30 cases of tumors on the base of the skull were reported. The symptoms and signs, the pathological types and the relationship between the location. and the histological findings of these tumors were analysed. 40 operations were carried out on 26 patients. 2/26 patients died postoperatively, the operative mortality was 7.7%.The choice of the operative procedure depended upon the tumor's location, size, nature and consistency, we suggested that the operative procedure of choice should be transcranial resection for the tumors located at the anterior or lateral region of the base of the skull, or at the cerebellepontine angle, because it would offer a wider operative field without any important structures there.The dumbbell tumors involving both intracranially and extracranially were difficult to remove. In such a case it was necessary for the neurosurgeon to cel-laberate with the otolaryngologist. The operative procedure in two stages was successful with no complication.

Among 109 patienta with basilar fracture of skull, 24 with special complications were analysed retrospectively, The complications included: delayed severe intracranial infection or brain abscess (7 cases), intracranial artery damage (9 cases), multiple cranial nerve injury (5 cases), and acute massive rhinorrhea and pneumocephalus (3 cases). Thirteen patients were operated on with various methods according to the clinical diagnosis. The relations between the biophysiological nature of the base of the skull and the mechanism of the complications were discussed. Forehead injury may cause "craniofacial cleavage fracture", and unilateral or bilateral temporal crush may caues "hinge fracture". All the basilar fractures mentioned above may damage the internal carotid artery and cranial nerves.

Objective To investigate the clinical effect of ulinastatin treating systemic inflammatory response in the patients with serious blood infection .Methods The patients with serious blood infection in our hospital were selected and divided into the control group and observation group .The control group was treated with the conventional treatment ,while on this basis the observation group was added with ulinastatin .The body temperature ,heart rate ,respiratory rate ,WBC ,Scr ,CRP ,PCT ,TNF-α,APACHE Ⅱscore and mortality rate were compared between the two groups .Results The body temperature ,heart rate ,respiratory rate and A-PACHE Ⅱ score in the observation group were lower than those in the control group ,moreover ,the levels of WBC ,CRP ,PCT , TNF-αand Scr ,and mortality rate in the observation group were lower than those in the control group ,the differences were statisti-cally significant (P<0 .05) .Conclusion Uinastatin has good effect for treating systemic inflammatory response in the patients with serious blood infection ,which can decrease the mortality and is worth clinical promotion .

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.

Attention deficit hyperactivity disorder(ADHD) is one of the most common psychiatric disorders among school-age children.The diagnosis and treatment of ADHD rely on a comprehensive evaluation of symptom,functional impairment and comorbidity.Therefore the standardized rating scales is widely used clinically.The standardized rating scales can be categorized into: Broad-band scales,evaluating the general misbehavior and sociopsychological functions andNarrow-band scales,evaluating ADHD specific symptoms,and also functional impairment rating scales.Useful comorbidity and functional impairment rating scales are in need domestically.This paper reviewed the published literature about the clinical application and progression of frequently-used rating scales for school-age ADHD evaluation,at home and abroad.

Objective To explore the application effect of strengthened pulmonary rehabilitation exercise in lung cancer patients with severe pulmonary ventilation dysfunction during perioperative period. Methods A total of 96 patients receiving lung cancer radical treatment under thoracoscope in our hospital during March 2013 to April 2015 were collected, and for all these patients, pulmonary function test before treatment showed that there was severe pulmonary ventilation dysfunction. The patients were divided into the routine group and the intervention group by random digital table method, with 48 patients in each group;patients in the routine group received routine perioperative nursing, and those in the intervention group received the strengthened pulmonary rehabilitation intervention plan; change in pulmonary function before treatment, duration of mechanical ventilation, time of oxygen therapy, retaining time of chest tube, length of hospital stay and occurrence of complications after treatment were compared between the two groups. Results After strengthened pulmonary rehabilitation intervention in the intervention group, the FVC was (2.63±0.47) L, the MVV was(53.14±9.40) L, the DLCO was(19.26±2.63) ml·min-1·mmHg-1, the VO2 was (23.15±4.36) ml/kg and the O2Pulse was(10.98±2.52) ml·min-1·times-1, Which were significantly improved compared with those before treatment, (2.41±0.40) L,(46.98±8.91) L,(17.56±2.83) ml·min -1·mmHg -1, (20.17±4.35)ml/kg and(9.82±2.07) ml·min-1·times-1, t=2.521, 3.512, 3.112, 3.421, 2.515, P<0.01 or 0.05. While there was no obvious change in the above- mentioned indexes of those in the routine group. After treatment of patients in the intervention group the duration of mechanical ventilation was (9.42±3.17) hours, time of oxygen therapy was (76.23±21.18) hours, retaining time of chest tube was (3.58±1.44) days and length of hospital stay was (6.62±2.14) days, which were significantly shorter than those in the routine group, (17.29±4.79) hours,(92.14±24.29) hours, (4.73±2.15) days and(8.68±2.96) days. The occurrence rates of complications such as pulmonary infection, pulmonary atelectasis and respiratory failure were 12.50%(6/48),10.42%(5/48) and 4.17%(2/48)in the intervention group, significantly lower than those in the routine group, 41.67%(20/48),29.17%(14/48) and 18.75%(9/48), χ2=10.338, 5.315, 5.031, P <0.01 or 0.05. Conclusions Strengthened pulmonary rehabilitation intervention can improve pulmonary function of lung cancer patients with severe pulmonary ventilation dysfunction before treatment, reduce the occurrence rate of post- operative complications and enhance safety during the perioperative period; it is worth of being further promoted clinically.

Objective Streptococcus sanguis is a possible candidate bacterium for the caries replacement therapy, which has no advantages in the acidic environment.The aim of the study was to construct acid-resistant strains of Streptococcus sanguis, determine its acid tolerance, and explore the mechanism of its antagonism against Sterptococcus mutans.Methods By gradually reducing the pH value of the medium, we constructed acid-resistant strains of Streptococcus sanguis, observed their growth and measured their acid tolerance according to their survival rate against lethal pH.We evaluated the competitive relationship between Streptococcus sanguis and Streptococcus mutans by plate experiment and detected the changes of related acid resistance genes by real-time quantitative PCR.Results The growth of Streptococcus sanguis and its acid-resistant strains were limited by the pH value, and that of Streptococcus sanguis was better in either acidic or normal environment.The lethal pH value of Streptococcus sanguis was 3.6, that of its acid-resistant strains was 2.3, and the survival rate of the acid-resistant strains was 66.59% in the pH 3.6 environment.In comparison, the lethal pH value of Streptococcus mutans was 2.5, that of its acid-resistant strains was 2.1, and the survival rate of the acid-resistant strains was 2.55% in the pH 2.5 environment.In the presence of chloramphenicol, the acid-resistant strains could not survive in the original lethal pH.In the sub-lethal pH environment, the expressions of the acid resistance-related genes Groel and Dnak in the acid-resistant strains were significantly up-regulated as compared with those in the original Streptococcus sanguis (P<0.05).Conclusion Streptococcus sanguis has an acid adaptability and can enhance acid resistance in the sub-lethal pH environment.Acid-resistant Streptococcus sanguis in the replacement therapy may provide some new ideas for the treatment of dental caries.

Affiliated Hospital. Second Military Medical College. ShanghaiForty-two cases of chronic subdural hematoma were treated by irrigation and drainage. Symptoms of elevated intracranial -pressure, localizing neurologic signs and cerebral angiography established the diagnosis. Operative treatment consisted of evacuation of the hematoma by repeated irrigation through burr holes made on the frontal and parietal side of the hematoma. A plastic tube was placed through the parietal hole for continuous drainage for three to four days. The above mentioned treatment is simple to perform and rather safe even for the senile and debilitated patients. Among 44 patients all 19 preoperatively unconscious patients regained consciousness postoperatively. Twenty-three cases were followed up from one to seventeen years. All patients recovered completely without recurrence of hema-toma or epilepsy, except one patient who is still having hemiparesis at present.

Objective:To seek the best part and optimal culture medium for the tissue culture of Bletilla striata. Methods: The effects of hormone concentration and proportion on the induced differentiation, propagation and rootage of Bletilla striata were investiga-ted. Results:The radicle of Bletilla striata was the best part to induce the clustered shoots with the optimal culture medium of 1/2MS+1. 0 mg·L-1 6-BA+2. 0 mg·L-1 NAA. The best hormone concentration for inducing the clustered shoots was MS+1. 0 mg·-1 L 6-BA+0. 05 mg·L-1 NAA, and the optimal rooting medium was 1/2MS+0. 5 mg·L-1 NAA. Conclusion: The tissue culture system for Bletilla striata is established.