Objective To establish a method for accurate typing of ABO in blood donors and patients with difficult blood types,and to provide clinical reference for safe blood transfusion,organ transplantation,and bone marrow matching.Methods The results of serological and genotyping of 178 volunteers from four ethnic groups in China were analyzed statistically,and the blood type difference coincidence test was carried out.Results The difference of blood type difference between the four nationalities was checked (x2 =24.5,P＞0.05).The results showed that there was no difference in blood group distribution between the four nationalities.Conclusion Serological results of 178 volunteers from four ethnic groups in China are consistent with the results of molecular biology,and there is no difference in blood type distribution.

Objective To study the changes of the myocardial cell apoptosis in myocardial infarction of rabbits. Methods The model of rabbit with myocardial infarction was established.HE staining,TUNEL staining, immunohistro-chemistry staining, ultrathin section for electron microscope and DNA electronic gel phorensis were performed in samples of ischemia or infarction in different times.The position of apoptotic myocytes in different phases of ischemia were observed by light microscope and electronic microscope. Results After 30 minutes to 4 weeks ischemia.there were a few TUNEL positive nucleus of myocytes in the margin area of myocardial infarction;HE staining-found typical expressions of apoptosis,such as chromosome conglomeration,chromosome gathered at the edge or chromosome aggregation,dark-stained nucleus,cell shrinkage,were obvious in 4-8 hours.A lot of positive nucleus of myocytes stained by TUNEL were found in the early stages of myocardial ischemia in myocardial infarction.gradually ascended and then became hardly visible from 8 hours to 3 days.Nucleus swelling,karyorrhexis and karyolysis were found in the area of myocardial infarction.then cells were broken.DNA agarose electrophoresis found DNA fragment of most myocytes in 30 minutes of ischemia,just a few cardiocytes decomposed to the big segments.At 4hours of ischemia the most cardiocytes decomposed to big segments,and there were a blurry"ladder"in DNA strand breaks from 8 hours to 1 day.It showed that apoptotic cardiocytes existed in the margin area of myocadial infarction. Conclusions There are cardiocytes apoptosis in the margin area of infarction from 30 minutes to 4 weeks after myocardial ischemia.Maybe it relates to the reperfusion caused by collateralization establishment or infiltration from circumference.

The current workflow in home-based rehabilitation for stroke patients were modified through focus group discussion,brainstorming and literature review.The mapping of three-tier rehabilitation network,the defined function of home-based rehabilitation and its integration with other rehabilitation services were made by literature review.The improved version of home-based rehabilitation flow chart specified the contents in the guideline Three-tier rehabilitation network of stroke rehabilitation in China.The chart provides a reference for the implementation of home-based rehabilitation in community health service centers with the family doctor system.

Objective To evaluate the protection of combined clostridium butyricum and bifidobac-terium living powders for antibiotic-associated diarrhea ( AAD ) with all kinds of infections in hospitalized children,and to compare the therapeutic effect with saccharomyces boulardii. Methods This study was a prospective,randomized case-control clinical trial which collected the data of the hospitalized children with all kinds of infections in Pediactric Department of Shengjing Hospital of China Medical University between May 2011 to May 2012. A total of 552 cases were enrolled and 480 cases completed the study. A total of 240 chil-dren were in experimental group,80 cases received combined clostridium butyricum and bifidobacterium liv-ing powders 840 mg per time,twice a day and the other 160 cases received saccharomyces boulardii 250 mg per time,twice a day,for one week; the control group took none of probiltics. Two groups received routine antibiotic therapy. Everyday′s defecate frequency was recorded, the traits of excrement according to bristol stool assessment scale were evaluated,the incidence of diarrhea and drug related adverse reactions were coun-ted. Results During the studied 7 days,the AAD incidence was 4. 2%(10/240) in experimental group and 20. 4%(49/240) in control group,there was significant difference between two groups. The risk of AAD in experimental group decreased 58. 5%. Compared to saccharomyces boulardii,combined clostridium butyricum and bifidobacterium living powders decreased 38. 2% (RR=0. 728, 95%CI 0. 257~0. 784, P=0. 009). Compared to control group,the average defecate frequency decreased in experimental group,diarrhea duration contracted,there was statistic difference between two groups ( P<0. 01 ) . No drug related adverse reactions happened during the trial. Conclusion Both combined clostridium butyricum and bifidobacterium living powders and saccharomyces boulardii could effectively reduce the risk of AAD in hospitalized children with bacterial infection,relieve diarrhea symptoms,short the duration of diarrhea,and did not find the adverse reac-tions. Combined clostridium butyricum and bifidobacterium living powders and saccharomyces boulardii had the same protective effect for AAD of northern China children.

BACKGROUND:In clinic, monosegmental pedicle screw fixation via the fractured vertebrae is commonly used for the treatment of thoracolumbar fracture. Studies have confirmed that the spinal stability is strengthened through bilateral pedicle screw fixation via fractured vertebrae, but some studies suggest that monosegmental pedicle screw fixation via fractured vertebrae can increase the spinal stability, and the conclusion lacks of the supports of biomechanics.
OBJECTIVE:To evaluate the biomechanical properties of monosegmental pedicle screws fixation via fractured vertebrae for thoracolumbar fracture.
METHODS:Eight cadavers’ thoracolumbar specimens (T11-L3) were provided by the Department of Anatomy, Yangzhou University School of Medicine. Saw was used to transect 2/3 of the vertebrae in order to make complete experimental thoracolumbar specimens. Eight specimens were divided into two group;beyond-fractured vertebrae fixation group and monosegmental fixation via fracture vertebrae group. The specimens in the two groups were treated with adjacent vertebral four screw fixation beyond fractured vertebrae and adjacent vertebral four screw fixation+monosegmental pedicle screw fixation via fractured vertebrae respectively.
RESULTS AND CONCLUSION:After thoracolumbar fracture, the differences between beyond fractured vertebrae fixation and monosegmental pedicle screw fixation via fractured vertebrae were as fol ows:load-strain relationship 12%, load-displacement relationship 11%, strength 18%, axial rigidity 11%, torsional mechanical properties 11%and pul out test 1.8%, and there were no significant differences between two groups (P<0.05). The biomechanics performance of monosegmental pedicle screw fixation via fractured vertebrae was more superior to that of pedicle screw fixation beyond the fracture vertebra for thoracolumbar fracture.

Objective To improve the arthroscopic posterior cruciate ligament (PCL) reconstruction using tibial Inlay technique. Methods The special arthroscopic device and related fixation technique were designed. Five cadaveric knees were used to simulate the process of arthroscopic posterior cruciate ligament reconstruction using tibial Inlay technique. The knees were cut open to observe whether the outlet of the tibial tunnel shape and location met the design requirements. Thirty normal MRI films were measured to identify tunnel angle and localizer angle. Results The inner outlet of tunnel was conical shape(14 mm×7 mm×15 mm) and the outer outlet was cylinder-shaped (a diameter of 7 mm). The tibial drill was designed into a split structure and could be assembled in vitro. According to the data obtained from MRI films, the angle between the plane of posterior cruciate ligament and horizontal place was 36°-47°, and the localizer was fixed at 50°.The achilles tendon was used as implant and the allogft bones were designed into conical shape to fit the inner outlet of tunnel. The other end of implant to the proximal tibia was fixed with button plate. All reconstruction operations were performed under arthroscopy. The outcomes of procedure were satisfactory. There were no vascular or peripheral nerve injuries in the cadaveric knees The tunnel position was accurate and the shape of tunnel had met the design requirements. Conclusion Our results imply that improved arthroscopic of posterior cruciate ligament using tibial Inlay technique is simple, accurate, rapid and stable fixation.

Objective: To analyze the risk factors affecting prognosis of calciifc aortic stenosis in patients elder than 75 years of age and to compare the safety among different treatments. Methods: A total of 421 consecutive aortic stenosispatients treated in our hospital from 2008-01-01 to 2015-01-01 were retrospectively studied. The patients were at the age of (79.1 ± 3.5) years and with 243 (57.7%) of male gender. According to echocardiography data, the patients were divided into 3 groups: Mild stenosis group,n=112, Moderate stenosis group,n=83 and Severe stenosis group,n=226. All patients were followed-up for 1 year to observe the end point of all cause and cardiac death. In Severe stenosis group, mortalities by different treatments were compared; the risk factors related to death were calculated by Logistic regression analysis. Results: The overall 1 year all cause and cardiac mortalities were 22.3% (94/421) and 19.7% (83/421) respectively, both all cause and cardiac mortalities were similar among 3 groups,P>0.05. Multivariate Logistic regression analysis indicated that peripheral vascular disease (OR=2.31, 95% CI 1.215-4.392), LVEF (OR=0.966, 95% CI 0.942-0.991) and NT-proBNP (OR=2.022, 95% CI 1.140-3.586) were the independent risk factors for 1 year all cause death; diabetes (OR=2.157, 95% CI 1.213-3.836), LVEF (OR=0.975, 95% CI 0.950-1.000), NT-proBNP (OR=2.786, 95% CI 1.449-5.356) and blood levels of phosphorus (OR=5.755, 95% CI 1.462-22.657) were the independent risk factors for 1 year cardiac death. In Severe stenosis group, the all cause mortalities by medication, PBAV, TAVR and SAVR were 43.6%, 57.1%, 7.3% and 6.45% respectively, the patients with TAVR, SAVR had the lower mortality than those with medication, P<0.0001, while the mortality was similar between the patients with TAVR and SAVR, P>0.05. Conclusion: All cause and cardiac mortalities within 1 year were increasing with the age accordingly, while aortic stenosis grade was not related to mortality in elder patients with calcific aortic stenosis. Peripheral vascular disease and blood levels of phosphorus were the risk factors affecting prognosis. TAVR and SAVR had better effect for treating the patients with severe aortic stenosis.

AIM:The objective of this study was to observe the effects of AP-1 element on endothelin-1(EDN1)gene transcription in homocysteine(Hcy)-induced human umbilical vein endothelial cells(HUVECs).METHODS:The redox level in Hcy-induced HUVECs was determined by using the fluorescent product DCF.The influences of Hcy on expressions of EDN1 mRNA and protein of c-jun/AP-1 in HUVECs were measured by the methods of RT-PCR and Western blotting,respectively.The EDN1 secretion level of HUVECs induced by Hcy was determined by enzymatic immunoassay.The transient transfection assay was performed and luciferase activity of transcriptional factor AP-1 reporter gene induced by Hcy was detected.RESULTS:The Hcy significantly increased EDN1 secretion,EDN1 mRNA expression and oxidative stress in HUVECs.Hcy remarkably induced the expression of pGL3-EDN1-AP-1(115/+135)luciferase reporter gene plasmid.However,basic expression of mutation of pGL3-EDN1-AP-1(-115/+135)luciferase reporter gene plasmid was downregulated markedly in HUVECs induced by Hcy.CONCLUSION:Redox-active and release of ROS are changed by Hcy.Activated AP-1 element plays an important role in EDN1gene transcription in HUVECs induced by Hcy.

Objective To investigate the short- and long-term complications after endoscopic Oddi's sphincterotomy (EST) upon endoscopic retrograde cholangiopancreatography (ERCP) procedure and determine whether the size of EST correlates to the occurrence of EST complications.Methods 95 cases receiving EST in the process of ERCP in our hospital were studied and followed up. The patients were divided into large, moderate and small incision groups according to the size of EST and the states of short-term and long-term EST complications were statistically analyzed.Results The incidence of short-term complications of EST was 18. 94% (18/95). They included bleeding in the process of ERCP in 11 cases, delayed bleeding in 3, acute pancreatitis in 1, acute cholangitis in 2 and duodenal perforation in 1. All these patients but 1 with duodenal perforation were discharged after undergoing symptomatic treatments. Eleven out of the 95 patients had long-term complications (11.57 % ). These included biliary system infection in 5 cases, recurrent calculus of bile duct in 3, papilla stricture in 1 and chronic relapsing pancreatitis in 2. All 11 patients recovered after therapeutic ERCP again or symptomatic drug treatments. There was no significant difference in incidence of short-term (χ2 =2.433, P=0.296) or long-term complications (χ2 = 1.151, P=0.562) among the 3 groups. Furthermore, there was no statistical correlation between the incision size of Oddi and complications including operative bleeding (P=0.109), short-term complications (P=0.124) and longterm complications(P=0.402). Conclusion There are many short-term and long-term complications after EST, but there is no correlation between the complications and the incision size of Oddi. The occurring rate of complications might be reduced through accurate direction of papilla incision, avoidance from injury of blood vessel, keeping bile drainage unobstructed and protection of the function of Oddi sphincter as far as possible in the process of ERCP.