BACKGROUND: The etiology of osteoarthritis is not yet clear. There are a large number of studies on the pathogenesis of osteoarthritis, such as cartilage degeneration, subchondral bone degeneration, joint mechanical changes, and nerve conduction abnormality. OBJECTIVE: To explore the latest advances in the pathogenesis and treatment methods of osteoarthritis at home and abroad.METHODS: The literatures concerning osteoarthritis at home and abroad were searched using the keywords of osteoarthritis, mechanism, therapy in English and Chinese, respectively. Finally, 46 eligible literatures were enrolled for overview.RESULTS AND CONCLUSION: The incidence of osteoarthritis is closely related to the degeneration of articular cartilage and subchondral bone, changes in joint mechanics and arthralgia. Superficial zone tissues of articular cartilage vary with age increasing, which is easy to cause osteoarthritis. The treatment should lay emphasis on prevention so as to reduce the risk of osteoarthritis and delay its progression, but not on the combination of non-drug and drug-based treatment. Notably, obesity is the most important risk factor for osteoarthritis. Non-steroid anti-inflammatory drug is the first choice for the treatment of knee osteoarthritis according to Guidelines for the Prevention and Treatment of Osteoarthritis. Fish oil cannot alleviate the progression of osteoarthritis. Surgical treatment is not recommended in the early osteoarthritis, osteoarthritis will not be cured completely through arthroscopic operation, and arthroplasty is recommended for those severe patients.

Objective To discuss the changes of quality of life and influence factors in patients with multidrugresistant pulmonary tuber-culosis. Methods Using the SF-36 scale of 80 normal subjects and 80 cases of MDRTB patients before and after treatment and quality of life score total score evaluated dimensions. Results Between the patients with MDR-TB and the control in the total Qol scores and eight dimensionality, there were significant differences(P＜0.01), total Qol scores and eight dimensionality in 3 months or 1 year after treatment were higher than before therapy,there were significant differences(P＜0.01 ). Between 1 year after therapy in the total Qol scores and PF, PR, GH, VT, SF, ER, MH, dimensionality were lower than control groups, there were significant differences(P＜0.05 ). The main factors affecting the Qol of patients with MDR-TB were cultural level, kinds of drug resistant and reduction of counts of white blood cell. Conclusion The correlation between quality of life and education, the number of drug resistance, reduction of white blood cell in patients with multi-drugresistant pulmonary tuberculosis.

OBJECTIVE To explore the application of data mining(DM) technique in the management against hospital infection in operating room.METHODS The data in hospital information system(HIS) were comprehended,prepared and then excavated by the base of DM technique,which were used to evaluate the management against hospital infection in operating room.RESULTS DM could be applied in variety fields against hospital infection in operating room,such as,intelligent preparing system of sterile and disposable articles in operating room,prediction of incisional wound infection after operation to arrange operation reasonably and to prevent abuse of antibiotic,analysis of the application of antibiotics during peri-operation and the rules of their drug resistance happened,and mangement of visitors and trainees,in solving the difficulty and avoiding the error using HIS,and in dynamic monitoring of routine work of hospital infection in operating room.CONCLUSIONS The new technique of DM can be applied to distinguish those unknown,effective,novel and potential information or knowledge from database,and can be effectively applied on the management of hospital infection in operating room.

Background Researches showed that thymic stromal lymphopoietin (TSLP) is an interleukin-17-like inflammatory factor and plays important roles in the pathogenesis and development of allergic diseases.However,the study whether TSLP plays roles in allergic conjunctivitis is rare.Objective This study was to investigate the expression change of TSLP and IL-4 in ocular surface tissue and cervical lymph node in the mice with allergic conjunctivitis induced by artemisia annua,a common plant in China,and to explore the role of TSLP and IL-4 in the pathogenesis and development of allergic conjunctivitis.Methods Twenty female BALB/c mice aged 6-8 weeks were randomized into normal control group and model group.Antigen solution was prepared using 400 μl extracting solution of artemisia annua pollen with 400 μl antigen solvent.The mouse models of allergic conjunctivitis were established by injection of 50 μl antigen solution in footpad followed by ocular topical administration of extracting solution once a day from day 10 to 12 after injection,and no any intervention was given in the normal control group.The mice were sacrificed and eyeballs were obtained 13 days after modeling,and corneal epithelium,conjunctiva and cervical lymph nodes were harvested for the detection of TSLP mRNA and IL-4 mRNA by real-time PCR.Immunochemistry was employed to assay the expression of TSLP and IL-4 proteins in corneal,conjunctival and subconjunctival tissues.Results Ocular inflammatory signs appeared 0.5 hours after ocular topical administration of extracting solution,including eyelid edema,conjunctival congestion,tears,scratching eyelids,etc.The symptoms lasted for 6-24 hours,with the model successful rate 80％.Real-time PCR indicated that the expression of IL-4 was absent in corneal epithelium in both model group and normal control group.The relative expression levels of TSLP mRNA in the corneal epithelium,conjunctiva and cervical lymph nodes in the model group were more (1.63±0.20)times,(2.71±0.48) times and (1.48 ±0.05) times than the normal control group,showing significant differences between the two groups (t =4.44,14.16,5.01,all at P＜0.05).Compared with the normal control group,the relative expression levels of IL-4 mRNA in the model group increased (2.94±0.39) times and (1.74±0.09) times,with significant differences between the two groups (t =9.92,14.54,both at P＜0.05).Immunochemistry assay showed that the expression of TSLP protein in the corneal and conjunctival epithelial cells were enhanced in the model group compared with the normal control group.In addition,an intensive expression of IL-4 protein was seen in subconjunctival tissue in the model group,while the expression of IL-4 was absent in the normal control group.Conclusions TSLP is mainly expressed in the cornea,conjunctiva and cervical lymph nodes of the mice with allergic conjunctivitis,suggesting that TSLP promotes the inflammatory process of cornea and conjunctiva;IL-4 is mainly expressed in conjunctiva,showing IL-4 participates in conjunctival inflammatory process.TSLP and IL-4 play synergistic roles in promoting the inflammatory process of ocular surface in the mice with allergic conjunctivitis,which may be new therapeutic targets.

Background The pathogenesis of allergic conjunctivitis has not been clearly established.Current researchers indicate that interleukin-4 (IL-4), IL-5 and IL-13 may play an important role in allergic conjunctivitis.But whether the roles of these inflammatory factors are same in different types of allergic conjunctivitis remains unclear.Objective This study was to investigate the expressions of IL-4, IL-5 and IL-13 in ocular surface with different types of allergic conjunctivitis.Methods A prospective cohort study was designed.Eighty individuals were recruited in Shanxi Eye Hospital from April 2013 to September 2014, including 20 patients with vernal keratoconjunctivitis (VKC), 20 patients with seasonal allergic conjunctivitis (SAC), 20 patients with perennial allergic conjunctivitis (PAC) and 20 normal healthy subjects.Surficial tissues were binocularly scraped using disinfected scraper from upper eyelid conjunctiva, and 4 μl of tear fluid was obtained with capillary tube.The expressions of IL-4, IL-5 and IL-13 protein and mRNA in the conjunctival epithelial cells were detected by immunohistochemistry and real-time fluorescence quantitative PCR.The IL-4, IL-5 and IL-13 concentrations in tear fluid were assayed by Luminex method.This study complied with Declaration of Helsinki and the research protocol was approved by the Shanxi Eye Hospital Ethics Committee.Written informed consent was obtained from each subject prior to entering the cohort.Results IL-4, IL-5 and IL-13 were positively expressed in cytoplasm of conjunctival epithelial cells in the VKC group,SAC group and PAC group,but the expressions of IL-4,IL-5 and IL-13 were absent in the normal control group.The relative expression levels of IL-4 mRNA were 4.11±1.24,2.71±0.71 and 2.00±0.80;the relative expression levels of IL-5 mRNA were 4.02±0.43,2.07±0.45 and 1.47±0.50;and the relative expression levels of IL-13 mRNA expression levels were 6.44±0.66,4.35±1.26 and 2.39±0.86 in the VKC group,SAC group and PAC group, showing significant differences among the 4 groups (F =51.32,220.18,162.49, all at P＜0.01).The relative expression levels of IL-4,IL-5 and IL-13 mRNA were significantly higher in the VKC group than those in the SAC group and PAC group;and those in the SAC group were significantly elevated in comparison with the PAC group (all at P＜0.05).No IL-4, IL-5 and IL-13 were detected in the tear fluid in the normal control group;while the concentrations of IL-4,IL-5 and IL-13 in the tear fluid were (14.06±3.50), (10.88±1.82) and (34.28±8.42) pg/ml in the VKC group,and (7.71 ±0.65), (5.10± 1.33), (23.77±6.29) pg/ml in the SAC group as well as (3.30± 1.50) pg/ml, (2.43± 1.28) pg/ml and (17.67 ± 4.28) pg/ml in the PAC group, showing significant differences among the 3 groups (F =200.29,260.49,128.23, all at P＜0.01).IL-4, IL-5 and IL-13 concentrations in the tear fluid were significantly higher in the VKC group than those in the SAC group and PAC group,and those in the SAC group were significantly raised in comparison with the PAC group (all at P＜0.01).Conclusions IL-4,IL-5 and IL-13 participate in the pathogenesis of multiple allergic conjunctivitis,but their expressions in the ocular surficial tissue are discriminatory in different types of allergic conjunctivitis.

Objective To explore the effect of health education on improving awareness of preven-tion of upper respiratory tract infection of parents of leukemia children. Methods 25 parents were ran-domly chosen, and comprehensive health education interventions were provided, including lectures, advisory guidance and brochures. The awareness of prevention of upper respiratory tract infection of parents was e-valuated before and after health education,and the results underwent χ<'2> test. Results After health educa-tion, the awareness of prevention of upper respiratory tract infection of parents significantly improved com-pared with that before. Conclusions Health education can improve awareness of prevention of upper res-piratory tract infection of parents and decrease the incidence of upper respiratory tract infections.

ObjectiveTo compare the accuracy of enhanced dynamic wedge (EDW) models of adaptive convolution algorithm (ACA) in Pinnacle3 9.0 and anisotropic analytical algorithm (AAA),and pencil beam convolution (PBC) algorithms in Eclipse7.3 treatment planning systems (TPS).MethodsTo evaluate the accuracy of the three algorithm models,we compared actual measurement values with TPS calculation values of EDW wedge factors under for different fields in which Varian-21EX 6 MV X-ray was applied,and also compared the actual dose distribution profile with that of TPS.ResultsThe deviations of EDW wedge factors of symmetry fields and asymmetric fields are within 2.8％ and 19.4％ for ACA in Pinnacle3 9.0.Meanwhile,the deviations are 1.0％ and 2.0％ for AAA,1.2％ and 3.0％ for PBC in Eclipse7.3.The deviations between measurement and calculation of all fields profile for ACA is within 3％ and within 2.7％ for AAA within 4.0％ for PBC in wedge direction.For the dose distributions,we evaluated the pass rates of three algorithms using gamma analysis.The gamma pass rates among all the three algorithms in symmetry and asymmetric fields are above 87％ and 85％ respectively.After the removal of the penumbra zone,the pass rates among all the three algorithms are above 96％ in symmetry fields,and above 95％ in asymmetric fields,respectively.Conclusions AAA and PBC algorithms in symmetric and asymmetric fields can meet the need of clinical applications.While,wedge factor of ACA should not be used in clinical due to its greater error in asymmetric fields.

Case teaching method has been widely used in clinical medicine teaching.Because of the complicated diseases in elderly patients and the individual differences,it is difficult to achieve the goal of teaching only through several cases.Typical cases of different level are selected according to students' different learning stages and difficulty degree in longitudinal stepped case teaching.The students can gradually understand and master the theoretical knowledge through this method.In addition,their clinical thinking and the ability of solving practical problems can also be trained continuously.Preliminary practice shows that this teaching method is more suitable for the development of modern medical education and the needs of teaching.

The clinical teaching of geriatrics is difficult to arouse the students' interest. The flipped classroom teaching method can improve it through the interaction. We used WeChat as a platform for flipped classes and designed a variety of micro lessons. The participation and study interests of students were obvi-ously increased through exchanging teaching, answering questions and discussing. The teaching efficiency was also improved after strengthening practice. The preliminary practice shows that this teaching method can provide students a virtual teaching platform. It not only can enhance the teaching effect, but also can share teaching resources in network even for the long-term cross hospital and cross school exchange promotion.

Objective To analyze the difference of irradiation dose and volume of organs at risk (OAR) particularly in small intestine between supine position and prone position on intensity-roodulated radiotherapy(IMRT) for cervical cancer. Methods 11 patients with Ⅱ_B-Ⅲ_B cervical cancer were scanned with supine position and prone position by CT.The CT images were transported to TPS,then target volumes were delineated and the IMRT plans were designed respectively.The prescribed dose was 95%PTV receiving 45 Gy in 23 fractions of 2 Gy.The exposure volumes of the OAR at different position and different dose levels in the dose volume histograms (DVH) were compared and analyzed.Results When tlle dose di8tributions met to the clinic request,the exposure volumes of small intestine at prone position were redueed than that at supine position in dose range 46-30 Gy(P<0.05),but this phenomenon Was not distinct in low dose range(< 20 Gy)(P>0.05).The exposure volumes of bladder, rectum, femur head and spine cord were no obviously differences at dissimilar position. Conclusion IMRT of cervical cancer should adopt prone position.because their small intestine will be protected better.