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 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.

BACKGROUND:The anatomical strucure of acetabulum is smal and shal ow in adult acetabular dysplasia patients. The large amount of cal us and scar tissues in the acetabulum make it difficult to identify and instal the acetabular cup during arthroplasty. The comprehensive understanding of the acetabulum before arthroplasty is the premise for selecting the appropriate acetabular prosthesis and making the acetabular reconstruction program. OBJECTIVE:To evaluate the application value of three-dimensional reconstruction technique in choosing the size of acetabular cup before total hip arthroplasty for acetabular dysplasia. METHODS:Spiral CT was carried out in the 11 acetabular dysplasia patients who waiting for total hip arthroplasty. The acetabulum was multi-planar reconstructed, and the size of the acetabular cup was determined through digitized acetabular cup template implantation, and then the mathching degree assessment was performed to compare with the actual size. RESULTS AND CONCLUSION:Spiral CT could clearly show the acetabular morphology, and the 71.4%of the acetabular size chosen in the three-dimensional preoperative plan was the same as actual one, the intraclass correlation coefficient was 0.888. The agreement was much higher than that of two-dimensional preoperative plan based on X-ray plain film. For the patients with acetabular dysplasia, the acetabulum became saml er and shal ower, and there were various extents of bone defects in the superior-lateral acetabulum. Three-dimensional multi-planar reconstruction can effectively evaluate the acetabular morphology, and three-dimensional preoperative plan can provide useful information for the choice of implant.

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 evaluate the clinical outcome of hip arthroplasty following femoral neck fracture.Methods Sixty-one cases of femoral neck fracture were treated by hip arthmplasty from January 2000 to April 2008,and their complete data were available,whose age ranged from 36 to 90 years old,mean age(71.5±14.7)years old.The group comprised 21 men and 40 women.Results Clinical follow-up ranged from 3 months to 8 years.The Harris hip score improved from(17.5±8.4)scores pre-operatively to(78.1±8.5)scores post-operatively,and the average leg-length discrepancy decreased from(2.52±1.09)cm pre-operatively to(0.81±0.73)cm post-operatively.The differences between pre-operative data and post-operative data were significant (P＜0.05).Conclusion Hip arthroplasty is an ideal procedure for old femoral neck fracture in elderly patients or those who followed failed previous treatment.

BACKGROUND:Hepatic cirrhosis may adversely affect the outcome of major orthopedic surgery, such as total hip arthroplasty. Peri-operative treatment is the chal enge for al orthopedic surgeons.
OBJECTIVE:To analyze the safety and feasibility of hip replacement surgeries in patients with hepatic cirrhosis.
METHODS:Thirteen patients with hepatic cirrhosis that underwent hip replacement were retrospectively analyzed to evaluate the treatments and their efficacy before and after replacement.
RESULTS AND CONCLUSION:Al 13 surgeries were successful y performed. Al cases were fol owed up for more than five months and were graded according to Child-Pugh Criteria for hepatic functional reserve preoperatively and postoperatively. Five cases of the seven preoperative grade A cases preserved grade A postoperatively during a two-week observation, while another two cases rose to grade B and needed hepatic conservation treatment before discharge. Two cases of the six preoperative grade B cases rose to grade C with developed jaundice and ascites. Of the two, one even suffered a complication of upper gastrointestinal hemorrhage 5 days after surgery. Somatostatin and proton pump inhibitors were administered to stop bleeding. Al cases gained a satisfying recovery. Harris hip score at fol ow-up showed favorable hip function. Hip replacement is safe and feasible for patients with hepatic cirrhosis when ful evaluation of hepatic function and appropriate perioperative management are ensured.

Aim To introduce and apply artificial lumbar interverte-brai disc replacement for the treatment of lumbar disc degenerative diseasesand lumbar disc herniation accompanying evident disc space narrowing andinvestigate the regulation of its recovering spinal motion and carrying a-bility. Methods Thirty-one cases (37 discs) of artificial lumbar disc re-placement were performed using SB Charite Ⅲ from April 1998 to April2000. Among them, disc degenerative diseases were in 16 cases (18discs), disc herniation accompanying evident disc space narrowing in 13cases ( 17 discs), rec urrent dise herniation in 2 cases. The rehabilitationtraining was done under postoperative instructions. Results All the caseswere followed up from 17 to 41 months (averagely 26 months) untilSeptember 2001. The clinical outcomes were excellent in 23 cases, goodin 6 cases, fair in 2 cases. The mobility of the operated level had 4.0°anterior flexion and 5. 1° posterior extension after operation and 9.1° ontotal mobility. Meanwhile, the operated intervertebral space got an average4. 2 mm higher than that before. Because of technical problem, a slightdisplacement of the core occurred in one case without any clinical symp-toms and signs. Conclusion Artificial lumbar disc replacement can re-covery spinal motion and carrying capacity and provides a new kind ofoperation for the treatment of lumbar disc degenerative diseases and discherniation accompanying evident disc space narrowing.

Objective To investigate the diagnostic value of diffusion kurtosis imaging(DKI)in the classification of hepatic fibrosis. Methods Thirty-five male SD rats were randomly divided into two groups:the hepatic fibrosis group(n=28)and the control group(n=7). The rats in hepatic fibrosis group were randomly divided into 4 subgroups and seven rats per group, the rats were administrated 50％ CCl4 intraperitoneally twice a week to establish hepatic fibrosis , and the four subgroups were injected 2, 4, 6, and 8 weeks, respectively. The rats in the control group were administrated same dose of olive oil for 8 weeks. One rat in hepatic fibrosis group was died of liver failure in the 7th week, and a total of 27 fibrosis experimental rats and 7 control rats were finally included in this study. DKI was performed at the end of the injection period for all rats, the apparent diffusion(D)and kurtosis(K)values were evaluated. Rats were sacrificed immediately after MRI scan and liver specimens were collected. The liver tissues were examined by pathology, liver fibrosis degree, which was graded from S0 to S4, and inflammatory activity, which was graded from G0 to G3 were graded. The difference of D value and K value between different liver fibrosis and inflammatory activity scores was compared by one-way ANOVA(normal distribution)or Kruskal-Wallis test(skewed distribution). Spearman correlation analysis and multiple regression analysis were used to reveal the correlation between DKI parameters and fibrosis staging/necroinflammatory activity grade. To confirm the efficiency of using the ROC curve of DKI parameters to qualify the liver fibrosis grade, which grade was≥3. Results Seven, 6, 6, 7, 8 rats were diagnosed as S0 to S4, respectively. The difference of D value and K value among different fibrosis grades was statistically significant(P<0.05). D value and the degree of fibrosis was negatively correlated(r=-0.650, P<0.01);K value and liver fibrosis grade no correlation(r=0.336, P=0.080). Thirteen, 6, 8, 7 rats were diagnosed as G0 to G3, respectively. D value was negatively correlated with inflammatory activity(r=-0.590, P=0.001);K value was no correlation with inflammatory activity(r=0.169, P=0.389). Compared with inflammatory activity, fibrosis classification was an independent factor in determining D values(P=0.001). ROC analyses demonstrated an area under the curve(AUC)of D value, K value, D value combined with K value in the diagnosis of liver fibrosis grading ≥ 3 level were 0.781, 0.672 and 0.833, respectlively. The sensitivity and specificity of D value combined with K value were 83.3％ and 75.0％, respectively. Conclusion DKI imaging is of great value in the classification of hepatic fibrosis and can be used as an effective method for the diagnosis of fibrosis.

In order to standardize the management of fixed assets in basic medical research, and to solve the problem ofone equipment with more than one code , we discussed the fixed assets coding of instrument and equipment in this paper.The existing equipment classification of the Institute of Basic Medical Sciences of the Chinese Academy of Medical Sciences was analyzed.Depending on application of the experiment and the principle of equipment, the novel fixed assets encoding dictionary of instrument and equipment is generated, which fits in the application and development of basic medical research.The managers may find the corresponding code quickly with the standardized equipment name.The new encoding dictionary may facilitate the classification of basic medical experimental instruments, prevent multiple coding situations of equipment and improve the management.