BACKGROUND: At present, the meniscus injury is very common, and can lead to serious injury of the knee joint.Meniscus biomechanics has been reported, but no studies have concerned the biomechanical characteristics of the meniscus in knee buckling during gait under different loading conditions.OBJECTIVE: To simulate and analyze the biomechanical characteristics of the knee joint meniscus under different loading conditions using finite element method.METHODS: Based on the knee magnetic resonance imaging data of normal adult volunteers, three-dimensional finite element model of knee joint was reconstructed. The stress, distribution and changes in the meniscus under different flexion angles were analyzed at 300 N, 400 N and 500 N.RESULTS AND CONCLUSION: (1) Under the respectively loading conditions of 500 N, 400 N and 300 N, the maximum stress point all from the place of posterior horn of medial meniscus anterior surface of tibia moved to the posterior margin of the anterior tibial attachment of the lateral meniscus, and the maximum displacement all from the place of midpoint of the inner edge of the medial meniscus moved to front outer edge of the lateral meniscus during normal dynamic buckling process of 0°, 30°, 60° and 90°, and the range of stress and displacement of lateral meniscus was greater than that of medial meniscus; simultaneously, the distribution range of stress and displacement was proportional to the size of the loading and the angle of the buckling. (2) The three-dimensional finite element model of the knee joint meniscus can be used to effectively dynamically simulate the distribution of force and displacement under different loading conditions, and can provide evidence for speculation of the mechanism of the injury of the meniscus in clinic.

BACKGROUND:At present, although the study of three-dimensional finite element biomechanical analysis of knee joint meniscus has been reported and we have a certain understanding of the biomechanical changes of the meniscus, but the dynamic simulation of the knee meniscus in the same load conditions in the process of biomechanical analysis of the knee meniscus is less reported. OBJECTIVE:To analyze the biomechanical characteristics of the knee joint meniscus under different flexion angle by using analogue simulation of finite element method. METHODS:Based on knee MRI data of the normal adult volunteers, the medicine finite element simulation software Mimics10.01 and reverse engineering software Rapidform XOR3 were utilized to reconstruct three-dimensional finite element model of knee joint meniscus. The advanced finite element analysis software Abaqus6.10-1 was utilized for analogue simulation and for analyzing biomechanical changes during flexion under vertical load of 300 N. RESULTS AND CONCLUSION:(1) While the knee joint flexed at 0°, 30°, 60° and 90°, with the increase of angle, maximum stress point moved from the anterior edge of tibia attachment surface of the medial meniscus posterior angle to the posterior edge of tibia attachment surface of the lateral meniscus anterior angle, and the stress range of lateral meniscus was greater than that of the medial meniscus. (2) The maximal displacement point moved from the midpoint of inner edge of the medial meniscus to the front outer-upper edge of the lateral meniscus at knee flexion of 0°, 30°, 60° and 90°. Moreover, the range of displacement of lateral meniscus was bigger than the medial meniscus. (3) These findings suggest that the meniscus is the major bearing structure in the process of knee flexion. The lateral meniscus injury rate is greater than the medial meniscus in process of exercise, which is associated with large stress and displacement.

Aim To develop an HPLC method for the determination of Aconitum alkaloids extracted from Radix aconiti preparata in rats. Methods Waters 2690@996 PAD system was used. The analytical column was a Halsil 100 C18 column (250 mm×4.6 mm ID, 5 μm). The mobile phase was water, methanol and diethyl amine at the ratio of 75∶ 25∶ 0.1. The flow rate was 0.9 mL·min -1. The wavelength of the detector was 240 nm. Results The linear ranges of aconitine in the heart, spleen, lung and kidney were 0.4-100 μg·mL -1, the correlation coefficients were 0.997 2, 0.998 6, 0.999 3 and 0.999 4, respectively. The linear range of aconitine in liver was 2-200 μg·mL -1 and the correlation coefficient was 0.999 0. The linear ranges of hypaconitine in heart, liver, spleen, lung, kidney, brain and spinal cord were 5-100 μg·mL -1, the correlation coefficients were 0.999 4, 0.999 7, 0.999 8, 0.998 4, 0.999 8, 0.999 8 and 0.999 7, respectively. Detection limits (S/N=3) of aconitine and hypaconitine were 0.4 μg·mL -1. The recoveries of aconitine and hypaconitine ranged from 88.7% to 102.2% and 86.5% to 101.3%, respectively, and the RSD of precision of aconitine and hypaconitine was 10%. Conclusion It appears to be an accurate and effective method that can offer reference basis for in toxication of Radix aconiti preparata clinically.

Objective:To discuss the rule of the prescriptions of professor JIANG Wen-zhao in treating the spleen and stomach ailment. Methods:Use the frequency analysis to analyze the 98 pieces of prescriptions of professor JIANG Wen-zhao in treating the spleen and stomach ailment. Results:To understand medicine state of professor JIANG Wen-zhao in treating the spleen and stomach ailment preliminarily,select the main medicine in treating diseases of the spleen and stomach,and make clear the significance of these medicines to the corresponding diseases. Conclusion:The basic rules of professor JIANG Wen-zhao in treating the spleen and stomach disease are regulating qi,removing dampness and reinforcing asthenia. Qi regulating herbs,diuretics for eliminating dampness,tonifying deficiency herbs,dampness-removing herbs,blood-activating and stasis-removing herbs,heat-clearing herbs are the key herbs.

The cultivation of communication skill of anesthesiology medical students has already become a request as time developing.Not only it accommodates the request of medical model and society development to cultivate the communication skill of anesthesiology medical students from the aspect of strengthening their self-confidence and pride,global consciousness and international view,catholicity and humanity as well as cognitive ability,but also embodies the requirement of anesthesiology anthropo-culture.So there should be pertinent measures to cultivate the communication skill of anesthesiology medical students.

Objective To compare direct magnetic resonance(MR)arthrography with arthroscopy of the wrist for evaluation of injury in the triangular fibrocartilage complex(TFCC).Methods Fourteen cases with suspicion of injury of triangular fibrocartilage complex were performed with conventional MR and direct MR arthrography,10 cases were done by arthroscopy.In the direct MR arthrography,needle placement was obtained using clinical landmark under sterile technique and fluoroscopy,intra-articular injection was performed at the radius-scaphoid space with 5-7 ml 0.3%mixture of Gadolinium (0.1 mmol/L)and saline(0.3 ml Gd-DTPA+100 ml saline).The findings of MRI and MR arthrography were analyzed with results of arthroscopy.Resuits (1)Among 14 cases with injury of TFCC,there were ulnar tear in 5cases,radius tear in 4 cases,complete tear in 5 cases(included 2 cases with long term rheumatoid).(2)High signal intensity and isointensity signal of injury of TFCC were revealed on STIR or T2 WI and T1 WIrespectively,normal hypointensity signal of the TFCC was partially or completely absent.Contrast media at the ulnar insertion(5 cases with ulnar tear)or radius attachment of the TFCC(4 cases with radius tear)were seen in the MR arthrography with difierent extent,5 cases with complete tear showed contrast media at the both ulnar insertion and radius attachment of the TFCC.The findings of MR arthrography were well corresponded with results of arthroscopy on the lesion site,including ulnar tear in 3 cases,radius tear in 4cases and complete tear in 3 cases.(3)Among 14 cases with TFCC,8 cases had dislocation of radius-ulnar joint,6 cases had bone contusion of radius or ulnar,synovial reaction was also clearly depicted on conventional MRI and direct MR arthrography in all cases.Conclusion Compared with results of arthroscopy,direct MR arthrography can adequately reveal the injury of the triangular fibrocartilage complex,synovial reaction and edema changes are depicted on conventional MRI.

To compare the performances of community family physicians in different patterns of chronic disease management.From June 2011 to April 2012,3 different models (A,B,C) of chronic disease management were employed for a total of 4972 patients.Statistics analyses were performed.The number of participants,session and average effective working time were different.In terms of standard management of hypertension,diabetic management rate and non on-site management rate,model C was superior to models A and B (P ＜ 0.01).And model A had the lowest rate of non on-site management (P ＜0.05).Though with each own advantage,three models are complementary.But model C reflects the residents' self-management concept of chronic disease.

Objective To investigate the effects and mechanisms of valproic acid on brain edema,neurobehavioral outcome and inflammatory response after traumatic brain injury (TBI) in rats.Methods TBI animal models were established using Feeney's method.Fifty-four SD male rats,weighting 220-250 g,were randomly divided into 3 groups (n =18):sham operation group (group sham),traumatic brain injury group (group TBI) and valproic acid treatment group (group TBI + VPA).Experimental rats were treated with valproic acid (300 mg/kg,twice daily) by intraperitoneal injection.Rat behavioral outcomes were measured by modified neurologic severity score (mNSS) tests at day 1,3,and 7 after TBI.Brain water content was measured with wet-dry weight method.The blood cells infiltration into cerebral cortex were tested with immunohistochemistry staining against ED-1 for macrophage.Inflammatory cytokines (INF-γ,tumor necrosis factor-α,interleukin-6) were measured by Western blotting.The statistical analysis were performed by ANOVA and chi-square tests using the statistical software program SPSS 13.0.Results Compared with the Sham group,the levels of brain edema,mNSS and macrophage cell infiltration were significantly increased after TBI (all P =0.00).The expressions of inflammatory cytokines were also increased significantly (all P =0.00).Compared with the TBI group,TBI + VAP group had significantly lower brain water content[3day:(80.12 ±0.59)％ vs.(82.14 ±0.67)％,P=0.04;7day:(74.74 ±0.72)％ vs.(77.93 ±0.48)％,P=0.01],and mNSS scores [3 day:(10.53 ±0.32) vs.(11.74 ±0.48),P =0.02;7 day:(7.97 ± 0.32) vs.(10.73 ± 0.42),P =0.01].VPA suppressed macrophage cell infiltration into cerebral cortex [(36.44 ± 0.72) ％ vs.(25.93 ± 0.48) ％ P =0.00].Meanwhile,VPA inhibited the expressions of inflammatory cytokines (INF-γ,TNF-α,IL-6) (P ＜ 0.05).Conclusions Treatment with VPA markedly reduced brain edema and improved neurological outcomes after TBI,possibly mediated by inhibited TBI-induced cerebral inflammatory responses and macrophage cell infiltrating into cerebral cortex.

Objective To compare the difference between volume computed tomography dose index (CTDIvol) and size-specific dose estimates (SSDE) in evaluating the radiation dose of abdominal CT scan.Methods Abdominal CT scan were performed on 180 patients with a Philips 256-slices spiral CT.The anterior-posterior dimension (AP) and lateral dimension (LAT) of each patients were measured at the level of left renal vein, and the effective diameter (ED) and SSDE were calculated with recorded CTDIvol Patients were categorized into 3 groups depending on body mass index (BMI): group A, BMI ＜ 20.0 kg/m2;group B, 20.0-24.9 kg/m2;group C, BMI ＞ 24.9 kg/m2.The differences between CTDIvoland SSDE of 180 patients and three different BMI groups were compared respectively.Results There was a significant difference between CTDIvol and SSDE of the 180 patients (t =-13.354, P ＜ 0.01), CTDIvol and SSDE were (9.91 ± 2.91) and (14.01 ± 2.82) mGy, respectively.For group A, CTDIvol and SSDE were (7.96 ± 1.83) and (12.83 ± 2.52) mGy, respectively (t =-8.417, P ＜ 0.01).Group B, CTDIvol and SSDE were (9.28 ± 1.76) and (13.62 ±2.18) mGy, respectively (t =-15.051, P ＜ 0.01).Group C, CTDIvol and SSDE were (12.19 ± 3.65) and (15.39 ± 3.47) mGy, respectively (t =-4.535, P ＜ 0.01).In addition, the mean percentage values of difference between CTDIvol and SSDE for the three groups were 62.83％, 47.80％, 28.40％, respectively, which meant CTDIvol underestimated the radiation dose compared to SSDE.With the BMI increasing, the values of difference between CTDIvol and SSDE decreased.Conclusions SSDE can be used to estimate the radiation dose of abdominal CT scan for a given size person.

Objective To explore the effect of narrative therapy on family environment and values in adolescents with emotional disorder.Methods 35 adolescents with emotional disorder and their parents from Affiliated Brain Hospital,Nanjing Medical University were enrolled and treated by narrative therapy.Family environment was assessed using Family Environment Scale-Chinese Version (FES-CV)and was compared between pre-and posttherapy.Results 28 adolescents with emotional disorder and their parents completed therapy.The cohesion,independence,intellectual orientation,active-recreation orientation and organization in FES-CV showed higher scores at post-therapy than at pre-therapy ((6.89 ± 2.56) vs.(4.21 ± 3.21) ; (5.54 ± 1.35) vs.(4.68 ± 1.51) ;(4.75±2.07)vs.(3.50±2.12);(4.07±2.65)vs.(2.50±2.32);(3.68±1.77)vs.(2.50±1.62)respectively).The contradict in FES-CV showed lower scores at post-therapy than at pre-therapy ((2.75 ± 2.44) vs (5.25 ± 2.50)).The values of adolescents with emotional disorder and their parents had a positive change after narrative therapy.Conclusion Narrative therapy is effective on the positive change of FES-CV and values of adolescents with emotional disorder and their parents.