ObjectiveTo understand the effect of student standardized patient-case teaching in orthopedic surgery.Methods A total of 120 clinical medicine students were selected,and they were randomly assigned to be research group ( n=60 ) and control group ( n=60 ),as students standardized patient,10 clinical medicine students and postgraduate students of orthopedic surgery were selected,and standardized patient-case teaching was applied to the students in research group while traditional case teaching was applied to students in control group.After teaching,the teaching effect and survey the feedback information about teaching form students were evaluated.ResultsTotal mark of effect evaluation of 2 groups is 83.50 + 6.55 and 71.11 ± 6.57,and both operational score and knowledge study achievements of research group were better than control group (P＜0.01),over 80％ research group students effect evaluation being positive.ConclusionStudent standardized patient-case teaching is helpful to improving students' study in orthopedic surgery and the teaching effect is remarkable.

Objective:To investigate clinical curative effect of trans-arterial chemo-embolization (TACE) in combination with radio-frequency ablation (RFA) for the treatment of massive primary hepatocellular carcinoma so as to provide theoretical basis for clinical practice.Methods: 60 patients with massive primary hepatocellular carcinoma were divided into control group (30 cases) and observation group (30 cases) according to the different treatment methods. The patients of control group received the treatment of TACE while the patients of observation group received the combined treatment of TACE and RFA, at the same time, all of the patients of two groups received the supportive treatment for protecting liver. After the operation, the necrosis situations of patients in the two groups were evaluated by using enhanced CT, and their complication and survival time were recorded. Besides, the changes of series of indexes including blood routine, hepatic and renal function and immunologic function were monitored. Based above data, the curative effect and safety of the two therapeutic methods were compared and analyzed. Results: After treatment, the 6 months, 1 year, 2 years, 3 years survival rate of observation group were significantly higher than that of control group (x2=5.787,x2=6.814,x2=4.802,x2=4.622,P<0.05). And the TBIL, ALT and AFP of observation group were significantly lower than that of control group (t=5.775,t=3.332,t=10.231,P<0.05). Besides, the CD3+, CD4+/CD8+, NK cells and TNF-α of observation group were significantly higher than that of control group (t=6.434,t=5.125,t=6.017,t=4.669,P<0.05).Conclusion: The curative effect of TACE combined with RFA is significantly better than that of single TACE, and it is worthy in clinical popularization and application.

BACKGROUND:To reducing bone damage in patients with chronic arthritis, anti-tumor necrosis factor alpha treatment has aroused wide concern.
OBJECTIVE:To summarize the action of tumor necrosis factor alpha in the pathogenesis of chronic arthritis and progress in anti-tumor necrosis factor alpha drugs.
METHODS:A computer-based search of NCBI, OVID, EBSCO was performed to col ect articles published from December 1st, 2005 to July 31st, 2013 with the keywords of“infliximab, etanercept, adalimumab, chronic arthritis”in English. There were 162 articles after initial retrieval, and final y 40 articles were included and summarized.
RESULTS AND CONCLUSION:Studies have shown that a number of factors are involved in the activation of osteoclasts, and tumor necrosis factor alpha is only a member resulting in osteoclastogenesis. In addition, there are some media behind tumor necrosis factor alpha and RANK-RANKL system, which may independently induce osteoclastogenesis. Because of this, a separate anti-tumor necrosis factor alpha therapy applied to chronic arthritis cannot achieve the desired therapeutic effects.

Objective To explore the relationship between the polymorphisms of the primary gout predisposing gene (BCAS3) rs11653176 locus and the incidence of gout in Han Chinese men in coastal areas of Shandong Province. Methods One hundred and fifty-two cases of patients with gout remission,68 cases of acute stage,252 patients with hyperuricemia, and 280 healthy subjects, total males, were enrolled. Genotyping the rs11653176 locus of BCAS3 gene by TaqMan probe technique. The expression level of BCAS3 gene mRNA in each PBMC was measured by RT-qPCR. The levels of tumor necrosis factor-α(TNF-α), interleukin-6(IL-6), and interleukin-18(IL-18)in serum were measured by ELISA. Results The change of allele frequency of rs11653176 locus in BCAS3 gene was associated with gout(P<0.01). BCAS3 mRNA in patients with gout was significantly higher than that of healthy people and patients with hyperuricemia(P<0.01). In gout patients, the expression level of BCAS3 gene containing C allele was higher than that of T allele(mRNA,P<0.05). The inflammatory factors in the acute phase of gout were significantly higher than those in phases of remission and hyperuricemia(P<0. 01). Conclusion Changes in the allele frequency of BCAS3 alleles rs11653176(high C, low T)may contribute to the expression of this gene,and lead to gout. And the onset of gout is closely related to the production of inflammatory factors.