BACKGROUND:Currently, there is a lack of effective hip preserving therapy in patients with alcohol-induced osteonecrosis of femoral head. Artificial hip replacement is the only choice for the patients whose function of the hip joint is affected by the colapse of the femoral head in the late stage. Therefore, to understand the pathogenesis of alcohol-induced osteonecrosis of femoral head is of great significance for the effective hip preserving therapy in patients.
OBJECTIVE: To review the research progress in apoptosis of bone cels in the pathogenesis of alcohol-induced osteonecrosis of femoral head both at home and abroad in recent years, so as to provide a theoretical basis for the study of the treatment of alcohol-induced osteonecrosis of femoral head.
METHODS:PubMed and Embase databases were retrieved by the first author using computer to search relevant articles addressing the effect of apoptosis of bone cells in the pathogenesis of alcohol-induced osteonecrosis of femoral head. The keywords were “osteonecrosis of femoral head and apoptosis”, “bone cell, apoptosis, gene, signal” or “osteonecrosis, alcohol”in the title and the full text. Repetitive and old literatures were excluded, and finally 40 foreign language articles were included in result analysis.
RESULTS AND CONCLUSION: In recent years, the theory of apoptosis of bone cells in the pathogenesis of alcohol-induced osteonecrosis of femoral head has been gradually recognized and has become the focus of research on the pathogenesis of alcohol-induced osteonecrosis of femoral head. Apoptosis of bone cells plays an important role in the pathogenesis of alcohol-induced osteonecrosis of femoral head. Various genes, such as p53, Bcl-2 family, tumor necrosis factor, Caspase, are crucial to control the apoptosis of bone cells. Although we have made some progresses at the gene level, there is still a lack of relevant studies on alcohol-induced osteonecrosis of femoral head due to the complexity of pathogenesis.

The research documents about educational system of medical schools were reviewed,and after deep analysis,some inadequacy was found by means of how to learn from advanced skills and how to improve the benefit of health service.This paper also put forward the chain of thought about reform of educational system of medical schools.

Academic teaching,scientific research and social service are the three major functions of higher school and there is an internal logical relationship among them.To give better explanation and evaluation on the relationship among the three functions of higher school,the pa-per puts forward the theory of bearing which is based on the relevant studies and its merits and demerits.

AIM: To analyze the characteristics of internal fixation implantation therapy for comminuted patella fracture. METHODS: A computer-based search of Pubmed database and Chinese Journal Full-text Database was undertaken, and the quotations of each literature were checked after the primary screening. Inclusion criteria: the papers about the application of internal fixation materials in comminuted patella fracture, those published in authority journals within recent five years were preferred. Exclusion criteria: repeated study or Meta analysis. RESULTS: Internal fixation approach differs as the fracture type. Tension band fixation is generally accepted to treat transverse patella fracture. Kirschner wire plus tension band fixation are inferior to transverse fixation, but in comminuted fracture it can induce more complications; despite of wide application, nickel titanium patella fixator is unsuitable for comminuted fractures due to its hypersensibility and carcinogenicity; silk or steel wire loop fixation fits various comminuted fractures, but metal cerclage is predisposed to induce infection and breakage because of insufficient fixation force. CONCLUSION: There is no common way for comminuted patella fracture therapy. Further researches on material and method which can cure all kinds of comminuted patella fracture are still needed.

Objective To investigate the causes and treatment of lymphatic fistulas(LF) after radical operation of gastric cancer . Methods We observed the clinical data of 31 cases of lymphatic fistulas after the radical operation of gastric cancer , including the amount of drainage from the abdominal cavity, the levels of hemoglobin and serum albumin, post operative morbidity and the survival rate. Meanwhile, the difference in the amount of abdominal drainage before and after using octreitide was observed in LF patients. Results The rate of complications in the LF group was significantly higher than that in the non LF group(control group) (P

Objective:To explore the clinical characteristics and diagnosis and treatment of occult poisoning caused by long-acting anticoagulant rodenticides.Method:Records of 12 patients from July 2008 to April 2011 diagnosed as anticoagulant rodenticide occult poisoning,who had been misdiagnosed initially at other hospitals were analyzed retrospectively.Elements from the records included clinical symptoms and signs,laboratory findings for prothrombin time (PT) and activated partial prothrombin time (APTT),and initial misdiagnosis and treatment outcome at our hospital.Results:The clinical presentations of patients were insidious and serious,often presented as skin ecchymose,hematuria,menorrhagia and gastrointestine bleeding.Laboratory examinations showed prolonged PT and APTT; bleeding was controlled effectively by administoring vitamin K1 daily.There were statistical difference between PT and APTT before and after the treatment (P＜0.01).Conclusion:Coagulation disorders might be caused by the reduced acquisition in vitamin K dependent coagulation factors,which tends to be neglected due to a hidden medical history,delayed signs of poisoning,and various organs involved.A detailed patient history and systematic review may improve the diagnostic accuracy.Once diagnosed is made,vitamin K1 should be given as soon as possible.

Clinical data of 150 pregnant women,who were confirmed with maternal thyrotoxicosis during January 2010 to January 2014,including 104 cases of gestational transient thyrotoxicosis (GTT) and 46 cases of Graves disease (GD),were retrospectively analyzed;65 normal pregnant women served as controls.Patients with GD had lower body mass index (BMI) than those with GTF and normal controls [(18 ± 5),(20 ± 4) and (22 ± 4) kg/m2,respectively,P ＜ 0.05].The frequency of thyrotoxic history and hyperthyroidism symptoms in GD patients were significantly higher than that in GTT patients [33％ (15/46) vs.3％ (3/104) and 52％ (24/46) vs.15％ (16/104),respectively,both P ＜0.01].In the first trimester,patients with GD presented lower TSH levels than those with GTT and controls(M =0.021,0.045and 1.660 mU/L,respectively,P ＜ 0.05) and higher free T4 (FT4) (M =24.99 vs.19.99 pmol/L,P ＜0.05),free T3 (FT3) (7.10 vs.5.85 pmol/L,P ＜ 0.05),thyroid peroxidase antibody (TPOAb) (99.22vs.4.54 kU/L,P ＜ 0.05) and thyrotrophin receptor antibody (TRAb) (5.28 vs.0.11 U/L,P ＜ 0.05)levels than patients with GTT.In the second trimester,there were 67％ (70/104) GTT patientsand 4％ (2/46) GD patients had normal TSH;and FT4 returned to normal in 82％ (85/104) GTT patientsand 17％ (8/46) GD patients.In the third trimester,there were 100％ (104/104) GTT patients and 9％ (4/46)GD patients had normal TSH;and FT4 returned to normal in 100％ (104/104) GTT patients and 48％ (22/46)GD patients.

Radiotherapy(RT) is one of the principle treatment options for prostate cancer.Modern RT and surgery show similar progression-free survival in localized prostate cancer.Adjuvant RT compared to observation significantly diminishes the risk of prostate-specific antigen (PSA) progression and local failure for patients at the highest risk for recurrence after radical prostatectomy,including with seminal vesicle invasion,extraprostatic extension,extensive positive margins,and detectable postoperative PSA.Salvage RT is effective at controlling local recurrence and reduces the risk of distant metastasis and prostate cancerspecific mortality (PCSM) for patients with PSA or local recurrence after prostatectomy.Hypofractionated radiotherapy of recent years' reports shows similar cancer control rates without an increased risk of late toxicity in comparison to conventional regimens.The addition of androgen-deprivation therapy (ADT) to radiation improves the overall survival and biochemical progression-free survival(bPFS) for intermediate-risk and high-risk patients.

Objective: To develop a quality of life instrument for hepatitis B patients(QOL-HBV) and examine it's reliability and validity.Methods:The item analysis, construct validity, content validity, criteria validity, reliability and discriminate were assessed by a survey on 134 HBV patients with QOL-HBV.Results:Item analysis showed that QOL-HBV had satisfactory item discrimination. Eight common factors were extracted by exploratory factor analysis and they can be reduced to three domains. The ?2/DF was 1.310, GFI was 0.972 and AGFI was 0.967 by the confirmatory factor analysis. The coefficients of Cronbach's ? of the instrument and all domains were above 0.80. In comparison with SF-36, there was good correlation among corresponding domains.Conclusion:QOL-HBV is a good scale in testing the quality of life, which has good reliability and validity.

0.05). After the injection, PaO 2 in group A, B and C increased significantly, whereas PaO 2 in group D did not change and was kept at low level below 13.3kPa (P