Currently,independent clinical medial femoral plate is more needed to apply in more complex C3 distal femoral fractures and knee valgus orthopedic surgery.The doctors always pre-bent the contralateral femoral lateral plate in order to achieve close to the natural shape of the bone.The cold deformation of the plate can change the metallographic structure and the biomechanics,and the position of the screw holes in the plate may also affect the healing of fractures.Compared with traditional manufacturing techniques,3D printing technology as a core technology in third industrial revolution,instead prior manufacture of molds,removing the large amount of material in the manufacturing process and the complex process of forging a final product,it is more suitable for difficult to machine materials,manufacture,inspection shape design,assembly,testing and fast reverse engineering.Therefore,a personalized interior distal femoral plate with 3D printing technology was designed,and the application of the plate,the current situation and prospects of 3D printing technology and other aspects were summarized in this article.

Objective:To investigate the pathway of C.albicans-induced murine thymocyte apoptosis.Methods:The chages of TNF-? level in murine plasma and caspase-3 activity were measured by ELISA and flurorescence spectrophoto meter respectively;FCM measurement was adopted for the expression levels of related genes.Results:The level of TNF rise,the caspase-3 activity serengthen significantly and bax,p53 gene expression are upregulated.Conclusion:It is possible that C.albicans elicits apoptosis in murine thymocytes by upregulating bax and p53 gene expression as well as raising the serum TNF-? level to strenghen the activity of caspase-3.

Objective: To study correlation between heart rate variability (HRV) and arteriosclerosis in patients with essential hypertension (EH).Methods: A total of 139 EH patients from our hospital were enrolled as EH group.According to carotid-femoral pulse wave velocity (PWV), they were divided into normal subgroup (n=65, PWV<9 m/s) and abnormal subgroup (n=74, PWV≥9 m/s).Another 60 healthy adults undergoing physical examination in our hospital during the same period were selected as healthy control group.HRV indexes, PWV, carotid intima-media thickness (IMT) and number of carotid plaques were compared among all groups.Correlation among above indexes were analyzed in EH patients.Results: Compared with healthy control group, there was significant reduction in standard deviation of normal to normal RR intervals in all 5 min segments of the entire recording[SDANN, (142.3±21.4)ms vs.(119.3±16.5)ms], significant rise in low frequency[LF, (341.7±37.9)Hz vs.(695.4±43.3) Hz], high frequency[HF, (519.1±33.6) Hz vs.(636.8±39.5)Hz], LF/HF[(0.6±0.3) vs.(1.0±0.2)], PWV[(7.44±0.82) m/s vs.(11.13±0.65) m/s]and IMT[(1.03±0.24)mm vs.(1.74±0.41)mm]in EH group, P<0.01 all;in EH group, compared with normal PWV subgroup, there was significant reduction in SDANN, and significant rise in LF, HF, LF/HF, IMT and mean number of carotid plaques in abnormal PWV subgroup, P<0.05 or <0.01;Pearson correlation analysis indicated that in EH patients, PWV and IMT were significant inversely correlated with SDANN (r=-0.713,-0.699, P<0.01 both), significant positively correlated with LF, HF, LF/HF and carotid plaques (r=0.506~0.935, P<0.01 all), and PWV was significant positively correlated with IMT (r=0.883, P=0.001).Conclusion: In EH patients, SDANN, LF, HF, LF/HF of HRV are significantly correlated with arteriosclerotic extent.Besides lowering blood pressure , HRV etc.related with artery pathological changs should also be treated.

OBJECTIVE：To systematically review the efficacy of tamsul osin a lone or combined with antimuscarinic drugs in the treatment of ureteral stent-related symptom （SRSs），and to provide evidence-based reference for the clinical treatment. METHODS：Retrieved from PubMed ，Embase，Cochrane Library ，CJFD，CBM，VIP and Wanfang database ，from the inception to Oct. 2019，RCTs about tamsulosin alone （monotherapy group ）or combined with antimuscarinic drugs （combination group ） versus placebo or blank control （control group ）in the treatment of SRSs were collected. After data extraction of included clinical studies met inclusion criteria ，their quality was evaluated with Cochrane collaborative network system evaluation manual 5.1.0，and Meta-analysis was conducted by using Rev Man 5.3 statistical software. RESULTS ：A total of 9 RCTs were included ，involving 932 patients. Meta-analysis results showed that after stent placement ，the urinary symptoms score [MD ＝－4.23，95％CI（－5.96， －2.51），P＜0.000 01]，body pain score [MD ＝－4.20，95％CI（－5.30，－3.10），P＜0.000 01]，general health score [MD ＝ － 1.36， 95％ CI（ － 1.75， － 0.98）， P＜0.000 01] in monotherapy group were significantly lower than control group with statistical significance ； there was no significantly 2805097532@qq.com difference in the work performance score [MD ＝0.19，95％CI（－0.99，1.37），P＝0.76]，sexual matters score [MD ＝－0.31 95％CI（－0.68，0.05），P＝0.09] in 2 groups. 4 weeks after the stent was removed ，the body pain score [MD ＝－0.64，95％CI（－0.84，－0.43），P＜0.000 01]，general health score [MD ＝ －0.28，95％CI（－0.41，－0.15），P＜0.000 01] ，urinary symptoms score [MD ＝－0.64，95％CI（－0.84，－0.43），P＜0.000 01] in monotherapy group were significantly lower than control group after stent placement ，with statistical significance ；there was no significantly difference in the work performance score [MD ＝0.31，95％CI（－0.22，0.84），P＝0.25] or sexual matters score [MD ＝ －0.31，95％CI＝（－0.68，0.05），P＝0.09] in 2 groups. The urinary symptoms score [MD ＝5.93，95％CI（2.83，9.02），P＝0.000 2]， body pain score [MD ＝3.49，95％CI（1.39，5.60），P＝0.001] and general health score [MD ＝2.96，95％CI（1.44，4.49），P＝0.000 1] in the monotherapy group were higher than the combination group ；there was no significantly difference in the work performance score [MD ＝1.53，95％CI（－0.12，3.18），P＝0.07] or sexual matters score [MD ＝0.46，95％CI（－1.03，1.96），P＝0.54] in 2 groups. CONCLUSIONS：Tamsulosin has a good therapeutic effect on SRSs ；its combination with antimuscarinic drugs can achieve better therapeutic efficacty.