Simply relying on the introduction of online teaching resources on the platforms such as Chinese University Massive Open Online Course (MOOC) to carry out online teaching, it is easy to encounter problems that the teaching resources are inconsistent with the learning situation and teaching syllabus of the students majoring in medical statistics of Binzhou Medical University, the lack of interaction among students, and the untimely teaching feedback. Therefore, on the basis of integrating the MOOC resources, we established asynchronous small private online course (SPOC) online curriculum resources for medical statistics that were suitable for the students of our school. The blended teaching mode of "SPOC+QQ living broadcast" was carried out. Before and after the implementation, two rounds of questionnaires were conducted to understand students' teaching and learning needs and teaching effect evaluation of online teaching, and then the teaching mode was optimized. The results show that the blended teaching mode of "SPOC + QQ living broadcast" designed in this study has the advantages of rich teaching resources, high enthusiasm of students, flexible teaching interaction, timely teaching feedback, and diversified teaching evaluation, which provides a reference for the better development of online and offline blended teaching reform in the future.

Objective:To describe the effect of distraction lengthening to correct nail deformity in unilateral congenital brachydactyly type D (BDD).Methods:Patients with unilateral BDD who were treated by distraction lengthening between January 2020 and December 2021 in the Department of Plastic and Reconstructive Surgery of Shanghai 9th People’s Hospital were retrospectively reviewed. A transverse osteotomy was applied on the middle diaphysis of distal phalanx, and one pin was inserted percutaneously on both sides of the osteotomy site, then a mini external fixator was installed. Distraction lengthening was performed with a slow and sustained procedure. The aesthetic and functional results were compared preoperatively and postoperatively. Patient satisfaction questionnaires were recorded.Results:35 patients were enrolled, including 12 males and 23 females, with a mean age of 29.5 years. 17 thumbs were left and 18 thumbs were right. The time for distraction lengthening was 10-17 days, and the mean time was 12.3 days. The total time for external fixator maintenance was 55-70 days, with a mean time of 61.4 days. The mean follow-up was 18.6 months. The mean thumbnail length was increased from (9.2±0.6) mm to (14.2±0.4) mm [lengthening ratio, (54.4±7.5)%] after distraction lengthening ( P<0.05). The ratio of nail length to width changed from 0.63±0.05 to 1.05±0.04 [increase ratio, (68.2±10.5)%, P<0.05], which was equal to the normal value (1.07±0.03) ( P>0.05). Meanwhile, the distal thumb length increased from (22.6±0.7) mm to (29.6±1.0) mm ( P<0.05), with a mean increase of (6.9±1.0) mm, and the increase ratio was (30.8±4.8)%. The ratio of nail length to distal thumb length changed from 0.41±0.03 to 0.51±0.02 [increase ratio, (23.6±8.3) %, P<0.05]. The thumb function was not significantly influenced ( P>0.05). 33 patients (94.3%) were very satisfied with the results. Conclusion:Short nail deformity in BDD can be corrected by distraction lengthening with a good aesthetic appearance and without functional impairment.

Objective:To describe the effect of distraction lengthening to correct nail deformity in unilateral congenital brachydactyly type D (BDD).Methods:Patients with unilateral BDD who were treated by distraction lengthening between January 2020 and December 2021 in the Department of Plastic and Reconstructive Surgery of Shanghai 9th People’s Hospital were retrospectively reviewed. A transverse osteotomy was applied on the middle diaphysis of distal phalanx, and one pin was inserted percutaneously on both sides of the osteotomy site, then a mini external fixator was installed. Distraction lengthening was performed with a slow and sustained procedure. The aesthetic and functional results were compared preoperatively and postoperatively. Patient satisfaction questionnaires were recorded.Results:35 patients were enrolled, including 12 males and 23 females, with a mean age of 29.5 years. 17 thumbs were left and 18 thumbs were right. The time for distraction lengthening was 10-17 days, and the mean time was 12.3 days. The total time for external fixator maintenance was 55-70 days, with a mean time of 61.4 days. The mean follow-up was 18.6 months. The mean thumbnail length was increased from (9.2±0.6) mm to (14.2±0.4) mm [lengthening ratio, (54.4±7.5)%] after distraction lengthening ( P<0.05). The ratio of nail length to width changed from 0.63±0.05 to 1.05±0.04 [increase ratio, (68.2±10.5)%, P<0.05], which was equal to the normal value (1.07±0.03) ( P>0.05). Meanwhile, the distal thumb length increased from (22.6±0.7) mm to (29.6±1.0) mm ( P<0.05), with a mean increase of (6.9±1.0) mm, and the increase ratio was (30.8±4.8)%. The ratio of nail length to distal thumb length changed from 0.41±0.03 to 0.51±0.02 [increase ratio, (23.6±8.3) %, P<0.05]. The thumb function was not significantly influenced ( P>0.05). 33 patients (94.3%) were very satisfied with the results. Conclusion:Short nail deformity in BDD can be corrected by distraction lengthening with a good aesthetic appearance and without functional impairment.

Objective:To evaluate the efficacy and safety of SPOT (GI Supply, USA), a new carbon-based permanent marker approved by the Food and Drug Administration (FDA), in the endoscopic marking for gastrointestinal lesions.Methods:A total of 115 patients with gastrointestinal lesions who underwent endoscopic treatment or surgery in Beijing Friendship Hospital or Beijing Chao-Yang Hospital from April 2019 to November 2019 were enrolled in the study. SPOT was used to mark the lesions, and marking points were found during endoscopic treatment or surgery to calculate the effective marking rate by single-group target value method. Adverse events after marking were recorded, and the changes of blood routine test, liver and kidney functions before and after marking were compared.Results:The effective rate of endoscopic marking with SPOT was 99.13% (114/115). The longest marking time was 57 days. There was no puncture of intestinal wall or injection into abdominal cavity during the marking process. One patient developed mild fever after marking. The incidence of adverse events was 23.48% (27/115), which were all unrelated to the test equipment. There was no significant difference in blood routine tests or liver and kidney functions before and after marking ( P>0.05). Conclusion:SPOT produced by GI Supply can effectively mark gastrointestinal lesions without serious adverse events, which meets the requirements of clinical use.

Objective:To explore the role of transgelin(TAGLN) in the occurrence and development of papillary thyroid carcinoma (PTC) and its possible signal pathway.Methods:One hundred cases of PTC tissues and corresponding paracancerous normal thyroid tissues were collected. Realtime quantitative PCR (RT-qPCR), Western blotting, and immunohistochemistry were used to analyze the expression of TAGLN in PTC tissues and corresponding paracancerous normal thyroid tissues. PTC cells were transfected with plasmid and shRNA lentivirus vector respectively to up-regulate or down-regulate the expression of TAGLN in order to detect the effects of them on the proliferation, invasion, and migration by cell proliferation assay(cell counting kit-8, CCK-8)and cell invasion and migration assays (Transwell). The effects of TAGLN on mitogen-activated protein kinase (MAPK)/extracellular-signal regulating kinase (ERK) signal pathway was detected with Western blotting.Results:RT-qPCR showed that there was no difference in the expression of TAGLN mRNA between PTC and corresponding paracancerous normal thyroid tissues ( P>0.05); Western blotting demonstrated that the expression of TAGLN protein in PTC tissues was significantly lower than that in corresponding paracancerous normal thyroid tissues ( P<0.01). Immunohistochemical results revealed that the expression of TAGLN in PTC tissues was significantly lower than that in corresponding paracancerous normal thyroid tissues. Overexpression of TAGLN inhibited the proliferation, invasion, and migration of PTC cells ( P<0.01), but knockdown of TAGLN promoted the proliferation, invasion, and migration of PTC cells ( P<0.01). Overexpression of TAGLN decreased the expression of phosphorylated ERK ( P<0.05), whereas silencing TAGLN increased phosphorylated ERK level in PTC cells( P<0.01). Conclusion:The expression of TAGLN in PTC is significantly decreased. It is related to the occurrence and development of PTC, and its mechanism may be related to MAPK/ERK signal pathway.

Objective To investigate correlative relations between the ultrasonic classification diagnosis and the clinicopathological features of thyroid calcification lesions.Methods The clinical data of 198 cases diagnosed as thyroid calcification lesions by ultrasonic,surgery and pathology were retrospectively analyzed.Spearman method was used to analyze the relationship of TCL ultrasonic diagnosis,clinical pathological traits and the classification of differentiated thyroid carcinoma(DTC).Results Among the 198 TCL cases,ultrasonic diagnosis and pathologic diagnosis were accordant in 178 (90.40％) cases.Among 119(60.10％) cases of thyroid carcinoma (TC),101 cases(84.87％)were papillary carcinoma,11 cases(9.24％)were follicular carcinoma,5 cases(4.20％) were medullary carcinoma and 2 cases(1.68％)were anaplastic carcinoma.Among 79 cases (39.90％) of benign lesions,34 cases(43.04％)were adenoma,27 cases(34.18％)were nodular goiter,and 18 cases(22.78％)were hashimoto's thyroiditis (HT).Calcified classification were as following 74 cases (37.37％)were type Ⅰ a and 4 cases (2.02％) were type Ⅰ b(both were TC);20 cases(10.10％)were type Ⅰ c,among which 19 cases were nodular goiter,and 1 case was TC.Among the 37 cases (23.74％) of type Ⅱ,28 cases were TC,and 19 cases were benign lesions.Among the 20 cases(10.10％) of type Ⅲ,8 cases were TC,and 12 cases were benign lesions.Among 22 cases(11.11％) of type Ⅳ,2 cases were TC,and 20 cases were benign lesions.Among 11 cases(5.56％) of type V patients,2 cases were TC,and 9 cases were benign lesions.The rate of TC with cervical metastasis was 41.18％(49/119).68.91％(82/119) of carcinoma nodules were grade Ⅱ-Ⅲ in color Doppler flow imaging (CDFI),grade 0-Ⅰ were mainly benign nodules,and grade Ⅲ with mussy blood flow in CDFI were HT.Conclusions Type Ⅰ a and Ⅰ b micro calcification is the pathological basis of ultrasonic diagnosis of papillary thyroid carcinoma and follicular carcinoma,which is closely related to DTC.Calcified isolation nodule of type Ⅱ and Ⅲ with level Ⅱ-Ⅲ bleeding is a risk factor for TC.Type Ⅰ c,Ⅲ,Ⅳ and Ⅴcalcification is closely related to benign TCL.CDFI has important value for identifying benign and malignant CLT.

Objective To establish the solid phase extraction (SPE) with GC/MS technology for fish poi-soning cases to determine five pesticides in fishpond. Methods By three solid phase extraction column including Oasis HLB cartridge, Bond Elut C18 and SampliQ C18, the recovery rate was compared to ex-tract and purify five pesticides in fishpond. The effects of different kinds and dosages of eluents on ex-tract rate were also reviewed. Results Using Bond Elut C18 as solid phase extraction column and 3 mL benzene as eluent, the linear range of mass concentration of five pesticides in fishpond was 1-50 μg/mL, and the correlation coefficient was 0.996 2-0.999 6. The limit of detection was 3.4-26 μg/L and the re-covery was 61.49%-102.48%. The relative standard deviations was less than or equal to 3.01%. Conclu-sion With high sensitivity, good accuracy and precision, SPE -GC/MS has simple and quick operation and less solvent. It can be applied to determination of five pesticides in fishpond.

BACKGROUND:Femoral offset reconstruction is significant for recovering strength of abductor and the balance of soft tissue tension surrounding hip joint, maintaining joint stabilization, restoring joint function, reducing limping after replacement, decreasing prosthetic abrasion, and the incidence of joint prosthesis dislocation.
OBJECTIVE:To discuss effect of femoral offset reconstruction on hip joint function in total hip arthroplasty.
METHODS:We comparatively analyzed 20 patients (20 hips) undergoing the modular prosthesis (S-ROM) total hip arthroplasty and 19 patients (20 hips) undergoing the one modular prosthesis (Corail) total hip arthroplasty at the same time. According to Harris hip score and radiography results, hip joint function and femoral offset reconstruction rate were comparatively studied in both groups.
RESULTS AND CONCLUSION:No infection, fracture, dislocation, deep venous thrombosis or neurovascular injury occurred in either group. Clinical fol ow-up results:In the modular prosthesis and one modular prosthesis groups, there was no significant difference in preoperative Harris hip score between the femoral offset reconstruction and non-reconstruction groups (P>0.05). At 12 months and the latest fol ow-up, the Harris hip score was higher in the patients with femoral offset reconstruction than those with femoral offset non-reconstruction (P<0.05). The range of abduction of hip joint was larger in patients with femoral offset reconstruction than those with femoral offset non-reconstruction (P<0.05). Radiographic fol ow-up results:significant differences in the rate of femoral offset reconstruction were detected between the modular prosthesis and one modular prosthesis groups (χ2=3.956, P<0.05). 39 (98%) femoral stems were in neutral position and one (2.5%) was in mild valgus. There was no significant difference in the abduction angle and the anteversion angle between patients with and without femoral offset reconstruction (P>0.05). These results indicated that functional recovery and the range of abduction were better in patients with femoral offset reconstruction than those without femoral offset reconstruction. Modular prosthesis has a high rate of femoral offset reconstruction.

BACKGROUND:Anatomic medul ary locking (AML) femoral prosthesis is circular cylinder and has satisfactory efficacy. However, some scholars found the complications such as thigh pain, loss of bone at the proximal end of the femur, and wearing-related osteolysis. F2L femoral prosthesis is cone-shaped and also has satisfactory efficacy, but the thigh pain incidence is relatively low. ＜br> OBJECTIVE:To compare the intermediate-long term results of AML versus F2L in total hip arthroplasty. ＜br> METHODS:Between November 1997 and January 2005, we retrospectively reviewed 60 patients (66 hips) undergoing total hip arthroplasty using biological femoral prosthesis. At fol ow-up examination, 58 hips in 52 patients were available for clinical and roentgenographic review. 26 AML devices were placed in 24 patients, and 32 F2L devices were placed in 28 patients. The AML group were reviewed with an average of 12.7 years fol ow-up (range 10 years and 3 months to 15 years and 5 months), while the F2L group were reviewed with an average of 9.5 years fol ow-up (range 8 years and 3 months to 11 years and 1 month). The clinical results were evaluated with Harris methods and X-ray examination. Kaplan-Meier analysis was performed to evaluate the survival of femoral component. End point was radiographical loosening or revision of the femoral component for any reason. ＜br> RESULTS AND CONCLUSION:There were no significant difference between AML and F2L about Harris score in the latest fol ow-up (P>0.05). After surgery, the incidence of thigh pain was significantly lower in F2L group than that in AML group (P＜0.05). In AMKL group, the stress-shielding 1 level was observed in 21 hips (81%), and 2 level in five hips (19%);in F2L group, the stress shielding 0 level was observed in 20 hips (62%) and 1 level in 12 hips (38%). There were significant differences between the two groups (P＜0.05). The stress shielding showed significant differences between the two groups (P＜0.05). The incidence of osteolysis in F2L group was significantly lower than that in AML group (P＜0.05). Kaplan-Meier analysis showed that, the survival rate of both AML and F2L components were 1.0 (95%confidence interval:0.98-1.00). Experimental findings indicate that, both AML and F2L femoral prosthesis have a satisfactory long-term efficacy after total hip arthroplasty, and the incidence of thigh pain and osteolysis is significantly lower in F2L group.

Objective To develop the accelerated solvent extraction (ASE ) for determ ining pesticides pre-sent in blood sam ples. Methods Pesticides were extracted by ASE with optimized param eters to study recovery rate affected by extraction tem perature, time and agent. GC/MS was used to perform quantita-tive analysis.Results The recovery rates of eight pesticides were 70.6%-92.4%. The coefficient of variation was less than 5.0%. Agood linear relationship was obtained at the concentration range of 0.5-5.0μg/m L . Conclusion The m ethod was fast and sim ple with high recovery rate and good repeatability. It can be applied to analyze pesticides present in the blood specimen.