The present paper analyzes common mistakes in exemplification in the writing part of Band 4 College English Test.It discusses pertinence,appropriateness,typicality,logic and novelty of exemplification instead of dwelling on mistakes in spelling,wording and grammar,and offers some practical strategies of exemplification.

Objective To investigate the state of perceived stigma,self-efficacy and quality of life of patients with mental disorders,and analyze the relationship among these variables,and explore the mediating effect of self-efficacy between the perceived stigma and quality of life.Methods Totally 406 patients with mental disorders were assessed with the Perceived Devaluation-Discrimination Scale (PDDS),Self-efficacy Scale (SES) and Schizophrenia Quality of Life Scale (SQOLS).Results The average score of PDDS was (2.44±0.36).The average score of GSES was (25.75±7.31).The perceived stigma,self-efficacy and quality of life were significantly correlated with each other.The self-efficacy played a mediating role between perceived stigma and quality of life.Conclusions The self-efficacy is the intermediary variable of perceived stigma and QOL of patients with mental disorders.

OBJECTIVE: To explore the clinical effects of using custom-made tumor prosthesis replacement to treat malignant tumor located in the distal femur or proximal tibia. METHODS: A retrospective study of 29 cases malignant tumors around knee treated surgically from June 2001 to October 2008. In the study there were 19 males and 10 females, aging from 17 to 65 years, with an average of 38.5 years. The location of tumors was at distal femur in 22 cases and 7 cases at proximal tibia. After the tumor was extensively resected or radically resected, custom-made tumor prosthesis replacement was performed for reconstruction, simultaneously, neoadjuvant chemotherapy and radioactive-therapy were used in treating the tumor according the pathology. RESULTS: All patients were followed-up for 18-84 months, with average follow-up period of 54.2 months. The 3 year survival rate was 79.8%, and the 5 year survival rate was 63%. As for the complications, prosthesis breakage occurred in 2 patients, aseptic loosening in 1 patients, 2 had a recurrence of the soft tissue tumor for which the diseased limb amputation was performed. The mean MSTS score showed excellent limb function in 15 patients, good in 8 patients, fair in 5 patients and poor in 1 patient. The overall excellent and good function was obtained in 79% of the patients. No superficial or deep infection occurred. Two patients suffered common peroneal nerve injury, but were cured by symptomatic treatments. CONCLUSION: Application of tumor prosthesis can give a satisfactory functional outcome, which is an effect method in limb salvage treatment of malignant tumor around the knee.

Objective To investigate the effect of modified electroconvulsive therapy (MECT) with different anesthetics on efficacy of patients with treatment-resistant depression (TRD). Methods Ninety patients with TRD were enrolled in this study to receive a standard 8 times MECT. The HAMD-17 scale was evaluated before MECT and after the completion of the first, second, third, forth, sixth and eighth MECT session. The TESS scale was evaluated before MECT and after the completion of the last MECT session. Results Scores of HAMD-17 after the completion of the first, second, third, fourth, sixth and eighth MECT session were significantly reduced (P<0.05). There were significant differences of HAMD scales among the three groups since the first MECT session (P < 0.05). The remission rate of ketamine group, propofol group and mixed group was 96.7%, 43.3%, and 73.3% (P < 0.05). Conclusion MECT of ketamine anesthetic might contribute to the best effect of TRD.

[Objective] To retrospectively analyze the outcome of unrelated umbilical cord blood transplantation in the treatment of aggressive-phase chronic myeloid leukemia.[Methods] Fourteen consecutive patients with aggressive-phase chronic myeloid leukemia were treated with unrelated umbilical cord blood transplantation,thirteen patients were treated with myeloablative unrelated CBT and one patients were treated with nonmyeloablative unrelated CBT.All patients received standard cyclosporine A (CsA) and mycophenolate mofetil(MMF) as a graft-versus-host disease (GVHD) prophylaxis.[Results] 14 patients were all successfully engrafted.The median times for their neutrophil returning to ≥0.5×109/L and for platelet returning to ≥20×109/L were 22.8 days and 37.8 days,respectively.Acute GVHD occurred in 10 of 13 evaluable patients.The grading of acute GVHD was gradeⅡ-Ⅳin 6 patients(46.2 ％).Chronic GVHD occurred in 7 of 11 evaluable patients(63.6％).Relapse occurred in 2 of 15 patients,lextramedullary relapse was included.9 of 14 patients were alive and event-free after CBT.The probability of OS rate at 5 years was 64.3 ％,the probability of DFS rate at 5 years was 5,7.1％.[Conclusion]Unrelated umbilical cord blood transplantation is effective in the treatment of aggressive-phase chronic myeloid leukemia.

Objective To investigate the clinical efficacy of rib's strapping-traction technology using absorbable implants combined with memory-alloy ribs embracing fixator in treating multiple rib fractures under video-assisted thoracoscope.Methods A retrospective case control study was performed to analyze 178 patients with multiple rib fractures treated from January 2015 to June 2017.According to the operation method,all patients were divided into observation group (91 patients) and control group (87 patients).The observation group including 59 males and 32 females aged (39.7 ± 7.8)years adopted internal fixation by rib's strapping-traction technology using absorbable implants combined with memory alloy ribs embracing fixator under video-assisted thoracoscopic surgery.The control group including 56 males and 31 females aged (40.2 ± 6.9) years adopted internal fixation by conventional rib's clamping-traction technology using towel forcep combined with memory-alloy ribs embracing fixator under video-assisted thoracoscopic surgery.The incision length,single rib internal fixation time,number of internal fixation rib fractures,visual analogue scale (VAS) score on postoperative 1 d,postoperative chest drainage,postoperative hospital stay,and postoperative fracture healing were compared between the two groups.Results All patients were followed up for 3-30 months (mean,16.7 months).All operations were successful,with no case of thoracotomy.The observation group had shorter incision length [(4.3 ± 1.2) cm vs.(6.2 ± 1.7) cm] and single rib internal fixation time [(10.3±2.9)min vs.(14.1 ±2.3)min] than the control group (P＜0.05).There were no significant differences (P ＞ 0.05) between the two groups in number of internal fixation rib fractures [(5.7±.3.6) vs.(5.9±3.3)],postoperative chest drainage [(668.3 ±131.4)ml vs.(703.7±116.2)ml],postoperative hospital stay [(6.4 ± 1.8) d vs.(6.8 ± 1.7) d],the VAS score on postoperative 1 d [0-3 point,62％ vs.61％;4-6 point,38％ vs.39％],postoperative osteophyte formation rate [postoperative 1 month,97％ vs.95％;postoperative 3 months,100％ vs.100％].Stable chest walls and thoracic deformity recovery were seen in all patients,with no significant complications occurred.Conclusion Rib's strapping-traction technology using absorbable implants combined with memory-alloy ribs embracing fixator under video-assisted thoracoscope is convenient and has exact efficacy for multiple rib fractures,with advantage of shorter incision length and operation time over conventional thoracoscopic surgery,and thus is worthy of clinical application.

Myocardial dysfunction is the most serious complication of sepsis. Sepsis-induced myocardial dysfunction (SMD) is often associated with gastrointestinal dysfunction, but its pathophysiological significance remains unclear. The present study found that patients with SMD had higher plasma gastrin concentrations than those without SMD. In mice, knockdown of the gastrin receptor, cholecystokinin B receptor (Cckbr), aggravated lipopolysaccharide (LPS)-induced cardiac dysfunction and increased inflammation in the heart, whereas the intravenous administration of gastrin ameliorated SMD and cardiac injury. Macrophage infiltration plays a significant role in SMD because depletion of macrophages by the intravenous injection of clodronate liposomes, 48 h prior to LPS administration, alleviated LPS-induced cardiac injury in Cckbr-deficient mice. The intravenous injection of bone marrow macrophages (BMMs) overexpressing Cckbr reduced LPS-induced myocardial dysfunction. Furthermore, gastrin treatment inhibited toll-like receptor 4 (TLR4) expression through the peroxisome proliferator-activated receptor α (PPAR-α) signaling pathway in BMMs. Thus, our findings provide insights into the mechanism of the protective role of gastrin/CCKBR in SMD, which could be used to develop new treatment modalities for SMD.