Objective To investigate the clinical features and prognosis of replantation of fingertips distal to the middle nail.Methods Between August 2001 and August 2005,16 fingertips amputated in the Ishikawa zoneⅠwere replanted.We anastomosed only the digital arteries,and adopted postoperative bloodletting.Results Fourteen fingertips survived,and two failed.The survival rate was 87.5%.Of the 14 successfully replanted fin- gertips,12 were followed up from 3 to 12 months.The length and appearance of the fingertips recovered and good joint motion were maintained.Their two-point discriminations ranged from 3 to 6 mm.Conclusion Fingertip replantation is an optimal treatment for fingertip amputation distal to the middle nail to regain satisfactory appearance and function of the digits with a high survival rate,but severe crush injury to the amputated part and high cost should be taken into consideration.

Objective To explore the methods and effects of specialty training for wound care. Methods Fourteen nurses working and studying in the wound care center received specialty training of wound care. Their current knowledge and train-ing needs were assessed through writing test and symposium before the training. Then,the training contents and plan were de-signed. The training duration was identified as 3-6 months. The open teaching method was applied in the training directed by the entrostomal therapists(ET). According to the evaluation index,the nurses were asked to finish a reading report in the first month,a case report in the second month,and group discussion on a case of complicated wound care the third month. In ad-dition,they needed to finish the exam of wound care theory and skills every three months. The correlations between perfor-mance in the examination and the nurses' age,years of working experlence,educational level,professional title,duration and times of training by correlation analysis. Results The times of training was significantly correlated with the performance in the examination(r=-0.49,P<0.05),especially with the performance of case report,reading report,and group discussion on compli-cated wound care(r=0.51,-0.60,P<0.05). There was no correlation between the performance with nurses' age,years of working experience,educational level,professional title and duration of training. Conclusion One time of specialty training at least 3 months can achieve good effect. The times of training is correlated with the training effect,especially in case report,reading report and group discussion on complicated wound care.

Antifungal Agents ; therapeutic use ; Aspergillus fumigatus ; pathogenicity ; Brain Abscess ; diagnostic imaging ; drug therapy ; microbiology ; Humans ; Infant ; Male ; Neuroaspergillosis ; complications ; pathology ; Occipital Lobe ; pathology ; Pulmonary Aspergillosis ; diagnostic imaging ; drug therapy ; microbiology ; Tomography, X-Ray Computed ; Treatment Outcome

Objective To investigate neurogenesis in the dentate gyrus of adult rat following conditioned fear stimulus.Methods 24 adult male rats were randomly divided into conditioned fear stimulus group and control group,and all rats were intraperitoneally injected bromodeoxyuridine(BrdU)3 days before conditioned fear stimuli.Animals in conditioned fear stimulus group were given monotone matching foot shock and made conditioned fear stimulus model,animals in control group only give monotone.Freezing time was detected before stimuli and 7th,14th days after stimuli,then rats were sacrificed 7th or 14th day after fear conditioned stimulus,and immunohistochemistry for Brdu was detected.Results Behavioral assessment showed that the percents of freezing time in conditioned fear stimulus group 7th,14th days after conditioned fear stimulus were significantly high(88.68%,91.33%)than those in control group(11.18%,14.23%,P<0.01)and before stimulus(24.11%,16.11%,P<0.01).Compared to control group(1567±28,580±5),Brdu positive cells in dentate gyrus of rat in conditioned fear stimulus group(1364±21,296±22)were decreased,and it reached to a statistical significance on 14th day (P<0.05).Conclusion The decreased neurogenesis in the dentate gyrus of adult rat following conditioned fear stimuli may have relation to fear and other emotion memory.

AIM: To investigate the effect of rigid contact lens in the treatment after pterygium excision and limbal stem cell transplantation in senile patients.METHODS: Totally 90 elderly patients diagnosed as unilateral pterygium in our hospital from March 2015 to March 2016 were selected and divided into two groups, observation group and control group, 45 case with 45 eyes in each group.Observation group was treated with limbal stem cell transplantation and rigid contact lens.Control group was treated with limbal stem cell transplantation only.The following indicators were observed and compared: corneal healing time, visual analogue score(VAS) at 1, 3, 5 and 7d after surgery and the recurrence rate of pterygium.RESULTS: The score on corneal irritation of observation group was significantly lower than that of control group (P<0.05).Control group took more time on corneal healing than observation group (P<0.05).VAS of control group were higher than that of the observation group at 1 and 2d after treatment with significant difference (P<0.05).The recurrence rates of pterygium were not statistically significant between the two groups (P>0.05).CONCLUSION: Autologous corneal stem cell transplantation combined with rigid contact lens for pterygium in elderly patients is effective with shorter healing time and less pain, and it does not increase the recurrence rate.

ObjectiveTo investigate the expression of heme oxygenase-1 (HO-1) in lung tissue of mice with acute paraquat poisoning, and discuss its pathological mechanism.Methods Fifty-eight healthy male mice were randomly divided into control group (n = 8) and poisoned group (n = 50). The mice in poisoned group were lavaged with 20% paraquat (50 mg/kg), and those in control group with equal amount of normal saline. The mice were sacrificed on the day of experiment in control group, and those in poisoned group at 6 hours and 1, 3, 7, 14 days after poisoning. The lung tissue was harvested to observe the changes in pathology of lung with hematoxylin and eosin (HE) staining. The positive expression of HO-1 was determined with immunohistochemistry, and the protein expression of HO-1 was determined with Western Blot. The contents of superoxide dismutase (SOD) and malonaldehyde (MDA) were determined.Results The mice showed shortness of breath and signs of exhaustion 1 hour after poisoning, getting worse on 3-5 days, but returned to normal 14 days after poisoning. Under the light microscope, it showed that the control group had no significant pathological changes in lung tissue. One day after the ingestion, pulmonary alveolar structure disorder, obvious hemorrhage, edema and infiltration of inflammatory cells were found. At 3 days, the pathological changes in the lung tissue were more pronounced. They were less pronounced on 7 days, and inflammatory changes disappeared on 14th day, but alveolar structure disorder remained. Immunohistochemical test showed that HO-1 was seldom expressed in the lung tissue, and a little amount was expressed in the mucosal epithelial cells of the airway in control group. It was shown that inflammatory cell and endothelial were mainly distributed in the mucosal epithelial cells of airway 1 day after poisoning followed by a gradually decrease tendence, and came to normal level of control group 7 days after poisoning. It was shown by Western Blot that HO-1 (gray value) in lung tissue increased 6 hours after poisoning (2.438±0.467 vs. 0.475±0.167,P< 0.01), peaked at 1 day (9.200±0.940 vs. 0.475±0.167,P< 0.01), continued to increase till 7 days after poisoning, and it lowered to normal level thereafter (0.825±0.260 vs. 0.475±0.167,P> 0.05). The SOD activity (μU/L) in lung tissue was lowered 6 hours after poisoning, and it was significantly lower than that of control group (649.681±13.951 vs. 1 167.051±15.744,P< 0.01), and it continued to decrease up to 14 days after poisoning (859.733±121.079 vs. 1 167.051±14.744,P< 0.01). MDA content (μmol/L) in the lung tissue homogenate was elevated 6 hours after poisoning with significant difference compared with that of the control group (4.542±0.266 vs. 3.705±0.176,P< 0.01). It peaked on day 1 (5.956±0.281 vs. 3.705±0.176,P< 0.01), then it declined and reached normal level 3 days after poisoning (4.134±0.168 vs. 3.705±0.176,P> 0.05).Conclusion HO-1 expression was increased significantly in lung tissue of mice with acute paraquat poisoning, which may be considered as an important protection mechanism against paraquat poisoning.

Objective:To investigate the impact of humanistic spirit cultivation on nursing students' ethics cog-nition. Method:Total 364 internship nursing students in 2010 were taken as the control group with the routine clini-cal teaching method, 381 in 2014 as the experimental group, not only a routine clinical teaching method but also to increase of their humanistic spirit culture. Results:Humanity spirit cultivation before and after practice nursing students in medical security system cognition difference is not significant, but in medical optimization, the patients right of informed consent, the life value differences of cognitive and ethical cognitive dimension score was statisti-cally significant ( P<0 . 05 ) . Conclusions:Humanistic spirit culture promote the practice of nursing students to raise the level of moral cognition foundation for humanity quality education and nursing ethics education, should further strengthen the diversification of internship training nursing students humanistic spirit.

BACKGROUND:Atlantal lateral mass screw fixation contains lateral mass screw fixation under the posterior arch of the atlas and lateral mass screw fixation via the posterior arch of atlas (also cal ed atlas pedicle screw fixation) according to different insertion points. The two methods have their advantages and disadvantages. There are lacks of the comparative studies on bony anatomy feasibility by two kinds of atlantal lateral mass screw fixation.
OBJECTIVE:To compare the feasibility associated with two kinds of atlantal lateral mass screw fixations taking Chinese data of atlantal bony anatomy as evidence.
METHODS:Data of CT scans in 30 adults with cervical spondylosis (60 sides) were col ected, and data were reconstructed using CT workstation. We measured key bone anatomy structure after atlantal lateral mass screw fixation. The atlantal lateral mass was suitable for lateral mass screw fixation via the posterior arch of atlas if its height and width of vertebral artery groove at the posterior arch ≥ 4 mm. It was suitable for lateral mass screw fixation under the posterior arch of the atlas if the height of posterior arch of atlas lateral mass ≥ 4 mm.
RESULTS AND CONCLUSION:The height of vertebral artery groove at the posterior arch was (4.54±1.17) mm. The width of vertebral artery groove at the posterior arch was (8.69±1.12) mm. The height of posterior arch of atlas lateral mass was (4.98±1.07) mm. There were 41 cases with the height of vertebral artery groove at the posterior arch>4 mm (suitable for lateral mass screw fixation via the posterior arch of atlas, occupying 68%. There were 52 cases with the height of posterior arch of atlas lateral mass>4 mm (suitable for lateral mass screw fixation under the posterior arch of the atlas), occupying 87%. There were significant differences in the differences between the two groups (P<0.05). These results indicated that lateral mass screw fixation under the posterior arch of the atlas was more feasible compared with lateral mass screw fixation via the posterior arch of atlas. Preoperative CT measure for key anatomic structure was significant for making personalized surgical plan.

Objective:To study the epidemiology of attention-deficit hyperactivity disorder(ADHD) in pupils of Zhenjiang urban districts. Methods: Questionnaire was designed and employed for parents of 3 698 pupils at schools in Zhenjiang urban districts. ADHD was diagnosed according to the international DSM-Ⅳ scale. Differences were determined by Qi-square test and multiple regression analysis. Results: Prevalence of ADHD was 6.54% in pupils of Zhenjiang urban districts, and was 9.14% in male pupils and 4.01% in female. There was significant difference between 2 gender groups (? 2=34.933,P

Surgical resection remains the only curative option of treatment for hepatocellular carcinoma,but centrally located tumors remain problematic.Extended right or left hepatectomy removes 60％ to 85％ of the hepatic parenchyma and is associated with more hepatic failure.Mesohepatectomy,resection of central hepatic segments (Couinaud's segments Ⅳ,Ⅴ,Ⅷ) and leaving the right and left segments in situ,preserves more functional hepatic tissues than extended hepatectomy.Despite its technical demands,mesohepatectomy should be considered as an alternative treatment for central huge hepatic tumors.