Students generally felt difficult in studying during clinical practice and the orthopedics teaching quality was unsatisfactory due to the discrepancies existed among teaching of anatomy,imagie and orthopedics clinical practice concerning the time,content,requirement and method.Students' understandings of anatomy and image knowledge were improved through launching theoretical study by means of lectures and case discussion.Students' understandings of orthopedics diseases were promoted through preoperative diagnosis and intraoperative conformation using anatomy and image knowledge for the patients they were responsible for.In all,orthopedics clinical teaching quality was promoted through applying these measures.

BACKGROUND:There remains controversy that whether patel ar resurfacing in total knee arthroplasty and whether patel ar chondromalacia has influence on clinical outcomes.
OBJECTIVE:To evaluate anterior knee pain, clinical function and effects of patel ar chondromalacia on clinical outcomes after total knee arthroplasty without patel ar resurfacing for degenerative osteoarthritis.
METHODS:Clinical data of 162 patients (162 knees) with degenerative osteoarthritis undergoing total knee arthroplasty without patel ar resurfacing from June 2008 to February 2010 were retrospectively analyzed. Outerbridge classification was used for patel ar chondromalacia, Visual Analogue Scale for anterior knee pain, and the Knee Society clinical scoring system for clinical function.
RESULTS AND CONCLUSION:The incision of al patients reached stage-I healing. The patel ar chondromalacia:grade I in 18 patients, grade II in 36 patients, grade III in 62 patients, and grade IV in 35 patients. At the final fol ow-up, there were six (4.0%) patients with anterior knee pain, including four cases of mild pain and two cases of moderate pain, no severe pain. The mean Knee Society clinical scoring system scores and patel ar score were obviously elevated. Outerbridge classification did not affect the incidence of anterior knee pain after replacement (χ2=0.42, P=0.94), the Knee Society clinical scoring system score (knee score:F=1.83, P=0.14;functional score:F=0.56, P=0.64) and partel ar score (F=0.78, P=0.51). These data suggested that total knee arthroplasty without patel ar resurfacing for degenerative osteoarthritis can obtain satisfactory clinical outcomes, and the patel ar chondromalacia may not affect the clinical outcomes.

Objective:To observe the changes of biomarkers in patients with non-ST segment elevation myocardial infarction (NSTEMI) after intervention with Salvianolate.Methods:A total 81 patients with NSTEMI who met the inclusion criteria from January 2016 to December 2019 were randomly divided into two groups. The control group dropped 6 cases, the treatment group dropped 6 cases, and finally each group had 35 cases. The control group was treated with conventional medicine therapy, and the treatment group was treated by intravenous drip of 0.9% NS 250 ml + Salvianolate on the basis of the control group. Both groups were treated continuously for 10 days. The latex immunoturbidimetric method was used to detect hypersensitive-C-Reactive-Protein (hs-CRP), double antibodysandwich immune chemiluminescence method for procalcitonin (PCT), electrochemiluminescence method for N-Terminal pro-B-type Natriuretic Peptide (NT-proBNP), coagulation method for plasma fibrinogen (FIB), and immunoassay for D-dimer. The number of episodes of angina pectoris after infarction, recurring myocardial infarction, malignant arrhythmia, and death in the hospital were recorded and collected during the hospitalization period (0-10 d).Results:After treatment, hs-CRP (2.46 ± 1.76 mg/L vs. 3.45 ± 0.67 mg/L, t=2.324), PCT (0.52 ± 0.30 ng/L vs. 0.11 ± 0.08 ng/L, t=2.059), FIB (1.30 ± 0.63 g/L vs. 1.97 ± 0.67 g/L, t=2.168) in the treatment group were significantly lower than those in the control group ( P<0.05). After treatment, the level of NT-proBNP and D-dimer showed a downward trend, but there was no statistically significant difference within and between groups ( P>0.05). During hospitalization, the number of angina pectoris after infarction in the treatment group was significantly lower than that of the control group ( t=4.019, P=0.045), while the incidence of acute heart failure, recurring myocardial infarction, malignant arrhythmia and death in the hospital showed no significant difference ( P>0.05). Conclusion:Salvianolate can reduce the inflammatory response of NSTEMI patients on the basis of western medicine, relieve the hypercoagulable state, and reduce the number of angina pectoris after infarction.

To explore the effects of Shenmai Injection (SMI), a compound traditional Chinese herbal medicine, on pharmacokinetics and serum concentration of digoxin when applied together with digoxin.

ObjectiveTo detect the expression level of programmed cell death (PDCD) 5 and tumor necrosis factor(TNF)-α in serum and joint fluid from rheumatoid arthritis (RA) and osteoarthritis (OA)patients,and analyze the correlation between PDCD5 and TNF-α in order to study the role of PDCD5 in the pathogenesis of RA.MethodsFiftypatients(including 26 RA,24 OA) between December 2009 and August 2010 were selected to this study.ELISA was used to detect the concentration of PDCD5 and TNF-α in the serum and joint fluid.Two-independent sample t-test and Pearson's correlation analysis were used for statistics.ResultsIn both serum and joint fluid,the concentration of PDCD5 from RA patients [(37±33) vs (37±26) pg/ml ] was significantly higher than that of OA patients [ ( 13± 14) vs ( 11 ±7 ) pg/ml ] (P＜0.05).The concentration of TNF-α in the serum from RA and OA patients did not differ significantly(P=0.122),but its concentration in joint fluid of RA patients was significantly higher than that of OA patients (P=0.037).In the serum,there was significant correlation between PDCD5 and TNF-α (r=-0.55,P=0.004; r=-0.51,P=0.012)in both RA and OA patients.The correlation between PDCD5 and TNF-α in joint fluid of RA patients was statistically significant(r=-0.49,P=0.012),but no correlation could be found in joint fluid between PDCD5and TNF-α of OA patients(r=-0.353,P=0.09).ConclusionThis study suggests that PDCD5 and TNF-αare important apoptosis-regulatory factors in RA,and play important roles in the occurrence and development of RA.

A novel subtype of influenza A virus 09H1N1 has rapidly spread across the world. Evolutionary analyses of this virus have revealed that 09H1N1 is a triple reassortant of segments from swine, avian and human influenza viruses. In this study, we investigated factors shaping the codon usage bias of 09H1N1 and carried out cluster analysis of 60 strains of influenza A virus from different subtypes based on their codon usage bias. We discovered that more preferentially used codons of 09H1N1 are A-ended or U-ended, and the intra-genomic codon usage bias of 09H1N1 is quite low. Base composition constraint, dinucleotide biases and translational selection are the main factors influencing the codon usage bias of 09H1N1. At the genome level, we find that the codon usage bias of 09H1N1 is similar to H1N1 (A/swine/Kansas/77778/2007H1N1), H9N2 from Asia, H1N2 from Asia and North America and H3N2 from North America. Our results provide insight for understanding the processes governing evolution, regulation of gene expression, and revealing the evolution of 09H1N1.

score 1, 2, 4, 8 weeks after SCI, somatosensory evoked potential (SEP) and spinal cord histopathological examination 2, 4, 8 weeks after SCI. Results The difference of BBB score was not significant between the groups 1 week after SCI (P>0.05), but improved more in group B than in group A 2,4,8 weeks after SCI (P<0.01), as well as the latency and wave amplitude of SEP (P<0.01). There were scar tissue and syringomyelia in injured spinal cord, and the size of syringomyelia was larger in group A than in group B. Neurofilament 200 (NF200) expressed 2, 4, 8 weeks after SCI, and was more in group B than in group A (P< 0.01). Conclusion Du meridian electroacupuncture can promote the recovery of neurological function in rats after spinal cord injury.

BACKGROUND:Bone marrow mesenchymal stem cels are crucial for bone and cartilage development and regeneration at a celular level. Insufficient quantity and functional impairment of bone marrow mesenchymal stem cels is widely considered to be one of osteoarthritis causes. OBJECTIVE: To explore the relationship between the functional status of bone marrow mesenchymal stem cels and disease progression in osteoarthritis patients.METHODS: Thirty patients with osteoarthritis were enroled from July 2013 to October 2014, and divided into control, mild osteoarthritis, and severe osteoarthritis groups, with 10 cases in each group. 5 mL bone marrow from the femur or tibia was extracted from each patient to isolate and culture bone marrow mesenchymal stem cels. Proliferation ability of cels at passage 3 was detected using cel counting kit-8; toluidine blue staining was performed at 14 days after chondrogenic induction; real-time PCR was used to detect the mRNA expression of Aggrecan and Col2A1 in the control group after chondrogenic induction. RESULTS AND CONCLUSION:Afterin vitro culture, bone marrow mesenchymal stem cels grew adherently in polygonal and fusiform shape with multiple processes at uniform size. The cytoplasm contained larger particles and the nuclei were ovoid. Most of cels were in cel division phase. The proliferation ability was strongest in the control group and weakest in the severe osteoarthritis group. Cels from the three groups were al at plateau phase after 1 week culture. At 14 days after chondrogenic induction, the cels were polygonal and quasi-circular, and purple metachromatic granules distributed outside of the cytoplasm. The expression of Aggrecan and Col2A1 in the control group displayed an overexpression trend. These findings indicate that the functional status of bone marrow mesenchymal stem cels from osteoarthritis patients is negatively correlated with the severity of disease, which can influence the disease progression in osteoarthritis patients.

Perlman syndrome is a rare autosomal recessive congenital overgrowth syndrome caused by pathogenic variants of the DIS3L2 gene at 2q37 region. Clinically this syndrome is characterized by polyhydramnios, macrosomia, distinctive facial appearance, and renal dysplasia. Prognosis of the disease is poor, and survivors usually have mental delay and a high risk of developing Wilms tumor. At present, the pathogenesis of this disease is still poorly understood. This article intends to provide a review for this disease.
Female ; Fetal Macrosomia ; Humans ; Kidney Tubules, Proximal ; Pregnancy ; Syndrome ; Wilms Tumor

Objective To analyze the risk factors of socio-demographic and clinical characteristics related to anxious symptoms in bipolar depression patients(BDP).Methods This was a secondary analysis of data from the Diagnostic Assessment Service for People with Bipolar Depression in China(DASP)from September 1,2010 to February 28,2011.According to the criterion that comorbid anxiety or not, BDP(n=306)were divided into comorbid anxiety group(n =200)(65.4％)and without anxiety group(n =106)(34.6％).Further analysis for risk factors of anxious symptoms in BDP was performed by the multivariate logistic regression analysis.Results BDP with anxiety were younger(35.10± 11.09), younger at illness onset(27.93-± 10.04), ruore male(t =4.603, P＜0.05), more lifetime episodes(3.21 ± 3.77), frequently episodes(t =17.328,P＜0.05),inducement onset(t=14.859,P＜0.05)and more seasonal episodes(t=8.300,P＜0.05)compared with BDP without anxiety.Logistic regression analysis showed that inducement onset(OR=5.023)and episodes frequency(OR=10.852)was significantly associated with anxious symptom(P＜0.05).Conclusion The finding indicates that postpartum onset and depressive episodes frequency may be risk factors of bipolar depression with anxiety.