Objective To observe the interaction between the extreme stress and mild traumatic brain injury in the patients surviving Wenchuan earthquake.Methods Forty survivors in Wenchuan earthquake were selected for the psychological status survey 2-30 days after the disaster,among them 20 survivors were suffering from mild traumatic brain injury,and the remainders were in normal physical conditions.The Symptom Checklist-90(SCL-90),which consisted of 90 items with 5 grades for each item(0-4 grade,grade zero as none and grade 4 as severe),including 9 symptom factors,was adopted to perform the evaluation for all the subjects in both groups,and the subscales were compared.Results Five subscales of SCL-90,including somatization,depression,anxiety,hostility and fear,which averaged 2.12?0.50,1.83?0.60,1.99?0.40,1.80?0.70 and 2.20?0.8,respectively,were significantly increased in mild traumatic brain injury group than that in control group(P0.05).Conclusions Mild traumatic brain injury occurred among survivors of severe earthquakes is strongly associated with psychological problems.A higher incidence of psychological disorder in survivors of earthquake with mild traumatic brain injury indicates that one must be cautious when attributing a health problem to mild traumatic brain injury,since the post-traumatic stress disorder and depression may be the primary problem.The high-risk population with psychological obstacle consists of the survivors with mild traumatic brain injury,and the interactions of both psychological stress and traumatic brain injury may lead to more complex clinical symptoms,so psychotherapy should be emphasized in the treatment of patients with mild traumatic brain injury.

Diabetic nephropathy is one of the most serious complications of diabetes mellitus and it seriously endangers people's health.Some previous studies indicate that the occurrence and development of diabetic nephropathy is not positively associated with control of blood glucose and course of disease,Its development has family aggregation and ethnic differences.In addition to environmental factors,genetic factors play an important role in the process of occurrence and development of diabetic nephropathy,Many genetic mutations can lead to a high degree of susceptibility to diabetic nephropathy.Discovery of some related genes of diabetic nephropathy and elucidation of these genes function provide an effective means in the early diagnosis,gene therapy and individualized drug therapy of diabetic nephropathy.In this review the action and function of discovered related genes of diabetic nephropathy are summarized.

[Objective]To analyze the causes of revision for bone tumor salvage limb operations and to explore the therapies.[Method]There were 4 cases of male,1 of female and with the mean age of 41.2 years old.The time between the first operation and revision was from 3 to 29 years.The common reason for revision was aseptic loosening,2 patients with sinus and 1 with fracture of prosthesis.During revision,the old prosthesis were implanted in 2 cases,the new one were used in the others.[Result]All patients were followed up with the mean time of 28 months,no patient died.The mean score of limb function was 21.5.[Conclusion]Revision should be performed as soon as the prosthesis aseptic loosening has been determined,and the satisfactory limb function could be obtained.

[Objective]To study the clinical matters of inactivated bone replantation with preservation of the epiphysis in children limb salvage with osteosarcoma.[Method]Eleven children(mean age 7.6 years old,5 male and 6 female)with osteosarcoma underwent inactivated bone replantation with preserving epiphysis following chemotherapy during 6 years.All lesions located in the distal femur.Seven were in Ⅰ type on MRI classification,4 in Ⅱ type.Two courses of the same protocol as preoperative chemotherapy were administered postoperatively.[Result]The operative time were 3~4 hours.The bleeding amount were about 300~500 ml.No complications occurred in operation and incisions healed well in all patients.Eleven patients were done follow-up from 10 to 72 months.Functions of the affected limbs were satisfatory.Local tumor recurrence was seen in one case and lung metastasis in two,3 patients died of the disease.Blot became flexible and inactivated bone fractured in one,respectively.[Conclusion]Inactivated bone replantation with preserving epiphysis for osteosarcoma in children is propitious to recover limb function and keep limb length.The main measures of preventing complications include no-touch technique in operation,incision drain completely,prolonging time of affected limb external fixation and safeguarding the affected limb during postoperative function exercise.

Objective To evaluate the safety and efficacy of OUR Rotating Gamma System in neurosurgical clinical application. Methods Based on the results of animal experiments, 2381 patients with intracranial disease were treated using OUR Rotating Gamma System in Aohai Gamma Knife Center of Navy General Hospital of PLA betwean December 1996 and November 2002. There were 1288 males and 1093 females and their age ranged from 3 to 84 years (mean 45.8 years). 1020 patients had benign intracranial tumors, and of them 446 suffered from pituitary tumors, 254 meningioma, 148 craniopharyngioma and 103 vestibular schwannomas. Malignant tumors were diagnosed in 796 patients, among them glioma was found in 360 and metastasis in 360. 374 patients had cerebral arteriovenous malformations (AVMs) and 191 functional neurological disorders. Treatment technique of Gamma Knife Stereotactic Radiosurgery, dose prescription and precise orientation performed in intracranial tumor or foci were analyzed, and the preliminary outcome of treatment was evaluated in this study. In addition, the management of the possible complication and adverse reaction was studied. Results Gamma Knife Stereotactic Radiosurgery alone, or combined with other treatment procedures, could cure some of selected patients with benign brain lesions including pituitary neoplasms, meningioma, vestibular schwannomas, AVMs, and craniopharyngioma etc. And this treatment was also beneficial to some patients with malignant tumors. The incidence of radiation edema was 0.75%. Conclusions The clinical results suggest that Gamma Knife Stereotactic Radiosurgery is a very effective, accurate and relatively safe neurosurgical tool used either as a primary or adjuvant procedure for treatment of intracranical pathologic processes. However, it might lead to some severe or fatal complications if used inappropriately. Thus, optimal result would not be obtained unless a careful and precise Gamma treatment based on the operative rules and the effective management for postoperative complications are well planned.

Objective To investigate the mechanism of capsaicin in treating active psoriasis vulgaris. Methods A total of 42 patients with active psoriasis vulgaris diagnosed by histology and clinical features were given either placebo or 0.025% capsaicin ointment four times daily for 30 days randomly by double-blind method. Vasoactive intestinal polypeptide receptor 1(VIPR1) gene translation in active psoriatic lesions before and after treatment with capsaicin ointment was detected by in situ hybridization. Results There was positive staining of VIPR1 gene in all the layers of psoriatic epidermis (95.5%) before the treatment with capsaicin ointment, but nearly no dyeing in epidermis (18.2%) after the treatment for 30 days. There was nearly no brown staining before and after treatment in control group. Conclusion VIPR1 gene translation in psoriatic epidermis is down-regulated after capsaicin treatment for 30 days.

Objective:To explore the pharmaceutical care points in advanced lung cancer patients with brain metastases. Meth-ods:Clinical pharmacists participated in the drug treatment process of one case of small cell cancer patient with brain metastases. Pharmaceutical care was carried out from various aspects, including brain metastases treatment, chemotherapy, antiviral therapy and patient education. Results:Cerebral transfer symptoms and quality of life of the patient were effectively improved and adverse reactions were reduced by the pharmaceutical care. Conclusion:By the implementation of pharmaceutical care on the patient, clinical pharma-cists can not only improve their own knowledge base and exploit professional advantage, but also provide suggestions on rational drug use for health care professionals.

Objective To explore the effect of comprehensively-designed experiment teaching methodology in the teaching of geriatric nursing. Methods Sixty-three nursing students in the grade of 2010 were assigned into the experiment group, where the comprehensively-designed experiment teaching methodology were adopted. And the fifty-eight nursing students in the grade of 2009 were assigned as the control group, where the traditional experiment teaching methods were adopted. The two groups were compared in terms of theory test scores and evaluations to the two teaching methods. Result The theory examination score and students'evaluation in the experiment were higher than those of the control group (P<0.05). Conclusion Comprehensively-designed experiment teaching method used in the teaching of geriatric nursing is beneficial for the students to improve their interest in learning, cultivate their comprehensive quality, shorten the gap between the experimental teaching and clinical practice and improve the teaching effect of geriatric nursing.

Purpose: To explore the relationship between the amount of lymphocyte containing adhesion molecules(CD_(44)) and the development and postoperative metastasis of bone tumors. Method: The percentage of peripheral blood CD_(44) positive lymphocyte's(PB CD_(44) + L) in 45 patients with bone tumor and the tissue CD_(44) content in 7 malignant bone tumors were determined with the flow cytomentric immunological method. Results: The PB CD_(44) + L in benign tumor group(BG) and malignant tumor group(MG) were much higher than that of the control, and the PB CD_(44) + L in MG was higher than that in BG. No difference was found in the content of PB CD_(44) + L between the mahgnant non-metastatic group (MNG) and the malignant metastatic group(MMG). The postoperative PB CD_(44) + L in the BG and MNG was decreased, but CD_(44) was unchanged pre-and postoperatively in the MMG. The patients with high CD_(44) content in the tumor tissues were liable to postoperative lung metastasis. Conclusions: The determination of CD_(44) in PBL and tumor tissue can be helpful to determine the nature of the neoplasm and to predict its prognosis.

Objective Use the automatic microbiological analysis system which for the streptococci (ATB rapid 32 Strep) to identify streptococci, and compare the examination speed and accuracy with the internationally recognized bacterium identification golden method API 20 Strep (streptococci identification biochemistry system) to enable the clinical microorganism room use ATB rapid 32 Strep identification system correctly, and provide the etiology basis to clinical promptly.Methods Isolate the bacterium from patient blood, cerebrospinal fluid, pig heart, pork and so on, then separate the streptococci in form to the blood plate, lay them in carbon dioxide incubator, after 35 ℃ 24 hours. Use ATB rapid 32 Strep,API 20 Strep and the traditional manual method to identify 18 strains of bacterias and carry on the medicine sensitive experiment.Results ATB rapid 32 Strep identified 16 strains as streptococcus suis II, 2 strains as streptococcus bovis II; API 20 Strep identified 17 strains as streptococcus suis II, 1 strain can not be identified; the tradition manually method identified all of the 18 strains as streptococcus group D . These 18 strains all sensitive to the Chloramphenicol , clindamycin, erythromycin, levofloxacin, penicillin, quinupristin/dalfopristin, cefotaxime, vancomycin and sulfafurazole , and resistant to the tetracyclin.Conclusion ATB rapid 32 Strep can identify the streptococcus suis in 4 hours , and the coincidence rate with API 20 Strep is 94.4%.So ATB rapid 32 Strep is one kind of system which could identify bacterium simply,quickly,accurately,and provide infectious disease etiology information for clinical immediately, satisfy the requirement of clinician and the microorganism examines.