“The second class” in medical college is an important carrier of humanities education.In order to give full play to its function,we must effectively rationalize the organization and management of medical humanities education institutions,not only to broaden the content and form of“ the second class”,but also to establish appropriate evaluation incentives.

OBJECTIVE:To study the use and developmental tendency of psychotolytics in hospitals of Guangdong province.METHODS:The psychotolytics used in hospitals of Guangdong province during the period of2000～2004were an-alyzed statistically in respect to consumption sum,DDDs and average daily expense.RESULTS&CONCLUSIONS:Both consumption sum and DDDs of psychotolytics in the past5years increased to a large extent.Benzodiazepine topped the list of anti-anxiety drugs.The consumption of2nd generation antipsychotics increased year by year.On the whole,the consumption of antidepressants increased annually,of which,fluoxetine,flupentixol/melitracen and paroxetine were the most frequently used drugs.However,the consumption of tricyclic antidepressants has a significant reduction.

[Objective]The patellar tendon lengths were compared in the knees with a history of patellar instability and in normal knees in Chinese,and the significance of patellar tendon length measurement in the knees of patellar instability was discussed.[Method]Totally 49 knees of 43 patients with patellar instability were reviewed from Jan.2003 to Dec.2005,including 15 males and 28 females and 6 paients with both instahle patellas.The mean age was 21.4 yrs(from 18~28 yrs),and the mean height was 163 cm(155~173 cm).And,50 normal control knees of 50 volunteers including 16 males and 34 females.The mean age was 24.2 yrs(from 18~35 yrs),and the mean height was 165cm(154~177 cm).The patellar tendon length,the distance between tibial tubercle and the anterior edge of tibial plateau and Insall-Salvati index on the lateral X-ray plain with 30? flexion of keens were measured and analyzed.[Result]The patellas tendon length of patients was longer than that of normal volunteers(53.3?2.7mm,47.3?3.3 mm,P0.05)of the distance from tibial tubercle to the anterior edge of tibial plateau between patients and volunteers.However,difference of Insall-Salvati index between patients and volunteers was significant(1.33?0.17,1.06?0.14,P

Objective To evaluate the safety of temporary cardiac pacemaker during perioperative period of laparoscopic cholecystectomy (LC) in patients with bradyarrhythmia. Methods Temporary cardiac pacemakers were installed preoperatively in 34 elderly patients with bradyarrhythmia for LC. On operation the ultrasonic harmonic scalpel, instead of electrotome, was used to perform dissection and coagulation. Results LC was completed successfully in all the 34 patients without surgery-related complications or perioperative serious cardiovascular diseases. Conclusions Utilization of temporary cardiac pacemaker and ultrasonic harmonic scalpel may considerably enhance the perioperative safety and reduce the incidence of cardiovascular complications in elderly patients with bradyarrhythmia.

Objective To determine the effect of Nuclear factor-erythroid 2-related factor 2 ( Nrf2 ) on acute hephrotoxicity induced by CCl4 in male rat.Methods 20 male Wistar rats were randomly divided into control group and CCl4 group, 10 rats in each group, another 10 male Wistar rats were transgenic rats microinjection through the carrier, obtained the Nrf2-tk gene integration and specific transgenic rats, as the CCl4 +Nrf2 integration group.The groups was given 1%polysorbate 80 for 4 days,Then the CCl4 and CCl4 +Nrf2 integration group were intraperitoneally injected with a single dose of CCl47.5 mg· kg-1 and were killed 24 h after CCl4 injection.The serum chemical parameters including asparate aminotransferase ( AST) ,alanine aminotransferase ( ALT) and lactate dehydrogenase ( LDH) were measured.Also malonaldehyde ( MDA) ,glutathione ( GSH) ,oxidized glutathione ( GSSG) levels in the liver as well as glutathione ( GSH)/oxidized glutathione ( GSSG ) ratios were detected. Histopathologic changes in the liver were examined. Results F1generation TK transgenic rats in liver and testis and other tissues and organs were not detected the transcription of Nrf2-tk, indicating that Nrf2-tk expression in tissues is specific good.Nrf2 significantly reduced serum AST, ALT and LDH levels in a dose-dependent manner.The results of MDA levels and GSH/GSSG ratios in liver and kidney showed that Nrf2 reduced CCl4-induced hepatic lipid peroxidation,and ameliorated glutathione depletion.The histopathologic results showed that Nrf2 restrained liver and kidney damage induced by CCl4 .Conclusion Nrf2 can effectively protect male rat from acute hepatotoxicity and nephrotoxicity induced by CCl4 .

Objective Intestinal obstruction is a frequent sequela of recurrent ovarian cancer and difficult to deal with We analyzed a series of such patients to determine if their outcomes have changed after undergoing palliative surgery Method We retrospectively reviewed 67 patients undergoing surgery for intestinal obstruction due to recurrent ovarian carcinoma and 75 patients receiving non surgical treatmen from 1997 to 2002 Results During the study period,67 operations were performed on 67 patients Among them,surgical procedure was completed in 58 cases Successful palliation was achieved in 64 2% of cases in which surgical correction was possible The median survival of the entire cohort was 7 8 months,and 12 6 months for the surgically successfully relieved patients and 3 7 months for those non surgical patients The rate of major surgical morbidities was 22 4 % The perioperative mortality rate was 6 0% Successful palliation was associated with the absence of two prognostic factors:multiple obstructive sites and palpable abdominal and pelvic masses Conclusion Palliative surgery for bowel obstruction in recurrent ovarian cancer can be worthwhile,and properly selected patients are the key to its success

Long bone osteomyelitis often results from serious open fractures or some closed fractures.Its treatment is a clinical difficultly in orthopaedics.Masquelet is a new strategy for bone reconstruction,validated by surgeons in their treatment of acute bone loss,bone tumor and bone infection.It is carried out in 2 stages.At the first stage,infection was eliminated by radical debridement and placement of antibiotic bone cement into the defect,which induces a pseudomembrane to facilitate the growth of bone graft.At the second stage,reconstruction of the bone defect is performed by bone grafting in the membrance after removal of the bone cement.The unique characteristics of this technique arouse more and more attention recently.Therefore,we would like to present a review about this Masquelet technique dealing with post-traumatic osteomyelitis of long bones.

Objective To evaluate the influencing factors on image quality and the value of clinical application of coronary artery angiography with 16-slice spiral CT.Methods 16-slice spiral CT angiography was performed in 31 suspected coronary heart disease(CHD).All patients were examined in ordinary scanning (slice 3 mm) and coronary artery scanning (slice 1 mm)with the technique of retrospective electrocardiography gating,and multiplanar reconstruction(MPR),maximum intensity projection(MIP) and volume reconstruction technology(VRT) were done.The showing rate of coronary arteriae,the detecting rate of CHD and the influencing factors on image quality were evaluated by CT.Results 16-slice spiral CT could clearly show RCA1,RCA2,LAD1,LAD2,,LCX1.The image quality was affected by heart rate,breath movement and much calcification in artery,etc.Conclusion 16-slice spiral CT is of significant value in screening and diagnosing coronary artery disease.

OBJECTIVE:To select a technique for preparation of fluconazole for injection and to establish a method for determination of its content.METHODS:The formula was selected on the basis of pH value and species of solution adjuvant.The content was determined by HPLC.RESULTS:The preparation was stable when pH value was between6.5～8.5,and its clarity could be increased by propylene glycol.The detectable concentration of fluconazole showed a good linear correlation in the range of40～200?g/ml.The average recovery was100.37%,RSD=1.37%(n=3).CONCLUSION:The fluconazole for injection prepared by the present technique is stable in quality and the method for content determination is accurate and practicable.

Purpose To investigate the clinical outcome of induced membrane technique for treatment of post-traumatic tibial osteomyelitis.Methods A retrospective analysis was made on 17 cases of post-traumatic tibial osteomyelitis admitted from August 2011 to October 2012.There were 13 males and 4 females aged 19-67 years (mean,40.9 years).Mean length of bone defect was 6.7 cm (range,2.0-18.5 cm).Surgical treatments were performed including phase Ⅰ surgical debridement and antibiotics-loaded bone cement impregnation to induce a membrane and phase Ⅱ bone defect reconstruction by intramembranous bone grafting.Clinical effect of the treatment was evaluated.Results Bone healing was detected at the 27-month follow-up (range,24-32 months).Radiographic healing was obtained 4-6 months after operation.Two cases of recurrent infection were noted after phase Ⅰ surgery and had another debridement.External fixator proximal pin track infection occurred in one case and infection was controlled by hardware removal and dressing change.There was one case of metal rejection,two function disorders,one clubfoot,and one ankle stiffness.Conclusion Induced membrane technique is effective in the treatment of post-traumatic tibial osteomyelitis,especially in lone bone defect reconstruction,but limb functional complications are worth consideration during treatment.