Case-based teaching (CBT) on the basis of treatment guidelines was carried out to develop standard medical behavior, improve learning efficiency and students' ability of solving clini-cal problems. In clinical internship teaching, guidelines for common and frequently-occurring respira-tory diseases and CBT were organically combined. Cases were carefully selected and questions were meticulously set. Guidelines were thoroughly analyzed and teaching was reasonably evaluated. There-fore, students' learning interests were initiated and learning efficiency was improved. It not only trained evidence-based medicine thinking of intern students, but also improved the teaching ability of clinical teachers.

Objective To analyze the clinical techniques of renal artery control in laparoscopic donor nephrectomy.Methods 211 relative living renal transplantations were performed from June 2003 to June 2012,and 136 donors underwent laparoscopic donor living nephrectomy (LDN) since 2007.Forty donors were subjected to the Hem-o-lock clips for renal artery control by open surgery,87 donors to the Hem-o-lock clips for renal artery control by laparoscope,5 donors to the Endo GIA stapler for renal artery control by laparoscope,and 4 donors to the Hem-o-lock clips by laparoscope combined with hand-assisted suture transfixion for renal artery control.Results The warm ischemia time of renal artery control was shortest (1.1 ± 0.3 min) by Hem-o-lock clips in open surgery,and longest (3.2 ± 0.8) min by the Hem-o-lock clips with laparoscope.There was significant difference in the warm ischemia time of renal artery between open group and other groups,the differences (P＜0.05).The comparison of prognostic factors in the transplant renal outcome showed no significant difference among groups.The renal arterial stump-rrhexis-caused massive secondary bleeding occurred in 1 case subject to Hem-o-lock clips for renal artery control by laparoscope,with conversion to open surgery urgently,the operation was successful at last.Other renal artery control ways were all safe without any adverse reaction.Conclusion The warm ischemia time of renal artery control by Hem-o-lock clips in open surgery was shortest in laparoscopic donor nephrectomy.The renal artery control way by Endo GIA stapler in laparoscope or by Hem-o-lock clips with hand-assisted suture transfixion is safest.The utilization of Hem-o-lock clips should be careful in high risk population such as severe atherosclerosis etc.

Objective To explore the method and effect of thumb and finger reconstruction and repair by emergent primary toes transplantation. Methods Three hundred and fourteen fingers of 282 cases including finger thumb defect and complex injury with hyperthena palm radid soft tissue of forearm were reconstructed and repaired by the second toes, wrap-around flap and the second third toes wrap-around flap combined with distal flap of leg or other complex tissue flap transplantation. Results Three hundred and eight reconstructed fingers survived, the survival rate was 98%. After a follow up to 6 months to 6 years, the reconstructed thumbs and fingers have accepted nip, grasp, opponent function. The result was graded as excellent in 214 fingers, good in 63, fair in 26, poor in 5. The excellent and good rate was 88%according to the upper limb functional evaluation criteria issued by the Hand Surgery Society of the Chinese Medical Association. Conclusion Different type of toes and combined toes transplantation can obtain preferable clinical effect on emergent primary thumb and finger defect.

Objective To explore the mechanism of deep brain stimulation(DBS)therapy to Parkinson's disease(PD).Methods We produced hemi-parkinsonian rat model with stereotaxically injecting 6-OHDA to right medial forebrain bundle(MFB)and stimulated ipsilateral subthalamu nucleus (STN)with platinum electrodes chronically to investigate the influence of DBS to the expression of Calbindin-28,synaptophysin and tyrosine dioxydase(TH)in Striatum by Western blot.In addition,slices of bilateral PD rats after DBS were stained to observe the expression of Calbindin-28 and synaptophysin in substantia nigra by Immunohistochemistry.Results High frequency stimulation impaired the rotational frequency 31% of unilateral PD rats triggered by apomophine;Long-term DBS increased the expression of TH in innocent striatum of unilateral PD rats 78.6%?9.5%,since the ipsilateral striatum(lesion side) was TH depleted by 6-OHDA insults;Calbindin-28 expression in ipsilateral striatum of hemi-PD rats raised up 75.4%?15.0% and long-term DBS reduced the effect by 43.0%?7.1%,meanwhile Calbindin-28 positive neurons in substantia nigra compacta in sham,PD and DBS rats were 74.5?10.2,75.7?15.6, 33.1?7.8.However,Synaptophysin expression in substantia nigra and striatum kept stable even after long- term DBS.Conclusions Consistent to the treatment to PD patients,DBS to STN alleviated the motor disorder of PD rats,the treatment might be based on regulating the expression of Calbindin-28 and TH.

OBJECTIVETo develop an electronic system (software) for collecting and analyzing periodontal examination data, and preliminarily evaluate its clinical application.

METHODSThe contents and frame of electronic periodontal examination system were designed based on the aim and requirement of periodontal examination, and the software system was developed under the assistance from computer engineers. The electronic system was implemented for entry, storage, retrieval and output of clinical data and data conversion. A questionnaire survey was performed in 23 periodontists and 20 nurses to evaluate the clinical application of this software.

RESULTSAn electronic periodontal examination system was developed, which was used for entry, storage, retrieval and output of clinical data, and converting data into chart. Most nurses could handle this software after 15 minutes of training. Thirteen nurses and 17 periodontists recognized that clinical work efficiency could be improved by application of this software. Nineteen nurses and all periodontists agreed that this software could meet clinical requirements.

CONCLUSIONSThe electronic periodontal examination system can fulfill clinical requirements and is helpful for clinical treatment and research work.

Humans ; Information Storage and Retrieval ; Periodontal Index ; Software ; Surveys and Questionnaires

OBJECTIVETo observe the clinical efficacy and adverse reactions of Paroxetine combined with electro-acupuncture (EA) in treating depression.

METHODSForty-two patients with depression were randomly assigned to the observation group (22 patients) treated with EA combined with Paroxetine, and the control group (20 patients) treated with Paroxetine alone, and the therapeutic course for both groups was 6 weeks. The therapeutic efficacy and adverse reactions were evaluated with scores by Hamilton depression scale (HAMD) and treatment emergent symptoms scale (TESS), respectively.

RESULTSHAMD scores determined at the end of the 1st, 2nd, 4th, and 6th week of the treatment course were significantly lower in the observation group than those in the control group (P<0.05). The significant improvement rate evaluated at the end of the 6-week treatment was remarkably higher in the observation group than that in the control group (72.7% vs 40.0%). No significant difference of TESS scores was found between the two groups.

CONCLUSIONEA combined with Paroxetine has better clinical efficacy than that of Paroxetine alone, with milder adverse reaction and quicker initiation of effect.

Adult ; Combined Modality Therapy ; Depression ; drug therapy ; therapy ; Electroacupuncture ; Female ; Humans ; Male ; Paroxetine ; adverse effects ; therapeutic use ; Serotonin Uptake Inhibitors ; adverse effects ; therapeutic use ; Treatment Outcome

OBJECTIVETo investigate the clinical effect of bridging fixation with locking plate for the Seinsheimer type V subtrochanteric femoral fracture.

METHODSFrom March 2009 to September 2014,18 cases of Seinsheimer type V subtrochanteric femoral fracture were treated by open reduction and bridging fixation with locking plate through proximal and distal approach including 16 males and 2 females with an average age of 41 years old ranging from 22 to 67 years old. Among them, 12 cases caused by traffic accident, 5 cases by falling, 1 case by heavy aboving. All cases were fresh and closed fractures. Time between injury and operation was from 4 to 9 days with an average of 6.2 days. Of them, 11 cases were fixed with reverse LISS and the other 7 cases were fixed with anatomical locking plates of proximal femur.

RESULTSThe mean time of operation was 110 min (ranged from 90 to 155 min). The mean blood loss during operation was 425 ml (ranged from 350 to 650 ml) and 16 cases got blood transfusion which was meanly 300 ml. The mean hospital time was 14 days (ranged from 12 to 18 days). The mean duration of followed up was 11.8 months (ranged from 8 to 22 months). The mean time of bone union was 6.6 months (ranged from 5 to 8 months). There was not any complication such as infection, implant failure, hip varus, external rotation deformity of low limb or fat embolism. The Sanders hip scores were 53.22 ± 6.48, the result was excellent in 12 cases and good in 6 cases at the last follow-up.

CONCLUSIONUnder the principle of biological osteosynthesis, treatment of Seinsheimer type V subtrochanteric femoral fracture with bridging locking plate fixation has such advantages as high mechanism, less interference of blood supply, stable fixation and little complication. It is a safe and idea way for the treatment of the Seinsheimer type V subtrochanteric femoral fracture.

Adult ; Aged ; Bone Plates ; Female ; Fracture Fixation, Internal ; methods ; Hip Fractures ; surgery ; Humans ; Male ; Middle Aged

OBJECTIVETo introduce a rapid colorimetric method for assessing the viability of osteosarcoma cells after chemotherapy.

METHODSColorimetric assay and automatic microplate scanning spectrophotometer were used for assaying the viability of osteosarcoma cells.

RESULTSClose correlation was found between the absorbance at 570 nm of the formazan products and the number of viable osteosarcoma cells.

CONCLUSIONAn effective, sensitive and convenient colorimetric assay has been established to assess the survival of osteosarcoma cells following chemotherapy.

Antineoplastic Agents ; therapeutic use ; Bone Neoplasms ; drug therapy ; pathology ; Cell Survival ; drug effects ; Colorimetry ; methods ; Formazans ; Humans ; Osteosarcoma ; drug therapy ; pathology ; Sensitivity and Specificity ; Tetrazolium Salts

Objective To investigate the characteristics and diagnostic value of 18F-fluorodeoxyglucose (FDG) PET/CT in patients with secondary malignant peripheral nerve lesions. Methods 18F-FDG PET/CT studies of 8 cases of secondary malignant peripheral nerve lesions confirmed by histopathology or follow-up were analyzed retrospectively. The maximum standardized uptake value ( SUVmax ) of infiltrating peripheral nerves and contralateral normal peripheral nerves was measured and compared with their morphological appearances on CT. Paired student t-test was performed by SPSS 10.0. Results Twelve secondary malignant peripheral nerve lesions with high 18F-FDG metabolism were found in 8 cases. On PET imaging,the lesions distributed along the neurovascular tissues or intervertebral foramina with appearances resembling those of fibre bundles,radices or nodes on PET but no density differences with the surrounding soft tissue or fat planes on CT. The SUVmax was 6.86 ± 3.87. The contralateral normal peripheral nerves showed no abnormal 18F-FDG uptake with a SUVmax of 1.10 ±0.46,which was significantly different from that of the secondary malignant peripheral nerve lesions (t = 9.231,P ＜ 0.001 ). Conclusion 18 F-FDG PET/CT may be useful in locating the secondary malignant peripheral nerve lesions and in assessing its regional infiltration.

OBJECTIVETo compare two different methods, namely orthotopic implantation and armpit implantation, for establishing nude mouse model bearing osteosarcoma in light of the tumor formation rate and time, tumor growth changes and lung metastasis.

METHODSOsteosarcoma cells were inoculated in the left armpit or the femoral medullary canal of nude mice, and the tumor growth was observed 6 weeks later. The differences in the pulmonary metastasis were examined macroscopically and microscopically.

RESULTSArmpit implantation allowed easy operation and fast tumor growth, but tumors often sustained damages by frictions on the surface (P<0.05), and avascular necrosis occurred earlier in the tumors (P<0.05). With this approach, the pulmonary metastasis rate was only 40% (P<0.05), and the metastases in the lungs were sparser (P<0.05) and small. Orthotopic transplantation could well simulate the original growth environment of osteosarcoma, and resulted in milder avascular necrosis and greater pulmonary metastasis rate (100%) with larger and denser metastatic foci. But orthotopic transplantation required more complicated operation for establishing osteosarcoma-bearing models.

CONCLUSIONThe two methods both result in high tumor growth rate, but orthotopic transplantation is superior in inducing pulmonary metastasis of osteosarcoma and reducing friction injury of the tumor and avascular necrosis in the tumor.

Animals ; Bone Neoplasms ; Disease Models, Animal ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Neoplasm Transplantation ; methods ; Osteosarcoma