By analyzing 94 questionnaires of majors in medical imaging technology on medical ethics teaching,we found that some teaching models will help students realize the necessity of studying medical ethics and case teaching,including increasing the expansion of case teaching,selecting certain videos and short films into case teaching,expanding case-study model and case-exploration model,strengthening teachers' after-case-teaching summary to advance and further ethical themes.These models will also improve students' ability in ethical analysis and their sense of ethics,and will surely apply the theoretical principles into practice once they are interested in studying medical ethics.

BACKGROUND:The molecular mechanism of periprosthesis osteolysis is not yet completely clear. Periprosthetic osteolysis and absorption is the pathological and physiological process typical of artificial joint loosening. Interleukin-1 can affect bone resorption process through a mitogen-activated protein kinases (MAPK) signaling pathway.
OBJECTIVE:To explore the effects of siRNA-induced interleukin-1 receptor-associated kinase-4 gene (IRAK-4) silence on MAPK expression in MG63 cells, which may provide experimental basis for treatment and prevention of periprosthesis osteolysis.
METHODS:The siRNA sequences of the target gene, IRAK-4, were constructed and transferred into MG63 cells using Lipofectamine 2000. There were three groups:blank group=MG63 cells, control group=MG63 cells transfected with scrambled IRAK-4siRNA, and silence group=MG63 cells transfected with specific IRAK-4 siRNA. The protein level of extracellular regulated kinase (ERK), c-Jun N-terminal kinase (JNK) and p38 mitogen-activated protein kinases (p38MAPK) were detected by western blot assay.
RESULTS AND CONCLUSION:The expression of IRAK-4 mRNA and protein in the silence group was significantly decreased compared with the control group. Compared with the blank and control groups, 48 hours after the transfection, IRAK-4 gene silencing in MG63 cells decreased protein expression of p-JNK1/2P46, p-ERK1/2 and p-p38MAPK (P<0.05). IRAK-4 silencing inhibited ERK, JNK and p38MAPK expression in osteoblast-like cells.

Objective To investigate the effect of selectively upward placement of acetabular implants on limb length and post?operative function of developmental dysplasia of the hip patients with shortened legs during total hip arthroplasty (THA). Methods Twenty?six cases of developmental dysplasia of the hip received THA between January 2008 and December 2013, in?cluding 12 cases of Crowe typeⅠ, 8 of Crowe typeⅡ, 6 of Crowe typeⅢ. There were 5 males and 21 females with an average age of 62.7 years (range, 36-80 years). The left hip was involved in 9 cases and the right hip in 17 cases. The preoperative mean Har?ris score was 42.30±12.84, and the preoperative mean WOMAC score was 59.08±13.84 at the last follow?up. The anteroposterior X?ray films and CT scan of the pelvis, anteroposterior and lateral X?ray films of the femur, and TraumaCad analysis were conducted routinely preoperation. More than 70%of the bone?implant interface was covered by appropriate upward distance of acetabular im?plant. Results The follow?up time ranged from 6 to 73 months (mean, 36 months). The Harris score improved to 91.18±7.09, and WOMAC score reduced to 9.85±3.75. According to postoperative measurement, affected limb had been lengthened by 0-5 mm in 8 cases, 6-10 mm in 5 cases, 11-15 mm in 5 cases,>15 mm in 7 cases, and shortening increased 1 mm in 1 case, but the average lengthening was 9.23±7.54 mm. The upward distance of acetabular implant was 0-5 mm in 10 cases, 6-10 mm in 7 cases and>10 mm in 9 cases. The average lengthening was 6.60±6.72 mm in patients having 0-5 mm upward distance, 11.90±5.64 mm in patients having 6-10 mm upward distance and 10.11 ± 9.35 mm in patients having>15 mm upward distance, showing no significant differ?ence. The leg length discrepancy was-3.70±6.43 mm in patients having 0-5 mm upward distance, 1.71±6.24 mm in patients having 6-10 mm upward distance and 0.56 ± 7.70 mm in patients having>15 mm upward distance, showing no significant difference. Con?clusion The limb length could be improved by selectively upward placement of acetabular implants in developmental dysplasia of the hip patients with anatomically abnormal acetabulum during THA, with reasonable preoperative design and corrective operation.

Objective To introduce a self-developed computer-assisted design/rapid prototyping and guidance system used for precise placement of the acetabular component in total hip arthroplasty.Methods We collected the preoperative pelvic CT scanning data of 10 hips with aeetabular dysplasia that had undergone primary total hip arthroplasty from January 2016 to January 2017.The total time for import of radiographic images,model reconstruction,model segmentation,acetabular component position design and STL model export was calculated and compared between our self-designed software and Mimics vl 7.0.Three kinds of STL model from each case were imported into our self-developed 3D printing device,Stratasys Objet30 and Stratasys Demension SST1200es respectively for rapid prototyping.The printing efficiency and accuracy were compared among the 3 printers.The accuracy of placing acetabular component with guidance system was evaluated.Results The average time forpreoperative planningwas7.7±1.3 minbyourself-designedsoftware and 52.5 ± 15.9 min by Mimics v17.0,showing a significant difference (P ＜ 0.001).In morphological point-based comparison for each case,the 3D models exported by the 2 different kinds of software showed an average difference of 0.072 1 ± 0.069 1 mm.The average durations for rapid prototyping by the 3 different printers were 5.3 ± 0.6 h,10.8 ± 0.5 h,and 9.3 ± 0.6 h,respectively,showing significant differences (P ＜ 0.001).The guidance system resulted in precise placement.The locations of the acetabular component achieved by guide-assisted placement were not significantly different from the target ones (P ＞ 0.05).Conelusion Our self-developed preoperative planning software,rapid prototyping device and guidance apparatus for acetabular component placement may lead to good accuracy and high efficiency.

BACKGROUND:Previous studies have indicated that resistin stimulates a large set of chemokines in chondrocytes that are known to be important in inflammatory joint lesions.
OBJECTIVE:To further investigate the mechanism of co-regulation roles of transcription and post-transcription in the up-regulation of two chemokine genes CCL3 and CCL4 in chondrocytes in response to resistin.
METHODS:Human chondrocytes, T/C-28a2 and ATDC5 cels were cultured. The function of resistin on the chemokine genes, and the expression of C/EBPβ, nuclear factor-κB isoforms and chondrogenic specific miRNAs were tested by qPCR. The co-regulation of C/EBPβ and nuclear factor-κB was investigated by nuclear factor-κB inhibitor (IKK-NBD) and C/EBPβ inhibitor (SB303580) treatments, and subcelular localization was detected with or without resistin stimulation.
RESULTS AND CONCLUSION:Resistin could increase the expression of chemokine genes independently. Chondrocytes reacted in a non-restrictedly cel-specific manner to resistin; C/EBPβ inhibitor, nuclear factor-κB and some chondrogenic specific miRNAs in a combinatorial manner regulated chemokine gene expression. The activity of C/EBPβ was augmented by a transient increase in activity of nuclear factor-κB, and both transcription factors acted independently on the chemokine genes, CCL3 and CCL4.

The purpose of this study was to evaluate the necrosis target and imaging potential of necrotic myocardium of 131I-emodin and 131I-emodic acid. The iodogen coating method was used to radioiodinate emodin and emodic acid with iodine-131. Mice model of muscular necrosis and rat model of myocardial infarction(MI)were established to evaluate the necrosis affinity and imaging potential of 131I-emodin and 131I-emodic acid. Mice were sacrificed at 2, 12 and 24 h after injection respectively. The radioactive uptake in major organs and necrotic muscle were calculated by a γ-counter. At 6 h after administration, SPECT/CT imaging of necrotic myocardium in rats, biodistribution detection, histopathological analysis were applied to evaluate their necrosis affinity and imaging potential. The results of biodistribution from mice demonstrated that 131I-emodin and 131I-emodic acid showed peculiar necrosis target and exhibited an obvious clearance of radioactivity from normal organs. On SPECT/CT images, relatively high uptake as a hot spot was shown in the heart of the model rat, while no obvious uptake was observed in the heart of the control rat. The radioactivity ratios of necrotic to normal myocardium of 131I-emodin and 131I-emodic acid amounted up to 9. 72 and 13. 14 by quantitative autoradiography analysis, respectively. These results suggested that 131I-emodin and 131I-emodic acid possess the necrosis target and imaging potential of necrotic myocardium.

Objective:To introduce a reliable and easy method of philtrum crest and philtrum repairing in secondary repair of cleft lip.Methods:Lift the upper lip flap after removing the scar on upper lip. Then the superficial orbicularis oris muscle was carefully separated, which formed the abnormal muscular eminence in the affected side after the first cleft lip repair. The pedicle of the orbicularis oris muscle the reconstructing philtrum crest. The lingual orbicularis oris muscle flap was lifted and curled from outside. The superficialorbicularis oris muscle was cut in philtrum longitudinally and turned outward. The two evertedorbicularisoris muscle flaps were sutured on both sides and fixed them on the reconstructing philtrum crest. The exposed deep orbicularis oris muscle in philtrum was sutured with the upper dermis, which formed the prominentphiltrum crest and deeper philtrum.Results:We reviewed the hospital records of patients from July 2008 to November 2021. In total, 201 patients were included in this study. All of these patients underwent the reconstruction of philtrum crest and philtrum with orbicularis oris muscle intertangling and philtrum plasty in secondary cleft lip repairing. During the treatment, the patients had no complications such as infection, hematoma and flap necrosis.198 patients were observed from 1 months to 36 months (7.8 months on average). All of them improved in different degrees in early postoperative period. Most reconstructed philtrum crest was raised and basically symmetrical with the contralateral side in shape. The philtrum was clear and the scar was not obvious. The reconstructed philtrum crest would decrease with time. 91.7% (90/98) patients were satisfied with the postoperative effects after three months.Conclusions:The method of reconstruction of philtrum crest and philtrum with orbicularis oris muscle intertangling and philtrum plasty in secondary cleft lip repairing is safe and effective. The long term postoperative effect is stable with high satisfaction as well. As a result, this method can be used as the philtrum crest and philtrum correction scheme for secondary cleft lip repairing.