The germination of medical ethics could date back to as early as the 15th century BC or even earlier.This subject successively takes on three theoretical forms possessing diverse peculiarities.The first stage could be called Classical Theory of Medical Morality,or Pre-Medical Ethics,with evident character of virtue ethics and deontology.The second stage is the traditional medical ethics.As a relatively mature theoretical system,it takes on the characteristics of meticulous,standardization,specialization,humanity and legislation.The third stage might be called the international medical ethics,whose prominent trait is the birth,progress and grandness of Modern Bioethics.

Objective To investigate a simple effective way to salvage failure of lateral retinacular release. Methods From March 2007 to May 2009,there were 23 knees of 23 cases for failure after lateral retinacular. All the patients had patellofemoral joint malatignment in some extend,whose patellofemoral joint CT scanned in dynamic. Before curing,the index of patellar tilting angle (PTA) was 19.6° ±5.7° , congruence angle(CA) was 23.6° ± 12.5° , patellar femoral index(PFI)was 2.7 ± 0.8, and hospital special score (HSS) knee score was (74.0 ± 9.2) points,then put on elastic knee sleeves for arranging the malalignment of patellofemoral joints, coincidentally, rehabilitation of vastus medians administered. Results All the patients were followed up for 6 - 26 (11.0 ± 2.3 ) months, 22 cases of 24 knees gained the excellent or good results,1 case had to experience surgery again. After curing, PTA was 11.2° ±3.7°,CA was 6.4° ±7.8°, and PFI was 1.1 ±0.3,escalated HSS knee score was (87.0 ±6.5) points, in these excellent or good patellofemoral joints. Significant difference showed apparently in the cohort through curing (P <0.05). Conclusion Administering elastic knee sleeves along with correct rehabilitation is a simple effective no-incisive cure for salvaging failure of lateral retinacular release.

Objective To investigate the X-ray and clinic manifestations of hereditary multiple osteochondroma(HMO).Methods Five patients with HMO clinically and pathologically confirmed and 63 persons in their pedigree were studied.Results Of 63 cases inquired in this study,there were 21 patients with hereditary multiple exostosis,including 16 men and 5 women.In 5 cases confirmed pathologically,4 patients had hereditary history of pedigree and the members of three generation in 1 patient with HMO had no the history of pedigree.Conclusion HMO has the remarkable sex difference and the typical inherited trend including the location of exostosis.HMO has inherited character of skipping generation.

Background Retinal vascular caliber changes can reflect the development status of cardiovascular disease and diabetes-associated vascular diseases,so it is very important to quantitatively measure retinal vascular caliber in the study of systemic diseases and retinal vascular disease.However,the methodology study is rately seen in China within our knowledge.Objective The present study was to investigate the repeatability and reproducibility of IVAN software in measuring retinal vascular caliber.Methods This study was approved by Ethic Committee of Affiliated Hospital of Inner Mongolia Medical University,and written informed consent was obtained from each subject prior to medical examination.A prospectively diagnostic trail was performed.The digitized fundus color photograph centered on the disc from 192 eyes of 96 healthy volunteers were collected in Affiliated Hospital of Inner Mongolia Medical University from January,2013 to December,2014,and central retinal arteriolar equivalent (CRAE),central retinal venular equivalent (CRVE) and arteriovenous ratio (AVR) were analyzed by IVAN measurement software.The repeatability and reproducibility of IVAN software for random repeat measurement of retinal vessel caliber from consecutive 85 right eyes of 85 volunteers were evaluation by interobserver and intraobserver measurement with interclass correlation coefficient (ICC).The correlations of measuring results between two observers or two-time measuring were analyzed with Pearson linear correlation analysis.Bland-Altman agreeement analysis was employed to assess the agreeement of the outcomes.Results No significant differences were found in CRAE,CRVE and AVR between the right eyes and the left eyes (t=-1.009,1.090,-1.259,all at P＞0.05).The CRAE,CRVE and AVR values from observer 1 were (145.02±12.94) μm,(400.72±9.12) μm and 0.36±0.03,and those from observer 2 were (145.10 ± 11.86) μm,(401.17 ± 9.85) μm and 0.36 ± 0..03,with no significant differences between observer 1 and observer 2 (t =-0.074,-0.913,0.116,all at P＞0.05).The repeat CRAE,CRVE and AVR values from observer 1 were (145.02 ± 12.94) μm,(400.72 ±9.12) μm and 0.36 ±0.03,which were significantly different from the initial values (t =-0.777,-0.048,-0.745,all at P＞0.05).In two-time measurements of intraobserver,all ICC were ≥0.738 and showed good correlations (all at r≥0.739).The two measurements of interobserver,showed good correlations (r≥ 0.662),with all ICC ≥ 0.657.Bland-Altman plots showed good agreements in CRAE and CRVE measurement with 95％ limits of agreement(LoA) ranged from-18.5 μm to 17.3 μm and-9.8 μm to 9.6 μm in intraobserver,and from-19.3 μm to 20.0 μm and-10.2 μm to 9.0 μm in interobserver,respectively.Conclusions IVAN measurement software yields good repeatability and reproducibility in the quantitative measurement of retinal vascular caliber.

Silk fibroin (SF) and hydroxyapatite (HA) composite powders were synthesized from CaO, H3PO4 and SF solution on the principle of neutralization. SF/HA porous materials were prepared through adding silk short fibers and NaCI particles as reinforcing material and pore-forming agent respectively by isostatic compaction. The structure and mechanical properties of the SF/HA porous materials were investigated. Results indicated that short silk fibers in it could markedly enhance flexural strength and flexural breaking energy. The average pore diameter and porosity could be regulated from 64 μm to183 pm and from 55% to 75% respectively by adding pore-forming agent.

It is an essential educational goal to strength experimental teaching and improving the practical skill of medical postgraduate students in medical colleges and universities.We made anexploration and practice on how to improve the practical skill and innovative ability of postgraduate students in medical immunology experimental teaching.The article points out that optimizing the design of experimental course,innovating the teaching methods,standard appraised of experiment and improving the quality of teacher are the efficient ways to enhance the practical skill of postgraduate students.

Objective To discuss the value of joint detection in patients with progressive cerebral infarction (PCI) on high sensi‐tivity c‐reactive protein(hs‐CRP) ,and homocysteine(Hcy) ,D‐Dimer ,Fibrinogen(Fib) ,ferritin(SF) .Methods According to the de‐velopment and evolution of the 156 patients with acute cerebral infarction were divided into progressive cerebral infarction group and non‐progressive cerebral infarction group ,to determine the level of serum hs‐CRP ,Hcy ,one or two D‐Dimer ,Fib ,SF .Results hs‐CRP ,Hcy ,D‐D ,Fib ,SF in the PCI group were higher than those in the control group ,the difference was statistically significant (P<0 .05) .Conclusion Between the development of the PCI with hs‐CRP ,Hcy ,D‐D ,Fib and SF ,there is a close relationship ,to detect the level has a certain significance to the prediction of progressive ischemic stroke .

Objective:To evaluate the efficacy and safety of acupuncture-moxibustion in the treatment of cerebral palsy-related speech impairment.Methods:A systematic literature search of 7 electronic databases was conducted between January 7,2000 and January 12,2021 to find randomized controlled trials(RCTs)examining the benefits of acupuncture-moxibustion combined with rehabilitation training to cerebral palsy-induced speech impairment.The included trials'quality was assessed using the Cochrane Reviewers'Handbook as a guide,and statistical analysis was carried out using the RevMan 5.3 software.Results:A total of 17 RCTs with 1238 subjects were finally recruited and analyzed.When acupuncture-moxibustion was combined with rehabilitation training,the results showed a considerable improvement in speech impairment compared with the rehabilitation training alone.The most commonly used points for the treatment of speech disorders are Baihui(GV20),Speech Area,Zhisanzhen[Shenting(GV24)and bilateral Benshen(GB13)],Niesanzhen[2 Cun above the ear tip as the first point,with 1.0 Cun anterior and posterior to the current point as the second and third points],and Sishenzhen[1.5 Cun anterior,posterior,and bilateral to Baihui(GV20)].Conclusion:Acupuncture-moxibustion has a stronger effect on children's development of receptive and expressive language,as well as the developmental quotient.Acupuncture-moxibustion in combination with rehabilitation training is not only more successful than the control treatment,but also safer and more dependable.Baihui(GV20),Speech Area,Zhisanzhen,Niesanzhen,and Sishenzhen are the most widely used points for speech impediment.

Objective To compare the clinical results of percutaneous compression plating (PCCP)and Trigen short reconstruction intramedullary nail for intertrochanteric hip fractures. Methods During 2005 and 2008, the patients suffered with AO/OTA Al and A2 intertrochanteric hip fractures were divided into two groups; 36 fractures were treated with PCCP and 48 fractures with Trigen short reconstruction nail.During an average of (16.3±3.2) months follow-up, clinical evaluation involved visual analogue scale(VAS)score for pain in the 1st week, the 1st month, the 3rd month, the 6th month and the 12th month, and a Harris hip score one year post operation. Radiographs were examined for fracture healing-time, displacement scale of the neck screws and fracture impaction scale. All the complication in both groups was recorded. Results There were no difference in blood loss and operation time in both groups. The postoperative pain was significantly lower in the PCCP group in the initial three months after the surgery. Larger scale of fracture impaction and screw telescoping were seen in PCCP group. Also shorter healing time, higher Harris score results were achieved in PCCP group than those of Trigen short reconstruction nail group. Four peri-implant fractures occurred in Trigen short reconstruction nail group, which included one in the greater trochanter and three in the femoral shaft, but only one case need revision for bone displacement. In PCCP group, it was found that the superior neck screw was slightly displaced for tendency to cut-out in one patient. Conclusion Both PCCP and Trigen short reconstruction intramedullary nail can be successfully used to treat Al and A2 intertrochanteric hip fractures with minimal invasive technique. And the PCCP showed more rapid pain relief and bone healing, easily bony reduction and fewer complications.

Objective To explore the surgical treatment strategy for tibial pilon fractures.Methods Forty-seven patients with tibial pilon fractures surgically treated in our hospital from May 2005 to March 2008 were retrospectively studied. There were 37 males and ten females, at mean age of 42 years (range 23-46 years). There were 51 sides of tibial pilon fractures, for four patients were with bilateral tibial pilon fractures. Injury causes included traffic accidents in 34 patients, fall from height in 12 and bruise by heavy objects in five. Open fractures were determined in seven patients and close fractures in 44 patients. According to Ruedi-Allgower classification, there were six sides of type Ⅰ fractures, 28 type Ⅱ fractures and 17 type Ⅲ fractures. According to Tscherna-Grotzen tissue injuries classification,open fractures were determined as 1° in two patients, 2° in three and 3° in two; close injuries were defined as 0° in two patients, 1° in 27 and 2° in 15. Distal tibia was partitioned as anterolateral column,anteromedial column and posterior column in order to select reasonable internal fixation. Eighteen fractures were treated with DePuy T plate, 10 with AO cloverleaf pattern plate, two with AO small T plate,two with locking plate, four with Link anterolateral anatomic plates and 15 with Orthofix overtake-anklejoint outside-fixed frame combined with limited internal fixation. Results The patients were followed up for a mean time of 23 months (range 12-44 months). According to Mazur ankle evaluation grading system, 29 patients were graded as excellent, 13 good, seven fair and two poor, with an excellence rate of 82.4%. Conclusions Correct operation time and treatment plans on the basis of Ruedi-Allgower classification and Tscherne-Gotzen classifications of soft tissues and reasonable internal fixation according to the condition of the involved three column in distal tibia can decrease postoperative complications and achieve good and satisfactory clinical effect.