ObjectiveTo explore the influence of narcissism of mothers of middle school students on maternal consciousness and their rearing patterns,and to provide theoretical support for family education.Methods361 pairs middle school students and their mothers were sampled randomly and tested by middle school students' mother maternal consciousness scale and the narcissistic personality Inventory for the mothers,and the mother's subscale of EMBU for the students respectively.The data were analyzed by ANOVA,product-moment correlation and path analysis.Results 1 ) Overt narcissism had significant differences among different levels of income(F=6.501,P＜0.001 ); 2)overt narcissism was correlated positively with emotional warmth and understanding of mother and mother' s over-interference,over-protection ( r =0.121,0.126,P ＜ 0.05 ) ; covert narcissism was correlated negatively with maternal consciousness and emotional warmth and understanding of mother,and positively with over-protection,refusal and deny,and severe punishment; 3 )narcissism of mothers not only would influence their rearing patterns through maternal consciousness indirectly( β=0.319,P=0.000),but would influence that directly ( covert narcissism:β =0.281,P =0.000 ; overt narcissism:β =- 0.278,P =0.000) ; and overt narcissism had positive effect,while covert narcissism had negative effect.ConclusionNarcissism of mothers of middle school students influences maternal consciousness and rearing patterns,and effect of overt narcissism is positive,and that of covert narcissism is negative.So it is important to perfect mother's character for ameliorating their rearing pattern.

ObjectiveTo explore the influences of parental rearing pattern and adult attachment on narcissism of college students.Methods 344 college students from two universities in Hebei Province were sampled randomly and tested by the Chinese version of EMBU,the Narcissistic Personality Inventory and the Experiences in Close Relationships Inventory (ECR) in Chinese version.Results ( 1 ) The whole score of overt narcissism correlated with paternal warming,punishment,interference,rejection and maternal warming( r =0.163,0.130,0.184,0.109,0.206),but not with adult attachment; covert narcissism correlated with paternal punishment,over-interference,rejection,over-protection,maternal over interference and protection,rejection,and punishment,and anxiety and aviodance of adult attachment positively ( r =0.135,0.169,0.210,0.123,0.220,0.194,0.215,0.183,0.269).(2) The parental reaming pattern affected overt narcissism directly,while that affected covert narcissism directly with adult attachment,and indirectly through adult attachment.ConclusionCotraditory rearing patterns between father and mother lead to overt narcissism,and negative rearning patterns lead to covert narcissism with the mediator role of adult attachment.

Objective To study the effect of breviscapine injection on cerebral blood perfusion in patients with hypoperfusion/decreased embolic clearance type cerebral infarction.Methods 100 patients with hypoperfusion/decreased embolic clearance type cerebral infarction in our hospital were selected and randomly divided into two groups.Both group were treated with conventional western medicines, and the experimental group was additionally treated with breviscapine injection.The plasma D-dimer (D-D), fibrinogen (Fib), systolic and diastolic blood pressure and recovery of neurological function were compared between the two groups.Results D-D and Fib levels and NIHSS score in the experimental group were significantly lower than those in the control group (P< 0.05), while the systolic blood pressure was significantly higher than that in the control group (P< 0.05).Conclusion Breviscapine injection can reduce the plasma D-D and Fib levels, increase cerebral vascular blood flow and improve the neurological function in patients with hypoperfusion/decreased embolic clearance type cerebral infarction.

Objective To analyze the clinical characteristics of spinal cord injury patients with postoperative adhesive intestinal obstruction, and summarize the clinical experience of diagnosis and treatment. Methods 35 spinal cord injury patients with postoperative adhesive intestinal obstruction in our department from August 2008 to August 2013 were reviewed. Results All of them had a history of abdominal surgery for various reasons, 22 cases received sigmoid colon pouch procedure and 13 cases received cholecystectomy. 25 cases suffered T10-L1 spinal cord injury, 10 cases suffered cervical spinal cord injury; 26 cases (74.3%) received non-operative treatment and recovered, 9 cases (25.7%) were transferred to surgery. Conclusion There is no typical clinical symptom and sign in spinal cord injury patients with adhesive intestinal obstruction after abdominal surgery, so early diagnosis is difficult, and the imaging examination is necessary. When non-operation treatment is not effective to these patients, surgical treatment should be timely carried out.

Objective To investigate the relationship of serum levels of macrophage migration inhibitory factor (MIF), matrix metallo-proteinase-9 (MMP-9), hypersensitive C-reactive protein (hs-CRP) with the severity of acute cerebral infarction (ACI). Methods 101 pa-tients with ACI were envolved and divided into 3 groups according to the scores of National Institute of Health Stroke Scale (NIHSS):mild group (group A, n=38, NIHSS score<4), moderate group (group B, n=36, NIHSS score 4-15) and severe group (group C, n=27, NIHSS score>15). Meanwhile, 44 non-ACI inpatients with atherosclerosis were included as control group (group D). Their serum MIF and MMP-9 were detected with ELISA, and hs-CRP with immunoturbidimety. Results The levels of serum MIF, MMP-9 and hs-CRP ranged from more to less as groups C, B, A and D (P<0.05). There was positive correlation of MIF with MMP-9 (r=0.301, P<0.01) and hs-CRP (r=0.309, P<0.001). Conclusion Serum MIF, MMP-9 and hs-CRP levels increased with the severity in ACI patients, which may be prediction of athero-sclerotic plaque instability.

ObjectiveStromal cell-derived factor -1 (SDF-1 ) is closely related to the biological characteristics of breast cancer. We aimed to explore whether estrogen affected breast cancer by SDF-1. MethodsThe breast cancer cell line MCF-7 and MRC5 were chosen, and divided into three groups: the control group, the estrogen group and the estrogen + estrogen receptor blocker group. Each group was cultured with different physiological concentrations of 17-β estrogen at certain time, and the same alcohol concentration of 17-β estradiol at different time points, and then the enzyme-linked immunosorbent assay (ELISA) was used to measure the concentration of SDF-1 in culture medium, and the semi-quantitative reverse transcriptionpolymerase chain reaction (RT -PCR) was used to detect the expression of SDF-1 mRNA in each group.ResultsSDF-1 can be detected in the culture medium of both MCF-7 and MRC5 cell lines. All different concentrations of 17-β estradiol may increase the secretion of SDF-1 in MCF-7 cells. When adding 17-β estradiol to the concentration of 107mol/L, the secretion of SDF-1 reached the peak in 2 hours, which was 6 times and 2.7 times that of control group ( P ＜ 0.01 ). The effect could be ehminated by pure estrogen receptor ICI182,780. In addition, the mRNA expression of SDF-1 was consistent with the SDF-1 protein levels-l07 mol/L group. The expression of SDF-1 mRNA was higher than both that of the control group and the blocking group in 2 hours (P ＜ 0.05 ). ConclusionsIn some breast cancer cell lines, physiological concentrations of estrogen can increase the secretion of SDF- 1, and this effect is mainly achieved through the estrogen receptor. Estrogen can influence the biological characteristics of breast cancer by SDF-1.

Objective To explore the relationship between apathy and lesion location and serum homocysteine during the acute stage of ischemic stroke. Methods 152 patients with acute cerebral infarction were recruited. 152 volunteers from medical center were as control group. The Apathy Scale (AS) was used to assess poststroke apathy (PSA). National Institutes of Health Stroke Scale (NIHSS) was used to assess the severity of stroke. Magnetic resonance imaging (MRI) with diffusion-weighted imaging (DWI) was used to evaluate the lesion location. Modified Fazekas Scale was used to assess leukoaraiosis. The serum levels of homocysteine of patients were determined. Results The prevalence of PSA was significantly higher in the patients than in the control group (P<0.001). Multivariate logistic regression demonstrated that frontal lesion (P=0.001), basal ganglia lesion (P=0.006), pons lesion (P=0.002) and higher homocysteine level (P<0.001) significantly related with PSA. Conclusion Frontal lesion, basal ganglia lesion, pons lesion and higher homocysteine level may be predictors for apathy in acute stage of ischemic stroke.

Objective To compare the incidence of limb dysfunction, sensory disturbance and lymphedema after different treatment methods in breast cancer patients, and evaluate the clinically relevant factors of limb dysfunction. Methods According to the different processing operation of axillary lymph nodes, 235 patients with breast cancer during 2005 to 2012 were divided into axillary lymph node dissection group in Mastoscopy (group A, n=120) and routine axillary lymph node dissection group (group B, n=115). The flexion, extension, abduction, adduction activity of the ipsilateral shoulder were compared with the contralateral, and the circumference of the up-and-down 15 cm of both upper limbs olecroanon were measured. The incidence of limb dysfunction of the patients was followed up in 6 months, 1 year and 2 years. Results There was no significant difference in limb activity and sensory disturbance between 2 groups 6 months, 1 year and 2 years after operation (P>0.05), the incidence of limb lymphedema was higher in group B than in group A (P<0.05). Radiotherapy was related with limb lymphedema in both groups (P<0.05). Conclusion Compared with the conventional axillary lymph node dissection, endoscopic axillary lymph node dissection can reduce the incidence of limb lymphedema after operation, but there was no significant difference in the limb activity and sensory disturbance between 2 groups. Postoperative radiotherapy is a risk to increase the occurrence of limb lymphedema.

Surgery pandect is an important subject in the process of transition from basic medicine to clinical medicine in medical students,and it is also an important link of medical education. This article discussed the teaching experience of surgery pandect in rehabilitation therapy.

Objective:To analyze the reasons of early failure of the PHILOS in proximal humerus frac-tures.Methods:From Nov.2010 to Nov.2014,there were 117 patients with humerus fractures treated with PHILOS locking plate in Department of Orthopaedics,Xuanwu Hospital.All of the patients were treated with the plate by open reduction internal fixation,and we analyzed these cases retrospectively. After the operation,we removed the drainage tube within 48 h,and the patients were allowed to do the passive motion 3 days after the surgery if the X-Ray showed the plate and screws were reliable.Eight ca-ses failed within 4 weeks after the operation.We analyzed the reasons of the failure.Results:The rate of the failed cases was 6.83%(8 /117).The average age was 72.4(66 -82)years.In the 8 failed cases, 3 were on the right side,and the other 5 on the left side.As for the reason of the fractures,2 cases were because of car accidents,and the other 6 because of daily life injury.According to the Neer classifica-tion,3 cases were 2-part fractures,and the other 5 3-part fractures.Three cases were total failure,and the other 5 partial failure.All the 8 failed cases failed within 4 weeks after the operation,of which 1 was on the sixth day after surgery,the other 7 2 to 4 weeks after the surgery.The 3 totally failed cases were treated by removing the screws and plates,the other 5 by conservative methods.All of the cases were malunion at the end.Conclusion:The early failure of the PHILOS locking plate in proximal humerus fractures is related to the bad reduction during the operation,the loss of medial cortex support,the limi-tation of screw length,the osteoporosis and the improper rehabilitation after operation.It is very important to do good preoperative plan for a surgeon.During the operation,we should try our best in the fracture reduction,use the appropriate plate and screws,and then pay attention to the rehabilitation after the operation.After all of this,the rate of failure may be decreased.