Objective Serum indicators of oxidative protein damage (OPD) were analyzed to explore the effect on renal MMP/TIMP system of OPD in diabetic nephropathy. Methods AOPP levels and PCO levels were measured by modified Witko-Sarsat's method and 2, 4-dinitrophenylhydrazine spectrophotometric method, expression of serum MMP-2 were determined by ELISA, and MMP-2 activity were detected by zymography . Results AOPP levels of group DN1, group DN2 were higher than those of group DM(78.23±19.30 vs 61.25±12.13,101.59±30.22 vs 61.25±12.13,F＝41.988,P＜0.01). PCO levels of group DN1 and group DN2 were higher than those of group DM (0.84±0.03 vs 0.66±0.02,1.05±0.05 vs 0.66±0.02,F＝205.763,P＜0.01). Pearson correlation analysis indicated AOPP and PCO were positively correlated with the expression (r＝0.460,0.480,P＜0.05) and activity (r＝0.385,0.560,P＜0.05) of serum MMP-2. Multiple stepwise regression analysis showed that AOPP and PCO were major influential factors of serum MMP-2 expression (P＜0.05,P＜0.01) and activity(P＜0.01,P＜0.05). Conclusions OPD might be involved in the imbalance of renal matrix metabolism, which was correlated with the development of diabetic nephropathy.

Objective To observe the expression level of stromal cell-derived factor-1 (SDF-1) in bone marrow stromal cells of acute leukemia at initial diagnosis and complete remission. Method Bone marrow stromal cells were isolated and cultured from five patients of acute leukemia at the time of initial diagnosis (Group A), five patients of acute leukemia at complete remission (Group B), and five healthy individuals or persons with no serious hematopathy (Group C). The content of SDF-1 protein in cultured supernatants was determined with enzyme-linked immunosorbent assay (ELISA). Results The contents of SDF-1 protein in supernatants of groups A, B and C were 2 941?374, 2 891?305 and 1 583?157pg/ml, respectively. The contents in both group A and group B were significantly higher than that in group C. Conclusion The SDF-1 expression level in acute leukemia bone marrow stromal cells was elevated at initial diagnosis, and the abnormality persisted until the stage of complete remission.

A variety of views and approaches were found in the appraisal and judgments of the people's courts in various provinces and cities,on medical disputes involving absence of a hand or foot of newborns,which result in different or event contradictory court decisions.This study made an analysis of the characteristics,nature,and classification of such cases as well as countermeasures of medical institutions,with recommendations on rational and appropriate handling of such cases,for the purposes of legitimate rights maintenance of both doctors and patients,and promotion of mutual understanding between the two parities,and establishment of a harmonious doctor-patient relationship.

Objective To detect the change of the plasma hydrogen sulfide in patients with chronic heart failure (CHF) and explore its clinical significance.Methods A total of 118 patients with CHF was enrolled in this study.According to the NYHA standard,they were classified into grade Ⅱ (34 cases),grade Ⅲ (54 cases),grade Ⅳ (30 cases).The patients were divided into normal treatment group and sodium nitroprusside treatment group with 59 cases each.Another 30 healthy person were selected as control group.The plasma hydrogen sulfide level was detected by spectrophotometer.Results The plasma hydrogen sulfide level in CHF patients and healthy person was (32.45 ± 3.86),(54.26 ± 5.63) μ mol/L,and there was significant difference (P ＜ 0.05).The plasma hydrogen sulfide level in CHF patients of grade Ⅱ,Ⅲ,Ⅳwas (43.26 ±4.73),(31.87 ±4.12),(23.66 ±3.54) μmol/L,and there was significant difference (P＜0.05).The plasma hydrogen sulfide level before treatment in normal treatment group and sodium nitroprusside treatment group was(31.66 ± 3.75),(33.04 ± 4.02) μ mol/L,and there was no significant difference between two groups (P ＞ 0.05).The plasma hydrogen sulfide level after treatment in normal treatment group and sodium nitroprusside treatment group was (36.83 ± 4.32),(44.54 ± 4.68) μ tmol/L,and there was significant difference (P ＜0.05).The plasma hydrogen sulfide level after treatment in two groups was increased compared with that before treatment,and there was significant difference (P ＜ 0.05).The total effective rate in normal treatment group and sodium nitroprusside treatment group was 42.4％ (25/59) and 67.8％(40/59),and there was significant difference between two groups (P ＜ 0.05).Conclusions The abnormal plasma hydrogen sulfide level may be involved in the occurrence and development process of CHF,which could be used as a factor to monitor the disease.The upregulation of plasma hydrogen sulfide level can significantly improve the prognosis of CHF patients.

Objective To evaluate a surgical approach and anastomosis for the treatment of carcinoma of the gastric cardia. Methods Transabdominal intramediastinal esophagogastric anastomosis covered by sero-muscular flap of gastricwall for cardial carcinoma in 187 cases. Results The method reached the satisfactory surgical result in terms of tumor free cut edge on esophagus end of the resected samples. And the morbidity rate was 5.8%. Conclusion The technique enables lymphadenectomy within the lower mediastinum and a sufficiently long enough resection of esophagus. Transabdominal incision of the crus dextrum of the diaphragm makes a clear operative field for the purpose of radical operation for carcinoma of the gastric cardia. The anastomosis effectively prevents anastomotic leakage. This procedure is indicated for cardial carcinoma cases in which the esophaged involvement is within 2cm.

Objective To study the dynamic imaging changes of the uterine leiomyomas before and after uterine arterial embolization (UAE) treatment and to discuss its therapeutic mechanism. Methods Color Doppler senography and both plain and enhanced MR[scanning were performed in 45 patients with uterine leiomyomas before and after UAE. Plain CT scan was performed in all patients after UAE. All the patients were followed up for 3-16 months (average 10±3.5 months). Results In 41 of the total 45 cases, the color Doppler senography showed rich blood flow signals in leiomyomas and myometrium before UAE and no or less blood flow signals in both leiomyomas and myometrium on the first day after UAE. On the seventh day, the blood flow signal was still absent in leiomyomas while it was restored in myometrium, and the same phenomena remained in the first, the third and the twelfth month after UAE. In the other four eases, color Doppler sonography demonstrated blood flow signals inside leiomyomas on the seventh day after UAE and it remained till twelve months after embolization. The embolic agent (Lipiodol) was found in both leiomyomas and myometrium on CT scan for 45 cases on the first day of UAE. CT scan also showed the deposit of the Lipiodol in myometrium, but Lipiodol gradually vanished in leiomyomas at one, three and the twelve months after UAE. The enhancement was apparent in leiomyomas and myometrium on MRI scan in all 45 cases before UAE. The enhancement was found in the myometrium, but not in leiomyomas, on MRI scan in 39 cases 3 months after UAE. The other six cases demonstrated different degrees of enhancement in leinmyomas after embolization. In two cases the detachment of the leiomyomas were observed after embolization and the desquamating materials were pathologicallyproved to be necrotic tissue. The difference in the measuring data about leiomyoma volume between MPI and color Doppler sonography was of no statistical significance (P > 0.05). Conclusion The therapeutic mechanism of UAE for uterine leiomyomas is selectively embolizing the vascular bed of uterus, leading to subsequent necrosis of leiomyomas. The color Doppler sonography should be the fast choice for the dynamic imaging follow-up after UAE.

ObjectiveTo summarize the application experience of laparoscopic totally extraperitoneal prosthetic(TEP) for inguinal hernia in grass-root hospitals.MethodsThe clinical data of 63 cases of inguinal hernia treated by TEP were retrospectively analyzed,and operation scheme suited to the actual conditions of grass-root hospitals was summed up.ResultsAmong the 63 cases,5 cases were treated by transabdominal preperitoneal repair of inguinal hernia(TAPP) to complete the operation because of relatively serious peritoneal rupture.No case was converted to open surgery.11 cases were subjected to continuous epidural anesthesia and the other cases to endotracheal anesthesia.17 cases gained satisfactory result withoutstapling fixation.Among them,a few people had postoperative complications:3 cases of pneumoscrotum,1 case of hematoma of scrotum and 2 cases of early groin pain.No case recurred.ConclusionTEP is a safe and effective operation method in grass-root hospital for inguinal hernia repair.A reasonable selection can be taken according to the individual condition of patients including operation,anaesthesia,mesh style and stapling fixation,to ensure the operation quality,to reduce the medical wst and to reduce the economic burden of the patients.

Currently,independent clinical medial femoral plate is more needed to apply in more complex C3 distal femoral fractures and knee valgus orthopedic surgery.The doctors always pre-bent the contralateral femoral lateral plate in order to achieve close to the natural shape of the bone.The cold deformation of the plate can change the metallographic structure and the biomechanics,and the position of the screw holes in the plate may also affect the healing of fractures.Compared with traditional manufacturing techniques,3D printing technology as a core technology in third industrial revolution,instead prior manufacture of molds,removing the large amount of material in the manufacturing process and the complex process of forging a final product,it is more suitable for difficult to machine materials,manufacture,inspection shape design,assembly,testing and fast reverse engineering.Therefore,a personalized interior distal femoral plate with 3D printing technology was designed,and the application of the plate,the current situation and prospects of 3D printing technology and other aspects were summarized in this article.

Objective To synthetically evaluate the relationship between miR-31 and the prognosis of carcinoma and to investi-gate its related mechanism.Methods The correlative literatures of tumor prognosis were retrieved from the electronic databases PubMed,EMBASE and ISI Web of Science.The pooled hazard ratios (HRs)and 95% confidence interval(95%CI )were extracted. The prognostic data were performed the synthesis analysis.Results A total of 7 trials conformed to the inclusion criteria including accumulated 2 012 cases of carcinoma.Meta-analysis revealed that the decrease of miR-31 expression in the tumor patients had the poor prognosis (HR=0.784,95%CI :0.630-0.974);in the subgroup analysis,the synthesis results adopting the multivariable a-nalysis and China subjects were 3.512 (95%CI :1.797-6.865)and 1.574 (95%CI :1.062-2.333),which indicating that the in-crease of miR-31 expression predicted the poor prognosis;miR-31 had no statistical significance in the digestive system (P >0.05). Conclusion The prognostic role of miR-31 may possess the histological and regional specificity and has the potential as a novel marker.

With the development of virtual reality, augmented reality, and mixed reality technology, their application in medical education has become increasingly widespread. With the advantages of virtuality-reality combination, real-time interaction and exact registration, mixed reality technology is expected to improve the drawbacks of traditional medical education, and exerts great potential in virtual classroom, virtual laboratory, anatomy teaching, medical operation training, surgery simulation, and telemedicine education. This article mainly introduces the applications of mixed reality technology in medical education in recent years, and hopes to provide a reference for the integration of mixed reality technology into the field of education.