Medical art are essential in consumer health education,facilitating consumers to un-derstand medical concepts,invisible body parts and complex pathology. This paper reviewed the origin and development medical arts,analyzed the characteristics of medical arts specific for consumers rather than professionals,and discussed the opportunities and challenges of medical arts in internet era.

Objective To investigate the average serum level and risk factors of serum cystatin C in Chinese healthy adults.Methods A total of 15 918 healthy adults who received health assessments in Peking Union Medical College Hospital during January 2012 and March 2013 were enrolled in this crosssection study.Serum cystatin C was measured.Estimated glomerular filtration rate was calculated by creatinine (eGFRcr).Multivariable linear regression analysis was used to assess factors that contribute to cystatin C variability.Results The mean serum cystatin C level was (0.79 ±0.14) mg/L (95％ reference interval (RI) was 0.56-1.08 mg/L).Male showed significantly higher cystatin C level than female (mean (0.84 ±0.13) vs (0.73 ±0.13) mg/L; RI 0.64-1.11 mg/L and 0.54-1.03 mg/L,respectively; P=0.000).Differences between genders are still significant after subgrouped by age.In the young-age group (age≤44 years old),the mean serum cystatin C level was (0.81 ±0.11)mg/L in male and (0.68 ±0.09)mg/L in female,P =0.000.In the middle-age group (45-59 years old),the mean cystatin C level was (0.85 ±0.12) mg/L in male and (0.75 ±0.12) mg/L in female,P =0.000.In the elderly group (≥60 yrs),the mean serum cystatin C level was (0.97 ±0.18) mg/L in male and (0.89 ±0.19) mg/L in female,P =0.000.Serum cystain C was increased with ages (in male:r =0.274,P =0.000 ; in femal,r =0.470,P =0.000).Differences between each two age groups are all significant for both gender,P =0.000.Cystatin C level in male is respectively (0.81 ±0.ll)mg/L,(0.85 ±0.12) mg/L and (0.97 ± 0.18) mg/L in the young-age,middle-age and elderly group.Cystatin C level in female is respectively (0.68 ±0.09) mg/L,(0.75 ±0.12) mg/L and (0.89 ±0.19) mg/L in the young-age,middle-age and elderly group.Male gender,older age,lower body weight,lower eGFRcr,lower high-density lipoprotein cholesterol,lower fasting blood glucose,increased mean blood pressure,higher body mass index and triglyceride were significantly associated with increased serum cystatin C level.Body weight,total cholesterol and low-density lipoprotein cholesterol were not risk factors of cystatin C.Conclusion Serum cystatin C level may be influenced by gender,age and other factors in Chinese healthy adults.

[Summary] In recent years , ultrasound guidance has been widely used in local anesthesia , particularly in peripheral nerve blockage .Ultrasound guided neuraxial blockage is also making progress .Previous studies have shown that pre-puncture ultrasound scanning could provide useful information on the correct intervertebral interspace , the midline of the spine , the optimal puncture point , the appropriate angle for needle insertion , and the distance from skin to the spinal canal .In this review, the ultrasonographic techniques and image analysis , as well as its clinical use , including pre-puncture scanning and real-time guidance for spinal and epidural anesthesia , were summarized .

Since it is one of the hotspots to discover the new knowledge in life science in data-intensive scientific discovery by integrating the biomedical literature and scientific data that can provide an open environment for their interactive operation , the mining of foreign and domestic biomedical literature and integration of scientific data were analyzed , the corresponding systems for different integration methods were investigated , the development trend in biomedical literature and scientific data integration was predicted .

With the wide application of liver transplantation techniques,rapid development of digital imaging medicine and continuous update of surgical implements,the theory of precision hepatectomy still keeps optimizing.Precision hepatectomy is not a surgical implement or surgical technique,but a concept of liver surgery emphasizing less bleeding,minimal invasion,fast recovery and long-term curative effect,which is updating and improving with the development of modern science.Much less intraoperative bleeding,shorter operation time,better postoperative recovery and long-term survival should be the chief pursuit and principle of precision hepatectomy.

Objective To evaluate the relationship between thyroid autoantibodies (ATA)and pregnancy outcome of infertility women after assisted reproductive technology (ART). Methods Relevant studies were identified by searching PubMed, Cochrane library, CNKI and CBM. Results 7 studies were appropriate for meta-analyses and total 4165 patiens were included. Meta analysis shows that the pregnancy rate difference between ATA positive patients and controls have no significance, but the miscarriage rate is greater significant between them. In the meta-analyses, the presence of thyroid antibodies was associated with an increased risk of miscarriage (OR 1.85, 95%CI 1.32~2.59), compared with the absence of thyroid antibodies. Conclusion Pregnant women with thyroid antibodies have an increased risk of complications, especially miscarriage. Future research,should focus on the treatment and thyroid disease on pregnancy outcome.

Recently, the morbidity of differentiated thyroid carcinoma (DTC) has increased annually. American Thyroid Association (ATA) published the management guidelines for patients with thyroid nodules and DTC in 2006 in order to standardize their management. The ATA guidelines was updated for the ifrst time in 2009 and its renewed version was completed in 2015 based on the considerable progress that had been made in the ifelds such as diagnostic assessment and management of thyroid nodules, surgery and radioactive iodine therapy for DTC in recent years. This article tried to interpret the updated contents about radioactive iodine therapy for DTC in 2015 version of the guidelines.

BACKGROUND:Docetaxel, a cel cycle specific anti-tumor drug, is a drug that is used primarily for treating breast cancer; however, its efficacy is low when used for treatment of cancer not sensitive to radiotherapy. Bone marrow mesenchymal stemcels have been shown to strengthen the effects of tumor-specific targeting chemotherapy drugs. OBJECTIVE:To investigate the effects of docetaxel combined with bone marrow mesenchymal stem cels (BMSCs) on human hepatoma cel line SMMC-7721. METHODS:BMSC cels were culturedin vitro. The logarithmic growth of SMMC-7721 hepatoma cels were randomly divided into blank control group, BMSCs group and combined treatment group (combined treatment of BMSCs and docetaxel). SMMC-7721 cel cycle was detected usingflow cytometry. Cel growth rate of SMMC-7721 was determined by MTT assay. mRNA and protein expressions of tumor suppressor genes PTEN and p53 were detected by reverse transcription polymerase chain reaction and western blot assay. RESULTS AND CONCLUSION:Combined treatment of docetaxel and BMSCs inhibited SMMC-7721 cell proliferation. Compared with the blank control group, the number of cells at the G0/G1 phase was significantly increased in BMSCs group and combined treatment group. The cell growth rate of SMMC-7721 was significantly inhibited in BMSCs group compared with the blank control group, and that was further inhibited in combined treatment group (P< 0.05). mRNA and protein expressionof PTENandp53 were significantly increased in combined treatment group compared with BMSCs group and blank control group (P< 0.05). Our results suggest that BMSCs inhibit the growth of SMMC-7721 cells,andcombined use of docetaxel and BMSCs strengthensthe antitumor effect of BMSCs.

SUMMARY A patient with previous L3 -4 posterior lumbar interbody fusion,pedicle screws instrumen-tation and L3 -4 decompression,was scheduled for left total hip arthroplasty.Two years ago,due to poor landmarks palpation,the patient experienced a failed lumbar puncture after multiple attempts before her-niorrhaphy.His plain radiography showed bilateral partial laminectomy at L3 -4 level,and between L3 and L4,two posterior pedicle screws connected by metal rods on both sides.This time,we used ultra-sound to locate L4 -5 interlaminar space in paramedian sagittal oblique view and identified the spine midline by transverse interlaminar view before puncture.According to this information,L4 -5 puncture point was verified and the combined spinal-epidural anesthesia was performed in a paramedian approach. After withdrawing clear cerebral spinal fluid,15 mg hyperbaric bupivicaine was injected into intrathecal space.An epidural catheter was then inserted into the epidural space.The sensory block level was fixed at T10 to S within 10 minutes.Intraoperatively,the patient received 10 mL 2% (mass fraction)lido-caine through the epidural catheter in total.The surgery was uneventful.No neurologic complication was observed after the surgery.This case report demonstrates that ultRASound imaging can provide useful in-formation for neuraxial needle placement and can be a valuable tool in managing patients with anatomical change around the spine.

As an important postsurgical adjuvant treatment for DTC, radioactive iodine (RAI) is administered to eliminate residual thyroid tissue as well as the potentially persistent or distant metastatic lesions.It plays a significant role in reducing disease recurrence and tumor-related mortality.The major challenge at present in RAI treatment decision-making is how to achieve optimum clinical outcome with minimal radiation exposure.ATA guidelines recommends a postsurgical recurrence-risk adapted approach to RAI treatment management based on the clinicopathological features.However, RAI therapy is not beneficial to all DTC patients.The potential benefits from RAI therapy in DTC patients with different risk stratification have attracted much attention, and are reviewed in this article in order to provide more evidence-based basis for clinical decision-making.