Objective To describe the method and the clinical effect of the transplantation of cutaneous iliac flap and external fixation for the repair of the defect of tibia and soft tissue of the leg. Methods Between May 1998 and May 2001, 22 tibial fractures associated with bone and soft tissue defects of the leg were treated with Bastiani external fixation device and transplantation of the groin osteocutaneous flap with the deep circumflex iliac vessels. There were 15 males and 7 females with the the age ranged from 16 to 58 years and an average of 37 years. The follow-up period ranged from 5 to 36 months, with an average of 25. 5 months. Results All the osteocutaneous flaps survived completely after operation; the defects were repaired at one setting; the external fixation apparatuses were steady and the fracture healed smoothly. The bone graft healed with the host bone in three to six months. The recovery of function of the limb were satisfactory. There were no major complicaton in this series. Conclusion The groin osteocutaneous flap with the deep circumflex iliac vessels can be used to repair the bone and soft tissue defects in the tibia at one setting. The external fixation device provides a convenient condition for bone graft and prevents the stress protection effect.

Alzheimer′s disease(AD)is one of the neurodegenerative diseases.Now it seriously threatens the life of the elderly.The pathogenesis of AD is not clear,thus there is no cure for this disease.The current treatment can′t reverse the pathological change of the disease or prevent the development of the disease,and the symptoms of the AD patients can only be partly improved.In recent years,the application of RNAi technology to the inhibition of the expression of the AD-related genes provides a new method for the treatment of AD.This article mainly introduces the application of the RNAi technology to AD.

Medical Solace Words are a kind of working language used by medical staff who tend to offer solace and encouragement to patients on purpose of medical treatment,and it is a kind of oral language frequently applied by medical staff in the new medical mode.Medical solace aims at decreasing and eliminating patients' negative emotions and improving their mood so as to establish a harmonious relationship between doctors and patients,and make the treatment smooth as well.This article analyzes medical solace words from the perspective of linguistic pragmatics,revealing that for the concealment and complexity of the expressing context for medical words,and the unique programmatic rules of medical language,medical staff should pay much attention to the language hierarchy and grasp the explanatory principle and the guiding principle of medical solace language to achieve the targeted effects of medical solace.

Objective This article provides a reform operative method for repairing non union in proximal or middle ulna Methods According to anatomical stady of recurrent interosseous artery from both blood supply and biology strength designs the transposition of proximal ulna periosteal bone flap, combining external fixator to repair non union in ulna Results Twelve cases of non union in proximal or middle ulna were treated by this means, these results were encouraging Conclusions Periosteal bone flap based on recurrent interosseous artery has a stable position, reliable blood supply and no injuring main vessel Moreover external fixator has many advanture, such as steady fixation, rarely damage, simply operation, function train early to prevent producing stiff joint, activate fracture with physiological force, Both can prompt the healing of fracture, It is an efficient method to cure non union in proximal or middle ulna

AimThe aim of this study was to establish a rodent model with similar characters of human metabolic syndrome(MS).Methods Three species mice and Wistar rats were fed with high energy chows(HEC)for 6 to 23 weeks.Animals were weighted every week.Fasting blood glucose(FBG)together with total cholesterol(TC)and low density lipoprotein-cholesterol(LDL-C)were investigated by oxidase test every two week.And fasting blood insulin(FINS)was determined by radioimmunoassay.Homeostasis model assessment of insulin resistance(HOMA-IR)was calculated as FBG×FINS/22.5.At the end of the experiment,oral glucose tolerance test(OGTT)was performed.Then animals were decapitated,and coel-fat and orchio-fat were collected and weighted to calculate the visceral fat coefficient(VFC).Results FBG,serum TC and LDL-C significantly increased(P<0.01)after 6 weeks feed of HEC in KM mice.The mice also formed abdominal obesity and insulin resistant together with impairment of glucose tolerance(P<0.05 or P<0.01).Though similar to the KM mice,C57BL/6 and BALB/c mice couldn't form abdominal obesity while the latter had increased body weight(P<0.05 or P<0.01).Wistar rats formed hyperlipidemia from 1 to 10 week and hyperglycemia from 10 to 23 week together with insulin resistance and impaired glucose tolerance(P<0.05 or P<0.01).Conclusion KM mice feed with HEC for 6 weeks could successfully establish metabolic syndrome mice model which might be suitable for drug-screening,the major characters includes the formation of abdominal obesity(increase of VFC),the increase of serum TC,LDL-C,FBG and HOMA-IR,and the decrease of OGTT.

Objective:To observe the effects of genistein on proliferation and apoptosis of human non -small cell lung cancer cell line A549/DDP.Methods:①MTT assay was applied to evaluate the resistance index of A 549/DDP cell line to cisplatin and half in-hibitory concentration ( IC50 ) .②Inhibition rate of A549/DDP cell proliferation and IC 50 value were evaluated by MTT assay after treat-ment with 0, 1.25, 2.5, 5.0, 10, 20, 40, 60, 80 μg/ml genistein for 48 hour respectively.③A549/DDP cell cycle and apoptosis were evaluated by flow cytometry after treatment with 6.25, 12.5, 25 μg/ml genistein for 24 hours respectively.Results:①In expo-sing to cisplatin, the IC50 of A549 and A549/DDP was 33.6 μmol/L and 76.9 μmol/L respectively.The resistance index was 2.3. Cell growth inhibition rate increased following the cisplatin concentration increasing gradually .②A549/DDP growth inhibition rate in-creased at first and later decreased gradually following treatment with the genistein dose increased .The IC50 of A549 and A549/DDP was about 85.1 μg/ml and 80.2μg/ml respectively.③After treatment with 6.25, 12.5, 25μg/ml genistein for 24 hours, there were more A549/DDP cells arresting and showing apoptosis along with the genistein dose increased .Conclusion: Genistein can inhibit A549/DDP proliferation, cause A549/DDP arresting in G2/M phase and induce A549/DDP cell apoptosis with dose dependently .

As an important neurotransmitter, adenosine displays its functions by acting on the adenosine receptors. Recent studies have shown that the distribution, expression and balance among subtypes of adenosine receptors are closely related with cognitive activities, and changes of adenosine receptors play key roles in neurodegenerative disorders including Alzheimer's disease. It has been pointed out that prolonged activation of adenosine receptors by high level adenosine may lead to the disturbance of balance among adenosine receptor subtypes. This imbalance mainly performed as increased expression of A2a receptor and decreased expression of A1 receptor, and enhancement of the excitatory signals mediated by A2a receptor and weakened inhibitory signals mediated by A1 receptor. Changes of these two subtypes of adenosine receptors may lead to a lot of disorders of neurological activities which developed into dysfunction of cognition to the end. These findings imply that the potential of maintaining the balance among adenosine receptors on the treatment of AD would facilitate both the revealing of the mechanism and the cure of AD.

Objective To explore the relationship between brain-derived neurotrophic factor (BDNF)gene polymorphisms and the susceptibility to pediatric epilepsy.Methods BDNF polymorphisms in 128 patients with pediatric epilepsy and 132 healthy controls were analyzed with polymerase chain reaction restriction and fragment length polymorphism (PCR-RFLP).Results There were significant differences between pediatric epilepsy and controls on genotype frequency of BDNF-270C/T (X2 =7.08,P =0.03 ).The CC genotype was positively associated with pediatric epilepsy (OR =3.91,95％CI =1.26 ～ 12.14).No differences in genotype or allele frequencies of the other polymorphisms were found between patients and controls.The frequencies of haplotypes did not show significant differences between patients and controls.Conclusion These findings support the hypothesis that BDNF-270C/T polymorphism may contribute to the risk of developing pediatric epilepsy.

Doctor-patient conflict is a social problem in the present phase of medical development in China that has come into being due to the huge gap between the doctor's and the patient's understanding and requirement concerning their roles,rights,obligations and interest.It results from intersection and collision of various social factors.From the sociological perspective,it has been found that the main causes of such a problem include: the limited health resources and its uneven distribution;the doctor as the monopoly of medical resources;the doctor and the patient both as seekers of maximal self-interest.According to the conflict theory in sociology,doctor-patient conflict can be classified,in terms of form,degree,and goal of conflict,into direct and indirect conflict,violent and non-violent conflict,and reality and non-reality conflict respectively.Indirect conflict and non-reality conflict deserve special attention because of their hiddenness,latency,and deep influence upon doctor-patient relationship.

With the developmetn of the medical humanistic education,more and more problems appear.The casualness of the medical humanistic curriculum,the monotony of the method of the evaluation,the insufficiency of the content,the inadequacy of the quality of the teachers,and the poor effect of the education are the factors affecting the development of our medical humanistic education.Through comparison of the humanistic education home and abroad,we find the key to these problems are the innovation of the curriculum and evaluation.