In teaching forensic medicine as a common optional course for clinical medicine undergraduate students, we carried on the beneficial attempt in the overall set-up of teaching program, the effective implementation of the case-based and discussion-based teaching methods, the use of multimedia and internet classroom, plentiful of teaching models such as demonstration and practice, discussion forums between teachers and students etc. Through these efforts, we enhanced the teaching quality of the public elective course offorensic medicine.

Objective To investigate the clinical effective of laparotomy or laparoscopic total mesorectal excision surgery for patients with colorectal cancer. Methods One hundred and one patients with colorectal cancer in the Beijing Jiangong Hospitalour were selected as our subjects and divided into control group and treatment group. Patients in control group were received laparotomy and patients in treatment group were performed laparoscopic total mesorectal excision surgery. Clinical effective were recorded. Results The blood loss volume,postoperative discharge time,postoperative indwelling catheter time,hospital stay in treatment group were(143. 9 ± 32. 3)ml,(3. 1 ± 1. 2)d,(3. 5 ± 1. 4)d and(11. 9 ± 2. 1)d,less than those in control group ((198. 9 ± 41. 2)ml,(5. 3 ± 1. 3)d,(6. 1 ± 1. 5)d and(16. 9 ± 2. 3)d respectively). And the differenced were significant(t = 4. 994,9. 858,6. 543,6. 593;All P < 0. 05). The operation time,hospital cost in treatment group were(213. 4 ± 45. 3)min,(3. 5 ± 0. 5)ten thousands,higher than those in control group((153. 4 ± 43. 4)min, (2. 8 ± 0. 4)ten thousands),and the differences were significant(t = 7. 653,6. 593;P < 0. 05). There was no significant difference between the two group in term of the number of resected lymph nodes( t = 0. 882,P> 0. 05). There were no significant difference between two group in terms of NK,CD3 + ,CD4 + and CD8 + level (P > 0. 05)at before treatment. The NK,CD3 + ,CD4 + and CD8 + levels in control group after treatment were 8. 3 ± 0. 9,(64. 5 ± 4. 8)% ,(34. 3 ± 3. 0)% and(32. 8 ± 2. 4)% and those were 13. 0 ± 1. 0,(71. 9 ± 5. 1)% ,(45. 2 ± 3. 2)% and(26. 1 ± 2. 2)% in treatment group after treatment. The differences were significant( t = 5. 488,8. 481,4. 954,7. 493;P < 0. 05 ). The wound infection rate of control group was significantly higher than this of treatment group(1. 8% vs. 11. 4% ;χ2 = 4. 103;P < 0. 05). There was no significant difference between the two group in terms of other complications( P > 0. 05). Conclusion The clinical effective of laparoscopic total mesorectal excision surgery is better than laparoscopic surgery.

[Objective]To study the feasibility and clinical effect of the treatment of thoracolumbar vertebral fracture with limited decompression of neighbouring segments with internal fixation and intervertebral body fusion.[Method]Forty-three patients with thoracolumbar fractures were treated with this technique.The fusion of bone graft,reduction rate of fracture,nerve functional recovery,the loosening of rectification,subsequent low back pain,and the degeneration of adjacent segments were evaluated.[Result]All cases were followed up for 21.4 months and showed the results of strong spine bony fusion,96.1% satisfactory reduction rate without reduction lost,various differences of nerve functional improvement,a rank-sum test P

To design and manufacture a new bone matrix material (NBM) composed of both organic and inorganic materials for bone tissue engineering, the osteogenic potential of NBM combined with osteoblasts was studied in vitro and in vivo. Osteoblasts from bone marrow stromal cells of New Zealand rabbit were cultured with NBM in vitro , then the materials combined with osteoblasts were implanted into the skeletal muscles of rabbits. The osteogenic potential of NBM was evaluated using contrast microscope, scan electromicroscope and histological examination. Osteoblasts could attach and proliferate well in the NBM, secrecting lots of extracellular matrix, while in vivo experiment of the NBM in osteoblasts group showed that a large number of lymphacytes and phagocytes invaded into the inner of the material in the rabbit skeletal muscle beds after 4 weeks of implantation, no new bone formation was observed after 8 weeks. The different osteogenic potential expressed by NBM between in vitro and in vivo may be due to the immunogenity of NBM which causes cellular immunoreaction to destroy the osteogenic environment. More attention should be paid to the immunoreaction problem in tissue engineering between the host and organic inorganic composite materials.

Objective To explore the sensitivity and specificity of conventional eytogeneties(CC),nested-reverse transcriptase polymerase chain reaction(nested-RT-PCR) and dual-color and dual-fusion fluorescence in situ hybridization(D-FISH) technique in monitoring the tumor load of chronic myeloid leukemia (CML) during treatment.Methods CC,nested-RT-PCR and interphase D-FISH were simultaneously carried out to detect the tumor load of 5 CML patients during treatment with interferon-Mpha(IFN-α).Results 24 specimens from 5 CML patients before and after IFN-α therapy were investigated and the results showed that 23 specimens were Ph+ with different positive ratios by CC.All specimens were bcl-abl mRNA (+) by RTPCR.The Ph-ber-abl+ specimen from case 2 after 75 months of post-treatment showed 4.5%bcr-abl+ cells by FISH.2 specimens from case 1 at 22 mortths,26 mortths of post-treatment.2 specimens from cage 5 after 12 months,16 menths of post-treatment and 2 specimens from case 4 after 6 menths,10 menths post-treatment with same Ph+ ratio respectively were investigated by FISH and showed 47.5% and 39.5%,74.0%and 60.5%,99.0% and 99.5% bcr-abl+ cells,respectively.Conclusion CC can be used as a basic tool to monitor the change of tumor load in CML during treatment. When CC can't evaluate precisely dynamic changes of tumor load and when tumor load in patient with treatment were too low to detect Ph bv CC while bcr-abl mRNA was still positive by RT-PCR,FISH Call be used to detect precisely tumor load and monitor dynamic change of the disease.More sensitive RT-PCR was used to monitor tumor load when it was negative to bcr-abl by FISH during treatment.

Connective Tissue Growth Factor ; Humans ; Myocardial Infarction ; physiopathology ; Ventricular Remodeling

ObjectiveTo evaluate the cytogenetic characteristics of the patients with acute myelomonocytic leukemia (AML-M4), acute monocytic leukemia (AML-M5)and myelodysplastic syndrome (MDS).MethodsChromosomes of bone marrow cells were prepared by short-term culture.Karyotype analysis was performed in 100 AML-M4,46 AML-M5 and 115 MDS by R-banding technique.Results26 ％ (26/100) AML-M4 had clonal cytogenetic abnormalities which mainly include +8,t(8;21) and -7.26 ％ (12/46) AML-M5 had clonal cytogenetic abnormalities which mainly include +11. 39 ％(45/115)had clonal cytogenetic abnormalities which mainly include +8, Hypodiploid and -7. ConclusionCytogenetic detection is very important for the diagnosis of myelodysplastic syndrome and acute myelocytic leukemia.

Objective To explore the diagnosis value of X-ray breast imaging reporting and data system (BI-RADS) combined with wire-guided localization biopsy for breast microcalcifications in impalpable breast cancer.Methods 192 palpation negative patients with 205 microcalcification lesions were detected by mammography.All lesions were classified according to BI-RADS descriptors for calcification and were categorized by the BI-RADS.The patients with BI-RADS category 4a and above underwent X-ray positioning guide wire-guided biopsy and pathological diagnosis.Results In 205 microcalcification lesions,74 (36.1％) were malignant lesions,131 (63.9 ％) were less than benign lesions.The positive predictive value of malignant breast lesions in clustered,segmental,regional linear branching calcifications were higher [83.3 ％ (5/6),100.0 ％ (11/11),100.0 ％ (1/1)],followed by clustered,linear,segmental,regional pleomorphic calcifications [55.9 ％ (38/68),50.0 ％ (1/2),40.0 ％ (8/20) and 33.3 ％ (4/12),respectively].The positive predictive values of malignant in linear branching calcifications and pleomorphic calcifications were significantly higher than those of coarse heterogeneous calcifications,amorphous or indistinct calcifications (x2 values were 34.44,51.87,16.71,29.86,all P ＜ 0.05).The linear branching calcification had the highest possibility.The proportions of malignant lesions in four different types of glands were extremely dense 40.5 ％ (30/74),heterogeneously dense 39.2 ％ (29/74),scattered areas of fibroglandular density 10.8 ％ (8/74) and fat 9.5 ％ (7/74),respectively.Conclusions BI-RADS categorization for breast microcalcification lesions can improve the detection rate of impalpable breast cancer.Linear branching calcification has higher predictive value for malignant lesions.Dense breast is the risk factors of breast cancer,which should be attached great importance.

The ablated aerosols of biological matrix sample were studied using 213 nm nanosecond laser ablation system.The stable signal intensity and high sensitivity were obtained when the laser energy was 25%, the spot size was 200 μm, the scan rate was 20 μm/s, the frequency was 20 Hz and the carrier gas was 700 mL He + 700 mL Ar.Relative fractionation index of 56 elements were investigated and 31P as the internal standard element was selected under the optimized laser ablation conditions.The results showed that particle size of the biological sample was 3 μm, which was larger compared with NIST 610 sample.Element fractionation in biological sample was smaller than in glass sample, and relative fractionation index of most elements attained 1.0 ± 0.1.Element fractionation mechanism of biological sample was discussed.The possible reason why the relative fractionation index in biological sample with large particle size did not significantly increase compared to the glass sample is that the 3-μm particles entered into ICP can be atomized.On the other hand, enrichment effect for large ablation particles was relatively small.Further study of the influence factors of fractionation effect indicated that, the fractionation effect had relations with laser ablation energy, laser frequency and scan rate, negatively relation with the oxide boiling point, and positively relation with oxide bond energy and ionization energy.

ObjectiveTo evaluate the clinical effects of guiding apparatus assisted individual posterior cervical pedicle screw fixation technique.MethodsThe study enrolled 24 patients treated with posterior cervical decompressive single open-door laminoplasty and transpedicular screw-rod fixation from January 2008 to December 2010.The point of screw penetration and screw path direction were confirmed by measuring the transverse nail angle (TNA) and sagittal nail angle (SNA) of nail channel on the pre-operative CT plain scan of cervical pedicle and sagittal two-dimensional imaging of transpedicular axis.According to the results of CT measurement,individual cervical pedicle screw was implanted with the assistance of self-made guiding apparatus and then fixed after decompression.Transverse screw angle ( TSA ) and sagittal screw angle ( SSA ) were determined on the CT scan of cervical pedicle and sagittal two-dimensional imaging of transpedicular axis one week postoperatively in order to analyze the accuracy of placement of pedicle screws.Periodical anteroposterior and lateral X-ray radiographs of cervical vertebra were taken postoperatively to detect the stabilization of internal fixation.ResultsA total of 223 pedicle screws were inserted successfully into the C3 ～ C7,of which 220 crews were inserted accurately but three had slight inclination according to the postoperative CT,with placement accuracy of 98.7％.The comparison between inclination angle of inserted screws and that of preoperative transpedicular axis showed insignificant statistical difference ( P ＞ 0.05 ).All the patients were followed up for 6-34 months ( mean,18.5 months),which showed no neurovascular complications related to screws perforation out of pedicle cortex or no screw loosening,prolapse or breakage.ConclusionPosterior cervical pedicle screw insertionperformed according to the individual CT measurement is easy and safe and has a high accuracy rate under the assistance of self-made guiding apparatus.