Purpose:To investigate the related factors affecting the prognosis of patients with cervical carcinoma treated with radiotherapy. To analyze the relationship between the survival rate and some factors such as the tumor size,treatment days and local control.Methods:From April 1993 to April 2001,83 cervical carcinoma patients with stage Ⅰ,Ⅱ,Ⅲ were treated with cobalt teletherapy and 192 Ir high-dose-rate brachytherapy as primary treatment. The method of external irradiation: first deliver DT25-26Gy/13 fraction,then increase the dose to DT48-50Gy with middle lead block in the field. The internal radiation method: the dose ir A point is DT 35 Gy/7 fraction. Kaplan- Meier method was used to calculate the survival rate and Log-rank test for the difference significance.Results:①local control: the 1-,2-,3-,5-year survival rates in complete response and partial response patients and progressive patients were respectively 95.87%,77.12%,73.09% 73.09%and 34.29%,0%,0%,0%,there is significant difference between them . ②treatment days :the 1-,2-,3-,5-year survival rates in the patients with treatment days exceeding 56 days and not exceeding 56 days were respectively 93.88%,82.86% 80.19%,80.19% and 78.95%,30.55%,22.91%,22.91%,there is significant difference between them . ③the maximum tumor diameter : the 1-,2-,3-,5- year survival rates in patients with the maximum tumor diameter exceeding 4 centimeters and not exceeding 4 centimeters were respectively 95.12%,82.86%,79.67%,79.67% and 81.93%,58.20%,53.35%,53.35%,there is significant difference between them.Conclusions:①The patients with local residual tumor and bigger tumor volume had relatively poorer prognosis;②The treatment days should be shortened to 8 weeks if possible;③ The comprehensive treatment and shortened treatment days may improve the therapeutic effect for the patients with tumor size ≥4cm,local residual and progressive tumor.

Objective: To study the chemical constituents of the methylene chloride of Rubus chingii Hu.. Methods: Chromatography on silica gel column, Sephadex LH-20 column, and recrystallization technique were used to isolate and purify the compounds. Spectroscopy methods including EI-MS, ES-MS, 1H-NMR, 13CNMR, HMQC, and HMBC were used to elucidate the structures of compounds. Results: Ten compounds were obtained and 9 compounds were identified as: hexacosanol (I), β-sitosterol (II), 4-hydro-3-methlbenzal acid (III), 4-hydrobenzal dehyde (IV), oleanolic acid (V), stigmast-5-en-3-ol, oleate (VI), H-2-indenone, 2, 4, 5, 6, 7, 7a-hexahydro-3-(1-methylethyl)-7a-methyl (VIII), 4-hydroxy-3-methoxybenzoic acide (IX), and liballinol (X). Conclusion: Compounds I, III, IV, VI, VIII, and X have been obtained from Rubus chingii for the first time.

Objective To compare the efficacy of Lichtenstein and transabdominal preperitoneal patch repair(TAPP) in the treatment of primary inguinal hernia in adults. Methods The clinical data of 223 patients who received Lichtenste and 121 patients who underwent TAPP in our hospital between January 2002 and January 2006,were analyzed retrospectively.The efficacy and complications of the two methods were compared.Results The rate of intraoperative injury of the inner organs in the TAPP group was significantly higher than that in the Lichtenstein group [5.8%(7/121) vs 0.4%(1/223),?2=7.626,P=0.006],while no significant difference was detected in the rate of abdominal organ injury between the two groups [0.8%(1/121) vs 3.1%(7/223),?2=0.969,P=0.325].The rate of postoperative complications in the TAPP group was significantly lower than that in the Lichtenstein group [14.0%(17/121) vs 36.3%(81/223),?2=18.881,P=0.000].In the TAPP group,during a follow-up of(14?7) months,one case of recurrence was found(0.8%).Whereas in the Lichtenstein group,the patients were followed up for(16?8) months,two of them had recurrence(0.9%).No significant difference existed in the recurrence rate between the two groups(?2=0.000,P=1.000).Conclusions Both the Lichtenstein and TAPP have benefits and drawbacks.Individulized therapy is recommended for the patients with inguinal hernia.It is important for surgeons to know the indications of the operations.

Objective To examine the efficacy of applying clinical pathway (CP) teaching model in orthopedics clinical teaching.Methods Totally 64 medical undergraduates were randomized into 2 groups.The traditional teaching method and CP model were separately preformed on them.Their scores of theoretical,manipulation and case analysis exams at the end of internship were compared.Meanwhile the questionnaire of satisfaction degree also was conducted.Results Scores of exams and satisfaction degree were better in CP group than in classical group (P ＜ 0.05).Conclusions The novel CP model can promote the standardization and systematization of clinical teaching in orthopedics.It is conducive to evaluating teaching effect and performing teaching reform.Meanwhile,it is in accordance with the problem-based learning and can improve clinical teaching effect and satisfaction degree.

BACKGROUND:Ribbed anatomic femoral stem meets the biomechanical features of the femur, and has achieved satisfactory clinical efficacy with good initial stability, rapid bone growth and low stress shielding.
OBJECTIVE:To evaluate the design features and clinical results of the cementless anatomic Ribbed femoral stem (Ribbed stem) in total hip arthroplasty.
METHODWe retrospectively analyzed 52 patients (52 hips) with hip joint disease who were treated with Ribbed stem in total hip arthroplasty between March 2010 and March 2012. There were 20 males and 32 females. The mean age was 59 years (range 22-78 years). The mean fol ow-up was 3.1 years (range 2-4 years). The preoperative and postoperative Harris hip scores, the rate of postoperative thigh pain, the incidence of intraoperative femoral fracture, wound healing, dislocation and revision were recorded. Radiographic evaluation was used to evaluate the rate of stem fil , subsidence of femoral stem, periprosthetic radiolucent line, bone ingrowth, stress shielding, and osteolysis.
RESULTS AND CONCLUSION:The incidence of intraoperative femoral fracture was 6%. Al incisions were healed. There were no cases of hip dislocation and revision;the rate of thigh pain was 6%, no patient had thigh pain after 1 year postoperatively. The mean preoperative Harris hip score was 48 points, which improved to a mean of 96 points at the final fol ow-up. Postoperative X-ray showed that al patients had a satisfactory femoral fil in both planes and al of the femoral stems were wel-fixed at the final fol ow-up. The average fil ing rate was 91%, 88%and 86%by normotopia imaging, while 88%, 85%and 81%by lateral imaging, at the metaphysic, middle and distal ends respectively. At the final fol ow-up, 49 hips (92%) showed stable bone ingrowth, 3 hips showed stable fiber ingrowth. No osteolysis around the components at the femur or acetabulum was observed. 5 (10%) hips appeared the subsidence of femoral stems, which were<2 mm. The stress shielding phenomenon occurred in al patients, including first-degree in 31 hips, second-degree in 19 hips, third-degree in 2 hips, and fourth-degree in no case. Experimental findings indicate that, Ribbed stem with a rational design can achieve satisfactory clinical outcomes with good initial stability, rapid bone growth and low stress shielding.

Objective To observe the effects of Shenqi Fuzheng injection on peripheral blood T lymphocyte subsets, T-cell apoptosis and cytokine in patients with sepsis and approach their significance.Methods Forty patients with sepsis admitted into Department of General Surgery of the General Hospital of Tianjin Medical University were randomly divided into two groups: routine group (20 cases, received routine western medicine treatment) and Shenqi Fuzheng treatment group (20 cases, received routine western medicine treatment and intravenous drip of Shenqi Fuzheng injection 250 mL per day), 7 days as a course of treatment in both groups. On the 1st, 3rd and 7th day after treatment, evaluation of acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) scores was carried out in the two groups. The percentages of peripheral blood T-lymphocyte subsets CD4+, CD8+, CD4+/CD8+ and apoptosis were measured by flow cytometry. Meanwhile, tumor necrosis factor-α (TNF-α), interleukins (IL-6 and IL-10) levels were detected by enzyme linked immunosorbent assay (ELISA).Results APACHE Ⅱ scores of two groups on the 3rd day were apparently decreased in comparison with those on the 1st day after treatment, and this situation persisted until the 7th day after treatment; meanwhile, the decrease in APACHE Ⅱ score in Shenqi Fuzheng treated group was more notable than that in routine group (10.05±3.71 vs. 13.15±4.65,P < 0.05). Along with the prolongation of time, in both groups, the peripheral blood TNF-α and IL-6 levels were gradually decreased; the IL-10 level was gradually increased, until the 7th day it began to decrease. On the 7th day, the TNF-α and IL-6 levels in Shenqi Fuzheng treated group were decreased more significantly than those in routine group [TNF-α (ng/L): 204.6±18.1 vs. 218.9±21.3, IL-6 (ng/L): 3.68±0.30 vs. 3.95±0.49, bothP < 0.05]. There was no significant difference between Shenqi Fuzheng treated group and routine group in the IL-10 level on the 7th day (ng/L: 173.8±23.3 vs. 174.8±18.9,P > 0.05). On the 1st, 3rd and 7th day after treatment, the percentage of CD4+ T cells and CD4+/CD8+ ratio were firstly fallen and then elevated up, the percentage of CD8+ T cells was gradually decreased, and the percentages of CD4+ and CD8+ apoptosis showed a trend of rise up first and then fall in the two groups. On the 7th day after treatment, there were significant differences between Shenqi Fuzheng treated group and routine group in terms of the percentage of CD4+, CD4+/CD8+ ratio and the rate of CD4+ apoptosis [CD4+ T cells: (38.3±4.7)% vs. (35.5±5.5)%, CD4+/CD8+: 1.55±0.29 vs. 1.36±0.27, CD4+ T apoptosis: (11.2±3.8)% vs. (14.1±5.5)%, allP < 0.05]. There were no statistically significant differences between routine group and Shenqi Fuzheng treated group in the percentages of CD8+ T cells and CD8+ apoptosis at each time point (allP > 0.05).Conclusion Shenqi Fuzheng injection can effectively reduce the percentage of CD4+ T cell apoptosis, increase the percentage of CD4+ T cells and CD4+/CD8+ ratio, lower the inflammatory factors, improve the immune function and disease severity in patients with sepsis.

Objective To evaluate different treatment modaltities for limited (local) hepatic metastasis in patients of colonic carcinoma Methods We conducted a retrospective analysis on 81 cases of colonic cancer suffering from hepatic local metastasis from 1987 to 2000 Results The 1、3、5 year survival rate was 85%、 46% and 32% respectively for patients underwent resection of metastatic liver cancer, and 26%、 0 and 0, respectively for those not having the metastatic liver cancer resected ( P 0 05) Conclusion Resection or ablation therapy promises a much longer long term survival than do nothing in colonic cancer patients with local liver metastatic tumor

Recently early noni-nvasive diagnostic techniques of bladder tumor are the hot resear- ches,which is significantly important for guiding clinical therapy and prognosis.This article will review the advancements of noninvasive diagnosis of bladder tumor in recent years and compare the new develop- ments with traditional exfoliative cytology test of urine,typical cystoscopy and improved cystoscopy.

Team-oriented scientific project competition-based ideas and measures in teaching of Medical Information Analysis course were studied by introducing non-medical cases into discussion and analysis , simulating brain storm conference , and supplementing team competition .