Medical art are essential in consumer health education,facilitating consumers to un-derstand medical concepts,invisible body parts and complex pathology. This paper reviewed the origin and development medical arts,analyzed the characteristics of medical arts specific for consumers rather than professionals,and discussed the opportunities and challenges of medical arts in internet era.

Objective To investigate the average serum level and risk factors of serum cystatin C in Chinese healthy adults.Methods A total of 15 918 healthy adults who received health assessments in Peking Union Medical College Hospital during January 2012 and March 2013 were enrolled in this crosssection study.Serum cystatin C was measured.Estimated glomerular filtration rate was calculated by creatinine (eGFRcr).Multivariable linear regression analysis was used to assess factors that contribute to cystatin C variability.Results The mean serum cystatin C level was (0.79 ±0.14) mg/L (95％ reference interval (RI) was 0.56-1.08 mg/L).Male showed significantly higher cystatin C level than female (mean (0.84 ±0.13) vs (0.73 ±0.13) mg/L; RI 0.64-1.11 mg/L and 0.54-1.03 mg/L,respectively; P=0.000).Differences between genders are still significant after subgrouped by age.In the young-age group (age≤44 years old),the mean serum cystatin C level was (0.81 ±0.11)mg/L in male and (0.68 ±0.09)mg/L in female,P =0.000.In the middle-age group (45-59 years old),the mean cystatin C level was (0.85 ±0.12) mg/L in male and (0.75 ±0.12) mg/L in female,P =0.000.In the elderly group (≥60 yrs),the mean serum cystatin C level was (0.97 ±0.18) mg/L in male and (0.89 ±0.19) mg/L in female,P =0.000.Serum cystain C was increased with ages (in male:r =0.274,P =0.000 ; in femal,r =0.470,P =0.000).Differences between each two age groups are all significant for both gender,P =0.000.Cystatin C level in male is respectively (0.81 ±0.ll)mg/L,(0.85 ±0.12) mg/L and (0.97 ± 0.18) mg/L in the young-age,middle-age and elderly group.Cystatin C level in female is respectively (0.68 ±0.09) mg/L,(0.75 ±0.12) mg/L and (0.89 ±0.19) mg/L in the young-age,middle-age and elderly group.Male gender,older age,lower body weight,lower eGFRcr,lower high-density lipoprotein cholesterol,lower fasting blood glucose,increased mean blood pressure,higher body mass index and triglyceride were significantly associated with increased serum cystatin C level.Body weight,total cholesterol and low-density lipoprotein cholesterol were not risk factors of cystatin C.Conclusion Serum cystatin C level may be influenced by gender,age and other factors in Chinese healthy adults.

Background choroidal neovascularization (CNV) is the common reason of visual acuity impairment in high myopia patients,which usually leads to irreversible central visual impairment.Objective This study was to evaluate the clinical efficacy and safety of conbercept intravitreal injection for CNV in high myopia.Methods Fifteen high myopia patients with macular CNV diagnosed by OCT and fluorescein fundus angiography (FFA) from July 2014 to July 2015 were retrospectively analyzed.All patients were performed with intravitreal injection of conbercept 0.5 mg (0.05 ml).The best corrected visual acuity (BCVA) and central macular thickness (CMT) were examined 1 day,l week,4,8 and 12 weeks after injection.The ocular and systemic complications relating to drug were also observed.Results Fifteen eyes of 15 patients totally received 45 times of conbercept intravitreal injection.Among the total,1 eye only received 1 time of treatment,2 eyes received 2 times of treatment,12 eyes received 3 times of treatment and 1 eye received 4 times of treatments.After 12 weeks of treatment,FFA showed that fluorescein leakage disappeared in 10 eyes;fluorescein leakage area decreased in 4 eyes;fluorescein leakage was continued in 1 eye.The BCVA before treatment and at 4,8 and 12 weeks after treatment were 0.61 ±0.46,0.60±0.43,0.41±0.53 and 0.41±0.51,with significant difference among them (F=7.862,P＜0.001).The CMT before treatment and at 4,8 and 12 weeks after treatment were (280.33±14.40),(269.00±10.10),(261.93±7.80) and (259.53±6.30) μm respectively,with significant difference among them (F =32.520,P＜0.001).None of the patients conducted anterior chamber puncture because of elevated intraocular pressure,and no intraocular inflammation,vitreous hemorrhage,retinal detachment and cardiovascular disease or other serious complications occurred.Conclusions Intravitreal injection of conbercept can relieve macular edema and improve the vision.It is an effective method for the treatment of CNV associated with high myopia,but long-term follow-up observation still need to perform.

Objective: To study the interaction between RET (GDNF receptor) with sucl-bingding neurotrophic target (SNT1) and search for the possible downstream substrates or regulatory proteins of RET, so as to reveal the mechanism of downstream signal transduction of RET. Methods: The RETIC (intracellular domain of RET) was fused to LexA and the product was used as a DNA-binding domain protein. SNT1, SNT1PTB or SNT1ΔPTB (SNT1 without PTB) was separately fused to B42AD and their products were used as an activation domain protein. The cotransformants were tested by β-galactosidase activity analysis and leucine medium growth analysis was used to study the interaction between SNT1 and RET. Results: Interaction between RET and SNT1 or SNT1PTB was found in yeast, but that between SNT1ΔPTB and RET was not observed. Conclusion: It i s confirmed that RET can interact with SNT1 in yeast, and the interaction may be mediated by PTB domain of SNT1.

As an important postsurgical adjuvant treatment for DTC, radioactive iodine (RAI) is administered to eliminate residual thyroid tissue as well as the potentially persistent or distant metastatic lesions.It plays a significant role in reducing disease recurrence and tumor-related mortality.The major challenge at present in RAI treatment decision-making is how to achieve optimum clinical outcome with minimal radiation exposure.ATA guidelines recommends a postsurgical recurrence-risk adapted approach to RAI treatment management based on the clinicopathological features.However, RAI therapy is not beneficial to all DTC patients.The potential benefits from RAI therapy in DTC patients with different risk stratification have attracted much attention, and are reviewed in this article in order to provide more evidence-based basis for clinical decision-making.

The skin organ model can be cultrured in ways of organ culture and organotypic raft culture It can be used in skin transplantation,pharmacy or investigate the mechanism of pigmentation. Though there are many ways in culturing skin organ model,how to further improve technology to produce more similar to human's skin organ,and put it in treating dermatosis still needs further exploring. The model of skin organ provides a good platform for new drug development,toxicology experiment and physiological function research. Some tissues engineering skin products have been approved by Food and Drug Administration in America for clinical use. It is believed that following the development of tissue engineering and relative subjects,skin organ culture model in vitro will become one of the effective means on dermatosis study.

Objective To investigate the effects of distraction on tourniquet pain in healthy subjects .Methods Tourniquet pain was induced by the tourniquet at continuous pressure of 200 mm Hg for 10 min .20 healthy college students were asked to perform two distraction tasks during the pressure ,one of which is pictorial dot-probe task with three kinds of emotional pictures ,the other is word dot-probe task with five kinds of pain-related words ,and a control task ,in which no distraction task was performed .The pain intensity ,pain distress were recorded by Visual Rating Scale(VRS)and Modified McGill Pain Questionnaire short-form(MPQ-SF) . Results Compared with the control task[(4 .1 ± 1 .8) ,(4 .0 ± 1 .8)] ,the pain intensity and distress were significant lower in picture [(3 .1 ± 1 .3) ,(3 .0 ± 1 .2)]and word[(3 .3 ± 1 .4) ,(3 .4 ± 1 .5)] distraction tasks[(F(2 ,8)=21 .424 ,P<0 .001;F(2 ,8)=17 .962 ,P<0 .001)] .The pain distress in word distraction task (3 .4 ± 1 .5) was higher than that in the pictorial distraction task (3 .0 ± 1 .2) (P<0 .05) .Meanwhile ,for the last four minutes ,the pain intensity was significant lower in pictorial distraction task compared with the control task(P<0 .05) .And at the beginning of the experiment ,the pain distress was significant lower in pictorial[(2 .3 ± 0 .7) , (2 .5 ± 0 .8)]and word[(2 .4 ± 0 .8) ,(2 .9 ± 0 .9)] distraction task compared with the control task [(3 .7 ± 1 .3) ,(4 .0 ± 1 .4)](P<0 .05) .Compared with the control task (5 .0 ± 1 .6) ,the present pain index (PPI) was significant lower in the pictorial distraction task(3 .5 ± 1 .4)(F=5 .097 ,P<0 .05) .Conclusion The tourniquet pain was attenuated by distraction of cognitive tasks in pain in-tensity and pain distress .

Recently, the morbidity of differentiated thyroid carcinoma (DTC) has increased annually. American Thyroid Association (ATA) published the management guidelines for patients with thyroid nodules and DTC in 2006 in order to standardize their management. The ATA guidelines was updated for the ifrst time in 2009 and its renewed version was completed in 2015 based on the considerable progress that had been made in the ifelds such as diagnostic assessment and management of thyroid nodules, surgery and radioactive iodine therapy for DTC in recent years. This article tried to interpret the updated contents about radioactive iodine therapy for DTC in 2015 version of the guidelines.

BACKGROUND:Docetaxel, a cel cycle specific anti-tumor drug, is a drug that is used primarily for treating breast cancer; however, its efficacy is low when used for treatment of cancer not sensitive to radiotherapy. Bone marrow mesenchymal stemcels have been shown to strengthen the effects of tumor-specific targeting chemotherapy drugs. OBJECTIVE:To investigate the effects of docetaxel combined with bone marrow mesenchymal stem cels (BMSCs) on human hepatoma cel line SMMC-7721. METHODS:BMSC cels were culturedin vitro. The logarithmic growth of SMMC-7721 hepatoma cels were randomly divided into blank control group, BMSCs group and combined treatment group (combined treatment of BMSCs and docetaxel). SMMC-7721 cel cycle was detected usingflow cytometry. Cel growth rate of SMMC-7721 was determined by MTT assay. mRNA and protein expressions of tumor suppressor genes PTEN and p53 were detected by reverse transcription polymerase chain reaction and western blot assay. RESULTS AND CONCLUSION:Combined treatment of docetaxel and BMSCs inhibited SMMC-7721 cell proliferation. Compared with the blank control group, the number of cells at the G0/G1 phase was significantly increased in BMSCs group and combined treatment group. The cell growth rate of SMMC-7721 was significantly inhibited in BMSCs group compared with the blank control group, and that was further inhibited in combined treatment group (P< 0.05). mRNA and protein expressionof PTENandp53 were significantly increased in combined treatment group compared with BMSCs group and blank control group (P< 0.05). Our results suggest that BMSCs inhibit the growth of SMMC-7721 cells,andcombined use of docetaxel and BMSCs strengthensthe antitumor effect of BMSCs.

SUMMARY A patient with previous L3 -4 posterior lumbar interbody fusion,pedicle screws instrumen-tation and L3 -4 decompression,was scheduled for left total hip arthroplasty.Two years ago,due to poor landmarks palpation,the patient experienced a failed lumbar puncture after multiple attempts before her-niorrhaphy.His plain radiography showed bilateral partial laminectomy at L3 -4 level,and between L3 and L4,two posterior pedicle screws connected by metal rods on both sides.This time,we used ultra-sound to locate L4 -5 interlaminar space in paramedian sagittal oblique view and identified the spine midline by transverse interlaminar view before puncture.According to this information,L4 -5 puncture point was verified and the combined spinal-epidural anesthesia was performed in a paramedian approach. After withdrawing clear cerebral spinal fluid,15 mg hyperbaric bupivicaine was injected into intrathecal space.An epidural catheter was then inserted into the epidural space.The sensory block level was fixed at T10 to S within 10 minutes.Intraoperatively,the patient received 10 mL 2% (mass fraction)lido-caine through the epidural catheter in total.The surgery was uneventful.No neurologic complication was observed after the surgery.This case report demonstrates that ultRASound imaging can provide useful in-formation for neuraxial needle placement and can be a valuable tool in managing patients with anatomical change around the spine.