The development of education in rehabilitation medicine in China were analyzed and some solutions were suggested: increasing the investment in rehabilitation education; strengthening the teaching staff to improve the quality of teaching; establishing a standardized vocational system; intensifying the rehabilitation education for medical students.

TWO average expense control(TAEC) is the method that the hospital want to control the increasing breadth of medicine expense by limiting the total expense which include both clinic expense and hospitalize expense.TAEC will fake great help to improve the relationship of docfor and patient and to promote the hospital work.But the method of TAEC will also to be optimize further.

Objective:To establish a method for the determination of total chloride in oral rehydration salts powder (Ⅲ) by ion chromatography (IC). Methods:The analysis was performed on an IonPac AS 14A (250 mm × 4 mm) column with an IonPac AG 14A (50 mm × 4 mm) guard column and 9mmol·L-1 Na2 CO3 solution as the mobile phase. The flow rate was 1. 0 ml·min-1 with isocratic elution and the sample size was 25 μl. The suppressor was AERS 500(4mm) with 45mA suppression current, and an ECD was used for the detection. The quantity of chloride ion ( Cl-1 ) was calculated by the peak area with an external standard method. Re-sults:The linear range of Cl-1 was 0. 05-20. 00 mg·L-1(r=0. 9999);the recovery was 98. 89％(RSD=0. 56％, n=6). Conclu-sion:The results demonstrated that the method has the advantages of high sensitivity, simple sample pretreatment, promising accuracy and good reliability, which is suitable for the determination of total chloride in oral rehydration salt powder (Ⅲ) .

Objective To evaluate the clinical effects of the interlocking intramedullary nails in treatment of the floating knee. Methods Internal fixation with the interlocking nail in unilateral femur and tibia was performed on 6 patients with the floating knee, and the treatments of complications were analyzed and summarized. Results After operation the 6 patients were followed up and their X ray films were reviewed after 3, 6, and 12 months respectively. Fractures in unilateral femur and tibia healed at once in 4 patients, the union of one femur fracture delayed in one case and the union of tibia fracture delayed in one case. The knee joint could flex to 80～90 degrees in 5 of the 6 patients, and the other one could flex to 60 degrees. No shortening of the limb occurred in all the patients who healed after 6～18 months. Conclusion As the “floating knee”is a kind of high energy injury, often complicated with injury of important organs, the complication should be treated while the internal fixation be conducted as soon as possible. The interlocking intramedullary nail is a good device with which the function of the limb can recover fast with the postoperative dysfunction of the knee and ankle joints greatly reduced.

Research on novel pullulanase has major significance on the domestic industrialization of pullulanase and the breakdown of foreign monopoly. A thermophilic bacteria LM 18-11 producing thermostable pullulanase was isolated from Lunma hot springs of Yunnan province. It was identified as Anoxybacillus sp. by 16S rDNA phylogenetic analysis. Full-length pullulanase gene was cloned from Anoxybacillus sp. LM18-11. The optimum temperature of the pullulanase was between 55 and 60 degrees C with a half-life as long as 48 h at 60 degrees C; and its optimum pH was between 5.6 and 6.4. V(max) and K(m) of the pullulanase was measured as 750 U/mg and 1.47 mg/mL, which is the highest specific activity reported so far. The pullulanase crystals structure showed a typical alpha-amylase family structure. The N-terminal has a special substrate binding domain. Activity and substrate binding were decreased when the domain was deleted, the V(max) and K(m) were 324 U/mg and 1.95 mg/mL, respectively. The pullulanase was highly heterologous expressed in Bacillus subtilis by P43 promoter. The extracellular enzyme activity was 42 U/mL, which increased more than 40 times compared to the initial strain. This pullulanase has good application prospects.
Anoxybacillus ; classification ; enzymology ; China ; Glycoside Hydrolases ; metabolism ; Hydrogen-Ion Concentration ; Phylogeny ; RNA, Ribosomal, 16S ; genetics ; Temperature

Objective To detect the expression of 84 signaling molecules associated with nuclear factor-κB in lesions of Uygur patients with psoriasis.Methods Skin specimens were obtained from the lesional and paralesional skin of eight Uygur patients with psoriasis.Total RNA was extracted from the skin specimens and reversely transcribed into cDNA.PCR-array analysis was carried out to quantify the expressions of 84 signaling molecules related to nuclear factor-κB.Genes with a fold-change ＞ or =2 were defined as differentially expressed.Results Among the 84 tested genes,22 showed upregulated expression,7 downregulated expression,and the remaining 54 genes showed no significant changes in psoriatic lesions compared with the normal skin.The strongest upregulation was observed in the gene expressions of Caspase recruitment domain family 11 (CARD11) and granulocyte-macrophage colony-stimulating factor 2 (CSF2),and the most significant downregulation in the gene expression of interleukin 10 (IL-10),tumor necrosis factor superfamily member 5 (CD40) and nuclear factor of kappa light polypeptide gene enhancer in B-cell inhibitor,epsilon (NFκBIE).Conclusion Multiple molecules involved in the NF-κB signaling pathway might be activated or inhibited in lesions of patients with psoriasis.

Objective To observe the photochemical effect of methylene blue (MB) on the inactivation of E. coli in blood and on biological functions of blood cells. Methods The blood was treated with 15 ?mol/L MB, 40 000 Lux halogen lamp irradiation and 0.35 mmol/l rutin for 10～40 min. The photochemical effect of MB on the inactivation of E.coli in blood was observed. The changes of biologic functions of blood cells were measured by means of RBC membrane binding to poly L lysine, reaction promoted by ATP enzyme and neutrophil phagocytosis tests. Results After treatment for 40 min, the E.coli count in blood decreased by 5 log units. The value of T/E of MB and irradiation of halogen lamp was higher than 1. No obvious changes of the morphology of blood cell were found. The negative electrical charges on membrane of RBC decreased by 11.23%～25.49%. After treatment of the blood for 20～30 min, the activity of Na + K +ATP enzyme of RBC membrane increased by 7.60%～20.07%. When the blood had been treated for 10～20 min, the positive rate of neutrophil phagocytosis enhanced by 9.00%. Conclusion MB photochemical treatment can effectively inactivate E. coli in blood. Under morphology specific condition of effectively inactivated blood bacteria, the shapes and functions of blood cells are not altered, but the RBC adhesion may increase by about 11.23%～25.49%.

Objective To observe the effect of MAC of the isoflurane at the general combined with epidural anesthesia with lidocaine and dicaine.Methods 78 cases of the cholecystectomy patients randomly double-blindly divided Ⅳ groups. General combined with epidural anesthesia were performed at the Ⅰ、Ⅱ、 Ⅲ groups. And general anesthesia were performed at the contronal group. The MAC of the isoflurane are checked with up-and-down method with electronic stimulation at left on C5 leveral. Results The MAC of the three observed groups of the general combined with epidural anaesthesia were 0.67?0.097%、0.68?0.084%、0.61?0.103 % differently. There is no siginificant difference.But the MAC of the general contronl group is 1.15?0.088%.There are siginificant difference with the three observed groups,The MAC of the isoflurane can be reduced with general combined with epidural anesthesia. Coinclousions The MAC the isoflurane can be reduced with general combined with epidural anaesthsia significantly compared with singal general anesthesia. And there are no significant different in the three observed groups.It is the pulsing action with lidocaine combined with dicaine at epidural anesthesia. The mechanism of anaesthesia with lidocaine or dicaine supposed to be the same.

Objective To compare the antitumor effects and chemical components of the extracts in cultivated Cordyceps sinensis (Cs) fungus HK-1 and natural Cs. Methods The cultivated Cs fungus HK-1 and natural Cs were extracted with petroleum ether (PE), ethyl acetate (EtOAc), ethanol (EtOH), and water. The cytotoxicity of all the extracts was observed with MTT assay on breast cancer cell line MCF-7, mouse melanoma cell line B16, human premyelocytic leukemia cell line HL-60, and human hepatocellular carcinoma cell line Hep G2. The antitumor activity in vivo of the extract was further studied with animal model. The chemical constituents in the extracts were analyzed by HPLC. Results All of the extracts from the cultivated Cs fungus HK-1 had much stronger cytotoxicity on B16 than those from natural Cs, and the EtOAc extract had the most potent activity. The activity of EtOAc extract from the cultivated Cs fungus HK-1 was more potent than that from natural Cs on all the four cancer cell lines. EtOAc extract from the cultivated Cs fungus HK-1 also can inhibit the growth of tumor in vivo. Chemical components of all extracts were analyzed and ergosterol and adenosine were found to be potential compounds. Conclusion The cultivated Cs fungus HK-1 has stronger antitumor activity than natural Cs and is a potential source of antitumor compounds.