Objective Through in vitro experiments,biomechanical data of the transtibial pullout suture(TPS),tendon reconstruction(TR),and tendon reconstruction with suture augmentation(TRS)were collected,so as to evaluate the biomechanical effectiveness of tendon reconstruction for repairing medial meniscus posterior root tear(MMPRT).Methods Eighteen porcine knee joint models were divided into TPS,TR,and TRS groups.Sutures were used to fix the meniscal root in TPS group.Tendons were passed through an incision at the meniscal root in TR group.Tendons were passed through an incision at the meniscal root and secured at tendon-meniscus contact area with additional sutures in TRS group.The sutures and tendons were pulled out through tibial tunnels and fixed at the anteromedial tibia.All groups underwent failure load tests,and ultimate failure load,displacement at failure load,load at clinical failure,stiffness,and failure modes of the samples were recorded.Results The maximum failure load in TPS group was significantly higher than that in TR group(P＜0.05),but there was no significant difference between TPS group and TRS group(P＞0.05).The maximum failure load in TRS group was significantly higher than that in TR group(P＜0.05).The displacement under failure load in TR group and TRS group was significantly lower than that in TPS group(P＜0.05),but there was no significant difference between TR group and TRS group(P＞0.05).There were no significant differences in the load under clinical failure among the 3 groups(P＞0.05).The stiffness of TRS group was significantly greater than that of TPS group(P＜0.05),but no significant difference was observed between TR group and TPS group,as well as between TR group and TRS group(P＞0.05).All failures were caused by suture or tendon cutting through the meniscus.Conclusions The tendon reconstruction techniques is superior to the TPS in terms of failure displacement and stiffness,while the TRS further enhances the stability of the repair.

Objective Through in vitro experiments,biomechanical data of the transtibial pullout suture(TPS),tendon reconstruction(TR),and tendon reconstruction with suture augmentation(TRS)were collected,so as to evaluate the biomechanical effectiveness of tendon reconstruction for repairing medial meniscus posterior root tear(MMPRT).Methods Eighteen porcine knee joint models were divided into TPS,TR,and TRS groups.Sutures were used to fix the meniscal root in TPS group.Tendons were passed through an incision at the meniscal root in TR group.Tendons were passed through an incision at the meniscal root and secured at tendon-meniscus contact area with additional sutures in TRS group.The sutures and tendons were pulled out through tibial tunnels and fixed at the anteromedial tibia.All groups underwent failure load tests,and ultimate failure load,displacement at failure load,load at clinical failure,stiffness,and failure modes of the samples were recorded.Results The maximum failure load in TPS group was significantly higher than that in TR group(P＜0.05),but there was no significant difference between TPS group and TRS group(P＞0.05).The maximum failure load in TRS group was significantly higher than that in TR group(P＜0.05).The displacement under failure load in TR group and TRS group was significantly lower than that in TPS group(P＜0.05),but there was no significant difference between TR group and TRS group(P＞0.05).There were no significant differences in the load under clinical failure among the 3 groups(P＞0.05).The stiffness of TRS group was significantly greater than that of TPS group(P＜0.05),but no significant difference was observed between TR group and TPS group,as well as between TR group and TRS group(P＞0.05).All failures were caused by suture or tendon cutting through the meniscus.Conclusions The tendon reconstruction techniques is superior to the TPS in terms of failure displacement and stiffness,while the TRS further enhances the stability of the repair.

Objective To predict the quality marker(Q-marker)of Wuwei disinfection decoction based on HPLC fingerprints and network pharmacology.Methods Using the Chinese Medicine Chromatographic Fingerprint Similarity Evaluation System(2012 version)software,the fingerprints of 15 batches of Wuwei disinfection decoction were established,and the peaks were found and assigned to each batch.Wuwei disinfection decoction's primary targets and routes were screened using network pharmacology,and a"component-target-pathway"network diagram was established.The five principles of the Q-marker were used to predict the quality marker in Wuwei disinfection decoction.Results The similarity of the fingerprints of 15 batches of Wuwei disinfection decoction was＞0.95,13 peaks were identified,and 11 peaks were recognized as neochlorogenic acid,chlorogenic acid,esculetin,cryptochlorogenic acid,loganin,secoxyloganin,chicoric acid,isochlorogenic acid B,isochlorogenic acid A,isochlorogenic acid C and linarin.Through the pharmacological analysis of the network,it was speculated that chlorogenic acid,esculetin,secoxyloganin,chicory acid,and linarin might be potential Q-marker of Wuwei disinfection decoction,which may regulate multiple genes,such as tumou suppressor p53/oncoprotein Mdm2,tyrosine-protein kinase SRC,as well as multiple cancer pathways such as pancreatic cancer and prostate cancer,to produce anti-tumor and anti-cancer effects.At the same time,Wuwei disinfection decoction was also predicted to be used for the treatment of COVID-19.Conclusion The established HPLC fingerprinting method of Wuwei disinfection decoction was sensitive,rapid,and stable.Based on the network pharmacology results,potential Q-marker with traceability,predictability,and close relevance to the clinical application of Wuwei disinfection decoction was screened,which can provide a reference for further research on Wuwei disinfection decoction in the future.

Objective To investigate the effects of general anesthesia and hard epidural anesthesia on the incidence of postoperative cognitive dysfunction (POCD),serum S-100β and Aβ1-42 protein in elderly patients with transurethral resection of the prostate (TURP).Methods 120 cases of elderly male patients who wanted to implement TURP were enrolled in this study.From March 2014 to August 2016,60 patients underwent general anesthesia (general anesthesia group) and 60 patients underwent epidural anesthesia (hard epidural Group).The effects of two anesthesia methods on the cognitive function,serum S-100 β and Aβ1-42 protein were compared.Results There was no significant difference in mini-mental state examination (MMSE) score in preoperative,postoperative 12 h,postoperative 24 h,postoperative 72 h,and postoperative 1 week between hard epidural group and general anesthesia group (P ＞ 0.05).The MMSE scores at 12 h,24 h and 72 h after operation in both groups were significantly lower than those before operation in both groups (P ＜0.05).There was no significant difference in clock drawing task (CDT) score in preoperative,24 h after operation,72 h after operation and one week after operation (P ＞ 0.05).The CDT scores of both groups at 12 h,24 h,72 h after operation were significantly lower than those before operation (P ＜0.05).There was no significant difference in serum S-100β levels between the two groups at preoperative and 12 h,72 h after operation (P ＞0.05).Serum S-100β levels at 12 h and 72 h after surgery in both groups were significantly higher than those before surgery (P ＜ 0.05).There was no significant difference in preoperative and postoperative 12 h,postoperative between hard epidural group and general anesthesia group (P ＞ 0.05).Serum Aβ1-42 levels at preoperative,12 h and 72 h after operation in both groups were significantly lower than those before operation (P ＜ 0.05).There was not statistically significant in the incidence of POCD between hard epidural group [28.33 ％ (17/60)] and general anesthesia group [35％ (21/ 60)] (P ＞ 0.05).Conclusions There was no significant difference in the incidence of POCD between general anesthesia and hard epidural anesthesia group in elderly patients with TURP.The incidence of POCD in elderly patients was related to the decrease of serum S-100β and the decrease of Aβ1-42.

In order to implement the 'excellent doctor education training plan' for clinical medicine majors,a series of principles and measures were adopted to train medical students.On the basis of clearing ideas and goals of ‘excellent doctor education training plan',constructing cmriculum system based on basic clinical skills,innovatively constructing the practical teaching platform,optimizing practical teaching system,improving teaching methods,revising assessment and evaluation methods and employing an outstanding teaching team with reasonable structure,we constructed the talent training mode with ‘one goal,two processes,three combinations'.In conclusion,the talent training mode played an important role in the cultivation of medical talents in clinical medicine.

Background and purpose:Chemotherapy including anthracyclin and taxanes is one of the effective regimens for patients with advanced breast cancer, but 20%-30% patients do not achieve a satisfactory curative effect .At present, there is no unified standard second-line chemotherapy regimen for these patients. We studied the efficacy and toxicity of gemcitabin plus capecitabine in the treatment of the patients with advanced breast cancer who had failed in response to the treatment of anthracyclin and taxanes chemotherapy. Methods:Gemcitabin 1 000 mg/m2 iv infusion at d1,8 and capecitabine 950 mg/m2 po tid at d1-14.The interval between the two cycles was 3 weeks. The assessment for clinical effect and side effect was conducted for the patients with completion of 2 cycles of chemotherapy at least.Results:30 female patients were enrolled in this trial ,overall response rate was 46.7%,with 6.7% complete response (2/30)and 40% partial response (12/30). Stable disease was seen in 42.3%(13/30),and disease progression in 10% (3/30).Median time to progression was 9 months, and median overall survival was 12.5 months. The main toxicities were myelosuppression and hand-foot syndrome.Conclusions:Gemcitabin plus capecitabine is effective for the patients with advanced breast cancer who failed in the treatment of anthracyclin and taxanes chemotherapy, and its side effect is tolerable.