Problem-based learning(PBL) has become new teaching model.It is considered that PBL is beneficial to practicing scientific logical thinking of clinical affairs,and to increasing their capabilities of learning,oral expression,communication and cooperation.To train new type of doctors in century 21st,it is necessary to use kinds of new learning methods,including PBL methods and standardized patient(SP) in clinical teaching.

BACKGROUND:Artificial biomaterials are used instead of the existing joints with obvious lesion, which is defined as artificial joint replacement, for the purpose of easing pain, correcting deformities, restoring and improving the joint function. OBJECTIVE: To investigate the effect of joint prosthesis materials and physical therapy after joint replacement. METHODS:Wanfang, CNKI and PubMed databases were retrieved for articles related to joint prosthesis materials and physical therapy after joint replacement published from 2000 to 2014 using the keywords of “artificial joints, joint materials, physical therapy” in Chinese and English, respectively. Papers published recently or in authoritative journals were preferred in the same field. Based on inclusion and exclusion criteria, 15 papers were included in result analysis. RESULTS AND CONCLUSION:Artificial joint prosthesis materials have their own rehabilitation programs. Physical therapy after joint replacement includes physical factor therapy and exercise therapy. Physical factor therapy can reduce the release of inflammatory factors and promote the absorption of inflammatory factors factor, effectively relive pain, and facilitate the drug release from bone cement containing antibiotic drugs under low-frequency ultrasound intervention. Exercise rehabilitation therapy assisted by continuous passive motion machine can promote lymphatic return, reduce limb sweling, avoid the occurrence of venous thromboembolism, prevent and treat joint contractures, strengthen the muscle and promote recovery of joint function after joint replacement. Appropriate joint prosthesis and reasonable physical therapy after joint replacement can accelerate patient’s rehabilitation, reduce complications and achieve a good joint range of motion.

BACKGROUND: The most commonly used physiotherapies for osteoporosis include low-frequency pulsed electromagnetic field, ultrashort wave therapy, and extracorporeal shock wave therapy. Because of the uncertain intensity of extracorporeal shock wave and uncertain efficacy of ultrasound therapy, low-frequency pulsed electromagnetic fields have become the most widely used treatment for osteoporosis in clinic. OBJECTIVE: To review the mechanism and clinical application of low-frequency pulsed electromagnetic fields in the treatment of osteoporosis. METHODS: A computer search by the first author of PubMed and CNKI databases was performed for relevant articles using the keywords of “pulsed electromagnetic fields and osteoporosis” or “osteoblast or osteoclast” in English and “osteoporosis; pulsed pulsed electromagnetic fields; osteoblasts; osteoclasts” in Chinese, respectively. After initial search, there were 169 articles, and according to the inclusion criteria, 29 highly relevant articles that are authentic and have clear views were analyzed. RESULTS AND CONCLUSION: The pulsed electromagnetic field as a non-drug therapy is characterized by no trauma, no infection, simple operation, low cost, long-term use, and good safety. Its efficacy has been increasingly affirmed by researchers and clinicians. Pulsed electromagnetic fields can promote the synthesis of DNA, influence the proliferation and differentiation of osteoblasts, increase the apoptosis of osteoclasts, and have a certain window effect. Pulsed electromagnetic fields can effectively relieve pain and increase bone density level in patients with osteoporosis, which can increase its efficacy in combination with other drugs and have a wide range of clinical applications.

In May 2005,269 patients with cnnfirmed stroke were enrolled in this studv and completed questionnaire survey or interview to explore the risk factors of the disease.Our results showed that Hypertension,tobacco smoking,alcohol intake,hyperlipidemia and diabetes mellitus were significant risk factors of stroke for patients.An earlier onset trend seemed to be found.According to these results.we proposed some effective interventions and standardized management to reduce the recurrence rate of stroke.

With increasing novel technology and new materials in the artificial limb, titanium alloy, carbon fiber and computer-based intelligentized control greatly improve quality of life of patients undergoing amputation. Depression, anxiety, self-concept change, increased compulsive sensitivity, and social adaptation changes are common mental problems in amputation and artificial limb treatments. Therefore, the rehabilitation therapy of amputation and artificial limb should involve both physical and mental aspects. The physicians should dredge and help the patients to face the reality and back to the life and society according to different disease conditions, various ages, social cultural background and economic conditions.

Objective:To investigate the clinical significance of the detection of cell surface marker and chromosome in diagnosis,treatment and prognosis of leukemia. Methods:Morphologic typing and immunophenotyping were carried out in 22 untreated patients with leukemia respectively with FAB criteria and monoclonal antibodies(McAb) which were used to label cell surface marker. Chromosomal specimens were prepared by 48-hour culture method. Chromosome was analysed by G-banding technique. Results:All the 22 cases were diagnosed as leukemia by combined detection of morphology and immunology. Among them there were 8 acute lymphocytic leukemia(ALL) in which 2 cases expressed myeloid lineage-associated antigens(My+ ALL),9 acute meylocytic leukemia(AML) and 3 chronic lymphocytic leukemia(CLL). In addition,2 cases were diagnosed as acute undifferentiated leukemia(AUL). Chromosomal karyotype analysis was carried out in 17 cases,among which chromosomal abnormalities were found in 11 cases in which 2 cases with complex chromosomal deformity had non-remission(NR). With the exception of the 2 cases aforementioned,others had complete remission(CR). Conclusion:The proper detection of cell surface marker and chromosome on limited condition is helpful for the diagnosis of leukemia,which would provide an experimental evidence for personalized treatment and prognosis.

Objective To observe the clinical effect of emergency operative treatment on thoracolumbar compression or burst fractures using pedicle screw instrument through posterior approach and indirect reduction.Methods53 acute thoracolumbar compression or burst fractures cases injured within 4 days were accepted the emergency operation of indirect reduction, decompression and fixation using pedicle screw instrument through posterior approach. The mean percentage of traumatic vertebral body height, sagittal diameter of spinal canal, degrees of kyphosis and Frankel scoring of nerve function were evaluated before and after operation.ResultsAll cases received two weeks following-up, 47 cases had more than one-year following-up. The mean percentage of traumatic vertebral height restored from 42.28% (pre-operation) to 93.46% (post-operation); the mean degrees of kyphosis recovered from 26.44° (pre-operation) to 17.73° (post-operation); the mean percentage of sagittal diameter of spinal canal changed from 63.14% (pre-operation) to 78.55% (post-operation). All but cases with completely spinal cord injury got more than one grade nerve functional restoration. Neither later spinal cord injury nor back pain existed among the patients. Three cases emerged partial internal fixation device failure, but neither symptoms nor abnormality correction missed.ConclusionEmergency operation using pedicle screw instrument through posterior approach is a feasible and confirmatory choice in treatment of the acute thoracolumbar compression or burst fractures if the cases are selected properly.

Objective To summarize the progresses in laboratory animal science in civil and military fields,and explore the problems existed in development of laboratory animal science in PLA. Methods Literature concerning the laboratory animal science published domestically and abroad were retrospectively and descriptively analyzed. Integrated with the practices on laboratory animal science,the strategies and suggestions for future development of laboratory animal science in PLA were herewith presented. Results Considerable developments have been achieved in the laboratory animal science in PLA,including the improved productive facilities and experimental conditions,and preliminarily established system of traiming of personnal. However,compared with the development level of laboratory animal sciences at home and that of abroad,such disparities as heterogeneity in quality of experimental animals from different breeding institues,lower standard in experimental technology,poorer foundation in the development of animal model special for military purpose,and lack of strategic reserve of laboratory animal resources,etc could still be found. Conclusions The development of laboratory animal science in PLA should depend on a combination of military efforts and civilian support,with establishment of the mechanism to share resources and professional personnel. Meanwhile a long-term mechanism should be developed for professional training of personnel in breeding experimental animals for researches in the field of military medicine,in order to establish a truly fundamental discipline of animal science for research of military medical sciences.

Iodine is the essential element of the human body. Both of iodine deficiency and iodine excess can produce different biological effects on organisms in various degree . It not only can damage the thyroid gland but also influence the nervous system and oxidize system, even damage hereditary material and immune system. The studies of the different biological effects of iodine deficiency and iodine excess on the cells and organisms can play an important role in unveiling the mechanisms of iodine deficiency disease and iodine excess disease. It also can offer the solution for preventing and curing the relevant disease of iodine.