Objective To study the changes in small intestinal motility during the process of gallbladder cholesterol stone formation.Methods Forty guinea pigs were divided into two groups of 20 each,the experiment group fed on high cholesterol diet ( cholesterol 2％ ),while the control group on normal diet.Animals were sacrificed at 8 weeks.Slow wave and tension of the isolated small intestinal muscle specimen were measured using a multi-channel physiological recorder,and its relation to gallstone formation was assessed.Results Compared with the control group,the frequency and amplitude of the slow wave significantly reduced in the experimental group (5.70 ± 1.05/min vs.17.45 ± 1.50/min and 0.23 ± 0.31 my vs.0.78 ±0.17 mv respectively,P ＜0.05).The t-value between the two groups were -27.083 and - 13.236 respectively; Frequency of contraction and muscle tension also reduced significantly (5.94 ± 1.25/min vs.15.85 ± 1.76/min and 0.78 ±0.002 g vs.1.20 ±0.11 g respectively,P ＜0.05).Thet-value between the two groups were - 19.448 and - 17.307 respectively.Conclusions Reduced small intestinal motility is present in guinea pigs fed on a lithogenous diet,and may have a role in the pathogenesis of cholesterol gallstone formation.

Objective To investigate the effect of fluvastatin on ventricular remodeling and serum tumor necrosis factor alpha(TNF-α)level in elderly patients with acute myocardial infarction.Methods 87 elderly patients with acute myocardial infarction were chosen in Jiande Hospital of Integrated Traditional Chinese and Western Medicine from October 2014 to October 2016,were randomly divided into control group(42 cases)and observation group(45 cases),the control group received aspirin,PI Gray chlorine and other conventional treatment,the observation group were given fluvastatinon the basis of the control group treatment.The changes of cardiac function and serum inflammatory factor TNF-α levels were observed before and after treatment.Results After the treatment,left ventricular weight index such asleft ventricular systolic volume index,left ventricular diastolic membrane membrane volume index,left ventricular ejection fraction in the two groups were improved in different degree,but the observation group improved significantly(P<0.05).In the control group,there was no significant improvement; and after treatment,the indexes of the observation group were significantly better than those of the control group(P<0.05).The effective rate in the observation groupwas 93.33％,was significantly higher than the control group(P<0.05).After treatment,the levels of serum TNF-α were significantly improved in the observation group,and the level of serum was significantly decreased compared with before treatment(P<0.05),and the observation group after the treatment was obviously lower than the control group(P<0.05).Conclusion For elderly patients with acute myocardial infarction with fluvastatin can better improve the patient's heart function,improve the body's inflammatory level,effectively improve the treatment effect,inhibit ventricular remodeling.

OBJECTIVE:To provide new ideas for the supervision of TCM decoction for patients. METHODS:The mode of outsourced TCM decoction for patients in Nanjing and Hangzhou area were investigated and analyzed,especially their operation mode. The safety problems of quality of the mode were analyzed from the legitimacy and standardization. RESULTS & CONCLU-SIONS:The present problems include the mismatch of professional and technical personnel of TCM decoction pieces and their qua-lification requirements;the lack of communication of pharmacists and prescribers;no restrictions for outsourced decoction of toxic TCM decoction pieces for patients;the insufficient attention for the quality and safety of packaging materials;being difficult to im-plement the main responsibility of medical institutions,etc. It is suggested to establish the filing system of centralized TCM decoc-tion institution for patients;the stationed system of pharmacy technician in medical institutions;the training and evaluation system of dispensing,decocting and other stations;the regular inspection system of health and pharmaceutical administration department;the quality evaluation system of TCM decoction for patients by following up medical staff and patients. So that it can explore a new idea for monitoring ofclearing the powers of regulatory,full participation in medical institutions,standardization and management of pharmaceutical wholesale enterprises,active supervision by patients.

Objective To investigate and analyze the efficacy of intravenous levosimendan in the treatment of acute cardiac failure after cardiac surgery. Methods The study of the 80 cases of acute heart failure in patients undergoing cardiac surgery after treatment in March 2014 to March 2017, the patients were monitored in the treatment before and after treatment of 24 h heart rate, left ventricular ejection fraction, mean arterial pressure and central venous pressure and other related indicators. Results Of all patients, 58 survived after treatment, and 22 died during or after treatment. Compared with before treatment, after treatment of 24 h in left ventricular ejection fraction in patients, mean arterial pressure, central venous and changes in heart rate were significantly improved, data between the two groups had significant difference compared with statistical significance(P<0.05). In 8 patients, transient blood pressure reduction occurred during treatment, but symptoms disappeared after taking appropriate measures, and other patients had no more severe adverse reactions. Conclusion According to the method of intravenous levosimendan in treatment of acute heart failure in patients undergoing cardiac surgery after treatment can make the patient's cardiac function improved, has a significant effect on the prognosis of patients, should have a relatively high value.

Objective To investigate the value of MR imaging in detecting occult fractures. Methods Sixteen cases with acute trauma were studied using radiography and MR imaging, three cases also underwent CT examinations. Three fractures occurred in the femur condyle, 8 in the proximal tibia and 5 in the thoracolumbar spine. Results All sixteen cases had normal radiographic results. In 11 cases with femur condyle and tibia occult fracture, MR imaging demonstrated linear low signal in the subcortical region in 3 cases and irregular low signal from articular faces to shaft in 8 cases on both T 1WI and T 2WI, and high signal changes around low signal were seen on T 2WI, and the width of low signal was less than 4 mm on both T 1WI and T 2WI. The high signal in T 1 weighted-Fat saturated sequence was more remarkable and wider than that on T 2WI. 3 cases with CT scanning showed no fracture signs. In five cases with thoracolumbar vertebral occlut fractures, MR imaging demonstrated horizontal linear low signal in the center of vertebra on both T 1WI and T 2WI, and high signal changes around low signal were seen on T 2WI. Conclusions MR imaging could early determine the diagnosis of occult fractures. MRI should be the next examination of choice when plain films fail to reveal suspected fractures in the setting of suggestive symptoms and positive physical examination.

Objective: The cytologic methods were used in the diagnosis of cancerous change of (intraductal papillomas,IP) and its significance was discussed. Methods： We studied the nipple discharge smear by using Wright-Gimsa staining. Meanwhile, infrared ray scanning B-ultrasound and X-rays were performed. Results： One hundred and twenty-eight patients were with IP， among them， 15 (11.7%)were confirmed as tumors by surgery and pathological examination. The cancerous change of cytomorphology was based on IP. The average age of patients with cancerous change was 48.1.The nipple discharge in patients with cancerous change was primarily bloody(66.7%). Conclusion： Introductal papillomas is carcerous. The possibility of canceration in persons with longer time of nipple discharge is larger than those with shorter time of nipple discharge. Women who are elder than 45 years old, with nipple discharge and post menopause, should be considered to have the possibility of cancerous change.

Objective To study the influence of collecting blood specimen of cancer patients through PICC on blood test result and catheter-related complication,and discuss the path and feasibility of collecting blood through PICC.Methods Adopting clinical self-contrast experiment,collecting blood specimens of 100 patients at one side through PICC (the observation group)and by ordinary method at the other side of limbs (the control group),comparing the test differences of blood routine,blood biochemistry,and coagulation function,etc.between the two groups.The incidence of catheter-related complication was also observed a week after collecting blood through PICC.Results There was no statistic difference between the two groups in terms of test results.No case of catheter-related complication in a week after collecting blood occurred in the observation group.Conclusions The method of collecting blood specimen through PICC is accurate,safe and feasible,the key point is to implement scientific and standard collecting path and entry-qualification of operators strictly.

BACKGROUND:Studies confirm that electromagnetic field (EMF) can promote the synthesis and secretion of many bone growth factors,and some growth factors can induce the osteoblastic directional differentiation of bone marrow mesenchymal stem cells (MSCs).OBJECTIVE: To investigate the effect of power-frequency EMF on mRNA expressions of bone morphogenetic protein-2 (BMP-2) and transforming growth factor-beta 1 (TGF-β1) in mouse bone marrow MSCs cultured in vitro.DESTGN: Single sample, block design, observation and controlled animal trial.SETTING: Department of Traumatic Surgery, Tongji Hospital Affiliated to Tongji Medical .College, Huazhong University of Science and Technology.MATERIALS: This trial was carried out in the laboratory of Department of Traumatic Surgery, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology during February to December 2005. ①Twenty Kunming mice of clean grade were selected for harvest of bone marrow MSCs. ②Magnetic field generator,which could generate EMF with 0 to 100 mT field strength and successive adjustable 50 Hz sinusoidal wave, was developed by Wuhan Naval University of Engineering. ③ Primer was all synthesized by Saibaisheng Bioengineering Co.,Ltd., Beijing.NETHODS: ① The involved mice were sacrificed by cervical dislocation. Bilateral femora and tibia were harvested. Bone marrow MSCs were isolated and cultured in vitro, and the second generation of cells were used for the trial. ②Different intensities of EMF stimulation tests: Negative control group, positive control group, EMF 0.4, 0.8 and 1.6 mT stimulation groups were set. Five bottles of cells of the second generation were chosen from each group for test. The cells in the negative control group and positive control group were not exposed to EMF. But medium containing osteogenic inductor(10-8 mol/L dexamethasone, 10 mmol/L β-sodium glycerophosphate and 50 mg/L Vitamin C included) was added in the positive control group at passage. After adhering to the wall, the cells in the EMF 0.4,0.8 and 1.6 mT stimulation groups were exposed to EMF of 0.4,0.8 and 1.6 mT field strength, respectively, one hour per day, five days later, they were detected.③ EMF stimulation tests in the same field strength and different time: Negative control group, EMF 1.6 mT stimulation 15,30 and 60 minutes groups were set.Five bottles of cells of the second generation were chosen from each group for test. The cells in the negative control group were exposed to EMF. The cells in the EMF 1.6 mT stimulation 15,30 and 60 minutes groups were respectively given 15,30 and 60 minutes of EMF stimulation at 1.6 mT successively.Five days later, they were detected.④ The mRNA expressions of BMP-2 and TGF-β1 were detected in each group by reverse-transcriptase polymerase chain reaction (RT-PCR) technique.MAIN OUTCOME MEASURES: ① The effect of different field strength of exposure of 50 Hz EMF on mRNA expressions of BMP-2 and TGF-β1. ② The effect of the same field strength and different time of exposure of 50 Hz EMF on mRNA expressions of BMP-2 and TGF-β1.RESULTS: ①Five days after EMF stimulation, the mRNA expressions of BMP-2 and TGF-β1 in the positive control group and EMF 0.4,0.8 and 1.6 mT stimulation groups were significantly enhanced as compared with negative control group (all P ＜ 0.01), and the mRNA expression of BMP-2 in the EMF 1.6 mT stimulation group reached the peak [(57.74±0.23)％]and mRNA expression of TGF-β1 in the EMF 0.4 mT stimulation group also reached the peak [(126.20±0.21 )％].② Five days after EMF stimulation, the mRNA expressions of BMP-2 and TGF-β1 in the EMF 1.6 mT stimulation 15,30 and 60minutes groups were significantly enhanced (all P ＜ 0.01) as compared with negative control group, and the mRNA expressions of two factors in the EMF 1.6 mT stimulation 60 minutes group reached peak separately [(28.06±0.11 )％ and (75.20±0.16)％].CONCLUSION:Proper intensity and action time of exposure of power-frequency EMF can obviously promote the mRNA expressions of BMP-2 and TGF-β1 in mouse bone marrow MSCs cultured in vitro.

The clinical internship is an important transitional period for humanistic spirit cultivation of the medical students.But in this period there are some problems exposed.For example,there is the lack of transitional link in management; the clinical instruction doctors lack educational consciousness or guidance ability,the medical students pay little attention to enhancing the individual humanistic spirit level and there is a gap between theory and practice of humanistic spirit for them.Strengthening training for students,attaching importance to training,selection and incentive of clinical instruction doctors and revising handbook of clinical internship will help to solve the problems.

Objective To evaluate the specific methods and clinical efficacy of docetaxel combined with doxorubicin in the treatment of locally advanced breast cancer and to evaluate its safety.MethodsThe clinical data of 72 pitients with locally advanced breast cancer who were treated in our hospital from July 2012 to July 2016 were retrospectively analyzed.According to the random double blind method,the patients were divided into the control group and the experimental group,with 36 cases in each group.The control group were treated with cyclophosphamide,5-fluorouracil and ammonia armor pterin methotrexate treatment,the experimental group were treated with docetaxel combined with adriamycin treatment,21 days for a cycle,withThe clinical curative effect,toxicity and quality of life were compared between the two groups of patients two cycles of treatment after the completion of the assessment.Results The total remission rate of the experimental group was 75.0％,which was significantly higher than that in control group 41.7％(P<0.05); the main adverse reactions were gastrointestinal reaction and bone marrow suppression,two groups of patients with 0-I,nausea and vomiting,hair loss,diarrhea,fatigue,white blood cell reduction,blood loss,blood loss,heart rate disorders,abnormal liver function and peripheral phlebitis.Two groups were compared.The two groups had no significant difference.Conclusion Docetaxel combined with adriamycin in the treatment of locally advanced breast cancer had definite and toxic and side reaction were slightly in patients can tolerance range,to promote the rehabilitation of patients,improve the quality of life has a very positive significance for popularization and application in the medical practice.