ObjectiveTo investigate the diagnostic and prognostic significance of serum human kallikrein11 ( KLK11 ) in patients with ovarian cancer. MethodsThe level of serum KLK11 was determined by enzyme-linked immunoassay(ELISA) for 30 patients with ovarian cancer, 26 patients with benign gynecologic processes and 32 healthy subjects,and the KLK11 value beyond the upper-limit of 95％ credibility interval( 95％ CI) based on the health controls was used as the positive value. The positive rate of KLK11 was compared among the three groups.ResultsThe positive rate of KLK11 in patients with ovarian cancer was significantly higher than those in patients with benign gynecologic processes or in healthy subjects[(73.3％) and(7.7％ ) or(6.3％ ) ,all P ＜0.01 )] ,and there was no significant difference between ovarian benign tumor group and the healthy control group ( P ＞ 0.05 ).ConclusionThe serum KLK11 should be a novel tumor marker in the clinical diagnosis of ovarian cancer.

Two-way choice is the main way for the seven-year-program clinical medical students and postgraduate supervisors.This article analyzes the influence factors and shortages of two-way choice for postgraduate supervisors and seven-year-program clinical medical students.This investigation discovers that the supervisor's abilities of research,teaching and clinical and their personal magnetism are important and key factors.The students' gender,character,hobbies and interests and the familiarity to profession are the secondary factors.The other factors that include employment status,the level of income and the advice of parents and friends also have influence on two-way choice for postgraduate supervisors and seven-year-program clinical medical students.In order to further improve the tow-way choice,the author gives some suggestions,including introducing profession and the scientific researches of supervisors in advance,encouraging the face-to-face communication between students and supervisors,promoting multiple profession choices and giving some aids to the students for choosing the supervisors.

OBJECTIVEThe objective of this paper was to study the expression of related protein and Twist transcription factor of epithelial-mesenchymal transition in oral squamous cell carcinoma (OSCC) tissue and the correlations of OSCC and oral squamous cell carcino-metastasis. The paper also investigated the clinical significance of expression on OSCC.

METHODSThe labels of epithelium materialization (E-cadherin and cytokeratin), stromal labels (N-cadherin), transcription factor Twist protein, and mRNA expression in 30 OSCC tissues were investigated via immunohistochemistry and in situ hybridization. The paper also conducted contrast analysis with clinicopathology.

RESULTSImmunization result showed that the expressions of Twist and N-cadherin in the OSCC group were more significant than those of the normal group (P<0.05). The expressions of E-cadherin and keratin in OSCC were significantly lower than those of the normal group (P<0.05). In the moderate- and low-differentiated group of OSCC, the expressions of Twist and N-cadherin were higher than those of the high-differentiated group (P<0.05). The expressions of E-cadherin and keratin were lower than those in the high-differentiated group (P<0.05). In the lymphatic metastasis group, the expressions of Twist and N-cadherin were higher than those of no-lymphatic metastasis group (P<0.05). The expressions of E-cadherin and keratin were lower than those of the no-lymphatic metastasis group (P< 0.05). Results of in situ hybridization showed that the expression of Twist mRNA in the moderate- and low-differentiated groups of OSCC, T3, and T4 groups as well as that of the lymphatic metastasis group were higher than those of the high-differentiated, T1 and T2 groups, and no-separate lymphatic metastasis group, and the differences were statistically significant (P<0.05).

CONCLUSIONEpithelium materialization exists in OSCC tissue. Twist can enhance the invasiveness of tumor cell and promote the infiltration and metastasis of OSCC. The combined detection of Twist, E-cadherin, and N-cadherin expressions can effectively predict and estimate OSCC metastasis.

Cadherins ; Carcinoma, Squamous Cell ; metabolism ; Epithelial Cells ; Epithelial-Mesenchymal Transition ; physiology ; Epithelium ; Humans ; Immunohistochemistry ; Lymphatic Metastasis ; Mouth Neoplasms ; metabolism ; RNA, Messenger ; Twist-Related Protein 1 ; metabolism

Objective To analyze the relationship between carotid intima-media thickness (CIMT) and metabolic syn?drome (MS), and explore risk factors for CIMT incrassation in Tianjin policemen. Methods Fifty MS patients (MS group) and 50 healthy people (control group) in health examination of Tianjin policemen were enrolled in this study. The question?naire survey(family history,past medical history,present history,living habits and occupational stress factors) were recorded in two groups of patients. The blood indicators (fasting plasma glucose, triglycerides, total cholesterol, high density lipopro?tein cholesterol, low density lipoprotein cholesterol, homocysteine) were detected. The color Doppler was used to measure CIMT incrassation, and incrassation ratio was calculated. The relative indicators were compared between two groups. The lo?gistic regression model was used to analyse the influencing factors of carotid artery intima-media thickness. Results CIMT and CIMT incrassation ratio (communis, internal and external carotid) were significantly higher in MS group than those of control group (P<0.01). The risk factors for CIMT included family history of hypertension, chronic stress, smoking, family history of diabetes, high fat diet and high homocysteine levels, and dairy products were protective factors for CIMT incrassa?tion. Conclusion The reason of carotid artery intima-media thickness is diversity. The healthy lifestyle and clinical inter?vention to retard CIMT are advocate, which are conducive to the control of atherosclerosis.

Objective To determine the safety location of the bony tunnel in reconstruction of the coracoclavicular ligaments on the basis of digital characterization of the anatomy of the clavicle and coracoid process.Methods Unilateral shoulder spiral CT scan was conducted in 30 patients without injury to the clavicle or coracoid process.They were 15 men and 15 women,aged from 20 to 71 years old (average,49.3 years).Thirty 3D digital models of the clavicle and coracoid process were constructed using the CT scan data by Mimics13.0.Half of the models were of the left shoulder and half of the right.Anatomic measurements of the clavicle and coracoid process were carried out on these models.Virtual transclavicular-transcoracoid bony tunnels were established according to the anatomy of the conoid ligament.Parameters of these bony tunnels were measured before the safety location was calculated.Results The mean clavicular length was 147.70 ± 5.34 mm in males and 133.09 ± 6.61 mm in females; the distance between the lateral edge of the clavicle and the center of the conoid tuberosity (CCD) was 35.90 ± 3.16 mm in males and 30.48 ± 0.54 mm in females; the distance between the lateral edge of the clavicle and the center of the trapezoid tuberosity (CTD) was 22.68 ± 1.23 mm in males and 18.69 ± 1.65 mm in females,with significant differences between genders (P ＜ 0.05).There were no significant differences between male and female regarding the ratio of the CCD to the clavicular length,the ratio of CTD to the clavicular length,or the mean internal rotational angle of the coracoid process (P ＞ 0.05).According the attachments of the conoid ligament on the clavicle and coracoid,from the superior-posterior edge of the clavicle to the anterior midpoint of the coracoid basement,the bony tunnels were established.These tunnels nearly bisected the cross section of the clavicle and coracoid basement,35.23° ± 2.36° medially inclined to the sagittal section and 5.91° ± 2.14° posteriorly inclined to the coronal section of the body.Conclusions To ensure that the bony tunnel should pass through the center of the clavicle and coracoid,it should be drilled from the superior-posterior edge of the clavicle and located at the clavicular attachment of the conoid ligament,tilting about 35° medially and 6° posteriorly to aim at the anterior midpoint of the coracoid basement.

BACKGROUND:Combination of mid-third clavicle fracture with acromioclavicular joint dislocation is a rare injury. The internal fixation treatment of this injury remains controversial.
OBJECTIVE:To investigate the treatment of a rare injury of mid-third clavicle fracture combined with acromioclavicular joint dislocation.
METHODS:Three patients with mid-third clavicle fracture with acromioclavicular joint dislocation from 2005 to 2011 were analyzed retrospectively. The three patients were treated with clavicle anatomic locking plate+wire subcoracoid cerclage, clavicle anatomic locking plate+clavicular hook plate and clavicle anatomic locking plate+dual Endobutton plate coracoclavicular ligament reconstruction, respectively. The treatment effects of these three methods were compared, including the operation time, blood loss, and the shoulder function evaluation.
RESULTS AND CONCLUSION:One case was misdiagnosed as simple mid-third clavicle fracture. Al the three patients were fol owed-up for more than 12 months, and the clavicle fracture healed in al three cases. The internal fixators were moved out at 12, 9 and 11 months, the Endobutton plate was stil in the body, and no redislocation happened in al cases. The pain, daily function, activity and muscle strength were compressively assessed before and after internal fixator removal. The scores of the three patients were 64, 71 and 92 before surgery, and 68, 79 and 95 after surgery. Patient treated with double Endobutton and locking plate had the best recovery. Double Endobutton plus clavicle plate are good choice as internal fixation in the treatment of mid-third clavicle fracture combined with acromioclavicular joint dislocation.

BACKGROUND:Treatment of complex tibial plateau fracture is a difficulty in orthopaedic trauma. Comprehensive assessment and appropriate surgical plan before surgery are the key points of surgery.
OBJECTIVE:To investigate the application value of three-dimensional reconstruction and virtual surgical techniques in assessing and surgical planning of complex tibial plateau fracture before surgery.
METHODS:The CT scan data of 30 patients with tibial plateau fracture were imported into the Mimics 13.0 software to establish the three-dimensional digital models of complex tibial plateau fracture, and three-dimensional measurements and reclassification was performed according to three-column classification were made. Virtual surgeries such as bone window operation, reduction of the fracture and bone grafting were made in these models.
RESULTS AND CONCLUSION:Reconstructed three-dimensional digital models of complex tibial plateau fracture could indicate the characteristics of fracture accurately, could be observed at any direction, and could help doctors to reclassify the fracture according to three-column classification. Virtual surgeries of bone window operation, reduction of the fracture and bone grafting made in computer by Mimics 13.0 were confirmed to be vividly simulate the clinical surgery, and helpful in estimating the amount of bone grafting. Three-dimensional reconstruction and virtual surgical techniques play an important role in assessing and surgical planning of complex tibial plateau fracture before surgery, which should be a conventional step in the management of complex tibial plateau fracture.

[Objective]To study the effects of different storage method on the viability of cheodroeytes so as to find out the idem method for preservation of articular cartilage.[Method]Under the aseptic condition,acquiring 240 pieces of osteoehondral plugs from both condyles of femur and tibial plateau.The control group was not treatment using any preserved means.The tissue-cultured group was to used F12-DMEM medium long-term preserved osteochondral plugs under the conditions of 37 ℃.At preserve 8 weeks,takes the osteochondral section to carry on examination observation ohondrocytes Viability activeness change separately.[Result]The control group chnadrocyte survival rate was 94.4%.At preserves 8 weeks,the cell survival rate of the tissue-cultured group was 76%,the grading-cooling cryopreservation group was 66%,the constant-cooling cryopreservation group only was 41.80%.[Conclusion]Under the condition of 37 ℃,tissue culture method can long term preservation of vital articular cartilage in vitro.The chondrocyte survival rate of the preservation of vital articular cartilage in vitro.The chondrocyte survival rate of the tissue-cultured method obvious higher than constant-cooling cryopreservation method.

As an essential part of all kinds of medical relations,the physician-patient relationship should be developed following the unceasing progress of medical modes.Patients were provided with the respect for their legal rights,dignity,freedom and personality with humanistic treatment and nursing care.With ethical and moral principles,such as patient first principle,body and mind unified principle,confidentiality principle,impartial treatment principle,optimization principle,medical informed consent principle,coordination principle and the principle of striving for perfection,patients' psychological state was taken into full consideration during perioperative period.Humanistic care is embodied by humanistic treatment and nursing care during perioperative period,and patients are provided with sympathy,encouragement and psychotherapy.The physician-patient relationship is improved and a harmonious medical atmosphere enhanced through humanistic caring.