Objective To use the genetic diagnosis technique to perform the gene detection in the patients with thalassemia for understanding the main gene mutation types and their gene frequencies .Methods Totally 5 500 outpatients and individuals un‐dergoing physical examination in the hematology department of the Huizhou Municipal Central People′s Hospital from January 2010 to October 2014 were taken as the research subjects .The GAP‐PCR and membrane reverse hypridition technology were adopted to conduct the gene analysis of α‐andβ‐thalassemia .Results A total of 1 604 cases ofα‐globin gene change were detected ,accounting for 29 .16% of the total detected subjects ;1 096 cases ofβ‐globin gene change were detected ,accounting for 19 .93% of the total de‐tected subjects ;119 cases of αβ‐complex thalassemia were detected .Conclusion The gene screening of α‐ and β‐ thalassemia pro‐vides the valuable basic data for conducting the marital and fertility instructions .

[Objective]To explore the result of total hip arthroplasty(THA) performed in patients with osteoarthritis secondary to developmental dysplasia of the hip(DDH) and the degree of hip dysplasia on the treatment result. [Method]Forty-seven cases(55 hips) with osteoarthritis secondary to DDH were treated with THA.According to the classification of Crowe,23 hips were in classⅠ,19 in classⅡand 13 in class Ⅲ/Ⅳ.Before operation,the morphological changes of acetabula and femurs were evaluated with helical CT.During the operation,the acetabula were reconstructed at the level of real acetabula,the femoral canal was carefully enlarged and the small and straight femoral protheses were employed.The Harris hip score was conducted in each patients preoperatively and postoperatively.[Result]The Harris hip score in class Ⅰ,Ⅱand Ⅲ/Ⅳ were from 50.7?7.6,44.9?6.2 and 41.1?8.2 preoperative to 90.6?3.7,87.3?4.5 and 82.7?7.3 postoperative,respectively.There was significant difference between them(P

To fully understand the characteristics of international students and importance, practicality and usefulness of internal medicine, many targeted measures were taken, including im-proving language level of teachers and students, applying case-based learning method and evidence-based medicine and strengthening the cultivation of humanistic spirit and professional ethics. Quality of internal medicine for international students was improved , which provided new ideas for clinical teaching reform.

Objective:To investigate whether elderly patients over 70 years of age with gastric stump carcinoma should be treated with operation and which surgical approaches should be selected.Methods:A retrospective analysis was performed on 36 patients with gastric stump carcinoma without any significant surgical contraindications hospitalized in lanzhou general hospital of lanzhou military area from January 2001 to January 2013.All these patients were over 70 years of age,with an active score of 0-3.The patients were divided into surgical and non-surgical treatment groups,and the surgical treatment group was further subdivided into radical surgery group and palliative surgery group.The treatment modalities,complications and survival of each group were analyzed.Results:A one-year and a three-year survival rate of surgical treatment group was 45.5％ and 22.7％,respectively,whereas the one-year and three-year survival rate of non-surgical treatment group was only 18.2％ and 0％,the difference was statistically significant (P ＜ 0.05).In the surgical treatment group,the radical surgery subgroup had a better survival rate than palliative surgery subgroup,with a one-year and a three-year survival rate of 58.3％ and 33.3％ respectively for the former,and 30％ and 10％ for the latter.The incidence of complications of radical surgery group and palliative surgery group was of no significant difference (P ＞ 0.05).Conclusions:Elderly patients over 70 years of age with gastric stump carcinoma can still benefit from radical surgery;while palliative surgery does not improve the survival rate of the patients,radical surgery is appropriate for elderly patients with gastric stump carcinoma.

A? plays a crucial role in Alzheimer's Disease and the soluble A? oligomers have been recognized as the emerging neurotoxins,which ultimately cause memory impairment and neuronal loss through different mechanisms.The development of novel drugs targeting A? oligomers indicates new and promising therapy approaches for AD.The pathological roles as the proximal toxins in AD and the compounds,targeting soluble A? oligomers,which are currently in preclinical and early clinical development,are reviewed.

OBJECTIVE To discuss the clinic presentation,imaging characteristics and surgical management of the external auditory canal cholesteatoma (EACC) with invasion of the tympaniccavity and the mastoid. METHODS This was a retrospective study including the clinical data of 14 cases of EACC invading tympanic cavity and mastoid from 1998 to 2003 . RESULTS All 14 cases showed different bone erosion in the four walls of external auditory canal with extention to the mastoid . Pars flaccida perforation were found in 4 cases with invasion of the cholesteatoma into the tympanic cavity, the ossicular chains were compressed or destroyed. The bony mastoid segment of facial canal was destroyed in 3 cases . Cerebral plate destruction and congenital stenosis of external auditory canal were found in one case respectively. According to the extent of disease, modified radical mastoidectomy was performed in 8 cases and radical mastoidectomy in 5 cases , meatoplasty in one case. The post-operative hearing of 10 cases with intact ossicula chains were normal.One case with compression,shift of ossicules also got normal audition after the operation. The hearing threshold of the air condition in 3 cases with ossicular disruptions got 15 to 20dB of improvement among the language frequency after reconstruction of ossicular chain. The 14 cases were followed-up from 18 months to 5 years and no recurrences were found. CONCLUSION The exact etiology of EACC still remains unclear. There is some difficulty in diagnosing external auditory canal cholesteatoma (EACC) invading the tympanic cavity and the mastoid because of its untypical clinic presentation . High-resolution temporal bone CT scan could help to find out the primary lesion and determine the range of the pathological changes, and choose the proper surgical approach.

Objective:To determine the status of glucose intolerance in breast cancer patients without DM history after combined treatment with surgery and/or chemotherapy through an oral glucose tolerance test (OGTT). Methods:All 121 breast cancer patients more than 3 months after combined treatments with surgery and/or chemotherapy and without the diagnosis of diabetes underwent OGTT and fasting. Then, 2 h glucose levels were measured to identify glucose tolerance and diabetes. Meanwhile, six patients with a history of diagnosed diabetes did not undergo OGTT. Results:The median ages of all breast cancer patients and the mean duration after combined treatments with surgery and/or chemotherapy were 50.4 years and 19 months, respectively. Among the 121 breast cancer pa-tients without the history of diabetes, the incidences of diabetes, prediabetes, and normal glucose intolerance were 19.8%(24 cases), 45.5%(55 cases) and 34.7%(42 cases), respectively. Among all breast cancer patients, the incidences of previously diagnosed diabetes, undiagnosed diabetes, and prediabetes were 4.72%, 18.9%, and 43.3%, respectively. The ratio of previously undiagnosed diabetes was about 80%. About 80.0% of undiagnosed diabetes and 74.5% of prediabetes met the criteria for elevated 2 h plasma glucose levels through OGTT instead of elevated fasting glucose levels. Conclusion: Breast cancer patients during follow-up after combined treat-ments with surgery and/or chemotherapy highly suffer from glucose intolerance, with high incidences of undiagnosed diabetes and pre-diabetes. OGTT should be made for breast cancer patients after combined treatments for early diagnosis, prevention, and treatment of di-abetes.

Objective To investigate the regulatory effects of glucocorticoids on the local renin-angiotensin system in osteoblasts by using MC3T3-E1 cells.Methods Cellular immune histochemistry was carried out to observe the renin-angiotensin system in osteoblasts.And then after 12-hour culture in serum-free solution,MC3T3-E1 cells were divided into four groups:control,dexamethasone (DXM),dexamethasone + mifepristone (DXM+MIF)and mifepristone (MIF).Components of the renin-angiotensin system including angiotensin type 1 receptor (AT1R),angiotensin type 2 receptor (AT2R)and angiotensin converting enzyme (ACE)in osteoblasts were detected at the mRNA and protein levels using Western blot and PCR.The activity of ACE was also measured after 36-hour intervention.Results The results of immunohistochemistry showed that AT1R,AT2R and ACE were all expressed in osteoblasts.The activity of ACE increased obviously after dexamethasone intervention compared with that in the control group,which was blocked by mifepristone.The mRNA levels of AT1R,AT2R and ACE were increased by dexamethasone compared with those in the control group,which was inhibited by mifepristone.The protein levels of AT1R,AT2R and ACE were enhanced by dexamethasone compared with those in the control group, which was blocked when the cells were co-intervened with mifepristone.However,ACE activity and the mRNA and protein levels of AT1R,AT2R and ACE did not change when the cells were intervened with mifepristone alone (P>0.05).Conclusion The local renin-angiotensin system in osteoblasts is activated by dexamethasone through glucocorticoid receptors on osteoblasts,which may be one of the pathogenesis of glucocorticoid-induced osteoporosis.

BACKGROUND:Intraarticular hyaluronic acid (HA)has been used as one common method in the treatment of osteoarthritis. But its application in treating Kashin-Beck disease (KBD) is generalizing. The effect of HA on chondrocyte metabolism in KBD patients remains unclear.OBJECTIVE:To investigate the effects of HA on the synthesis of collagen Ⅱ and aggrecan in KBD chondrocytes cultured in vitro to understand its clinical treatment for KBD.DESIGN,TIME AND SETTING:Comparative observation. The experiment was performed in the Laboratory Center of Biomedicine and Endemic Disease Laboratory of College of Medicine,Xi'an Jiaotong University from September 2006 to January 2009.MATERIALS:Samples of KBD were from cartilage and corpus liberum excised from 6 KBD patients undergoing knee joint operation,and normal samples of fresh knee cartilages were provided by 6 people undergoing amputation or death by accident METHODS:Chondrocytes of KBD and normal control were separated and cultured in vitro. Varying dosages of HA (100,500 gm/L) were administered to normal and KBD chondrocytes cultured in vitro for 6 days. Negative control was not treated with HA.MAIN OUTCOME MEASURES:Effects of HA on collagen Ⅱ and aggrecan mRNA expression in KBD patients and normal people by RT-PCR.RESULTS:Compared with normal control group,the mRNA level of collagen Ⅱ and aggrecan were lower in KBD (P＜0.05).After administration of HA (100,500 mg/L) the mRNA level of collagen Ⅱ and aggrecan were significantly increased,and the effects of 500 mg/L was more significant.CONCLUSION:HA can increase the collagen Ⅱ and aggrecan mRNA level of KBD chondrocytes cultured in vitro. In particular,500 mg/L HA significantly promoted chondrocyte metabolism compared with 100 mg/L HA.

Objective To evaluate the effect of surface electromyography (sEMG) applied bilaterally to the limbs in the rehabilitation of motor dysfunction among stroke survivors.Methods Sixty stroke survivors were randomized into a bilateral group (n =30) and a control group (n =30).Both groups received routine rehabilitation for 4 weeks,but the bilateral group accepted additional limb rehabilitation training for the uninjured side.Before and after the intervention,motor function was assessed using sEMG during maximal voluntary contraction of the deltoid,biceps,triceps,rectus femoris,biceps femoris and tibialis anterior muscles.Integrated EMG (iEMG) and root mean square (RMS) values were computed.Results Before the training there was no significant difference in any of the measurements between the two groups.After the training both groups had significantly improved the average strength of their maximum contractions and their average iEMG and RMS values.The bilateral group,though,demonstrated significantly better results than the control group.Conclusion Bilateral limb rehabilitation training is superior to the conventional unilateral procedure in improving the motor function of stroke survivors.