With the increasing incidence of pelvic fractures, the concept of damage control was applied to the treatment of severe pelvic fractures, and the principle of phased treatment and indications were put for-ward. Meanwhile, the development of damage control surgery, which improves the survival rate and reduces the disability rate of patients, brings the treatments of pelvic fractures to a new stage.

This research mainly analysed the section of clinical experience in the reporl of"A panoramic snapshot of medical students'education at the beginning of the 21st century"and gave a brief introduction to the mainstream medical education in No,hem Amercia according to the literature.At last,the enlightment from the report and reformation of our clinical practice were put forward.

[Objective] Posteroanterior weight-bearing radiographs,made with the knee in 45 degrees of flexion while the patient was standing on the homolateral foot,were compared with the weight-bearing anteroposterior radiographs with both knees in full extention,in order to find a more sensitive method to detect knee osteoarthritis.[Methods]Seventeen osteoarthritis knees were radiographed in the weight-bearing anteroposterior view with both knees in full extention and in the weight-bearing posteroanterior view with the knee in 45 degrees of flexion while standing on the homolateral foot.The minimum joint space width of all the radiograph were measured.The data were analysed statistically with SPSS 11.5.[Results]The mean minimum joint space width of the medial compart in extended knee view and standing on the homolateral foot were 4.65 mm?1.44 mm and 2.52 mm?1.69 mm,respectively(P

Objective To investigate the subthreshold depression for long-term survivors after breast cancer surgery and its effect on their quality of life (QOL). Methods The self-made general questionnaire, Centre for Epidemiological Studies Depression Scale (CES- D), Hamihon Rating Scale for Depression and Functional Assessment of Cancer Therapy- Breast were used to investigate the subthreshold depression and its effect on their QOL for 210 long-term survivors after breast cancer surgery. The difference in general conditions and score of QOL between the subthreshold depression and non-subthreshold depression groups was also compared. Results The subthreshold depression with incidence rate of 46.67%(98/210) was observed for the log-term survivors after breast cancer surgery in this study. The results indicated that the age (≤50) (OR=5.627, 2.662,P<0.01), marriage (unmarried, divorced or widowed) (OR=5.087, P<0.01), employment (unemployed, sick leave or retired) (OR=2.077,P<0.05) and low income (<3000 RMB/month) (OR=3.375,P<0.01) were the key factors that led to the occurrence of subthreshold depression. The score of QOL for the subthreshold depression group were lower than those of the non-subthreshold depression group (t=-6.653--2.926,P<0.01), and had a significantly negative correlation with score of depression and QOL (β=-0.362--0.132). Conclusions A high incidence rate of subthreshold depression for long-term survivors after breast cancer surgery was observed. The incidence rate of subthreshold depression increased for the patients with younger age, low income,unmarried or unemployment. Due to their low QOL, attentions should be paid to the early detection and early prevention for the long-term survivors with subthreshold depression after breast cancer surgery.

Objective To evaluate the correlation of interval from injury to surgery with outcome for central cervical spinal cord injury syndrome.Methods A retrospective analysis was done for 31 patients with central cervical spinal cord injury syndrome treated surgically between March 2007 and March 2011.According to the timing of surgical intervention,the patients were divided into early operative group (＜7 days from injury,n =14) and late operative group (≥7 days from injury,n =17).Japanese Orthopedic Association (JOA) score on admission,at postoperative half-year and at final follow-up were recorded and compared between the two groups.JOA recovery rate was determined and analyzed for correlation with operation time point.Results Mean follow-up was (16.1 ± 4.5) months (range,12-25 months).All patients had different degree of neurological recovery.JOA recovery rate in early operative group was apparently better than that in late operative group at final follow-up (P ＜ 0.01).JOA recovery rate at follow-up was negatively correlated with intervals between injury and surgery (r =-0.763,P ＜ 0.01).Conclusion For patients with central cervical spinal cord injury syndrome,time from injury to surgery is negatively correlated with outcome,indicating that early surgery may be associated with better outcomes.

Objective To discuss the clinical significance of percutaneous cervical diskectomy (PCD) in the management of radicular type cervical spondylosis. Methods A retrospective analysis was carried out on clinical records of 106 radicular type cervical spondylosis cases treated by PCD from July 1993 to June 2002. Results Follow-up observations for 6 months～8 years(mean 3.6 years) in 91 cases showed the outcomes were excellent in 36 cases, good in 40, and unchanged in 15, the rate of excellent-or-good results being 83.5%. Conclusions PCD has an excellent therapeutic effect for nerve-root symptoms resulted from cervical disc herniation, such as numbness and pain of the upper extremities or shoulders.

Objective To observe the management effect of pressure pain point and painful tubercle in occiput-neck part on tension-type headache (TTH). Methods 380 TTH patients were treated by palpating the central and both sides part from the external occipital protuberance to the spinous processes of neck; recording the total number and position of pressure pain points and painful tubercles; kneading, hitting and pressing all recorded pressure pain points and painful tubercles.Results After 1-6 times treatment, 283 were cured and 58 were effected. The efficiency ratio is 89.7%. Conclusion Muscle obstacle in occiput-neck part plays an important role in TTH. Massage therapy has a significant effect on pressure pain points and painful tubercle.

To investigate the efficacy and adverse effects of venlafaxine in the treatment of depression, patients were given venlafaxine or amitriptyline for 6 weeks. The efficacy of the drugs were assessed by using HAMD and HAMA at the 4th, 7th, 14th and 42nd day before and after the medication. The adverse effects were evaluated by TESS. Our results showed that the effect time of venlafaxine was (8.52±4.47) d, which was fasler the that of amitriptyline. The effective rate of venlafaxine was 83%, which was faster the that of amitriptyline. but venlafaxine caused less dry mouth, constipation, blurred vusion, tachycardia and anorexia etc. It is concluded that venlafaxine worked faster with less side effect in the treatment of depression as compared with amitriptyline.

Objective To obtain a single toxin component from the jellyfish Cyanea capillata and provide a foundation for the further study on bioactivity and function of the serine proteases from C.capillata.Methods Primers designed with restriction enzyme were used to amplify the coding region of cDNAs (CcSP1, CcSP2 and CcSP3).PCR fragments were ligated with the pET-24a( +) vector to construct the recombinant plasmids (pET24a-CcSP1, pET24a-CcSP2 and pET24a-CcSP3).After screening and identification,the recombinant plasmids were transformed into the Rosetta (DE3).plysS for protein expression.After induction with IPTG, SDS-PAGE and Western-blot were used to detect the expression of the recombinant proteins.Results SDS-PAGE showed that the proteins of rCcSP1, rCcSP2 and rCcSP3 were expressed in a single band at about 34 kDa, 42 kDa and 42kDa, respectively.Western-blot detection with anti-His antibody further confirmed that these recombinant proteins were His-tagged CcSP1, CcSP2 and CcSP3 fusion protein were obtained.Conclusion Prokaryotic recombinant plasmids of C.capillata serine proteases are contructed and recombinant proteins are obtained, which establishes the foundation for future study on the function of serine proteases from jellyfish.

Objective To investigate the expression of CD133 protein in primary lesions of hepatocellular carcinoma (HCC) and its clinical significance.Methods The expression of CD133 protein in 190 patients with HCC was detected by immunohistochemical staining ABC method.The correlation of CD133 protein expression with the clinicopathologic parameters and features after operation was analyzed.Results The expression positive rate of CD133 protein in cancer tissues was 22.1％ (42/190).There was significant correlation between the expression of CD133 protein and tumor differentiation (P ＜ 0.001),micro vessel invasion (P =0.016) and hepatitis B virus infection (P =0.024).Univariate analysis of factors demonstrated that differentiation level,lymph node,macro vessel invasion,micro vessel invasion,TNM stage and CD133 expression were correlated with disease-free survival after surgery (all P ＜ 0.05).Multivariate analysis of factors demonstrated that both CD133 expression and micro vessel invasion were independent prognostic factors of disease-free survival after surgery.Prognostic analysis demonstrated that the disease-free survival of CD133 positive group was significantly lower than that of CD133 negative group.Conclusion The CD133 protein expression in HCC tissues is related with development,metastasis and prognosis of HCC.