Space-time is extremely attached importance to in the thinking of recognizing diseases and syndrome differentiations in TCM. For instance, internal/external and upper/lower in Neijing, are the concept of compartmentalization of the tissue and structure in the body, also are the mechanism of recognizing generations and changes of diseases by combining both space and time organically. Moreover, the thinking of upper/lower and internal/external syndrome differentiations and treatments in TCM constitute a relatively completely space-time system, which are in favor of systematicness and integrality of syndrome differentiation and analysis, and then are usually used clinically. Therefore, upper/lower syndrome differentiation is the medical concept deriving from yin/yang. However, it exceeds mechanical space-time concept, also has the meaning of‘principle’ to guide syndrome differentiation and treatment. Thus, raising an issue that blending the thinking of upper/lower syndrome differentiation into eight principles and other methods of syndrome differentiation, in order to make methods of syndrome differentiation more practical.

Objective To explore relationship between anterior knee pain after total knee arthroplasty and patella resurfacing and prosthesis design,and to evaluate which femoral prosthesis is more friendly with patella:Genesis Ⅱ or PFC knee prostheses.Methods Data of 145 patients (145 knees) who had undergone primary total knee arthroplasty for treating osteoarthritis were retrospectively analyzed.Posterior-cruciate-substituting total knee prostheses were used in all patients.Among 74 patients who had undergone patella resurfacing,Genesis Ⅱ knee prosthesis was used in 32 patients and PFC knee prosthesis in 42 patients.Among 71 patients who had not undergone patella resurfacing,Genesis Ⅱ knee prosthesis was used in 38 patients and PFC knee prosthesis in 33 patients.The Hospital for Special Surgery(HSS) score,patella score,patellar function score,range of motion of knee,anterior knee pain scale,and patient satisfaction were used to evaluate clinical outcomes.At the same time,the imaging results were evaluated by X-rays.Results 144 patients were successfully followed up for 21 to 43 months (average,33 months).There was no significant difference in incidence of anterior knee pain between the group with patella resurfacing and the group without patella resurfacing,while a significant difference was found between patients receiving Genesis Ⅱ knee prosthesis and those receiving PFC knee prosthesis.Four patients who had undergone total knee arthroplasty using PFC prosthesis underwent reoperation.There were no significant differences in postoperative HSS score,range of motion of knee and patient satisfaction between the Genesis Ⅱ group and the PFC group,while there were significant differences in patella score and patellar function score between them.Conclusion Postoperative anterior knee pain was related to the prosthesis design,rather than to the patella resurfacing.Genesis Ⅱ knee prosthesis was more friendly with patella than PFC knee prosthesis.

OBJECTIVEThis study aims to explore the effect of Notch signaling depression on the receptor activator of nuclear factor kappa B ligand (RANKL)-induced osteoclastogenesis of RAW264.7 cells.

METHODSMice RAW264.7 cells were cultured and differentiated into osteoclasts with the induction of RANKL. The expressions of Notch1, Notch2, Deltal, Jagged1, Hes1, tartrate-resistant acid phosphatase (TRAP), and Cathepsin K genes during osteoclastogenesis were analyzed using real-time polymerase chain reaction. Osteoclast formation was analyzed using TRAP assay with suppression of Notch receptors by a selective γ-secretase inhibitor (GSI).

RESULTSNotch1, Notch2, Delta1, Jagged1, and Hes1 expressions in RAW264.7 cells were upregulated following 50 ng · mL-RANKL stimulation for 3 d, concomitant with the expression of the osteoclast differentiation markers TRAP and Cathepsin K. Notch2 and Jagged1 had the most remarkable increase in the Notch family members. GSI inhibited RANKL-induced osteoclastogenesis of RAW264.7 cells and Hes1 expression dose-dependently.

CONCLUSIONNotch signaling activation may promote RANKL-induced osteoclastogenesis of RAW264.7 cells.

The bioavailability of zinc in normal and zinc deficient LACA mice was investigated using isotope zinc-65. The intestinal absorption of Zn in the zinc-deficient mice (71.913.6%) was significantly higher than that in the normal mice (38.8?6.8%). No difference on Zn distribution in the body was observed. Specific activity of zinc-65 in liver, spleen, kindey and muscle in the zinc-deficient mice was significantly higher than that in the normal mice. The retention curve of zinc-65 in mice was properly fitted into two exponential functions. The biological half-times of zinc in blood, spleen, lung, femur and muscle attached to femur in the zinc-deficient mice was slower and ration ratio in the slower clearance component in the zinc-deficient mice, was larger than that in the normal mice.

Objective: To study the influence of anterior crossbite on the position and morphology of teeth. Methods: 81 teenagers with permanent dentition and anterior crossbite were in volved in group 1 and 95 teenagers in permanent dentition without anterior crossbite in group 2. The teeth in both groups were compared on their position and morphology. Results:① The percentage of ill-positioned teeth in maxilla in group 1 and in group 2 was 14.0% and 8.8% respectively (P

High grade B-cell lymphoma (HGBL) has been defined as a separate entity in World Health Organization classification in 2016 and is considered to be clinically aggressive. People make continuous analysis of the subgroups and accurate treatments, such as the comparison between the prognosis of HGBL-not otherwise specified and double-hit lymphoma (DHL), transformed and primary DHL, myc partner/bcl-2/bcl-6 translocation, TP53 expression, serum albumin, chemoimmunotherapy, hematopoietic stem cell transplantation, T cells with chimeric antigen receptors therapy, etc. This report will address the progress of HGBL prognosis and therapy in the 58th American Society of Hematology Annual Meeting.

A scientific and appropriate construction of curriculum of medical ethics such as teaching hours,teaching content,teaching methods and examination & evaluation in Institute of Medicine and Nursing is to improve the effectiveness of the teaching of medical ethics,to fulfil its goal of fostering applied skilled medical talents,and to meet the needs for the talents in the development of time so that students can better access and understand medical ethics for the sake of facing and dealing properly with problems related to medical ethics work in their future medical work.

Objective To establish an evaluation index system for the quality and safety of the specialized nursing care in cardiovascular medicine. Methods To screen and evaluate the safety quality evaluation index via a group discussion with Delphi method and analytic hierarchy process referenced to the literatures from the evaluation index of domestic nursing safety quality (NSQ)and on the base ofthe factor quality- quality of links-final quality3-dimensional quality structure theory by Donabedian. Results The first and second round of expert consultation and the recovery rate were 97.05% (33/34) and 94.12% (32/34) respectibely, the effective rate was 100%;The authoritative coefficient of expert of the safety quality evaluation index of the specialized nursing care is 0.867 and 0.879 respectively. In the first round, the average of the importance rating is 3.50-5.00, the standard deviation is 0-0.042 and full mark rate is 34.10%-100%. In the second round, the average of the importance rating is 3.80-4.70, the standard deviation is 0~0.047 and full mark rate is 31.60%-100%. The fluctuation degree of the first round is more than 0.10 with a low coordination degree. However, the fluctuation degree of the second round result is less than 0.10. The coordination coefficients from all qustionnair scores by experts in the two roudns are 0.169 and 0.286. The difference was statistically significant according to the chi-square analysis (X2=6.842, P=0.002). The NSQ evaluatin index included 3 first degree indexes (weight coefficient including 0.2684,link qualing 0.6144,and quality 0.1172),16 second degree indicators (weight coefficient 0.034~0.0859) and 61 third degree indexes ( weight coefficient 0.034~0.0859) and 61 third degree indexes (weight coefficient 0.0052~0.0412). Conclusions This paper preliminary established a specialied NSQ evaluation index with factor quality- quality of links-final quality 3-dimensional quality structure in the field of cardiovascular medicine, which is based on Delphi method and analytic hierarchy process. NSQ provides a measurement tool for nurses in CME.

Objective To study the effects of prenatal exposure to low level lead on the physical and neuro-behavioral development of mice and the interaction between lead and zinc. Methods Kunming pregnant mice were provided with drinking water containing lead, zinc and lead-zinc jointly and respectively. The body weight of maternal mice, offspring's survival rate and body weight were observed. Neuro-behavioral development of offspring was assessed by observation of offspring's behavior performance. The levels of dopamine (DA), 5-hydroxytryptamine (5-HT) and malonaldehyde (MDA) in offspring's brains were measured. Results At the doses of lead and zinc which did not effect the increase of maternal body weight during pregnancy, the lead exposure group showed low survival rate, growth retardation and delay of physiological development and neonatal reflexes in the offspring, the levels of DA and MDA in offspring's brains increased compared with the control group. Offspring's low survival rate and growth retardation couldn't be antagonized by zinc, but equal mole as lead of zinc could inhibit the harmful effects on neuro-reflex development. Zinc could also inhibit the increase of DA and MDA levels in offspring's brains induced by lead . However joint exposure to lead and half dosage as much as lead of zinc could deteriorate the effects on delay of physical, neuro-behavioral development and accelerate the DA and 5-HT decompose compared with that in the lead exposure group. Conclusion The harmful effects on offspring's growth and neuro-behavioral development could be induced by prenatal exposure to low level of lead. The types of joint-effect of lead and zinc were different according to the concentration of zinc, which indicated that the zinc-lead interaction was very complicated and it should be very prudent to antagonize lead toxicity using zinc.

Objective The frequency of G6PD deficiency in the Tujia nationality in Jiangkou,Guizhou was investigated.Methods In Oct.2002,227 male subjects were selected randomly from the local people,and NBT qualitative and G6PD/6PGD quantitative methods were used to detect G6PD deficiency in them.Results Among the 227 subjects,17 cases of G6PD deficiency were found.The gene frequency of G6PD deficiency was 0.0749.Conclusion There is a high incidence of G6PD deficiency in Tujia nationality in Jiangkou,Guizhou.The investigation will illustrate the distribution of G6PD deficiency in Guizhou,and provide some useful data for the preventing G6PD deficiency,directing clinical management,improving minority population diathesis and studying the origin of Tujia nationality.