The medical education has long paid great attention to students' specialized knowledge education and neglected the humanities education for all-around development excessively. Diagnostics is a bridge curriculum between basic medicine and clinical medicine. Enhancing the quality education by fully combining the process of diagnostics teaching plays an important role in qualified medical talents training.

Objective To discuss clinical results of self-made anatomical dynamic hip lock plate (ADHLP) in treatment of intertrochanteric fractures. Methods ADHLP was applied in 73 patients in-eluding 52 males and 21 females at age range of 19-92 years ( mean 54.7 years). Fractures were caused by traffic accidents in 32 patients, sllp in 21, fall from height in nine and other factors in 11. According to the Evans' s classification system, there were 42 patients with type Ⅰ fractures, 17 with type Ⅱ, nine with type Ⅲ and five with type Ⅳ. Self-made ADHLP was applied to manage various fractures with differ-ent operation strategies. The curative effect of ADHLP was observed for evaluation of ADHLP. Results The operation lasted for mean 60 minutes (40-90 minutes). The volume of blood loss was mean 200 ml (100-400 ml). All patients were followed up for 6-48 months (average 36 months), which showed that the function of hips was satisfactory, with excellence rate of 99%. There were no complications like coxa yam, femoral head eoncis, rotation displacement, iatrogenic fracture, infection or internal fixation break and loosening. Conclusions ADHLP takes advantages of reasonable vitodynamics, wide operation in-dicatioas, convenient operation, minor trauma, fast recovery, stable fixation and few complications for in-tertrochantefie fractures, especial]y osteoporotie and gemntal patients.

Objective To investigate the polymorphism of glutathione S-transferease P1 gene(GSTP1) and the association between the mutation and susceptibility in childhood asthma.Methods The distribute frequency of Ile105/Ile105,Ile105/Val105 and Val105/Val105 ge-notype in GSTP1 of 51 children with asthmatic and 40 normal children were studied with polymerase chain reaction-restriction tragment length polymorphism(PCR-RFLP).Results The frequencies of Ile/Ile Ile/Val,Val/Val genotype were 66.7%,27.4% and 5.9%,the frequencies of Ile,Val allele were 80.4% and 19.6% in the asthmatic group.But the frequencies of Ile/Ile,Ile/Val,Val/Val genotype were 90.0%,7.5% and 2.5%,the frequencies of Ile,Val allele were 93.8%,6.2% in control group.The frequencies Ile/Val,Val/Val genotype and Val allele in asthmatic group were more than that in control group.A significant difference was found in the frequency distribution of GSTP1 genotypes between two groups(?2=6.947 P

Objective To evaluate the application of modified Abbe flap in repairing moderate defects of the upper lip and time point to divide the pedicle.Methods Classic Abbe flap was modified in its design,pedicle cutting and dividing time,which was used to repair moderate defect of the upper lip in 12 cases.Surgery was divided into two phases:one with modified Abbe flap surgery was performed for the combined nasal deformity repair simultaneously,and then the pedicle was divided 9days after surgery.Results 12 patients underwent modified Abbe flap.No vascular complications were found in these flaps.Upper lip shape was well and satisfactory functional recovery,corresponding improvement in nasal appearance.Conclusions The surgery that the modified Abbe flap with the pedicle is divided 9 days after surgery is very simple.On one hand,it greatly improves the patient's appearance and function of the upper lip,improve the overall shape of midface,on the other hand,dividing pedicle time is significantly shorter than in the past,specially reducing the suffering of patients and duration.It is particularly suitable for unilateral and bilateral cleft lip of the upper lip on secondary moderate deformities and combined nasal deformities.

Objective To investigate the practical anatomy and clinical applications of the lateral sural nerve-lesser saphenous vein vascular plexus island flap with median sural nerve preserved.Methods Ten lower limbs injected with color red latex and 20 fresh limbs were observed.Based on anatomical studies,the island flap pedicled with the vascular axis of lateral sural nerve and lesser saphenous vein was designed for clinical application in 63 cases.In procedure,the median sural nerve were preserved in donor site and the distal end of the lesser saphenous vein were not ligated.Results The accompanying arteries formed a favourable vascular plexus around the nerve and the vein,lied along the lateral sural nerve and the lesser saphenous vein and nourished the skin through cutaneous branches.The distance of the lateral ankle to the confluent of lateral and median sural nerve was (8.5± 0.8) cm.63 patients with soft tissue defects in the distal leg and foot were repaired.Their appearance and function were satisfaction without feeling lose in the heel and lateral side of the foot.Conclusions The lateral sural nerve-lesser saphenous vein vascular island flap is a reliable source of soft tissue to cover defects in the lower leg and foot.This flap has sufficient blood supply and high survival rate without the sacrifice of the median sural nerve.

Objective To analyze the causes for the thigh pain after treatment of femoral trochanteric fractures by proximal femoral nail antirotation Ⅱ( PFNA Ⅱ) . Methods Included in this ret-rospective study were 236 patients who had been treated by us for femoral trochanteric fracture from October 2011 to December 2015. They were 103 men and 133 women, aged from 42 to 86 years (average, 50. 3 years) . According to AO classification, 13 cases belonged to type 31-A1. 2, 32 to type 31-A1. 3, 35 to type 31-A2. 1, 27 to type 31-A2. 2, 33 to type 31-A2. 3, 38 to type 31-A3. 1, 39 to type 31-A3. 2 and 19 to type 31-A3. 3. All the fractures were single, fresh and closed and treated with PFNAⅡinternal fixation. Results This cohort was followed up for 8 to 26 months (average, 13. 2 months). Nonunion occurred in one case who had to accept artificial hip replacement. The remaining 235 cases obtained bony union after 22 to 39 weeks (average, 29. 3 weeks). By the Harris evaluation at final follow-ups, the affected hips scored from 81 to 93 points (average, 85. 1 points) . Post-operative thigh pain was reported in 19 cases (8. 05％) . The causes included varied anatomic morphology of the proximal femur in 6 cases, distal defects of the intramadullary nails in 4, insufficient stability of internal fixation or uneven biomecanical distribution in 3, unskillful operation in 2, and severe oesteoporosis in 4. Avascular necrosis of femoral head was not observed during follow-ups. Conclusions Postoperative thigh pain is worthy of serious atention from orthopaedists following PFNA Ⅱtreatment of femoral trochanteric fractures. PFNA Ⅱshould be modified according to the specific Chinese features of the proximal femur, especially in the respects of anterior arch and distal structure of the main nail and lateral declination as well.

This study was aimed to explore the effect of Periplaneta Americana against alcohol-induced liver injury in mice, in order to provide a theoretical basis for the industrial production of P. Americana. Kunming mice were randomly divided into six groups, which were the normal group, model group, positive group, high-, middle-, low-dose of P. Americana groups. Intragastric administration of Tiopronin Enteric-coated Tablets 100 mg·kg-1 was given to the positive group. Intragastric administrations of whole powder of medicine were given to the high-, middle-, low-dose groups with the dosage of 6.667, 3.333, 1.667 g·kg-1, respectively. The drugs were given daily for 10 con-secutive days. After 3h of the 10th day drug administration, intragastric administration of distilled water was given to the normal group, while 14mL·kg-1 of 56℃ Red Star Liquor was given to other groups. No food was given but water for 12h. Blood was collected from the orbit. The ALT, AST and GGT in blood serum of mice were measured. The liver was dissected and liver coefficient was calculated. Histopathological examination was given on liver tissues. The results showed that compared with the normal group, the level of ALT, AST in blood serum of the model group had obvious enhanced (P< 0.01), the level of GGT had obvious enhanced (P< 0.05). Compared with the model group, the level of GGT, AST of the high-, middle-dose group had obvious enhanced (P< 0.05), the level of ALT activity had obvious enhanced (P< 0.01). There were severe liver histopathological damages in mice of the high-, middle-, low-dose group. It was concluded that P. Americana had some side effects in the treatment of alcohol-induced liver injury.

The biochemical mechanism of degrading keratins by S.fradiae var S-221 was primarily studied.The compounds (Na_ 2 SO_ 4 , Na_ 2 SO_ 3 and sulfdryl acohol), which respecitively enhance specific activity of keratinase, activate keratinase intensively and mainly act on the disulfide bonds reductase in the keratinase, Na_ 2 SO_ 3 activates intensively both disulfide bonds reductase and polypeptide hydrolytase at 0.01 mol/L, whereas Na_ 2 S_ 2 O_ 3 , which acts on the disulfide bonds reductase, inhibits keratinase.On the condition that substrate, keratins exists, S.fradiae var S-221 is induced to produce exo-keratinase, which is a multiproteinase, containing disulfide bonds reductase, which is a key enzyme degrading keratins, then, with polypeptidic, hydrolytase, graduately hydrolyzates denatured keratins into polypeptides, oligopeptides and free amino acids, so that keratins have been decomposed completely.Sulfur in the keratins was transferred into sulfhydryl compounds, H_ 2 S and sulfates in the course of keratinolysine.

Objective To understand the Oncomelania hupensis distribution and infection status in the schistosomiasis sur?veillance sites of Yunnan Province,so as to provide the evidence for making the control and prevention measures. Methods Eighteen administrative villages were selected as the surveillance sites where the schistosomiasis endemic was serious in 18 epi?demic counties,one village for one county. The snail status was investigated with the systematic sampling and environmental sampling methods,and the infection status of the snails was detected by a microscope and loop?mediated isothermal amplifica?tion(LAMP). The surveillance database was established and descriptively analyzed. Results In 2015,the total surveillance ar?ea was 1 826.55 hm2,and the area with snails was 55.03 hm2,that was reduced by 57.70% as compared to that in 2013,and by 40.63% as compared to that in 2014. No new snail area was discovered,and also no schistosome infected snails were discovered. Totally 718 532 frames were surveyed,and the occurrence rate of frames with snails was 0.45% and the density of living snails was 0.013 9 snail/0.1 m2. In the endemic controlled areas,the snail area and density of living snails were both the highest. The snails concentrated on the environments of paddy field,ditch,bottomland,small reservoir,and dry land,and the vegetations of rice,dry crop,weed and wood. The snail area,occurrence rate of frames with snails,total number of snails and number of liv?ing snails all showed a downward trend. No infected snails were found for three years. Conclusions The Oncomelania hupensis snails have been effectively controlled in the national schistosomiasis surveillance sites of Yunnan Province. However,the com?prehensive snail control measures still should be continually strengthened in order to consolidate the achivements.

Objective To evaluate the imaging performance and characteristics of peripheral primitive neuroectodermal tumors (pPNET), in order to raise awareness of the disease and the diagnostic accuracy. Methods Thirteen patients with pPNET who confirmed by puncture or pathology were enrolled in this study. The CT and MRI features were retrospectively analyzed. Four patients received simple routine CT examination, and 9 patients had MRI examination based on X-ray, CT examination. Results The part of body involved was more widely.Two patients occurred in the sinuses, 1 patient in the chest wall, 1 patient in the lung, and 3 patients in the abdominal and pelvic(1 patient involved the pelvic floor through the pelvic wall lesions to basins), 1 patient in the spine, and 5 patients located in the extremities. The characteristics of pPNET by CT and MRI in soft tissue of 8 patients showed single large soft tissue mass, and the biggest was 11.2 cm × 10.6 cm. In bonds and joints of 5 patients, CT and MRI showed wide range of soft tissue mass, mixed internal signal/density with obviously uneven enhancement, significant bone destruction and dissolvable osseous changes, and no obvious tumor bone and calcification. Conclusions Each site has its relative imaging characteristics of pPNET. CT and MRI can show lesions involving the scope, internal structure, with or without adjacent tissue invasion and metastasis, and provide guidance for clinical treatment and selecting treatment regimen. But in the end, it depends on the diagnosis of pathological and immunohistochemical examination.