Excellent mutilmedia courseware is the base to ensure teaching effect. Making excellent mutilmedia courseware by Director can make mutilmedia courseware more beautiful and have much more interaction and expressive force.

In order to further promote friendly cooperation with developing countries, Chinese government has been committed to increasing the intensity of cooperation and human resource development among developing countries. Healthcare is one of the key areas of China’s foreign aid. This article described the general conditions and experiences of national foreign aid training projects for developing countries undertaken by the Beijing Traditional Chinese Medicine Hospital and Beijing Traditional Chinese Medicine Research Institute. From aspects of participant enrollment, training program implementation, and training feedback, the training mode of national foreign aid on traditional medicine was introduced. This article focused on the selection of teachers, preparation of professional textbooks, and evaluation of teaching quality. Training programs over the years were guided by clear training concepts and accurate goal settings, which provided a useful exploration for the personnel training mode of national foreign aid on traditional medicine.

With the rapid development of critical care medicine (CCM) in China, there are increases in the number of intensive care units (ICUs), the scale of one center ICU and the team. Subspecialty construction of CCM is of great concerns for personnel training as well as discipline development, and is currently one of the urgent problems that need to be resolved. Experience of CCM subspecialty construction from Europe and the United States is lacking and it is necessary to propose some opinions on innovation to construct CCM subspecialties with Chinese characteristics. We believe that CCM sub-specialties construction should be based on the core knowledge (pathophysiology) and skill (organ monitoring and support). The following 7 sub-specialties can be set up: ① acute lung injury and mechanical ventilation; ② shock, hemodynamic monitoring and treatment; ③ acute kidney injury and blood purification; ④ sepsis and anti-infective therapy; ⑤ stress, sedation and analgesia; ⑥ nutrition and metabolic support; ⑦ coagulation, immune and inflammation. The core knowledge and skills of critical care medicine will constantly be updated and enriched. Therefore, sub-specialty settings should be constantly updated as well.

Objective To screen the preparation process of 3,4,3″-trihydroxy p-terphenyl nanosuspension. Methods The nanosuspension was prepared in combination with the nanoprecipitation and microfluidization method. Taken the particle size for indicator, we investigated the stirring speed and precipitation temperature in the nanoprecipitation process, the homogeneous stress and cycles in the microfluidic process through single factor experiment. In addition, by factorial design, the variety and dosage of stabilizers are investigated. Results The excellent preparation condition of the nanosuspension are as follows: 0 ℃ for the precipitation temperature, 900 rpm for the stirring speed, 1600 bar for the microfluidization pressure and 12 times for cycles. The ingredient ratio for drug: poloxamer 188: lecithin is 1: 0.8: 0.8. Conclusion Through optimizing the preparation technology, we have successfully prepared nanosuspension with lower size , which will lay a foundation for further study.

Objective To study on the correlation between plasma homocysteine (Hcy),folate acid(FA) and vitamin B12(VitB12) levels and vascular dementia (VD).Methods To measure plasma Hcy, FA and vitamin B12 in 96 patients with VD ,in 152 non-dementia cerebrovascular disease ( NDCVD ) and in 80 normal controls re-spectively,and results werw compared between each two groups by using student test .Cognitive status was evaluar by using mini mentai state examination(MMSE).The effect of Hcy,FA and VitB12 on VD and its cognitive function were analyzed.Results The levels of plasma Hcy in VD and NDCVD were higher than those in normal control grop ,and there was significantly difference (t=3.26,3.14,all P<0.01),and the best high one is VD;The levels of plasma FA and VitB12 in VD and NDCVD were lower than those in normal control grop ,and there was significantly difference ( t=3.16,2.98,3.21,2.91,all P<0.01),and the best low one is VD.The levels of plasma Hcy concentrations were in-creased and MMSE scores were decreased with severity of dementia , and there were negative correlation between MMSE scores and plasma Hcy concentrations (r=-0.69,P<0.05).Conclusion The levels of plasma Hcy corre-lated with VD.High-Hcy is one of possible rise factor for VD in senior .Both low-FA and low-VitB12 were indirect fac-tors for VD.

Neonatal respiratory distress syndrome (RDS) is most common in premature infants,the smaller the gestational age,the higher the incidence.Continuous positive airway pressure (CPAP) started in the delivery room has been shown in multicentre randomized controlled trials to reduce the need for mechanical ventilation (MV) and surfactant.The European Consensus Guidelines on the Management of Neonatal Respiratory Distress Syndrome in Preterm Infants-2013 Update recommended that CPAP should be started from birth in all babies at risk of RDS and a starting pressure of at least 6 cmH2O(1 cmH2O =0.098 kPa)should be applied.CPAP with early rescue surfactant should be considered the optimal management for babies with RDS.Using CPAP immediately after birth with subsequent selective surfactant administration may be considered as an alternative to routine intubation with prophylactic or early surfactant administration in preterm infants.If endotracheal intubation is needed,early administration of surfactant is preferable.Nasal intermittent positive pressure ventilation may reduce the risk of extubation failure in babies failing on CPAP.Several strategies have been employed specifically to improve the success of noninvasive ventilation and shorten the duration of MV.Caffeine should be used to facilitate weaning from MV and to reduce bronchopulmonary dysplasia.A short tapering course of low-or very low-dose dexamethasone should be considered to facilitate extubation in babies who remain on MV after 1 ～ 2 weeks.Very early steroid treatment and treatment with high doses cannot be recommended.

Objective To investigate the efficacy of conservative treatment with laparoscopy for patients with ectopic pregnancy.Methods From January 2000 to December 2005,76 patients with ectopic pregnancy received conservative treatment by laparoscopy in our hospital.The data of the patients were analyzed retrospectively.Results In this series,fenestration of the Fallopian tube was performed on 42 cases,salpingostomy on 21,fimbrial expression on 8,and segmental resection and end-to-end anastomosis on 5.Salpingography showed that the Fallopian tube was patent after the operation in all of the patients.The mean operation time was(58.5?19.4) minutes(ranged from 35 to 105).The serum level of ?-hCG decreased to a normal range in 3 weeks postoperation.Follow-up was available in 61 cases for 1 year,during which 35 of the cases(57.4%,35/61) had intrauterine pregnancy;2(3.3%) had spontaneous abortion,and 2(3.3%) showed ectopic pregnancy;the other 22(36.1%) had no pregnancy.Conclusions Conservative treatment by laparoscopy is safe and effective for ectopic pregnancy.To avoid repeated ectopic pregnancy,?-hCG monitoring after the operation is necessary.

Through the network medical teaching and guidance system,the live video of clinical medicine activity can be multicast by MPEG2 code and MPEG4 code simultaneously on the LAN or WAN.It may meet the request of different network bandwidth,realize the bidirectional audio or video frequency at the same time,and satisfy the clinical teaching or guidance need.The client port can be deployed in the random terminal on LAN or WAN,while the user with the authorization can see the high clear surgery image in real time at any place,make communication through the bidirectional audio and video system,and even remotely control the camera's lens angle and focus for perfect video effect.

OBJECTIVE:To investigate therapy efficacy of large-dose of methylprednisolone plus therapy for acute myelitis, and it effects on nerve function recovery,pyramidal tract conduction function and sensory disturbance. METHODS:A total of 116 patients with acute myelitis were randomly divided into observation group and control group,with 58 cases in each group. Both group received conventional treatment. Control group was additionally given Dexamethasone sodium phosphate injection 0.4 mg/(kg·d)intravenously,once a day;7 d later,they were given Methylprednisolone tablet 60 mg,orally,qd,gradually decreasing to 5 mg/d. Observation group was given Methylprednisolone sodium succinate injection 1000 mg intravenously,once a day;7 d lat-er,they were given Methylprednisolone tablet 60 mg,orally,qd,gradually decreasing to 5 mg/d. The treatment course in eaeh group was 1 month. The nerve function recovery time,pyramidal tract conduction function,sensory disturbance scores,clinical ef-ficacy and ADR were compared between 2 groups. RESULTS:After treatment,the response rate of observation group was signifi-cantly higher than that of control group(93.10% vs. 79.31%);the time of muscle strength improvement≥grade 2,walking down the ground,urination and defecation function recovery in observation group were all significantly shorter than control group,with statistical significance(P<0.05). Before treatment,there was no statistical significance in lower limb cone conduction latency,am-plitude of pyramidal tract conduction,scores of sensation,sense of pain and touch between 2 groups. After treatment,lower limb cone conduction latency of 2 groups were significantly lower than before,and the observation group was significantly lower than the control group,the amplitude of pyramidal tract conduction,scores of sensation,sense of pain and touch in 2 groups were sig-nificantly higher than before,and the observation group was significantly higher than the control group,with statistical significance (P<0.05). There was no significant difference in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:Based on conventional treatment,large-dose of methylprednisolone plus therapy shows good efficacy in the treatment of acute myelitis,which can helps to improve pyramidal tract conduction function of patients with acute myelitis,ease sensory disturbance,promote the nerve functional recovery with good safety.

BACKGROUND: Disturbance of lipid metabolism is responsible for many kinds of diseases, and to screen safe and effective prescription for lipid reduction has clinical significance.OBJECTIVE: To study the influence of puerarin-arginine composition on lipid metabolism in rats.DESIGN: Comparative observing study based on animal model.SETTING: Experimental animal center and department of biochemistry in a military hospital of Chinese PLA.MATERIALS: This study was carried out at the Experimental Animal Center and Department of Biochemistry of the General Military Hospital of Chinese PLA between May and August 2004. Eighty Wistar rats were randomly divided into high dosage, middle dosage, low dosage group and control group with 10 male and 10 female rats each.METHODS: Rats took food freely, and experimental groups were supplemented with puerarine-arginine composition of different dosage (0, 0.93,1.39 and 1.85 g/kg) for observing the influence on rats.MAIN OUTCOME MEASURES:① blood parameters; ② change of body mass and utilization rate of food; ③ parameters of vital organs;④histopathological changes.RESULTS: From onset of the second week, body mass of both male and female rats in experimental groups were found obviously lower than those in control group. The levels of blood cholesterol in female rats were(1.63 ±0.20) and (1.29 ±0.23) mmol/L in 0.93 g/kg dosage group and control group respectively, and were(1.75 ±0. 13) and(1.31 ±0. 19) mmol/L in male rats,and both have statistical significance( F = 6.43, 6. 58, P ＜ 0. 05).Fatty parameters of the three experimental groups were found obviously lower as comparing with those of control group.CONCLUSION: Such composition has been proved to be able to exert function in lipid reduction by decreasing body mass, and improving utilization rate of food and proportion of cholesterol and organic fat.