An objective analysis of the status quo of the teaching of"Applied Writing"in medical colleges and universities is first conducted from the perspectives of insufficient importance attached to this course by the school authorities,lack of qualified teachers,lack of good textbooks tailored for medical schools,and unsatisfactory teaching effect and the concrete measures are pro-posed for improving and strengthening the teaching of this course.

97 cases of jaw bone fractures were treated with rigid internal fixation.16 cases had malocclusion postoperation.The etiology was analyzed and the prevention methods were proposed.Intermaxillary elastic traction or fixation and craniomaxillofacial fixation or craniomentum elastic traction were performed to treat the malocclusion.By this way,14 cases were cured.1 case was operated again to resume the normal occlusion,1 case received occlusal adjustment.Incomplete reduction,incorrect operative performance,deficiency of postoperative intermaxillary fixation and incorrect intermaxillary fixation were the main causes to malocclusion.So anatomic in time reduction,correct operative performance,intermaxillary fixation,application of craniomaxillofacial fixation or craniomentum elastic traction instead of intermaxillary fixation for some special cases are effective methods to correct postoperative malocclusion.

ObjectiveTo investigate the protective effect of combination of triptolide and irbesartan on the podocytes in a type 2 diabetic(T2DM) rat model,and evaluate its mechanism.Methods T2DM rats were induced by fed with high-sucrose-high-fat diet combined with a low dose of streptozocin.The rats were randomly divided into 5 groups:normal control group ( NC,n =10),diabetes group ( DM,n =11),triptolide treatment group (DT,n =12),irbesartan treatment group (DI,n =12) and triptolide combined with irbesartan treatment group (DTI,n =13). Ultrastructure of podocytes was observed by electronic microscopy and urinary albumin (UAL) excretion by ELISA was determined after 8 weeks.The expression of nephrin and bone morphogenetic protein-7(BMP-7), connective tissue growth factor (CTGF),transforming growth factor (TGF)β1 mRNA and proteins were detected by immunohistochemistry,real-time PCR and Western blot. Results Increased UAL was significantly attenuated in all treatment groups.Compared to NC group,UAL in DM group was increased significantly (0.45 ± 0.09 vs 6.36 ± 0.87,P ＜ 0.01 ),while decreased in triptolide or irbesartan alone treatment group (2.48 ± 0.37 and 2.68 ±0.42,both P ＜ 0.01 ).Compared with those in control groups,kidney expression of nephrin,BMP-7 mRNA and proteins were downregulated while CTGF, TGFβ1 mRNA and proteins were significantly upregulated in T2DM rats. Triptolide or irbesartan each alone moderately ameliorated albuminuria and podocyte damage.However,their combined usage showed a dramatic therapeutic synergism,manifested by prevention of progressive albuminuria,restoration of the glomerular filtration barrier,reversal of the decline in slit diaphragm proteins,reduction expression of CTGF,TGFβ1,and upregulation of BMP-7.Conclusion Our findings show that triptolide can increase the efficacy of irbesartan,leading to a more effective prevention of kidney disease in T2DM rat model,which may through upregulation of BMP-7 and inhibition the overexpression of CTGF and TGFβ1.

Objective To evaluate CTA characteristics of anomalous origin of coronary artery from the pulmonary artery (ACAPA).Methods The clinical data of 24 patients with ACAPA were retrospectively analyzed,and the results of CTA were compared with operation.Results In 24 ACAPA cases,20 cases (20/24,83.33％) occurred in the left coronary artery (LCA),1 case (1/24,4.17％) was in the right coronary artery (RCA),1 case (1/24,4.17％) was in the anterior descending artery (LAD) and 2 cases (2/24,8.33 ％) were in the circumflex artery (LCX).The origins of coronary anomalies originated from the posterior wall of the pulmonary sinus or pulmonary trunk in 11 cases (11/24,45.83 ％),left wall in 7 cases (7/24,29.17％),right wall in 4 cases (4/24,16.67％),originated in the left pulmonary artery in 2 cases (2/24,8.33％).Collateral circulation:Infant type was in 5 cases,no collateral vessels between the coronary artery was observed;adult type was in 19 cases,of which 16 cases were of abnormal origin of the LCA and RCA,1 case was of LAD,2 cases were of LCX.The double LAD and coronary arteries with an intramural segment were found in 1 case respectively.Surgery were performed in 19 cases.Five cases were reviewed by CTA,1 case with anastomotic stenosis of LCX,1 case with restenosis of right ventricular outflow tract and 1 case with coronary pseudoaneurysm.Conclusion CTA can clearly show the origin of abnormal coronary artery,the distance from the ascending aorta,collateral vessels,combined with other coronary artery malformations,which can help surgical preparation of preoperative surgical approach,and postoperative follow-up.

Objective By using multi detector row spiral CT (MDCT) to investigate the CT imaging findings of gallbladder abnormalities caused by hepatic parenchymal diseases and those of inflammatory cholecystitis. Methods CT and clinical data of 80 patients with gallbladder abnormalities were retrospectively reviewed. Fifty patients were in hepatic disease group, including 20 chronic hepatitis, 25 liver cirrhosis, and 5 cirrhosis with hepatocellular carcinoma. Thirty patients were in inflammatory group, including 19 chronic cholecystitis, 6 acute cholecystitis, 3 cholecystitis with acute pancreatitis, 1 gangrenous cholecystitis, and 1 xanthogranulomatous cholecystitis. All patients underwent MDCT plain scan and contrast enhanced dual phase scanning of upper abdomen. Results In hepatic disease group, 48 cases had evenly thickened gallbladder wall (96%) with mean thickness of (3.67?0.49) mm; 38 cases had clear gallbladder outlines (76%); 38 cases had gallbladder wall enhancement of various degree (76%); 14 cases had gallbladder bed edema and localized non dependant pericholecystic fluid collection (28%). In inflammatory cholecystitis group, 28 cases had obscuring gallbladder outlines (93%) ; 26 cases had gallbladder wall evenly thickened (87%), 4 cases showed unevenly thicked wall (13%), the mean thickness being (4.54?1.14) mm; 30 cases had inhomogenous enhancement of the gallbladder wall (100%); 9 cases had high attenuation bile (30%); 4 cases had dependant pericholecystic fluid collection (13%); 5 cases had transient enhancement of adjacent hepatic bed in arterial phase (17%); micro abscess and gas in the gallbladder wall was observed in 1 case respectively. Conclusion MDCT can offer imaging findings useful for differentiating abnormal gallbladder changes caused by hepatic parenchymal diseases from those due to inflammatory cholecystitis.

Objective To investigate the changes of lead,zinc,copper,iron and calcium in blood of chronic poisoned infantal mice.(Methods) Forty-eight 21 day-old kunzea mice were randomly divided into 4 groups,each having 12 mice.Distilled water group was as control group and other three lead acetate poisoning groups had a dose of 10,20,40 mg/kg,respectively.The poisoning was carried out by lavage once a day,and consecutively for 46 days.Eyeballs of mice were picked then for blood sampling,and BS trace element analysis grapher was used to determine level of lead,zinc,copper and iron.Level of calcium was measured by Dimentional-RXL auto-biochemistry analysis meter.Results The lead and zinc levels in poisoned mice blood were increased with increasing lead acetate level administration,while zinc level changed inversely with lead acetate level.Significant differences were shown among control group and poisoning groups in terms of lead(P0.05).Conclusion Lead posioning can lead to zinc decreasing and copper(increa)-sing,which suggests that zinc works as a poential antidote of lead poisoning.

Calcitonin gene-related peptide( CGRP) is the strongest vasodilator discovered to date,the synthesis and release of CGRP are regulated by multiple factors.CGRP possesses multiple biological func-tions,such as vasodilator,myocardial strengthener,lung protector,brain protector,immunomodulator.It plays an important role in regulating the function in the body.

Objective:To examine the expression of odontoblast related proteins in dental pulp stem cells(DPSCs)induced by BMP-7.Methods:DPSCs were cultured in the common culture medium or medium supplemented with 1 00 ng/ml BMP-7.Electron microscope,CCK8 and immunohistochemical staining were carried out to estimate the cell morphology and differentiation.Results:In-duced by BMP-7,the morphology of DPSCs was not changed,the proliferation of DPSCs was slower than that of the cells without BMP-7 treatment.DPSCs were negative for the expression of DSPP,DMP-7 and ALP.However,DPSCs were found strongly positive for DSPP,DMP-7 and ALP after the induction of BMP-7.Conclusion:BMP-7 induction may promote the differentiation of DPSCs.

Objective To examine the effectiveness of self-efficacy training on fluid intake in maintenance hemodialysis patients.Methods Fifty-four hemodialysis patients participated in the study.The intervention was based on Bandura's self-efficacy theory.The outcome measure was self-efficacy for managing chronic disease,the mean interdialysis weight gain,dialysis-related complications and patient satisfaction.Data were collected at baseline and 3 months after the intervention.Results The mean score of selfefficacy,the mean interdialysis weight gain,dialysis-related complications and patient satisfaction after the intervention were all statistically significant compared with those bcfore the intervention.Conclusions The study supports the effectiveness of the self-efficacy training in improving the fluid intake compliance in maintenance hemodialysis patients.So it is worth being popularized in clinic.

Objective To evaluate the potential of three commercial CT iterative reconstruction methods (ASIR,MBIR and iDose4) for the image quality and accuracy of volumetric measurement of ground-glass opacity (GGO) nodules on low-dose chest computed tomography (CT) using a phantom study.Methods A phantom containing GGO nodules was examined in volumetric mode on 2 multi-detector CT scanners at low dose.CT images were reconstructed with adaptive statistical iterative reconstruction (30％ ASIR),model-based iterative reconstruction (MBIR),iDose4 L3,L6 reconstruction algorithm.Then two radiologists measured CT value of the region of interests (ROI) on reconstruction images,and calculated average noise and contrast to noise ratio (CNR) of reconstruction images.And they applied the lung nodules evaluation software to measure the volume of GGO nodules on the reconstruction images,and calculated the absolute percentage error (APE) of nodule volume measurement.The difference of noise and CNR at different reconstructions was compared with ANOVA test,and Kruskal-Wallis H ranking test was used to the difference of GGO measurements at different reconstructions.Results The average noises of CT image reconstructed with the standard FBP algorithm,30％ ASIR algorithm,MBIR algorithm were 40.38 ± 4.49,30.06 ± 20.17,10.55 ± 1.56,and the CNRs were 5.00 ± 2.36,8.43 ± 3.89,20.27 ± 7.35,respectively.Compared to CT image reconstructed with the standard FBP algorithm and 30％ ASIR algorithm,CT image noise reconstructed with MBIR algorithm decreased by 73.9％ and 64.9％,while the CNR increased by 75.3％ and 58.4％ with effective dose of 0.36 mSv in HDCT,respectively(F =13.053,9.459,P ＜0.01).When effective dose was equal to 0.64 mSv in iCT,the image noise reconstructed with iDose L6 algorithms decreased by 36.5％ compared with the standard FBP algorithm,and CNR increased by 78.4％.The reconstruction algorithm,NI and tube current were no significant difference in lung nodule volume measurement of absolute percentage error(P ＞ 0.05).Conclusions Three kinds of iterative reconstruction algorithms are able to reduce the image noise in low-dose CT and improve the image quality.