[Objective]To summarize the growth of 51 famous experts in traditional Chinese medicine, in order to provide the young and middle-aged scholars of this area with studying materials and references. [Methods] Finding the similarities and making a summary by interviewing, organizing and ana-lyzing the growing experiences of these 51 experts. [Results]Being enthusiastic about traditional culture of Chinese medicine and having careful y read re-lated classics when studying medicine, most of the experts have either experiences of learning from famous doctors, or strong interest motivated by learning the practical effect of traditional Chinese medicine. They have been insisting on a lifetime, perseverant, diligent and strenuous learning, and they are good at summarizing. In addition, they have attached great importance to medical ethics and self-cultivation, which is considered to be the general characteristic of their bril iance. [Conclusions] To cultivate talents of modern Chinese medicine under the roof of col eges and institutes, it is important to develop their interest first, then to put great emphasis on reading classics, learning from famous doctors, summarizing through the way of “reading-clinical verification-reading again”, and final y, paying great attention to the education of medical ethics.

Eukaiyotic translation initiation factor 4E(eIF4E) is a key factor initiate eukaryotic transla-tion. eIF4E has significant correlation with the carcinogenesis, cancer development and invasion, etc. Recent studies in breast cancer show that eIF4E is an important prognostic factor and associated with sensitivity of breast cancer cells to radiotherapy. eIF4E expression has a potential contribution to therapeutic strategy mak-ing, meanwhile, it is a promising effective target of breast cancer treatment.

Objective To clarify the mechanism of Yifeiqinghua granules on tumor angiogenesis and tumor inhibition by observing its influence on the expression of vascular endothelial growth factor (VEGF) and its receptor KDR in Lewis lung cancer mice. Methods Eighty C57BL/6 inbred mice subcutaneously planted with Lewis tumor cell suspension 0.2 mL were randomly divided into 8 groups:blank group, control group, low-, medium- and high-dose of Yifeiqinghua granules groups, Gefitinib group, Gefitinib plus medium-dose of Yifeiqinghua granules group and CTX group, 10 mice in each group. Drugs were administrated from the second day. CTX group was administered on third day and seventh day, other groups were administered for 14 days. The mice were killed to take the tumor on the 15th days. VEGF and KDR expression in tumor tissue was measured by Western Blot. Results Compared with the blank group, the expression of VEGF was significantly decreased in the low- and medium-dose of Yifeiqinghua granules groups (P<0.01). Gefitinib group’s VEGF value was lower than the blank group (P<0.05). Compared with the blank group, the expression of VEGF was significantly decreased in the high-dose of Yifeiqinghua granular group, Gefitinib plus medium-dose of Yifeiqinghua granules group and CTX group (P<0.001). Compared with the blank group, the expression of KDR was significantly decreased in the low-, medium- and high-dose of Yifeiqinghua granules groups, Gefitinib group and CTX group (P<0.05). Conclusions The possible mechanism of Yifeiqinghua granules in treating non-small cell lung cancer is reducing the expression of VEGF and KDR, thus play an inhibitory effect.

Objective To investigate surgical strategy and outcome for cervical metastasis in different anatomical segments.Methods Data of 31 patients,who had undergone surgical treatment for cervical metastasis from 2001 to 2009,were retrospectively analyzed.Two anatomical regions were defined:upper cervical spine (C1 and C2)and subaxial cervical spine plus cervicothoracic junction (C3-T1).VAS score,Frankel grade,Tomita score and Karnofsky performance scale were used to evaluate pain,neurological status,expected survival time and general health.The improvement of symptoms,survival time and characteristics of surgical strategies for different anatomical regions were analyzed.Results Twenty-four patients were followed up successfully.An effective recovery in neck pain and quality of life was found after operation.The median survival time was 45.0 months.In upper cervical spine group,the surgical strategies included posterior occipitocervical fixation combined with 125I seed brachytherapy and other surgical methods,and the median survival time 48.0 months) of patients who underwent 125I seed brachytherapy was longer than that 22.0 of patients treated with other surgical methods.In C3-T1 metastasis group,patients who underwent combined anterior-posterior approach total spondylectomy had a longer survival time than those treated with anterior corpectomy.Conclusion Surgical treatment can effectively relief neck pain,maintain or improve neurological function and improve quality of life.Doctors should choose different surgical strategies according to anatomical region of cervical metastasis.For upper cervical spine,the main purpose of surgery is to stabilize the cervical spine; the posterior occipitocervical fixation is usually chosen,and the 125I seed brachytherapy is useful in local control of metastasis.For subaxial cervical spine and cervicothoracic junction,the anterior corpectomy is usually chosen,and a combined anterior-posterior approach total spondylectomy can be used for patients with corresponding conditions.

OBJECTIVE:To observe clinical efficacy and safety of salmeterol fluticasone combined with tiotropium bromide in the treatment of COPD via different inhalation devices.METHODS:Eighty COPD patients were selected from our hospital during Jan.2014 to Jan.2015,and then divided into trial group and control group according to random number table,with 40 cases in each group.Both groups were given Salmeterol fluticasone inhalant 500 μg,bid+Tiotropium bromide inhalant 18 μg,qd.Control group was given medicine via inhalation device coming with medicine,while trial group was given medicine via gas compression type ultrasonic spray inhalator.Both groups were treated for 1 year.Blood concentration of medicine 0.5 h after medication,mMRC score and COPD acsessment test (CAT) score 3,6,9 months after treatment,the times of acute exacerbation during treatment,FEV1％ before and af ter treatment were all observed in 2 groups.The occurrence of ADR was recorded.RESULTS:Four cases withdrew from trial group and 1 case from control group.After medication,there was no statistical significance in blood concentration of fluticasone,salmeterol and tiotropium bromide between 2 groups (P＞0.05).0.5 h after medication,mMRC score of trial group was slightly lower than that of control group,without statistical significance (P＞0.05);CAT score of it was significantly lower than that of control group,with statistical significance (P＜0.05).The times of acute exacerbation in trial group during treatment was significantly less than control group,with statistical significance (P＜0.05).The decrease of FEV1％ in trial group was slightly lower than control group,without statistical significance (P＞0.05).The incidence of ADR in trial group was significantly lower than control group,with statistical significance (P＜0.05).CONCLUSIONS:For COPD patients,salmeterol fluticasone combined with tiotropium bromide via gas compression type ultrasonic spray inhalator is better than inhalation device coming with medicine in clinical efficacy and safety.

SUMMARY Delayed postoperative spinal epidural hematoma(DPSEH) is a rare and potentially devastating complication of laminoplasty, and cervical nerve root palsy occurs more frequently than DPSEH, especially with C5 nerve root palsy. The authors describe a case of DPSEH with C5 nerve root palsy that developed in a patient 3 days after he underwent laminoplasty. In this case, a 78-year-old man with a history that having taken Aspirin without the doctor’s instruction for 5-6 years,he underwent cervical laminoplasty for mild myelopathy. On the 3rd postoperative day, he complained of weakness of his left upper extremity and could not raise his left arm. The symptom aggravated in the next few days. On the 9th postoperative day, there was an obvious motor deficit of both upper and lower extremities. Magnetic resonance imaging demonstrated abnormal signal characteristics consistent with a hematoma at levels C3-C4, compressing spinal cord. The clot was evacuated during emergency revision surgery, and the postoperative course after the operation was uneventful and the muscle strength was improved five days later. Therefore, the symptoms of DPSEH are not so typical that its possibility should be kept in mind. Sometimes a differential diagnosis should be made with C5 nerve root palsy which may only represent weakness of upper extremities. The authors recommend that magnetic resonance imaging is helpful for the diagnosis of DPSEH and a revision surgery should be taken as soon as possible once the hematoma causing the neurologic deterioration was confirmed.

Objective To study the expression of cyclooxygenase-2 (COX-2) in colorectal cancer,and its relationship with the sensitivity of rectal cancer neoadjuvant radiotherapy.Methods 102 rectal cancer patients with preoperative radiotherapy were selected from January 2013 to January 2016.The COX-2 expression of samples were detected by immunohistochemical.We analyzed the relationship of tumor and adjacent to carcinoma tissue COX-2 expression,radiation sensitivity and the prognosis of patients.Results 71 cases with radiation sensitivity and 31 radiation resistance cases,radiation sensitive rate was 69.6％.The COX-2 expression in the tumor tissue was significantly higher than adjacent tissue (P ＜ 0.05),radiation sensitive patient proportion with positive and strong positive COX-2 expression was significantly lower than the radiation resistance (P ＜ 0.05).The adjacent to carcinoma tissue's COX-2 positive expression of radiation resistance group proportion was significantly higher than the radiation sensitive group (P ＜ 0.05).The tumor COX-2 positive OR strongly positive (OR:4.21,95％ CI:1.26-7.17),tissue adjacent to carcinoma COX-2 positive (OR:8.15,95％ CI:1.43-38.21) were risk factors for neoadjuvant radiotherapy resistance.The survival analysis showed that tumor tissue COX-2 expression of negative OR weakly positive patients survival significantly extended.Conclusions There were significant correlations between the expression of COX-2,neoadjuvant radiotherapy sensitivity and prognosis in colorectal cancer patients.the joint detection biopsy COX-2 expression in colorectal cancer patients with tumor and cancer adjacent tissues,may screening out patients sensitive to radiation and chemotherapy,which making patient better prognosis.

The continuing education system at the Peking University Health Science Center for vis-iting scholars (Research program for young and middle-aged doctors) is a relatively advanced and compre-hensive medical continuing education system in China, among which, the tutorial system is a good method to guide the visiting scholars of continuing education. On this basis we conducted scholars learning effect questionnaire survey and combined with the feedback results, discussed the advantages and disadvantages of the current educational system of visiting scholars in China, and put forward some concrete suggestions on the development of the continuing education in China.

Objective To investigate the effect of Amikacin and prulifloxacin alternate application in the treatment of Lung infections in ICU resistant Acinetobacter Bauman.Methods 82 cases of Lung infections in ICU resistant Acinetobacter Bauman from August 2014 to August 2016 in our hospital were selected and randomLy divided into two groups, 41 cases in control group were given routine treatment, 41 cases in the experimental group were treated with Amikacin and prulifloxacin alternate application, and patients were treated continuous for two weeks.Levels of serum CRP, PCT, WBC, N%, SCR, BUN, AST, ALT, scores of APACHE II and CPIS and clinical efficacy were observed pre-and post-treatment.Results After two weeks, levels of serum CRP, PCT, WBC and N% in experimental group were significantly lower than control group, scores of APACHE II and CPIS were significantly lower than the control group, the total clinical efficiency was higher than the control group(P<0.05), and the levels of serum SCR, BUN, ALT, AST were lower, but had no statistically difference.Conclusion Amikacin and prulifloxacin alternate application in the treatment of Lung infections in ICU resistant Acinetobacter Bauman can reduce the patient's inflammatory reaction and the degree of infection.

Objective To investigate the application effects of new-type glove constraint in intensive care unit. Methods A total of 113 eligible patients were randomly divided into two groups by random digits table method, of which 59 patients used the traditional restraint for body constraint in the control group while 54 patients applied the new-type glove constraint in the treatment group. The skin conditions of restraint position, tube coming off and the satisfaction of patients and relatives were compared between two groups. Results The incidence of skin abnormality at restraint position was 0 in the treatment group and 13.6%(8/59) in the control group. The difference had statistical significance (χ2=7.880, P<0.01). The satisfaction of patients and relatives was 33.3%(18/54) in the treatment group and 5.1%(3/59) in the control group, and the difference had statistical significance (χ2=16.619, P<0.01). Conclusions The use of new-type glove constraint may give a maximum activity space to patients;reduce patient′s psychological adverse impacts;and decrease the skin and body damages. It is worthy of clinical promotion and application.