Based on the shortcomings of graduate education in clinical medicine of our country and the characteristics of this specialty, the author point out that the cultivation of graduates in otolaryngology, head and neck surgery should be focused on the training of humanities, professional knowledge and skills. And they also make some suggestions and discussion about the reform of graduate education mode.

1he increased peripheral benzodiazepine receptors are more significant than normal ones after cerebral ischemia. Its main reactions are the multiple pathological changes,including microglial activation, participating in neuroinflammation response, and regulation of mitochondrial function. Using radionuclide-laheled specific ligands of the peripheral benzodiaz-epine receptor (such as PK11195) for in vivo imaging contribute to the location and quantitative detection for brain injury and the study of the pathophysiological changes after cerebral ischemi-a. In addition, this receptor is promising to become a new target of neuroprotective treatment.This article reviews the recent progress in research on peripheral benzodiazepine receptors and cerebral ischemia.

Objective To investigate the changes of peripheral benzodiazepine receptors (PBRs)in rat spinal cord synaptosomes during ageing and to explore the correlation between PBRs in spinal cord synaptosomes and PBRs on platelet membranes.Methods A total of 24 Sprague-Dawley rats were divided into 3-month group and 24-month group (n=6 males and 6 females for each).All animals were sacrificed by decapitation and the spinal cords were immediately removed.Synaptosomal fractions from spinal cords were isolated by gradient centrifugation.The platelet membranes were prepared from venous blood by the method of hypotonic haemolysis.The specific binding of the radioactive PBRs antagonist [3H]PK11195 to membranes was determined.Results No significant differences in [3H] PK11195 binding activity in spinal cords and platelet membranes were observed between male and female rats in the same group (all P＞0.05).[3H] PK11195 binding activity in spinal cords and platelet membranes were higher in 3-month group than in 24 month group [(213.94±10.65) fmol/mg pro.vs.(50.65± 2.74) fmol/mg pro.,(104.97± 2.24) fmol/mg pro.vs.(56.20±5.36) fmol/mg pro.,respectively,t=51.418,29.041,both P＜ 0.001].There was a positive correlation between [3H]PK11195 binding activity in platelet membranes and in spinal cord synaptosomes (r=0.985,P＜0.001).Conclusions The level of PBRs is gradually decreased in rat spinal cord synaptosomes with ageing.[3H] PK11195 binding activity of platelet membranes can reflect the changes of PBRs in spinal cords.

Klebsiella Pneumoniae is a opportunity infection and nosocomial infection bacteria in Enterobacteriaceae,which can lead to serious infection or death.Klebsiella Pneumoniae leads to increased infections proportion in recent years,which resisits to many common antibiotics.Clinical drug resistant strains include Carbapenem-resistant Klebsiella Pneumoniae,Multidrug-resistant Klebsiella Pneumoniae,Extensively drug resistant bacteria and Pandrug-resistant Klebsiella Pneumoniae.Researches beared out that the risk factors of acquiring nosocomial infection of Klebsiella Pneumoniae are state of an illness,time of hospitalization,mechanical ventilation,the kind and number of antibiotics.

OBJECTIVE To explore the expression and its significance of focal adhesion kinase(FAK)and matrix metalloproteinase 9(MMP-9)in the pituitary adenomas. METHODS The expressions of FAK and MMP-9 were determined by immunohistochemical technique in 50 pituitary adenoma tissues samples obtained during operation, including 27 invasive pituitary adenomas and 23 non-invasive pituitary adenomas. The relationship of FAK and MMP-9 expression with tumor invasiveness were analyzed. RESULTS The expression of FAK and MMP-9 in the invasive pituitary adenomas were significantly higher than those in the non-invasive pituitary adenomas(P

Objective To compare the influence between target controlled infusion propofol vein anesthesia and midazolam vein anesthesia toward serum amylase and triglyceride in children with cleft lip and palate.To make a definitude that the feasibility of target controlled infusion propofol used in children′s anesthesia.Methods Sixty children with cleft lip and palate aged from 4 months to 3 years,weighting 6.5-15.9 kg,American Society of Anesthesiologists(ASA)Ⅰ-Ⅱ,were randomly allocated to group P and group M(n=30,each).Group P received target controlled infusion propofol.Anesthesia was induced with target controlled infusion propofol at the target effect-site concentration 3.0 mg/L,remifentanyl 2.0 ?g/kg and vecuronium 0.1 mg/kg.Anesthesia was maintained with a continuous remifentanyl infusion at 0.2 ?g/(kg?min) and vecuronium 0.01 mg/(kg?min) and target controlled infusion propofol at the effect-site concentration 3.0 mg/L.Group M received intermittent boluses of midazolam 0.1 mg/kg.Anesthesia was induced with midazolam 0.2 mg/kg,remifentanyl 2.0 ?g/kg and vecuronium 0.1 mg/kg.Anesthesia was maintained with a continuous remifentanyl infusion at 0.2 ?g/(kg?min) and vecuronium 0.01 mg/(kg?min) and intermittent boluses of midazolam 0.1 mg/kg every hour.The venous blood samples were taken before anesthesia induction(T1),4 hours(T2) and 24 hours(T3) after surgery to measure the serum concentration of serum amylase and triglycride.Results The duration of anesthesia induction,extubation and emergence were shorter in group P compared with group M(Pa0.05).Conclusions The serum concentration of triglyceride may increase because of the stress of anesthasion and operation,and can be higher during target controlled infusion propofol,but does not exceed the normal value.The serum amylase concentration does not increase during target controlled infusion propofol in children.

Plasma aldosterene/renin ratio (ARR) is a sensitive screening test and parameter for primary aldosteronism(PA).The use of ARR leads to a marked increase in the detection rate of PA in the hypertensive population.However,ARR remains a nonstandardized test,and the cutoff value of ARR used in the different studies is varied.Further and systematical studies are needed to improve the accuracy of the test.

OBJECTIVE: To investigate the effect of LARS artificial ligament on reconstruction of anterior and posterior cruciate ligament of keen joint.METHODS: Articles addressing reconstruction of anterior and posterior cruciate ligament by LARS artificial ligament were retrieved from VIP database (http://www.cqvip.com/) with the key words of "LARS artificial ligament, cruciate ligament,reconstruction" in Chinese between January 2000 and February 2010.Inclusion criteria: advantages and disadvantages of reconstructing anterior and posterior cruciate ligament by LARS artificial ligament; clinical application of reconstructing anterior and posterior cruciate ligament by LARS artificial ligament.Exclusion criteria: Duplicated studies or old references were excluded.A total of 31 articles were included in the final analysis.RESULTS: Reconstruction of anterior and posterior cruciate ligament by LARS artificial ligament characterized by convenient operation, short operative time, mild trauma, engaging in movement early, great strength, simple implantation, and reliable fixation; however, most patients were not able to bear the high medical cost, thus clinical application was limited.Scholars thought that LARS artificial ligament had great effects on reconstruction of anterior and posterior cruciate ligament.CONCLUSION: Patients who had multi-ligament injury, overhauling of ligament, and early movement were treated with LARS artificial ligament.

BACKGROUND:There have been many studies on the diagnosis of osteoporotic vertebral compression fractures. However, there are few studies on the diagnostic methods of fracture in different periods. OBJECTIVE:To comparatively analyze the application value of high-intensity magnetic resonance imaging (MRI) and single photon emission computed tomography combined with CT scan image fusion (SPECT-CT) in the diagnosis of osteoporotic vertebral compression fractures. METHODS:Clinical data of 35 patients with osteoporotic vertebral compression fractures were retrospectively analyzed, including 56 vertebrae. There were 14 males and 21 females, with an average age of 72.6 years. The course of disease was within 3 weeks in 22 patients, belonging to acute fractures. The course of the disease was between 4 and 12 weeks in 10 patients, belonging to the subacute fractures. The course of disease was 6 months in 3 patients, belonging to the fracture healing period. Al patients were tested with high-intensity MRI and SPECT-CT examination, and were treated with vertebroplasty or percutaneous kyphoplasty. The Fisher exact method was used to compare the two diagnostic methods in the diagnosis of vertebral fracture. RESULTS AND CONCLUSION:(1) In the 56 responsible vertebral bodies, 32 vertebral bodies belonged to the acute-stage fractures, and 24 vertebral bodies belonged to the non-acute-stage fractures. In al the fractures, MRI diagnosed 49 segments;SPECT-CT diagnosed 52 segments. The sensitivity of SPECT-CT testing was higher than MRI, and its specificity was less than MRI. There was a high consistency of diagnosis between fractures. (2) In the 32 acute vertebral fractures, the two tests diagnosed 29 segments. The sensitivity of SPECT-CT was higher than that of MRI, but its specificity was lower than that of the MRI. There was a high consistency between the diagnoses of fractures. (3) In the 24 non-acute vertebral fractures, MRI diagnosed 20 segments;SPECT-CT diagnosed 23 segments. SPECT-CT was more sensitive than MRI;the specificity of SPECT-CT was lower than MRI. There was a high consistency between the two diagnoses of fractures. (4) There was a high consistency in the MRI and SPECT-CT examination to determine the fracture of different periods of responsibility of the vertebral body, but the sensitivity of SPECT-CT is higher than MRI examination;SPECT-CT is an effective inspection method in the diagnosis of vertebral fractures.

Animals ; Colonic Neoplasms ; metabolism ; pathology ; Female ; Humans ; Liver Neoplasms ; metabolism ; secondary ; Lymphatic Metastasis ; Neoplasm Proteins ; metabolism ; Ovarian Neoplasms ; metabolism ; pathology ; Protein Tyrosine Phosphatases ; metabolism ; Stomach Neoplasms ; metabolism ; pathology