Based on the shortcomings of graduate education in clinical medicine of our country and the characteristics of this specialty, the author point out that the cultivation of graduates in otolaryngology, head and neck surgery should be focused on the training of humanities, professional knowledge and skills. And they also make some suggestions and discussion about the reform of graduate education mode.

Objective:To provide informational and personalized health service platform for the current number of chronic diseases and health groups. Methods:a variety of portable devices physiological data were collected to transmit to the remote health monitoring platform, making the service with strong mobility for home care, postoperative care and patient care whenever and wherever needed to provide the best care service model, so that medical and health care is no longer subject to the constraints of time, hospitals and other fixed places. Results: Through a variety of wireless transmission technology and the intelligent terminal and regional health data center, it can be further mining, analysis and storage for the data information, and provide diagnostic advice. It can effectively alleviate the tension of medical resources. Conclusion:The establishment of remote health monitoring platform can alert doctors and relatives when data is abnormal to win time for rescue. It can effectively manage the disease treatment, prevention and rehabilitation.

CD3 Complex ; metabolism ; CD5 Antigens ; metabolism ; Diagnosis, Differential ; Female ; Gene Rearrangement, gamma-Chain T-Cell Antigen Receptor ; Humans ; Leukocyte Common Antigens ; metabolism ; Leukosialin ; metabolism ; Lymphoma, T-Cell, Cutaneous ; metabolism ; pathology ; Middle Aged ; Skin Diseases ; pathology

Objective To investigate the effect of combined application of mannitol and monosialoganglioside on neurological function and its efficacy in brain edema after intracerebral hemorrhage. Methods 92 cases of cerebral edema in patients with cerebral hemorrhage in our hospital, were randomly divided into groups, each group of 46 cases, the control group on the basis of the treatment of mannitol (125mL per times, once per 8h) treatment, the study group on the basic of control group received monosialogangliosides (20mg per times, once daily), 10d for a course of treatment, determination of serum indexes, neurological functions were recorded. Results The effective rate of control group was 71.74%, which was lower than 91.30% of the study group, there was significant difference (P < 0.05); compared with control group after treatment , in study group the intracranial pressure, intracranial hematoma, edema decreased, the urine volume increased, National Institutes of Health Stroke Scale (NIHSS) and quality of life score decreased, interleukin (IL-1β), high sensitive C reaction protein (Hs-CRP), IL-6 and IL-8 levels decreased, Na+-K+-ATP enzyme increased, the ratio of cerebrospinal fluid albumin and serum albumin, matrix metalloproteinase (MMP-2) and MMP-9 decreased, there were significant differences (P < 0.05). Conclusion The effect of the combined application of mannitol and monosialoganglioside on cerebral edema after cerebral hemorrhage is exact and could improve neurologic function.

OBJECTIVETo evaluate clinical results of plate on the metatarsal side to reconstruction of tarsometatarsal joint dislocations secondary to diabetic charcot foot.

METHODSSeven patients (9 feet) patients with tarsometatarsal joint dislocations secondary to diabetic charcot foot were treated with plating from April 2012 to December 2014. All patients were male, and 5 cases were on the unilateral side and 2 cases were on the bilateral sides. The age of patients ranged from 45 to 52 with an average of 48 years old. The history of diabetics was from 6 to 15 years. X-ray and CT were used to evaluate fractures healing,and AOFAS was applied to estimate recovery of joint function.

RESULTSAll patients were followed up from 12 to 24 months with an average of 19 months. All incisions were healed at stage I . No infection, loosening and breakage of internal fixation, bone nonunion were found after operation. According to postoperative X-ray and CT results, the time of fracture healing ranged from 10 to 20 weeks with an average of 16 weeks. Six feet got excellent results, 2 good and 1 moderate based on AOFAS scoring.

CONCLUSIONTarsometatarsal joint dislocations secondary to diabetic charcot foot treated with plate on the metatarsal side could obtain stable fixation and got satisfied early clinical results.

Adult ; Bone Plates ; Diabetes Complications ; surgery ; Diabetes Mellitus, Type 2 ; complications ; Female ; Foot Diseases ; etiology ; surgery ; Fracture Fixation, Internal ; Humans ; Joint Dislocations ; surgery ; Male ; Metatarsal Bones ; surgery ; Middle Aged ; Tarsal Joints ; surgery

Breast ; pathology ; Breast Neoplasms ; blood supply ; pathology ; Carcinoma, Ductal, Breast ; blood supply ; pathology ; Carcinoma, Intraductal, Noninfiltrating ; blood supply ; parasitology ; Female ; Humans ; Hyperplasia ; Microcirculation ; pathology ; Neovascularization, Pathologic ; pathology

Objective To analyze the efficacy and safety of CT-guided percutaneous injection of the fibrin glue bv double needle technique to treat sacral cyst.Methods Clinical data of 20 cases with double-needle injection of fibrin glue technology to treat sacral cyst were retrospectively analyzed.All patients had varying degrees of sacral nerve root compression symptoms.The treatment for sacral cyst was carried out after clear diagnosis was made.On the basis of CT-guided percutaneous injection of fibrin glue,the improved CT-guided percutaneous injection of fibrin glue by double-needle technique was used to treat these patients.The average dose of fibrin glue was(5.9 ± 2.4)ml.The clinical results of improvement as to pain and neurological function were evaluated after follow-up of an average of 17 months.The assessment criteria were as follows:excellent,complete resolution of signs and symptoms,with the patient returning to his or her regular employment and no recurrence of cysts during 1 year of follow-up,good,symptoms and signs in the legs and perineal region resolved but with persistent pain in the lumbosacral region,which did not interfere with the patient' s regular work (the cysts did not recur for 6 months during follow-up),fair,no improvement in clinical symptoms,but a decrease in cyst size on the imaging study,poor,no improvement in clinical symptoms and no observed changes in cyst size in imaging studies or recurrence.Results Most patients experienced some degree of pain relief and functional improvement after fibrin glue therapy,with most experiencing complete or marked resolution of clinical symptoms.Nine patients reported excellent recovery,8 reported good recovery,2 reported fair recovery,and 1 reported poor recovery.The overall percentage of positive outcomes (excellent and good recovery) was 85％.No serious postoperative complications were discovered.Conclusions CT guided percutaneous injection of the fibrin glue bydouble needle technique to treat sacral cyst is an ideal method.Double needle technique is simple,safe and reliable.

BACKGROUND:Studies have shown that the reason of the slower liver regeneration in individuals of cirrhotic liver after partial hepatectomy compared with healthy liver may be related to the delayed synthesis and secretion of hepatocyte growth factor during liver regeneration, but the cause of this phenomenon is not clear. The hepatocyte growth factor activator inhibitor found in recent years can indirectly inhibit the activation of hepatocyte growth factor, but there is little research to explore the expression of hepatocyte growth factor activator inhibitor in the regeneration process after partial hepatectomy in cirrhotic liver and its relationship with the liver regeneration. OBJECTIVE:To investigate the expression of hepatocyte growth factor activator inhibitors (HAI-1, HAI-2) during cirrhotic and normal liver regeneration after partial hepatectomy through establishing the cirrhotic rat model, and to explore the biological effects of HAI-1, HAI-2 in cirrhotic liver during the liver regeneration after partial hepatectomy. METHODS:We used 40%CCl4 subcutaneous injection to establish the cirrhotic rat model, then we performed 70%liver resection for the experimental group. The rats in the control group only received ordinary water feeding and 70%liver resection. Rats in each group were randomly sacrificed before surgery and at 3 hours, 6 hours, 12 hours, 24 hours and 48 hours after surgery, and samples were col ected. We used RT-PCR technology to detect the expression of HAI-1 mRNA, HAI-2 mRNA in splenic tissue. RESULTS AND CONCLUSION:The expression levels of HAI-1 mRNA of two groups after partial hepatectomy were increased firstly and then decreased. The expression of HAI-1 mRNA in cirrhotic rats was sustained higher than that of the control group (P<0.05), there was no significant difference between the two groups of the expression of HAI-2 mRNA (P>0.05). The expression of HAI-1 mRNA in liver cirrhosis rats after resection was consistently higher than that in healthy rats, which may lead to the insufficient synthesis and secretion of hepatocyte growth factor activator in cirrhotic rats, then hepatocyte growth factor precursor may not be activated enough, eventual y leading to slow liver regeneration. HAI-2 may not be involved in the wound repair process of liver.

Objective To evaluate the application value of DNA ploidy detection using flow cytometry method(FCM)in malignant tumor identifi?cation,so as to provide the theoretical basis for the clinical diagnosis of malignant tumors. Methods Two researchers finished the literature screen?ing independently,and all the literatures were given the secondary screening according to the inclusion and exclusion criteria. The included literature data was analyzed by Meta?DiSc 1.4,including heterogeneity test,sensitivity,specificity,diagnostic odds ratio(DOR)and summary receiver operat?ing characteristic(SROC)etc. Results Totally 12 literatures were included in the study finally,including a total of 1 340 subjects consisting of 516 cases with malignant tumor and 824 cases with benign tumor. Heterogeneity inspection results showed that the Spearman correlation coefficient of sensitivity logarithm and(1-specificity)logarithm was-0.343 and there was no threshold effect(P=0.275). DOR curves was Cochran?Q=26.49 (P=0.005 5),indicating the heterogeneity was caused by non threshold effects. Combined statistical quantity was calculated with a random effects model and the results were as followings:the sensitivity was 0.72(95%CI:0.68?0.76,I2=50.1%)and the specificity 0.84(95%CI:0.81?0.86,I2=65.5%). SROC curve drawing,DNA ploidy detection of benign and malignant tumors showed AUC=0.845 3 and Q*=0.776 8. Conclusion FCM DNA heteroploid has a high accuracy for diagnosis of malignant tumor,which can be an important supporting means for the discrimination between benign and malignant tumor.

Objective To observe the effect of vascular endothelial cell growth factor (VEGF)on apoptosis and matrix metabolism of rat intervertebral.disc cells cultured in vitro. Methods Culture system of rat intervertebral disc cells was established to culture the monolayer intervertebral disc cells in vitro.The well-grown intervertebral disc cells of the second generation were chosen and anti-Fas antibody was applied to induce their apoptosis.Then,VEGF at different concentrations ( 10,100,1 000 μg/L)were used to affect their apoptosis and metabolism.The apoptosis of the cells stained with Propidium Iodide (PI) was detected by using flow cytometry.The levels of hydroxyproline and proteoglycan in the culture medium were detected by using chloramines T method and DMB chromometry method,respectively.Results ( 1 ) The apoptotic ratio of the intervertebral disc cells affected by different concentrations of VEGF (10,100,1 000 μg/L) was (87.62 ±11.06)％,(53.30 ±9.23)％ and (16.75 ±4.21)％ respectively,with significant differences in comparison with the control group (P ＜ 0.01 ).(2)The contents of hydroxyproline [ (6.71 ±0.33) μg/L,(9.12 ±0.41 ) μg/L,( 11.58 ±0.12) μg/L] and proteoglycan [ (23.21 ± 2.87) μg/L,( 32.45 ± 5.23 ) μg/L,(37.18 ± 3.22) μg/] in the culture medium raised with the increase of VEGF concentration ( 10,100,1 000 μg/L),with statistical differences compared with those of the control group (P ＜0.01 ).The contents of hydroxyproline and proteoglycan were positively correlated with the concentration of VEGF (ra=0.972,P＜0.01;rb =0.907,P＜0.01). Conclusion VEGF can inhibit the apoptosis of the rat intervertebral disc cells cultured in vitro and promote collagen and proteoglycan synthesis of the cell matrix.