nerve end to side anastomosis.Results After primary repair,all flaps survived,with good appear- ance and wear-resisting as well as satisfactory two-point discriminations.Conclusion Digital artery re- verse island flap combined with digital nerve end to side anastomosis is a simple and effective procedure for repair of finger defect.

The producing condition and properties of chitinase secreted by Nomuraea rileyi strain CQ031021 were studied.The optimal conditions for the strain to produce chitinase are 6 days of 28℃ with the initial pH 6.0,and the liquid medium containing 2.0% glucose as its carbon source and 0.6% peptone plus 0.6% beef extract as nitrogen source after inoculating dosage 2mL suspension of conidia(1?107/mL).The optimal temperature and pH for enzyme activity is 50℃ and 6.0,respectively,while the activity can be enhanced by Tween-80 and inhibited by SDS.The enzyme activity is stable under 40℃ and in pH range of 5.5～6.5.

Objective Analyzing the impact of teachers' background characteristics on the Students' evaluation to improve the quality of teaching from the angle of the teachers professional development. Methods Based on the data of students' evaluation of teaching of Shanghai medical college of Fudan University from 2008 to 2011, the article analyzed the teachers' gender, age, job title, diploma, and other relevant background characteristics. Excell2007 was used to build dataset and the data was analyzed statistically by software of SPSS 11.0 and expressed with x±s. The statis-tical method of one-way analysis of variance was used to compare the teachers with different genders, education backgrounds, ages and professional titles, showing statistically significant difference (P<0.05). Results comparative analysis showed that no statistically significant differences existed in fac-ulty teaching evaluation scores among the teachers of different genders or different education back-grounds(P=0.613 9、0.891 0). There were however significant differences in teaching evaluation of teachers of diverse ages and professional ranks(P=0.017 3 and P=0.032 5). Conclusions According to the analysis results of faculty teaching evaluations, associate professors' teaching evaluation scores were lower than intermediate grade teachers', and the score of the teachers between the age of 41 to 45 was lower than that of the teachers between the age of 36 to 40. Therefore individual variations and various social backgrounds of teaching faculties should be taken into consideration and the corre-sponding countermeasures for the professional development of teachers should been put forward. In addition, the cultivation of new teachers, young and middle-aged teachers should be strengthened, and the proportion of teaching evaluation in the Performance Appraisal should be increased.

OBJECTIVE: To explore the severity index of Meniere's disease during acute phase by a statistical method of principal component analysis (PCA). METHOD: Ninety-five patients with Meniere's disease in the acute phase who saw the doctor with 24 hours after onset were included in this study and their clinical data were analyzed retrospectively. The subjective symptoms of hearing loss (X1) and ear stuffy plug (X4) were evaluated by VAS scoring system, and the impact of vertigo (X2) and tinnitus (X3) on the patients were evaluated by DHI and THI score. The principal component analysis (PCA) method was used to analyze the quantified data and construct a synthetic evaluate function of subjective symptoms. RESULT: (1) The quantitative results of subjective symptoms in patients with Meniere's disease were as follow: VAS score (X1) of hearing loss was 0-91 points, with an average of 46.23 ± 18.80, DHI score (X2) of vertigo was 8-98 points, with an average of 49.66 ± 15.67, THI score (X3) of tinnitus was 10-100 points, with an average of 47.53 ± 17.44, and ear VAS score (X4) of stuffy plug feeling was 0-82 points, with an average of 21.55 ± 27.54. (2) The eigenvalue of principal components Z1, Z2 and Z3 were 1.876, 0.984 and 0.703 respectively, and the variance contribution were 46.898%, 24.592% and 17.574% respectively. (3) The constructed synthetic evaluate function of the disease was as follow: The Meniere's disease severity index ƒ = 0.213ZX1 + 0.398ZX2 + 0.370ZX3 + 0.455ZX4. CONCLUSION The method of PCA for the subjective evaluation of symptoms in Meniere's disease can be constructed as a model of comprehensive evaluation system, which may provide relatively comprehensive information of clinical original variables included in the four main symptoms, reflecting the severity of the disease.
Hearing Loss ; complications ; Humans ; Meniere Disease ; complications ; diagnosis ; Principal Component Analysis ; Retrospective Studies ; Severity of Illness Index ; Tinnitus ; complications ; Vertigo ; complications

It is an important teaching task how to make respiratory disease specialists to accept the standardization training of pulmonary function. However, the theory of pulmonary function is comparatively abstract and the training time is short, but the task is heavy. In order to explore a set of feasible training mode, the pulmonary function laboratory of Zhongshan Hospital affiliated to Fudan University carries out various forms of training, such as compiling textbooks, establishing case database, using multimedia teach-ing, arranging one-to-one guided teaching, and training the ability of doctor-patient communication.

Objective To study the anatomy of pelvic autonomic nerves, to avoid autonomic nerves damage during rectal cancer surgery. MethodsAnatomical dissections were carried out on 7 adult cadavers, and clinically autonomic nerve-preserving rectal cancer resection was performed. Results The superior hypogastric plexus lies just posterior to the inferior mesenteric vessels. There were no obvious autonomic nerve trunks in the loose areolar tissue plane between the parietal fascia and the visceral fascia right posterior to the rectum. There were no obvious autonomic nerve trunks between the rectum and the seminal vesicles or the prostate. The inferior hypogastric plexus was a rhomboid shaped plaque of nervous tissue. The main components of the lateral ligament were autonomic nerves passing from the pelvic plexus to the rectum within a condensation of connective tissue. WT5”HZConclusionsThe inferior mesenteric vessels can be used a landmark intraoperatively to identify the superior hypogastric plexus. In order to preserve the inferior hypogastric plexus while dissecting the lateral of rectum, we should dissect along the medial surface of the inferior hypogastric plexus, and along its curvature. JP2

OBJECTIVETo explore the efficacy and safety of zero-profile implant for anterior cervical discectomy and fusion (ACDF) in treating single cervical disc herniation.

METHODSFrom August 2011 to June 2012,30 patients with single cervical disc herniation were treated with ACDF using zero-profile implant in one motion segment. There were 18 males and 12 females with a mean age of 55.3 years old (ranged, 36 to 68). Incidence of dysphagia, height of intervertebral space and condition of bone fusion were observed after operation. Spinal nerves function and clinical results were assessed according to Japanese Orthopaedic Association (JOA) score, Odom criteria.

RESULTSAll patients were followed up from 12 to 24 months with an average of 15.9 months. The mean intraoperative blood loss was (85.3 +/- 14.2) ml (70 to 120 ml) and operative time was (90.0 +/- 12.8) min (70 to 120 ml). Preoperative, postoperative at 3 months and 1 year, JOA score was 8.72 +/- 2.36 (5.0 to 13.0), 14.72 +/- 1.66 (11.5 to 17.0) and 15.65 +/- 1.03 (13.5 to 17.0), respectively. One year after operation, according Odom criteria to assess, 22 cases got excellent results, 7 good, 1 fair. All dysphagiaes vanished completely at 3 months after operation. The lost height of intervertebral space was (0.34 +/- 0.13) mm (0.1 to 0.6 mm) and (0.39 +/- 0.15) mm (0.2 to 0.7 mm) at 3, 12 months after operation, respectively. All patients obtained bone fusion at 1 year after operation.

CONCLUSIONThe zero-profile implant is a valid alternative to anterior cervical plate in treating single cervical disc herniation with ACDF, it has advantages of convenient procedure, satisfactory effect, lower incidence of postoperative dysphagia, reliable stability and less implant-related complications.

Adult ; Aged ; Cervical Vertebrae ; surgery ; Diskectomy ; adverse effects ; methods ; Female ; Follow-Up Studies ; Humans ; Intervertebral Disc Displacement ; surgery ; Male ; Middle Aged ; Prostheses and Implants ; Safety ; Spinal Fusion ; adverse effects ; Treatment Outcome

OBJECTIVETo investigate the clinical effectiveness of sertraline hydrochloride combined with four-spot caress in the treatment of primary premature ejaculation (PE).

METHODSWe randomly assigned 90 primary PE patients to three groups of equal number. The patients in group A (aged [28.1 ± 5.2] yr and with a disease course of [3.1 ± 1.9] yr) were treated with oral sertraline hydrochloride at 50 mg qd, those in B (aged [27.8 ± 4.1] yr and with a disease course of [3.2 ± 2.0] yr) by four-spot caressing (caressing the tongue, breasts, and vulva prior to intercourse), and those in C (aged [27.1 ± 4.7] yr and with a disease course of [3.1 ± 2.0] yr) by the combination of oral sertraline hydrochloride and four-spot caressing, all for 12 weeks. Before and after 4, 8, and 12 weeks of treatment, we obtained the intravaginal ejaculatory latency time (IELT) and Chinese Index of Sexual Function for Premature Ejaculation-5 (CIPE-5) scores and compared them among the three groups of patients.

RESULTSThe IELT was dramatically prolonged in groups A, B, and C after 4 weeks ([1.08 ± 0.29], [0.93 ± 0.28] and [1.21 ± 0.27] min), 8 weeks ([1.43 ± 0.30], [1.20 ± 0.33] and [1.72 ± 0.42] min) and 12 weeks of treatment ([2.12 ± 0.63], [1.90 ± 0.65] and [2.67 ± 0.82] min) as compared with the baseline ([0.63 ?0.14] , [0.60 ?0.14] and [0.62 ?0.11] min) (P < 0.05), even longer in group C than in A and B (P < 0.05). The CIPE-5 scores were markedly improved in groups A, B and C after 4 weeks ([15.17 ± 1.74], [14.57 ± 1.94] and [15.60 ± 1.63] min), 8 weeks ([17.13 ± 1.63], [16.37 ± 1.97] and [18.00 ± 1.05] min) and 12 weeks of intervention ([18.93 ± 1.57], [18.53 ± 1.67] and [20.00 ± 1.46] min ) as compared with the baseline ([12.57 ± 2.05], [13.20 ± 2.51] and [13.07 ± 2.01] min) (P < 0.05), even higher in group C than in A and B (P < 0.05).

CONCLUSIONSertraline hydrochloride combined with four-spot caressing, with its definite efficacy and rare adverse reactions, deserves wide clinical application in the treatment of primary PE.

Adult ; Coitus ; Ejaculation ; Female ; Humans ; Male ; Premature Ejaculation ; drug therapy ; Sertraline ; therapeutic use ; Young Adult

OBJECTIVETo study the clinicopathologic features of intraductal papillary mucinous neoplasm (IPMN) and its distinction from mucinous cystic neoplasm of pancreas.

METHODSThe clinical, radiologic and histologic features of 17 cases of IPMN and 13 cases of mucinous cystic neoplasm (MCN) were reviewed. Mucin profiles (MUC1, MUC2 and MUC5AC) were studied by histology (HE) and immunohistochemistry (EnVision).

RESULTS10 of the 17 cases of IPMN were males. 13 cases of the IPMN were located in head of pancreas. Communication with the main pancreatic duct was demonstrated in 15 cases. Histologically, there were mild to severe papillary ingrowths of dysplastic epithelial cells, associated with intervening normal or atrophic pancreatic parenchyma. Ovarian-like stroma was not seen. Ancillary investigations showed that MUC2 and MUC5AC were detected in tumor cells of 9 and 4 cases respectively. The 4 cases with invasive component showed MUC1 positivity. On the other hand, 11 of the 13 cases of MCN occurred in middle-aged to elderly females and were located in the body and tail of pancreas. Ovarian-like stroma was commonly seen and there was no connection with the main pancreatic duct. All non-invasive MCN, regardless of the degree of cytologic atypia, were positive for MUC5AC (but not MUC2). In the 2 cases with invasive component, MUC1 expression was observed, as in IPMN.

CONCLUSIONSThe age and sex of patients, tumor location, absence of ovarian-like stroma, communication with main pancreatic duct and characteristic mucin profiles represent useful parameters in distinguishing IPMN from MCN of pancreas. The tumor cells of IPMN express mainly MUC2, while those of MCN express MUC5AC. MUC1 may also be a useful marker in demonstration of stromal invasion in these tumors.

Adult ; Age Factors ; Aged ; Antigens, Neoplasm ; metabolism ; Biomarkers, Tumor ; metabolism ; Carcinoma, Pancreatic Ductal ; diagnosis ; metabolism ; pathology ; Carcinoma, Papillary ; diagnosis ; metabolism ; pathology ; Cystadenocarcinoma, Mucinous ; diagnosis ; metabolism ; pathology ; Cystadenoma, Mucinous ; diagnosis ; metabolism ; pathology ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Mucin 5AC ; Mucin-1 ; Mucin-2 ; Mucins ; metabolism ; Pancreas ; metabolism ; Pancreatic Neoplasms ; diagnosis ; metabolism ; pathology ; Precancerous Conditions ; diagnosis ; metabolism ; pathology ; Sex Factors

Standards of commodity classes of Chinese materia medica is an important way to solve the "Lemons Problem" of traditional Chinese medicine market. Standards of commodity classes are also helpful to rebuild market mechanisms for "high price for good quality". The previous edition of commodity classes standards of Chinese materia medica was made 30 years ago. It is no longer adapted to the market demand. This article researched progress on standards of commodity classes of Chinese materia medica. It considered that biological activity is a better choice than chemical constituents for standards of commodity classes of Chinese materia medica. It is also considered that the key point to set standards of commodity classes is finding the influencing factors between "good quality" and "bad quality". The article also discussed the range of commodity classes of Chinese materia medica, and how to coordinate standards of pharmacopoeia and commodity classes. According to different demands, diversiform standards can be used in commodity classes of Chinese materia medica, but efficacy is considered the most important index of commodity standard. Decoction pieces can be included in standards of commodity classes of Chinese materia medica. The authors also formulated the standards of commodity classes of Notoginseng Radix as an example, and hope this study can make a positive and promotion effect on traditional Chinese medicine market related research.
China ; Drug Industry ; economics ; standards ; Drugs, Chinese Herbal ; economics ; standards ; therapeutic use ; Humans ; Medicine, Chinese Traditional ; economics ; methods ; standards ; Panax notoginseng ; anatomy & histology ; chemistry ; Phytotherapy ; economics ; methods ; standards ; Plant Roots ; anatomy & histology ; chemistry ; Quality Control ; Reference Standards ; Research ; trends