The article summarized the practice teaching experience of traumatology: strengthening the learning education of medical ethics and the knowledge of psychology,understanding the specificity and complexity in traumatology,following the rule of evidence-based medicine and establishing clinic thoughts,strengthening the training of basic skill,basic knowledge and basic theory and helping the interns transit to clinical clerkship.

Objective To investigate the expression of E-cadherin (E-cad), CD44v6 and VEGF-C in esophageal carcinoma and investigate their relationship with lymph node metastasis. Methods The expression of E-cad, CD44v6 and VEGF-C was detected with immunohistochemical EnVision method in 56cases of esophageal carcinoma and 12 cases of normal esophageal mucosa. Results Among 56 cases of esophageal carcinoma, the positive expression rates of E-cad in esophageal carcinoma was 55.4 %(31/56),significantly lower than that in normal esophageal mucosa 100.0 %(12/12) (P ＜0.05). The positive expression rates of CD44v6 and VEGF-C were 71.4 % (40/56) and 62.5 % (35/56), significantly higher than that in normal esophageal mucosa (P ＜0.05). The positive rates of E-cad was 31.3 % (10/32) in the group of positive lymph node metastasis, significantly lower than that in the group of positive non-lymph-node metastasis 87.5 % (21/24) (P＜0.05). The positive rates of CD44v6 and VEGF-C were 84.4 % (27/32) and 75.0 % (24/32) in the group of positive lymph node metastasis ,significantly higher than that in the group of positive non-lymph-node metastasis 54.2 % (13/24) and 45.8 %(11/24) (P＜0.05). E-cad was negatively correlated with lymph node metastasis; CD44v6 and VEGF-C were positively correlated with lymph node metastasis (P ＜0.05). Conclusion E-cad, CD44v6 and VEGF-C play important roles in the process of soakage and metastasis of esophageal carcinoma. The combined detection of E-cad, CD44v6 and VEGF-C can help to prodict biological behaviors and prognosis of esophageal carcinoma.

Objective; To evaluate the effects of gingival shade guide in visual shade-matching in vitro models. Methods; 42 tabs of Shofu NCC shade guide were adopted for color measuring. Each tab was fixed in the middle of Gingiva-Indicator, Guray(1,2,3,4) respectively and located in a black box. The measurements were made using the Shadepilot instrument. The color parameters ( CIE1976L * a * b * ) of cervical, body, incisal area of each tab were recorded. The color difference A E value in the same position of each tab was calculated between non-gingival shade guide group and Gumyl ,2,3,4 groups with Shadepilot software. Results; The AE value in the same position of 42 tabs between non-gingival shade guide group and 4 gingival shade guide groups were; cervical (2.93±0.79)NBS,body(0.51±0.27)NBS and incisal(0.61 ±0.29)NBS. In the cervical, body and incisal area, there was no statistically difference among Gumyl ,2,3,4 groups on affecting shade of tabs(P >0. 05). Conclusion; The gingival color has an effect on the cervical shade of tabs, and it can be recognized by human eyes, while gingival color has little effect on the shade of body and incisal area.

Objective To investigate the expression of EphrinB2 and microvessel density(MVD) in colorectal carcinoma and to analyze the relationship between the expression of EphrinB2 and the biological characteristics of colorectal carcinoma. Methods EphrinB2 and MVD of 63 colorectal carcinoma diagnosed by pathology were examined by immunohistochemistry, and 25 specimens from normal colorectal tissue were examined as controls. Results The expression of EphrinB2 protein was 82.0 % (51/63) in colorectal carcinoma and 32.0 % (8/25) in the normal colorectal tissues, the difference was significant (P <0.05). Meanwhile, MVD was significantly higher in EphrinB2 positive group (39.39±8.97) than that in negative group (33.00 ±10.19) (P<0.05). The expression of EphrinB2 protein had significant positive correlation with differentiation grade, infiltration, lymph node metastases and clinical stage (P <0.05), and had no relation to age, sex, tumor size and location(P >0.05). Conclusion The EphrinB2 protein expression increase may be involved in development of colorectal carcinoma and play important roles in the tumorigenesis and progression of colorectal carcinoma.

Objective To investigate the difference of retinal nerve fiber layer thickness(RNFL)in opti-cal coherence tomography(OCT)under low and moderate signal strength. Methods Four hundred eyes of people aged 46~75 with clear fundus image,no obvious fundus diseases,and satisfactory optical coherence tomography were classified according to their ages and signal strength. The peripapillary and 4 quadrants of RNFL were detect-ed with OCT. Results In satisfactory OCT images ,the signal strength that reached 4/10 and 7/10 was 1.5% and 27% respectively. Under low and moderate signal strength ,the maximum thickness of RNFL was at the superior and inferior,and the minimum thickness of RNFL was at the nasal and temporal. There were no significant differ-ences in RNFL thickness under low or moderate signal strength. Conclusion RNFL results are reliable under low and moderate signal strength.

Objective To understand the result coincidence of 4 hematology analyzers (LH780 ,LH750 ,XN-1000 ,and XS-1000i) .Methods 20 samples of routine blood test were selected and detected by different hematology analyzers whose within-run precision and between-run precision all met the requirements of WS/T 406 standard .LH750 was chose to be the reference instru-ment ,and its detection results were standard values .The relative deviations and coincidence rates of WBC ,RBC ,Hb ,HCT , PLT ,MCV ,MCH and MCHC of the other 3 hematology analyzers were calculated .The WBC and PLT coincidence results of 82 cases of low-WBC samples ,86 cases of low-PLT samples ,and 35 cases of platelet aggregation samples were investigated .Results The coincidence rates of all items were more than 90% between LH780 and LH750 .For XN-1000/XS-1000i ,the coincidence rate was 80% in HCT ,and which were less than 80% in MCV and MCHC ,and more than 85% in other items .After readjusting the calibration factors of HCT of XN-1000 and XS-1000i ,the coincidence rates of HCT ,MCV and MCHC were all increased to more than 85% .The coincidence rates of WBC and PLT were less than 70% in low-WBC samples (WBC<1 .0 × 109/L) and low-PLT samples (PLT<30 × 109/L) .The results of WBC and PLT could not reach the relative deviation standards in 35 platelet aggrega-tion samples .Conclusion The comparative tests should be carried out among different hematology analyzers in one laboratory .

Objective To evaluate an agarose gel electrophoresis for quantitative determination of Lipoprotein(a) cholesterol and its clinical application.Methods Quantification of LP(a)-C was performed by a new agarose gel electrophoresis method that allows the separation of LP(a) by Hellen REP system and the determination of LP(a)-C by enzymatic staining of cholesterol,The results of electrophoresis method were compared with the ones of INA and ITA. The specimens of 135 health men were assayed by electrophoresis for the reference range.Results The inter and intra CV of electrophoresis method at low, middle and high LP(a) concentration specimens were 4.7%～5.3% and 5.8%～6.4%. The linearity was 0.058～1.55 mmol/L. Interference with bilirubin (

Objective To find up a suitable beginning scan time so that to assure the image quantity during CTA of brain.Methods 30volunteers were checked by heart colour sonography first,then CTA at earlier stage was done,when the density in basilar artery high up to120 HU,that time was regarded the time as beginning scan time,the relative curve between beginning scan time and ejection fraction(EF) was drew,according to this relative curve,34 patients were examined by CTA,the displaying situation of vessel was evaluated comparatively with DSA in part of patients.Results According to this method,the successful rate of CTA in patient’s group was 100%,the trunk of brain vessel and its 1~3 level branch were showed in 100%,the 4~5 level branch of middle cerebal artery showed in 94.1%(32/34).Conclusion According to EF of heart to determine the beginning scan time of CTA is practical,that the image quantity of CTA can be assured.

Objective To explore the relationship between the abnormal expression of anti-oncogene PTEN in gastric carcinoma and the clinicopathological characteristics. Methods Mythylation specific PCR was applied to detect the expression of PTEN methylation in gastric carcinoma and their normal tissues from 45 patients. Results The methylation took place in 40.0 percent in gastric carcinoma and 2.2 percent in their normal tissues, and the difference was significant(P<0.05). The methylation rate in poorly differentiated adenocarcinoma was 60.0 percent ,while 15.0 percent in highly-moderately differentiated group, the difference was significant (P<0.05). In the 24 cases with lymph node metastasis, mythylation was observed in 13 cases, and the difference was significant (P<0.05). Conclusion The methylation of PTEN gene was associated with gastric carcinoma, it may play an important role in the development of the disease.

Objective To compare the diagnostic efficacies of narrow-band imaging (NBI) in distinguishing neoplastic from non-neoplastic colorectal lesions with routine endoscopy and with magnifying endoscopy. Methods Patients with colorectal lesions detected by NBI from September 2008 to February 2010 were enrolled in the study. These lesions were classified by pit pattern and capillary pattern, which was then assessed by reference to histopathology. Results A total of 100 patients with colorectal lesions were enrolled, and the lesions were observed by NBI with ordinary endoscopy (n =64) and NBI with magnifying endoscopy (n =36), respectively, and 7 cases (5 in NBI with ordinary endoscopy and 2 in NBI with magnifying endoscopy) which did not meet the diagnostic criteria were excluded. The overall diagnostic accuracy of NBI endoscopy in distinguishing neoplastic from non-neoplastic colorectal lesions was 91.4% ( 85/93 ), in which NBI with ordinary endoscopy and magnifying endoscopy was 89. 8% (53/59) and 94. 1% (32/34),respectively, with both significantly higher than that of conventional colonoscopy reported in the literature (79. 1% ) (P ＜ 0. 05 ). However, no significant difference was detected between 2 methods ( P ＞ 0. 05 ).Conclusion Similar with NBI magnifying endoscopy, NBI endoscopy without high magnification may also be useful to distinguish neoplastic from non-neoplastic colorectal lesions.