Adult ; Female ; Fibula ; transplantation ; Free Tissue Flaps ; Humans ; Imaging, Three-Dimensional ; Maxilla ; diagnostic imaging ; surgery ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps ; Tomography, X-Ray Computed

It has been confirmed that circulating tumor cells (CTCs) may be the origin of a wide variety of tumor metastasis,which plays an important rote in tumor metastasis,recurrence and treatment-resistant.Through the enrichment detection and analysis of biological characteristics of CTCs,useful information can be provided for the early diagnosis of tumor,assessment of metastasis risk and prognosis,as well as individualized anti-tumor treatment project.In this paper,the research progress on detection of CTCs and its clinical application were reviewed in recent years.

BACKGROUND:In addition to infection, the reasons for total knee arthroplasty revision are polyethylene liner wear and prosthesis loosening. The impact of joint line height on patelofemoral biomechanics was inconclusive. OBJECTIVE: To study the impact of joint line changes after total knee arthroplasty on patelofemoral joint biomechanics. METHODS: Three-dimensional finite element models were established after total knee arthroplasty. The impact of different joint line height on quadriceps tensile force, patela tendon tension, and patelofemoral joint forces was calculated at range of flexion of 0°, 30°, 60° and 90°. RESULTS AND CONCLUSION: (1) At knee flexion of 0°, the height of the joint line in-3 mm-4.5 mm did not have great impacts on quadriceps tensile force, patela tendon tension and patelofemoral joint forces. (2) At knee flexion of 30°-90°, the height of the joint line below 3 mm did not have great impacts on quadriceps tensile force, patela tendon tension and patelofemoral joint forces. The height of the joint line more than 3 mm had obvious impacts on quadriceps tensile force, patela tendon tension and patelofemoral joint forces. (3) It was recommended that the height of joint line in total knee arthroplasty was preferably controled within 3 mm.

To analyze the significance of intraocular scattered light and contrast sensitivity in cataract patient's visual quality.METHODS: Seventy-three cases of cataract patients ( 120 eyes ) in our department from January 2012 to January 2014 were selected, of which 32 cases (52 eyes) were cortical cataract, 18 cases ( 33 eyes ) were nuclear cataract, 23 cases ( 35 eyes ) were posterior subcapsular cataract, and 40 normal persons ( 40 eyes ) were as the normal group. The full-eye corneal astigmatism and total astigmatism were observed in all those enrolled. The contrast sensitivity of different perspective was checked by automatic glare contrast sensitivity tester.RESULTS: The corneal astigmatism and full eye total astigmatism in the cortical cataract group, nuclear cataract group and the posterior capsule cataract group was significantly higher than that in the normal group( P<0. 05). The total astigmatism was no significant difference cataract in three groups of patients with corneal astigmatism and total full eye astigmatism (P>0. 05). The contrast sensitivity in the cortical cataract group, nuclear cataract group and posterior subcapsular cataract group in the whole band were significantly lower than the normal group (P<0. 05). The contrast sensitivity of posterior subcapsular cataract group in the whole band was significantly lower than cortical cataract groups and nuclear cataract group(P<0. 05).CONCLUSlON: lntraocular scatter light and contrast sensitivity joint inspection can effectively evaluate the visual quality of cataract patients, which lead to early treatment.

Idiopathic membranous nephropathy (IMN) is one of the main causes of nephrotic syndrome in adults, and is a kind of glomerular capillary loops epithelial side immune complex deposition of glomerular disease. At present, Western medicine treatment mainly uses hormone combined with immunosuppressive agent, but the adverse reactions are bigger. According to many years clinical experience, Professor TAN Jin-chuan starts from the spleen and kidney deficiency and blood stagnation in kidney meridian, and uses modified Yishen Tongluo Prescription to support right qi and regulate spleen and kidney at the same time. She is good at use of insect medicine to seize the meridians, and focuses on comprehensive care, which provides positive reference value for TCM treatment of IMN.

OBJECTIVE:To establish an HPLC method for the determination of the contents of baicalin,berberine hydrochloride and jasminoidin in Coptidis decoction for detoxification.METHODS:The samples were separated on Shimazu Sim-pack VP-ODS C18(250 mm?4.6 mm,5 ?m)with mobile phase consisted of acetonitrile-(0.05% potassium dihydrogen phosphate+0.05% trolamine solution,with pH adjusted to 3.0 by phosphoric acid)in gradient elution under a detection wavelength of 254 nm.RESULTS:The linear ranges of jasminoidin,berberine hydrochloride and baicalin were 0.4～2.0 mg?mL-1(r=0.998 1),0.020～0.40 mg?mL-1(r=0.992 0)and 0.020～0.40 mg?mL-1(r=0.996 3),respectively,and their average recoveries were 99.8%,97.5% and 98.1%,respectively,with RSD at 1.8%,2.5% and 1.5%,respectively(n=6 for all the three).CONCLUSION:The established method is specific,sensitive,simple and applicable for the quality control of Coptidis decoction for detoxification.

Objective To investigate the expression of COX-2,PCNA and Cyclin D_1 in the progress of reflux esophagitis.Methods A total of 54 SD rats were divided into two groups randomly model group were treated with esophagoduodenostomy;control group were normals.The lesions of esophageal mucosa were observed in the 5~(th),17~(th),28~(th),40~(th) week in model group and 40~(th) week in control group,respectively.The changes of COX-2,PCNA and Cyclin D_1 were evaluated by immunoperoxidase staining in the progress of reflux esophagitis.Results The positive rates of COX-2,PCNA and Cyclin D_1 were 0.0%,0.0% and 12.5% in normal respectively,and were(42.1%),42.1% and 42.1% in RE respectively,73.7%,63.2% and 63.2% in BE,and 100.0%,100.0% and 100.0% in EAC,respectively.The expression of COX-2,PCNA and Cyclin D_(1) increased gradually with the development of reflux esophagitis,and significant difference was found between RE,BE and EAC,no difference was found between BE and EAC.Conclusion In the progress of RE,COX-2,PCNA and Cyclin D_1 increased gradually.

Objective:To detect the expression of IL-4 in bleomycin-induced pulmonary fibrosis in rats and to study the effect of IL-4 in pulmonary fibrosis pathogenesis.Methods:Female wistar rats (170～190g weight) were treated with bleomycin(5 mg/kg weight) by intratracheal perfusion on day 0 to induce pulmonary fibrosis,while the controlled animals were only injected with normal saline (NS).The rats were killed on day 7 and 14,and lung tissue and blood serum were collected.The right lung was stained with hematoxylin-eosin.Reverse transcription polymerase chain reaction (RT-PCR) was used to detect the expression of IL-4mRNA in the left lung and ELISA was used to detect the levels of IL-4 in blood serum.Results:Alveolus inflammation was observed on day 7 and fibrosis focus was found on day 14.Compared with controlled group,the expression levels of IL-4mRNA in lung tissue and the levels of IL-4 in blood serum were elevated significantly in model groups(P

This paper was to explore the application of case based learning method in medical psychology course for medical undergraduates.According to curriculum standard,nine cases were compiled which matched six articles,forming the complete instructional design.We followed the five steps of scientific teaching stage.The preliminary results showed that the case teaching was helpful to improving the medical students' knowledge acquisition,and their ability to master and solve practical problems.

Objective:In recent years, the medical systems has continuously explored the construction of Regional Medical Association, and promoted the classification diagnosis and treatment mode, as the reform of the medical system in our country. Through the regional information sharing, the Medical Association can realize the interconnection and information resource sharing among various medical institutions at all levels, which is for optimizing the allocation of medical resources, improving the level of medical services and alleviating the difficult and expensive medical treatment has an important significance.Methods: This paper adopted the method of literature research. Through the arrangement of the Chinese Medical Association of exploration and the progress of abroad regional medical care grade development, the paper focused on the analysis of problems in preparation and the continued operational of the Medical Association projects, such as guiding patient stratification clinics, the utilization of data in medical research, protection of the quality of medical care, integration of data and other critical medical problems. Results: The paper also presented the following recommendations to build and operate high-quality of the Medical Association, rational allocation of functions at all levels of medical institutions to guide patient stratification clinics, establish disease specialist data centers, and establish quality evaluation system to protect the quality of medical care, develop information standards and integrate medical data.Conclusion:Establishing Regional Medical Association is significantly important to optimize the distribution of medical resources, improve the levels of basic medical services and relieve the problems in the treatment.