Osteosarcoma and ewing sarcoma are the two most common types of primary malignant bone tumors. Receptor tyrosine kinases(RTKs),including varieties of cell growth factors and proto-oncogene pro-ducts,are the high-affinity cell surface receptors which play an important role in the normal physiological func-tion of cells. A large number of studies have demonstrated that the abnormal RTKs signaling pathways may pro-mote the tumorigenesis and development of osteosarcoma and ewing sarcoma by affecting tumor cell survival, proliferation,invasion and metastasis. Targeting treatment of RTKs is a promising therapeutic approach for osteosarcoma and ewing sarcoma.

Objective:To explore the medical undergraduate teaching method of ECG. Methods:random sampling in the practice of medical undergraduates in our hospital ,2013 medical undergraduates as the experimental group, 2012 medical undergraduates as control group, two groups of 40 (male, female 20), age 22~23 years old, the experimental group internship period adjustment of ECG in 2 week internship, ECG during the internship period, by the junior high the doctor, according to a set of prior to the development of the teaching plan, practice teaching, the control group had no ECG internship content; in the two groups before and after the end of internship, were an ECG, theory of knowledge, operation and map reading test. Results:In the experimental group in the ECG theoretical knowledge, operation method, normal electrocardiogram, abnormal electrocardiogram exam scores, were more than that of the control group, there was significant difference in two groups(x2=22.321, x2=37.883, x2=31.179, x2=10.66;P<0.001). Conclusion: According to undergraduate medical situation, summarize the clinical teaching process ideas, enhance the practice ability, is before the practice was significantly increased in the reading and analysis abilities of ECG, far more than the control group. The teaching plan is feasible and effective;it is worth further exploration and promotion.

BACKGROUND: The image edge of rabbit femur is identified using self-programmed Matlab program. But owing to the complexity of the model, can we set up a femoral structure model after the solid model of the femur created in UG three-dimensional (3D) software is put into ANSYS software? OBJECTIVE: To explore the method of constructing 3D biomechanical model of rabbit femur.DESIGN: Randomized controlled observation.SETTING: Biomechanics Laboratory of Beijing Institute of Technology.MATERIAL: One 1-year-old female New Zealand white rabbit weighing 2.6 kg. ACTIS 400/225 industry CT scanner (BIR,USA).METHODS: The experiment was performed at the Biomechanics Laboratory of Beijing Institute of Technology from July to transformed into *.bmp format. Photoshop image processing software was applied for some essential processing on the original image, such as contrast control, smoothing and noise attenuation to strengthen the differentiability and analyzability of the image. In addition, the magnetic noose tool was used to outline the contour line of inside and outside boundary, and obtain the inside and outside contour line of every layer of the femur. The rabbit femur was scanned by industry CT starting from the upper extreme of the femur, vertical to femoral ordinate axis line (slice space=I ram). The scanning slice space was adjusted to 2 mm from the 43rd layer below small trochanter to the 53ra layer of middle femur because the shape between these layers was relatively regular. Totally 87 slices of layer images were scanned 9.9 cm in length. The image was put into the computer and processed to get the boundary contour line; the contour line coordinate for modeling was obtained through imported from UG into ANSYS software. A solid model of the femur was produced automatically. Finally, the solid model with cavity was obtained using subtraction option of Boolean in ANSYS.MAIN OUTCOME MEASURES: Establishment of rabbit femoral structure model. connected by the multiple valid points was formed. The 2nd, 3rd, 4th until the 87th layers were read in turn, and the inside and automatically divide the mesh to produce finite element meshes and 42 221 nodes and 27 768 elements were obtained. CONCLUSION: The 3D model of rabbit femur actually simulated the anatomic appearance of the femur. This model lays a foundation for identifying the optimal parameter of vibration that can improve bone mineral density by finite element analysis.

Objective To explore the correlation between social support and subjective well-being of Zhuang elder people in rural area.Methods 320 Zhuang nationnality rural old man were randomly selected from the xiangxian town,the Guangxi Zhuang Autonomous Region.Left behind elderly among them (A group) was 160,non left behind elderly (B group) was 80,five elderly (C group) was 80.General access volume,Memorial University of Newfoundland scale of happiness (MUNSH) and social support rating scale (SSRS) were investigated.Results Memorial University of Newfoundland scale of happiness scores of A,B,C groups were (27.90± 10.61,35.11 ±9.92,31.67± 12.07),and the difference was statistically significant (F=11.45,P＜ 0.05).SSRS scores of A,B,C groups were (34.91±8.13,39.53±6.95,30.31±7.62),the difference was statistically significant (F=26.53,P＜0.05).A,B group's happiness score and objective support was positively correlated (r=0.20,0.25 ; P＜0.05),A,B,C group's happiness score is positively correlated with subjective support (r=0.17,0.36,0.31; P＜0.05),happiness score and utilization degree positive correlation in A,C groups (r=0.23,0.39; P＜0.05).Conclusion Zhuang rural elderly subjective well-being is associated with each dimension of social support,and strengthen social support helps to improve the old man's subjective sense of happiness.

10.3969/j.issn.2095-4344.2013.26.011

Objective:To study the anatomic and clinical experience in distally based neuroadipofascial turnover flap incorporating superficial peroneal nerve.Methods:Thirty six (32 preserved and 4 fresh) cadaver lower limbs were used to investigate the blood supply of superficial peroneal nerve and the relationship with the vascularization of its vicinity integument.Distally based neuroadipofascial flap incorporating the nutrifying vessels of superficial peroneal nerve was designed for dorsal foot reconstruction.Results:The proximal part of superficial peroneal nerve was supplied by an accompanying superficial peroneal artery.In the one third part of the lower leg,this artery became an interlacing paraneural vascular plexus and was reinforced by branches from the distal perforators of anterior tibial artery,the supramalleolar perforator of peroneal artery,and the recurrent branches of dorsal pedal artery.Two chain linked longitudinal vascular plexuses (fascial and paraneural) were confirmed in the anterior lower leg integument.In practice,distally based superficial peroneal neuroadipofascial turnover flaps were successfully transferred in 5 cases.The flap measured (10 14) cm?(4 5) cm in size.The pedicle was (3 4) cm in width.The pivot point was located (2 3) cm above the line between medial and lateral malleolus.Conclusion:Distally based superficial peroneal neuroadipofascial turnover flap is a simple and safe procedure with minimal morbidity of the donor site.

Objective To investigate treatment method for existing and impending benign pathological femoral neck and trochanteric lesions.Methods A retrospective study wad done on 25 patients with benign proximal femur lesions treated between 2002 and 2004.All patients were treated with lesion curettage,cauterization,autografting and/or allografting.Then,dynamic condylar screw (DCS) or hip joint-span external fixator were selected according to the involved area of the lesion of the proximal femur.The duration of follow-up was mean 2.3 years (2-4 years).Results Sound bony union was seen on the radiographs of all patients by 3-6 months after surgery.There found no local recurrence or avascular necrosis of the femoral head,or complications like necrosis,infections or fractures.Function of the patients in the current series was graded excellent,assessed by the validated outcome measures MSTS-87,MSTS-93 and TESS lower extremity.Conclusion DCS or hip joint-span external fixator may be better alternative treatment of benign pathological femoral neck and trochanteric lesions,compared with conventional surgical methods such as simple bone grafting,traction and hip spica cast.

Objective To investigate the experiences in the diagnosis and treatment of space-occupying lesions of the head of pancreas.Methods The clinical data of 247 patients with space-occupying lesions of the head of pancreas who were admitted to the First Affiliated Hospital of Chinese Medical University from January 2011 to April 2014 were retrospectively analyzed.All the patients received enhanced computed tomnography and (or) magnetic resonance imaging of the pancreas.The levels of alpha-fetal protein (AFP),CA19-9,CA125 and carcinoembryonic antigen (CEA) were detected,and the serum level of IgG4 was detected in patients who were suspected of autoimmune pancreatitis.Intraoperative pathological examination was applied to patients who were diagnosed as with cancer of the head of pancreas.Pancreaticoduodenectomy,extended pancreaticoduodenectomy or bilio-jejunostomy or (and) gastrointestinal anastomosis were applied to patients according to the stage and infiltration of the tumor.Duodenum-preserving pancreatic head resection or pancreaticoduodenectomy could be selected after informed consent.The adjacent tissues and organs should be preserved on the premise of complete tumor resection for patients with benign and low-grade malignancy.Results A total of 194 patients had solid spaceoccupying lesions of the head of pancreas,including 125 with pancreatic head cancer,45 with mnass in the head of pancreas,9 with chronic pancreatitis with mass in the head of pancreas,11 with autoimmune pancreatitis,4 with insulinoma.Fifty-three patients were with cystic space-occupying lesions,including 12 with mucinous cystadenoma,8 with serous cystadenoma,17 with pancreatic cyst,12 with solid-pseudopapillary tumor of pancreas and 4 with intraductal papillary mucinous neoplasm.The positive rates of AFP,CA19-9,CA125 and CEA of the 71 patients who were confirmed as with pancreatic cancer by pathological examination were 7.0％ (5/71),94.4％ (67/71),42.3％ (30/71) and 0,respectively.The positive rates of AFP,CA19-9,CA125 and CEA of the 12 patients with chronic pancreatitis with mass in the head of pancreas were 1/12,4/12,1/12 and 0,respectively.Seventynine patients with pancreatic head cancer,mass in the head of pancreas and chronic pancreatitis with mass in the head of pancreas received intraoperative pathological examination.A total of 119 patients received operation,including 71 with pancreatic head cancer,7 with chronic pancreatitis with mass in the head of pancreas,4 with insulinoma,1 with pancreatic tuberculosis,8 with mucinous cystadenoma,4 with serous cystadenoma,6 with pancreatic pseudocyst,1 with huge lymphangioma,1 with lymphoepithelial cyst,12 with solid-pseudopapillary tumor of pancreas and 4 with intraductal papillary mucinous neoplasm.Of the 247 patients with space-occupying lesions of the head of pancreas,61 received pancreaticoduodenectomy,4 received duodenum-preserving pancreatic head resection,4 received pancreatic head and neck resection,2 received partial resection of the uncinate process of the pancreas,9 received enucleation of the tumor,38 received bilio-jejunostomy or (and) gastrointestinal anastomosis,22 received endoscopic retrograde cholangio-pancreatography + stent installation,18 received percutaneous transhepatic cholangial drainage + stent installation,1 received exploratory lapartomy and the other 88 patients were untreated.Conclusions The diagnosis and differential diagnosis of the space-occupying lesions of the head of pancreas depend on the clinical presentation,medical history,laboratory examination,sonography,computed tomography or magnetic resonance imaging.Individualized treatment plan based on the feature of the tumor and kinds of the lesions combined with intraoperative pathological examination is helpful for selecting the surgical procedures.

Acute kidney injury is a clinical common disease,but it is a dangerous illness with higher o-verall mortality.Even mild renal insufficiency carries complications.Therefore,it is very important for the early diagnosis of acute kidney injury,which is based on high sensitivity,strong specificity of biomarkers.

Objective To reduce the birthrate of ?-thalassemia major and improve the quality of population. Methods 527 pregnant women and their spouses were screened at 12~26 weeks of gestation with hematological data to find out carriers of ?-thalassemia. The blood samples of the couples who were both carriers were analyzed with PCR-RDB method for prenatal gene diagnosis. The umbilical blood samples were examined to prove the results. Results There were 28 cases of ?-thalassemia out of 1054 individuals, the positive rate was 2.66%; the ratio of male to female was 1/1.15. As the result of prenatal gene diagnosis, among four fetuses at risk, one was completely normal while three were with ?-thalassemia major(one homozygous and two compound heterozygous) who were aborted within 2 weeks after prenatal gene diagnosis. Conclusions It suggests that the PCR-RDB assay is effective in preventing the birth of ?-thalassemia major and has clinical significance in improving the population quality.