From the status quo of doctor—patient relationship and medical students' communication competence and in combination with the need of transformation of modern medicine,the article discussed stressing the training of the clinical medical students' ability to deal with doctor—patient relationship so as to cultivate their communication competence.

Objective:The patients undergoing operation for the fracture of hip or/and pelvis are at risks for venous thromboembolic complication.We measured the level of tumor necrosis factor-alpha(TNF-?) and intercellular adhesion molecule-1(ICAM-1) to evaluate the relation between cytokine and deep venous thromboses(DVT).Methods:28 patients of fracture of hip or/and pelvis were divided into two groups according to venography.The levels of ICAM-1 were tested with enzyme-linked immunosorbent assay(ELISA),while TNF-? were tested with radioimmunoassay at the first day after injury,and 1st,3rd,7th,12th day of postoperative period.Results:We found a marked increase of TNF-? and ICAM-1 in all the patients,and there was significant difference between the patients and normal controls (P

Objective To explore the clavicular hook plate in the treatment of distal clavicle fracture dislocation acromioclavicular joint clinical effects.Methods Twenty-three cases of Neer Ⅱ type distal clavicle fracture and 28 cases of Allman Ⅲ acromioclavicular joint dislocation line with open reduction and clavicular hook plate fixation.Results Fifty-one patients in this group have received 6-24 months of follow-up,an average of 18 months.2-3 weeks after the activities returned to normal off the shoulder,clavicle fractures were 3-12 months after bone healing and no-dislocation of acromioclavicular joint occur.According to Karlsson evaluation criteria:excellent in 40 cases,good in 9 cases and poor in 2 cases,excellent rate of 96.1％.Conclusion The clavicular hook plate fixation strength in the design and in line with the anatomical acromioclavicular joint physiological characteristics,surgical trauma,and has a fixed precise,allows early functional exercise.It is the ideal way to lock joint dislocation.

Forty patients with hip disease who underwent first total hip arthroplasty (THA) in Department of Orthopedics, Second Hospital of Chongqing Medical University from January 1999 to January 2002 were selected. They were treated with cemented (n =16) and cementless THA (n =24). The time to leave bed of cemented-THA group was obviously shortened compared with cementless THA group (P

Objective To detect a quantitative relation between reaction time of substance P (SP) and histamine release of mast cells (MC) in hypertrophic scar (HS) and discuss the interaction and time-effect of substance P and histamine release in HS. Methods The HS specimens were from the 4 to 7-year-old scalded or burnt patients who underwent operation because of cicatricial contraction. The normal skins were the autograft. HS specimens were cut into 0.5-1 mm 3, then treated with 5?10 -5 mol/L SP for 5, 15, 30, 60 min. The degranulation of MC was detected and the histamine released by mast cells in the supernate after SP treatment was examined by immunofluorescence. Conclusion SP and MC are of a close relationship in HS, and SP can affect histamine release of mast cell in time-dependent manner.

Fourty - seven cases were treated with this remedy, a~ mong them, 26 cases were markedly effective, 12 cases abated, 4 cases ineffective, the total effective rate being 91. 5%. The results were apparently superior to the blank control group. The mechanism of such effectiveness lies in the improvement of evacuation of gastric content and gastrointestinal movements.

ObjectiveTo introduce a new procedure of penile lengthening which yields satisfactory outcomes and avoids persistent postoperative hydrophallus with the results of fresh body researches.MethodsIndirect intralymphatic injection and routine H-E staining were used to investigate the ramification of lymphatics of penis on fresh bodies.We found that the lymphatic return of penis was primarily mediated by dorsal and bilateral superficial lymph vessels,which converged dorsally at the root of penis and then ramified into the superior region of pubic symphysis and bilateral inguinal grooves.However,most previous incisions were done at the converging region of lymph vessels at the dorsal root of penis.It blocked most lymphatic return.Our modified method avoided interruption of lymph vessels in the converging region.Based on the results of the above investigations,the operative incision at the root of penis was shifted upward by 1.5 cm,and then the lengthened cavernous body of penis was covered by scrotal flap.ResultsEighty patients who accepted the new method achieved satisfactory outcomes.Postoperative hydrophallous decreased gradually from the 3rd day and vanished basically on the 6-7 day.ConclusionsOur modified procedure of penile lengthening reduces the damage of these vessels.Consequently,postoperative hydrophallus resolves fast and the new procedure yields high success rates,sound appearance and sensation of penis.Therefore,the new procedure is an ideal option for surgenons in clinical practice.

Objective To explore the etiology of and timing for operation of acalculous biliary acute pancreatitis(ABAP).MethodsWe retrospectively analyzed the etiology study and treatment experience of 38 cases of ABAP.ResultsThirteen cases underwent a surgery, including 6 early operations for complicated biliary tract infection without morbidity and mortality, 5 middle staged patients (5～14 days after onset of ABAP) underwent surgery because of intraabdominal indications with one postoperative death and 2 late operations for severe acute pancreatitis (SAP) resulted in one postoperative death of sepsis. The total postoperative mortality rate was 15%( 2/13). Four SAP cases were managed conservatively with one death of MOF. The remaining 21 cases of acute edematous pancreatitis (AEP) were cured by nonoperative methods.ConclusionWhereas an early exploration is indicated, when complicated by biliary tract infections, it is judicious to try a conservative therapy first for ABAP patients.

BACKGROUND:Usual mechanics experiment approach cannot be applied directly to human body and the inter-comparability of models is low.Therefore finite element numerical simulation to mechanical behavior of human body has become an effective method for better understanding of the human body.OBJECTIVE:To establish a three-dimensional finite element model of femoral osteoporosis.METHODS:According to the average Chinese femur parameters,1 male patient with severe osteoporosis,aged 86 years,with no hip joint diseases,was selected.The data of femoral osteoporosis was obtained by means of spiral CT scanning.The graphical data were processed by the Mimics 11.1 (a graph processing software),and the outline curve data of femoral bone cortex inside and outside surface were obtained.The curve data were imported into the Unigraphic NX4.0 for solid modeling.The femur three-dimensional model composed of the cortical bone,cancellous bone and medullary canal was obtained.The model data were imported into the Ansys 11.0 for operations such as assigning,meshing,and contact interactions to establish three-dimensional finite element model of osteoporotic femur.RESULTS AND CONCLUSION:Three-dimensional finite element model of femur of osteoporosis was successfully established,which provides a reliable method for the construction of finite element model of femoral osteoporosis,and creates conditions for investigating femoral osteoporosis fracture fixation method and joint replacement.

Objective Calcified epithelioma is a rare benign tumor in head and face. It is seldomly seen canceration. But it has local invasion behavior. The aim of this study was to explore the methodology in the diagnosis and treatment of calcified epithelioma in head and face, and to improve the accuracy of clinical diagnosis. Methods A retrospective analysis was carried out in 26 patients with calcified epithelioma in head and face. Results 53. 8 % patients with calcified epithelioma were less than 13-year-old. The disease was easily misdiagnozed. In this group of patients the misdiagnosis rate reached to 42. 3 %. Btype ultrasonographic diagnosis possessed a high level of concordance with histological diagnosis. There were three major types of calcified epithelioma: type 1, a mass with internal echoic foci; type 2, a hyperechoic mass with high beam; type 3, no calcification in the parenchyma. Piomatricoma was described as a skin tumour histologically composed of shadowcells, basophillic cells, foreign body giant cells and intracellular and stromal calcification. The treatment was excision and no recurrences were found by followup. Conclusions It is important for clinicians to know the clinical features of calcified epithelioma. Imaging studies including ultrasonography would help establish the diagnosis. Surgical excision with clear margins is recommended for this tumor.