Objective To investigate the injury posterior vertebral pedicle nail fixed treatment of thoracolumbar fractures of the clinical efficacy and safety .Methods Forty-eight cases of thoracolumbar fractures were treated by the posterior vertebral pedicle screw fixation ,according to cases decompressive laminectomy ,underwent intertransverse fusion treatment .Postoperative follow-up of 1 year ,preoperative ,postoperative 3 months ,after 1 years of vertebral compression rate ,Cobb Angle were compared .Results Forty-eight patients with postoperative 3 months and 1 year after injury postoperative spinal vertebral body compression rate were significantly decreased compared with preoperative (P<0 .05);After 3 months and 1 year after the Cobb Angle were markedly sig-nificant reduction than preoperative(P<0 .05) .X-ray showed all fractures were obtained good reduction ,internal fixation with no looseness or breakage ,no protruding after spinal deformity ,neural function were all in 1 -3 level recovery .Conclusion Posterior vertebral pedicle injury by nail fixed treatment of thoracolumbar fractures with fixed reliable ,reset effect is good .

Objective To explore the influence of smoking upon the level of the serum interleukin and TNF-? in patients with bronchial asthma.Methods Sixty-five patients with bronchial asthma,grade 3 or 4 as asthma group and 50 healthy examinees as control group were selected.According to the smoking history,each group was divided into the smoking subgroup and the non-smoking subgroup.For each group,the level of cytokines in serum were detected,and at the same time,their smoking history and general condition were collected.The differences between the groups were compared and the relationship of all indexes was analyzed.Results Compared with the control group,the level of IL-2、IL-6、IL-8 and TNF-? of the asthma group was significantly higher(P0.05).The level of IL-2、IL-8 and TNF-? of the smoking asthma subgroup was significantly higher than the smoking control subgroup(P0.05).Conclusion The influence of smoking upon the level of cytokines of asthma patients is significant.The level of IL-8、TNF-? in serum of a smoking asthma patient increases.The level of five cytokines in serum of 65 asthma patients in our research is related to patient's condition severity.

Strengthening the construction of open optional courses of medicine in universities is necessary for us to make good use of the teaching resources,to optimize the open optional courses system,and to improve the quality education.This thesis analyzes the problems of open optional courses of medicine in the university by questionnaire.It brings out ways to further improve the construction of open optional courses of medicine in universities.

The research of curriculum tells us that in every university there are two kinds of curriculums.One is noticeable,the other is hidden.Both of them work for the goal of bringing the students up.The witchery of hidden curriculum is that it affects the students continually and secretly.This essay discuses the significance,principle and approaches of the construction of hidden curriculum in higher learning.

Aim To observe the expression of MRTF-A in rat glomerular mesangial cells(GMCs) induced by advanced glycation end products(AGEs) and its effect on ICAM-1 and FN;to explore whether MRTF-A is involved in the process of diabetic nephropathy by affecting NF-κB pathway.Methods Under the condition of AGEs, CCG-1423 and anti-MRTF-A small interfering RNA were used to knock down MRTF-A and MRTF-A plasmid was used to activatt MRTF-A, The expression level of MRTF-A, ICAM-1, FN and p65 in nucleus were detected by Western blot.Results The protein expressions of MRTF-A was increased in AGEs-induced GMCs.The expressions of FN and ICAM-1 and p65 in nucleus were downregulated by knocking down MRTF-A.However, the expressions of FN, ICAM-1 and p65 in nucleus were upregulated by overexpressing MRTF-A.Conclusions AGEs can upregulate the expression of MRTF-A in GMCs, and MRTF-A mediates the protein expressions of FN and ICAM-1 by affecting NF-κB signaling pathway in AGEs-induced GMCs.

It is difficult for medical students to understand electrocardiogram theory. The sec-ond clinical medical college of Wuhan University has explored clinical pathophysiology and therapy (CPPT) pattern in electrocardiogram education. Basic medical knowledge and clinic medical knowl-edge are combined with electrocardiogram theory to reinforce students ' comprehension and attract theit interest in order to obtain better teaching effect. Drawing themselves, analyzing electrocardiogram sys-tematically and memorizing theory with figure is aimed at solving forgetful problems. In addition, the problems such as lack of conformable teaching material, professional teaching teams and objective mode of examination are raised, and the solutions are explored under CPPT pattern.

Objective To investigate the surgical treatment and outcome of distal humeral shear fractures in adults through Kaplan approach.Methods Nine patients with closed shear fracture of the distal humerus were surgically treated through Kaplan approach from September 2005 to September 2009.The lateral collateral ligament was released only in 1 case.All the fractures were classified into type 1A (3 cases),type 1B (1 case),type 2A (1 case),type 3A (1 case) and type 3B (3 cases) according to Dubberley classification.Under the direct vision,cannulated screw was used after anatomic reduction was confirmed by fluoroscopy.Results All fractures were reduced anatomically without any neural or vascular injury.Only 1 case of grade 1 heterotopic ossification was found 12-24 months postoperatively.There were excellent in 4 cases,and good in 5 cases.The average Broberg-Morrey score was 94.2.The average arc of flexion-extension was 116°.As to the 4 cases with posterior comminution,the averaged score and the arc of flexion-extension was 92.8 and 104°,respectively.Conclusion Through Kaplan approach,the reduction and internal fixation of distal humeral shear fractures can be manipulated successfully with lateral collateral ligament intact,and the short-term outcome is satisfactory.Dubberley classification which focused on the severity and prognosis is helpful to make a surgical plan.

Objective:There is definite therapeutic effect in tuina treating low back pain.The comparative observation was performed on the two types of tuina manipulation for degenerative lumbar spondylolisthesis,in order to explore the best tuina manipulation for lumbar spondylolisthesis.Methods:All of 121 cases with degenerative lumbar spondylolisthesis were divided into the experimental group and control group randomly by the visit orders and pathological gradations,61 cases in the experimental group,including 34 cases of grade Ⅰ and 27 cases of grade Ⅱ,and 60 in the control group,including 34 cases of grade Ⅰ and 26 cases of grade Ⅱ.There was no significant difference in the general materials of the two groups.Based upon the similar tuina therapy applied on the soft tissues in the two groups,micro-regulating manual technique of the spine was applied in the experimental group,and the hip and knee-flexed and pillow method was applied in the control group.The treatment was given 3 sessions a week,with 10 sessions as one course of the treatments.The therapeutic effects were assessed after one course of the treatments.Results:There was significant difference (P＜0.01) in the total effective rate and in the remarkable effective rate and curative rate of the patients with grade Ⅰ between the experimental group and control group,also there was significant difference (P＜0.05) in the total effective rate of the patients with grade Ⅱ.Conclusions:The therapeutic effects by the micro-regulatory manual technique are comparatively better for degenerative lumbar spondylolisthesis,and the milder the pathological condition is,the better the therapeutic effects would be.

With the increasing demand for liver transplantation,some previously abandoned donors,called marginal donor,started to be involved in clinical liver transplantation,which raises higher requirement on the organ preservation methods.Normothermic perfusion is regarded to be superior to the currently adopted hypothermic perfusion,and plays an important role in the organ preservation of marginal donors.This review will summarize the clinical applications of liver normothermic perfusion in transplantation and repair,as well as its roles in basic research.

Objective To analyze and compare the emergency therapeutic methods for renal colic,and to explore the preferable way of emergency therapies for renal colic.Methods A total of 340 cases of renal colic in emergency department were randomly divided into groups A (pethidine),B (diclofenac sodium),C (phloroglucinol),and D (diclofenac sodium + phloroglucino).The average time of therapeutic effect after given 30 min in different groups was observed.Results The average time of effect in group A [(9.53 ±3.34) min],group D[(10.49 ±2.54) min],and group B[(10.51 ±2.27)min] and they were much shorter than group C [(18.51 ±4.86) min] (P ＜0.01).There was no significant difference in the effective rate among the 4 groups(P ＞ 0.05).The relapse rate of group C (11.43％) and group D (9.00％) were much lower than group A (24.59％) and group B(23.75％).There was no adverse reaction in group C.The rates of adverse reactions in group B (2.27％) and group D (2.78％) were much lower than group A (27.27％).Conclusions Diclofenac sodium combined with phloroglucinol was preferable emergency treatment for renal colic.