Medical diagnostics is an important subject using basic theory,basic knowledge and basic skills in the diagnosis of the disease.However,the traditional teaching of physical diagnosis only provides the limited clinical operations based on the books,and lacks detailed and comprehensive knowledge of important theories of practical application,while the multi-media in the samples on the application of diagnostics can be a good solution to this problem.

Seven cases of benign bone tumors, a case of spinal fusion and. seven rases of un-united fractures of shafts of long bones, were treated with a.llogenir bone matrix gelatin (BMG) implants and were followed up for more than one year. All tumor cases were cured by osteo-induction from BMG, while only three of the seven fractures united. Two of the failures were reimplanted with BMG and failed again. Not a single case developed post-operative infection nor immunologic reaction. The BMG used was obtained from the same preparation, so that deterioration of its biological activity by endogenous protease was not likely. BMG small BMG cubes were used in tumor cases and slabs in fractures. The small cubes . were mixed with pieces of gel-foam and parked into the post-operative bony cavities while the slabs were arranged layer by layer at the fracture sites. This might be one of the reasons why the tumor rases had higher rate of cure Another reason was that non-unions needed prolonged, continuous and firm internal and external fixation post-operatively while the tumor cases needed not The amount of BMP calculated from BMG was not enough for early and solid osteogenesis. In the authors'opinion, with the use of new biomaterial, it should be followed by new method of application, but the principles of surgery should not be changed

To investigate the expression of ICAM 1 and TNF ? in gastric mucosal cell during drug induced mucosal injury, the authors carried out the study in SD rats with aspirin by mouth with immunohistochemical method . The results showed that ICAM 1 began to express at 30min after administration of aspirin, peaked at 1h, maintained until 6h, decreased at 12h,and expressed slightly at 24h . TNF ? began to express at 15min, peaked at 3h to 6h,decreased at 12h, and expressed significantly at 24h. There was a slight ICAM 1 and TNF ? expression in gastric mucosal cells in the control group. It was suggested that the expression of ICAM 1 and TNF ? plays an important role in the mechanisms of gastric mucosal injury .

OBJECTIVETo clone human gastric cancer related gene and to analyze its expression profile in gastric mucosal tissues.

METHODSPaired tumor, paratumor and non-tumor specimens from 7 gastric adenocarcinoma patients (male 4, female 3, with average age 51 +/- 18 years) were studied by means of fluorescent differential display reverse transcription polymerase chain reaction (DDRT-PCR). The differentially expressed cDNA bands of interest were cloned and analyzed by Northern blot and in situ hybridization. Thirty cases (male 23 female 7 with average age 59 +/- 8 years) of paired paraffin-embedded gastric tumor and non-tumor tissues were used in in situ hybridization analysis.

RESULTSA gene expressed much lower in 6 out of 7 tested tumor samples than in their normal and paratumor counterparts was identified. It was named GCRG123. Northern blot analysis confirmed the differential expression. Human multiple tissue Northern blot analysis showed that GCRG123 expressed in various adult human tissues including thymus, prostate, testis, ovary, small intestine, colon and peripheral blood leukocyte. Sequence analysis revealed that GCRG123 (GenBank accession number AF454554) was a lamin like protein gene. It had one open reading frame which consisted of 49 amino acids (GenBank accession number AAL61668.1). In situ hybridization analysis showed a high GCRG123 expression level in normal gastric epithelium and pylori glands, but low expression level in tumor as well as dysplasia and most intestinal metaplasia at the paratumor regions.

CONCLUSIONA lamin-like protein gene was identified in human gastric mucosa, it is down-regulated in gastric cancer and its precancerous leisions.

Adult ; Aged ; Blotting, Northern ; Cloning, Molecular ; DNA, Neoplasm ; chemistry ; genetics ; Down-Regulation ; genetics ; Female ; Gene Expression Regulation, Neoplastic ; Humans ; In Situ Hybridization ; Lamins ; genetics ; Male ; Middle Aged ; Molecular Sequence Data ; RNA, Messenger ; genetics ; metabolism ; Sequence Analysis, DNA ; Stomach Neoplasms ; genetics

Objective:To analyze the effects of a novel type of polydopamine (PDA)-coated porous titanium alloy scaffolds loaded with zoledronic acid-gelatin nanoparticles (ZOL-GNPs) for topical sustained drug release on osteoclasts in vitro. Methods:After porous titanium alloy scaffolds were fabricated using electron beam melting technique and ZOL-GNPs with different ZOL concentrations (0, 1, 10, 50, 100, 500 μmol/L) were prepared by desolvation method, PDA-coated porous titanium alloy scaffolds loaded with ZOL-GNPs were constructed by combining the two. The characteristics of the scaffolds were analyzed. The biomechanics of 3 different scaffolds (bare porous titanium alloy scaffolds, PDA-coated porous titanium alloy scaffolds, and PDA-coated porous titanium alloy scaffolds loaded with ZOL-GNPs) were investigated. Drug release detection was carried out by high performance liquid chromatography on the 1st, 4th, 7th, 14th, 21st, and 28th days respectively. The osteoclasts were inoculated into the novel scaffolds with different ZOL concentrations. The expression of osteoclast-related genes was detected by real-time quantitative (RT)-polymerase chain reaction (PCR); the expression of osteoclast-related proteins was detected by Western-blot.Results:The PDA-coated porous titanium alloy scaffolds loaded with ZOL-GNPs were successfully constructed. Electron microscope scanning showed that the GNPs were well spheroidized, smooth in surface, and uniformly dispersed, with a particle size of (243.6±63.4) nm. The ZOL-GNPs were uniformly compounded on the surface and in the pores of the scaffolds, and the spheres were regular in shape with no adhesion. The biomechanical experiments showed that the elastic moduli of the porous titanium alloy scaffolds under 3 different conditions were (1.81±0.12) GPa, (1.80±0.23) GPa and (1.81±0.15) GPa, showing no significant difference ( P> 0.05). The drug release percentage in the porous titanium alloy scaffolds was obviously high on the first day, and increased gradually and slowly in the subsequent 27 days. In the scaffolds with a low concentration ZOL, more osteoclasts adhered and proliferated; in the 50 μmol/L scaffolds, spheroid cells appeared; the spheroid cells increased and even apoptosis occurred with an increase in the ZOL concentration. RT-PCR showed that the expression of Ctsk gene and TRAP gene increased with the increased ZOL concentration, peaked in the 50 μmol/L scaffolds, and then decreased with the increased concentration, showing statistically significant differences ( P < 0.05). Western-blot showed that the expression pattern of Ctsk and TRAP was similar to that of their related genes. Conclusions:The novel PDA-coated porous titanium alloy scaffolds loaded with ZOL-GNPs demonstrate good mechanical properties and an anti-osteoporosis effect via their topical sustained drug release. The scaffolds with a ZOL concentration of 50 μmol/L may exert the best effect on inhibition of osteoclasts.

Objective:To design a large-scale mobile emergency resuscitation unit based on 5G communication technology to improve the efficiency of prehospital transportation and treatment.Methods:The study was conducted in Hangzhou from November 2022 to September 2023. It's sorted out the application scenario requirements for prehospital first aid, transfer, and prehospital-intrahospital emergency linkage in carrying out the program design, single technology testing, onboard debugging, and integration debugging phases sequentially.Results:In September 2023, a large-scale 5G mobile emergency resuscitation unit was completed and delivered. The unit was converted from an electric bus and consists of five parts: (1) Vehicle appearance: the vehicle is 12.9 meters long, 2.3 meters wide and 2.6 meters high, with a single mileage of 200 kilometers; (2) The overall internal structure: the vehicle has one resuscitation bed and two stretcher positions. Additionally, there is a comprehensive operating table located at the front of the vehicle. The middle of the vehicle is equipped with a central digital control screen. (3) First aid materials and instruments: the vehicle's materials are modularly configured in accordance with the resuscitation, guardianship, surgery, inspection and testing, Communication modular configuration, equipped with a defibrillation monitor, transfer ventilator, extracorporeal membrane lung oxygenation and other critical care first aid and electrocardiogram, digital radiography, blood gas analyzer, chest pain 5 monitors and other inspection and testing equipment; (4) Vehicle communication and information systems: equipped with high-definition remote video interactive system, telemedicine terminal DP300 integrated system, a real-time panoramic experience system and centralized guardianship system; (5) Vehicle disinfection: a plasma disinfector installed on the top of the car can meet the hospital disinfection hygiene standardsⅡ class environmental management requirements.Conclusions:Incorporating 5G communication technology, the large-scale mobile emergency resuscitation unit is equipped with various advanced treatment equipment and remote consultation systems. It can accommodate the resuscitation needs of the most critically ill patients, offering substantial support for public emergency rescues. Further exploration of its potential is merited.

Objective: To evaluate the effect of biofeedback training on bowl function among rectal cancer patients with chemoradiotherapy and temporary enterostomy. Methods: Using randomized controlled trial design, 109 rectal cancer patients were randomly divided into three groups, the first blank control group, the second group pelvic floor muscle exercise group, the third group biofeedback group. High resolution anorectal manometry was used for 6 longitudinal traces in 16 months. Data of bowel function were collected by Memorial Sloan Kettering Cancer Center (MSKCC) Bowel Function Instrument. Results: The main effect of the change of five indicators, anal resting pressure, rectal resting pressure, maximum squeeze pressure, maximum squeeze time and high pressure zone, was time. The other four indicators, rectal volume at first senory, rectal volume at sense of convenience, maximal tolerable rectal volume and rectal compliance, among patients of biofeedback group were (32.71±5.00) ml, (74.26±8.30) ml, (188.40±12.68) ml, (5.69±1.18) ml/kPa and (68.09±6.38). The rectal volume at first senory, rectal volume at sense of convenience, maximal tolerable rectal volume and rectal compliance, among patients of biofeedback group were significant higher than blank control group and pelvic floor muscle exercise group (F=3.589-26.826, P<0.05). Conclusion The biofeedback could significantly improve the sensory indicators of patients with middle and low rectal cancer. High-resolution anorectal manometry could effectively evaluate the effect of biofeedback training in patients with middle and low rectal cancer.