Objective To study the clinical features of meniscal cyst of the knee. Methods From January 2001 to December 2007,totally 5986 cases of meniscus operation were performed in our hospital,104 of them were diagnosed as having meniscal cyst in the knee. The clinical data of these patients,including gender and age distributions,causes and mechanism of injury,clinical presentations,characteristics of the cyst,and the type of the injury,were investigated. Results Incidence rate of meniscal cyst was 1.7% (104/5986) and the ratio between medial and lateral meniscal cysts was 1∶12 (8∶96). The mean age of the 104 patients was (30.7?12.2) years (range,13 to 65 years),and the radio of male to female was 1.2 to 1. Of the patients,60 cases (57.7%) had history of trauma,32 or them were hurt in sports,including football (11 cases),basketball (8 cases) and others. The most common primary symptom was pain (102 cases,98.1%),followed by swelling (50 cases,48.1%). Tenderness over the joint line (85 cases,81.7%) and palpable mass (79 cases,76.0%) with or without signs of meniscal tear were common presentations. The anterior and middle portions of the medial meniscus (5/8,62.5%),and posterior extension of the lateral meniscus (88/96,91.7%) were the most commonly involved sites (?2=15.167,P=0.000). The most frequently observed meniscal tear was a horizontal cleavage,alone (25/104,24.0%) or associated with another types of lesions (52/104,50.0%). In 5.8% (6/104) of the cases,the discoid meniscus was involved. Conclusions Meniscus cysts are unusual. The ratio between medial and lateral meniscal cysts favors the lateral meniscus. Meniscal tear and myxoid degeneration are the common causes of the cyst. The most frequently observed meniscal tear is a horizontal cleavage,and the anterior and middle portions of the medial meniscus and posterior extensions of the lateral meniscus are the most commonly involved sites.

Objective To investigate the clinical effect of cervical circular cutting technique in the treatment of cervical intraepithelial neoplasia.Methods 120 patients with cervical intraepithelial neoplasia were selected.They were treated with cervical circular cutting technique,and the effect was analyzed.Results 120 patients after treatment,the obvious effective rate was 76.67 ％ (92/120),the effective rate was 19.17 ％ (23/120),the ineffective rate was 4.17％ (5/120),the total effective rate was 95.83％.The LEEP operation time was controlled at (9.0 ± 0.5)min,the intraoperative blood loss was (16.2 ± 1.2)mL.The postoperative pathologic examination results compared with cervical multi-point biopsy under colposcope had no statistically significant difference (x2 =1.238,P ＞ 0.05).Conclusion The cervical circular cutting technique in the treatment of cervical intraepithelial neoplasia has good effect,can not only completely remove cervical lesions,and has less blood loss,fewer complications,it is worthy of widely use in clinic.

Objective To verify and confirm the optical performance of the Olympus AU5400 Automatic Analyzer is satisfied for the professional requirements.Methods According to the Medical Standard of the People's Republic of China:Automatic chemistry analyzer(YY/T 0654-2008),the Analyzer Modular Ⅰand Ⅱ optical performance were measured to verify the stray light,the ab-sorption accuracy,linear range,stability and repeatability.Results The stray light absorption of tow modular was 4.789 4-5.158 9;The absorption accuracy of potassium dichromate standard solution (1-1)was (-0.002 1--0.024 7),and solution (1-2)was (-0.008 6--0.067 7);The D-value of stability that the highest absorption of standard solution (1-1)minus the lowest was 0.000 5-0.001 5;The CV% of repeatability for standard solution (1-2)was 0.02%-0.04%;Therof absorption linear was 0.999 6-0.999 9. Conclusion The optical performance of Olympus AU5400 Analyzer conforms to the standard of YY/T 0654-2008.

Objective To observe the effects of lycopene on fibrinolytic activity and nitric oxide in atherosclerosis rabbits. Methods 30 New Zealand rabbits were randomly divided into three groups. They were individually housed in metal cages. Throughout the experimental period, they were given restricted amounts of food. Control group was fed with normal diet,model group was fed with 1% cholesterol,10% lard and 89% normal diet, lycopene group was fed with 1% cholesterol,10% lard and normal diet plus 6% lycopene.At the time of the first day and the 8th week, blood samples were drawn from ear edge vein of rabbits. The activity and content of plashaa tissue type plasminogen activator(t-PA)and plasminogen activator inhibitor(PAI-1)were detected. The levels of serum Nitric oxide (NO)were determined.At the end of the study, the plaque areas were measured. SPSS 10.0 software was used to evaluate the differences among the three groups. Results Compared with control group, atherosclerosis rabbits had lower content and activity of t-PA, higher content and activity of PAI-1 and lower content of NO. Compared with model group, lycopene group had no significant difference about the content and activity of tPA and PAI-1.But lycopen increased the levels of serum NO, significantly diminished the area of lipid plaque. Conclusions The experimental results suggested that lycopene had antiatherogenic effects. The possible mechanisms might be that lycopene could decrease lipid peroxidation injure, maintain the concentration of NO and protect vascular endothelium. The antiatherogenic effects of lycopene had no correlation with the fibrinolytic activity.

[ ABSTRACT] AIM: To investigate the underlying genetic changes of a Chinese patient with infantile malignant osteopetrosis ( IMO) .IMO is a monogenic disease, mostly caused by mutations of TCIRG1 and CLCN7 genes.The former is believed a homozygous gene and only cause the disease in homozygous or compound heterozygous status.However, it has been reported that heterozygous mutations also cause the disease in 6 non-Chinese cases.METHODS:Genomic DNA was extracted from peripheral blood of the patient and his parents.All exons and splice sites of TCIRG1 and CLCN7 genes were amplified by PCR followed by Sanger sequencing.Mutation detection in the 2 genes was also investigated in the parents. Haplotypes were constructed by variations obtained in mutation detection and microsatillites flanking TCIRG1 gene in the family by Cyrillic.Chromosomal microarray analysis ( CMA) was performed to detect copy number variations ( CNV) of the patient and his mother.RESULTS:A novel mutation c.449_452delAGAG ( p.Gln149Glnfs16) was detected in the pa-tient.This mutation truncated 666 amino acids at the C terminal of the V-ATPase 116 kD isoform a3 protein.It wiped out the entire ATPase V0 complex and was predicted to result in total loss of protein function.This mutation was also detected in the patient’ s father.No pathogenic mutation was detected in CLCN7 gene.CMA did not reveal any CNV involving TCIRG1 or CLCN7 gene.CONCLUSION:We reported a novel heterozygous mutation of TCIRG1 gene causing IMO.This represents the first IMO case in China caused by heterozygous TCIRG1 gene mutation.

Objective To evaluate the diagnostic performance of diffusion kurtosis imaging (DKI) and its combination with DWI and proton MR spectroscopy (1H-MRS) in differentiating malignancy from benign breast lesions. Methods Fifty-three patients with 38 histopathologically confirmed malignant and 15 benign breast lesions were retrospectively studied. The patients were examined by breast MRI at 3.0 T prior to operation, including conventional T1WI, fat-suppression imaging, DWI, DKI and 1H-MRS. The shape and margin of breast lesions, and their corresponding mean values for ADC, mean kurtosis (MK) and mean diffusivity (MD) were determined by two blinded radiologists in consensus. The presence or absence of choline (Cho) peak was identified using LCModel software. Independent-samples t test or χ2 test was performed for the comparison of clinical characteristics, shape and margin of lesions, and imaging parameters between malignancy and benign lesions. ROC analysis was performed to evaluate the diagnostic accuracy of DKI, DWI and 1H-MRS alone or in combination, in comparison with the histopathologic findings. Results The onset age of breast malignancy was higher than that of benign ones, and the difference has statistical significant (P<0.05). Malignant lesions were most often seen in postmenopausal women, with unclear margin. There was no significant differences for body mass index (BMI), fiber type, the size and shape of lesions between benign lesions and malignancy (P>0.05). The mean ADC,MD and MK of benign lesions were(1.464 ± 0.348)× 10-3mm2/s,(1.726 ± 0.268)× 10-3mm2/s and(0.692 ± 0.227), the mean ADC,MD and MK of malignancy were(0.963 ± 0.170)× 10-3mm2/s,(1.158 ± 0.262)× 10-3mm2/s and(1.311 ± 0.218), respectively. Significant differences were obtained between benign and malignant lesions for all parameters (P<0.05).The area under the ROC curve (AUC) of ADC, MD and MK for differentiating malignancy from benign lesions was 0.913, 0.933 and 0.968, respectively. Taken the maximum Youden's index of MK (1.110) as the ROC optimal cut-off point, MK exhibited better diagnostic sensitivity, specificity and accuracy for distinguishing malignancy from benign lesions [89.5%(34/38),93.3%(14/15) and 90.6%(48/53), respectively], compared with MD and ADC. Multiparametric imaging with combination of DKI, DWI and 1H-MRS improves the diagnostic specificity (with the highest as 100.0%) but decreases the sensitivity (with the highest as 81.6% and lowest as 71.1% ), compare with the single parametric imaging. Conclusions MK generated from DKI enables differentiation of breast lesions with a higher diagnostic sensitivity and specificity than DWI and 1H-MRS. DKI combined with DWI and 1H-MRS increase specificity but decrease sensitivity for breast cancer characterization.

Objective To construct a large animal model of ischemic heart disease induced by acute myocardial infarction (AMI) . Methods Male Diannan Mini-pigs were selected (n=8), weight 20 ± 4 Kg. After general anesthesia and endotracheal intubation, blood pressure and electrocardiograph were monitored. Parasternal incision was taken and thoracotomyv was performed at 4th-to-5th intercostalgap. Pericardium was opened and left anterior descending artery was ligated. Echocardiography was performed at baseline, postoperative 28 and 60 day. Euthanasia and heart explanted was conducted at 60 day of experimental pig. After gross examination of the heart, the histological examination was used to assess myocardial infarction by using H&E staining. Results All of the pigs were presented with ventricular arrhythmias in varying degrees after ligation of the left anterior descending artery, of whom 2 died of refractory ventricular fibrillation, the mortality was 25%. Echocardiography assessment showed the loss left ventricular function, the thinning of left ventricular apical and the enlargement of left ventricule. Histological examination revealed that myocardial fibrosis and fibrous scar were formed in myocardial infarction area. Conclusion The ligation of left anterior descending artery through thoracotomy under direct vision is a reliable strategy for construction of AMI porcine model and the experimental porcine can develop ischemic cardiac dysfunction progressively.

Service learning is a kind of quality education way method that has sprang up in the United States and integrates service practice with academic courses. Through studying the relationship between service learning and medical ethics education of postgraduates with professional degrees in clinical medicine, combining the training characteristics of postgraduate with professional degrees in clinical medicine, this paper explored the specific application of service learning in the cultivating of clinical postgraduate medical ethics. This paper conducted a questionnaire survey including pre-tested and post-tested on the medical ethics among some students who participated in the medical ethics education, combined with individual interviews, and showed that the application of service learning model was an effective way to improve the effectiveness of medical ethics education for clinical graduate students, and it had played an active role in enhancing students' medical ethics cognition, improving their medical ethics and standardizing medical ethics behavior.

Objective To explore the application of transcatheter arterial chemoembolization (TACE) combined with selective portal vein embolization (SPVE ) in two-stage hepatectomy of hepatocellular carcinoma (HCC).Methods From September 2010 to September 2013,a total of 107 patients with HCC in the right liver lobe who were not suitable for one stage hepatectomy received TACE or TACE combined with SPVE treatment were enrolled.Among them,55 received TACE therapy and 52 accepted TACE combined with SPVE treatment.The technique success rate,complication,adverse reactions,the volume change of each liver lobe and the rate of hepatectomy of HCC were observed.Chi-square test was used for numerical data comparison and Student′s t test for measurement data.Results TACE or TACE combined with SPVE therapy was successfully applied in all the 107 patients,the technique success rate was 100%.During treatment period,no complications such as ectopic embolization, liver function failure,puncture tract bleeding,gastrointestinal bleeding,bile leakage and hepatic abscess were observed.After treatment,the adverse reactions included liver function impairment,pain in hepatic region,fever,nausea and vomiting.Four weeks after the treatment,the volumes of tumor and right liver lobe decreased to certain degree in patients with HCC of both TACE group and TACE combined with SPVE group.The volume of left liver lobe in TACE group had no obvious change,while remarkably increased in TACE combined with SPVE group.The pre-treatment residual liver volume (RLV)of TACE group and TACE combined with SPVE group was (404.0 ± 46.3 )cm3 and (393.9 ± 65 .7 )cm3 , respectively,and the difference was not statistically significant (t=0.927,P =0.356).Four weeks after the treatment,RLV was (415.4 ±45.7 )cm3 and (567.3 ±88.7 )cm3 ,respectively,and the difference was statistically significant (t= -11 .219,P <0.05).Patients were followed up for three to six months,the rates of hepatectomy were 38.2%(21/55)and 86.5 %(45/52)in TACE group and TACE combined with SPVE group,and the difference was statistically significant (χ2 =26.440,P <0.01 ).Conclusion For patients with HCC not suitable for one stage hepatectomy,the treatment of TACE combined with SPVE before operation could effectively control the growth of the tumor,decrease the volume of tumor,increase RLV,and then increase the rate of two-stage hepatectomy.

Objective To investigate the clinical effects and postoperative complications of arthrotomy and arthroscopy in repair of 170 menisci in 168 cases.Methods One hundred and sixty-eight patients with meniscus injury were repaired by arthrotomy or arthroscopy.They were 121 males and 47 females.There were 77 left knees and 91 right knees;117 medial menisci and 53 lateral ones.Their average age was 25.5?8.4 years old.Arthro- scopic repair methods included puncture and grinding,bio-absorbable meniscus arrow fixation,Outside-In suturing, Inside-Out suturing,Elite scuff instrument repairing,T-Fix fixation and FasT-Fix fixation techniques.The clinical results were assessed on the basis of symptoms,physical signs,Tegner scores and Lysholm scores of the cases. Postoperative complications were also investigated.Re-arthroscopic exploration was done for patients with obvious symptoms and physical signs.Results The average folluw-up time was 49.3?28.8 months.Their mean pre- operative Tegner score was 3.3?2.3,and their postoperative one 6.8?2.1 (P＜0.05).Their preoperative Lysholm score was 30.1?18.2,and their postoperative one 87.5?22.5 (P＜0.01).There were significant differences in Tegner and Lysholm scores before operation and after operation.Ninety-eight repaired menisci were rated as excellent(57.7%),57 as good (33.5%),10 as fair (5.9%),and five as poor (2.9%).The total ex- cellent and good result was 91.2%.Of the 19 patients with obvious symptoms and physical signs,re-arthroscopic exploration found no healing in five and partial healing in six.Postoperative complications included pain at the Outside-In suture nodes in three cases,referred pain at posterior articular capsule resulted from failed Outside-In meniscus anterior horn suturing in one case,and twinge at the meniscus arrow site in the posterior capsule in five cases.No serious lesion occurred at blood vessels or nerves.The postoperative complication incidence was 5.3%. Conclusion The eight methods of arthrotomy and arthroscopy to repair injured menisci investigated in our study can have a high successful rate and low perioperative and postoperative risk.