Objective To analyse the effect of hedyotisdiffusa on expressions of apoptosis related protein Fas , caspase3 and caspase7 in Renca renal cell carcinoma of model mice.Methods One hundred and twenty BALB/C male mice were randomly divided into normal control group, model control group, interleukin group, hedyotisdiffusa group, 30 mice in each group, half male and female.Excepted for normal control group , renal cell carcinoma models were established in the other groups , and were given corresponding drug treatment.The tumor size and weight , and the tumor inhibition rate of all mice were observed, and the expression levels of Fas,FasL,caspase3 and caspase7 were detected.Results Compared with model control group, the tumor size and weight were lower , the tumor inhibition rate were higher , the positive expression rates and protein levels of Fas were higher , the positive expression rates and protein levels of FasL were lower, the positive expression rates and expression levels of Caspase3,Caspase7 protein were higher in the mice of interleukin group and hedyotisdiffusa group, all with significant differences ( P<0.05 ).The above indicators in hedyotisdiffusa group were significant improved compared with interleukin group (P<0.05).Conclusion The hedyotisdiffusa can effectively promote the expressions of apoptosis related protein Fas,caspase3 and caspase7 in renal cell carcinoma of model mice, inhibit the expression of FasL protein, improve the tumor suppression rate.

Objective To compare the efficacy of laparoscopic gallbladder bed dissection(LGBD)between retrograde plus anterograde and anterograde only manners.Methods All of 575 cases of laparoscopic cholecystectomy(LC)were randomly divided into two groups(group A and group B).Patients underwent LGBD with retrograde plus anterograde mannerin group A(297 cases)oronly with anterograde manner in group B(278 cases)respectively.The efficacy and safety were compared between two groups.Results The operative time were(10.0±3.7)min and(13.0±3.9)min in group A and group B respectively (P<0.05).There were 33 cases of bleeding volume more than 5 ml in group A with 85 cages in group B (P<0.05).Three cases of gallbladder rupture were found in group A compared with 10 cases in group B (P<0.05).Postoperative fluid collection in gallbladder bed occurred in 5 cases in group A compared with 19 cases in group B(P<0.05).The conversion rate was 3.70%(11/297)and 3.96%(11/278)in group A and group B respectively(P>0.05).One cage of abdominal fluid collection was observed in group A whichwas relieved after conservative therapy.No other complications occurred.Conclusions LGBD applying retrograde plus anterograde manner may shorten the operative time,decrease the bleeding during operation and minimize the postoperative complications.Surgeons might benefit from its advantage of easier manipulation.

Objective To investigate the value of prostate-bladder angle (PBA) measured by MRI in the diagnosis of benign prostate obstruction (BPO). Methods A retrospective analysis was carried out on 87 benign prostatic hyperplasia (BPH) patients referred for lower urinary tract symptoms (LUTS) between March 2009 and November 2009. PBA was measured by MRI and urodynamic parameter Qmax was measured as well. With the diagnostic criteria of BPO as Qmax＜10 ml/s, the patients were divided into two groups: obstruction group and non-obstruction group. PBA was compared between these two groups. The sensitivity and the specificity of PBA in diagnosing BPO were also analyzed. Results The age range of the patients was 57-90 years with a median age 73 years; Qmax was 2.325.4 ml/s with median Qmax 7.9 ml/s; PBA was 4°-52° with median PBA 27°. There were 25 patients in the non-obstruction group with PBA between 4°- 21°(13°); in the obstruction group,there were 62 patients with PBA between 15°- 52°(34°). PBA was found statistically different between the obstruction and non-obstruction group (P＜0.01). With the cutoff at PBA≥20°for the diagnosis of BPO, the sensitivity and specificity of the diagnosis were 90. 3 % (56/62)and 96.0% (24/25), respectively. Conclusion PBA measured by MRI is valuable and can be used as a new non-invasive parameter in the diagnosis of BPO.

Objective To understand employment status of the eight-year program medical graduates from different medical colleges and put forward reasonable proposals on the current prob-lems. Method Through questionnaire, we conducted research among eight-year program medical graduates of three different grades (Grade 04,05,06) on the general condition of employment, research level, actual working time, expectations and actual salary, satisfaction with jobs and so on. Data statis-tics was done by Excel 2007. Totally, our research involved 11 medical colleges and 389 questionnaires. Results 94.34% (367/389) of the eight-year program medical graduates work in top three hospitals. The top five factors affecting the employment were reputation of the school 86.38%(336/389), reputation of the Principal Investigator 66.83% (260/389), social relations 60.15% (234/389), scientific research level 52.96% (206/389) and gender 46.79% (182/389). The amount of published papers from those graduates and their satisfaction with jobs vary greatly. Conclusion Eight-year program medical grad-uates employment faces both opportunities and challenges, and a clear training objective and improve-ment of continuing medical education system for the eight-year program medical graduates will have great significance on the promotion of their employment.

Objective To study the surgical treatment strategy for heamophilic arthropathy and musculoskeletal appara?tus. Methods A total of 120 heamophilic patients underwent 166 primary operations from January 1996 to June 2015 in Pe?king Union Medical College Hospital, with the average age of 29.7±12 years (from 6 to 61 years). Hemophilic type A accounted for 109 patients and hemophilic type B accounted for 11. Eighty?seven patients presented with bleeds within the joints, with 63 cases for knee involved, 29 cases for hip, 11 cases for ankle. Fifteen patients presented with intramuscular bleeds, 21 patients with heamophilic pseudotumors. Strategy of clotting factor replacement therapy was designed according to the different level of opera?tion procedure. The clinical manifestation, operative strategy, clinical outcome and complications were retrospectively recorded. Results 41 cases (34.2%) of patients underwent surgeries for more than one location. Totally, 166 procedures were performed for 120 patients. There were 103 procedures of joint arthroplasty (62.0%, 103/166), 21 procedures of pseudotumor resection (12.7%, 21/166), 15 procedures of tendon lengthening, 12 procedures of ankle arthrodesis, 13 procedures for knee flexion contracture. There were 30 cases of postoperative complications, with the rate of 18.1% (30/166). The coagulation related complication was 4.8%in this group (8/166). The surgical procedure related complication was 7.2%(12/166). All the preoperative symptoms were relieved during the follow?up. Conclusion Surgical treatment was effective for the heamophilic arthropathy and lesion of mus?culoskeletal apparatus, under the reasonable clotting factor replacement therapy. The incidence of perioperative complication in heamophilic patients is higher than that in non?hemophilic patients. Closely inspection was inevitable for perioperative treat?ment in hemophilic patients.

Objective To explore the clinical features and repositioning maneuver effects of benign paroxysmal positional vertigo ( BPPV ).Method The clinical features of 326 patients with BPPV from August 2009 to July 2011 were analyzed retrospectively.Different types of BPPV were compared.Results BPPV was more common in female and the peak period of onset was between the ages of 50 and 60.The average latency of vertigo attack was ( 1.52 ± 1.22) s and 43 patients ( 13.2％ ) had no obvious latency.The median duration of vertigo attack was 10 s,with less than 60 s in 312 patients (95.7％) and between 60—180 s in 13 patients (4.0％).The latency of vertigo attack of posterior semicircular canal-BPPV ( ( 1.74 ± 1.21 ) s) was longer than that of horizontal semicircular canal-BPPV ( ( 0.96 ± 1.06 ) s,t =5.546,P ＜0.01 ).But there were no differences in the gender,the course of disease and the duration of vertigo attack.The patients with posterior semicircular canal-cupulolithiasis were younger than those with posterior semicircular canal-canalithiasis.The duration of vertigo attack of posterior semicircular canalcupulolithiasis was longer than that of posterior semicircular canal-canalithiasis.The latency and the duration of vertigo attack of horizontal semicircular canal-cupulolithiasis were longer than that of horizontal semicircular canal-canalithiasis and the age was older.Conclusions The posterior semicircular canal is more involved in BPPV.The latency of vertigo attack of posterior semicircular canal-BPPV is longer than that of horizontal semicircular canal-BPPV.The latency and the duration of vertigo attack of horizontal semicircular canal-cupulolithiasis are longer than that of horizontal semicircular canal-canalithiasis and the age is older.

Background Epidemiological investigation showed that 15％-29％ of patients with cataract have preexisting astigmatism of ＞ 1.50 D.So to control astigmatism is very important to the improvement of visual function after cataract surgery.The implantation of Toric intraocular lens (IOL) is a new option for the correction of preexisting astigmatism during cataract surgery,now.Short-term clinical studies of cataract patients with AcrySof Toric IOL implantation have revealed a good stability.However,the evaluation of long-term clinical result is seldom.Objective This study was to evaluate the long-term clinical results of Toric intraocular lens(IOL) implantation.Methods A serial case-observational study was designed.One hundred and twenty eyes of 78 cataract patients were included in this study.Phacoemulsification combined with AcrySof Toric IOL implantation was performed and the patients received a 2-year follow-up.Uncorrected distance visual acuity (UCDVA),best corrected distance visual acuity(BCDVA),residual cylinder,IOL rotation,vector analysis and accuracy of astigmatic correction were clinically evaluated in 1 day,1 month,3 months,6 months,1 year and 2 years,respectively.Comparison of these results of different follow-up periods were made.Results Sixty-seven patients (101 eyes)finished the follow-up and 19patients(19 eyes)lost visit due to other diseases affected.At 2 years visit after AcrySof SN60TT implantation,UCDVA,BCDVA,residual cylinder,absolute value of IOL rotation degree,vector magnitude of surgically induced astigmatism (SIA) was 0.16 (0.20),0 (0.1),0.75 (0.5) D,(2.9± 1.8) °,(1.2 ± 0.6) D,and the correction index (CI)was 0.90±0.41.A positive correlation was found between SIA and TIA(r=0.74,P =0.000).Compared to 1 month,3,6 months and 1 year,there was a mild tendency of decrease in accuracy of astigmatism correction and CI.Residual cylinder and degree of IOL rotation at 2 years after surgery were also slightly higher.However these changes were not statistically significant (P＞0.05).Conclusions After 2 years of follow-up,patients with AcrySof Toric implantation remain good visual acuity.AcrySof Toric IOL presents excellent long-term rotational stability and accuracy of astigmatism correction.

Objective To observe the spinal stability of regrafting the posterior ligamentous complex after spinal canal tumor resection. Methods The data of 43 cases with spinal canal tumor in our department from July 2008 to July 2013 were retrospectively analyzed,who were fixed the free of the lamina by mini titanium-plate. Results The operation time was 130 to 220 min,the average time was 150 min. The blood loss volume was 200 to 750 mL,with average volume 340 mL. All patients were followed up for 6 to 42 months. No iatrogenic spinal cord injury nor complications such as artery injury,spinal cord and spinal nerve root local anomalies hydrops occurred. By Flexion-extension radio-graphs,regrafting of the posterior ligamentous complex after the resection of spinal cord tumors preserved spinal mobility well. Conclusion The mini titanium-plate fixation treatment of spinal canal tumor has good superiority and clinical feasibility by regrafting the posterior ligamen-tous complex and reconstructing the spinal stability.

Objective To observe the extent of bone coagulation and the thermal field distribution created in ablating the swine vertebral bodies in vitro with multi-polar radiofrequency and to discuss the correlation between the electrode position in the vertebral body and the safety of the spinal cord as well as the soft tissue injury around the vertebral body. Methods Thirty fresh adult porcine vertebrae, were randomly and equally divided into two groups. The depth of the electrode needle was 10 mm or 20 mm. When the ablation process reached to a stable state, the temperature at the scheduled spots was estimated. Twenty minutes after ablation, the vertebral body was cut along the electrode needle plane and also along the plane perpendicular to the electrode needle to observe the extent of bone coagulation. Results The temperature at the scheduled spots reached to a stable state in 3.5 minutes. The more close to the electrode the spot was,the more quickly the temperature rose. No soft tissue injury around the vertebral body was observed in both groups and no spinal cord injury occurred when the electrode needle was 10 mm or 20 mm deep in the vertebral body. Conclusion In treating vertebral metastases, the radiofrequency ablation is safe and reliable if the posterior wall of the vertebral body remains intact.

BACKGROUND: An ideal model of osteonecrosis of the femoral head is beneficial to the study on the cause of disease, pathogenesy and treatment. So far there has not been a coherent method to prepare this model. OBJECTIVE: To establish a rabbit model of osteonecrosis of femoral head induced by microwave heating, and to decide optimum microwave temperature and heating time.DESIGN: Randomized controlled animal trial.SETTING: Animal Experimental Center of Kunming Medical College.MATERIALS: The experiment was performed at the Animal Experimental Center of Kunming Medical College between September 2004 and November 2005. Forty-eight healthy adult New Zealand rabbits, either male or female, were provided by the Animal Experimental Center of Kunming Medical College. The animal procedure was accorded with the ethical standards. GW-92C multi-functional microwave therapy apparatus was the product of Grand World Medical Apparatus (Tianjin) Co., Ltd. METHODS: The microwave antenna was inserted into the rabbit femoral head. Ninety-six femoral heads in forty-eight rabbits were randomly divided into four groups (n =24) according to the microwave temperature and heating time: microwave heating at 50 ℃ for 10 minutes group; 55 ℃ for 10 minutes group; 50 ℃ for 20 minutes group and 60 ℃ for 10 minutes group. The models of osteonecrosis of femoral head were induced by microwave heating using multi-functional microwave therapy apparatus according to the temperature and heating time of grouping. MAIN OUTCOME MEASURES: In each group, two rabbits (four femoral heads) were killed immediately, one, two, four, eight and twelve weeks after operation, respectively. A series of examinations were carried out, including gross observation, X-ray to observe bone trabecular arrangement, cystis degeneration, head collapse or hip joint destruction, MRI to observe the necrotic area, and HE staining to observe the osteonecrosis and bone repair. RESULTS: Marrow tissues partially coagulated in the microwave heating at 50 ℃ for 10 minutes group at the end of the 1st week, and the osteonecrosis returned to normality at the end of the 8th week. In 55 ℃ for 10 minutes group, marrow tissues were completely coagulated at the end of the 1st week, and decreased signal on T1 weighted images and increased signal on T2 images were identified at the end of the 2nd week. In the 4th week, bone repair was found simultaneously when osteonecrosis occurred. At the end of the 12th week, the osteonecrosis continued and the repair stopped, and the femoral head collapse occurred. All femoral heads collapsed at the end of the 8th week in 50 ℃ for 20 minutes group and 60 ℃ for 10 minutes group. CONCLUSION: Microwave heating at 55 ℃ for 10 minutes is the optimal choice to develop a rabbit model of osteonecrosis of the femoral head.