The authors first describe their preparation for and implementation of the assessment of candidates to be fostered as leaders in various fields of learning, viz. selecting assessment methods, identifying an assessment index system, and specifying the index weight and ways to keep the score and implement the assessment. Then they give an account of the assessment results. Finally they analyze the clinical abilities and research capacities examined in the assessment and sum up their practical experience as: ①emphasis by the leading group on the creation of the right environment and mechanism for the growth of leaders in various fields of learning; ②transformation of concepts regarding the use of personnel; ③specification of the function of the assessment; ④identification of strengthened assessment as the key to guaranteeing the quality in fostering leaders in various fields of learning.

BACKGROUND:Inactivated autologous replantation in repair of bone defects after bone tumor resection has obvious advantages. Boiling, alcohol soaking, cryogenic freezing, microwave, radiation and other methods have been used for inactivation; however, they al have shortcomings. OBJECTIVE:To study the effect and feasibility of high temperature and high pressure inactivated autologous bone in repair of large segmental bone defects. METHODS: Bone defect models of bilateral distal radius were established in New Zealand white rabbits. Bone defect at the right side was repaired by high temperature high pressure inactivated autologous bone via in situ replantation, as experimental group. Bone defect at the left side was repaired byin situbone replantation, as control group. The general observation of bilateral radius, X-ray detection, bone radionuclide scan test and histological examination were conducted at the 6th, 12th and 24th weeks after surgery. RESULTS AND CONCLUSION: At the 24th week after surgery, X-ray films showed normal bone healing in these two groups. At the 24th week after surgery, bone radionuclide scan test showed that in the experimental group, the radiation on the repaired bone segments was uneven; the concentrations of nuclear elements were stil slightly higher on both ends, but decreased in the middle area; and the concentration in the control group was closed to normal. At the 24th week after surgery, histological observation showed that there were a majority of trabecular bone tissues in the bone defect area of the experimental group, and some woven bone tissues were immature, which was similar to the performance of the control group at the 12th week after surgery; and normal bone was visible in the control group. These results demonstrate that high temperature and high pressure inactivated autologous bone can be used to repair long segmental bone defects, but can result in delayed bone healing.

Objective To explore the changes of CD4~+ cell and relevant cytokines from chronic hepatitis B patients and the significance was discussed. Methods The expression of CD4,CD8 and CD28 molecules on PBMC was detected with Flow Cytometry.The levels of IL-2,IFN-?,IL-4,IL-10 and IL-12 in serum were measured with ELISA,and the liver function test including serum ALT,SB,ALP and albumin was conducted. Results Three conditions of CD4~+ ratio from PBMC in 86 patients were observed,that showed lower,similar or higher comparing with normal controls.According to CD4~+T cell ratio,the patients were divided into 3 groups.In three groups,the changes of CD28 expression paralleled to that of CD4~+T cell ratio.Except IL-4,the level of cytokines related to viral clearance such as IL-2,IFN-?,IL-10 and IL-12 in patients was elevated compared with controls(P

Objective:To compare the analgesic effects of naborphine and desorine after surgery for supracondylar fracture of humerus in children.Methods:Eighty-seven children with supracondylar fracture of humerus who received surgical treatment in Zhoushan Hospital of Traditional Chinese Medicine between January 2019 and January 2020 were included in this study. They were randomly assigned to receive postoperative analgesia either with dezocine (control group, n = 44) or naborphine (observation group, n = 43). The postoperative agitation score, postanesthetic recovery score, postoperative visual analogue scale score, and adverse reactions were determined between the two groups. Results:The heart rate and mean arterial pressure at the time of extubation were (102 ± 7) beats/min and (83 ± 6) mmHg respectively in the observation group, which were significantly lower than those in the control group [(115 ± 8) beats/min, (92 ± 7) mmHg, t = 6.214, 8.283, P < 0.05]. In the observation group, the postoperative agitation score was (4.45 ± 0.34) points, (5.02 ± 0.38) points, and (3.65 ± 0.39) points, at the time of spontaneous eye opening, at the time of extubation and at 30 minutes after extubation respectively, which were significantly lower than those in the control group [(5.31 ± 0.48) points, (5.75 ± 0.35) points, (4.12 ± 0.37) points, t = 6.392, 7.194, 7.382, all P < 0.05]. At 30 min, 3 h and 6 h after surgery, the visual analogue scale scores in the observation group were significantly lower than those in the control group ( t = 5.345, 6.124, 7.553, P < 0.05). The time to return to spontaneous breathing, the time to spontaneous eye opening and the time to extubation in the observation group were (7.32 ± 4.17) min, (11.65 ± 3.32) min, (12.13 ± 2.41) min, respectively, which were significantly shorter than those in the control group [(10.34 ± 4.15) min, (14.43 ± 3.18) min, (15.16 ± 2.23) min, t = 7.216, 5.382, 7.319, all P < 0.05]. The incidence of adverse reactions in the observation group was significantly lower than that in the control group [6.97% (3/43) vs. 27.27% (12/44), χ2 = 6.280, P < 0.05]. Conclusion:Naborphine for analgesia after surgery for supracondylar fracture of humerus in children can effectively reduce the incidence of agitation during the recovery period, enhance postoperative analgesic effect, and lower the incidence of reverse reactions.

Objective To compare two different gastric tube insertion methods on neonatal pain responae.Methods From April to July 2010,47 neonatal patients underwent gastric tube insertion in the neonatal department of our hospital were randomly classified into two groups:the nasal gastric tube insertion group(28 cases) and the oral gastric tube insertion group( 19 cases).Neonatal pain score and incidence of complications during gastric tube insertion between both groups were compared.Results The mean rank of pain scores were significantly higher in the nasal gastric tube insertion group than in the oral gastric tube insertion group.The incidence of pain and complications were higher in the nasal gastric tube insertion group than in the oral gastric tube insertion group.Conclusions The impact of oral gastric tube insertion on neonatal pain response is not significant,and few complications occur during oral gastric tube insertion,so it is worthy of clinical application.

Immunohisto-chemical S-P method was used to examine the expression of E-cadherin,Vimentin and TGF-β1 in 54 cases oral carcinoma and 10 cases of normal oral mucosa.The positive rates of the expression of E-cadherin,Vimentin and TGF-β1 were 55.6%, 33.33% and 59.3%,respectively in oral carcinoma group(vs normal oral mucosa,P <0.05).The expression of TGF-β1 was correlated with lymph node metastasis,and showed significant positive correlation with Vimentin.Epithelial-mesenchymal transition may promote inva-sion and metastasis of oral carcinoma,and TGF-β1 promotes EMT.

Background:CXC chemokine receptor type 2(CXCR2)is a member of G protein coupled receptor superfamily,and is mainly involved in the growth of tumor,angiogenesis and the pathogenesis of inflammatory diseases. Studies showed that CXCR2 was associated with the pathogenesis of inflammatory bowel disease(IBD),but the exact role has not yet been clarified. It was found that the interaction of interleukin-8(IL-8)with CXCR1 and CXCR2 played an important role in the pathogenesis of IBD. Aims:To investigate the expressions and significance of CXCR2 and IL-8 in patients with IBD. Methods:A total of 121 IBD patients in active stage from October 2013 to December 2014 at Zhongnan Hospital of Wuhan University were enrolled and assigned into Crohn’s disease(CD)group and ulcerative colitis(UC)group. Seventy healthy subjects were served as controls(HC). Expressions of IL-8 mRNA and CXCR2 mRNA in peripheral blood and intestinal mucosal tissue were determined by real-time PCR;expression of CXCR2 protein in intestinal mucosal tissue was determined by Western blotting. Results:In peripheral blood,expression of IL-8 mRNA in UC group was significantly higher than that in HC group(P = 0. 017),while expressions of CXCR2 mRNA in CD,UC and HC groups were not significantly different (P = 0. 285). In intestinal mucosal tissue,expressions of IL-8 mRNA in CD,UC and HC groups showed no significant difference(P = 0. 206),while expressions of CXCR2 mRNA in CD and UC groups were significantly higher than that in HC group(P = 0. 002;P < 0. 001),and expression of CXCR2 mRNA in UC group was significantly higher than that in CD group(P = 0. 005);expressions of CXCR2 protein in UC and CD groups were higher than that in HC group(P = 0. 049 P =0. 080). Conclusions:Expressions of CXCR2 mRNA and protein in intestinal mucosal tissue of patients with IBD, especially UC are significantly increased. Down regulation of CXCR2 expression in intestinal mucosa may provide a new target for treatment of UC. IL-8 is significantly highly expressed in peripheral blood of patients with UC,which suggests that IL-8 might be related mainly with UC.

Objective To report a new surgical approach (modified anconeus flap approach) in which the anconeus and part of triceps are reflected in the treatment of distal intercondylar humerus fracture (AO type C).Methods To design the modified anconeus flap approach,the anatomy of the distal tendon of the triceps brachii and the anconeus was studied using 15 cadaveric adult specimens (30 sides).The new surgical approach was compared with the triceps-reflecting anconeus pedicle (TRAP) approach in terms of the area of exposure at the distal humeral articular surface.Furthermore,the new surgical approach was applied in 16 patients who had been treated for intercondylar humerus fracture (AO type C) from May 2005 to May 2013.The clinical outcomes were evaluated using the Mayo elbow performance score (MEPS) and Broberg-Morrey scoring systems.Results The blood supply and innervation of the anconeus was interrupted minimally during incision along the radical edge of triceps tendon.The area of exposure at the distal humeral articular surface provided by the part triceps and anconeus reflecting approach and the medial humerus approach was 42.66％ ± 0.03％ at the elbow flexion from 0° to 50°.This was significantly smnaller than that provided by the TRAP approach (46.11％ ±0.03％) (P ＜0.05).Of the 16 patients,15 obtained complete follow-ups from 6 months to 4 years(average,16.5 months).The mean MEPS at the last follow-up was 90.5 points (range,from 82 to 93 points),with 10 excellent and 4 good cases and one poor case.The Broberg & Morrey score system showed 11 patients with no articular cartilage degeneration (level-0),3 patients with level-1 degeneration,and 2 patients with level-2 degeneration.Conclusion The modified anconeus flap approach proposed in the present study provides clear surgical vision and needs no olecranon osteotomy or olecranon dissection or ablation of the major triceps brachii tendon for intercondylar humerus fractures,thereby leading to early active motion and satisfactory clinical outcomes.

Objective To explore the establishment and evaluation of various forms of complementary transfer. Methods The former method using the traditional handover method, the establishment of various forms of complementary shift model improved, including optimized bedside handover, handover of patients′ bedsore image and emotional barometer over emotional changes, establish WeChat group to observe improvement;the first two months (99 cases, monitoring 42 days) and the improvement after the six months (97 cases, monitoring 43 days) score of nurses for the patient to grasp, bedside shift time and transfer the missing information. Concrete research and implementation methods, research objects, sample size, measurement indicators, evaluation methods, etc. Results Both shift mode, there is no information on patients admitted to general statistical difference (P>0.05);under complementary shift mode, nurse the patients′ condition from the master score (80.95 ± 4.30) points increased to (84.88 ± 4.01) points, in which the patients′condition data mastery score from (40.81 ± 2.02) points increased to (44.16 ± 2.88) points, nursing problems and measures of control points value from (13.21 ± 1.54) points increased to (14.44 ± 1.72) points, the difference was statistically significant (t =4.362, 6.209, 3.462, P<0.01);general information master score, treatment information at its disposal no difference scores statistically significant (P>0.05). Bedside nurse shift change time decreased from former improvements (31.21 ± 2.63) minutes to (14.42 ± 2.40) minutes, and the difference was statistically significant (t=30.767, P=0.000). Shift nurse missing information dropped from 16 times to 7 times, the difference was statistically significant (χ2=5.124, P=0.024). Conclusions Complementary model can reduce the insufficiency of current clinical succession work, help nurse master the patients′physical and mental conditions and more comprehensive understanding of the ward, reduce the omission or missing information and improve the working efficiency and responsibility.

Objective:To demonstrate the feasibility of the osteosarcoma devitalization method by vacuum dehydration at room tem-perature. Methods:For the in vivo study, the VX2 tumor mass was treated by vacuum dehydration, rehydrated in ice water, and im-planted in the rabbit to determine the safety time to deactivate the tumor. For the in vitro study, the osteosarcoma mass was devital-ized by vacuum dehydration, and the dehydration rate and ATPase activity were determined. Histopathological changes in the tumor were also observed. The change in the biomechanical strength of rabbit bone and tendon after vacuum devitalization treatment was detected. Results:At room temperature, the safety time to deactivate the VX2 tumor was 60 min, and the dehydration rate was 93.8%at this time point. After vacuum dehydration, the tumor mass evidently shrunk, presenting a porous structure. The osteosarcoma cell became small, and cell structure damage was observed under light microscope. Disrupted cell membrane and organelles were seen un-der transmission electron microscope as well as broken down chromosomes. The activity of ATPase was evidently lower than in the control group. The strength of bone and tendon did not decrease significantly after vacuum dehydration. Conclusion:Treatment by vacuum dehydration at room temperature for 60 min does not result in differences of the bone and tendon strength. However, it can inactivate both soft tissue and bone tumor mass completely.