Diagnostics is a highly practical course.According to the training model,we set up the goals of curriculum development,optimized and updated the teaching contents,attached importance to teaching materials development,reformed the teaching methods and strengthened faculty training.It started with each teaching step of diagnostics,the teaching quality has been remarkably improved.

[Objective]To estimate the results of the total knee replacement for osteoarthritis knee joint.[Method]Eighty-one patients(95 knees)with osteoarthritis of knee joint were selected for total knee replacement.The average age of the patients was 65.5 years with a range of 50~82 years,which involved 10 males and 71 females.Left knee was in 35 cases and right knee was in 26 cases.Bilateral knee replacement one time was 17 cases.The posterior crnciate ligament retaining prosthesis was 18 knees,posterior stabilizing prosthesis was 62 knees and mobile bearing prosthesis was 15 knees.[Result]All the patients were available at the follow-up,with a mean of 42 months(14~108 months).According to HSS system,80 knees(84.21%)had an excellent results;10 knees(10.53%),a good result;3 knees(2.86%),a fair result;and 2 knees(1.9%),poor result.The satisfactory rate was 95.23%.[Conclusion]Total knee replacement can decrease knee pain and improve knee function.The prosthesis choice,surgical technique and postoperative rehabilitation are key factors to the operation results.

Objective To investigate the levels of complement and activated complement factors in peripheral blood and skin in patients with psoriasis and their significance in the development of psoriatic lesion.Methods Enzyme linked immunosorbent assay (ELISA) and immuno turbidi metric analysis were used to determine the levels of C3d, sC5b-9, C3 and C4 in sera from 57 patients with psoriasis vulgaris.Immunohistochemistry was employed to assess in situ expression of SC5b-9 in lesional and non lesional skin of 37 patients.Results There was a significant decrease of C3 and C4, and increase of C3d and sC5b-9 in patients with psoriasis in comparison with those of normal controls (t=10.88～ 24.80, P<0.01).The levels of C3 and C4 were significantly lower, while the levels of C3d and sC5b-9 were significantly higher in progressive stage than those in static stage (t=4.55～ 6.77,P< 0.01).In situ expression of sC5b-9 was significantly higher in stratum corneum and dermo epidermal junction of lesional skin than that in non lesional skin and normal controls (χ2=62.90,45.45;P< 0.01).There was no significant difference of C5b-9 expression in stratum corneum and dermoepidermal junction of lesional skin between progressive and static stage.Conclusions There is significant correlation between the development of psoriatic lesion and local deposit of activated complement factors.

[Objective]To discuss the results of the GIEBEL system in high tibial osteotomy to treat varus knee.[Method]Nineteen patients with medium varus knee were selected to be treated with osteotomy.Preoperatively,the mean varus angle was 12.29?,without deformity in other department of the knee joint.The main symptom was the pain in medial department.Accurate high tibial osteotomy with GIEBEL system fixation was performed in 31 knees of these patients.Weight-bearing extremity X-ray testing,varus angle,mechanical axle and anatomical axle were marked preoperatively and postoperatively.Joint space discrepancy between lateral and medial joint,the range of motion,Lysholm assessment and objective satisfactory survey were also performed to determine the outcome of the treatment.[Result]The mean follow-up of nineteen patients was 22 months.During this period,one case of temporary common fibular nerve paralysis occurred and healed at several days.All of the osteomy interface achieved bony healing.The corrected abnormality was 12.32?.The mechanism axle of the extremity maintained as the level just after operation during the follow-up and no degeneration of the joint space aggravated.The excellent and good rate of the treatment was 89.5%,and 84.2% of the patients expressed satisfactory for the operation.No difference of the range of motion was found before and after operation,but the Lysholm score,joint space discrepancy between lateral and medial joint and varus angle were improved after the osteotomy.[Conclusion]The GIEBEL system can fixate the bony interface of the high tibial osteotomy effectively,and possess the advantages of minimal invasion,stronger intensity and higher healing rate.

Objective To observe and classify the structure of the circle of Willis by using magnetic resonance angiographic(MRA)method. Methods A total of 2104 MRA head images from October 2013 to May 2015 in Shenyang Weikang Hospital was retrospective analyzed ,and the structure was classified by anterior circle or posterior circle according to the actual situation of the cerebral basilar artery. Results According to the origin of anterior cerebral artery and whether there was anterior communicating artery or not ,anterior circle was classified into three types:type Ⅰ,type Ⅱ and type Ⅲ. Type Ⅱ was classified into two subtypes,namely,type ⅡR and type ⅡL. Posterior circle,on the basis of whether there was posterior communicating artery or not,was classified into three types,which were type Ⅰ,type Ⅱ and type Ⅲ. According to the origin of posterior cerebral artery,type Ⅰ was classified into four subtypes,including type ⅠB,type ⅠC,type ⅠRC and type ⅠLC;type Ⅱ was classified into eight subtypes,including type ⅡBR,type ⅡBL,type ⅡCR,type ⅡCL,type ⅡRCR,type ⅡRCL,type ⅡLCR and type ⅡLCL;type Ⅲ was classified into four subtypes,including type ⅢB,type ⅢC,type ⅢRC,type ⅢLC. Conclusion There is a correlation among the different types of cerebral basi-lar artery,and each type of artery has their own sources of blood supply and the traits of communication compensation. When the anterior circle and posterior circle were both type Ⅲ,the complete ring structure of cerebral basilar artery,namely the circle of Willis,was formed. The existing rate of the circle of Willis was about 10.7%. Understanding of the differences among the individual types of arteries has great significance to the prevention and treatment of the cerebrovascular disease.

AIM: To improve on the acute cumulative death rates method in animal by intravenous (iv) administration. METHODS: A mathematic model was established to simulate the pharmacodynamic and pharmacokinetic process by the program written by Visual Basic.net. This program evaluated the acute cumulative death rates (ACD method) for use of pharmacokinetics of traditional Chinese medicine (TCM). RESULTS: The ACD method related on its first dosage, and an unsuitable dosage could lead to a wrong results. It also had been proved that, by adjusting the 2nd dosage it was a more suitable to wider range of dosage. CONCLUSION: By suitable 2nd dosage and enough animal number, ACD method can be used in the pharmacokinetics of TCM.

Objective To explore the correlation between the leukocyte rheology, cell adhesion molecule(CAM) expression and psoriasis. Methods Enzyme linked immunosorbent assay(ELISA), erythrocyte deformability apparatus and in vitro thrombus and platelet adhesion dual purpose apparatus were used to determine the changes of leukocyte CD18 expression, levels of serum soluble intercelular adhesion molecule 1(sICAM 1), and the changes of leukocyte filtration index(LFI) and leukocyte adhesion rate(LAR). Results The leukocyte CD18 expression, sICAM 1 level, LFI and LAR were significantly increased in patients with psoriasis than those in controls(P

Objective To investigate the levels of complement and activated co mplement factors in peripheral blood and skin in patients with psoriasis and the ir significance in the development of psoriatic lesion. Methods Enzyme linked im munosorbent assay (ELISA) and immuno turbidi metric analysis were used to dete rmine the levels of C3d, sC5b－9, C3 and C4 in sera from 57 patients with psori asis vulgaris. Immunohistochemistry was employed to assess in situ expression of SC5b－9 in lesional and non lesional skin of 37 patients. Results There was a significant decrease of C3 and C4, and increase of C3d and sC5b－9 in patient s with psoriasis in comparison with those of normal controls (t=10.88～ 24.80, P

ObjectiveTo investigate and analyze the doctor-patient communication skills of medical students and hereby to explore the efficient training system.MethodsUsing the questionnaires and statistic analysis,we focused on the doctor-patient communication skills of the observed 914 medical students in our college,their awareness of doctor-patient communication and the existing problems in the field.Results96.6％ of medical students realized the importance and necessity of doctor-patient communication,while 62.7％ of them lacked such kind of communication skills.Additionally,some other problems are exposed in medical history taking.ConclusionDoctor-patient communication skills might be the most important prerequisite for establishing harmonious relationship between doctors and patients,improving the quality of medical service and reducing the number of medical disputes.Consequentially,it's time to redesign relevant curriculum,to improve the old-fashioned training methods,to enhance the practice of doctor-patient communication training.Furthermore,improvements of teaching quality and a scientific evaluation system are also effective approaches to resolving the issue.

BACKGROUND: The existed repair method for cartilage defects has shortcomings of insufficient repairing tissue numbers, poor biomechanical properties, as well as donor site complication. Thus it is deficient to repair large-sized osteochondral defects using one method.OBJECTIVE: To investigate the therapeutic effect of tissue engineering modified Mosaicplasty on repairing large-sized osteochondral defects.DESIGN, TIME AND SETTING: A randomized controlled animal experiment was performed at the Center Laboratory of Qingdao University Medical College from January to September 2009.MATERIALS: The hircine bone mesenchymal stem cells (BMSCs) were in vitro cultured, and resuspended with algin solution to obtain BMSCs-calcium alginate gel.METHODS: Totally 12 goats were prepared for osteochondral defects models and were divided into 3 groups.BMSCs-Mosaicplasty group, BMSCs compound with injectable alginate calcium gel was then applied to fill the "dead space" after Mosaicplasty. In the Mosaicplasty group, the defects were repaired by Mosaicplasty. There was no treatment in the control group.From 4 to 16 weeks postoperatively, the animals were sacrificed and the in gross and under electromicroscopy.MAIN OUTCOME MEASURES: ①Gross observation: the joint was exposed to observe the repair effect at weeks 4, 8,16 after operation. ②Histological examination: specimens were harvested at 16 weeks after operation and observed by haematoxylin-eosin staining, toluidine blue staining under light microscopy. ③Transmission electron microscope was used at 16 weeks after operation.RESULTS: The transplanted subchondral bone and superficial cartilage was integrated hardly with each other or with recipient sites in tissue engineering modified Mosaicplasty groups at 16 weeks after operation. The quality and appearance of the transplanted and regenerated cartilage was similar to normal hyaline cartilage. Under microscopy, the regenerated cartilage was integrated with neighbor tightly in regular arrange. ECM distributed evenly and deeply stained by alcian blue. There was no obviously repaired in the control group.CONCLUSION: Tissue engineering can ameliorate the outcome of Mosaicplasty to repair the osteochondral defects.