The comprehensive capacity of medical students means mainly the medical operating skill, and the ability toresolve the practical troubles by integrating the knowledge of multisubject, and creative capability. For a long time, inthe teaching of many madical colleges, importance has been attached to imparting the basic theory and knowledge,rather than to fostering the comprehensive capacity of medical students. In 1999, the Medical College of ShandongUnivesity incorporated the physiological, phamacological, pathophisiological and psycological experiment and inte-grated them as a independent experimental curriculum-the functional science experiment. Many years practice showsthat the functional science experiment is a good platform or carrier to foster the comprehensive capability of madicalstudents.

Objective To evaluate the clinical values of endogenous creatinine clearance rate(Ccr) ,serum creatinine (SCr) ,urea nitrogen(Urea) ,serum cystatin C(s‐Cys‐C) ,serum retinol binding protein(s‐RBP) ,Urine total protein (u‐Pro) ,urine albumin and creatinine ratio(u‐Alb/Cr) ,urine RBP(u‐RBP) ,urine Cys‐C(u‐Cys‐C) ,u‐NAG and et al in the diagnosis of chronic renal failure (CRF) ,find suitable and effective detection combinations to increase the diagnostic accuracy of CRF .Methods SCr ,Urea ,s‐Cys‐C , s‐RBP ,u‐Pro ,u‐Alb/Cr ,u‐RBP ,u‐Cys‐C ,u‐NAG were detected respectively in 206 hospitalized patients and Ccr values were calcu‐lated at the same time .By using Excel and SPSS19 .0 softwares ,the data were analysed .Combined detections included two and four items combined detections .Results Youden index(YI) of serum Cys‐C was 0 .59 .Area under the curve in the receiver operating characteristic(ROC) of Cys‐C was 0 .872 which was the highest of all the single detection items .Combined detection of SCr and s‐Cys‐C got the highest YI (0 .60) .Combination of four items(Urea ,SCr ,s‐RBP ,s‐Cys‐C) had the highest positive predictive value (100 .00% ) .Combination of u‐RBP and u‐Cys‐C had the highest negative predictive value(100 .00% ) .Conclusion Combined detec‐tion was more favorable for CRF diagnosis .Combination detection of SCr and s‐Cys‐C was the most valuable detection for the diag‐nosis of CRF .Among single item detections ,s‐Cys‐C detection had better sensitivity and specificity ,and diagnostic efficiency than other detection items .U‐RBP and u‐Cys‐C could be used to exclude renal impairment due to its noninvasive sampling .

Malignant gliomas represent the largest group of brain tumors in humans. Recent studies have explored the molecular changes and apoptosis on gliomas, which involved the molecular etiology malignant progression, molecular subtyping, gene therapy, and prognostic evaluation of gliomas. This paper reviewed the relevant advances in the field of gliomas molecular biology.

Objective To investigate the clinical efficacy of target fire red-hot needling in treating articular deformity due to rheumatoid arthritis.Methods Ninety-six rheumatoid arthritis patients with articular swelling and deformity were randomly allocated to treatment and control groups, 48 cases each. The treatment group received target scattered fire red-hot needling and the control group, conventional acupuncture. After two courses of treatment, pre-/post-treatment changes in the self-reported pain score, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and immunoglobulins (IgA, IgG and IgM) were observed in the two groups and the clinical therapeutic effects were compared between the two groups. Results The total efficacy rate was 89.6% in the treatment group and 50.0% in the control group; there was a statistically significant difference between the two groups (P<0.01). There were statistically significant pre-/post-treatment differences in ESR, CRP, IgA, IgG and IgM in the treatment groups (P<0.05). There were statistically significant pre-/post-treatment differences in ESR, CRP, and IgG in the treatment groups (P<0.05). There were statistically significant post-treatment differences in ESR, CRP, IgA, IgG and IgM in the treatment and control groups (P<0.05).Conclusion Target fire red-hot needling is an effective way to treat articular deformity due to rheumatoid arthritis.

Objective To evaluate the medial longitudinal arch of the foot with and without hallux valgus in order to establish the relationship between hallux valgus and the arch. Methods 34 feet of 24 cases with hallux valgus and 34 normal feet of 18 cases were investigated by roentgenography. On the dorsal plantar view while weight-bearing standing, the hallux valgus angle (HVA), the first intermetatarsal angle, and the position of the tibial sesamoid relative to the first metatarsus were measured respectively. On the lateral view while weight-bearing standing, the top angle of the medial longitudinal arch, the anterior angle of the medial longitudinal arch (also named as the first metatarsal inclination angle) and the relative height of the talus, which are similar to measurement of the height of the medial longitudinal arch, were measured respectively. The characteristics of the medial longitudinal arch of the feet with and without hallux valgus were compared, and the correlation between the height of the medial longitudinal arch and the severity of the hallux valgus, which were manifested by the hallux valgus angle, first intermatatarsal angle, the relative position of the tibial sesamoid, was analyzed. Results The top angle of medial longitudinal arch was 136.9??7.6? in hallux valgus feet and 126.7??2.1? in normal feet; the anterior angle of medial longitudinal arch was 10.8??2.6? in hullux valgus feet and 16.6??1.6? in normal feet; the relative ratio of height of talus was 0.159?0.03 in hallux valgus feet and 0.199?0.01 in normal feet , there was significant difference between two groups. While with the increase of the lateral displacement of tibial sesamoid, the angle of hullxus valgus and the first intermetatarsal angle, the top angle of medial longitudinal arch became larger, the anterior angle of arch became smaller, and the relative height of talus became lower. The medial longitudinal arch of the foot with hallux valgus was collapsed, and there was moderate to high relationship between the height of the medial longitudinal arch and the severity of the hallux valgus. Conclusion Hallux valgus is a three dimensional deformity, which will disturb the normal biomechanics of the foot.

[Objective]To analyze the causes of perioperative periprothetic fracture with hip arthroplasty and discuss the prevention and treatment of the fracture.[Method]18 of 640 THR cases occurred femoral fracture from July 1995 to August 2006,11 with intraoperative fracture and 7 with postoperative fracture,12 were and 6 female,the mean age 68 years(range:51 to 79 years).According to AAOS'standard,18 cases were divided into 6 types:1 of I type,6 of II type,4 of III type,4 of IVa type,2 of IVb type,1 of V type and 2 of VI type.10 of 11 cases of intraoprative fracture were operated immediately with internal fixation,and one of II type was treated with conservative method.4 of 7 cases of postoperative fracture were operated with open reduction and internal fixation in two weeks,2 cases with loosen stem were operated by revision hip,and one of V type was treated with conservative method because of other disease.[Result]The mean followed up perioid were 15.2 months(rang:6 to 42 months),15 fractures united,2 delayed united and 1 dead after 8 months postoperatively.The average scores were 80 according to Harris'standard(range:67 to 92).[Conclusion]Violence、abnormal of femur cannal、osteoprosis and bigger prothesis are the main causes of intraoperatively peri-prothetic femur fracture after THA,and loosening、 osteoperosis and outside injury are the main causes of postoperatively periprothetic femoral fracture,different treatment should be used according to the different types.

[Objective]To study the reason of loosening prothesis by observing the interface membranes harvested during the hip revision operation.[Method]Thirty eight specimens of interface membranes around the loosening prothesis were harvested from thirty eight patients who underwent the revision of total hip replacement.All the specimens were underwent outer observation,light and scanning electronic microscopic observation.[Result]All the gap of the loosening prothesis were filled with interface membranes with different thickness.A large number of the foreign pelletand bone pieces were found under scanning electronic microscope.[Conclusion]Interface membranes growed and filled in the gap between the loosening prothesis and bone(or bone cement).The wear debris stimulated the interface membrane to release bone resorption factors which caused the prothesis loosening,and the more loosening,the more large gap appeared,and the more resorption factors released from the interface membranes due to the debris stimulating,which formed vicious circle.Cutting the link of the circle could decrease the loosening rates.

Objective:To observe the impact of compound glycyrrhizin combined with triamcinolone acetonide on clinical effects and immune function in the patients with oral lichen planus ( OLP) . Methods:Totally 100 patients with OLP were randomly divided into the control group (50 cases) and the study group (50 cases). The control group was locally injected with triamcinolone acetonide, and the study group was treated with compound glycyrrhizin tablets additionally. The treatment course was 4 weeks. Visual analogue scale ( VAS) and REU scoring system were used to assess pain and symptoms of OLP, the clinical effects and cellular immune function were compared, and the adverse reactions were recorded as well. Results:After the treatment, the VAS score and REU score respec-tively lower than those for the control group, and there were differents between the two groups (P<0. 05). The total effective rate was 84. 0% in the study group, which was higher than that in the control group (66. 0%) (P<0. 05). The percentage of CD3+ and CD4+ cells was increased, that of CD19+ cells and the ratio of CD4+/CD8+ were decreased, and there were significant differences be-tween the two groups (P<0. 05). The adverse reactions in both groups were mild. Conclusion:Compound glycyrrhizin combined with triamcinolone acetonide is effective for OLP and can improve the immune function in the patients.

Objective: To study the effects of static tensile strain on the cytoskeleton of human periodontal ligament fibroblasts (HPLFs). Methods: Tensile strain with the strain variate of 8%,12%,16% and 20% was applied in the culture of HPLFs for 1,2 and 3 d respectively with a self-devised loading apparatus. With the aid of laser scanning confocal microscope, the projected areas of each observed cell and its nuclear were calculated and the cell cytosketeton was observed. The data analysis was carried out with SPSS using Dunnett test. Results:The projected areas of the cells and nucleus incereased with the increace of loading time and tensile strain value in trial groups of 8%,12% and 16%(P

Magnetic resonance (MR) images can be used to detect lesions in the brains of patients with multiple sclerosis (MS). An automatic method is presented for segmentation of MS lesions using multispectral MR images in this paper. Firstly, a Pd-w image is subtracted from its corresponding T1-w images to get an image in which the cerebral spinal fluid (CSF) is enhanced. Secondly, based on kernel fuzzy c-means clustering (KFCM) algorithm, the enhanced image and the corresponding T2-w image are segmented respectively to extract the CSF region and the CSF-MS lesions combinatoin region. A raw MS lesions image is obtained by subtracting the CSF region from CSF-MS region. Thirdly, based on applying median filter and thresholding to the raw image, the MS lesions were detected finally. Results were tested on BrainWeb images and evaluated with Dice similarity coefficient (DSC), sensitivity (Sens), specificity (Spec) and accuracy (Acc). The testing results were satisfactory.
Algorithms ; Brain ; pathology ; Humans ; Image Enhancement ; Magnetic Resonance Imaging ; Multiple Sclerosis ; diagnosis ; Sensitivity and Specificity