Background Optic nerve crush (ONC) model is an available tool in the basic research on the mechanism and treatment of optic nerve injury.The opening optic nerves sheath crushing and via bulbar conjunctiva lateral canthus optic nerves crushing are frequently used ONC modeling methods.However,the comparison between these models is not elaborated.Objective This study was to compare the outcomes between opening sheath ONC model and via bulbar conjunctiva lateral canthus ONC model.Methods Twenty-four male SD rats were randomized into four groups.ONC models were established via superorbital rim opening sheath to crushing optic nerve for 20 seconds in the opening sheath ONC group,or via bulbar conjunctiva lateral canthus cutting to crush optic nerve for different time in the via bulbar conjunctiva ONC 20-second,40-second and 60-second groups,respectively.All models were monocular created in the rats,and the fellow eyes served as controls.In 14 days after modeling,flash visual evoked potential (F-VEP) were recorded,optic nerve and retinal sections were prepared in the rats.The histopathology of the samples was examined by hematoxylin and eosin staining.The expression of Brn-3α in the retinal ganglion cells (RGCs) was detected by immunofluorescence technique and the number of Brn-3α+ RGCs was counted.The modeling procedure and outcomes were compared between the two approaches.Results The latencies of P1 waves were significantly extended in the opening sheath ONC group,via bulbar conjunctiva ONC 20-second,40-second and 60-second groups in comparison with the corresponding control eyes (t =-11.64,-8.04,-6.50,-10.84,all at P＜0.01).The P1 latencies were longer in the opening sheath ONC group than those in the via bulbar conjunctiva ONC 20-second,40-second and 60-second groups (P =0.01,0.02,0.05),but no significant differences were found in the amplitudes of P1 waves between model eyes and corresponding control eyes (all at P＞0.05).The Brn-3α+ RGCs numbers were evidently decreased in the model eyes in comparison with the fellow control eyes.The Brn-3 α + RGCs numbers were (13.60 ± 2.14),(18.74 ± 3.61),(15.84 ± 2.31) and (14.58 ± 3.23)/field in the opening sheath ONC group,via bulbar conjunctiva ONC 20-second,40-second and 60-second groups,which reduced to 47.49％,67.70％,56.69％ and 50.17％ of the fellow eyes,respectively.No significant differences were seen in the Brn-3α+ RGC numbers between the opening sheath ONC group and via bulbar conjunctiva ONC 40-second or 60-second groups (both at P＞0.05).The disorder of glial cell arrangement,vacuolization of the cell matrix and infiltration of inflammatory cells were displayed in various model groups,with the prominent findings in the opening sheath ONC group.Conclusions Compared with the via bulbar conjunctiva ONC models,the morphological and functional damage of optic nerve is more obvious,and the survival rate of RGCs is lower in the opening sheath ONC models.

Objective To investigate the features and prevention measures of complications secondary to severe traumatic hemorrhagic shock (THS) of different crowds in plateau (3 658 meters above the sea level).Methods A retrospective study was conducted on 591 severe THS patients undergone traditional resuscitation (traditional resuscitation group,n =103) from October 1976 to October 1990 and integrated treatment (integrated treatment group,n =488) from October 1991 to October 2012.The patients included native Tibetans,Han immigrants in plateau (≥ 3 months) and Han people who entered plateau rapidly (＜ 7 days).Outcome of the two treatments was compared.Results With regard to the traditional resuscitation group,native Tibetans sustained the main complications including stress ulcer (n =2),pulmonary edema (n =1),MODS (n =3) and death (n =3) ； Han immigrants in plateau sustained the main complications including stress ulcer (n =9),pulmonary edema (n =8),ARDS (n =3),cerebral edema (n =1),acute renal failure (n =3),disseminated intravascular coagulation (DIC) (n =2),MODS (n =13) and death (n =11)； Han people who entered plateau rapidly sustained the main complications including stress ulcer (n =5),pulmonary edema (n =4),ARDS (n =4),cerebral edema (n =2),acute renal failure (n =3),DIC (n =2),MODS (n =6) and death (n =4).Whereas in contrast to the relevant patient crowds in the traditional resuscitation group,the native Tibetans,Han immigrants in plateau and Han people who entered plateau rapidly presented significant reduction of complication rate and mortality rate in the integrated treatment group.Conclusions (1) Traditional resuscitation for severe THS patients in plateau results in much more complications with quick occurrence,high incidence,rapid progression,high severity and high mortality.Moreover,the complications are more severe in Han people who entered plateau rapidly than in the Han immigrants in plateau and native Tibetans.(2) The incidence of complications and death rate are significantly reduced after integrated treatment.(3) Han people who entered plateau rapidly present larger dependence on integrated treatment than the Han immigrants in plateau and native Tibetans.

Objective To establish the reconstructive ladder for the leg without sufficient recipient vessels by case analysis and literature review.Methods From January,2009 to January,2015,772 cases were treated in our center using free flap for leg coverage and 129 cases were found intra-operatively to have insufficient recipient vessels.There were 113 males and 16 females,and the age ranged from 4 to 71 years,averaging 36.5 years.The wounds were post-traumatic (n=108) and non post-traumatic (n=21).The management methods included elongating incision (n=25),vessel transfer(n=22),Flow-through anastomosis(n=17),end-to-side anastomosis (n=13),useing neighboring vessels (n=1S),anastomosis distal to the injured zone (n=14),cross-leg free flap (n=7),and abandoning free flap transfer(n=13).Results Except for the cases of abandoning surgery (n=13,10.1％),there were 86 cases whose flap healed totally (66.7％),9 cases total lost(7.0％),and 11 cases marginal loss (8.5％).It established a reconstructive ladder for this special situation according to the principle of difficulty level.Conclusion The insufficient recipient vessels of the leg were had multi-causes which should be taken account generally before surgery.The optimal protocol for each case should be chosen from the reconstructive ladder based on the technical difficulty level.

OBJECTIVE To observe Staphylococcus aureus(SAU) infection at high altitude and plain after gunshot injury. METHODS Used 7.62mm bullets to injure posterior limbs of piglets with the same age.We got contusing tissues in different time after injury,to make bacteriologic examination,identify and make a statistic analysis of SAU. RESULTS The main infection was caused by SAU after gunshot injury in two regions.From contusing tissues in two regions,the rate of contamination caused by SAU in Chongqing and Lasa was 48% and 18%,respectively.The time of SAU colonization was 3 hours at high altitude,and less 3 hours at plain.The velocity of reproduction of SAU at high altitude for 12 hours was 5-6 passages,and at plain was 4-6 passages for 3-6h.The time of remaining relative steady state between tissues and germs was 48 hours at high aititude and 24 hours at plain.The difference of the number of SAU between two regions after injury 3-36 hours was significant,But after 36 hours the difference was unsignificant. CONCLUSIONS At high altitude region,SAU is the main germ that causes contamination after gunshot injury,the velocity of reproduction of SAU is slower than that at plain,the time of infection is delayed obviously.

Objective To explore a more effective way of lavage so as to improve the curative effect of management for postoperative femoral infection.Methods A retrospective analysis was performed in 76 patients who received lavage therapy by using two connecting lavage tubes admitted into Department of Orthopedics,Second Hospital of Tangshan from March 2001 to May 2008.The advantages and disadvantages of this lavage method were discussed.Results All the wounds in 76 patients were healed at one stage.There was no recurrence after more than six months of follow-up.Conclusion Lavage using two connecting lavage tubes is an modification to conventional lavage,for it can reduce loss rate and blocking rate of the irrigation tube.

Objective To compare the impact of tobacco control curriculum on self-efficacy of tobacco control in different major of public health students, and offer theoretical foundation for improving tobacco control curriculum.Methods We offered tobacco control curriculum for 150 public health students (including students of preventive medicine and public service administration research direction) in medical university of Harbin, and investigated twice general self-efficacy, smoking selfefficacy and tobacco control self-efficacy before and after tobacco control curriculum, then compared intervention effects between two major students by t test.Results There were no differences of tobacco control self-efficacy, smoking self-efficacy and general self-efficacy between two major students, t values were-0.832 (P=0.407), 0.190 (P=0.849) and-0.492 (P=0.624).The tobacco control self-efficacy (t=-3.566, P=0.001) and general self-efficacy (t=-2.237, P=0.028) increased remarkably but smoking self-efficacy (t=-1.102, P=0.273) in preventive medicine students after intervention.And all of three kinds of self-efficacy were not gotten better by intervention in public service administration students.There was no obvious difference of intervention effects between tobacco control self-efficacy and general self-efficacy among preventive medicine students (t=1.541, P=0.125).Conclusions The improvement of preventive medicine students by tobacco control curriculum is better than that of public service administration students.We should further perfect the tobacco control course, and on the one hand, improve the intervention effect of students majoring in course of public health management;on the other hand, strengthen the target effects of the tobacco control curriculum to students' tobacco control self-efficacy and smoking self-efficacy.

Objective To explore the tobacco control project based health education curriculum reform's effect of improving medical students' tobacco control.Method Choosing the students of two classes of students in preventive medicine specialty of Harbin Medical University as the research object, investigating the students respectively with the questionnaire prepared uniformly by 7 schools before and after the course.All data were coded by Epidata 3.0, and SPSS 18.0 was used to carry out the relevant information for the chi square test and t test.Result The sample size of baseline survey was114 and after the intervention was 87.The knowledge pass rate of the girls before and after the intervention were 87.3％ (48/55) and 98.2％ (54/55) respectively (P=0.000).The boys' awareness rate of the secondhand smoke safety level were 13.6％ (8/59) and 21.9％ (7/32) respectively, and the girls were 13.0％ (7/55) and 31.5％ (17/55) (P=0.021).Students interested in tobacco increased from 79.8％ (91/114) before intervention to 90.8％ (79/87) after intervention (P=0.033).Students willing to work in the tobacco related increased from 52.2％(59/114) before intervention to 66.7％ (58/87)after intervention (P=0.044).The girl who replied after intervention I am not smoking now, but won't smoke either when working in the disease control in the future reached as high as 96.4％ (53/55), but the students were lack of confidence to help people to stop smoking.Conclusion The reform of social practice activity curriculum designed for tobacco control project is effective, and it is urgent to strengthen the training of preventive medical students' smoking cessation skills and enhance their confidence.

Objective To investigate the mediating effects of neurotic personality between parental rearing patterns and depressive symptom.Methods Using multistage sampling method,982 town middle-school students were surveyed by the Symptom Checklist 90(SCL-90),the Egna Minnen av Barndoms Uppfostran (EMBU),the Eysenck Personality Questionnaire (EPQ).Correlation and regression analysis,mediating effect test,and structural equation model were constructed.Results ①)Depressive symptom (D) (1.73 ± 0.72) was significantly associated with Neurotic personality (N) (51.50± 11.37) and parental rearing patterns (r=-0.138-0.582,P＜0.01).②N,mother's rejection and deny(M3),father's emotional warmth and understanding(F1),father's over-protection(F6) had a direct effect on D,which can explain 41.6％ of the variance.F1,F6,mother's over-interference and over-protection(M2),M3 had a direct effect on N,which can explain 15.3％ of the variance.The mediating effect of N between F1,F6,M2 and D were significant(95％CI =-0.212--0.069,-0.351--0.233,0.414-0.480).③The explanation for D was 41.3％.N had completely mediating effect between M2 and depressive symptom.N had partial mediating effect between F1,F6 and D,and the proportion was 43.6％ and 49.1％.Conclusion Neurotic personality plays a mediating role between parental rearing patterns and depressive symptom in middle-school students.

Objective:To explore the factors influencing the supportive communication ability of medical undergraduates, and to propose strategies to improve supportive communication.Methods:By cluster sampling, we selected 388 medical undergraduates of grades 2017 and 2018 from Harbin Medical University for a questionnaire survey on supportive communication, general self-efficacy, and health education abilities. SPSS 22.0 was used for descriptive statistical analysis. AMOS 22.0 was used to construct a structural equation model to verify the relationship between the three variables. Mediating effects were also tested.Results:The students showed good supportive communication ability, with a total score of (74.28±10.84) points. The general self-efficacy score was (27.81±5.58) points, and the total score of health education ability was (25.50±4.76) points. General self-efficacy had direct positive effects on supportive communication and health education abilities ( β=0.75, 0.31, both P<0.001). Health education ability had a direct positive effect on supportive communication ability ( β=0.14, P<0.001). Health education ability played a significant mediating role in the influence of general self-efficacy on supportive communication ability (standardized mediating effect value=0.042, P<0.01), with the mediating effect accounting for 5.1%. Conclusions:The health education competency of medical undergraduates can mediate the effect of general self-efficacy on supportive communication ability. By strengthening medical humanities education to increase general self-efficacy and also emphasizing the cultivation of health education competency, the supportive communication ability of students can be improved.

OBJECTIVETo analyze the clinical feature and constituent ratio of adult hip fractures in Southwest China.

METHODSThe data of adult inpatients and outpatients with hip fractures treated between January 2010 and December 2011 in 11 hospitals of the Southwest China were collected and analyzed. The data includes gender, age, age distribution and fracture pattern according to AO classification.

RESULTSThere were a total of 2,833 adult hip fractures, including 1,340 (47.30%) males and 1,493 (52.70%) females, with a male-to-female incidence ratio of 1: 1.11 and a mean age of (66±18) years. The highest frequency of hip fractures was seen in the 71 to 85 years age group (42.18%, 1,195/2,833). There were 844 fractures (29.79%) in the young and middle-aged group (16-<60 years) and 1 898 fractures (70.21%) in the geriatric group (≥60 years). Men had a higher rate than women (men: 577 fractures, 68.4%) in the young and middle-aged group, while women had a higher rate than men (women: 1,226 fractures, 61.64%) in the geriatric group, with a significant difference in the sex distribution between the two groups (χ2=214.001, P<0.01). The proportion of intertrochanteric fracture (type 31-A), femoral neck (type 31-B) and femoral head fracture (type 31-C) was 46.59%, 49.74% and 3.67% respectively. The highest frequency of the sub-type in each fracture type was type 31-A2, type 31-B2 and type 31-C2.

CONCLUSIONSWomen have a higher rate than men in Southwest China. Geriatric patients are more than the young and middle-aged patients. The femoral neck fractures, intertrochanteric fractures and femoral head fractures are in descending orders according to the proportion of the three different hip fractures.

Aged ; Aged, 80 and over ; China ; epidemiology ; Female ; Femoral Fractures ; Femoral Neck Fractures ; Femur ; Femur Head ; Femur Neck ; Hip Fractures ; epidemiology ; Humans ; Incidence ; Male ; Middle Aged