Evidence-based medicine(EBM)is a new mode for modern medical education in orthopaedic teaching.The theory of evidence-based medicine is an essential part of clinical education for young doctors in practice,which improves their ability of thinking,scientific research and self-education,so as to enhance the students'comprehensive ability and lay sound basis for medical practice in future.

Objective To study the effect of the expansive open-door laminoplasty on the three-dimensional motion and stiffness of the cervical spine. Methods 55 cases after open-door laminoplasty of cervical spine due to myelopathy were follow-up for an average of 35.9 months. Cervical axial symptoms, neural functionality (JOA scoring system) and pre- and post-surgery dynamic cervical spine lateral X-ray films were evaluated. The Three-dimensional Motion and Stiffness of the Cervical Spine of Human Body Measuring Equipment was used in 12 post-operative open door laminoplasty cases and 10 pre-operative cases to measure the active and passive range of motion(ROM), load-displacement relationship, stiffness of cervical spine and torque caused by the isometric contraction of the extensors and flexors of the cervical spine. Results The average rate of improvement was 66. 2%. The excellent and good rate was 78.2%. The number of cases with distinct or severe cervical axial symptoms increased after the surgery ( P ＜ 0. O1 ) . The patients who have severe axial symptoms tend to have less curved cervical spine (P ＜ 0. 01 ) . There was no significant statistic difference between the severity of post-surgery cervical axial symptoms and JOA improvement level (P ＞ 0. 05). The active and passive ROM of extension, rotation and lateral bending of cervical spine were decreased after the surgery ( P ＜ 0. 05), and the main affection was on the middle and lower part of the cervical spine. The load-displacement figure of cervical spine can fit into an exponential equation T= b0eb1θ. In each direction, the lateral bending had the strongest stiffness, then the extension and flexion. The stiffness of rotation was the weakest. The stiffness of cervical spine of the post-surgery group was stronger than that of the contrast group. Conclusion The open-door laminoplasty of cervical spine damages the static mechanic balance on the sagittal plane and decreases the ROM and the flexibility of cervical spine. The curvature of the cervical spine is related to the severity of the axial symptoms and seems not to be related to the JOA score improvement.

Objective To investigate epidemiological characteristics of Salmonella infection in children with infectious diarrhea in Zhuhai City from 2009 to 2014 .Methods Isolation ,culturing ,biochemical identification and serotyping of Salmonella were carried out in strains isolated from stool specimens of 4 395 children with infectious diarrhea in inpatient and outpatient settings in Zhuhai Municipal Maternal and Child Healthcare Hospital from 2009 to 2014 ,and data were statistically analysed .Results A total of 546 strains of Salmonella was isolated(the overall isolation rate was 12 .42% ) and 30 serotypes were identified .Among children with Salmonella infection ,those under 3 years old accounted for 93 .22% .There was no statistically significant difference of isolation rate between male and female children with infectious diarrhea(P<0 .05) .June and July were peak period of Salmonella infection ,and the isolation rate was 16 .40% and 16 .09% respectively .Isolates of Salmonella typhimurium ,Salmonella enteritidis and Salmonella stanley account for 50 .92% ,13 .55% and 10 .26% respectively ,which were dominant serotypes .Conclusion Salmonella is the main pathogenic bacteria in children with infectious diarrhea in Zhuhai area ,and Salmonella typhimurium is the main serotype .The infec‐tion of Salmonella might be correlated with children′s age and climate change .

The application of network and multimedia technology in combination with bilingual teaching in orthopedics is explored which not only promotes the use of multimedia technology in teaching,but also enhances students' understanding ability for professional knowledge.Moreover,it can enhance students' learning interest in medical English and medical knowledge,thus promoting education effectively.

Gene expression exhibits temporal and spatial patterns to response environmental changes and growth cycle. Gene expression is under strict control at different levels among which control at transcription level is the predominant mode, especially in prokaryotes. In this review, we summarized the new developments of methods used in transcriptional studies, including modifications and improvements of the classic methods, such as gel-shift assay, DNA foot printing, and in vivo reporter system. In addition, we introduced examples to apply new methods, such as surface plasmon resonance (SPR) and isothermal titration calorimetry (ITC) to characterize protein-DNA, ligand-protein, and ligand-protein-DNA interactions. The collection of these methods and their application could guide and accelerate relevant studies.
Calorimetry ; DNA Footprinting ; Gene Expression ; Ligands ; Proteins ; Surface Plasmon Resonance ; Transcription, Genetic

Bacterial two-hybrid system is a newly developed method for studying protein-protein interactions. However, in our studies of the interaction of regulatory proteins in Streptomyces, it was found that the bacterial two-hybrid system is not sensitive enough by the blue-and-white selection on X-gal plate. To overcome this drawback, the reason of false positive clone was firstly determined, which was the disturbance of other direct or indirect regulation on lacZ promoter. Then the disturbance was diluted by introducing multicopy lacZ promoter, which drive another reporter gene gfp. By such design, the sensitivity of the modified bacterial two-hybrid system was significantly inproved and the two different reporters also help to decrease the rate of the false positive clones. Further the evaluation of the modifiedd bacterial two-hybrid system indicated that the sensitivity was significantly improved.
Bacteria ; Genes, Reporter ; Promoter Regions, Genetic ; Protein Interaction Mapping ; methods ; Two-Hybrid System Techniques

Objective To investigate the expression and significance of MMP-3 in knee joint synovium of different stage in osteoarthritis (OA) patients. Methods MMP-3 protein were detected by immunohistochemical method in knee synovial tissues from 90 OA patients (the OA group) and OA group was divided into 3 subgroups according to Kellgren and LawrenceX-ray diagnosing standards: the gradeⅠ(n = 30), gradeⅡ (n = 30) and grade Ⅲ subgroups (n = 30). 30 patients were enrolled as control group. Immunohistochemistry was used to detect the expression of MMP-3 protein in the tissue. Results The expression level of MMP-3 protein in OA group was significantly higher that in the normal synovium (P < 0.05). There existed significant difference in the expression of MMP-3 protein between the grade Ⅲ subgroup and the gradeⅠ, or Ⅱsubgroups (P < 0.05). The expression of MMP-3 protein related positively to the severity of OA (r = 0.912, P < 0.05). Conclusion The expression of MMP-3 protein related closely to the pathogenic mechanism of OA. It may serve as an important indicator of early diagnosis and the activity of OA.

Objective To investigate the antibiotic resistance of Haemophilus influenzae isolates collected from the children with respiratory tract infection for rational use of antibiotics in clinical practice .Methods The H .influenzae strains were isolated from children and subjected to antimicrobial susceptibility testing by Kirby-Bauer method .Nitrocefin disc test was used to detect the production of beta-lactamases .WHONET 5 .6 software was used to analyze the susceptibility data .Results A totalof1256strainsof H.influenzaewereisolated.About37.8% ,65.5% and16.5% ofthe1256strainsof H.influenzae were resistant to ampicillin ,trimethoprim-sulfamethoxazole ,and ampicillin-sulbactam ,respectively .Less than 10 .0% of these strains were resistant to any other antibiotics tested .Beta-lactamase was produced in 33 .5% of the 1 256 strains of H . influenzae .Conclusions The H . influenzae strains in this study are mainly resistant ampicillin and trimethoprim-sulfamethoxazole .About 80 .0% of these H . influenzae strains were still susceptible to cefaclor ,ampicillin-sulbactam , cefixime ,ceftazidime ,azithromycin ,ciprofloxacin ,meropenem and rifampin .The primary mechanism of ampicillin resistance in Haemophilus is production of beta-lactamases .

Alzheimer's disease(AD),a most common type of dementia,often results in cognitive and behavioral dysfunction,A growing body of research suggested that there are specific correlations between AD and traditional vascular risk factors.There are significant associations between the incidence of AD and diabetes mellitus,hypercholesterolemia,hypertension,hyperhomocysteinemia,antioxidants,alcohol consumption,smoking,physical activity,and the presence of atrial fibrillation.These risk factors may he the potentially preventable etiologies of AD.

Objective To investigate the factors that affecting the efficacy of arthroscopic debridement in the treatment of knee osteoar-thritis. Methods The clinical data of patients with knee osteoarthritis treated with arthroscopic debridement in our hospital from January 2009 to December 2013 was retrospectively analyzed,and the treatment effect was evaluated by Lysholm score. The factors that may affect the efficacy were selected to make a single factor analysis,and then made a multiple logistic regression analysis with the factors which were of sta-tistical significance through single factor analysis. Results Single factor analysis showed that age,course of disease,body mass index,psycho-logical factor,preoperative VAS score,preoperative Kellgren-Lawrence grade,preoperative Lysholm score and postoperative rehabilitation exer-cise were the factors that affected the efficacy of knee arthroscopy in the treatment of knee osteoarthritis,and the difference between the two groups was statistically significant. Further multivariate analysis showed that high body mass index,high preoperative VAS pain score,low Ly-sholm score,high psychological expectations and high preoperative Kellgren-Lawrence grading were expected to be the independent risk fac-tors of knee arthroscopy in the treatment of knee osteoarthritis. Strict compliance with the postoperative rehabilitation exercise was the protect factor. Conclusion High body mass index,high preoperative VAS pain score,low preoperative Lysholm score,high preoperative Kellgren-Lawrence grading,and high psychological expectations were expected to reduce the effect of surgery,while strict compliance with the postoper-ative rehabilitation exercise can improve the curative effect.