Medical staff's recognization of medical model will make important influence to the whole medical undertakings. The anthor has survevyed some medical staff who are from two triple hospitals,six second hospitals and eight grass-roos hospitals in Shanghai district, about modern medical model.Through analynzing and discussing,the anthor proposed some positive countermeasures to improve medical staff's conciouness of modern medical medel and adapt to its tranformation.

Long non-coding RNAs (lncRNAs) have gradually become a research hotspot in recent years. The abnormal expression of some lncRNAs has been proven to promote tumorigenesis and progression. Among the lncRNAs, metastasis-associated lung adenocar-cinoma transcript 1 (MALAT-1) has attracted considerable attention in various tumor studies, particularly lung cancer. Therefore, the mechanism in which MALAT-1 regulates the cellular activities of tumors should be analyzed. This review mainly discusses the molecu-lar structure, biological function, and role of MALAT-1 in regulating cell proliferation, tumor metastasis, cell cycle, apoptosis, and so on. Furthermore, the role of MALAT-1 in epigenetic regulation is appropriately illustrated to provide a novel perspective in literature on the prevention and treatment of tumors.

Objective Evaluation of application of looping vascushunt tubes in microsurgical total removal of para sinus meningiomas Methods Eighteen patients harboring para sinus meningiomas were treated in our hospital from Feb,2000 to Mar,2002,Tumors were located in the posterior two thirds superior sagittal sinus in 17 patients and in the congenitally isolated transverse sinus in one patient Looping vascushunt were applied in all cases and tumors were removed under microscope using microsurgical techniques Results Tumors and involved sinus walls were resected (Simpson grade Ⅰ) in all patients Venous sinus reconstruction were achieved in 12 patients using artificial blood vessels,sinus walls were repaired with duramater in 4 patient, venous sinus ligation was applied in two patients because of the sufficent collateral venous drainage All patients recovered and no mortality occurred Conclusions Application of vascushunt tubes is one of the important techniques in microsurgical total resection of para sinus meningiomas

Objective To restore the profile of the youthful human fa ce, the concept of three dimensions in the full face rejuvenaton is presented. Methods Under general anaesthesia, the operation was perf ormed, in which the lap of buccal soft tissues, the liposuction of part of face, the mobilization and/or repositioning of fat pockets, the transplantation of fa t, implantation of variant plastic materials etc. were applied. Resul ts We performed the procedures for 18 patients using three dimension s facial rejuvenation and obtained good results from February 2001 to May 2004. Conclusion Through above-mentioned procedures, three-di mensional concept is embodied, and the patients not only obtain better effect o f full face rejuvenation, but also improve the facial profile.

Objective To explore the importance of the separation and reconstruction of the shared venous sinuses of a craniopagus twins Methods The shared superior sagittal sinus, confluence of sinuses, transverse sinus and straight sinus were separated using microsurgical techniques Meantime, one bypass was established from the superior sagittal sinus and the straight sinus to the internal jugular vein with help of the bypass shunt in twin B (right) The above mentioned sinuses were reconstructed with the artificial vessels The normal superior sagittal sinus and confluence of sinuses were preserved in the twin A (left) Results Twin A recovered with no nervous deficits Unfortunately, twin B died of renal failure and hyperkalemia 22 hours after the operation Conclusion The shunt and reconstruction of the venous sinus are the key techniques for the success of separation of craniopagus twins using the microsurgical techniques

Objective To introduce a method of using perforators flap adjacent to the defect to repair small sized skin defect.Methods From October 2009 to December 2013,a total of 23 cases of skin lesions were treated with perforators flap adjacent to the defect.The perforator artery was preoperatively detected with Portable Doppler in the region of relative slack skin.Skin defects with the area changed from 1.5 cm × 2.0 cm to 5.0 cm × 4.0 cm.Results All the flap survived smoothly,with pleased appearance and primary healing.Postoperative follow-up of 3 to 6 month showed no recurrence in tumor patients during the follow-up period.Conclusions Application of perforators flap adjacent to defect to repair small sized skin defect has the advantages of flexibility,reliable blood supply,which obtains good result.

Objective To study the effects of suicide gene system mediated by adenovirus containing the CD-TK fusion gene controlled by human vascular endothelial growth factor(VEGF)promoter on apoptosis of human hepatocellular carcinoma cells HepG2 in vitro.Methods The VEGF-expressing HepG2 cells were infected by adenovirus vector containing CD-TK fusion gene controlled by the VEGF promoter(Ad-VEGFP-CDglyTK).The infection efficiencies in HepG2 cells were observed under a fluorescence microscope.The toxic effect of 5-fluorocytosine(5-FC)and ganciclovic(GCV)on infected cells was determined by light microscopy,electron-microscopy and flow cytometry(FCM).Results The transfection efficiency in HepG2 cells increased with the increasing adenoviral titer.The pro-drug(5-FC and GCV)could induce apoptosis of HepG2 cells in certain range of dosage(the doses of GCV+5-FC:1mg/L + 20mg/L,10mg/L + 40mg/L,100mg/L + 60mg/L)at the multiplicity of infection(MOI)of 100.The effect showed a time-dependent manner.HepG2 cells showed typical morphologic changes of apoptosis after administration of the pro-drug(GCV:10mg/L,5-FC:40mg/L)for 72 hours:chromatin condensation and disposition along nuclear membrane.Karyopyknosis and karyoklasis were seen under electron microscopy(?10 000).Apoptotic peak was also shown in HepG2 cells treated with the pro-drug(5-FC and GCV)by flow cytometry.The cell apoptosis rate was increased accordingly as the concentration of pro-drug(5-FC and GCV)increased.The apoptosis was increased obviously in comparison with the negative control group(P

Objective The aims of this study were to assess the efficacy of video-assisted thoracoscopic extended thymectomy(VATET) as a treatment for non-thymomatous myasthenia gravis (NTMG) and to identify prognostic factors for thymectomy.Methods Retrospectively analyzed clinical datas of 112 patients received VATET for the treatment of NTMG.Clinical efficacy and variables influencing outcome were evaluated by Kaplan-Meier method and Cox proportional hazards regression analysis.Results At 3.2 years averaged (1.5-6.2 years) of follow-up,none of these patients were lost to follow up.According to the MGFA post-intervention status,54 patients(48.2％) obtained complete stable remission during follow-up,21 patients(18.8％) obtained pharmacologic remission,10 patients (8.9％) obtained minimal manifestations,7 patients (6.3％) improved,20 patients(17.8％) unchanged,and none of these patients were worse or died of MG.By multivariate analysis,the chance of complete stable remission was significantly increased when age ＜ 40 years (P ＜ 0.01,OR =3.468),symptom duration ＜ 12 months(P ＜ 0.01,OR =3.203) and the presence of thymic hyperplasia (P ＜ 0.01,OR =3.064).Conclusion Video-assisted thoracoscopic extended thymectomy achieved satisfactory long-term results in patients with nonthymomatous myasthenia gravis,while age,symptom duration,the presence of thymic hyperplasia correlated with response to operation.

Objective To investigate the infection of 23 kinds of human papillomavirus ( HPV) subtypes in female cervical epithelium samples and to analyze their relationships with age and results of cyto-logic test in Haikou area. Methods A total of 4 037 local healthy women were enrolled in this study from July 2013 to August 2016, 1 967 of whom received cervical cytology test. Cervical cell samples collected from those women were detected for HPV typing by using PCR-reverse dot blot hybridization. Results (1) The total positive rate of HPV in 4 037 samples was 22. 15% (894 cases), and the detection rates of carci-nogenic, possibly carcinogenic and non-carcinogenic HPV were 16. 13%, 3. 99% and 5. 55% (651, 161 and 224 cases), respectively. The positive rates of 6 genotypes were high, which were HPV52, 53, 81, 51, 16 and 58 in turn. (2) The detection rates of carcinogenic, possibly carcinogenic HPV and some of the gen-otypes (HPV18, 52, 53, 66) increased with age (all P<0. 05). (3) Multiple infection in HPV-positive women accounted for 24. 38% (218/894), in which the infection rates of carcinogenic types declined with age and the numbers of HPV genotypes in carcinogenic infections were negatively correlated with age ( both P<0. 05). (4) Only 2. 49% (49/1 967) of the samples were positive for cervical cytologic test, classified into the ≥ASC-US ( atypical squamous cells of undetermined significance ) group. The detection rates of eight kinds of carcinogenic and two kinds of possibly carcinogenic HPV in≥ASC-US group were significantly higher than those in the negative (no intraepithelial lesion or malignant lesion, NILM) group (all P<0. 05). Conclusion This study indicates that Haikou women have higher rates of HPV infection, especially the eld-erly group. HPV subtype infections present some regional characteristics and are mainly single type infec-tion. Cervical cancer screening should be combined with tests for HPV and cytology analysis to improve its effectiveness.

Objective To evaluate CT findings and dynamic changes of post-traumatic intrapulmonary hematoma.Methods CT data of 43 patients with traumatic intrapulmonary hematomas were analyzed retrospectively.Results A total of 52 lesions were found in 43 patients with intrapulmonary hematomas.The majority of hematomas were located in the peripheral lung fields close to the pleura,single or multiple in number.CT showed nodular,mass,fusiform,ribbon and irregular shadows with uniform and high density in lung.There are two types of evolution: (1) The hematomas gradually reduced in size and finally disappeared;(2)The hematomas evolved into gas-liquid cyst cavity or gas cyst cavity, and then was absorbed gradually.Conclusion CT examination is helpful in the early diagnosis of post-traumatic intrapulmonary hematomas, and can monitor the morphology changes over time.