Evidence-based practice advocated that clinical decisions should based on the most relevant and valid evidence. The medical postgraduates in our university were investigated with questionnaires about their influencing factors of the evidence-based practice. The countermeasures were found to improve the competence of evidence-based practice.

Objective To investigate the relationship between thyroid carcinoma and psychosocial risk factors.Methods A hospital based case-controlled study of thyroid carcinoma was conducted.Cases were path-ologically confirmed as primary papillary thyroid carcinoma.Both 102 cases and 114 controls were tested by the PSSG scale.Results Multivariate conditional logistic regression analysis showed that overworking,children′s fu-ture,depress,anxiety,and like to suppress their emotions could increase the risk of thyroid carcinoma,pleasing e-motion and forget unhappy as soon as possible might prevent the thyroid carcinoma.Conclusion Psychosocial risk factors are important in the onset and progression of the thyroid carcinoma.

Objective To analyze the related factors of surgical site infections after spine surgery so as to provide basis for clinical prevention. Methods We retrospectively reviewed the clinical data on 2,083 patients who had undergone spine surgery during the period of June 2010 to May 2013, and then conducted a statistica analysis. Results A total of 38 patients developed surgical site infections. The incidence of surgical site infections after spine surgery was 1.8%. 11 risk factors including gender, history of smoking, and history of prolonged uses of medications were related to surgical site infections The logistic regression analysis indicated that surgical site infections were more closely related to gender, length of hospital stay, and spine surgical invasiveness index. Conclusions Multiple factors can be attributed to surgical site infections after spine surgery. Gender , length of hospital stay, and spine surgical invasiveness index are the independent risk factors.

Objective To retrospectively analyze the results of 52 cases with different diseases of alimentary tract treated by APC and evaluate its effectiveness and safety. Methods From April 2001 to May 2002, 52 cases with different digestive diseases were treated by APC under endoscopy , the disorders included 29 cases of GI bleeding (peptic ulcer 9, angiodysplasia 8, stoma bleeding 3, postpolypectomy bleeding 5 and flat crenated adenoma bleeding , duodenal angiodysplasia, multiple colon AVM and stoma bleeding of cardiac cancer, 1 in each) ,and 23 cases of polypoid lesion( esophagus and cardia polyps 5, flat esophageal lesion with dysplasia 1, Menetrier's disease 1, colon-rectal polyps 6, multiple polyps 5, and stump of giant sessile adenoma 4 and postoperative recurrence of cardia carcinoma 1). Results The theraputic results showed that only one GU case with artery spurting faild after APC therapy of bleeding ulcers, the hemostasis rate for all GI bleeding was 96. 5%. For the polyp smaller than 5mm in diameter, APC was the choice of treatment, but polypectomy with snare is suitable for bigger polyp or adenoma before APC for stump clearance, and the endocut (high-frequency e-lectron) was safe and effective for giant sessile adenomas, we had only one case with mucosa gas vacu-ole which had no clinical event. Conclusion APC has excellent effect of hemostasis on most non-porta-hypertensive GI bleeding except bigger artery spurting, and it combined with endocut is a safe and effective treatment of various polypoid lesions.

【Objective】To observe the effect of Buzhong Yiqi Wan(BYW)on thyroid hormones in rat model of spleen-asthenia.【Methods】Thirty-four SD male rats were randomized into 3 groups:normal control group(N=10),spleen-asthenia model group(N=12),BYW group(N=12).Except the normal control group,the rats in other groups were given the decoction of Radix et Rhizoma Rhei(4 g?d-1 for each rat)to induce spleen asthenia,and meanwhile,BYW group reveived BYW(3.9 g?kg-1?d-1).The treatment lasted 20 days.Radioimmunoassay was used to detect serum levels of triiodothyronine(T3),thyroxine(T4),reverse triiodothyronine(rT3)and thyroid stimulating hormone(TSH).Meanwhile,the body weight,spleen and thymus weight as well as their ratio with the body weight were also observed.【Results】Serum T3 and T4 levels,spleen and thymus weight as well as their ratio with the body weight were decreased in the model group as compared with those in the normal control group(P

Objective To analyze the clinical effect of percutaneous sacroiliac screw internal fixation in treatment of sacroiliac joint dislocation. Methods From June 2002 to August 2006,16 patients with sacroiliac joint dislocation were treated with percutaneous sacroiliac screw internal fixation under C-arm X-ray tomography.There were 10 males and 6 females at age range of 10-58 years(mean 34.3 years).Results The operation lasted for 30-90 minutes(average 50.5 minutes).All patients were followed up for 12-36 months(average 18.3 months).The results of postoperative normotopia,lateral,ingate and egress Xray and CT scanning showed that all the screws were located within S1 and S2 of all,14 patients obtained satisfactory result of reduction,with no infection,nerve injuries,loosening or breakage of the screw fixation.The function and the sensation of the sacroiliac ioint and low extremities recovered to normal. Conclusions Percutaneous sacroiliac screw intemal fixation is an ideally safe and effective way to treat sacroiliac joint dislocation,for it has many advantages such as minimal invasion,reliable fixation,less complication and quick recovery.It is also very necessary to take caudad and cephalad view under an image intensifier during the operation to assure the accuracy of implantation.

Objective To study the changes of gastrointestinal movement function in rats with chronic unpredictable mild stress(CUMS) and explore the mechanisms underlying it.Methods The rats were divided into stress model group and control group.The stress model rats were induced by 21-day chronic unpredictable mild stress as well as social-isolated fed.The rate of ink propulsion of gastrointestinal tract and the contraction of intestinal canal in rats were observed.Immunohistochemistry was adopted to detect the expression of OT in rats.Results (1) After the models were induced,weight-gain and sucrose preference of model group ((69.97 ± 9.81) g,(49.05± 5.98) g) were lower than those in control group ((116.27 ± 13.60) g,(83.51 ± 3.08) g) (P ＜ 0.001),and both the crossing-score and rearing-score ((24.00 ± 13.52),(3.90 ± 2.51)) were lower than those in control group ((53.60 ± 27.98),(11.50 ± 8.85)) in the open-field test.(2) The rate of ink propulsion of model group ((67.33 ± 6.24) ％) was decreased when compared to the control group ((76.83 ± 10.00) ％) (P ＜ 0.05),and the intestinal canal contraction amplitude and contraction frequency ((1.37 ± 0.18) g,(0.58 ± 0.02) S-1) were lower than those in control group ((1.88 ± 0.13) g),(0.62 ± 0.04) S-1) (P ＜ 0.05).(3) Compared with the control group (6.07 ± 3.71),OT immunoreactive substance was increased in model group (59.17 ± 16.08) of rats (P＜0.001).Conclusion Chronic stress can cause the decrease in gastrointestinal movement function of rats.These changes may be related to the increased expression of OT in paraventricular nucleus.

AIM: To observe whether arachidonic acid (AA) could induce apoptosis in mouse fibroblast cell line L929 and the potential mechanism involved. METHODS: The viability and damaged degree of L929 was monitored by MTT and the release of lactate dehydrogenase (LDH). Lipid peroxidation in L929 was measured as malondialdehyde (MDA) content by colorimetric assay. Hoechst 33258 staining was used to observe AA-induced morphological changes. Agarose gel electrophoresis was used to detect DNA fragmentation. RESULTS: Treatment of L929 cell with AA for 24 h, in the range of 40-160 ?mol/L, caused a great decrease in cell survival and increased MDA contents and the release of LDH simultaneously( P

Objective To observe the effect of advanced oxidation protein products (AOPPs) on articular and synovial in a rabbit model of osteoarthritis (OA).Methods 48 male New Zealand rabbits were randomly divided into 3 groups:AOPPs group,PBS group and sham-operated group.OA model were created in AOPPs group and PBS group by anterior cruciate ligament transection and medial meniscus resection (ACLT+MMx).then intra-articular injection of 1 ml AOPPs or PBS were performed once every other day in AOPPs group and PBS group,respectively.In sham-operated group,the anterior cruciate ligament was just exposed without transection,and then the incision was sutured.All rabbits were saerificed after 4 and 8 weeks of intervention,respectively.Results The India ink seore of 4 and 8 weeks were 4.19±0.60,5.75±0.60 in AOPPs group,and 1.06±0.18,1.38±0.60 in sham-operated group,2.50±0.46、3.06±0.62 in PBS group,respectively.In addition,the differences were statistically significant among the three groups.The Mankin score of 4 and 8 weeks were 8.19±0.70,11.94±0.90 in AOPPs group,and 0.75±0.53,1.06± 0.73 in sham-operated group,4.25± 1.46、4.50±0.89 in PBS group,respectively.The differences were statistically significant among the three groups.Meanwhile,the protein expression level of matrix metalloproteinases (MMP)-3 on synovial at 4 and 8 weeks in AOPPs group were 1.006±0.080,1.098±0.088;0.065±0.006,0.053±0.011 in sham-operated group;and 0.552±0.024,0.839±0.084 in PBS group,respectively.The proteiu expression level of MMP-13 on synovial at 4 and 8 weeks in AOPPs group were 0.966±0.080,1.621 ±0.041;0.101±0.022,0.367±0.033 in sham-operated group;and 0.564±0.030,1.322±0.085 in PBS group,respectively.The differences were statistically significant among the three groups at two times.Conclusion AOPPs participate in the occurrence and development of artieular cartilage by upregulating the protein expression of MMP-3 and MMP-13 on synovial.

Objective To investigate the CT and MRI features and morphology classification of intraductal papillary mucinous neoplasm of the bile duct (IPMN-B).Methods A total of 18 patients with IPMN-B proved by pathology were retrospectively analyzed.Out of 18 patients,16 patients underwent enhanced and non-enhanced CT,13 underwent contrast enhanced MR,and 11 out of 13 underwent both CT and MRI.IPMN-B was classified into 4 types:typical IPMN-B,cystic-forming IPMN-B,non-tumor IPMN-B and invasive IPMN-B,according to imaging findings and gross pathological findings.Results Typical IPMN-B (9 cases):tumors were distributed along the bile ducts,both upstream and downstream bile ducts were obviously dilated.Cystic-forming IPMN-B (5 cases):single or multiple tumors were found in aneurysmal dilatation of bile ducts.Non-tumor 1PMN-B (2 cases):no mass was found in the widely dilated bile ducts with smooth bile duct wall.Invasive IPMN-B (2 cases):tumors protruded into the dilated bile ducts causing jagged wall of bile duct,with accompanied abnormal density or signal intensity outside the bile ducts.Bile duct dilatations were shown in all 18 cases,and tumors were shown in 16 cases.In 2 cases no mass was displayed in widely dilated bile ducts.CT density of the tumor was lower than that of liver parenchyma,and higher than that of the bile and intraductal mucin.Signal intensity of the tumor was higher than that of stones,and lower than that of bile and intraductal mucin at MR T2WI.All tumors showed high intensity on DWI.Tumors showed mild to moderate enhancement after injection of contrast agent,CT density or signal intensity of the tumors were lower than that of the liver parenchyma during all three phases of contrast-enhanced CT or MRI.Conclusion IPMN-B has some specific CT and MR imaging features,which are helpful for the diagnosis and classification of IPMN-B.