The pattern differentiation method is the most representative part of the inheritance of the experience of renowned practitioners of traditional Chinese medicine,reflecting their clinical thinking characteristics. Among them,Professor LYU Renhe proposed and developed the theory of abdominal masses in the long-term diagnosis and treatment of kidney diseases. Based on his clinical experience,he formed the method of differentiation of Shenluozhengjia (tangible or intangible abdominal masses of kidney collaterals). This differentiation method is characterized by its simple and easy clinical application. Tangible or intangible abdominal masses of kidney collaterals refer to chronic kidney disease,which is based on the basic cause of kidney deficiency. External or internal pathogenic factors cannot be eliminated,and prolonged illness invades the kidney collaterals,causing pathological products,such as qi stagnation,blood stasis,phlegm dampness,heat toxin,and turbid toxin to stagnate in the kidney collaterals,resulting in damage to the kidney body and loss of kidney function. The basic pathogenesis is a deficiency of kidney qi and the formation of tangible or intangible abdominal masses of the kidney collaterals. During pattern differentiation,the type is determined by the deficiency,which is fixed,and the pattern is determined by the excess,which is constantly changing with the condition and can be combined. Furthermore,he summarized the dietary principles as having more essence and less coarseness,more milk and less meat,a phased diet,and the selection of the symptomatic diet. To inherit and improve the theory and clinical practice of the pattern differentiation theory of tangible or intangible abdominal masses of kidney collaterals,this article reviews and summarizes the unique pattern differentiation method of the kidney collateral pattern from the aspects of definition,theoretical origin,etiology and pathogenesis,differentiation and treatment,and regulation,providing a basis for forming suitable diagnosis and treatment method for clinical promotion.

Objective:To explore the latent categories of child neglect and its influencing factors, and to investigate the relationship among different categories, personality trait and self-efficacy, as well as the moderating effect of different categories.Methods:A total of 558 middle school students in Xinmi were investigated by the child neglect scale, the Eysenck personality questionnaire, and the general self-efficacy scale. Mplus 7.0, SPSS 26.0 and PROCESS v3.5 softwares were used for latent profile analysis, binary Logistic regression analysis, independent samples t-test and moderating effect test. Results:(1)Children were divided into "high-risk group" (21.3%(109/551)) , "low-risk group" (78.7%(402/551)). (2)The occurrence ratio of the high-risk group increased by 33.4% every one year in age( B=0.288, OR=1.334, P<0.05). Middle school students who live with their grandparents were more likely to be in the high-risk group( B=0.822, OR=2.275, P≤0.05). (3)The scores of extraversion, lie and self-efficacy in high-risk group((51.803±9.877), (46.860±6.552), (23.321±5.448)) were significantly lower than those in low-risk group((54.341±10.521), (48.981±6.548), (24.933±4.961)) ( t=2.262, 2.998, 2.945, all P<0.05), and the scores of neuroticism and psychoticism((58.316±1.880), (56.536±10.663)) were significantly higher than those in low-risk group((48.731±12.371), (49.850±9.562)) ( t=-7.235, -6.314, both P<0.001). (4)The latent categories of child neglect played a moderating role between psychoticism and self-efficacy ( B=-0.111, P<0.05). For the low-risk group, psychoticism had no significant predictive effect on self-efficacy( B=-0.032, P=0.223), for the high-risk group, self-efficacy showed a significant downward trend with the increase of psychoticism( B=-0.143, P=0.002). Conclusion:Child neglect can be divided into two potential categories, which have a moderating effect on the relationship between psychoticism and self-efficacy of high school students.

We carry out the tutorial system in the standardized training of residents,promote students to grasp the clinical skills and clinical research and thinking,and promote teachers' professional theoretical level and teaching ability.In the orthopedic rotation we define the teaching focus to the trainees of different seniority:for junior trainees,the training of medical records writing and basic clinical skills should be focused,and for senior trainees,the emphasis of training is to improve their clinical capacity of diagnosis and treatment.In teaching,the teaching methods of a combination of Multidisciplinary team (MDT) of bone and soft tissue tumors and problem based learning (PBL) have been actively tried to improve students' learning enthusiasm and initiative,which helps the trainees fully grasp the diagnosis and treatment of certain diseases.

Aedes ; virology ; Animals ; China ; epidemiology ; Genetic Variation ; Genome, Viral ; Humans ; Multigene Family ; Viral Proteins ; genetics ; Zika Virus ; classification ; genetics ; isolation & purification ; Zika Virus Infection ; epidemiology ; virology

Objective To investigate the effects of miR-93 on proliferation and apoptosis of osteosarcoma cells and the possible mechanism .Methods The expression levels of miR-93 and the naked cuticle homolog 2 (NKD2) in 6 osteosarcoma cell lines (143B, HuO9, Saos2, MG63, U2OS and G292) and one osteoblast cell line hFOB 1.19 were determined by quantitative real-time PCR and Western blot assays, respectively. MiR-93 down-regulated 143B and HuO9 cells were constructed by lipofection transfection, and their proliferation and apoptosis were detected by MTT and flow cytometry assays , respectively.Luciferase reporter assay was used to determine whether the 3′UTR of NKD2 mRNA was a binding target of miR-93.In addition, 143B cells were transfected with NKD2 cDNA, and the effects of NKD2 on proliferation and apoptosis of osteosarcoma cells were investigated .Results Up-regulation of miR-93 and down-regulation of NKD2 were detected in osteosarcoma cell lines .MTT and flow cytometry assays showed that miR-93 promoted proliferation and inhibited apoptosis in osteosarcoma cells .Luciferase assay confirmed that miR-93 targeted NKD2 directly. In addition, overexpression of NKD2 inhibited proliferation and promoted apoptosis of osteosarcoma cells were found .Conclusions MiR-93 targets NKD2 to promote proliferation and inhibit apoptosis of osteosarcoma cells . The findings may have significant implications in the diagnosis and treatment of osteosarcoma .

BACKGROUND:Posterior maleolar fractures are often accompanied by ankle joint instability,if the stability of ankle joint is not recovered,it is prone to traumatic arthritis of the ankle.However,the indications of internal fixation of posterior maleolar fractures remain controversial.OBJECTIVE:To explore the indications for internal fixation of posterior maleolar fractures by comparing the clinical effects of posterior maleolar fractures treated with internal fixation or not.METHODS:42 patients with maleolar fractures involving posterior ankle were recruited from the First Affiliated Hospital of Chongqing Medical University from January 2007 to January 2012.According to preoperative CT scans of ankle joint,42 cases were divided into the internal fixation group and the non-fixation group.27 cases in the fixation group had posterior maleolar fractures in more than 10％of the distal tibial articular surface and/or dislocation of the posterior maleolar fractures greater than 2 mm,and were treated with screws.15 cases in the non-fixation group had posterior maleolar fractures in less than 10％of the distal tibial articular surface anddislocation of the posterior maleolar fractures less than 2 mm,and were treated with non-operation.The average healing time of posterior maleolar fractures,postoperative complications,ankle-hindfoot scores of American Orthopedic Foot and Ankle Society were compared during the folow-up postoperatively.RESULTS AND CONCLUSION:Al of 42 patients with ankle fractures achieved bony union within 6 months.In the fixation group,1 case had postoperative superficial infection of the wounds in the medial ankle and lateral ankle,and the wound got healed completely with anti-infection therapy.One case in each group had postoperative superficial necrosis in the incisional edges,and got healed by dress changing.For the other cases,there was no wound infection,internal fixation loosening,breakage or failure and other adverse events during the folow-ups.Ankle functions were evaluated one year after operations according to the ankle-hindfoot score standard of American Orthopedic Foot and Ankle Society.The score of the fixation group was (83.74±10.35) points,with excelent ankle functions in 10 cases,good in 12 cases,fair in 5 cases,and no poor case,and the rate of patients achieving excelent and good ankle functions reached 82％; the score of non-fixation group was (85.60±10.40) points,with excelent ankle functions in 7 cases,good in 5 cases,fair in 3 cases and no poor case.The rate of patients achieving excelent and good ankle functions reached 80％.The ankle function evaluation results of both groups showed no statistical difference (P＞0.05).It is reasonable to consider posterior maleolar fractures is higher than 10％of the distal tibial articular surface and/or dislocation of the posterior maleolar fractures greater than 2 mm as the indications for internal fixation of posterior maleolar fractures.

Objective To evaluate the clinical effect of femoral neck fracture fixed with 7.5mm QWIX screws and to find out risk factors for avascular necrosis of the femoral head postoperatively.Methods From January 2009 and March 2013, 53 patients underwent closed or open reduction of femoral neck fracture with 7.5mm QWIX screws.Healing process of fracture, complications of internal fixation, Harris hip score and avascular necrosis of the femoral head were followed up.The data reviewed were age, gender, injury patterns, fracture type, preoperative waiting time, reduction ways, reduction condition, and others.Unilateral and multivariate Logistic analysis were applied to identify factors for avascular necrosis of the femoral head.Results All patients were followed up for 2-5 years (mean, 3.4 years).There was no non-union at follow-up, and all the screws were in the original site without loosening, cut-out or penetration.Mean Harris score was 91.2 points (range, 68 to 100 points) 2 years after operation, including 42 excellent, 6 good, 1 fair and 4 poor results with the excellent-good rate of 91％.Four patients (8％) had avascular necrosis 12 to 15 months after operation.With Logistic regression analysis, fracture anatomic type was identified as the only factor for avascular necrosis of the femoral head.Conclusions The 7.5 mm QWIX fixation screw provides rigid fixation, high healing rate and low incidence of avascular necrosis of the femoral head, appearing to be a good hardware to repair femoral neck fracture.Avascular necrosis of the femoral head is associated with the anatomic type of femoral neck fracture after operation.

Objective To investigate the effects of laminar shear stress ( LSS) on the proliferation and apoptosis of mesenchymal stem cells ( MSCs) . Methods The influences of laminar shear stress ( the physiological levels) on MSCs were studied. DNA synthesis and cell cycle were measured,to detect the cellular proliferation. The apoptosis-related gene expression ( Bcl-2/Bax) was examined to determine the effect of LSS. Results The percentage of MSCs’ proliferation rate was reduced by the fluid shear stress. Furthermore,it was detected that LSS exerted a potent suppression effect on MSC apoptosis. Conclusion These data revealed a critical role of LSS in maintaining the quies-cence of MSCs.

BACKGROUND:The most important influence caused by patel ar fracture is the breakage of knee extension apparatus continuity and potential uncoordination of patel ofemoral joint. The aim of patel ar fracture surgery is to restore the smoothness of patel ar articular surface and to maintain the continuity of knee extension apparatus, to provide stable effective fixation, so as to do early functional exercises. OBJECTIVE:To evaluate the clinical effectiveness of a fixation technique for patel ar fractures using QWIX combined with Kirschner wire and wire. METHODS:From September 2011 to September 2012, 30 patients with patel ar fractures were treated using QWIX screws combined with Kirschner wire and wire in the First Affiliated Hospital of Chongqing Medical University, China. There were 17 males and 13 females, at the age of 47.7 years on average. In accordance with the situation of comminuted fracture and the degree of displacement, QWIX screws or QWIX screws+tension band wire or QWIX screws+Kirschner wire+tension band wire were used for fixation. Active and passive knee motion exercises began at 1 day after surgery, without any external fixation. At 6 weeks, 3, 6, 12 months, and 1 year after surgery, the patients were fol owed up in out-patient clinic to identify fracture healing and to make sure whether complications appeared or not. The range of flexion and extension of bilateral knee was measured. The knee function of the affected side was evaluated using Bostman score at 1 year postoperatively. RESULTS AND CONCLUSION:Al patients were fol owed up for 12 to 24 months. 24 cases were healed within 3 months after surgery, and 6 cases were healed within 4 months after surgery, with an average healing time of 3.2 months. With time prolonged, the range of flexion and extension of bilateral knee gradual y increased. The knee function of patients recovered to the level before injury at 1 year after surgery. During fol ow-up, one patient experienced knee pain due to Kirschner wire loosening. No infection, knee pain, fixation failure, or flexion dysfunction occurred in the remaining patients. In accordance with Bostman score, there were excellent in 27 cases, good in 3 cases, and poor in 0 case, with an excellent and good rate of 100%at 1 year fol owing surgery. Results data suggested that QWIX screws combined with Kirschner wire and wire fixation in repair of patel ar fracture have some advantages such as continuous dynamic and static pressure at the broken ends of the bones, early flexion and extension exercises, and reducing the fixation-related complications. It is an effective method to repair patel ar fracture.

Objective To analyze the postoperative complications of external fixator in treatment of elderly high-risk intertrochanteric fractures and its effect on length of hospital stay and on in-hospital fees.Methods The study involved 55 elderly patients with high-risk intertrochanteric fractures fixed with Orthofix external fixators from January 2009 to December 2011.There were 21 males and 34 females at age range of 70-79 years.All patients were associated with one underlying disease at least.Relationship of complications with patients' age,preoperative underlying diseases,surgery operation and postoperative care were analyzed.Results Common postoperative complications were lung infection (11％),screw channel exudation (25％),superficial pin tract infection (13％) and pain around the screws (22％).Factors for lung infection included the underlying lung disease and cerebral infarction before operation.Influential factor of screw channel exudation was the degree of damage to soft tissue intraoperatively.Influential factor of the superficial pin tract infection was postoperative care level.Average length of hospital stay was 5.17 days longer for patients who experienced complications after operation.Conclusions Common postoperative complications are influenced by preoperative occurrence of underlying lung disease as well as cerebral infarction,intraoperative damage to soft tissues and postoperative care level.Postoperative complications prolong the length of hospital stay and increase the treatment expense.