After investigating conditions of 210 seven-year system medical students' extracurricular reading,we discovered that most medical students were rather interested in extracurricular reading,but there existed certain problems in the aspects of the arrangement of time and choice of books etc,which not only lowered the quantity of the student' extracurricular reading,but was disadvantageous to the effective display of the humanities education.Therefore,it was necessary to enhance the seven-year system medical students' extracurricular reading.

Objective To investigate the feasibility of amplitude of intraoperative nerve action potentials (NAP) for early quantitative diagnosis of peripheral nerve injury. Methods The sciatic nerve injury model were established in 16 rabbits. Intraoperative NAP were recorded after 4 weeks. According to amplitude of NAP, the injuried nerve were divided into 3 groups: NAP ＜ 100 μV in A group, 100 μV ≤NAP ＜ 500 μV in B group, NAP ≥ 500 μV in C group. Nerve specimen 1cm distal to injuried point were resected that received glycine silver stain and image analysis including number, diameter and cross section area of regenerative axons. Footprint parameter and ulcer area were measured and contrasted between each two groups. Results The number, diameter and cross section area of A group regenerative axons have significant difference with B and C group, no significant difference between B and C group; Footprint parameter and ulcer area have significant difference in each two groups. Conclusion Amplitude of intraoperative NAP can be a quantitative criteria to diagnose the degree of peripheral nerve injury that provides experiment evidence for guide intraoperative decision-making in clinical practice.

Primary liver cancer has various potential causes and insidious onset, and its progression is affected by many factors. Immunotherapy and targeted drug therapy have been used as non-radical treatment methods for primary liver cancer, but they cannot achieve a satisfactory effect and may lead to drug resistance. In recent years, the wide application of 16s high-throughput sequencing and the in-depth studies of microbiology have revealed the key role of microorganisms in the development and progression of liver cancer. The association of the liver with oral and intestinal flora is gradually clarified, and the regulation of oral and intestinal flora has brought new treatment methods for the disease. This article reviews the microbial theory of the oral-gut-liver axis and its application and development in the treatment of primary liver cancer.

OBJECTIVE: To analyze the prenatal diagnosis procedure for a 45,X male fetus. METHODS: A 31-year-old women underwent amniocentesis due to a moderate risk of trisomy 21. The fetal cells were subjected to chromosomal karyotyping, BACs-on-Beads (BoBs) assay, chromosomal microarray analysis and fluorescence in situ hybridization. RESULTS: Combined analyses revealed that the whole of Yp has translocated to 21p, which yielded a fetal karyotype of 45,X,dic(Y;21)(q11;p11).ishdic(Y;21)(SRY+,CEPY+;CEP21+). CONCLUSION BoBs and modified N-banding method are helpful for the diagnosis of 45,X male fetus with Yp translocation.

Objective: To report the pedicled anterolateral thigh flap with kiss technique for reconstruction of vulva. Methods: From Mar.2015 to Mar.2017, 17 patients with vulvar tumor were treated with radical resection and transfer of the pedicled anterolateral thigh flap with kiss technique. Results: All the flaps survived completely with no complication. The contour and function of reconstructed vulva was satisfactory. Conclusions The pedicled anterolateral thigh flap with kiss technique for reconstruction of vulva has the advantages of reliable blood supply, low morbidity at donor sites, and good therapeutic effect.

With the further development of endoscopic technology and the application of minimally invasive concept in the diagnosis and treatment of colorectal surgery diseases, the diagnosis and treatment of colorectal related diseases have undergone tremendous changes. Surgical diagnosis and treatment of colorectal diseases have achieved great results in the minimally invasive field, ranging from traditional transabdominal surgery to laparoscopic surgery, transvaginal surgery, and transvaginal specimen removal. One of the most cutting-edge surgical methods in the field of minimally invasive colorectal surgery at present, this method avoids the incision in the abdominal wall by taking specimens through the rectum and vagina, thus further minimally invasive colorectal surgery. The NOSES technology combines the advantages of traditional laparoscopic surgery with the concept of modern minimally invasive surgery. It embodies the characteristics of minimally invasive, fast track rehabilitation in surgery, functional surgery and other concepts on the basis of ensuring the operation effect. This paper mainly summarizes the relevant experience, experience and experience in the development of colorectal surgery diagnosis and treatment by carrying out the nose technology at home and abroad.

Objective To investigate the mechanism of matrix metalloproteinase(MMP)-9 involved in epithelial mesenchymal transformation(EMT)in chronic sinusitis(CRS).Methods The expression of MMP-9 from polypoid middle turbinate tissue was detected by immunohistochemical staining qPCR and Western blot assay in 42 patients with CRS and 8 patients underwent septoplasty.Primary human nasal epithelial cells HNEpc were cultured in vitro and divided into the control group,the TGF-β1 group(5 μg/L TGF-β1 intervention)and the TGF-β1+si-MMP-9 group(transfected with si-MMP-9 and 5 μg/L TGF-β1 intervention).The expression of MMP-9 was detected by cell immunofluorescence staining.Expression levels of TGF-β1,MMP-9 and EMT-related proteins E-cadherin,vimentin and α-SMA were detected by Western blot assay.Results(1)The positive expression rate of MMP-9 was significantly higher in the nasal mucosa of CRS with nasal polyps(CRSwNP)group(54.5%,12/22)than that of the CRS without polyps(25.0%,5/20)group and the control group(12.8%,1/8).The relative expression levels of MMP-9 mRNA and protein in nasal mucosa were higher in the CRSwNP group than those in the CRSsNP group and the control group(P＜0.05).(2)Compared with the control group,the expressions levels of TGF-β1,MMP-9,vimentin and α-SMA were increased in the TGF-β1 group,while the expression of E-cadherin was decreased(P＜0.05).Compared with the TGF-β1 group,expression levels of TGF-β1,MMP-9,vimentin and α-SMA were decreased in the TGF-β1+si-MMP-9 group,and the expression of E-cadherin was increased(P＜0.05).Conclusion The expression of MMP-9 is increased in CRS patients,which may be involved in the development of CRS through the regulation of EMT.

Objective To investigate the therapeutic effect of damage control neurosurgery (DCNS) on patients with bilateral frontal contusion.Methods Thirty-three patients with bilateral frontal contusion,admitted to and accepted DCNS in our hospital from September 2017 to January 2019,were chosen in our study.According to DCNS rules,the disease condition changes of these patients were monitored,the internal environment disorders after trauma were adjusted,plasma osmotic pressure was increased,and blood oxygen saturation was maintained;once the patients grew worse,craniotomy and decompression should be undertaken immediately;the patients were followed up for 6 months after the injury and Glasgow outcome scale (GOS) was used to determine the prognoses of these patients.Results Among the 33 patients,25 (76％) received conservative treatment successfully,8 (24％) were converted to surgery during conservative treatment.Among the 8 patients,5 received unilateral craniotomy and three received bilateral craniotomy.The lower the Glasgow coma scale scores,the lower the proportion of conservative patients.GOS 6 months after injury showed good recovery in 11 patients,mild disability in 16 patients,severe disability in 4 patients,and plant survival in two patients;22 patients from the conservative treatment group and 5 from the surgery group had good recovery or mild disability.Conclusion DCNS can reduce the operation rate and its complications so as to make the patients recover earlier and better in the treatment of bilateral frontal contusion.

OBJECTIVE: To present on a prenatally diagnosed case with complex structural rearrangements of chromosome 8. METHODS: Chromosome karyotyping, chromosomal microarray analysis (CMA) and fluorescence in situ hybridization (FISH) were carried out for a fetus with increased nuchal thickness. RESULTS: The karyotype of the amniotic fluid sample showed extra materials on 8p. FISH revealed a centromeric signal at the terminal of 8p with absence of telomeric signal. CMA revealed partial deletion of 8p23.3 [(208049_2256732)×1], partial duplication of 8p23.3p23.2 [(2259519_3016818)×3], and partial duplication of 8q [8q11.1q12.2(45951900_60989083)×3]. CONCLUSION The complex structural rearrangements of chromosome 8 in this case has differed from the commonly seen inv dup del(8p).
Female ; Pregnancy ; Humans ; Chromosomes, Human, Pair 8/genetics* ; In Situ Hybridization, Fluorescence ; Gene Rearrangement ; Prenatal Diagnosis ; Centromere

ObjectiveTo investigate the effectiveness and safety of Bushen Yugu Formula （补肾愈骨方） promoting postoperative functional rehabilitation of patients with chronic lateral ankle instability （CLAI） with syndrome of liver-kidney insufficiency and sinews-vessels deprived of nourishment. MethodsClinical data were retrospectively collected from 40 patients with CLAI with syndrome of liver-kidney insufficiency and sinews-vessels deprived of nou-rishment who underwent external ankle ligament repair surgery. They were divided into 20 cases each in the treatment group and control group according to whether or not they took Bushen Yugu Formula； patients in the control group underwent postoperative functional rehabilitation， while patients in the treatment group took Bushen Yugu Formula in the 3rd and 4th postoperative weeks combined with the rehabilitation. The American Orthopaedic Foot and Ankle Society （AOFAS） scores， the flexion/extension and internal/external rotation， the imaging scores of the ankle joint on the operated side and the traditional Chinese medicine （TCM） syndrome scores were recorded in the preoperative and 3-month postoperative， respectively. The patients' liver and kidney functions were tested in the preoperative and 4-month postoperative， and adverse events during treatment were recorded. ResultsCompared with the preoperative period， the AOFAS scores were higher and the TCM syndrome scores were lower in both groups 3 months after surgery （P＜0.01）， and the ankle internal and external rotation mobility and imaging scores were higher in the treatment group （P＜0.05 or P＜0.01）， and ankle flexion/extension mobility was lower in the control group （P＜0.05）. At 3 months after surgery， the AOFAS score was higher in the treatment group than in the control group， and the TCM syndrome score was lower than in the control group （P＜0.05 or P＜0.01）. Two cases of gastrointestinal reactions were reported in the treatment group， which relieved on their own after stopping the formula， and no abnormality was observed in liver and kidney function indexes. ConclusionBushen Yugu Formula can promote functional rehabilitation of ankle joint and improve clinical symptoms in CLAI patients with syndrome of liver-kidney insufficiency and sinews-vessels deprived of nourishment， and it shows a good safety.