Objective To explore the effect of fetal thymus transplantation on enhancing the immunity of patients with late-stage malignant tumors. Methods The whole thymus of 24～32 weeks fetus was transplanted into the forearm of the patients with late-stage milignant tumors by microvascular surgery. The levels of serum IgA,IgG and IgM were measured before and at the third, 6th and 12th months after operation. No immunosuppressive regimen was performed in all the patients after operation. The follow-up period was 1 to 2 years. Results The clinical symptoms of all the patients improved after treatment, and no rejection reaction occurred. The levels of serum IgA,IgG and IgM significantly increased 3,6 and 12 months after treatment(t≥4.23,P

Serum pepsinogen(PG)is an effective marker for evaluating gastric mucosa function and can be used as a supplement for screening and early diagnosis of gastric cancer. Recently,serum PG has become a hot spot of study in portal hypertensive gastropathy and functional dyspepsia. Serum PG detection is a noninvasive,simple and low cost investigation method with marked clinical value. This article reviewed the value of serum PG detection in warning gastric cancer and evaluating gastric mucosa function.

Objective To discuss the clinical value of simultaneous morcellation in situ in laparoscopic myomectomy (LM). Methods One hundred and eighty-nine women who underwent LM for symptomatic myomas were randomly divided into in situ group(94 cases) and standard group(95 cases). The operation time, hemorrhage perioperative,exhaust time postoperative, length of hospital stay were compared.Results The operation was successful in two groups. The operation time and hemorrhage perioperative in situ group were significantly less than those in standard group [ (98.20 ± 40.70) min vs. ( 129.20 ± 68.50)min (P＜0.05) and (113.40± 38.30) ml vs. (168.90±61.70) ml (P＜0.01)]. There was no statistical difference in exhaust time postoperative, length of hospital stay between two groups (P ＞0.05). One case occurred eechymoma in two groups respectively. Conclusion The application of simultaneous morcellation in situ in LM is safe and feasible.

Objective To examine the expression of CGRP in congenital pseudarthrosis of tibia(CPT) in order to find the pathogenesis of CPT.Methods Periosteum and bones from CPT patients were collected as experimental group.Immunohistochemistry stain was applied to determine the differences of the expression of CGRP in two groups.Results CGRP was located at vessel wall of periosteum and intracytoplasm of osteoblasts and osteoclasts in bones,its expression was significantly less in periosteum and bones of CPT than that in control group(P

BACKGROUND:Tranexamic acid administered either in intra-articular route or in intravenous route can significantly reduce blood loss during total knee arthroplasty. Recent studies are stil controversial in application mode of tranexamic acid in the clinic.
OBJECTIVE:To compare the clinical outcomes of tranexamic acid in intra-articular route and intravenous route during total knee arthroplasty.
METHODS:PubMed, OVID, Web of Science, and EMBASE were searched to identify randomized control ed trials concerning the comparison of tranexamic acid in intra-articular route and intravenous route during total knee arthroplasty published before 1 May 2015. Transfusion rate, hemoglobin decline, drainage volume and thromboembolic complication rate were considered as indexes to evaluate the clinical effect, for meta-analysis.
RESULTS AND CONCLUSION:Six randomized control ed trials involving 847 patients were included. Meta-analysis results showed no significant difference between intra-articular and intravenous administration of tranexamic acid in terms of transfusion rate, hemoglobin decline, drainage volume, total blood loss, and thromboembolic complication rate. Subgroup analysis for dose regimen showed that when occlusion time of drainage tube was<2 hours. Intra-articular route of tranexamic acid showed high drainage volume and hemoglobin decline compared with the intravenous route of tranexamic acid (P<0.01). Results confirmed that during total knee arthroplasty, clinical effects of intra-articular and intravenous routes of tranexamic acid are similar during total knee arthroplasty. Moreover, it is recommended that occlusion of drainage tube can be conducted for 2 hours in intra-articular route of tranexamic acid.

Objective To compare the sensitivity and diagnostic features of mammogram (MG) and magnetic resonance imaging (MRI) on diagnosis of breast ductal carcinoma in situ (DCIS) with or without microinvasion (DCIS-MI).Methods From Jan 2012 to Nov 2013,results of MG and MRI from 72 cases of DCIS or DCIS-MI were retrospectively analyzed.Results The sensitivity of MG was 52.8％ (38/72).The sensitivity of MRI was 87.5％ (63/72),among those 76.2％ (48/63)lesions presented as non-mass-like enhancement.Sensitivity of MRI was significantly higher in DCIS-MI than DCIS (84.6％ vs 100％,P =0.027).Logistic regression analysis showed calcifications was an independent factor influencing the sensitivity of MG (OR =23.785,P ＜ 0.001).Conclusions The sensitivity of MRI is higher than MG for the diagnosis of DCIS and DCIS-MI.

This article elaborated on professional development objectives of traditional Chinese medicine (TCM) clinical teachers and analyzed on the existing teaching ability development foundation of clinical teachers from the trend of clinical practice teaching development.Meanwhile,the article proposed the basic connotation of TCM clinical teachers' teaching ability development based on the construction of the module of clinical teachers' professional ability development and the opening learning environment.

Objective To evaluate the application of “expert-guided network tracking system” in training community general practitioner for hypertension management.Methods Total 855 general practitioners (GPs) from 20 community health service centers in Hangzhou,Jiaxing and Shaoxing of Zhejiang province were divided into two groups: 430 GPs from 10 community health centers received training for hypertension management using “ expert-guided networking tracking system” (intervention group) in December 2008 and 425 GPs from another 10 health centers received conventional training (control group).Questionnaire surveys about the knowledge and skill of hypertension management were conducted before and 3 y after training.Results The awareness rates of knowledge about hypertension prevention and control,non-drug therapy and drug therapy increased from 37.0％ (159/430),45.6％ (196/430),42.8％ (184/430) to 66.8％ (284/425),81.4％ (346/425),77.6％ (330/425),respectively and the accuracy of case analysis increased from 38.4％ (490/1290) to 73.3％ (946/1290) (P ＜0.01) after training in intervention group.Meanwhile the knowledge and case management abilities in control group were also improved after conventional training,but the degree was significantly lower than that in the intervention group.Conclusions “Expert-guided networking tracking system” can significantly improve the knowledge and skills for hypertension management in community general practitioners.

Objective To summarise the methods for a long segmental avulsed inj ury of ureter.Methods Ureteroscopies were performed on three male patients with upper ureteral calculi and one female patient with haematuria from upper urinary tract.Ureteral calculi caused small and middle hy-dronephrosis,obstruction wasn't seen on the upper urinary tract with haematuria.The kidney on the affected side showed normal founction on IVP.Four patients were suffered from a long segmental avulsed inj uries of full-thickness of ureter from ureteroscopy in a continuous epidural anesthesia.The injuries took place in UPJ and upper ureter.The length of avutsed ureters is 20-25 cm,mean length is 24 cm. Results The ureteroscopies were altered to open operations which were ileal ureteral substi-tutions on two patients,being anastomosed the avulsed ureter wrapped by caul on one patient and nc-phrectomy on one patient under general anesthesia in an emergercy.Two ileal ureteral substitutions had reached satisfied results that were no damaged renal functions,no metabolic acidosis,no repeatly U-rinary tract infections and no complains about micturition.One patient has maintained normal renal morphology and function after thirteen years followup,the other formed stricture in the anastomosis of the proximal piece of-ileum to the renal pelvis tWO years after operation,and then improved after ante-grade dilation.The patient with being replaced back and anastomosed the avulsed ureter had compli-cated with a renal atrophy on the affected side three months after the double-J was extracted.The kid-ney showed no function on isotop nephrogram and then was ablated.The last one with nephrectomy and the one before were followed up regularly,the renal functions and blood pressures remain normal.Conclusion Ileal ureteral substitution would be a good choice and has a stable curative effect and provide a good prognosis for treating long segmental avulsed injury of ureter suffered from ureterosco PY when no available urinary tract was utilized for reconstruction.

OBJECTIVE：To investigate the efficacy and safety of l ow-dose(80～160mg/d) sotalol on atrial fibrillation in the elderly patients of C hina.METHODS：Total 60 patients,65～89 years old with atrial fib rillation entered the randomized study,30 patients received sotalol and 30 recei ved amiodarone.There were no significant differences in baseline clinical charac teristics between groups.Patients randomized to sotalol began with 80mg/d.After first and second week,the dosage was added 40mg/d for those who had not reached the responsible criteria,patients randomized to amiodarone began with 200mg/d,me anwhile 100mg/d would be added for those who had not reached the responsible cri teria until the dose reached the maximum(400mg/d).Holter monitoring was used to assess the arrhythmias.RESULTS：①The total efficacy rate of sot alol was 63.3% and that of amiodarone was 62.1%(P＞0.05).②After the first week of treatment, the efficacy rate of sotalol reached 26.8% and that of Amiodrone was 10.3%(P＜0.05).③There was signifcant relativi ty between efficacy rate of sotolol and average heart rate decreasing(r =-0.85,P＜0.001),and there was also signifcant relativity betw een efficacy rate of sotalol and lengthened QTc interval(r=0.74,P＜0.001).④The accident rate of side effect of sotalol was 6.7%,no patients di scontinued sotalol therapy.CONCLUSION：Low-dose sotalol(80～160m g/d)was efficient and safe in the Chinese patients with atrial fibrillation.