Objective To study whether closed reduction and interlocking intramedullary nailing will worsen the injured radial nerve associated with the fracture of humeral shaft.Methods Of the 353 patients with fracture of humeral shaft who received operation from January 2002 to January 2005,63 ones were complicated with preoperative injury to their radial nerve.A retrospective analysis was done of their physical examination records, operative records,X-ray films and results of the treatment.Eleven cases were treated with closed reduction and interlocking intramedullary nailing,and 52 cases with open reduction and internal fixation of plates and screws fol- lowed by exploration to the radial nerve.Chisquare test of PEMS 3.1 system was adopted to analyze the clinical data. Results The radial nerve was embedded by the fracture ends in nine cases(17.3%)of the 52 cases,and con- tused in the other 43 ones.In the 63 cases,The injured nerves recovered spontaneously 2 to 12 weeks postoperatively except in twn cases.All the eases got bony union 3 to 4 months after operation.Closed reduction and interlocking intramedullary nailing has hardly more harmful effects on the injured radial nerve assoeiated with the fracture of humeral shaft than open reduction and internal fixation of plates and screws followed by neural exploration.Con- clusion Closed reduction and interlocking intramedullary nailing is fit for the freatment of fractures of humeral shaft with radial nerve injury.

Objective To analyze the prevalence of nosocomial infections among inpatients and its influential factors.Methods The retrospective survey was performed by reviewing and analyzing the clinical data of 7788 inpatients in 2004 in Nankai Hospital of Tianjin.Results Totally 250 nosocomial infection cases were identified,which gave a prevalence of 3.21%.The all-year highest prevalence was found in September.Among all the departments,the highest rate,5.20%,occurred in Department of Gynecology.The inpatients aged more than 60-year-old showed higher prevalence than those under 60 years old.The main infection position was lower respiratory tract(41.60%).Concludes The prevalence of nosocomial infections of Nankai Hospital were within the acceptable standard range defined by Ministry of Health,China.Nevertheless,the prevalence would be reduced if measurements for surveillance and control could be properly applied.

Objective To explore the role of Kupffer cell-expressed Fas ligand(FasL) on acute pancreatitis(AP),and the protective effect of gadolinium chloride(GdCl3),a Kupffer cell inhibitor,on liver injury during AP.Methods Fifty-four ICR mice were randomly assigned into three groups: healthy control group(n=6);AP group(four time points for observation,6 mice each);Gd+AP group(GdCl3 pretreatment group,four time points for observation,6 mice each).AP was induced in mice using cerulein.Liver parenchymal enzymes(AST,ALT and LDH) and amylase(AMY) were assayed using an automatic analyzer.Serum FasL was assayed with ELISA and FasL protein expression in liver was assayed by Western blotting.Results After induction of AP in mice,the serum levels of AST,ALT,LDH,AMY and liver FasL expression were significantly elevated.Serum FasL levels at 4,8,16 and 24h after AP induction were 505.94?36.21,496.60?33.65,476.64?22.66 and 450.75?38.21,respectively,which were significantly higher than those in healthy control group(83.60?7.75,P

Objective To investigate the effect of liver transplantation on hepatitis B associated diseases and the efficiency of prevention and treatment on the re-infection of hepatitis B.Methods The data of 17 patients undergoing liver transplantation were analyzed after treatment of lamivudine and hepatitis B immune globulin (HBIg). Results Of the 17 cases of hepatitis B pretransplantation, 2 cases were positive for HBsAg. Liver function was normal in all patients.Conclusions Liver transplantation is an effective therapy for hepatitis B. Lamivudine and HBIg could effectively prevent and treat the re-infection of hepatitis B after liver transplantation.

0.05). In the xenogeneic fresh nerve graft group, the xenogeneic nerve segment was rejected and absorbed by the recipient. CONCLUSION Xenogeneic acellular nerve could sustain facial nerve regeneration, and may be a substitute to autograft for repairing facial nerve defects.

Objective To observe the effect of levocarnitine and trimetazidine on left ventricular mass index in patients with maintenance hemodialysis (MHD),and to explore the safety and efficacy of the two drugs when used in combination.Methods 48 cases of MHD were randomly divided into control group and treatment group,24 cases in each group.On the basis of routine treatment,treatment group was treated with L -carnitine 1.0g by intravenous, 3 times per week,and trimetazidine tablets 20mg,3 times daily at the end of each dialysis.The control group was only treated with L -carnitine.The course of treatment was 12 months.The left atrial diameter (LAD),left ventricular end diastolic diameter (LVDD),left ventricular end diameter (LVDS),interventricular septal thickness (IvST),left ventricular posterior wall thickness (LVPWt),left ventricular ejection fraction (LVEF),stroke volume (SV),left ventricular mass index calculation were detected and compared before and after treatment in the two groups.Results After treatment,the LAD,LVDd,LVDs,IvST,LVPWt in the control group were (40.25 ±1.73)mm,(51.16 ± 3.17)mm,(32.52 ±2.86)mm,(11.16 ±1.23)mm,(10.23 ±1.19)mm,which were decreased compared with before treatment [(42.63 ±1.82)mm,(53.71 ±3.26)mm,(35.83 ±3.12)mm,(12.51 ±1.39)mm,(11.76 ± 1.37)mm],and the LAD,LVDd,LVDs,IvST,LVPWt in the treatment group were (37.61 ±1.86)mm,(47.53 ± 3.18)mm,(29.71 ±2.93)mm,(10.46 ±1.32)mm,(9.14 ±1.32)mm,which were decreased compared with beforetreatment [(42.89 ±1.91 )mm,(54.18 ±3.29)mm,(35.76 ±3.27)mm,(12.49 ±1.35 )mm,(11.73 ± 1.41)mm](t control group =4.643,2.747,3.831,3.563,4.130,t treatment group =9.702,7.120,6.750,5.209, 6.569,all P <0.05 ),and each index of the treatment group was significantly lower than the control group (t =5.091,3.961,3.362,2.901,3.005,all P <0.05 ).The LVMI of the control group and treatment group was (121.63 ±7.16)g/m2 ,(115.49 ±7.91)g/m2 after treatment,which were decreased compared with before treatment [(127.32 ±7.51)g/m2,(126.87 ±7.28)g/m2 ](t =2.686,5.186,all P <0.05).The EF and SV of the control group were (58.16 ±4.35)%,(43.61 ±4.72)mL after treatment,which were increased compared with before treat-ment[(55.32 ±4.17)%,(40.52 ±4.13)mL](t =2.686,5.186,all P <0.05).The EF and SV of the treatment group were (61.26 ±4.13)%,(46.25 ±4.17)mL after treatment,which were increased compared with before treat-ment[(55.28 ±4.51)%,(40.81 ±4.96)mL](t =4.791,4.113,all P <0.05).After treatment,LVMI in the treat-ment group was lower than that in the control group,SV and EF were higher than those in the control group (t =2.819,2.532,2.053,all P <0.05).Conclusion Compared with single levocarnitine,the therapy of levocarnitine and trimetazidine can better reduce left ventricular mass index in MHD patients and improve the cardiac structure and function,which is safe and effective.

BACKGROUND: There is no study on starch/polyvinyl alcohol (PVA) as guided tissue regeneration membranes. The guided tissue regeneration membrane with porous structure were prepared, which combined with the advantages of natural polymer and synthetic polymer. OBJECTIVE: To research the effects of the preparation conditions on the properties of starch/PVA membranes. METHODS: The porous membranes of guiding tissue regeneration were prepared mainly by starch and PVA through solution mixing, casting, freezing and drying. The effects of the mass ratio of PVA and starch, solution concentration, and pre-freezing temperature on the properties of the membrane were researched. The surface morphology, tensile strength, porous ratio, water absorbance and cell cytotoxicity were characterized. RESULTS AND CONCLUSION: The aperture of the membrane was 1-50 μm, the porosity was 60%-70%, and the tensile strength was 12-26 MPa. And this membrane had the excellent biocompatibility and hydrophilicity. The pores in the surface were evenly distributed with the solution concentration of 5% and the pre-freezing temperature of -30℃. The more content of starch was, and the larger of the aperture was.

BACKGROUND: Primate is the best animal to establish a model of spinal implants. However, ethics and cost limit its application. Mixed-breed dogs have similar anatomic structures as human. Moreover, it is easy to obtain with low cost, so it may replace primate to serve as models.OBJECTIVE: To determine the feasibility of canine lumbar spine to establish the anterior interfixation model following measurements of related anatomic data.METHODS: A total of 9 adult healthy dogs were selected. The transversal diameter, sagittal diameter and height of vertebral body and disc were measured, and the artificial vertebral body replacement was performed. Bone graft fusion was observed. RESULTS AND CONCLUSION: The transversal diameter, sagittal diameter and height of vertebral body and disc increasedgradually from L_(1) to L_(7), and the height was greatly exceeded its sagittal diameter. All dogs survived, but one was paraplegia. Allthe others stood and acted in 12 h to 72 h after operation. The fusion effect was proved to be good by imageology and histology. The establishment of models was simple and cost-effective, and the biocompatibility of bone tissues and implants, as well as thebone tissue ingrowth can be observed. The lumbar spine of dog can be used as an anterior interfixation model in vitro test.

BACKGROUND:Poly-D,L-lactic-co-glycolic acid (PLGA) that was characterized as absorbable,weak cytotoxicity,and adjustable hardness was ideal to be synthetized artificial spinal dura mater.Because of lacking of functional group at the surface of PLGA,it should be modified to fit the demand of satisfied biocompatibility.OBJECTIVE:To study the biocompatibility of PLGA membrane modified by type-Ⅰ collagen and chitosan.DESIGN,TIME AND SETTING:Contrast observation study,which was carded out in the Biochemistry and Molecular Biology Laboratory Shanghai University of Traditional Chinese Medicine from May to December 2007.MATERIALS:Porous PLGA membrane was provided by Jinan Banzheng Biology-Technology Co.,Ltd.,type-Ⅰ collagen by Sigma Company,USA,chitosan by Shanghai Qisheng Biological Agent Medical Apparatus and Instrument Company,and L929 L cell by Cellular Institute of Shanghai Academy of Life Science,Chinese Academy of Science.METHODS:PLGA membrane (P membrane),PLGA/type-Ⅰ collagen composite membrane (PG membrane),PLGA/type-Ⅰ collagen/chitosan (9:1) composite membrane (PGC 9:1 membrane) and PLGA/type-Ⅰ collagen/chitosan (5:5) composite membrane (PGC 5:5 membrane) were produced through a certain process.MAIN OUTCOME MEASURES:Contact angle,absorption rate and cytotoxicity were tested.Morphological changes of L929 L cell cultured for 1,3,and 7 days were observed under fiberscope.RESULTS:Contact angle was shown as PG membrane＜PGC 9:1 membrane＜PGC 5:5 membrane＜P membrane (P＜0.01 );absorption rate was shown as P membrane＜PGC 5:5 membrane＜PGC 9:1 membrane＜PG membrane (P＜0.01).L929 L cell was characterized as well distribution,expansion and appearance after inoculation of PG membrane,PGC 9:1 membrane and PGC 5:5 membrane.Cytotoxic experiment (MTT methods) showed that,on the 1st day,there was no significant difference in absorbency among groups (P＞0.05).On the 3rd and 7th days,there were significant differences between P membrane and PG membrane or PGC 9:1 membrane,and between PGC 9:1 membrane and PCK2 5:5 membrane (P＜0.05).PGC 9:1 membrane could further improve cell adhesion and proliferation,and PGC 5:5 membrane could inhibit cell proliferation and differentiation.CONCLUSION:Type-Ⅰ collagen and chitosan appended to the exterior of PLGA can enhance the biocompatibility of membrane.In terms of biocompatibility,PLGA/type-Ⅰ collagen/chitosan (9:1) composite membrane can be fit to the qualification as a type of material of artificial spinal dura mater.

Objective To assess standardized patients (SP) in resident general practitioners training for their consultation skills to explore its role in clinical competence training. Methods SP are employed in standardized training for 52 resident general practitioners in Shanghai during May to July 2008 to assess trainees' clinical consultation skills, including medical history taking and physical examinations, as well as clinical competencies of trainers including medical history taking, physical examinations, clinical thinking (diagnosis, differential diagnosis and treatment plans), health education, medical record writing,and reception time management. Feedback and appraisal for their consultation skills were provided by SP later. Problems encountered in trainees' consultation were discussed in group manner with their trainers.And two mouths later, assessment with SPs was undergone again for their consultation skills to compare their scores in consultation skills and percentages of them passing the assessment before and after training. Results Trainees were enrolled in the training aged (28±1 ) years in average ( with a ratio of men to women of 19/33 ). Percentage of trainees passing the assessment by SP for consultation skills was significantly higher after training (88.5%) than that before it (46. 2% ) ( P < 0. 01 ). Percentage of trainees with scores passing assessment by trainers was also significantly higher after training than that before it (86.5% vs. 51.9%, P < 0.01 ), with a percentage of those qualified for clinical skills and health education after training of 80. 8% and 88.5%, respectively, as compared to those of 46. 2% and 67. 3%,respectively before it, ( P < 0. 01 ), and with a percentage of trainees qualified for clinical thinking, out-patient medical record writing and reception time management not changed after training (71.2%, 100. 0%,100. 0%, respectively) as compared to those before it (51.9%, 100. 0% and 100. 0%, respectively)(P > 0. 05 ). Conclusions Application of SP can effectively enhance consultation skills of the trainees,especially in their medical history taking and physical examinations. However, there is still rooms to improvein their clinical thinking.