A great number of experiments on education system,curriculum,teaching methods,administeration,selection and organization of knowledge were performed in higher education in China in the second half of the 20th century. As a whole ,we find that they changed from serving the political,economical and social needs to focusing on variables of experiments themselves. Selection and organization of knowledge became the theme of experiments. Effective means and methods of education constituted the key contents. However, while concerning scientificity and impartiality of the experiments were tested, their motive,process and results still need to be carefully examined.

Objective To evaluate the effect of mini-abdominal incision for choledochoscopy via cystic duct in exploration of the common bile duct(CBD).Methods The right subcostal incision was 4-6 cm in length.Choledochoscopy via cystic duct stump for exploration and extraction of CBD stones was done in 135 cases.Results The CBD stone was removed in 109 of 135 patients(80.7%).The CBD exploration was negative in 26 cases(19.3%)and retained CBD stones occurred in 4 cases(3.0%).One case(0.7%)had intraoperative injury of common bile duct,2 cases(1.5%)had tear of cystic duct stump,and 2 cases(1.5%)had biliary leakage,all the 5 cases were recovered after treatment.Conclusions The mini-abdominal incision with choledochoscopy via cystic duct for exploration of the CBD is safe and feasible.

Objective To explore early endoscopic diagnosis and treatment of the clinical value of biliarypancreatitis. Methods From January 2007 to December 2009 completed 93 cases acute pancreatitis of endoscopic treatment,routining for endoscopic incision nipple,observed remission of symptoms and recurrence after treatment. Results In these cases acute biliarypancreatitis was 62.4% (58/93),occult biliarypancreatitis diagnosed by endoscopy was 27.6% (16/58),remission rate was 93.8% (15/16),no surgical operation and recurrence. Conclusion Occult biliarypancreatitis occupies a certain proportion of acute pancreatitis,also easily missed diagnosis and recurred,endoscopy is currently the most effective method.

Objective To determine the value of ERCP and EST after Billroth gastroenterostomy. Methods ERCP was used in 31 patients after Billroth- Ⅰ gastroenterostomy, 12 of whom received EST. It was in 137 patients after Billroth-Ⅱ gastroenterostomy, of the 34 received EST and 4 EPBD.Results Billroth- Ⅰ gastroenterostomy ERCP was successfully performed in 28 out of the 31 patients and EST in 11 out of the 12 patients. Billroth- Ⅱ gastroenterostomy ERCP was successfully performed in 109 out of the 137 patients and EST in 31 out of the 38 patients. There were no serious complications in patients receiving endoscopic treatments. Concluasion The success rates of ERCP and EST are high in patients with bile duct lithiasis after Billroth-gastroenterostomy. Endoscopic treatment or cholangioduodenostomy has good therapeutic effects.

Objective To investigate the causes of and prophylactic measure for complications of minilaparotomy cholecystectomy (MC).Methods The clinical data of 10 200 patients receiving MC from Apri1 1991 to March 2006 were analyzed.Results MC was successful in 9 835 cases(96.4%), and in 365 cases(3.6%) the incision was lengthened. Serious complications were 12 cases(0.12%)of bi1e duct injury, 4 cases(0.04%)of colon injury, 8 cases(0.08%)of massive haemorrhage, and 25 cases (0.25%)of bile leakage. Four 4 cases(0.04%) died. Conclusions The key to prevention of complications is a strict selection of MC indications,careful identification of the anatomical structures of Calot's triangle,use of suture ligation of the mesentery of gallbladder triangle and the technique of deep knot-tying and the timely use of extension of the incision.

BACKGROUND:At present, finite element analysis technology can set up the model, predict diagnosis, treatment design, as wel as surgical plan, and can be used in the treatment of necrosis of femoral head. OBJECTIVE:To sum and discuss recent progress in clinical and experimental research regarding biomechanical study in osteonecrosis of femoral head by using finite element analysis. METHODS:A computer-based retrieval was performed by the authors (Hong Guo-ju and Zhou Guang-quan) in PubMed, Google, SpringerLink, ChinaNational Knowledge Infrastructure databases for literatures published from January 2010 to December 2015. The key words were“(finite element analysis OR finite element) AND (osteonecrosis OR osteonecrosis of femoral head)”. Inclusive criteria:studies with contents closely related to this paper;original papers with reliable topics and evidence;or papers with clear points and al-round analysis and both studies in vitro and in vivo. RESULTS AND CONCLUSION:A total of 27 studies were included. The articles in the latest five years related to femoral head osteonecrosis and finite element analysis application were concentrated on. We summarized the latest research progress and problems, including the applied research carried out in the femoral head osteonecrosis clinical cases, innovational skil s, so as to point out the direction of future research in the finite element analysis.

Objective To investigate the diagnostic threshold value and diagnostic performance of high-sensitivity troponin T (hs-cTnT)for elderly patients with acute myocardial infarction(AMI).Methods 835 emergency department patients with chest pain were recruited in the study,then these patients were divided into elderly group (≥65 years old)and control group(<65 years old).Hs-cTnT concrentrations were compared between the two groups;The difference of hs-cTnT concentrations between AMI pa-tients and non-AMI patients were compared in elderly group and control group respectively;The optimal threshold values of the hs-cTnT for acute myocardial infarction were determined by receiver operating characteristic(ROC)curve.Results The hs-cTnT con-centrations of non-AMI patients in elderly group were 18.4(14.5-32.5)ng/L,which were higher than those of non-AMI patients in control group[3.2(3.0-8.2)ng/L],and the difference were statistically significant(P <0.05);The hs-cTnT concentrations of AMI patients in elderly group were 136.1 (51.6 - 384.1 )ng/L,which were higher than those of AMI patients in group 68.5 (25.6-217.1)ng/L,and the difference were statistically significant(P <0.05).According to the ROC curve,the optimal threshold value for AMI diagnosis in elderly group by using hs-cTnT was 32 ng/L,which was higher than that in control group(14 ng/L). The specificity and the positive predictive value of the optimal threshold value determined by ROC were apparently higher than the 99th percentile(P 99 )in elderly group respectively,the difference were statistically significant(P <0.05).Conclusion The hs-cTnT levels were positively related with age.The optimal threshold value of hs-cTnT for AMI(32 ng/L)was higher than the P 99 (14ng/L)in elderly group.

The model of knee OA (KOA) was established in our laboratory with three-dimensional (3D) reconstruction technique based on the CT data. We then designed the unicompartmental prosthesis matching KOA model with parametric software Pro/e 5. 0. Finally, the models were used to mimic the operation of knee unicompantment replacement and the model of unicompartmental knee athroplasty (UKA) was analyzed using 3D finite element method. The results indicates that the approach for designing the model by 3D parametric is effective and meets the need of automation and efficacy to design unicompartmental prosthesis. The results proves that the model is vivid and precise, and the 3D parameteric modeling method can provide biomechanical research of unicompantment replacement with model foundation and new experimental method. It can be widely utilized in the clinics and research.
Algorithms ; Arthroplasty, Replacement, Knee ; methods ; Computer-Aided Design ; Finite Element Analysis ; Humans ; Imaging, Three-Dimensional ; methods ; Knee Joint ; diagnostic imaging ; surgery ; Knee Prosthesis ; Prosthesis Design ; Tomography, X-Ray Computed

Objective To study thyroid function in patients with depression.Methods The average levels of TSH,FT3,FT4 in 5 316 patients with depression were compared with 5 316 healthy controls.The average levels of TSH,FT3,FT4 were compared between male and female patients with depression.The differences of thyroid disease detection rate were compared between elder and group younger group.Results The differences of TSH,FT3,FT4 levels between the depression patients and healthy controls have statistically significant(P＜0.05).The differences of TSH,FT3,FT4 levels between the male depression patients and the female depression patients have statistically significant (P＜ 0.05).The hyperthyroidism prevalence were as follows:6.50 ％ versus 6.10 ％ (P＞0.05),compared between older and younger depression patients.The subclinical hypothyroidism prevalence 24.30 ％ versus 9.40 ％ (P＜0.05),compared between older and younger depression patients.The hypothyroidism prevalence 14.30 ％ versus 2.90％ (P＜0.05),compared between older and younger depression patients.Conclusion Depression is easily caused by low thyroid hormone levels.Women and elder people with hypothyroidism should more prevent depression.Thyroid hormones can be used as routine screening index of depression,but not specific indicators.

This paper is aimed to acquire high Geometric similar Subject-specific three-dimensional (3D) finite element mesh model of hip joint containing necrotic femoral head according to individual patient's X-ray, CT and MRI by using the image registration and fusion technology. We selected a middle-aged female patient with osteonecrosis of femoral head, obtained the X-ray, CT and MRI images respectively. Then we established 3D solid model separately based on these image data by using Mimics 13. 1 and Pro/E 5.1 software. We confirmed the match points and then proceed the 2D image registration after image projection conversion. Finally we showed the 3D finite element mesh model. A highly geometric similar subject-specific 3D finite element mesh model for osteonecrosis of femoral head has been established, which included normal cortical bone, cancellous bone, articular cartilage and necrotic zone, fractured trabecular bone within the femoral head. The model truly reflects the morphological characteristics and relationship of hip joint with osteonecrosis of femoral head, provides a relatively ideal research platform for further biomechanical analysis and surgical simulation.
Female ; Femur Head Necrosis ; diagnostic imaging ; pathology ; Finite Element Analysis ; Humans ; Image Processing, Computer-Assisted ; methods ; Imaging, Three-Dimensional ; Magnetic Resonance Imaging ; Middle Aged ; Models, Anatomic ; Tomography, X-Ray Computed