The graduates of Traditional Chinese Medicine Institutions face greater pressure in recent years' severe employment situation.It is an effective way to develop career education for students to achieve a good career planning and placement.The paper mainly discusses the status of career education in the Traditional Chinese medicine institutions,the mode establishment,the core latitude and the significance of career education.

Objectives: To reveal the possible role and mechanism of disc-facet angle in the occurrence and progress of Hirayama disease by analyzing the correlation of clinical appearance and the variation of disc-facet angle in Hirayama disease. Methods: 45 patients with Hirayama disease treated in the orthopedic de-partment of Peking University Third Hospital from October 2006 to January 2012 were reviewed. There were 44 males(97.8%) and 1 female(2.2%) with an average age of 19.33±3.89(range 13-37) years old. The onset age was 16.33±2.73 (range 10-27) years old and the duration of history was 35.64±23.24 (range 1 to 120) months. The disc-facet angle of C3-T1 was measured on PACS system. An extension line was made along the upper edge of objective vertebral body on the CT scan sagittal reconstruction image. An extension line was made along the joint surface of upper articular process of objective vertebra on the sagittal plane which crossed the midpoint of the facets. The blunt angle between two lines was the disc-facet angle. The cases were divided into unilateral affect and bilateral affected group according to history, spinal cord function and spinal cord lesion level. The correlation of above data and the variation of disc-facet angle were analyzed. Results: The duration of history in unilateral affected patients was significantly shorter than that of bilateral affected patients (P<0.05). The duration of history in sequential onset patients was significantly shorter than that of simultaneous onset in bilateral affected patients (P<0.05). The JOA score 17 and Chinese score 40 in unilateral affected patients were higher than those of bilateral affected patients. The C3-C7 disc-facet angle of affected side was bigger than that of normal side in unilateral affected patients, and C5, C6 had statistically significant difference (P<0.05). The spinal cord lesion level was mainly at C5 and C6 in unilateral affected group. The disc-facet angle had no difference on both sides in bilateral affected patients but the figures at C4 and C5 level were bigger than that of normal side in unilateral affected patients. The spinal cord lesion level was mainly at C4 and C5 in bilateral affected group. The stability of upper cervical spine segments was even worse in unilateral affected group and resulting in higher level of spinal cord lesion comparing with bi-lateral affected group. Conclusions: The disc-facet angle of C4, C5 is bigger in bilateral affected patients and may be correlated with higher level spinal cord lesion and more severe clinical symptoms. The C5, C6 disc-facet angle of affected side is significantly bigger than that of normal side in unilateral affected patients. This may be the key factor of spinal cord lesion mainly at C5 and C6 level on the same side.

Objectives: To study the morphological difference of luscka joints between Hirayama disease patients and non-Hirayama disease patients on CT scan and to provide a new possible mechanism of Hirayama disease. Methods: 32 patients(all males) with a mean age of 19.4±4.1(range 16-37 years) and with Hirayama disease were treated in our hospital from October 2006 to January 2012, the mean course of disease was 31.7±23.7 months(range, 1-120 months). 32 patients(all males) with a mean of age was 19.1±4.3 (range, 12-26 years) suffering from acute neck pain and having no Hirayama disease were reviewed as control. Both groups showed no age related difference. From the cervical CT coronal plane reconstruction images which passing through the transverse foramen center of C3-C7 in GE-PACS system, the following data were measured in both sides: ①The width of the uncinate process base: the distance between inner and outer margin of the uncinate process at the upper edge of the vertebral body. ②The height of the uncinate process:the vertical distance from the top of the uncinate process to the upper edge of the vertebral body. ③The distance between two uncinate processes: the distance between the tips of the bilateral uncinate processes. ④The inclination angle of the uncinate process: the angle between the uncinate process and the upper edge of the vertebral body. ⑤The inclination angle of the inferior endplate: the angle between the uncinate process:the vertical distance from the top of the uncinate process to the upper edge of the vertebral body. Results:There were no significant side-related differences on the width of the uncinate process base, the height of the uncinate process, the distance of the uncinate process, the inclination angle of the uncinate process and the inclination angle of the inferior endplate at the same segment from C3 to C7 in Hirayama disease patients(P>0.05). However, differences were found on the height of the uncinate process and the distance between two uncinate processes of C3-C7 (P<0.05), C6 and C4 had the highest and lowest height of the uncinate process as C6>C5>C7>C3>C4. The distance of the uncinate process gradually increased from C3 to C7. There were no significant differences on the width of the uncinate process base, the inclination angle of the uncinate pro-cess and the inclination angle of inferior endplate(except for C3) of C3-C7(P>0.05). Then, using the mean value of the left and right sides as the width of the base of uncinate process, the height of uncinate process, and calculating the sum of inclination angle of the uncinate process, the sum of inclination angle of inferior endplate of the upper vertebra and the difference between the sums (the sum of inclination angle of uncinate process - the sum of inclination angle of inferior endplate of the upper vertebra), then calculating the mean value and standard deviation. Compared with the non-Hirayama disease patients, there were no significant dif-ferences on the uncinate process base, the distance of the uncinate process and the sum of inclination angle of the uncinate process at the same segment of Hirayama disease patients (P>0.05), while the height of the uncinate process and the sum of inclination angle of uncinate process of Hirayama disease patients were sig-nificantly smaller than those of the control group, respectively(P<0.05), and the differences between the sums were larger than those of the control group (P<0.05). Conclusions: Hirayama disease patients may possess a dysplasia in the luscka joint, manifesting the nonuniform development of the uncinate indicators. Lower unci-nate process and smaller inclination angle of inferior endplate of the upper vertebra are common, The conse-quential cervical instability may play a significantly important role in the pathogenesis and progress of Hi-rayama disease.

The running cost of medical equipment embodies in every stage of the whole process of the equipment using. The control of the running cost in procurement phase is discussed in four aspects: chemical reagent, maintenance, training and quantity control, i.e. controlling the running cost in the beginning. This is a good method for controlling the running cost.

[Objective] To determine the effects and possible mechanism of the thrombin antagonist r-RGD-Hirudin (HIR) on ventricular arrhythmia(VA) after acute myocardial infarction (AMI). [Methods] Seventy adult male Sprague-Dawley rats were randomly subjected to the 10 groups according to duration of left coronary occlusion: HIR 0 min, HIR 5 rain, HIR 10 min, HIR 20 min, HIR 30 min, and normal saline(NS) 0 min, NS 5 min, NS 10 min, NS 20 min, NS 30 min; and the average of every group is 7 rats. Acute myocardial infarction was produced by the occlusion of the left anterior descending coronary artery, then the measurements of arrhythmia and infarction sizing by Evans blue were assessed as well as the expression of three isoforms of inositol 1,4,5-trisphosphate receptors (IP3Rs) mRNA in isehemic myocardium by reverse transeriptase polymerase chain reactions (RT-PCR). [Results] Compared with NS groups, the measurements of VA in HIR were reduced significantly in 5 to 20 minutes after AMI (P<0.05). The incidence of VA was all positive related to the expression of three isoforms of IP3Rs mRNA (P<0.01). Compared with NS groups, the expression of type2,inositol 1,4,5-trisphosphate receptor (IP3R2) mRNA at 10 min and type3, inositol 1,4,5-trisphosphate receptor mRNA (IP3R3) at 10 min and 20 min after AMI were significant decreased (P<0.05) in HIR groups. [Conclusion] The thrombin antagonist r-RGD-Hirudin exerts its myocardial protection against ventricular arrhythmia after acute myocardial infarction possible through IP3R2 and IP3R3 and not typel, inositol 1,4,5-trisphosphate receptor (IP3R1).

Three kinds of biomedical materials of stomatology were introduced,including metal materials,polymers and non-metal bio composites.The literatures related to stomatology biomedical materials from 2008 to 2015 were collected in PubMed medical literature retrieval service system,and then statistical method was used to analyze the literature number,the numbers of literatures on different materials as well as the nations distribution.Composite,intelligent and functional materials were pointed out to be taking the place of metal materials,and thus might extend their clinical application in the future.

Objective　To observe the change of lipidemia and lipoprotein in wistar rats with fluorosis.Methods　14 wistar rats were fed normal food with hyper concentration of NaF water (100 mg/L) for six months,the TC,TG,HDL-c,LDL-c,APO AI APO B and AI,R-CHE were measured in serum.Results　The result show that there are an increace of T C,TG,HDL-c,LDL-c,APO AI，APO B and AI,R-CHD compared with normal rats (P <0.05).Conclusions　The result indicate that the fluorosis can increase the lipidemia and lipoprotein in rats with fluorosis and lead to athero selerosis.

Objective To evaluate the clinic value of multiple tumor markers plus PSA in diagnosing prostate cancer.Methods We collected serum samples of 140 prostate cancer patients with average age of 68 (48-82) years,104 benign prostate hyperplasia patients with average age of 70 (52-87) years,and 162 healthy people with average age of 38 (23-49) years.We had detected PSA levels and also the protein expressions of XAGE-1b,SSX-2,AM ACR and AKAP4.In healthy people,the ranges of the normal values with 95％ data range were determined.Multiple tumor markers and PSA were calculated their positive rate,specificity and sensitivity in diagnosing prostate cancer.We had randomly chosen one positive serum,and analyzed the 4 protein expressions by Western bolt.We detected the serum with the four markers plus PSA by Luminex medthod,then drew ROC curve and calculated AUC area according to the results.Results Among all those samples,PSA levels of 266 samples were under 4tμg/L,86 samples were between 4-10 μg/L,and 54 samples were above 10 μg/L.The positive rates of XAGE-1b,SSX-2,AMACR and AKAP4 in prostate cancer patients were 53.6％ (75/140),34.3％ (48/140),27.9％ (39/140),44.3％ (62/140) respectively.The AUC of XAGE-1b,SSX-2,AMACR,AKAP4 and PSA were 0.666,0.615,0.551,0.768,0.675 respectively.The AUC of their combination was 0.887; The specificity and sensitivity of single PSA detection and combination detection were 60.0％,46.2％ and 80.0％,82.2％.Among those whose PSA value was between 4-10 μg/L,the AUC of single PSA detection was 0.505,the specificity and sensitivity of single PSA detection were 43.2％ and 31.8％; the AUC of the combination detection was 0.803; their specificity and sensitivity were 83.7％ and 73.2％.Conclusions Compared with the single PSA detection,the combination of XAGE-1b,SSX-2,AMACR,AKAP4 and PSA has been greatly improved the specificity and sensitivity in prostate cancer detection.This tool still has significant value even in patients with PSA value between 4-10 μg/L.

Objective To investigate the treatment options of acute biliary pancreatitis.Methods A retrospective review was performed in 134 consecutive patients who presented to a single tertiary care institution from 2000 to 2010 with acute biliary pancreatitis.Results Of the 134 patients,30 had a persistent (commonbile duct,CBD)stone.Following multivariate analysis,at admission CBD size on ultrasound,alkaline phosphatase(ALP),total bilirubin(TB),significantly correlated with persistent CBD stone.Receiver operator curve analysis and linear regression were applied to obtain optimal and equitable predictive values,and variables combined.Optimal values were.,CBD≥10 mm;AP≥150 U/L;and TB≥51.3μmol/L.Presence of three variables had an associated odds ratio(OR)of29.5(P<0.001)for presence of persistent CBD stone.Zero variables conferred asignificantly decreased probability of CBD stone,OR 0.07(P<0.001).Conclusions Presence of three variables significantly correlated with persistent CBD stone.Biliary evaluation by endoscopic retrograde cholangiopancreatography(ERCP)is suggested.In the absence of any positive predictive variables,cholecystectomy may be sufficient.Decisions regarding patients with one to two be made vailables should occur on a case-to-case basis.

Objective To explore the outcome of the tibial bone-skin flap grafts in the management of severe traumatic osteomyelitis complicated with bone and skin defect in leg.Methods Twenty-seven cases of the traumatic osteomyelitis complicated with bone and skin defect in leg were treated with vascularized tibial bone-skin flap grafe from August, 2007 to November, 2013.Reconstruction of limb tibia continuity and cover the wound.Results The tibial bone-skin flaps were completely survived in 26 of the 27 cases except 1 ease which was repaired by adjacent flap because of the disorder blood circulation.The followed-up showed that all flaps had good blood circulation.The infection was controlled completely.The leg function and contour were satisfactory.Conclusion The tibial boneskin flap has the advantages of abundant blood supply, full bone-skin flap supply, shortens hospitalization and suitable for treatment of traumatic osteomyelitis complicated with bone and skin defect in leg.