Nowadays,with the sharply increasing morbidity and stable high mortality,tumor has become the greatest threaten for human health and life.After taking a view of preservations,diagnoses and treatments on tumor, oncologists considered the cure rate had not improved evidently in patients with advanced tumor in the past several decades even though the total cure rate and survival rate had increased.Facing the puzzle,people should evaluate original tumorigenic theories again.A review about it was presented here.

BACKGROUND:Hydrolysis in vivo is the key mechanism of degradation in DL-polylactic acid (PDLLA). When it is combined with hydroxyapatite (HA), could the biodegradation and weight loss rate be improved? OBJECTIVE: To observe the changes in the interface and structure of HA/PDLLA composite after in vivo implantation into rabbit femoral defects.DESIGN: Randomized grouping and controlled observation.SETTING: Biomedical Materials and Engineering Research Center, Wuhan University of Technology.MATERIALS: Forty healthy adult Japan White Rabbits of 2.0-2.5 kg, either male or female were provided by the Animal Experimental Center of Hubei Province (No. SCXK. 2003-0005).METHODS: The experiment was conducted in Biomedical Materials and Engineering Research Center, Wuhan University of Technology from June 2005 to March 2006. ①The rabbits were randomly divided into two groups: HA/PDLLA group and PDLLA control group with 20 animals in each group. After anesthetized with ketamine and proazamine, the sample rods of HA/PDLLA and PDLLA were respectively implanted into the drilled bone cavities (φ5 mm × 8 mm) among condyles of femur sites of the rabbits, and the rod could be slightly higher than the surface of bone substance. The samples were covered by periosteum and skin, and then the skin and periosteum were repositioned. ②The complete implants and peripheral bone tissues were taken out respectively after 3, 6, 12 and 24 weeks implantation. The changes in the interface and structure of HA/PDLLA composite after in vivo implantation were observed by using scanning electron microscope (SEM, JSM-5610LV, Japan).MAIN OUTCOME MEASURES: Changes in the interface and structure of HA/PDLLA composite after in vivo implantation.RESULTS: Totally 40 rabbits were involved in the result analysis. After the materials were implanted, HA granules shed from the material surface, some fibroblasts grew into the tissue and a little new osteotylus was formed, indicating HA/PDLLA composite had capabilities of bone-formation and bone-connection. After 24 weeks implantation, the material was divided and wrapped by tissues, neogenetic bone tissue grew into the material, and the fracture healed well,indicating HA/PDLLA composite had good biocompatibility. As for biodegradable PDLLA polymer, hydrolysis in vivo is the most main mechanism of degradation; the degradation speed was decreased owing to being compounded with HA.CONCLUSION: HA/PDLLA composite has capabilities of bone-formation and bone-connection; the biocompatibility of the composite is improved accordingly on account of the decrease of the degradation speed. HA/PDLLA composite is suitable for clinical application as absorbable materials for internal fixation.

Objective To evaluate the applied value of CT in breast lesions.Methods Imaging data of 120 patients with normal breast were reviewed retrospectively in 4 groups of different age(15～25,26～35,36～50 and 51～80),and imaging data of 49 patients with breast lesions biopsy-proved were also analysed.Of 49 breast masses,31 were malignant tumor,18 were benign lesion.All the patients underwent CT scan with supine position whole thoracic region.Results The CT imaging features of normal breast in different age groups were different.65% of normal people had small sporadic axillary lymph nodes.Breast cancer usually showed hillslike and benign tumor showed round oroval-shap.The signs of spiculated lesion,deformed adipose space and thicken of local skin were statistical difference between benign and malignant lesions(P0.05).The metastatic axillary lymph nodes usually showed as the significant enlarged nodes with indefinite margin or multiple small nodes.Conclusion CT scan is valuable in detecting breast disease and differential diagnosis,and also can offer the informations on tumor staging and treatment.

Objective To evaluate the value and feasibility of Microsim medical simulation training system in medical students' clinical thinking training. Method 96 students of 5-year program of medicine of Grade 2009 and Grade 2010 were the research object. These students were randomly divided into two groups (group A:After 3 weeks' clinical practice in respiratory medicine, taking 1 week Microsim training. group B: Taking 4 weeks clinical practice in respiratory medicine. Each group has 48 students.). The examination and teaching satisfaction of the two groups were observed after the end of the internship. SPSS 17.0 statistical software was used to analyze the collected data (measurement data matching t test, counting data by chi-square test). Results The Microsim system score: group A was (89.37±7.18), group B was (61.95±15.34). The difference between groups was statistically signifi-cant. The following scores suggested the assessment of students' ability of clinical thinking: ability to analyze problems [group A (89.95±4.02) vs. group B (75.51±6.34)], the ability to deal with the prob-lem [group A (78.81±8.09) vs. group B (59.67±9.33)], treatment scheme [group A (86.74±6.59) vs. group B (70.39±7.05)] and the treatment effect [group A (88.61±8.16) vs. group B (63.54±11.48)]. In these aspects, the two groups had statistically significant difference, but communication [group A (82.47 ±5.23) vs. group B (84.09 ±3.72)] had no statistically significant difference between the two groups. 89.6% (43) of the participants believed that the Microsim medical simulation training system could significantly improve the clinical thinking ability, but only 58.3% (28) of the students believed that the basic theory of knowledge could be consolidated. Conclusion Microsim medical simulation training system can improve the students' ability of clinical thinking and clinical comprehensive treat-ment ability. It can be used as an effective complement to clinical practice teaching.

AIM To study the chemical constituents from twigs of Trigonostemon lutescens Y.T.Chang et J.Y.Liang.METHODS The ethyl acetate fraction of 95％ ethanol extract from T.lutescens twigs was isolated and purified by silica,Sephadex LH-20 and MCI column,then the structures of obtained compounds were identified by physicochemical properties and spectral data.RESULTS Ten compounds were isolated and elucidated as 3-O-acetyloleanolic acid (1),methyl 3-acetoxy-12-enly-oleanen-28-oate (2),taraxerone (3),spiciflorin (4),simiarenol (5),β-sitosterol palmitate (6),3,3',4-tri-O-methylellagic acid (7),β-sitosterol (8),stigamasterol (9),palmitic acid (10).CONCLUSION Compounds 1-6 are isolated from genus Trigonostemon for the first time,compounds 7 and 9 are first obtained from this plant.

Objective To investigate the expressions and effects of interleukin-4(IL-4) and its alternative spliced variant(IL-4?2) in patients with atopic asthma.Methods The expressions of IL-4 and IL-4?2 were detected in 10 cases of patients with atopic asthma using a quantitative nested reverse-transcription polymerase chain reaction(RT-PCR) protocol.Result The expression level of IL-4 was higher in the patients with atopic asthma than that of the healthy controls.The median ratio of IL-4 to IL-4?2 was much higher in the patients with atopic asthma compared with that of the healthy controls.Conclusion The relative expression of IL-4 and IL-4?2 may play an important role in the mechanism of the pulmonary pathology in patients with atopic asthma,and may be one of the reason for the functional diversity of Th2 cells in different clinical conditions.

Objective To approach the normal manifestations of the hypopharynx of the adults at the level of cricoid cartilage as seen on CT images, and to evaluate their clinical value. Methods Eighty-four CT images of the normal hypopharynx were reviewed. The hypopharynx was divided into three regions:(1) the piriform sinus, (2) the retropharynx area, and (3) the postcricoid region. The postcricoid region of hypopharynx was subdivided into three levels as follows : (1) the upper margin slice of the cricoid cartilage at the cricoarytenoid joint level, (2) the middle portion slice of the cricoid cartilage, and (3)the inferior margin slice of the cricoid cartilage. The anteroposterior and transverse diameters, and anterior and posterior wall thicknesses in the postcricoid region were measured. Depiction of the layers of the musculature and adjacent fat planes was evaluated. Statistical comparisons of measured results were made by using ttest and x2 test. Results The posterior wall tended to be (0. 9±0. 4) mm thicker than the anterior wall. The average transverse extension of the postcricoid musculature was (4. 5±0. 3)mm shorter in female than that in male at CT images. There were statistically significant differences related to sex (at the upper margin level of the cricoid cartilage : the transverse extension was (38. 6±3. 3)mm in male, (34. d±2. 5) mm in female, t = 6. 26,P < 0. 05 ; at the middle portion level of the crieoid cartilage: (33.6±3. 6) mm in male,(28.9±2.8) mm in female t =6.36, P <0.01;at the inferior margin level of the cricoid cartilage:(28.6 ±3. 1) nun in male, (24. 0 ±2. 1) mm in female, t = 7.52, P <0. 01). The transverse diameter tended to taper (10. 1±2. 4) mm from the upper cricoid slice level to the lower cricoid slice levelDemonstration of the intramural fat planes of the postcricoid region decreased from the upper [ 81.0%(68/84)] to the lower region [23.8% (20/84)] of the cricoid cartilage. In fat planes around the postcricoid region at all levels, the posterior fat plane was seen least frequently, and the left-sided fat plane was seen most frequently. There was a statistically significant difference at every level(at the upper margin level of the cricoid cartilage, the visibilities of the left-sided, the right-sided, and the posterior fat plane around the postcricoid region were 77.4% (65/84), 72. 6% (61/84), and 28. 6% (24/84) ,x<'2> =24. 64,P <0.01 ; at the middle portion level of the cricoid cartilage, the visibilities were 89.3% (75/84), 75.0%(63/84), and 34.5% (29/84) ,x<'2> =24. 76, P <0. 01 ; at the inferior margin level of the cricoid cartilage:the visibilities were 95.2% (80/84), 88. 1% (74/84), and 52. 4% (44/84), x<'2> = 13.59, P < 0. 01.Conclusion Knowledge of the normal appearances and variations of the hypopharynx at the level of cricoid cartilage is essential in detecting abnormalities in this area.

Objective To investigate the CT features of hepatic echinococcosis in children.Methods Clinical and CT data of 27 cases with hepatic echinococcosis confirmed by pathology and/or serology were retrospectively analyzed.Results Totally there were 26 cases of cystic echinococcosis and 1 case of alveolar echinococcosis.Ten cases were with simple hepatic echinococcosis and 17 cases with other organic echinococcosis,18 cases of intrahepatic single hydatid and 9 cases of intrahepatic multiple hydatid.A total of 1 alveolar lesion and 47 cystic lesions were found,including unilocular cyst accounted for 51.06％ (24/47),cysts with collapse of the internal capsule accounted for 42.55％ (20/47),cysts with wall calcification accounted for 4.26％ (2/47) and multiple cysts accounted for 2.13％ (1/47).There was no solid lesions.The cyst diameters which were larger than 5 cm accounted for 74.47％ (35/47).Conclusion The CT can qualitatively diagnose hepatic echinococcosis in children.It is a reliable method of examination.

Objective: To analyze the association between alcohol consumption and hyperuricemia among residents in Chengdu City, so as to provide the evidence for prevention and control of hyperuricemia. Methods: Based on the Natural Cohort Study in Southwest Area, residents at ages of 30 to 79 years were recruited in Chengdu City in 2018. Information of demographics, smoking, alcohol consumption and diet were collected through a questionnaire survey. Blood uric acid was tested in the laboratory. Participants were divided into never, moderate and excessive drinking groups based on alcohol consumption. A multivariable logistic regression model was used to analyze the association between alcohol consumption and hyperuricemia, and subgroup analysis was conducted according to gender, current residence, physical activity and body mass index (BMI). Results: A total of 20 164 residents were investigated, including 8 776 males (43.52%) and 11 388 females (56.48%), with a mean age of (51.22±12.33) years. There were 9 769 never-drinkers (48.45%), 8 310 moderate-drinkers (41.21%), and 2 085 excessive-drinkers (10.34%). Hyperuricemia was detected in 4 101 patients, with a detection rate of 20.34%. Multivariable logistic regression analysis showed that moderate drinking (OR=1.122, 95%CI: 1.031-1.222) and excessive drinking (OR=1.529, 95%CI: 1.349-1.734) were associated with an increased risk of hyperuricemia. Moderate and excessive drinking were associated with an increased risk of hyperuricemia among men, urban residents, residents with a high level of physical activity, and those with BMI less than 24 kg/m2 (all P<0.05). Excessive drinking were associated with an increased risk of hyperuricemia among rural residents, residents with a low level of physical activity and with BMI of 24 kg/m2 and higher (all P<0.05). Conclusions Both moderate and excessive drinking are associated with an increased risk of hyperuricemia. Moderate drinking is not associated with a higher risk of hyperuricemia among rural residents, residents with a low level of physical activity and with BMI of 24 kg/m2 and higher.

Objective:To explore the current status of intrinsic capacity in elderly patients with hospitalization-associated disability (HAD) and explore its influencing factors.Methods:From November 2023 to January 2024, convenience sampling was used to select 203 elderly patients with HAD at Xuanwu Hospital of Capital Medical University as the study subjects. A survey was conducted on elderly patients using the General Information Questionnaire, Fried Frailty Phenotype, Barthel Index, Social Support Rating Scale, and Intrinsic Capacity Assessment Tool. Binomial Logistic regression was used to analyze the influencing factors of intrinsic capacity in elderly patients with HAD.Results:A total of 203 questionnaires were distributed, and 199 valid questionnaires were collected, with a valid response rate of 98.03% (199/203). The total score of intrinsic capacity in 199 elderly patients with HAD was 5.00 (4.00, 6.00), with scores for cognitive dimension, psychological dimension, motor dimension, vitality dimension, and sensory dimension being 1.00 (1.00, 2.00), 2.00 (1.00, 2.00), 0 (0, 1.00), 1.00 (1.00, 1.00) and 1.00 (1.00, 1.00), respectively. The binomial Logistic regression showed that department of medicine and surgery, self-rating health status, social support, serum albumin, and Barthel Index were the influencing factors of intrinsic capacity in elderly patients with HAD ( P<0.05) . Conclusions:The intrinsic capacity of elderly patients with HAD is at medium to low level, with the most severe impairment in the motor dimension. Medical and nursing staff should develop personalized rehabilitation measures for elderly HAD patients based on the influencing factors of their intrinsic capacity, enhance their intrinsic capacity, and reduce the burden of care on families and society.