Determination of SCE frequency, chromosomal aberration and micronucleus rate of cultured peripheral lymphocytes of 38 miners who worked in the well, and 40 non-miners who worked outside the well in Dachang Area and 27 other workers who didn't work and live there (as control group) was carried out. The result showed that the miners had higher SCE incidence and chromosomal aberration rate. The nonmining workers and the control group had much lower rates. There was a significant difference between the miners and non-miners or control group, but no statistically differences were found between the non-miners and the control group. Micronucleus rate among the miners, the non-miners and the control group were all the same level statistically. We proposed that some toxic substances in the Dachang Tin Mine might be respousible for the genetic damages in the miners. We suggested that a combined assay of SCE with chromosomal aberration or micronucleus might be a good screening method for the high risk population such as the miners in Dachang Tin Mine.

Apoptosis is involved in a variety of physiological and path ol ogical conditions. Bax is proapoptotic member in signal pathway of apoptosis. It will contribute to the survival of cells if reducing its expression and activit y. Advances in factors influencing Bax, biological effects induce d by Bax knock-out, and antisense nucleotides targeted to Bax-mRNA were r eviewed in this article during recent years.

Objective To investigate the effect of salbutamol aerosol combined with magnesium sulfate on IL-2, IL-4, IL-5, IFN-γand T lymphocyte subsets in pediatric asthma patients.Methods 38 pediatric asthma patients were selected and randomly divided into control group and experimental group.Control group was treated by clinical routine method.Experimental group was treated by salbutamol aerosol combined with magnesium sulfate.The IL-2, IL-4, IL-5, IFN-γ, T lymphocyte subsets, blood pressure, heart rate, respiratory and clinical effects were observed and compared.ResuIts Compared with control group, the serum levels of IL-2 and IFN-γwere higher(P<0.05).The IL-5, IL-4 level were lower(P<0.05).The CD3 +, CD4 +, CD4 +/CD8 +level were higher(P<0.05).The serum CD8 +were lower(P<0.05).The total efficiency were higher(P<0.05).ConcIusion Salbutamol aerosol combined with magnesium sulfate can effectively regulate T lymphocyte subsets proportion and cytokine levels in asthmatic children, enhance immunity, and improve the clinical symptoms.

0.05). Significant differences of post-operative VA, time of retinal detachment, and neurepithelial thickness were found (P0.05). Conclusions The time of retinal detachment and post-operative VA in patients with retinal detachment relate to the neurepithelial thickness detected by OCT. When the duration of retinal detachment becomes longer, the macular neurepithelium becomes thicker, the histomorphological changes increase, and the post-operative VA decreases.

Objective To get more detailed information about the microsurgery of the Willis circle,in order to provide evidence of clinical operation.Methods The microsurgical anatomy of the Willis circle via combined frontotemporal-orbitozygomatic approach was studied in 5 adult cadaver brains under microsurgical scope. Results The Willis circle was composed of anterior communicating artery (ACOA), A 1 segments of the right and left anterior cerebral arteries (ACA), right and left internal carotid arteries(ICA) right and left, posterior communicating artery (PCOA), Pi segments of the right and left posterior cerebral arteries (PCA).The variation are present obviously in A 1 segment of the ACA. The outer diameter of left A 1 segment are larger than that of right ones. There are many perforating arteries of each part of Willis circle. Most of them arise from their original arteries, then course medial-superiorly to the optic tract, the pituitary stalk, the optic chiasm, the thalamus, hypothalamus, the floor of third ventricle, basal nuclei and internal capsule etc blood supplied areas. Conclusion To understand the microsurgical anotamy of the Willis circle and protections against its penetrating branches perfectly are the key to gain a good curative effect during the concerned operation .

Objective To evaluate the multi-slice spiral CT (MSCT) features of crush pulmonary parenchymal injuries in the massive Wenchuan earthquake. Methods One hundred and seventeen patients with crush pulmonary parenchymal injuries in the massive Wenchuan earthquake were reviewed, the location, extent and MSCT appearances of the injuries and associated thoracic injuries were evaluated. The MSCT appearances of the injuries on 1 d, 2--5 d and 6--14 d were compared using Chi-square test. Results One hundred and thirteen patients had pulmonary contusion and bilaterally in 70 cases, 7 had pulmonary laceration. A total of two hundreds and eighty-three lung lobes were involved and 3 or more lobes involved in 47 patients. Ill-defined patchy opacity was detected in 75 patients, associated ground-glass opacity (GGO) in 24 cases. Lung laceration presented as pneumatocele in 4 cases and demarcated hematoma in 3 cases. Coexisted rib fractures were detected in 98 patients and flail chests were in 29 patients. Forty-three patients had coexisted fractures of scapula, clavicle and (or) sternum. Ninety-nine patients had coexisted pleural injuries. Conclusions Crush pulmonary parenchymal injuries in the Wenchuan earthquake are severe. The bilateral, multifocal and multiple lobes involved injuries with a high incidence of coexisted other severe thoracic injuries are the noticeable features.

Objective To apply 360 degree evaluation in competence assessment of community general practice trainers.Methods The 360 degree evaluation questionnaire was designed by authors and the evaluation was applied to assess the personal comprehensive quality,competence in general practice and teaching of 16 general practice trainers in Fenglin Community Health Service Center of Shanghai Xuhui District.Results The scores of personal comprehensive quality,competency in general practice and teaching were 7.73 ± 0.73,6.91 ± 0.91 and 6.44 ± 1.38,respectively.The total scores from different evaluators were 6.93 ± 0.12 for peers,6.68 ± 0.74 for hospital executives,8.17 ± 0.12 for nurses and 6.43 ± 0.89 from self evaluation (F =27.91,P =0.000).Conclusion The variance between different evaluators in 360 degree evaluation can avoid bias of single one.The results of 360 degree evaluation show that the teaching ability of community general practice trainer is relatively low,suggesting the training of teaching ability should be strengthened for these trainers.

Objective To survey the double-preceptor system in standardized residency training of general practitioners (GPs).Methods A questionnaire survey was conducted among 48 residents,53 clinical and community preceptors during May and June 2013.Results The preceptors mostly agree with the necessity to carry out double-preceptor system.82.8％ (24/29) clinical preceptors,95.8％ (23/24) community preceptors and 89.6％ (43/48) residents considered that it was very effective.Less than half of the clinical(13/29) and community (11/24) preceptors knew very clearly about their responsibilities and obligations ; 93.1％ (27/29) clinical preceptors and 95.8 ％ (23/24) community preceptors hoped to receive corresponding training courses.72.4％ (21/29) clinical preceptors and 75.0％ (18/24) community preceptors communicated with residents frequently,75.9％ (22/29) clinical preceptors thought residents were not actively involved was the main obstacle in the implementation of double-preceptor system.The guide contents were focused on clinical skills,scientific research and how to pass assessments.The main approaches were interviews,checking the quality of medical instruments and small lecture.Only 6.9％ (2/29) clinical preceptors conducted outpatient teaching,83.3％ (40/48)residents thought tutors did not knew clearly about their responsibilities and obligations was the main obstacle in the practice of doublepreceptor system.Regarding how to evaluate the double-preceptor system,clinical and community preceptors tended to use examination results and feedback of residents.Clinical preceptors,community preceptors and residents all gave low comments about the preceptor-resident contact handbook.87.5％ (21/24) community preceptors thought lack of corresponding incentive mechanisms was the main obstacle in the practice of double-preceptor system.Conclusions Double-preceptor system has been widely recognized by both preceptors and students.In order to improve the system,we should conduct tutor training courses regularly and establish an effective mechanism to assess and evaluate tutors.

Clinically, atrial fibrillation (AF) is one of the most common cardiac arrhythmia, and patients with arterial fibrillation carry high risk of stroke. Oral administration of anticoagulation such as warfarin for the prevention of stroke has some risks to induce bleeding; moreover, some patients are not able to tolerate the medication. Percutaneous occlusion of the left atrial appendage is safe and effective for the prevention of stroke in patients with atrial fibrillation, although at present it is only used for the patients who have contraindications to anticoagulation medication. This paper aims to review a variety of left atrial appendage occlusion devices and to analyze the relationship between the different shape design of occluder and the left atrial appendage morphology.

Objective To explore the relationship between R time in thrombelastography (TEG) and prognosis of traumatic brain injury (TBI).Methods The data of TBI patients were collected in Fourth Peoples Hospital in Shaanxi Province from January 2015 to June 2016.The patients were divided into two groups according to the prolongation of R time at admission,and the basic data and the outcomes were analyzed.Results In basic data,Glasgow coma scale (GCS) [(9.7 ± 4.4) scores vs (12.1 ± 2.2) scores] was lower,and injury severity score (ISS) [(32.4 ± 8.9) scores vs (21.7 ± 10.4) scores],head abbreviated injury scale (AIS) [(5.0 ±0.0) scores vs (4.1 ± 1.5) scores],hemorrhage volume [(6.2 ± 5.5) ml vs (1.1 ± 1.8) ml] and mean arterial pressure[(127.2 ± 28.1) mmHg vs (103.3 ± 17.0) mmHg] were higher in the prolonged R time group.In outcomes,the in-hospital mortality (42.9％ vs 17.2％) and the rate of neurosurgical intervention (71.4％ vs 37.7％) were higher,and the duration of mechanically ventilated [(9.3 ±3.2) d vs (4.1 ± 1.7) d],ICU stay [(10.2 ± 4.4) d vs (5.6 ± 2.1) d] and hospital stay [(22.4 ± 8.1) d vs (8.3 ± 4.7) d] were longer in prolonged R time group.The Logistic regression analysis results showed that GCS ≤8 scores,ISS ＞ 25 scores and R time ＞ 10 min were the possible risk factors of hospital mortality.Conclusion TBI patients with longer R time have worse prognosis and longer R time is the possible risk factor of hospital mortality,and the prediction efficiency of R time need to be explored and validated by more research.