Objective To discuss the value of color Doppler ultrasonography in the diagnosis and differential diagnosis of urinary tract urothelial carcinoma (UTUC).Methods Color Doppler ultrasonography exam was practiced in 84 UTUC patients preoperatively.According to ultrasound characteristics,lesions was classified into nodular type,wall thickening type and solid mass type,which were confirmed by pathology in all cases postoperatively.Results In the total of 84 cases (76 transitional-cell carcinoma,5 adenocarcinoma and 3 epidermoid carcinoma),lesions infiltrated laminae propria and surrounding tissue in 65 cases.In the nodular type of UTUC,there were nodules raising into lumen.Wall thickening type of UTUC was characterized by irregularly wall thickening,lumen narrowing,truncating and breaking.Similarly,obstruction broke off the ureteral lumen suddenly in solid mass type of UTUC.A clear demarcation could be found between the pipe wall and surrounding tissue in nodular type.However,such clear demarcation could not be found in wall thickening type and solid mass type.The accordance rate of ultrasonographic located diagnosis were 92.9 ％ (78/84),with 6 missed diagnosis cases.The accordance rate of qualitative diagnosis were 89.7％ (70/78).Conclusions As result of color Doppler ultrasonography,there were different relationship between lesion and the peripheral tissue in different types of UTUC.In types of wall thickening and solid mass,the demarcation was unclear and it is easier to violate the surrounding tissue.Color Doppler ultrasonography can provide more effective information for diagnosis and therapy UTUC.

Objective To investigate the effects of sensorimotor therapy on patients with knee osteoarthritis.Methods Ninety-two patients with knee osteoarthritis were divided into a treatment group and a control group by using random digits table. Both groups received conventional rehabilitation therapy, including knee isometric and isotonic contraction training, ultrashort wave diathermy as well as aerobic exercise. The treatment group was also administered with sensorimotor training, in addition to the conventional training,including the muscle strengthening and control training of quadriceps and hamstring muscle using sling exercise therapy system and on the Thera-band mattress. The visual analogue scale (VAS) for pain, manual muscle testing and knee range of motion as well as the Japanese Orthopedic Association knee function evaluation form were used to evaluate the patients. Results There was no statistic difference between the 2 groups before treatment, with regard to the evaluation parameters used in this study. After 2 months of treatment, both groups improved significantly (P ＜0.05),with the treatment group improved to a significantly greater extent (P ＜0.05). Conclusions Sensorimotor training in addition to the conventional rehabilitation treatment can further relieve the pain of patients with knee osteoarthritis joints arthritis and improve the function of patients with knee osteoarthritis.

Based on the educational structure theory, the difference between mass education and elite education is probed at the macroscopic level to make it clear that the essence of Physician education and training program of excellence is elite education for occupational purposes; at the mi-croscopic level the orientation of English teaching for the class ofexcellent physicians is determined as English for occupational purposes. Moreover, the curriculum system of medical English is designed, and teaching materials associated with clinical medicine are selected, the language laboratory simulat-ing hospital scenes is constructed, and the transboundary team of teachers is built comprising university teachers and doctors in hospitals. At the level of individual, the competency model of English forexcellent physicianshas been developed, English competence requirements in medical industry being clearly established . In a word , the study of macrostructure points out the direction and target of English teaching for excellent physicians; the study of microstructure perfects the mode of English teaching forexcellent physicians;and the study of individual structure indicates the ultimate foothold of English education forexcellent physicians. Three aspects are integrated into an organic whole.

Objective To explore the strategy of repairing penile defect after necrosis caused by shortwave diathermy.Methods Between January 2004 and June 2012,18 cases with penile defect after necrosis caused by shortwave diathermy were admitted in our hospital.The age of those patients ranged from 18 to 55 years old (mean 34 years old).Among them,15 cases have been married.All patients have the history of penile shortwave diathermy therapy after surgery.After debridement,penile complete defect was found in 6 cases,incomplete defect was found in 10 cases and corpus cavernosum and corpus spongiosum partly defect was found in 2 cases.Under general anesthesia,we applied penis extent in 10 cases with incomplete defect,forearm free flap in 2 cases with penile complete defect,abdominal artery perforators flap in other 4 cases with penile complete defect.In 2 cases with corpus cavernosum and corpus spongiosum partly defect,the scrotal septal skin flap and fascia pedicle flap was used for 1-stage urethral reconstruction and costicartilage was implanted for 2-stage cavernosum reconstruction.Results 18 patients were followed up for 0.5-10.0 years (mean 2.3 years).16 cases with penile complete defect or incomplete defect had normal length after operation,ranged from 6.3 to 9.2cm.During erectile phase,the length of their penis ranged from 8.7 to 11.5 cm.No feeling abnormality or erectile dysfunction was complained.All patients exhibited the excellent morphology and felling of penis with minor scar in donor site.Early (half a month) complications included distant flap necrosis in 1 case and disruption of the wound in 1 case,which were cured after debridement and conventional treatment.After one year,we did not see the flap atrophy.One case had tumid which influenced penile beautiful and sexual intercourse.It was improved by local liposuction.One month after surgery,two patients with corpora cavernosa and corpus spongiosum partial defect had normal voiding.No feeling and erectile dysfunction were complained during the following-up.Conclusions According to the characteristics of the penile defect due to the shortwave diathermy,selecting the optimal skin flap and individual repair strategy are the keys to successful treatment.

In accordance with students' learning needs and future professional development, individualized practices of formative assessment are analyzed in terms of diverse evaluators, accumula-tive learning contents, after-class tutoring, thus to maximize student's learning potentials, to be capa-bility-oriented, to make students highly qualified and competent for their future clinical position and academically developed. Additionally, the assessing competence of teachers is vital to the successful implementation of formative assessment. Importantly, each medical university can explore further into the practice of formative evaluation, based on the orientation of itself.

Objective To study the human papilloma virus(HPV) infection in lesion tissues of patients with common anus and rectal disease .Methods Gene amplification combined with gene chip technology were employed to conduct genotyping test in lesion tissue of 566 patients with common anus and rectal disease .Results In lesion tissues of 566 patients with common anus and rectal disease ,the overall HPV infection rate was 32 .86% (186/566) .In male patients ,the overall HPV infection rate ,monopole infection rate and multiple infection rate were 32 .14% (117/364) ,23 .35% (85/364) and 8 .79% (32/364) ,respectively ,which showed no sta-tistically significant difference with female [34 .16% (69/202) ,24 .75% (50/202) and 9 .41% (19/202) ,respectively ] (P>0 .05) . HPV 18 ,16 ,33 ,31 types were the main types of common anus and rectal disease .Conclusion HPV genotyping test of anus and rectum tissues is important for molecular epidemiological studies of HPV infection in anus and rectum .

Objective To investigate the changes of iodide uptake and the expression of thyroidspecific genes in poorly differentiated follicular thyroid carcinoma (FTC) cells after transfection of human TSH receptor (hTSHR) gene in vitro. Methods The recombinant eukaryotic expression plasmid PcDNA3. 1/hTSHR-cDNA was transformed into DH5a bacterial for amplification and then the recombinant plasmid was extracted. The recombinant was identified with PCR amplifying, restriction enzyme digestion analysis and DNA sequencing. The recombinant plasmid pcDNA3.1/hTSHR was transfected into FTC-133 cell line by lipofectin methodin vitro. Immunofluorescence, iodide uptake studies and real time-PCR were applied to detect target protein expression. Statistical analysis was performed with t-test using SPSS 13. 0 software. Results Kpn Ⅰ and Xba Ⅰ restriction enzyme digestion, PCR amplifying and DNA sequencing confirmed that pcDNA3. 1/hTSHR was successfully constructed. After transfection of the recombinant plasmid pcDNA3. 1/hTSHR-cDNA and the stimulation of hTSH, the tumor cells displayed the expression of hTSHR protein at cell surface and cytoplasm. The iodine uptake in pcDNA3. 1/hTSHR transfected cells was 2. 9 times higher than that of control(pcDNA3.1(+) transfected cells) group(t = 28.63, P ＜0. 01). The expression of TSHR,NIS, TPO and Tg (mRNA levels) in pcDNA3. 1/hTSHR transfected cells were also significantly elevated by 1.74 (t =5.959, P＜0.01), 7.2 (t =3.807,P＜0.05), 2.88 (t=4.769,P＜0. 01) and 2.67 times (t=6.388,P ＜0.01) respectively compared to those of the control group. Conclusion The study demonstrates that iodide uptake may be reactivated by hTSHR receptor gene transfection in poorly differentiated FTC cell.

OBJECTIVETo search for an effective method for treatment of chronic hepatitis B.

METHODSOne hundred and twenty-three cases were randomly divided into a treatment group (n = 63) and a control group (n = 60). The treatment group were treated with injection of Huangqi injectio and Danshen Injectio into Ganshu (BL 18) and Zusanli (ST 36), once every other day; and the control group were treated with oral administration of Gankangning tablet and fufang yiganling tablet. The clinical symptoms, hepatic function, hepatitis B e antigen (HBeAg), hepatitis B virus-desoxyribose nucleic acid (HBV-DNA) were compared between the two groups.

RESULTSThe total effective rate was 93.7% in the treatment group and 76.7% in the control group with significant difference between the two groups (P < 0.01); and the treatment group in hepatic function and the effects of turning negative for HBeAg and HBV-DNA was better than the control group (P < 0.01).

CONCLUSIONAcupoint-injection has a better therapeutic effect on chronic hepatitis B.

Objective To investigate the effect of 17β-estradiol on ketamine-induced long-term cognitive deficits in neonatal rats.Methods 80 SD male rats aged 7 days were randomly divided into group C,V,E,K and K+E,and 16 per group.Group C was intraperitoneally injected with same volume of saline for three consecutive days,Group V was subcutaneously injected with same volume of sesame oil for three consecutive days,Group E was subcutaneously injected with 600 μg · kg-1 17β-estradiol for three consecutive days,group K was intraperitoneally injected with 75 mg · kg-1 ketamine for three consecutive days,group K+E was intraperitoneally injected with 75 mg · kg-1 ketamine in combination with 600 μg · kg-1 17β-estradiol injected subcutaneously for three consecutive days.At 2 months of age,learning and memory abilities were tested with the Mortis water maze.After Morris water naze test,ten rats from each group were decapitated and the prefrontal cortex (PFC) was isolated to detect acetylcholine esterase(AchE) activity with ELISA assay and to measure acetylcholine(Ach) level by hydroxylammonium chloride method.Results The escape latency ((40.26±2.36) s,(30.25±2.20) s,(21.55±2.42) s) and path length((1019.35±58.13) cm,(811.16±27.58) cm,(598.34±34.74) cm) of group K were more than those of group C on the third,fourth aud fifth training days (all P＜0.05),while escape latency ((29.46±2.20) s,(24.86± 2.14) s,(17.20±1.91) s) and path length((913.90±41.89) cm,(729.42±31.36) cm,(487.64±18.61)cm) of group K+E were significantly lower than those of group K(all P＜0.05).On test day 6,rats were subjected to a probe trial,ratio of time spent in the target quadrant ((24.5±2.7) ％) and the number of crossings over previous platform locations (1.9±0.5) in group K were fewer than those of group C (all P＜0.05),while ratio of time spent iu the target quadrant((42.3±3.0) ％) and the number of crossings over previous platform locations(3.5±0.5) of group K+E were more than those of group K (all P＜0.05).The AchE activity((0.69±0.04) U · mg pro-1) in rats PFC of group K was significantly higher than that of group C ((0.52±0.06) U · mg pro-1) (P＜0.05).The AchE activity of group K +E ((0.58±0.12)U · mg pro-1) was lower than that of group K(P＜0.05).The Ach level ((2.59±0.34)mg · g-1) in rats PFC of group K was significantly lower than that of group C ((4.35±0.56) mg · g-1) (P＜0.05).The Ach level of group K+E((3.88±0.61) mg · g-1) was higher than that of group K(P＜0.05).Conclusions These results indicate that ketamine impairs learning and memory abilities as rat matures,while 17β-estradiol treatment improves these impairments by inhibiting AchE activity and increasing Ach level.

Objective To evaluate the effect on the reversal of left ventricular aneurysm (LVA) and on heart function of percutaneous coronary intervention (PCI) therapy at different time of acute myocardial infarction (AMI). Methods A total of 326 patients with primary anterior AMI-accompanied LVA diagnosed by left ventriculography (LVG) from January 2001 to July 2004 were enrolled in this study. They were randomized into 4 groups according to the time of accepting PCI:≤3 h group, 4-6 h group, 7-12 h group and one week group. At the baseline and 6 months after AMI, the parameters of left ventricular diastolic volume index (LVEDVI), left ventricular systolic volume index (LVESVI), left ventricular ejection fraction (LVEF), left ventricular wall motion score (LVWMS) and left ventricular end diastolic pressure (LVEDP) were measured by LVG. The paradox volume index (PVI) was measured by equilibrium radionuclide at one week and 6 months after AMI.At 3 year following up to, the major adverse cardiac events (MACE) were recorded. Results At 6 months after PCI, the LVESVI, LVEDVI, WMS and LVEDP were all decreased while LVEF was increased in the four groups as compared with pre-PCl (P<0.05, respectively). Those parameters changed most obviously in ≤3 h group. At the 6th month after PCI, the PVI was lower in ≤3 h group (12.1±2.1)% than in 4-6 h, 7-12 h and one week group [(15.4±2.4)%, (16.5±2.5)% and (20.4±3.7)%, all P<0.05]. Within the 3 years follow-up, the MACE was significantly lower in 3 h, 4-6 h and 7-12 h groups than in one week group, and the mortality was lower too [(2.8%, 3.0% and 3.1% vs. 17.9%, all P<0.05]. Conclusions The early, fully and permanent open of the infraction-related artery can effectively inhibit the left ventricular remodeling process, prevent LVA formation, improve LV function and prognosis.