The long-year program for medical education is the major way to train the high level medical professionals.This paper colleeted the research papers on this topic published in Chinese journals in recent years,extracted their key words and counted the high frequent key words According to the co-occurrence of a pair of key words in one paper.these high frequent keywords were clustered into groups.The research structure and main directions of the long-year program were outlined as the study of macro-planning of long-year program,the study of teaching models and teaching system,study of teaching practice.These results could be a useful reference for the medical educational researchers and managers.

Objective To analyze multislice CT characteristics of intestinal obstruction transition zone caused by different patholo-gy.Methods 67 cases of intestinal obstruction were collected in our hospital.Multislice spiral CT scan combined with multi-plane re-organization (MPR)of the bowl obstruction transitional zone were analysed.Results Among 67 cases of intestinal obstruction,there were 28 cases of simple mechanical intestinal obstruction,1 7 cases adhesion intestinal obstruction,5 cases paralytic intestinal obstruc-tion,4 cases internal hernias and 4 cases mixed intestinal obstruction.Conclusion Intestinal canal transitional zone and arounding tis-sues of intestinal obstruction have certain characteristics for the same pathology which can be clearly displayed by multislice CT scan combined with MPR.

Objective To find a new method of tangential view of patello femoral joint. Methods 62 cases of lateral knee radiographs were studied. The knee flexion angles, patello femoral angles, patello tibial angles and frontal patello tibial angles were measured and their relationships analyzed. The knee flexion angles and the patello femoral angles had linear relationship with a linear equation = 2 + 0.8x . The angles of posterior patellar line with tibial long axis and frontal tibial line were 3.3? and 12.7?respectively. According to the measurement results, an accessary positoning table was designed. The patients′ patello femoral joints were examined with the knee flexed at an angle of 30?. The patients were in supine position and the central X ray was angled at 73?vertically toward the film. Results 58 patello femoral joints of 40 patients were radiographically studied (10 males, 30 females) .All radiographs were classified into 4 degrees as Grade A, B, C and D. Eighteen cases were Grade A (31%), 30 cases were Grade B(52%), 8 cases were Grade C(18%)and 2 Grade D(3%).The reason for Grade D was due to small or negtive anterior patellotibial angles. Conclusion This new method of tangential view of patello femoral joint is accurate, comfortable and simple and could be used as routine examination for patello femoral joint diseases.

Objective:To compare the visual quality of patients with astigmatic multifocus intraocular lens (ART IOL) and astigmatic monofocus IOL (Toric IOL) after implantation.Methods:A prospective, non-randomized, controlled study was conducted to include 72 eyes of 72 cataract patients with corneal astigmatism (1.0-2.5 D) who were scheduled to receive phacoemulsification combined with IOL implantation in Chaoju Eye Hospital of Inner Mongolia from July 2017 to October 2018.Patients were divided into ART IOL group (37 eyes) and Toric IOL group (35 eyes) according to different IOLs implanted.All patients were followed up for 1 year after surgery.The main and secondary outcome indicators were compared.The main outcome indicators included distance (5 m), intermediate (80 cm), and near (40 cm) uncorrected visual acuity and best corrected visual acuity, defocus curve, contrast sensitivity, postoperative IOL rotation and residual astigmatism, while the secondary outcome indicators included visual subjective symptoms and spectacle independence rate.The above outcome indicators were compared between the two groups.This study followed the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Chaoju Eye Hospital of Inner Mongolia (No.CJYKLL202012).Written informed consent was obtained from each patient before surgery.Results:There was no statistically significant difference between the two groups in average uncorrected distance visual acuity and best corrected distance, intermediate and near visual acuity (all at P>0.05).The average intermediate and near visual acuity in the ART IOL group was significantly higher than that in the Toric IOL group, showing statistically significant differences (both at P<0.05).The defocus curve of the ART IOL group presented a double peak, which reached the peak at the far focus (0.0 D) and near focus (-2.5 D), respectively.The visual acuity range from 1.5 to-3.0 D was above 0.2 logarithm of the minimum angle of resolution (LogMAR), and the focus depth range was 4.5 D (1.5 to -3.0 D).The defocus curve of the Toric IOL group had only one crest, which was located at best corrected visual acuity (0.0 D).The visual acuity reached 0.2 LogMAR or above were from 1.0 to -1.0 D, and the focal depth range was 2.0 D (1.0 to -1.0 D).There was no statistically significant difference in contrast sensitivity at different spatial frequencies between the two groups in bright light, bright flashing light and dark light (all at P>0.05), while the contrast sensitivity of the ART IOL group at high dark flashing light frequency was lower than that of the Toric IOL group, showing statistically significant difference ( P<0.05).In the ART IOL group and the Toric IOL group, the average residual astigmatism after surgery was (-0.47±0.51)D and (-0.49±0.42)D, respectively, with no statistically significant difference ( t=0.408, P>0.05).There was no significant difference in postoperative IOL rotation between the two groups ( t=1.906, P>0.05).The total postoperative spectacle independence rate in the ART IOL group was 97.30%(36/37), which was higher than that in the Toric IOL group (17.14%, 6/35), showing statistically significant difference ( χ2=15.320, P<0.05). Conclusions:Both Toric IOL and ART IOL can better correct corneal astigmatism and improve patients' distance visual acuity, but ART IOL implantation can provide better distance, intermediate and near visual acuity, and higher spectacle independence rate.

Brucellosis ; China ; Epidemics ; Humans

CD163 is one of transmembrane glycoproteins expressed only in activated monocyte-macrophage cell membrane, which acts as a marker of activated macrophages. In sepsis, CD163 activates the intracellular signal transduction pathways in macrophages,regulates TNF-α, IL-10 and IL-6 expression, have antiinflammatory and antioxidant effects in the inflammatory process. Soluble CD163 (sCD163) is a soluble form of CD163 ,which could play anti-inflammatory and immunoregulatory effects by inhibiting T cells proliferation and activation. Serum concentration of sCD163 may be highly increased when severe infection. Detection of serum sCD163 is helpful to diagnose sepsis,and to evaluate the prognosis of severe infection and sepsis.

OBJECTIVE:To analyze the clinical effects of Orion anterior plate combined with titanium mesh and bone graft in the treatment of unstable cervical spondylosis METHODS:The databases of PubMed and Wanfang were retrieved using search terms of"cervical vertebrae,Orion anterior plate,titanium mesh,and spinal fusion"both in English and Chinese for documents concerning Orion anterior plate combined with tltanium mesh and bone graft in the treatment of unstable cervical spondylosis.The literatures published between 1990 and 2008were selected.The repetitive studies were excluded.A total of 54 documents were searched by computer,and 13 papers were included in the final analysis according to inclusive criteria RESULTS:By the application of Orion anterior plate combined with titanium mesh and bone graft in the treatment of unstable cervical spondylosis,the cervical curvature and stability could be restored,the intervertebral height would be maintained and the implanted bone could get fusion easily.The injury and complications caused by auto-ilium graft could be avoided.In addition,the locking cervical plate could effectively prevent damage caused by spondylolisthesis,and strengthened the cervical stability.It is a good method for anterior internal fixation of cervical vertebrae CONCLUSION:It is an ideal method to treat unstable cervical spondylosis by using Orion anterior plate combined with titanium mesh and bone graft .

Objective To evaluate the changes of C-reactive protein (CRP) and matrix metalloproteinase-9 (MMP-9) in cerebrospinal fluid and serum of patients with intracranial infection,in order to explore their significance.Methods The levels of CRP and MMP-9 in 43 cases patients with intracranial infection of the acute and recovery phase and 21 normal people (control group) were determined by immunohistochemical turbidimetric method and radioimmunity method.In 43 patients,24 cases of viral encephalitis (viral encephalitis group),12 cases of tuberculous meningitis (tuberculous meningitis group) and 7 cases of purulent meningitis (purulent meningitis group).Results The levels of CRP of cerebrospinal fluid and serum in the acute phase in tuberculous meningitis group [(7.12 ±2.32),(28.84 ±4.91) μg/L] and purulent meningitis group [(8.68 ± 2.32),(32.60 ± 6.94) μg/L] were significantly higher than those in control group [(3.20 ± 1.62),(9.96 ± 3.45) μ g/L] (P ＜0.05);the levels of CRP had no significantly statistical difference in the acute and recovery phase between viral encephalitis group and control group (P＞0.05),and there was no significant difference in the levels of CRP of cerebrospinal fluid and serum in the recovery phase between tuberculous meningitis group or purulent meningitis group and control group (P＞0.05).There was no significant difference in the levels of CRP in tuberculous meningitis group and purulent meningitis group between the acute phase and recovery phase (P＞0.05).The levels of MMP-9 in the acute and recovery phase of all the groups were significantly higher than those in control group (P ＜0.05).The levels of MMP-9 in the recovery phase of all the groups were significantly decreased,compared with those in the acute phase (P＜0.05).Especially the levels of MMP-9 in the acute and recovery phase in tuberculous meningitis group and purulent meningitis group were significantly higher than those in viral encephalitis group (P＜0.05).There were no significant difference in the levels of MMP-9 in tuberculous meningitis and purulent meningitis group between the acute phase and the recovery phase (P＞0.05).Conclusions There is no significant relationship between CRP and viral encephalitis,however the levels of CRP are significantly increased in the acute phase of bacterial intracranial infections.The levels of MMP-9 in the three kinds of intracranial infection are signifcanfiy increased,especially in tuberculous meningitis and purulent meningitis patients,and they gradually decrease during the recovery procedure.The changes of CRP and MMP-9 would help to determine the phases,the kinds,the severity and the prognosis of intracranial infection.

Objective To observe the indicative function of pulse pressure(PP)and PP index(PPI)on early renal damage in patients with hypertension.Methods Eighty old aged patients with hypertension and renal damage were selected as group A,60 old aged patients with hypertension as group B,and 30 old aged healthy people as group C.PP and PPI were examined in all groups,and early renal damage index was examined in group A.Results The rates of PP ≥ 60 mm Hg(1 mm Hg=0.133 kPa)and PPI ≥0.5 in group A were significantly higher than those in group B and group C[70.0％(56/80)vs.41.7％(25/60)and 26.7％(8/30),75.0％(60/80)vs.43.3％(26/60)and 23.3％(7/30),P＜0.05].In group A,there were significant differences between PP ≥ 60 mm Hg patients and PP＜60 mm Hg patients in beta 2 microglobulin(β 2-MG),microalbuminuria(MAU),high-density lipoprotein(HDL),low-density lipoprotein(LDL)and homocysteine protease inhibitors C(Cys-C)[(13.23±3.22)mg/L vs.(12.03±2.32)mg/L,(56.6±13.2)mg/24 h vs.(42.7±12.3)mg/24 h,(1.9±1.2)mmol/L vs.(2.2±1.3)mmol/L,(2.6±1.2)mmol/L vs.(2.9±1.3)mmol/L,(2.01±0.80)mg/L vs.(1.21±0.90)mg/L,P＜0.05],but there was no significant difference in serum uric acid(SUA)and serum creatinine(SCr)(P＞0.05).There were significant differences between PPI ≥0.5 patients and PPI＜0.5 patients in β 2-MG,SCr,MAU,LDL and Cys-C[(10.53±2.43)mg/L vs.(14.00±2.15)mg/L,(97±22)μmol/L vs.(82±16)μmol/L,(52.5±12.4)mg/24 h vs.(40.7±11.3)mg/24 h,(2.2±1.2)mmol/L vs.(2.7±1.3)mmol/L,(1.91±0.90)mg/L vs.(1.23±1.10)mg/L,P＜0.05],but there was no significant difference in SUA and HDL(P＞0.05).Conclusions The rates of PP ≥ 60 mm Hg and PPI ≥ 0.5 in hypertension with renal damage are significantly higher than those in simple hypertension and healthy people.PP and PPI can be served as the indexes of early renal damage,and it should be cautious on this kind of patients.

Objective To observe the effect of Juanbi granulae on rheumatoid arthritis belonging to cold dampness obstruction and kidney yang qi deficiency syndrome.Methods All 120 RA patients in accordance with the inclusion criteria were divided into a 80 cases of study group,and a 40 cases of control group,by random table method.Methotrexate,10mg once a week,was given orally,as a basis for treatment.The treatment group given Juanbi granulae,15g for each time,3 times a day; while the control group was Zhenqingfengtongning sustained-release tablets,60mg for each time,twice daily.Both groups have adopted a one-month course of treatment.Statistics effect was evaluated after 4-week course of treatment.Results ①There was significant difference between the two group in terms of therapeutic effects and symptom effects after the treatment (the total effective rate of study group and control group was 100.0％,86.7％,U value was-4.071,-3.232 respectively,P＜0.05).② The treatment effects and the symptom effect of the cold dampness syndrome and the kidney yang qi deficiency syndrome in the same group showed statistical difference after the treatment (the total effective rate of study group and control group was 88.0％,80.0％,The U value of treatment effect was-5.50,-3.67 respectively,P＜0.01 or P＜0.05).(U value of syndrome effect was-2.909,-3.992 respectively,P＜0.05).③ Study group of after treatment ESR (17.05±7.15) mm/h,RF (32.46± 14.22) U/L,compared with the control group of after treatment,the difference was statistically significant (P＜0.05).Conclusion Juanbi granulae was effective in treating rheumatoid arthritis of both kidney yang qi deficiency syndrome and cold dampness obstruction syndrome,the effects were especially better for cold dampness obstruction syndrome.