Evidence-based medicine(EBM) is a new medical model,which is an inevitable tendency of modern clinical education.This article analyses the advantages and disadvantages of the evidence-based medical education(EBME) and emphasizes the great significance of EBM in paediatrics teaching.

Objective To evaluate the performance of surgical approaches in the treatment of linear scleroderma of the head and face. Methods Forty-three patients with stable linear scleroderma of the head and face were included in this study. Surgical approaches, which included direct suture,skin flap translocation, soft-tissue augmentation and filling operation with dermal tissues, were selected and utilized alone or in combination according to the size, location and degree of atrophy and depression of lesions. Results After surgical treatment, wound dehiscence developed in one of these patients, but the wound healed after two sessions of suture. During one year of follow up, all the patients achieved favorite color, feeling and blood supply in the filling areas as well as good facial profile and visual appearance with no obvious convexity and concavity. Skin flaps matched well with surrounding tissues, incision lines were inconspicuous, and hairline looked naturally with well-distributed hairs in these patients after treatment. Patients were satisfied with treatment results. Conclusion Satisfied cosmetic outcomes can be achieved by using surgical approaches in patients with stable linear scleroderma of the head and face.

Objective To investigate ?-catenin and lymphoid enhancing factor 1 (LEF-1) expression in malignant melanoma. Methods ?-catenin and LEF-1 protein expression was examined using the PowerVisionTM immunohistochemical method in 25 cases of intradermal nevus and 45 cases of malignant melanoma. Results Comparing malignant melanoma with intradermal nevi, there was a significant difference in the expression of ?-catenin (33/45= 73% vs. 9/25 = 36%, respectively; P

Objective To investigate the inhibition of lymphoid enhancer factor-1 (LEF-1) expression in human malignant melanoma cell line A375 by RNA interference method. Methods Sense and antisense oligonucleotides with hairpin structures, targeted specifically at LEF-1 mRNA, were designed, synthesized, then linked to the expression vector psilencer3.1-H1 neo after annealing. After identification, the re-combinant psilencer3.1-H1/LEF-1 siRNA was used to transfect the cultured A375 cells by a liposome-medi-ated method. The cells expressing the recombinant RNA was detected by G418 screening. The mRNA and protein levels were detected by RT-PCR, Western blotting and immunocytochemistry, respectively. Results The expression vector psilencer3.1-H1/LEF-1 siRNA was successfully constructed, and its stable expression in cell clones was achieved. The mRNA and protein levels of LEF-1 were both down-regulated in the trans-fected cells. Conclusion The recombinant of psilencer3.1-HI/LEF-1 siRNA can inhibit the mRNA and protein expression of LEF-1 in A375 cells.

Objective To evaluate the efficacy and safety of endoscopy-assisted percutaneous interventional procedure with a 980-nm laser for the treatment of venous malformations.Methods A total of 167 patients with venous malformation were enrolled,including 102 females and 65 males,whose age ranged from 0.5 to 60 years.Skin lesions occurred on the limbs in 66 patients,on the head and face in 48,on the chest and abdomen in 24,on the back in 13,on the neck in 10,as well as on the scrotum in 6.A 980-nm laser operated at pulse width of 0 ms-2.5 s and pulse energy of 0-20 W with a 400 μm-diameter optical fiber.Puncture was performed after circular infiltration anesthesia around skin lesions,and then the optical fiber was inserted at the same puncture point to directly or indirectly destruct the vascular wall by photothermal effects and thermal coagulation.For deep lesions around important anatomical structures,the interventional therapy was performed with the assistance of endoscopy or ultrasound.According to the size and shape of tumors,these tumors were irradiated back and forth with speeds of 2 cm/s-4 cm/s.The optical fiber was also inserted in different directions in a fan-shaped pattern for 3-5 sessions until tumors were shrunken or even disappeared.The time interval between two treatments was 3 months,and all the patients were followed up for 4 months on average.Results Of the 167 patients,148 (88.6％)were cured,11 (6.6％) markedly improved,4(2.4％) improved,and 4(2.4％) unimproved.The response rate was 97.6％.Totally,159 patients were satisfied with the therapeutic effects after 1 session of treatment,and 8 were improved after 2 sessions of treatment with a time interval of 3 months.In addition,mild postoperative pigmentation occurred in 6 (3.6％) cases,and skin burns in 3 (1.8％) cases.After 3 months,the above symptoms were improved significantly.Two (1.2％) patients had vascular recanalization and residual lesions,but they were improved after reoperation.No adverse reactions were observed,such as bleeding,scar,tendon and nerve injuries,and dysfunction.Conclusion A 980-nm laser percutaneously delivered through an optical fiber is safe and effective for the treatment of venous malformation.

Objective:Investigated the effect of recombinant urease A subunit and catalase vaccines on protection against Helicobacter pylori (HP) infection Methods:Recombinant plasmids expressing UreA or KatA were constructed Expression was induced with IPTG,analyzed by SDS PAGE and Western blot UreA and KatA were purified with Bulk GST purification module Results:The recombinant plasmids could express GST UreA and GST KatA fusion proteins,which accounted for 35% and 19% of total bacteria proteins respectively,and could specially react with antibody against GST The purity of the purified UreA and KatA was over 95% Conclusion:The work laid a foundation for further studies of HP vaccine The recombinant vaccines may play an important role in preventing and treating HP infection and related diseases

Objective To observe the structure of cognitive injury and the effect of psychologic behavior training on cognitive function in community chronic schizophrenic patients. Methods80 healthy adults (control group) and 76 community chronic schizophrenia patients (research group) were assessed with World Health Organization-battery of cognitive assessment instrument for elderly (WHO-BCAI), mini-mental state examination (MMSE), and activities of daily living (ADL) pre- and post-psychologic behavior training. ResultsThere were significant differences in the scores of WHO-BCAI, MMSE, ADL between control group and research group (P<0.05 or P<0.01). 12 months after training, all the scores of research group significantly improved compared with that before training (P<0.05 or P<0.01). ConclusionCognitive disorders have occurred in the community chronic schizophrenia patients in wide range. Psychologic behavior training can improve their cognitive function.

ObjectiveTo investigate the effects of imatinib mesylate as a tyrosine kinase inhibitor on the biological activity of and Wnt/β-catenin pathway in Hs294T melanoma cells.MethodsAfter Hs294T cells were incubated with imatinib mesylate at various concentrations(4,8,10,16,20 and 24 μmol/L) for 24 hours or imatinib mesylate at 10 μmol/L for 24,48 and 72 hours,methyl thiazolyl tetrazolium (MTT) assay was performed to estimate the proliferation of cells and to determine the effects of imatinib mesylate on the proliferation of Hs294T cells.Then,Hs294T cells were treated with imatinib mesylate at 10 μmol/L or dimethyl sulfoxide (DMSO) for different durations,followed by the detection of cell apoptosis with flow cytometry,localization of β-catenin with annexin V/propidium iodide-double staining and laser confocal microscopy,quantification of β-catenin and cyclin D1 protein with Western blot,and measurement of LEF1 and C-myc mRNA expression with real time fluorescence-based quantitative PCR.Matrigel invasion assay was performed to evaluate the invasiveness of Hs294T cells after treatment with imatinib mesylate at 5 μmol/L or DMSO for 24 hours.ResultsImatinib mesylate at 4-10 μmol/L elicited a dose-dependent decline in the proliferation of Hs294T cells (F =125.3,P ＜ 0.05),and imatinib mesylate at 10 μmol/L induced a time-dependent decrease from 24 to 72 hours(F =714.6,P ＜ 0.01 ).The percentage of early and late apoptotic cells was markedly increased,while the invasiveness was decreased by about 48％(P ＜ 0.01 ),together with a downregulation in the expression of LEF1,C-myc and Cyclin D1 in imatinib mesylate-treated Hs294T cells compared with the DMSO-treated cells.No obvious changes were observed in the protein expression of β-catenin,but a decline in the nuclear localization of β-catenin was noted in Hs294T cells after being treated with imatinib mesylate.ConclusionImatinib mesylate may suppress the proliferation and invasion of,but promote the apoptosis in,melanoma cells,by downregulating the Wnt/β-catenin pathway.

Objective To assess the dynamic changes of bacteria culture of patients with chronic suppurative otitis media (CSOM ) preoperative ,intraoperative ,and postoperative the mastoidectomy .Methods Secretions or tissues in 86 CSOM patients were collected for bacterial culture and drug sensitivity tests ,and analyzed the rusults between cholesteatoma group and nonchol-esteatoma group .Results Hospitalized CSOM patients with positive culture rates preoperatively ,intraoperatively and postopera-tively were 75 .6% ,41 .9% and 1 .2% respectively ;Before the mastoidectomy ,positive bacteria ,positive fungus and no pathogenic bacteria were found correspondingly 49 .1% ,25 .0% and 28 .6% of positive bacteria during the surgery .Culture positive rates be-tween the cholesteatoma group and noncholesteatoma group were significantly different intraoperatively (P<0 .05);while during in-traoperative samples ,no significant differences of positive rates were found between pyogenic fluids and tissues ,as well as tissues of mastoid tympanic antrum area and tympanic antrum entrance area (P>0 .05) .Different bacteria showed different drug sensitivity results .Conclusion Intraoperative bacteriological results shows the different bacteria and drug sensitivity from the preoperative bacteriological results ;CSOM patients with cholesteatoma are more likely to develop bacteria ;it is necessary to carry out dynamic detection on bacterial culture and drug sensitivity tests before ,during and after the surgery .

Objective To investigate the relationship between alcohol and smoking and the development of pancreatic calcification in chronic pancreatitis (CP) in China. Methods The patients were divided into two groups according to the presence of pancreatic calcification at admission and the data were analyzed; furthermore, the discharged patients without pancreatic calcification were divided into two groups as newly diagnosed pancreatic calcification group and persistent non-pancreatic calcification group. Logistic regression and Cox proportional-hazards model was used for multivariate analysis of the risk factors for pancreatic calcification. Results From January1997 to July 2007, 449 patients with CP were enrolled and followed up successfully. 248 patients presented with pancreatic calcification at admission; among the 201 patients presented without pancreatic calcification, 13 patients developed pancreatic calcification after discharge. Patients with pancreatic calcification had a young age at onset, long CP history, higher incidence of diabetes mellitus and diarrhea. Age at onset ≤ 40, alcohol intake over 20 g/day, and diabetes mellitus and diarrhea were risk factors for pancreatic calcification. The only risk factor of development of pancreatic calcification after discharge was excessive alcohol intake (OR: 3.2). Conclusions Alcohol intake increased the risk of pancreatic calcifications, suggesting the patients abstain from alcohol intake. Further studies are necessary to clarify the role of smoking.