Objective To analyze the superiority of implanting operation with autoskull stored at ultrahypothermia over low temperature's and frozen skull bone of oneself.Methods 42 case were observed and followed up after operation.Results Incision is healing by firct intention.there were many advantages,such as good biological activity,beautiful appearance,no repellent response,no immunoreaction and hard to infection,etc. After storing 1,3,6 and 12 months,the histological structure of frozen skull observed by electronscope was similar to those of fresh skull.Pestroyed skull bone cells were not found.All cases had no complication during the period of 3 to 12 months(mean 6.5 months) follow-up after operation.After 12 months,X ray and CT scan showed that skulls were healed.Conclusions Implanting operation with autoskull stored at ultra-hypothermia is one of the most effective technique for repairing skull defects.

Objective To compare the therapeutic effects of closed reduction and transverse fixation with Kirschner wires and open reduction and fixation with mini-plates or Kirschner wires for the fifth metacarpal base fracture.Methods Data of 50 patients,who had been treated in our hospital for the fifth metacarpal base fracture from August 2005 to May 2012,were enrolled in this study.Twenty-six patients underwent closed closed reduction and transverse fixation with Kirschner wires,including 22 males and 4 females,aged from 17 to 41 years; according to the OTA classification,there were 8 of type A1,11 of type B1,and 7 of type C1.Twenty-four patients underwent open reduction and fixation with mini-plates or Kirschner wires,including 21 males and 3 females,aged from 19 to 46 years (average,26 years); according to the OTA classification,there were 11 of type A1,8 of type B1 and 5 of type C1.The total active motion (TAM) score of Chinese Medical Associaition was used to evaluate the range of motion of the joint.Results In closed reduction group,the operation time ranged from 14 to 33 min; the treatment costs ranged from 2018 to 2995 yuan; 23 patients were followed up for 6 to 26 months; X-rays showed the anatomic reduction was achieved in all patients,and the fracture healing time ranged from 4 to 7 weeks; according to the TAM score,the result was excellent in 15,good in 6 and fair in 2,and the excellent and good rate was 91.3％.In open reduction group,the operation time ranged from 45 to 105 min; the treatment costs ranged from 3874 to 4793 yuan; 22 patients were followed up for 6 to 21 months; X-rays showed the anatomic reduction was achieved in all patients,and the fracture healing time ranged from 4 to 8 weeks; according to the TAM score,the result was excellent in 13,good in 7 and fair in 2,and the excellent and good rate was 90.9％.Conclusion Closed reduction and transverse fixation with Kirschner wires is an effective method for the fifth metacarpal base fracture,which has several advantages,such as simple operation,stable fixation,satisfactory results,short operation time and low treatment costs.

AIM: To investigate the effects of irbesartan on acute myocardial ischemia-reperfusion injury and on expression of ICAM-1 and VCAM-1 in myocardial ischemia-reperfusion areas in rabbits. METHODS: Anterior descending branch of left coronary artery (LAD) was ligated in ischemia-reperfusion (IR) group but not in the sham group. Rabbits of IR group were subjected to 60 min of LAD occlusion, and 360 min of reperfusion. In the treated group, the rabbits were given irbesartan until the trial ended. Then, all rabbits were killed and tissue samples were removed from IR areas. After disposed with routine histological methods and stained with hematoxylin and eosin (HE), these samples were examined by light microscopy. The expression of ICAM-1 and VCAM-1 were also investigated by employing immunohistochemical SP method in the tissue samples. RESULTS: Degree of damage in cardiocytes and of neutrophil infiltration were more serious in IR group than those in sham group (P

Objective To investigate the effect of using massage by finger pressing to prevent the enteroparalysis which caused by continue atropine injection. Methods Divided 60 patients with severe organophosphorus poisoning into experimental group and control group randomly, there were 30 cases in each group.Routine nursing cares were used in the control group, the massage by finger pressing was added in the experimental group.Compared the correlative indexes such as the time of first defecation, the times of defecation, the number of patients with enteroparalysis, the time of cholinesterase reactivation between the two groups. Results By the statistic test, all the indexes which have mentioned above had significant differences between 2 groups,P

Objective To investigate the effects of solution-focused brief therapy on self-perceived burden and quality of life in patients with stroke.methods 60 patients with stroke recruited at the department of rehabilitation of a hospital in Chengde city from January to June 2016 were divided into control group (n=30) and experimental group (n=30).Both groups received conventional nursing care and rehabilitation treatment.In addition,the experimental group received psychological intervention of solution-focused brief therapy,2-3 times a week,30-45 minutes for each time.The self-perceived burden scale(SPBS),memorial university of Newfoundland scale of happiness(MUNSH) and short from 36 health survey questionaire(SF-36) were used to assess the patients before and after intervention.Result s(1)The differences of the scores of SPBS ((39.27±5.83) vs (22.40±4.03),t=16.248,P<0.01) and MUNSH ((4.20±4.50) vs (31.10±3.66),t=-24.136,P<0.01) for the experimental group before and after the intervention were statistically significant.There were statistically significant differences in scores of SPBS ((22.40±4.03) vs (35.30±2.63),t=-14.683,P<0.01) and MUNSH ((31.10±3.66) vs (19.67±3.64),t=12.127,P<0.01) between the experimental group and control group after the intervention.(2)The scores of physiologic functioning,general health,vitality,social functioning,role-emotional and mental health for the experiment group were higher than before(t=-23.427--6.624,all P<0.01).After the intervention,the scores of physiologic functioning,general health,vitality,social functioning,role-emotional and mental health in the experiment group were higher than those in control group(t=5.705-12.806,all P<0.01).Conclusion Solution-focused brief therapy can effectively reduce the self-perceived burden of stroke patients and improve their quality of life.

Objective To investigate the survival of advanced stage periampullary carcinoma and its prognostic factors.Methods The clinical data and follow up of 134 patients with advanced stage periampullary carcinoma admitted to our hospital between January 2007 and December 2010 were retrospectively collected and analyzed.Results Of 134 patients,there were 83 males and 51 females.The mean age±S.D.was 62.49±11.41 (28-83).For the 86 patients who underwent surgery,32 had extensive peritoneal metastases on surgical exploration,27 had metastases/involvement of the liver or stomach,and 27 had major vessel infiltration.For these 86 patients,55 received surgical exploration,whereas 31 had surgical exploration plus bypass anastomosis. 45 patients received chemotherapy,while 67 received chemotherapy plus radiotherapy.The improvements in quality of life and in clinical response rate after concurrent chemoradiotherapy or chemotherapy alone were 73.1％ and 57.8％,respectively.The overall survival was 14.27±1.06 months.The median survival time was 11 (8.95±13.05) months.The 1- and 3-year survival rates were 43％ and 10％,respectively.Karnofsky performance status,and the presence or absence of jaundice co-related with poor prognosis on single factor analysis.The Karnofsky performance status was an independent survival predictor on multifactor analysis.Conclusions The prognosis of patients with advanced stage periampullary carcinoma was poor.Chemotherapy with or without radiotherapy had similar impact on overall survival,Karnofsky performance status was an independent survival predictor.

Objective To investigate the clinical data and laboratory features of acute megakaryocytic leukemia transformed from idiopathic myelofibrosis after 26 years in one case and the prognostic factors of myelofibrosis.Methods A case of acute megakaryocytic leukemia (M7) transformed from idiopathic myelofibrosis after 26 years was reported,and the clinical data was analyzed.Bone marrow cytology,cytogenetic and mutation detection in JAK2V617F were detected before and after transformation.Standard chemotherapeutic protocols including idarubicin plus cytarabine (IDA),homoharringtonine and cytarabine (HA),mitoxantrone and cytarabine (MA),pirarubicin plus cytarabine (TA) sequential therapies were performed.Results JAK2V617F mutation and normal karyotype were found before and after the transformation.This patient was treated with standard chemotherapeutic protocols of IDA,HA,MA and TA sequential therapies until getting complete remission,and he lived well till now.Conclusions Chromosome karyotype is related to the prognosis of IMF.Acute megakaryocytic leukemia (M7) with the normal karyotype transformed from the IMF can achieve complete remission by rational consecutive chemotherapy.

OBJECTIVETo study the expression of EpCAM and E-cadherin in papillary thyroid carcinoma and to analyze its correlation with various clinicopathologic parameters.

METHODSImmunohistochemical study for EpCAM and E-cadherin was carried out in 91 cases of papillary thyroid carcinoma. Twenty-four cases of papillary hyperplasia of thyroid were used as controls.

RESULTSIn all of the 24 cases of papillary hyperplasia, EpCAM was located on the cell membrane, while in the 91 cases of papillary thyroid carcinoma studied, EpCAM was located within the cytoplasm, with 36.3% (33/91) showing nuclear localization as well. In all the papillary hyperplasia cases studied, E-cadherin showed membranous expression. E-cadherin expression was reduced in 84.6% (77/91) of papillary thyroid carcinoma, as compared with the surrounding native thyroid parenchyma. Amongst the 33 cases of papillary thyroid carcinoma which showed nuclear localization of EpCAM, 30 cases also showed reduced E-cadherin expression. There was a positive correlation between nuclear expression of EpCAM and loss of E-cadherin expression (P = 0.000; Spearman correlation coefficient = 0.857). Nuclear expression of EpCAM correlated with follicular variant of papillary thyroid carcinoma and presence of extrathyroidal extension ( P = 0.037 and 0.033, respectively). Loss of E-cadherin expression correlated with age of patients and presence of lymph node metastasis (P = 0.018 and 0.010, respectively).

CONCLUSIONSE-cadherin expression is reduced in papillary thyroid carcinoma, as compared with native thyroid parenchyma and papillary hyperplasia. Papillary thyroid carcinoma shows loss of EpCAM membranous expression and increased cytoplasmic/nuclear accumulation. Detection of these two markers may provide a valuable reference in defining the biologic behaviors of papillary thyroid carcinoma, including extrathyroidal extension and lymph node metastasis.

Antigens, Neoplasm ; metabolism ; Cadherins ; metabolism ; Carcinoma, Papillary ; metabolism ; secondary ; Cell Adhesion Molecules ; metabolism ; Cell Membrane ; metabolism ; Cytoplasm ; metabolism ; Epithelial Cell Adhesion Molecule ; Humans ; Lymphatic Metastasis ; Neoplasm Proteins ; metabolism ; Thyroid Neoplasms ; metabolism ; pathology

Objective To evaluate the effects of nucleoside/nucleotide analogue treatment on immunoglobulin and complement in patients with chronic hepatitis B (CHB).MethodsA total of 157 CHB patients were recruited and divided into CHB group,liver cirrhosis (LC) group and severe hepatitis B (SHB) group.There were 50 patients who received oral antiviral treatment (lamivudine 100 mg/d,or entecavir 0.5 mg/d,or telbivudine 600 mg/d).Serum levels of complement 3 and 4 (C3,C4),C-reaction protein (CRP),hemolytic complement (CH50),immunoglobulin G,M,A (IgG,IgM,IgA),hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) were detected by enzyme-linked immunosorbent assay (ELISA) or immunoturbidimetry.Hepatitis B virus (HBV) DNA was quantified by real-time polymerase chain reaction (RT-PCR) before and 1,2,3 and 4 weeks after nucleoside antiviral therapy.Comparison of means was done by t test and Mann-Whitney test.The correlation was analyzed by Pearson correlation coefficient test.ResultsSerum IgA and IgM levels of SHB and LC patients were significantly higher than those of CHB patients (P＜0.01).Levels of C3,C4,CH50 and CRP were significantly different among three groups.Levels of C3,IgM,IgG and HBV DNA in HBeAg positive patients were significantly different from those in HBeAg negative patients.There was a statistically significant difference of IgA,IgM,C3 and CH50 levels between patients with high HBV DNA level and low HBV DNA level in HBeAg-positive patients.While in the HBeAg-negative patients,only the IgA level was significantly different with HBV DNA levels.After anti-viral treatment,immunoglobulin and HBV DNA levels were all decreased in three groups,while the serum complement level was increased compared to baseline,and the differences became significant at week 4 of treatment. HBV DNA level was negatively correlated with C3 (r=-0.78,P=0.021) and HBeAg titer was positively correlated with C3 (r=0.87,P=0.015).ConclusionsThe immunoglobulin,CRP,C3,C4,and C H50 could reflect the inflammatory activity in liver.The changes of C3 level can predict the efficacy of antiviral therapy.

Objective To train medical students' competence of independent thinking and problem solving and to improve the quality of teaching.MethodsThe case-based PBL teaching model was introduced to teaching practice for 25 undergraduates majoring in medical laboratory.The teaching process included pre-class mobilization,question,self-study,discussion and summary.Effectiveness of teaching was evaluated with questionnaire.Results For these medical students,the enthusiasm of learning ( 83.3％ ),ability of self-learning and information seeking ( 79.2％ ),ability of discussing and problem solving ( 79.2％ ),ability of scientific thinking and clinical reasoning ( 79.2％ ) were significantly improved.Teaching satisfaction rate of case-based PBL teaching model was up to 95.8％.ConclusionBetter results of teaching were achieved and the case-based PBL teaching model is worth spreading.