[Objective]To analysis the clinical manifestation and treatment of tendious sheath tubercular,probe the influencing factor of misdiagnosis and effect of treatment,in order to offer evident base for diagnosis and treatment.[Method]The material of 86 cases(from January 1994 to Jun 2005)were reviewed and statistically analyzed including sex,age,nidus region,clinical manifestation,method and effect of treatment,etc.[Result]65% of the cases were 30~49 years old.Sexual difference was not significant.Nidus region in right side was apparently higher than that in left(67%:30%).Major manifestation was edema,tenderness and mal-motion.The misdiagnosis rate and recurrent rate were 88% and 1.2%.[Conclusion]Untypical clinical symptoms and sign,non-special laboratory examinations lead to misdiagnosis.The effective treatment includes integrity excision,local and general chemotherapy,which made recurrent rate low.

ObjectiveTo explore the relationship among self consistency and congruence,the feeling of inadequacy(FIS) and anxiety as well as the mediating effect of FIS between self consistency and congruence and anxiety.MethodsA total of 1164 students recruited from two medical colleges in Hebei province using cluster random sampling were investigated with scale for the feeling of inadequacy,self consistency and congruence scale and rating anxiety scale.ResultsThe relevance ratio of anxiety in Hebei medical colleges students was 42.7%.There were significant differences in the detection rate among genders(male:46.4%,female:40.5%),grade(freshman:38.9%,sophomore:41.0%,junior:47.5%)and family economic status(Preferably:38.5%,commonly:40.1%,badly:50.8%) in medical students(all P<0.05).There were no statistical significance for the incidence rates of students from different origins(P>0.05).Anxiety score was positively correlated with the score of self consistency and congruence(r=0.274,P<0.01),and was negatively correlated with the score of the feeling of inadequacy (r=-0.364,P<0.01).And the score of self consistency and congruence was negatively correlated with the score of feeling inadequacy(r=-0.335,P<0.01).Multiple stepwise regression analysis revealed that factors of the feeling of inadequacy and self consistency and congruence accounted for 35.6% of anxiety variance.The feeling of inadequacy played a mediating role in self consistency and congruence and anxiety.The mediating rate was 60.06%.ConclusionThe anxiety issue of medical students should be paid more attention.It is possible for the high level of feeling of inadequacy and low level of self consistency and congruence to increase the occurrence rate of anxiety.The feeling of inadequacy can strongly predict medical students'anxiety.

Currently seeking for employment of students of basic medical sciences has become a serious challenge.In this report,some important factors that affect the employment are analyzed,such as the students' qualities,the reputation of school,the opinion to occupation,concerned information and so on.Some responding strategies are proposed such as guaranteeing the students' qualities,strengthening reformation and employment tutoring principles,all those ways help the students to face the situation reasonably and build the right employment opinion to better their choice of occupation.

Objective To investigate the clinical effects of surgical treatment of acute deep vein thrombosis (DVT) in the lower limbs. Methods Twenty four cases with DVT were treated with a 2～3cm incision at the cross of superficial and deep femoral veins to take the thrombasis out. Moulding thrombasis were pulled up with ova circular tongs, and fragmented thrombi were spilled out of the incision with the prelum arteriol winding from foot to thigh. The artery was rinsed with heparinized saline for three minuets till the femoral vein was completely unobstructed. The vein was sutured, and the wound was drained under negative pressure. Results The near future effects: Limb swelling and pain disappeared in seventeen cases, conditions turned for the better in six cases, and there was no improvement in one case. The long term effects: Twenty one were followed up for an average of one year and three months. All patients had excellent walking and standing except two cases who suffered lower limb swelling and pain occasionally. Conclusions The operation of vein thrombectomy is a simple, easy and excellent approach to treat DVT, especially within six days after the the condition.

Objective To analyze the causes, prevention and treatment measures for nerve palsy complications in artificial hip replacement. Methods A total of 413 consecutive hip replacements performed from January 1991 to December 2001 were retrospectively studied. There were three cases of nerve palsy with a prevalence of 0.73%. Among them, there were two cases of sciatic nerve palsy and one femoral nerve palsy. Results The causes for nerve palsy in these three cases were hypotension shock due to excessive anticoagulation against deep venous thrombosis, hematoma compression and unknown causes respectively. The neuronal function of three cases of nerve palsy was recovered at different degrees through correction of shock, clearance of hematoma and rehabilitation therapy. Conclusions The causes for nerve palsy complication during artificial hip replacement are direct or indirect traction, compression and ischemia. Understanding the etiology of nerve palsy to avoid the nerve injury, immediate and correct management play an important role in prevention and treatment of nerve palsy during artificial hip replacement.

Objective To compare the MRI features of hepatic neuroendocrine tumors (NET G1,G2) and neuroendocrine carcinomas (NEC G3),as well as to improve the accuracy in hierarchical diagnosis.Methods Twenty patients with histopathologically proven NET and nineteen patients with histopathologically proven NEC were retrospectively analyzed.The morphological and MR signal features were compared.Results The morphological features of vascular invasion (P ＜ 0.05) and lymphadenectasis or necrosis (P ＜ 0.05),as well as the MR signal features on portal phase (P ＜ 0.05) and delayed phase (P ＜0.05) were different between the NET group and the NEC group;contrast to noise ratios (CNR) were also different between the two groups (x2 =5.14,P ＜ 0.05),CNR of the NEC group on both arterial phase (Z =121.75,P ＜ 0.05) and portal phase (Z =139.31,P ＜ 0.05) were significantly lower than the NET group;ROC analysis of CNR demonstrated an area under the curve of 0.729 (P ＜ 0.05) on portal phase,when the optimal cut-off value of-61.38 was used,a sensitivity of 90.0％ and a specificity of 63.2％ can be achieved.Conclusions MRI plays an important role in the hierarchical diagnosis of hepatic neuroendocrine neoplasms.The signs of vascular invasion,lymphadenectasis or necrosis as well as the MR signal features during dynamic enhanced scanning are of great value in differentiating NETs from NECs.

BACKGROUND:The anatomical structure of acetabulum is different for the developmental dysplasia of the hip, which is smal and shal ow, with abundant cal us and scar tissue. It is difficult to determine the diameter of cup and instal ation of the cup during arthroplasty. Loosening and survival of postoperative prosthesis were influenced by local mechanical changes.
OBJECTIVE:Using the three-dimensional finite element analysis, the stress distribution in acetabular cup-bone interface after implanting cups with different diameters was studied during total hip replacement in treating the dysplasia of hip.
METHODS:Pelvis of developmental dysplasia of the hip patients was selected in this study. Acetabulum in the dysplasia was scanned by spiral CT. The computer simulation technology was applied to reconstruct the three-dimensional model of the pelvic for observing the dysplasia of hip from CT scan picture. Implanting cups with different diameters were simulated. Then the pelvis and acetabular cup model were meshed. The mechanics analysis tool was used to analyze three-dimensional model.
RESULTS AND CONCLUSION:For the developmental dysplasia, we chose cup with smal diameter that could lead to better bone bed inclusion of cup during total hip replacement. Smal diameter cup induced a smal contact area and increased unit area stress. On the other hand, with implanting the larger cup and increasing degree of acetabular grinding, the acetabular wal bone breaks more obvious, so that the stress (compressive stress and shearing force) concentration at the top of the acetabulum and uneven stress in the rest were apparent increasingly. Thus, in clinical practice, under the premise of the bone bed inclusion, a large diameter cup is helpful to good distribution of stress during total hip replacement, but the perforation of acetabular wal induced by enlarged bone bed should be avoided or minimized.

Objective To compare the MR features of small hepatocellular carcinoma (sHCC) and small intrahepatic mass-forming cholangiocarcinoma (sIMCC) (≤ 3 cm) and improve the accuracy in diagnosis.Methods Imaging studies of 318 patients with 351 sHCCs and 42 patients with 47 sIMCCs were retrospectively reviewed.Signal intensity on T2WI and on each phase of dynamic enhanced imaging,enhancement patterns,and accompanying findings of the two groups were compared by qualitative and quantitative studies.The qualitative imaging features of tumors were compared by the x2 test and the Fisher exact test,and the statistically significant variables obtained from univariate analysis were used to conduct multivariate stepwise logistic regression analysis.Enhancement pattern between sHCCs with elevated AFP and normal AFP were assessed by thex2 test.Results Multivariate analysis indicated that signal features of enhancement pattern and the accompanying findings of tumor capsule and hepatic capsule retraction were key predictors in differentiating sHCC from sIMCC:Wash-out pattern (276/351) with enhanced tumor capsule (275/351) highly indicated sHCC,while progressive enhancement pattern (27/47) with hepatic capsule retraction (8/47) indicated the diagnosis of sIMCC (P ＜ 0.01).Compared with sHCC with normal AFP,atypical patterns as progressive (n =4) and stable enhancement (n =32) were more commonIy seen in lesions with elevated AFP,dynamic enhancement pattern was different between the two subgroups (x2 =8.241,P ＜ 0.05).Conclusions Enhancement patterns and the accompanying tumor capsule and hepatic capsule retraction were the most important predictors in differentiating sHCC from sIMCC.In addition,enhancement pattern was relatively more typical in sHCCs with normal AFP which provided valuable information in diagnosis for clinicians.

Objective: To study the effects of deguelin on proliferation and apoptosis of human breast cancer cell line MCF-7 and on phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt) signaling pathway. Methods: After treatment with 0, 1, 5, 10, 15 and 20 μmol/L of deguelin for 6, 24, 48 and 72 hours, the proliferation inhibition rate of MCF-7 cells was measured by cell counting kit-8 assay. Apoptosis rate of MCF-7 cells was detected with Annexin V-fluorescein isothiocyanate/propidium iodide double staining by flow cytometry and the apoptotic morphology was observed under a transmission electron microscope. After treatment with 0, 1 and 5 μmol/L of deguelin for 6 hours, 5 proteins involved in the PI3K/Akt signaling pathway were examined by Western blot analysis. Results: Deguelin at doses of 5, 10, 15 and 20 μmol/L inhibited the proliferation of MCF-7 cells at 6, 24, 48 and 72 hours. There was a significant difference in each group compared with the control group (P<0.01). The inhibitory effect was more marked with increasing concentration and duration of treatment. There were statistical differences (P<0.05) among 5, 10, 15 and 20 μmol/L groups. However, 1 μmol/L of deguelin had no obvious effects on the proliferation of MCF-7 cells at 6, 24, 48 and 72 hours, showing no significant difference compared with control group (P>0.05). Deguelin at doses of 5, 10, 15 and 20 μmol/L induced apoptosis of MCF-7 cells at 6 hours. There were significant differences (P<0.01) in the early and late apoptosis rate between the treated groups and the control group. The typical apoptotic MCF-7 cells were observed under the transmission electron microscopy. However, 1 μmol/L of deguelin had no apparent effect in inducing apoptosis of MCF-7 cells at 6 hours. After treatment with 5 μmol/L of deguelin for 6 hours the expression of phosphorylated phosphatase and tensin homologue deleted on chromosome 10 (PTEN) (Ser380), phosphorylated 3-phosphoinositide-dependent protein kinase 1 (PDK1) (Ser241), phosphorylated Akt (Thr308) and phosphorylated glycogen synthase kinase-3β (GSK-3β) (Ser9) proteins were significantly reduced in MCF-7 cells, while there was no significant change in the expression of total Akt protein. However, after treatment with 1 μmol/L of deguelin for 6 hours, there was no apparent change in the expression of these 5 proteins. Conclusion: Deguelin can inhibit the phosphorylation of GSK-3β (Ser9) via inhibition of the phosphorylation of PTEN (Ser380) and PDK1 (Ser241) pathway, thus inducing apoptosis and inhibiting proliferation of MCF-7 cells.

Objective To study the relationship among resilience,self feeling of inadequacy and alexithymia in depressive undergraduates,and to provide a theoretical basis for the prevention and intervention of depression among undergraduates.Methods 500 undergraduates of two universities in Hebei Province were collected by cluster sampling method.Beck depression scale,adolescent resilience scale,Toronto alexithymia scale and self feeling of inadequacy scale were applied to undergraduates.The survey results were analyzed statistically.Results The detection rate of depression was 28％(119/426) in undergraduates.Total score of Alexithymia Scale(69.99±9.43) was higher than the norm(65.70±7.98),and the difference was statistical significant (P＜0.05).The score of self feeling of inadequacy had a significant difference between male (149.88±28.00) and female(138.58±28.79) (P＜0.01).Neither gender nor grade had significant difference in depression,alexithymia and resilience(P＞0.05).Self feeling of inadequacy was positively correlated with alexithymia (P＜0.05).Resilience was negatively correlated with self feeling of inadequacy and alexithymia(P＜0.05).For the depressive undergraduates,self feeling of inadequacy served as a full mediator between the resilience and alexithymia,whereas for the non depression undergraduates it was a partial mediator.Conclusion Depression undergraduates have serious alexithymia,serious self feeling of inadequacy and poor resilience.Self feeling of inadequacy serves as a mediator between the resilience and alexithymia in depressive and non-depressive undergraduates.