Following the development of the socialist market economy and the reformation of the medical safeguard system and the improvement of the higher education reformation,the shortcoming of the medical safeguard system of college students which has started in the period of planned economy has become visible.Through the narration of present situation and the analysis of the reasons to the domestic college students'medical safeguards,this article suggests that our government should establish university student medical service safeguard system which is a perfect and multi-level system and brings the university students'medical safeguard system into the national society medical service safeguard.At the same time,we must strengthen university students'realization of medicine guarantees so as to guarantee them to complete their studies successfully

OBJECTIVETo investigate the effect on intramuscular connective tissue and passive range of joint motion by the stress produced in limb lengthening.

METHODSAn animal model of limb lengthening was established in the tibia of rabbits. Distraction was initiated at a rate of 1 mm/d and 2 mm/d in two steps respectively, and both proceeded until 10% and 20% of the tibia length was achieved. Muscle samples were harvested at the time when distraction ended and at the 4th week of consolidation after the distraction. Scanning electron microscope was applied to observe the morphological changes of the perimysium. The goniometer, which we made for this study, was used to measure the passive range of joint motion.

RESULTSThe collagen fibers were partitioned in bundles, crimped and interconnected closely and orderly. In the regime of 1 mm/d distraction with 10% lengthening, no apparent changes of the collagen fiber and passive range of joint motion was demonstrated. When tibia was increased to 20%, the crimped fibers showed a tendency of being straightened while the passive range of joint motion was reduced. The findings remained the same at the 4th week of consolidation. In the regime of 2 mm/d distraction with 10% lengthening, the crimped structure of the collagen fibers in the perimysium disappeared and the fibers were almost straightened. Additionally, the interconnection of the collagen fibers became loosened and interstice was presented among the fibers. At the 4th week of consolidation, the restoration to the original crimped structure was not completed. When the lengthening ratio was increased to 20%, the collagen fibers were straightened completely. This condition remained unchanged throughout all 4 weeks. The passive range of joint motion was reduced dramatically in the regime of 2 mm/d distraction.

CONCLUSIONThe ultrastructure of perimysium and the passive range of joint motion in the regime of 1mm/d lengthening shows the condition closest to the normal ones. The regime of 2 mm/d lengthening may cause an apparent change in the ultrastructure of perimysium and passive range of joint motion.

Animals ; Bone Lengthening ; Collagen ; ultrastructure ; Connective Tissue ; injuries ; physiology ; ultrastructure ; Male ; Osteogenesis, Distraction ; Rabbits ; Range of Motion, Articular ; physiology ; Regeneration ; physiology

Objective To compare the efficacy of different rehabilitation models on acalculia after acquired brain injury. Methods 113 cases were randomly assigned to 3 groups: control group(n=37), computer-assisted training group(n=38) and face-to-face training group(n=38). The control group just received cognitive dysfunction evaluation. The training groups received cognitive rehabilitation training 5 days a week and 30 minutes a day which sustained for 6 weeks. And 33 patients were selected to prolong for 12 weeks. They were evaluated with Revised EC301Calculation and Number Processing Battery in Chinese version (EC301-CR) at the beginning, the 6th week point and the 12th week point respectively. Results 6-week after treatment, The performance of both the computer-assisted training group and face-to-face training group significantly improved(P<0.001); It showed that computer-assisted group>face-to-face group>control group(P<0.001) both 6 weeks and 12 weeks latter. Significant negative correlation was found between age and performance of EC301-CR(P<0.05).Conclusion The effect of computer-assisted training on acalculia is superior to face-to-face training; The first 6 weeks of training is the best period for rehabilitation; The younger the patient is, the better results are.

METHODS: The clinical data of 15 patients with primary diffuse large B-cell lymphoma treated in our hospital from January 2013 to December 2020 were collected, the clinical data and prognosis of the patients were analyzed retrospectively. RESULTS: The median age of the 15 patients was 59 (19-89) years old; among the patients, 7 were males and 8 were females, ostealgia was the initial symptom. The pathological types of the 15 patients were diffuse large B-cell lymphoma (DLBCL), 5 cases of Has type GCB subtype (5/15), and 10 cases of Non-GCB subtype (10/15). After 15 patients were diagnosed, 11 patients (11/15) received chemotherapy, 3 patients (3/15) received surgery, and 1 patient was untreated (1/15), median chemotherapy courses was 5 (1-9). 8 patients have achieved complete remission (8/15), 3 patients achieved partial remission (3/15), and 1 patient achieved stable disease (1/15), 1 patient was lost to follow-up (1/15), 1 patient was untreated (1/15), and 1 patient was progression of disease (1/15). Age, pathological subtype, sex, stage, β2-MG level, LDH level, and the using of rituximab were not correlated with the complete remission rate of the patients(P>0.05), while the IPI score was correlated with the recent complete remission rate (P<0.05). The median follow-up time was 19 (1-38) months, 10 patients survived, in which 6 cases were still in complete remission, and the median time to progression-free survival was 15 (1-38) months. CONCLUSION The first symptom of primary bone diffuse large B-cell lymphoma is bone pain, the main pathological subtype is Non-GCB, the optimal treatment is combined chemotherapy, and the IPI score is related to the prognosis of the treatment.
Aged ; Aged, 80 and over ; Female ; Humans ; Lymphoma, Large B-Cell, Diffuse ; Male ; Middle Aged ; Prognosis ; Remission Induction ; Retrospective Studies ; Rituximab

Objective    To study the learning curve of minimal invasive coronary artery bypass grafting (MICS CABG) and the influence on the perioperative clinical effects by analyzing operation time. Methods    From March 2012 to November 2020, 212 patients underwent MICS CABG by the same surgeon. Among them, 59 patients (52 males and average age of 62.89±8.27 years) with single vessel bypass grafting were as a single-vessel group and 153 patients (138 males, average age of 59.80±9.22 years) with multi-vessel bypass grafting were as a multi-vessel group. Two sets of operation time-operation sequence scatter plots were made and learning curve was analyzed by cumulative summation (CUSUM) and regression method of operation time. The surgical data of each group before and after the inflection point of the learning curve were compared with the main clinical outcome events within 30 days after surgery. Results    There was no death, perioperative myocardial infarction and stroke in 212 MICS CABG patients and no transfer to cardiopulmonary bypass or redo thoracotomy. The learning curve conformed to the cubic fitting formula. In the single- vessel group, CUSUM (x operation number)=–1.93+93.45×x–2.33×x2+0.01×x3, P=0.000, R2=0.986, the tipping point was 27 patients. In the multi-vessel group, CUSUM (x)=y=2.87+1.15×x–1.29× x2+3.463×x3, P=0.000, R2=0.993, and the tipping point was 59 patients. The two sets of case data were compared before and after the learning curve and there was no statistical difference in main clinical outcomes within 30 days (mortality, acute myocardial infarction, stroke, perioperative blood transfusion rate), ventilator tube, and intensive care unit retention. Conclusion    The learning curve of MICS CABG conforms to the cubic formula, and the process transitions from single to multiple vessels bypass. To enter the mature stage of the learning phase, a certain number of patients need to be done. Reasonable surgical procedures and quality control measures can ensure the safety during the learning phase.