Since the beginning of the surgery studies,disparities among medical students have existed. In order to avoid the disparities becoming more series among medical students in their surgery studies,based on author’s teaching experience in disparity teaching practices for the past few years,this article focuses on four aspects to expatiate: disparities of students,optimizing of teaching content,selection of teaching instrument and promotion of teacher’s self-quality.

Objective To explore the efficacy of breast-conserving therapy of ductal carcinoma in situ (DCIS),and to evaluate its safety.Methods 54 patients with DCIS receiving breast-conserving therapy(the experimental group) and 49 patients with DCIS treated with mastectomy(the control group) in the First Affiliated Hospital of Wenzhou Medical College from Mar.2010 to Mar.2013 were retrospectively analyzed.The follow-up results of the 2 groups were analyzed in terms of the local recurrence,distant metastasis and the 3-year diseasefree survival(DFS).The efficacy and safety of breast-conserving treatment were evaluated.Results All patients were followed up for 5 months to 39 months,with the average of(22.3 ± 8.5) months.No local recurrence happened in the experimental group.There was 1 case of chest wall recurrence in the control group.One case in the experimental group and 2 cases in the control group had distant metastasis.DFS rate in the 2 groups was 100％ and 95.9％ relatively.No statistically significant difference was found between the 2 group in terms of the above items (P ＞ 0.05).Conclusion For DCIS patients,the difference between breast-conserving therapy and mastectomy surgery in the rate of local recurrence and distant metastasis was not significant.Breast-conserving therapy is safe for DCIS patients and should be further promoted.

Objective [WT5”BZ] To study the relationship between human papillomavirus (HPV) 16 and its serum antibody in the development of gastric carcinoma (GC) [WT5”HZ] Methods [WT5”BZ] Polymerase chain reaction (PCR) technique was used to detect HPV DNA in 42 fresh GC specimens and 42 fresh normal gastric mucosa adjacent to the tumour (NGMAT). Enzyme linked immunosorbent assay (ELISA) was used to screen the serum HPV16 antibody(Ab) of 42 GC patients and 46 controls using HPV16 virus like particles (VLPs) which was produced by recombinant bacilovirus in insect cells [WT5”HZ] Results [WT5”BZ] HPV16 DNA was found in 26 2% (11/42) of GC specimens,but in none (0/42) of NGMAT ( P

Objective To choose the best surgical procedure,the surgical results and clinical outcomes of inguinal hernia repair with either an open anterior or posterior approach,were studied.Methods The 366 cases of inguinal hernia patients according to surgical side approach in different ways,is divided into A,B groups,Among group A of 186 cases repaired with application of prolene hernia system (PHS) via anterior approach,while group B of 180 cases surgically treated with Kugel technique with a posterior approach,and surgical procedure,postoperative recovery and complications were compared between these two groups,respectively.Results No significant differences were found in operation time,hospital stay,incisional infection rate and the recurrence rate (P ＞ 0.05).However,compared with group,the group B patients had less pain of the wound,slight postoperative swelling response,less foreign body aesthesis and hydrocele(P ＜ 0.05).Conclusion Compared with the anterior approach surgery,the posterior approach (Kugel technique) has less traumatic,low complication rate and rapid recovery after operation.

Objective To investigate the anti-tumor activity of a novel chalcone analogue-H175.Methods We synthesized chalcone analogues and further tested the cytotoxicity on colon cancer cell line (CT26) through MTT method,and identified H175 with powerful biological activity.Flow cytometry was used to assay the ability of H175 to induce CT26's apoptosis and inhibit its cell cycle.Western blot was used to detect the effect of H175 on ATF4 and CHOP expression in CT26.After knockdown CHOP by siRNA technology,further investigate the influence of H175 on cell's apoptosis through immunofluorescence (IF) and FCM.Results H175 inhibits the proliferation of CT26 (ICs0 =1.9 μmol/L),by inducing CT26's apoptosis inhibiting its cell cycle,on a dose-dependent manner of key protein CHOP of endocytoplasmic reticulum stress (ERS) signal path.siRNA technology confirmed H175 induce apoptosis by stimulating the CHOP over-expression.Conclusions Novel chalcone analogue-H175 show inhibitory effects on the proliferation of CT26 by activating the ERS signal path's key protein CHOP.

Objective To study the effects of decoy strategy targeted to NF-?B on IL-6 in rat's liver after traumatic inflammatin. Methods Ninty six Wistar rats were randomly divided into 4 groups: control group,traumatic inflammation group, decoy ODN group, and mutant decoy ODN group. Rats were killed on 3 , 6, 12, 24, 48 , and 72 h respectively, for the determination of plasma ALT. Hepatocytes were isolated and nuclear protein was extracted, DNA binding activity of NF-?B was measured by EMSA. Decoy ODN's competition inhibition effect was assayed by EMSA. IL-6 gene expression in liver tissue was assessed by RT-PCR and IL-6 protein level was determined by ELISA. Results After traumatic inflammation, DNA binding activity of NF-?B in the liver increased. IL-6 mRNA and protein level also significantly increased and was in positive correlation with the activity of NF-?B. Decoy ODN effectively inhibited the activity of NF-?B ex vivo. After using decoy ODN, IL-6 mRNA and protein levels of liver tissue significantly decreased, plasma ALT levels were also significantly decreased. Conclusions Decoy strategy targeted to NF-?B could effectively inhibit rat's liver IL-6 release by inhibiting specifically the activity of NF-?B.

Objective: To assess the predictive value of the platelet-to-lymphocyte ratio(PLR), neutrophil-to-lymphocyte ratio(NLR)and tumor-related factors on the peritoneal metastasis in advanced gastric cancer patients. Methods: A total of 701 pathologically confirmed gastric cancer patients who underwent surgery at the First Affiliated Hospital of Wenzhou Medical University between Jan 2009 and Jan 2012 were enrolled. Results: Univariate analysis indicated that tumor location, tumor size, serosal invasion, depth of invasion, pathological type, lymph node metastasis and PLR were related to peritoneal metastasis(all P<0.05). According to the area under the ROC curve, the optimal cutoff value of PLR for predicting peritoneal metastasis was 132.43 (sensitivity 71.8%, specificity 50.6%). There were significant differences in tumor size, TNM stage, lymph node metastasis and serosal infiltration between high PLR group and low PLR group. Multivariate Logistic analyses revealed that PLR (HR=2.205, P=0.003), lymph node metastasis(HR=3.113, P=0.010)and tumor size(HR=1.150, P=0.014) were independent risk factors for peritoneal metesfasis. Conclusions Preoperative PLR is valuable in predicting peritoneal metastasis of advanced gastric cancer and it is an independent risk factor for peritoneal metastasis of gastric cancer.

【Objective】  To study the composition and function of tongue coating (TC) and gastrointestinal tract (GIT) microbiota in participants with yellow-greasy tongue coating (YGTC), and to explore the representative metabolite markers and pathways in this group. 【Methods】  Subjects with YGTC or thin-white tongue coating (TWTC) were recruited from December 1, 2021 to October 30, 2022, and the TC and fecal samples were collected. Samples were subjected to both whole-genome shotgun (WGS), and 16S rRNA gene sequencing. The α-diversity analysis, principal component analysis (PCA), and Spearman correlation analysis were performed for two groups. Ultra-performance liquid chromatography combined with tandem mass spectrometry (UPLC–MS/MS) analysis was used to analyze metabolomics and enrichment of metabolic pathways. 【Results】  The results revealed 20 YGTC participates and 19 TWTC participates. At the genus level, the dominant bacterial species of TC flora and intestinal flora in the two groups were roughly the same, but the relative kurtosis difference was marked, and the abundance of potentially pathogenic bacteria in TC and fecal samples of YGTC subjects was higher. There were 9 down-regulated microorganisms in the TC samples, 26 down-regulated microorganisms, and 6 up-regulated microorganisms in YGTC subjects. The α-diversity analysis indicated that the Chao and abundance-based coverage estimator (ACE) indices of TC bacteria in the YGTC subjects showed a decreasing trend, but the difference was not statistically significant (P > 0.05). The α-diversity of fecal samples and the Chao and ACE indices decreased significantly (P < 0.05). PCA showed that the microflora structure of TC and fecal samples were significantly different between the two groups. Spearman correlation analysis showed that there was no correlation between TC and fecal microorganisms at phyla and genus levels in the same subjects (P > 0.05). The metabolomics results demonstrated that fumarate reductase, V/A ATPase, and phosphatidylethanolamine were increased, and glycerate-3p, UDP-glucose, and quinone oxidoreductase metabolites were decreased in YGTC TC samples. Inosine monophosphate (IMP), uridine monophosphate (UMP), and gamma-aminobutyric acid(GABA) were increased in YGTC fecal samples, while the contents of ribo-5P, histidine, biotin,and cobalamin were decreased. Metabolic pathway analysis indicated that the abundance of the TC and fecal samples of the YGTC subjects was relatively low in various metabolic pathways, including amino acid metabolism, carbohydrate metabolism, nitrogen metabolism, and energy metabolism. 【Conclusion】  Structural and functional changes in TC and GIT microbiota or metabolite markers could be potential biological bases of YGTC formation.

Femoral neck fracture (FNF) in the elderly patients is currently a major health challenge worldwide, with excessive consumption of medical resources, high incidence of complications as well as suboptimal outcome and prognosis. Hip joint arthroplasty (HJA) has been the mainstream treatment for FNF in the elderly, but the conventional surgical approaches and techniques are still confronted with a series of bottlenecks such as dislocation, limp and limb length discrepancy. In recent years, direct anterior approach (DAA) for HJA (DAA-HJA) has been a major new choice in the field of joint replacement, which achieves improved clinical effectiveness of HJA in the treatment of elderly FNF, due to the fact that DAA approach involves the neuromuscular interface and accords with the idea of soft tissue retention and enhanced recovery after surgery. However, there is still a lack of unified understanding of standard technique and procedure of DAA-HJA in the treatment of elderly FNF. Therefore, relevant experts from the Hip Joint Group of Chinese Orthopedics Association of Chinese Medical Association, Youth Arthrology Group of Orthopedic Committee of PLA, Orthopedic Committee of Chongqing Medical Association, Branch of Orthopedic Surgeons of Chongqing Medical Doctor Association and Sport Medicine Committee of Chongqing Medical Association were organized to formulate the " Chinese expert consensus on the technical standard of direct anterior hip arthroplasty for elderly femoral neck fracture ( version 2023)" based on evidence-based medicine. This consensus mainly proposed 13 recommendations covering indications, surgical plans, prosthesis selections, surgical techniques and processes, and postoperative management of DAA-HJA in elderly patients with FNF, aiming to promote standardized, systematic and patient-specific diagnosis and treatment to improve the functional prognosis of the patients.