Different from the general local hospital,the affiliated hospital of medical school plays double social roles that it not only serves as a teaching hospital but also a medical uniL Every medical staff in it shoulders the responsibility of teaching,researching and medical treatmenL According to the relative independence of affiliated hospital in comprehensive university,the particularity of professional and technical post,the multiplicity of post task,as well as problems existed in the current appraisal and appointment of professional and technical posts such as lacking objectivity and maneuverability in clinical skills examination and evaluation.the paper tries to put forward a new mode of clinical skills examination and evaluation system in accordance with the characteristics of affiliated hospital.

Graves' ophthalmopathy (GO) is an autoimmune disorder representing the commonest and most important extrathyroidal manifestation of Graves' disease.GO can be a debilitating component of the disease,resulting in impaired quality of life.Although therapeutic methods appear to be widespread,the optimal treatment remains challenging.This article reviewes recent studies on therapy pattern and evidence-based medicine,to provide practical information for managing patients with GO.

Exendin-4,a peptide analogue of glucagon-like peptide-1(GLP-1),is presently in clinical trials as a therapy for type 2 diabetes mellitus.Exendin-4 selectively acts on GLP-1 receptors,which are coupled to the cAMP nucleotide second messenger pathway to enhance the survival and plasticity of neurons in the brain.Exendin-4 has potent effects on homeostasis of Ca2+,on multiple targets to block apoptotic signaling pathways,and on neuronal proliferation and differentiation.It has also been demonstrated to possess properties against oxidative stress and excitotoxicity.In this review the functions of exendin-4 on central nerve system and the potentia therapeutic effects on neurodegenerative diseases will be involved.

Objective To evaluate the efficacy and adverse events of oxcarbazepine(OXC) on the children with partial epilepsy.Met-hods Sixty-four children with partial epilepsy were divided into 2 groups.Forty-one newly diagnosed patients who had never accepted standard therapy entered monotherapy group,and 23 patients who had many anti-epileptic drug(AEDs) in turn with poor efficacy served as add-on therapy group.The initial dose was 4-8 mg/(kg?d).The dosage was increased by one time every 2 weeks,and should not exceed 10 mg/(kg?d) in each time.The maintenance dose was 28-40 mg/(kg?d).With open-label autocontrol method,the efficacy and adverse events of OXC were analyzed during the first 6 months of treatment both in 2 groups.Results The effective rates were 85.4%,69.6% and 79.7%,in monotherapy,add-on therapy and total groups.The seizure free rates were 53.7%,17.4% and 40.6%.It showed that the seizure frequencies between 2 groups at 6 months after therapy were significantly difference(P0.05).The common adverse events were dizziness,headache,fatigue and nausea.Six patients had dropped out because of rashes,however,they all recovered after drug withdrawal and nonspecific therapy.Conclusion The efficacy of OXC is sustained with good safety and tolerability profiles on the treatment of children patients with partial epilepsy.

The capsule endoscope swallowed from the mouth into the digestive system can capture the images of important gastrointestinal tract regions. It can compensate for the blind spot of traditional endoscopic techniques. It enables inspection of the digestive system without discomfort or need for sedation. However, currently available clinical capsule endoscope has some limitations such as the diagnostic information being not able to correspond to the orientation in the body, since the doctor is unable to control the capsule motion and orientation. To solve the problem, it is significant to track the position and orientation of the capsule in the human body. This study presents an AC excitation wireless tracking method in the capsule endoscope, and the sensor embedded in the capsule can measure the magnetic field generated by excitation coil. And then the position and orientation of the capsule can be obtained by solving a magnetic field inverse problem. Since the magnetic field decays with distance dramatically, the dynamic range of the received signal spans three orders of magnitude, we designed an adjustable alternating magnetic field generating device. The device can adjust the strength of the alternating magnetic field automatically through the feedback signal from the sensor. The prototype experiment showed that the adjustable magnetic field generating device was feasible. It could realize the automatic adjustment of the magnetic field strength successfully, and improve the tracking accuracy.
Capsule Endoscopes ; Endoscopy ; Gastrointestinal Tract ; Humans ; Magnetic Fields

Objective To find out the difference or the regularity by the comparison study on the Auto-CPAP application to treating severe OSAHS patients in daytime nap and nocturnal sleep.It also supplies an evidence for reducing the expense in treating and testing severe OSAHS patients.Methods The patients who complained of snoring or dyspnea during sleeping and excessive daytime somnolence were selected as the subjects.They were monitored by PSG or Auto-CPAP ventilator system.Meanwhile their somnolent level were estimated by Epwoth.After that the patients with more than 20 AHI were selected as the advanced subjects.They were treated respectively in daytime nap and in the nocturnal sleep.And the daytime treating time lasted more than one hour and less than two hours and thirty minutes.Monitoring items included AHI,AI,HI,the longest duration of apnea or hyponea(LAHT),the lowest SaO\-2,the highest CPAP pressure(HP),median pressure(MP),90% pressure(90%P) and 95% pressure(95%P).Results The therapeutical effect is distinguished and is the same with the severe OSAHS in both daytime nap and nocturnal sleep.And also they need the same CPAP pressure level basically.Conclusion The CPAP pressure level titrated in daytime nap treatment period can be used in the nocturnal sleep therapy for severe OSAHS patients.

Translational medicine appears as a new branch of medicine, aiming at quickly transforming the basic research products into clinical application. Nowadays there is a trend that laboratory researches do not have a close relationship with clinical reality, which is facing the present medical research and education field. Herein translational medicine appeared to solve this fundamental conflict.In this paper, we will analyze the essence and status quo of translational medicine, and provide suggestion on the development of translational medicine from the perspective of medical research management.

OBJECTIVE:To prepare glycyrrhetic acid derivatives-modified norcantharidin(NC)liposome(GDNL)and study its liver-targeting property.METHODS:Gal-GAOSt targeting molecules were synthesized to modify NC and prepare GDNL,with the parameters such as the entrapment efficiency and particle diameter,etc.investigated.Mice were enrolled to be injected with GDNL and NC water solution,respectively via vena caudalis followed by determination of NC concentration in different tissues to compute the targeting-index(TI)of GDNL in liver.RESULTS:The prepared GDNL had an entrapment efficiency of 56.29%,particle diameter of(210?20)nm and TI of 5.213 in liver.CONCLUSION:The prepared GDNL has high entrapment efficiency and remarkable liver-targeting property.

BACKGROUND: Cartilage stent materials were abundant. With the development of preparation technique, structure, and surface modification technique, performance of materials were improved remarkably; thus, Integrated-repaidng defects of articular cartilage and subchondral bone required high stability of cartilage replacement materials.OBJECTIVE: To evaluate the effect of polyurethane/nano-hydroxyapatite+polyamide66 (PU/n-HA+PA66) biological composite material on repairing articular cartilage and subchondral bone.METHODS: Twenty dog models were randomly divided into 4 groups: porous PU/n-HA+PA66 implant group, compact PU/n-HA+PA66 implant group, n-HA+PA66 implant group and blank control group. The macroscopic and histological evaluations were performed at 4, 12, and 24 weeks postoperatively. The interfaces of biomaterial implants with articular cartilage were observed by scanning electron microscope.RESULTS AND CONCLUSION: After 12 and 24 weeks, bone tissue grew into lower layer materials. Porous PU was well fused with peripheral cartilage. At 24 weeks postoperatively, the porous PU was closely connected with surrounding articular cartilage than the compact PU, and the articular cartilage surrounding the compact PU degenerated obviously. PU/n-HA+PA66 had a similar structure with normal cartilage and subchondral bone and had remarkable effects on repairing defects of articular cartilage and subchondral bone.

BACKGROUND: Polyvinyl alcohol hydrogel (PVA) has been generally considered as a good substitute material of articular cartilage. Polyamide 66 (PA66) polymer has achieved an extensive application in the fields of engineering and medicine owing to its high intensity, strong tenacity and good stability. Polyurethanes exhibit good histocompatibility and blood compatibility and show distinct advantages in repairing cartilage.OBJECTIVE: To compare the outcomes of repairing articular cartilage defects in rabbit knee joints with three materials and to find the best material.METHODS: Thirty-six healthy adult New Zealand rabbits were prepared for the models of articular cartilage defects by perforating on the patellofemoral joint and randomly divided into 4 groups, with 9 animals in each group. PVA, polyurethane, and PA66 were implanted into the into articular cartilage defects in rabbits of corresponding groups. There was no treatment in the control group.The macroscopic and histological evaluations of rabbit knee joints were performed at 4, 8 and 12 weeks postoperatively. The score of histology was used to evaluate the repairs of articular cartilage defects at 12 weeks postoperatively.RESULTS AND CONCLUSION: No infection was observed in all animals with good motion of joints. At 12 weeks postoperatively, the materials got well with surrounding cartilage, which did not degenerate obviously. The defects in the control group were filled with fibrous scar-like tissues that arranged in disorder. The histological score of the in the group implanted by PVA, as well as polyurethane, was higher than that in PA66 and the control groups (P < 0.05), but the difference between the two groups had no significance (P>0.05).The porous materials PVA and polyurathane have good function for replacing articular cartilage, with good biocompatibility.