Through studying Marxism philosophy,medical graduate students can master scientific methodology and dialectic thought.This is helpful to analyze and comprehend rightly different kind of complicated issues and to improve cognition level and practice ability.It is also very important for medical graduate students to guide political education and moral cultivation,medical practice and science research.

Bile dut injury (BDI) is one of the severe complications of laparoscopic cholecystectomy (LC).The classification,diagnosis and treatment of the BDI caused by LC are partly controversial.The most efficient classification of the BDI is Strasberg-Bismuth's classification and the three modes and four classes developed by the Biliary Surgery Group of Surgery Branch of Chinese Medical Association.Although the success rate of intraoperative diagnosis for the BDI is very low,in most cases,the BDI is diagnosed by clinical manifestations and assistant examinations.Accurate classification and early diagnosis could help us to make a specific one for each patient according to certain situation.In this review,we focus on the classification,diagnosis and treatment of the BDI caused by LC.

Objective To assess the clinical feasibility and safety of coronary artery angiography(CAG) and intervention through transradial approach. Methods 134 patients received coronary artery angiography and interventions through transradial approach were selected. The complications such as hematoma, thrombus were observed. Results Transradial puncture succeed in 126 cases, the successful rate of transradial coronary intervention was 94.0%.The complication occurred in 12 patients (8.9%). Conclusion This investigation demonstrated the safety and feasibility of transradial approach for coronary angiography with less procedure complications and pain for patient.

Hedgehog( Hh)signaling pathway is evolutionarily conserved in vertebrates,its excessive activation is associated with abnormal cell differentiation, over proliferation, apoptosis resistance and promotion of invasion and metastasis of tumor cells. Hh signaling pathway involves in the formation and maintenance of esophageal columnar epithelium in embryonic stage,however,undetectable or barely expressed in matured esophageal squamous epithelium. Studies have shown that esophageal Hh signaling pathway can be activated by gastric acid and bile salts. Aberrant activation of Hh signaling pathway can cause the gradual transition of squamous epithelium to columnar epithelium and intestinal-type epithelium,ultimately induces the occurrence of Barrett’s esophagus( BE). Therefore,targeted inhibiting the Hh signaling pathway may be a new strategy for the treatment of BE. This article reviewed the advances in study on Hh signaling pathway in the pathogenesis of BE.

Objective To investigate the effect of tetramethylpyrazine(TMP), a traditional Chinese herbal medicine, on the neural injury caused by spinal cord ischemia and reperfusion in rabbit.Methods Twenty-two male New Zealand white rabbits were anesthetized with isoflurane. Spinal cord ischemia was induced by 20min by infra-renal aortic occlusion. Animals were randomly allocated to 3 groups. Group C received no pharmacologic intervention. Group P and T received 30 mg?kg -1 TMP infused iv at a constant rate over 30min before aortic crossclamping(prevention) and after reperfusion(therapeutic) respectively. Neurologic deficit was assessed at 4, 8, 12, 24 and 48h after reperfusion using neurologic dificit score(NDS 4 = normal, 0 = paraplegia) . The animals were sacrificed at 48h after reperfusion and spinal cords (L 5-7) were removed immediately for histopathologic study.Results All animals survived the experiment. The NDSs at each observation interval were significantly higher in group P and T than those in group C (P

Colorectal cancer remains a major threat to people’s health around the world. Researchers have paid more and more attention to colorectal cancer epigenetics. From two main aspects of colorectal cancer epigenetics: DNA methylation and histone modiifcation, this article analyzes the similarities and differences between patients with colorectal cancer in Eastern and Western countries. This review brielfy introduces epigenetic modiifcation of genes that were used to be biomarkers and therapeutic targets. Although there are some common features of colorectal cancer in the world, analysis has showed that some obvious epigenetic differences do exist in different races. For example, it had been conifrmed in the studies that there are differences in speciifc gene methylation, histone modiifcation sites and the degree of methylation and acetylation among countries, which provide the basis for speciifc diagnosis, treatment and prognosis of colorectal cancer in different ethnic groups. With improved research methods and increased sample size, more and more special molecular targets of colorectal cancer tissues will be found, and then personalized therapy for colorectal cancer can be achieved.

Objective To improve the biocompatibility of the metallic stent used for interventional treatment. Methods Inner coatings, outer coatings and micro-porous coatings were made using the solution-injection method, and salt crystallite with demanded size was added in order to develop micro-porous coatings. Results The optical concentrations of polyurethane solution and of salt crystallite (for micro-porous coatings) were obtained, and the corresponding processes were developed. Conclusion The poly-coated stent retains its elasticity, and it become very convenient to develop stents carrying drugs. Its effects on animals ard under test.

Objective To observe the effect of intravenous pre-injection of neostigmine on cardiovascular response(CVR) caused by neuromuscular electrical stimulation(NMES) in selective posterior rhizotomy(SPR) for patients with cerebral palsy.Methods 56 patients with cerebral palsy undergoing SPR at lumbarsacral segments under general anesthesia were randomly assigned to 2 groups: intravenous neostigmine 0.04 mg/kg(no more than 1 mg in total) and intravenous atropine 0.02 mg/kg(no more than 0.5 mg in total) 5 min before NMES in group N,and intravenous normal saline 0.12 ml/kg instead in group C.The systolic blood pressure(SBP) and heart rate(HR) at following time points: before skin incision(T1),before intravenous neostigmine/atropine or normal saline injection(T2),1 min after NMES(T3),and 10 min after NMES(T4).Results SBP and HR at T3 in group N were significantly lower than those in group C(P<0.01).No significant difference was found at T1,T2 and T4 between two groups(P>0.05).Cases who needed extra dose of fentanyl during NMES in group N were significantly lower than those in group C(P<0.01).Conclusion Intravenous pre-injection of neostigmine before NMES can effectively decrease the CVR caused by NMES.

ObjectiveTo evaluate the two common anesthesia techniques used in the hip joint replacement surgery (HJRS) and provide references to the most reasonable choice for them. MethodsTo undertake a retrospective study on 34 patients that received continuous epidural anesthesia(CEA) or combined intravenous and inhaled anesthesia(CIIA)respectively in HJRS. Results and Conclusions CEA had higher incidence of bone cement reaction than that of CIIA, whereas there was no significant difference in blood loss and the anesthesia efficacy between them. CIIA seemed to be easier to be performed. CIIA sounds more reasonable than CEA in HJRS although both of them are safe anesthesia techniques.

Objective To observe the effect of ropivacaine in infiltration anesthesia before the end of surgical procedures for postoperative analgesia on patients with spinal cord injury. Methods 60 patients with spinal cord injury undergoing internal fixation of spine fractures under combined general anesthesia were assigned in 3 groups, who received 0.25% ropivacaine in infiltration anesthesia (group RL, n=20),0.5% ropivacaine in infiltration anesthesia (group RM, n=20), or no infiltration anesthesia (group C, n=20) before the end of surgical procedures.The time for post-anesthesia recovery (PART), agitation score (AS), and Visual Analogue Score (VAS) for pain 2 h, 6 h, 24 h, and 48 h post operation were recorded, and related side effects were observed. Results AS within 6 h postoperation was significantly less in group RL and RM than in group C (P<0.05), as well as VAS, PART, mean of arterial pressure and heart rate 2 h, 6 h, and 24 h post operative (P<0.05).There was no significant difference in side effects including postoperative nausea and vomiting, and pruritus among these groups (P>0.05). Conclusion Ropivacaine in infiltration anesthesia would provide better postoperative analgesia, decrease the incidence of postoperative agitation, and increase the safety of patients with spinal cord injury in the postoperative period.