Two-way choice is the main way for the seven-year-program clinical medical students and postgraduate supervisors.This article analyzes the influence factors and shortages of two-way choice for postgraduate supervisors and seven-year-program clinical medical students.This investigation discovers that the supervisor's abilities of research,teaching and clinical and their personal magnetism are important and key factors.The students' gender,character,hobbies and interests and the familiarity to profession are the secondary factors.The other factors that include employment status,the level of income and the advice of parents and friends also have influence on two-way choice for postgraduate supervisors and seven-year-program clinical medical students.In order to further improve the tow-way choice,the author gives some suggestions,including introducing profession and the scientific researches of supervisors in advance,encouraging the face-to-face communication between students and supervisors,promoting multiple profession choices and giving some aids to the students for choosing the supervisors.

Objective　This study was To investigate the incidence rate of Cockett syndrome and relationship between Cockett syndrome and varicose veins and deep venous incompetence of the left lower extremities.Methods　73 patients(100 legs) with varicose veins of the lower extremities were investigated by descending deep venography and iliography preoperatively.Results　There were 35(47.9%) cases with abnormalities of the left common iliac vein (ALCIV)in all the cases.There were 31 cases with this conditions in the patients with varicose veins of the left or both lower extremity.While in the patients with varicose veins of the only right lower extremity,there were only 4 cases with ALCIV.In contrast,there was a significant difference between groups(χ2=9.8641,P=0.0017).In the patients with ALCIV,14 cases with Ⅲ or Ⅳ grade of deep venous incomptence were found, and only 6 cases with deep venous incompetence in the patients without ALCIV.There was a significant difference(χ2=5.3688,P=0.0205).Conclusion　Cockett's syndrome frequently occurs in varicose veins of the left lower extremity.There is a relationship between them.Cockett's syndrome might be one of the causes for the deep venous incompetence of the left leg.

Objective To investigate the alkaloidal constituents of Nauclea officinalis, an anti-inflammatory and antibacterial traditional Chinese herb. Methods The alkaloids were isolated and purified by silica gel, Sephadex LH20, and C-18 ODS column chromatography repeatedly, and their structures were identified by spectral analysis. Results Eleven alkaloids were isolated from the stems of N. officinalis and their structures were identified as angustoline (Ⅰ), 19-O-ethylangustoline (Ⅱ), 3-S-3, 4-dihydroangustoline (Ⅲ), 3-R-3, 4-dihydroangustoline (Ⅳ), naucleamide A (Ⅴ), strictosamide (Ⅵ), vincosamide (Ⅶ), 6′-acetyl-strictosamide (Ⅷ), 2′-acetyl-strictosamide (Ⅸ), pumiloside (Ⅹ), 3-epi-pumiloside (Ⅺ). Conclusion Compounds Ⅰ-Ⅺ are isolated from this plant for the first time.

Pedicle screw fixation is widely used in spine surgery, which allows 3?dimensional fixation with a more rigid construct and permits a shorter fusion length. However, conventional pedicle screw fixation has some drawbacks, including signifi?cant muscle dissection for the exposure of bone marks. Although percutaneous pedicle screw technique can compensate for above defects, it requires an additional approach for decompression and bone graft insertion. Besides, the percutaneous pedicle screw technique depends on intraoperative multiplanar fluoroscopy, which results in high risk of radiation exposure of the surgeons and patients. Screw loosening is a well?known complication, especially in osteoporosis patients. Several methods can enhance screw stability, for example, modifying screw design and augmenting vertebral bodies with reinforcing materials that can improve the structural capacity of the deteriorated tissue, however, they also have some disadvantages. Although we can enhance bone?screw by modifying screw design, it is not useful in severe osteoporosis patients. At the same time, bone cement can increase pedicle screw axial pullout strength and fatigue resistance, however, it is associated with a number of inherent disadvantages such as its high exothermic polymerizing temperature, toxicity of the monomer, and risk of leakage to the spinal canal. Santoni et al. intro?duced cortical bone trajectory (CBT) for lumbar pedicle screw with a new screw design that is shorter and smaller in diameter which has been proposed to maximize the thread contact with this higher density bone surface. In addition, the CBT technique fol?lows a caudocephalad path sagittally and a laterally directed path in the transverse plane, engaging only cortical bone in the pedi?cle without the involvement of the vertebral body trabecular space. Finally, the screw insertion point of this technique locates around lateral pars, enabling less tissue dissection. Therefore, it can be an alternative approach to enhance screw fixation strength, and it may rescue failed pedicle screw and be used in minimally invasive spine surgery.

Cells, Cultured ; DNA Damage ; drug effects ; Dimethylformamide ; administration & dosage ; toxicity ; Dose-Response Relationship, Drug ; Hepatocytes ; drug effects ; pathology ; Humans

Adult ; Aged ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; pathology ; physiopathology ; Respiratory Function Tests

The purpose of this study is to investigate the effects of multiple-trough sampling design and nonlinear mixed effect modeling (NONMEM) algorithm on the estimation of population and individual pharmacokinetic parameters. Oxcarbazepine and tacrolimus were used as one-compartment and two-compartment model drugs, respectively. Seven sampling designs were investigated using various number of trough concentrations per individual ranging from 1-4. Monte Carlo simulations were performed to produce state-steady trough concentrations. One-compartment model was used to fit simulated data from oxcarbazepine and tacrolimus. The accuracy and precision of the estimated parameters were evaluated using the median prediction error (PE), the median absolute PE and boxplot. The results indicated that trough concentrations could yield reliable estimates of apparent clearance (CL/F). For oxcarbazepine, as the number of trough concentrations per subject increased, the accuracy and precision of CL/F, between-subject variability (BSV) of CL/F and residual variability (RUV) tended to be improved. For tacrolimus, however, although no improvement were observed in the accuracy of CL/F and BSV of CL/F, the PE distribution ranges were significantly narrowed and the RUV estimates were less bias and imprecise. In terms of algorithm, Monte Carlo importance sampling (IMP) and IMP assisted by mode a posteriori estimation (IMPMAP) were consistently better than other methods. Additionally, the sampling design had no significant effects on the individual parameter estimates, which were only depended on the interaction between BSV and RUV in various algorithms. Decreased in BSV and RUV levels can improve the accuracy and precision of the estimation for both population and individual pharmacokinetic parameter estimates.
Algorithms ; Bayes Theorem ; Carbamazepine ; analogs & derivatives ; pharmacokinetics ; Humans ; Immunosuppressive Agents ; pharmacokinetics ; Models, Biological ; Monte Carlo Method ; Nonlinear Dynamics ; Regression Analysis ; Tacrolimus ; pharmacokinetics

Since Hosobuchi first found that spinal cord stimulation had the effect of significantly increasing cerebral blood flow (CBF) more than two decades ago, spinal cord stimulation had attracted wide attention in the field of treating cerebral ischemia. A large number of animal and clinical studies have been performed in this field, which make it another research focus following thrombolysis and interventional therapy. This article reviews the research history, mechanisms, and current status of clinical applications of spinal cord stimulation in cerebral ischemia protection.

Objective To investigate the influence of smoking,drinking cognition and behavior among the officers and soldiers in South China War Zone after health management,and to explore the establishrent of appropriate health management model for the army.Methods Harmfulness cognition,rate,quantity,types of drinking and smoking were investigated and analyzed before and after health management among 1 102 officers and soldiers in South China War Zone by providing a set of health education,psychological counseling service,disease and lifestyle intervention of health management as a whole.Results The harmfulness cognition rate of smoking and drinking raised from 95.6％ and 94.1％ to 98.7％ and 97.8％,the smoking and drinking rate dropped from 64.7％ and 72.6％ to 37.2％ and 61.4％ after health management.The x2 values were 18,18.9,153,20.8,and had significant difference (P＜0.001).The rate of occasional smoking,a small amount of smoking,often smoking dropped from 28.3％,25.8％,45.9％ to 18.5％,12.2％,31.5％ as well as the rate of occasional drinking,a small amount of drinking,often drinking has dropped from 56.6％,32.3％,11.1％ to 49.8％,23.4％,4.1％.The x2 values were 26.8,62.1,31,9.61,8.06,19.4,and had significant difference (all P＜0.01).Conclusion The health management improves the harmfulness cognition of smoking and drinking,and decreases the rate and quantity of smoking and driking.It has a positive effect on improving the heahh literacy and developing health way of life in officers and soldiers.