It is a request of social development for medical service to provide patients with high-quality and humanistic medical care.The medical science reform should be strengthened in order to disassociate medical care and medicine marketing.Medical service reform is to be furthered and medical curriculum be properly set up.The medical specialities,public subjects and humanistic care curricula should be compatible with each other,in order to coordinate with the development of modern medical skills and the cultivation of humanistic spirit,and cultivate medical talents with both exquisite medical skills and noble medical professionalism.

Between 40 to 60, especially after menopause, breast cancer have a higher incidence in women population. CA-153 ( carbohydrate antigen-153 ) is a tumor marker commonly used for monitoring breast cancer in clinic. However, CA-153 appears to have no clinical value for early diagnosis of breast cancer. Gene expression profiling technology becomes hot-spot through which some breast cancer related genes have been found. Moreover, the methods used for diagnosis of breast cancer also has certain shortcomings, and it is still uncertain that breast cancer is likely to be found at the early stage or be predicted in advance.

CD44 is a transmembrane receptor protein, belonging to the family of adhesion molecules, which is involved in cell-cell and cell-matrix interactions by binding with ligands such as hyaluronan. Recently a lot of researches reported that CD44 and its variant isoforms, especially CD44v6, are usually aberrantly expressed in many kinds of tumor cells, which is correlated with the invasion and metastasis of tumors and the prognosis of the patients.

Objective To study the clinical effect of the minimally invasive surgery for treating recurrent lumbar disc protrusion . Methods Thirty operative cases of recurrent lumbar disc protrusion treated with the minimally invasive surgery from July 2009 to July 2013 were retrospectively analyzed for statistically describing the age ,body mass index ,recurrent segment ,operating time ,intr-aoperative bleeding volume and postoperative painless walking time .The recurrence segments were 1 case of L34 ,10 cases of L45 and 19 cases of L5 S1 ;the visual analogue scale (VAS) was adopted to evaluate the operative effect .Results The operating time was 65 min on average (50-100)min;mean intraoperative bleeding volume was 145 mL(100-180)mL ;average length of hospital stay was 13 d (9-16)d;average hospitalization costs were 7 300 Yuan;average postoperative painless walking time was 11 d (7-15)d;post-operative non-manual labor work time was 27 .3 d .The VAS score was reduced from (7 .3 ± 1 .3) before operation to (3 .1 ± 0 .9) after operation and (2 .2 ± 0 .6) at the last follow-up ,which was statistically significant(P<0 .05) .Followed up for 6-33 months , average 16 .5 months .Superior efficacy in 16 cases ,gord in 7 cases ,average in 5 cases ,bad in 2 cases ,the rate of good efficacy was 76% .Conclusion The minimally invasive surgery is one of effective methods to treat postoperative recurrence of lumbar disc pro-trusion .

The need of eight-year clinical students for bioinformatics undergraduate courses is described.In addition,the measures and experiences on textbooks choosing,teaching content assignment,teaching methods designing and test means innovation are also discussed.All these provide a reference implementation for the development of eight-year clinical bioinformatics courses.

Objective To explore the associations between interferon induced helicase C domain 1 (IFIH1) gene single nucleotide polymorphism (SNP) rs1990760 C >T and polymyositis/dermatomyositis (PM/DM) in Chinese Han patients from Jiangsu area. Methods A total of 183 PM/DM patients and 400 healthy controls were included. SNP typing was performed by Taqman MGB probe method. The distributions of genotypes and alleles and Hardy-Weinberg equilibrium (HWE) were examined by χ2 tests or Fisherˊs exact tests. Results The distribution of IFIH1 rs1990760 genotypes of all patients group and the control group were consistent with HWE. The frequencies of T and C alleles were not significantly different between the PM/DM group (20.8% and 79.2%, respectively), the DM group (20.9% and 79.1%, respectively), the PM group (20.5%and 79.5%, respectively) and control group (18.0%and 82.0%, respectively). In recessive model (TT vs CT+CC) and additive model (TT vs CC), the frequencies of TT genotype in PM/DM group (6.6% vs 2.8%; χ2=4.8 and 4.54, respectively; both P=0.03) and in DM with interstitial lung disease (ILD) group (8.3% vs 2.8%;χ2=4.84 and 4.41, respectively; P=0.03 and 0.04, respectively) were significantly higher than those in the control group.In recessive model (TT vs CT+CC), the frequency of TT genotype in PM without ILD group was significantly higher than that in the control group (9.8% vs 2.8%, χ2=5.56, P=0.04). The genotype and allele distributions of rs1990760 were not significantly different between the anti-MDA5 positive group and control group. Conclusion The rs1990760 TT genotype of IFIH1 gene may be associated with the susceptibility of PM/DM in Jiangsu Han Chinese population, and the associations may differ based on the ILD status.

Objective To elucidate the relationship between polymorphisms of NRAMP1 gene and susceptibility to tuberculosis in Chinese Han nation by case control study. Methods We selected 127 patients with active pulmonary tuberculosis who were all Han people with mean age of 52.5 years and 58 ethnically matched healthy controls. We typed the polymorphisms of NRAMP1, INT4 and D543N, through polymerase chain reaction restriction fragment length polymorphism (PCR RFLP) techniques. Results Two NRAMP1 polymorphisms were both significantly associated with smear positive pulmonary tuberculosis. Subjects who were heterozygous for polymorphisms in INT4 and D543N were related with tuberculosis. It was the cooperation of different polymorphisms of NRAMP1 that led to the susceptibility to tuberculosis. Conclusions The polymorphisms in NRAMP1 gene affect susceptibility to tuberculosis in Han people in China.

Experiments were carried out to investigate the effect of garlic, both fresh and old, on hypercholesterolemia. Forty healthy rabbits were equally divided into four groups, namely control, cholesterol, fresh garlic and old garlic. Except the control group, each rabbit in the other three groups was given 0.5g of cholesterol every day. The rabbits of fresh and old garlic groups were fed in addition respectively with fresh garlic, and garlic that had been stored for seven months, the doses being 2g for each. The results showed that fresh garlic had a significant effect of reducing diet-induced hypercholesterolemia and diminishing arteriosclerotic changes in aorta, but old garlic failed to show such effects.During the 50-day period when rabbits were fed with fresh or old garlic no toxic reaction was observed.

Objective To explore the clinical and serological features of patients with pneumomdiastinum (PNM) and dermatomyositis associated interstitial lung disease (DM-ILD).Methods A total of 145 polymyositis/dermatomyositis (PM/DM) patients hospitalized in our department from March,2010 to December,2012 were recruited.The sera,clinical and laboratory data were collected.Anti-aminoacyl-tRNA synthetase (anti-ARS) and anti-melanoma differentiation-associated gene 5 (MDA5) antibodies were detected by RNA-immunoprecipitation (RNA-IP) and ELISA,respectively.Anti-NXP2,anti-TIF1γ,anti-SRP,anti-SAE and antiMi2 antibodies were detected by immunoprecipitation-Western blotting.Variables were compared between DM patients with and without PNM,as well as between DM-ILD patients with and without PNM.Chi square test,Fisher's exact test,t test,Mann-Whitney U test and a multivariate logistic regression model were used for statistical analysis.Results A total of 11 DM patients (10 patients positive for anti-MDA5 and 1 patient positive for anti-Mi2) developed spontaneous PNM.No PM patient developed PNM.No differences of sex,age at the onset of DM,serum ferritin levels and C reactive protein (CRP) levels was observed between DM patients with and without PNM.Compared with DM patients without PNM,DM patients with PNM had significantly higher frequencies of rapidly progressive ILD (RP-ILD) (63.6％ vs 24.4％,x2=7.25,P=0.01),anti-MDA5 antibodies (90.9％ vs 52.4％,x2=5.86,P=0.02),clinically amyopathic DM (CADM) (63.6％ vs 22.0％,x2=8.57,P=0.007) and cutaneous ulcers (36.4％ vs 11％,x2=5.20,P=0.04),but significantly lower creatine kinase (CK) levels [58.5 (30.5,394.3) U/L vs 284 (73.0,917.0) U/L,t=207.5,P=0.04].The logistic multivariate analysis indicated that cutaneous ulcer was the only independent risk factor for the occurrence of PNM in DM [OR=5.98,95％ confidence interval (CI) (1.12,31.98),P=0.037].In the comparisons between DM-ILD patients with and without PNM,a higher frequency of CADM was observed in the PNM group (63.6％ vs 27.9％,x2=5.37,P=0.03),but no significant difference of the frequencies of RP-ILD,anti-MDA5 antibodies,cutaneous ulcers and CK levels was found in these two groups.All patients with PNM were treated with corticosteroids and immunosuppressants.During the follow-up period,6 patients died of respiratory failure.Conclusion Spontaneous PNM is a refractory complication with poor prognosis,and tends to occur in DM patients with RP-ILD,anti-MDA5 antibody,CADM diagnosis and low CK level,especially in patients with cutaneous ulcers.

BACKGROUND:Manual reduction for external fixation of distal radius fractures can achieve good outcomes.
OBJECTIVE:To carry out the bibliometric analysis on manual reduction for external fixation of distal radius fractures.
METHODS:Literatures concerning reduction for external fixation of distal radius fractures were retrieved in CNKI database from 2003 to 2012. The keywords were“external fixation;distal radius fractures”. Duplicate and irrelevant articles were eliminated, and a total of 408 articles were retrieved. A bibliometric analysis of these 408 articles was performed in terms of publishing time and number, subject categories, source journals, research institutions, times cited and download frequency.
RESULTS AND CONCLUSION:Literatures concerning manual reduction for external fixation of distal radius fractures exhibit an upward trend in number. In 2012, there were 85 relevant articles. In the past 10 years, 18 relevant articles have been published in Chinese Journal of Traditional Medical Traumatology&Orthopedics, which is the most. There are not many relevant studies in various research units, only 1-7 articles published per unit, and five articles are funded.