Objective To study the application of open reduction and plasticity titanium plate in the treatment of calcaneal fracture.Methods 29 patients with sanders Ⅱ、Ⅲ、V calcaneal fracture were treated by surgery with open reduction and titanium plate fixation.The clinical effects were observed.Results All patients were followed by Maryland Foot score postoperative functional evaluation system,the group of 29 cases of fracture,excellent 21 cases,good 9 cases,acceptable 2 cases,excellent rate was 93.7％.Condtusion The open reduction and internat fixation with plastic titanic plate was reliable to treat displaced intra-articular fracture of calcaneus.

Objective To investigate the features of clinical pathology,phenotye and differential diagnosis of thyroid follicular carcinoma-like renal tumor.Methods A 25-year-old female patient was hospitalized in February 28,2011 because of hypertension for 20 months.Physical examination revealed a right renal space-occupying lesions without percussion pain.Blood pressure was 200/130 mm Hg (1 mm Hg =0.133 kPa).Thyroid,heart,lung,and abdominal examination showed no abnormalities.Blood,urine routine,biochemical examination,blood catecholamines,and thyroid function test results were normal.CT examination showed that a visible circular nodules with clear boundary was in the upper pole of the right kidney,and the maximum section about 2.2 cm × 3.0 cm withuneven density andrenal artery was pressed down.Clinical diagnosis was right renal tumor,and right renal tumor was removed under general anesthesia.Intraoperative tumor was located in the right renal hilumwithclear boundary,and the surrounding mild adhesions.Postoperative blood pressure wasnormal.Results General inspection of the specimen:a 2.5 cm diametermasswith intact capsule.The color of the section of the mass is gray red and gray.Multiple small cysts are seen in the section and the cysts contain jelly material.Microscope inspection:the tumor tissue is arranged like thyroid follicular and the follicular contains much acidophil colloid.Immunohistochemistry:the tumor cell is EMA (+),Vimtin (+),CK7 (+),CK20 (+),CD117 (-),TTF-1 (-),TG (-),CgA (-),Syn (-).Conclusions Thyroid follicular carcinoma-like renal tumors is a very rare kidney epithelial cell tumor,which is attributable to any known subtypes of renal cell carcinoma.To improve the understanding of it can avoid misdiagnosis and prevent inappropriate treatment.

In the twenty-first Century,with the rapid development and popularization of the In ternet and E-learning,bending learning is given a new definition,which claims the advantage combination of traditional learning and E-Learning,advocates the teaching mode of teachers' leading role and students' predominant position.Micro-lecture is a newly emerging force on teaching.This study probes into the medical micro-lecture design mode based on the concept of blending Learning,illustrates the stages of teaching preparation,micro-lecture design,micro-lecture application and evalua tion in order to improve higher medical education.

MOOC,a Massive Open Online Course,is a new curriculum model,which is having a significant impact on higher medical education in China.The paper discussed the feasibility and theoretical basis of MOOC platform-Coursera which was applied to M-learning for medical students,and tried to explore the way to benefit higher medical education reform.

WRKY proteins, a big family of transcription factors, are involved in regulation diverse developmental and physiological processes in plants. Here, a novel WRKY gene, OsWRKY52, was isolated from a rice cDNA library. This gene included an open reading frame of 1 719 bp in length, and the deduced polypeptide contained 572 amino acids,sharing 54% identity with a WRKY1 protein from Avena sativa. Expression of OsWRKY52 gene was induced rapidly by Magnaporthe grisea in the incompatible interaction with rice plant. OsWRKY52 protein, expressed prokaryotically bound specifically to W box cis elements derived from the promoter of a rice PR1a. Transcriptional activation assay was performed by a yeast one- hybrid method. Regions of transactivation were identified to be the N-terminal serine- and threonine-rich islands and the C-terminal acidic domain of OsWRKY52. These results suggest that OsWRKY52, as a transcription activator, may be involved in defense responses against Magnaporthe grisea in rice plants.

In this paper,the contents of nutrition ingredients and five elements of limit quan- tity in eight species of shellfish in South China Sea were studied. It was found that the contents of Cd was high and Ag,As Cu and Ph were general low in comparison with hygiene criterions.

Objective To explore clinical application of retrograde medial and lateral gastrocnemius muscle flap for soft tissue defects of the middle and lower third of the leg. Methods From August 2008 to December 2009, in our hospital we adopted retrograde medial and lateral gastrocnemius muscle flap to renovate 5 cases of refractory soft tissue defects of the middle and lower third of the leg. Results Five cases of retrograde medial gastrocnemius muscle flap were survived, morphology and function of soft tissue defects were renovated well. Conclusion This operation is an effective and reliable technique for soft tissue defects of the middle and lower third of the leg, which is performed without sacrificing the major blood vessels, probing vascular pedicle and matching vascular anastomosis.

Objective To investigate the outcomes of increased gestational diabetes mellitus (GDM) and the influencing factors after the implementation of the new GDM diagnostic criteria.Methods A total of 1 439 GDM women who delivered in the Peking University First Hospital between May 1,2011 and December 31,2012 were studied and divided into two groups.Group Ⅰ included the women who met the new GDM diagnostic criteria (fasting plasma glucose and 1 or 2 h plasma glucose levels for 75-g oral glucose tolerance test performed between 24 and 28 weeks of gestation were no less than 5.1,10.0 and 8.5 mmol/L),but did not meet the National Diabetes Data Group (NDDG) criteria;and Group Ⅱ included the women who met the NDDG criteria only.Women in Group Ⅰ were further divided into two subgroups according to whether attending the one-day GDM outpatient visit.Follow-up rate and detecting rate of abnormal glucose metabolism at 6-12 weeks after delivery were analyzed.Chi-square test,t test and multivariate Logistic analysis were used for statistical analysis.Results There were 849 GDM women in Group Ⅰ (59.0％,849/1 439) and 590 (41.0％,590/1 439) in Group Ⅱ.The follow-up rate in group Ⅰ was lower than in group Ⅱ [25.9％(220/849) vs 32.0％(189/590),x2=6.112,P=0.013].There were five cases of impaired fasting glucose and 34 impaired glucose tolerance in Group Ⅰ;and four cases of impaired fasting glucose,56 impaired glucose tolerance,eight impaired fasting glucose tolerance with impaired glucose tolerance and five diabetes mellitus in Group Ⅱ;there were significant differences [17.7％(39/220) vs 38.6％(73/189),x2=33.810,P=0.000].(2) In Group Ⅰ,the increased glucose level at 2 h in oral glucose tolerance test during pregnancy (OR=1.547,95％CI:1.038-2.306,P=0.032) and family history of diabetes mellitus (OR=1.879,95％CI:1.066-3.313,P=0.020) were risk factors for postpartum abnormal glucose metabolism,while breast-feeding was a protective factor (OR=0.290,95％CI:0.092-0.914,P=0.035).(3) In group Ⅰ,the follow-up rate in those who attended the one-day GDM outpatient visit was higher than those who did not [30.7％(185/603) vs 14.2％(35/246),x2=23.780,P=0.000],but the detecting rate of postpartum abnormal glucose metabolism were similar in women attending the one-day GDM outpatient visit and those not attending [17.8％(33/185) vs 17.1％(6/35),x2=0.020,P=0.887].Conclusions Increased GDM women still have glucose metabolism abnormality after delivery,especially those who have higher glucose level at 2 h after glucose intake in 75 g oral glucose tolerance test during pregnancy and who have a family history of diabetes mellitus.The one day GDM outpatient visit may improve the follow-up rate for these women.

0.05). The mean growth values in AdCMV-tk/GCV- and AdVEGF-tk/GCV-treated tumors were significantly lower than those in untreated tumors and AdVEGF-tk/saline-untreated tumors( P

Objective To report the clinical features and inwardly rectifying potassium channel 18 (KCNJ18) gene mutation in a group of patients with thyrotoxic periodic paralysis (TTP).Methods Fiftyseven TTP cases (55 male and 2 female) were collected in our clinic from July 2002 to October 2011.The KCNJ18 gene was directly sequenced in 57 TTP patients and 50 health Chinese controls through the nested PCR.According to the results of gene screening,the clinical features of KCNJ18 patients and non-KCNJ18 patients were retrospectively summarized and analyzed.Results In 4 male patients with TPP,we found 3 novel heterogeneous mutations (p.Q126X,p.K360T,p.E388K) and 1 reported mutation (p.A200P) in the KCNJ18 gene.The age of onset was 19-25 years old,and the duration ranged from 2 to 8 hours.The 4 patients all presented severe muscle weakness.The attacks of muscle weakness preceded overt symptoms of hyperthyroidism in the 4 patients. Three patients showed recurrent weakness during the 13-28 months follow-up,while the episodic weakness never appeared when patients got euthyroid. Conclusions The mutations in the KCNJ18 gene are responsible for a part of Chinese patients with TPP.The patients with KCNJ18 mutations have a shorter disease course,severer manifestation,and higher prevalence of recurrence as compared with those TPP patients without KCNJ18 mutations.