The score of the final test papers of rehabilitation medicine among the fiveyear prgram clinical students of Grade 2005 in our university were analyzed,which showed that the test paper had the degree of difficulty and discrimination was good,which reflected the students’real level.And at the same time we found that students could not to make good use of learning to analyze and work out a solution. Therefore,we should pay attention to the combination between teaching and clinical practice,increase student’chance of learning on the job, and properly append such subjects as application, synthetic and evaluation in the test papers.

Objective To determine the relationship between the levels of serum cortisol and patent conducted.Thirty-eight pairs of preterm infants were selected from January 1 to December 31 in 2009.Thirty-eight preterm infants developed PDA.And we also selected 38 non-PDA preterm infants as the controls,who had the corresponding gestational age,same exposure to antenatal steroid and sameechocardiography examination time.The serum cortisol concentrations of these infants were measured twice by chemiluminesence immunoassay.All data were analyzed via SPSS 13.0.Results No significant difference was found between PDA and control groups in demographic characteristics and influence factors for serum cortisol.The first mean level of serum cortisol in PDA group was (261.9± 229.6) nmol/L,significantly lower than that in control group [(379.8 ± 236.3) nmol/L] (t = 2.20,P = 0.03).Logisticregression analysis showed low serum cortisol concentrations at birth was risk factor for PDA in preterm infants(OR = 0.916,95% CI:0.854-0.983,P = 0.015).The second adjusted mean levels (95 % CI) of serum cortisol in PDA and control groups were 300.0 nmol/L(232.4-367.4 nmol/L) and 263.6 nmol/L (196.2-331.2 nmol/L),respectively.There was no significant difference between the two groups (t=0.537,P=0.466).Conclusions Low serum cortisol concentrations at birth is a risk factor for PDA in preterm infants,while the serum cortisol value may be not affected by PDA.

Patent ductus arteriosus(PDA) is a common condition in the premature infants. It is associated with an increase in mortality and sequelae in these infants. The various factors contributing to an patency of the ductus arteriosus in the preterm infants are involved in: insufficient histological development of ductus arteriosus, failure of remodeling theductus, abnormal sensitivity of the ductus to oxygen and vasoactive substances,and genes.

Objective To identify the association between antenatal exposure to magnesium was conducted on 93 preterm infants with PDA and 93 cases of matched controls without PDA hospitalized in our neonatal intensive care unit between January 2008 and December 2009. Information on antenatal exposure to magnesium sulfate, neonatal birth weight and other perinatal factors was collected and analyzed with univariate analysis, multivariate Logistic regression analysis. Results There were 51 preterm infants exposed to magnesium sulfate antenatally in PDA group and 34 infants in controls. The median (P25-P75) level of neonatal serum magnesium in PDA cases was 0.98 mmol/L (0. 92-1.32 mmol/L),significantly higher than that in controls [0. 90 mmol/L(0. 82-1.09) mmol/L](Z = 3.56, P=0.00). Logistic regression analysis showed that PDA in preterm infants was significantly associated with antenatal magnesium sulfate exposure(OR= 2. 646,95 %CI: 1. 356-5. 163,P=0.004), fetal distress (OR=7. 189, 95% CI:1. 209-42. 756, P=0. 030), neonatal birth weight (OR = 1. 842,95 % CI:1. 087-3. 438, P = 0. 049 ), respiratory failure (OR = 3. 499,95 % CI:1. 256-9. 752, P=0. 017)and postnatal oxygen inhalation (OR=0. 482,95% CI:0. 233-0. 999, P=0. 045).Also, a significant positive correlation was found between PDA and the dose of magnesium sulfate and the concentrations of serum magnesium in preterm infants (x2trend =7. 41, P=0.007; x2trend = 12. 13, P=0.000).Conclusions Antenatal exposure to magnesium sulfate might increase the risk of PDA in preterm infants.

Objective To evaluate the benefits of fluconazole prophylaxis in preventing fungal infection in high risk premature infants using broad-spectrum antibiotics consecutively more than 10 days. Methods From October 2007 to September 2009, 164 preterm infants in high risk of fungal infection using broad-spectrum antibiotics consecutively more than 10 days were eligible for the study. Eighty-five infants,hospitalized from October 2008 to September 2009, were in the fluconazole group and were administered intravenously 3 mg/kg fluconazole every day for three days since the 11th day of antibiotic course. The other 79 infants, hospitalized from October 2007 to September 2008, were in the control group with no fluconazole administration. Fungal infection and colonizations and common complications were observed in the two groups. Results Fungal infection occured in six infants in the control group and none in the fluconazole group(χ2 = 4. 719,P = 0.03). There were no significant differences between the two groups in fungal colonization(χ2 =0. 175,P = 0. 675). No adverse effects of fluconazole therapy were documented. Conclusions Fluconazole prophylaxis may reduce the risk for fungal infection in high risk preterm infants.

Objective Appraising the clinical curative effect on the lower extremity serious deep venous thrombosis through thrombolytic arterial catheterization.Methods With Seldinger's technique, placing catheter into popliteal artery through the contralateral healthy side femaral artery and then dripping the thrombolitic agents into the thrombotic popliteal artery. Results The cure rate reached 87% in the treatment group and for the controll group was 30%,( P

The incidence of toileting problems is associated with the level of intellectual disability,and more common among the children with severe intellectual disability.This paper would review the classification,prevalence,consequences,origins of toileting problems,and also include the descriptions,assessment and practical considerations of behavioral interventions.

The incidence of thyroid cancer in South Korea increased 15 times over the past twenty years, that made South Korea became a country of the highest reported incidence in thyroid cancer all over the world. But the mortality of thyroid cancer was stable and unchanged. The incidence of thyroid cancer in our country was growing at an annual percentage change of 20. 1%. It is a generally accepted that the sharply increased incidence is attributed tooverdiagnosis. Here we introduced the definition of overdiagnosis of cancer and the current understanding in tumor field. The corresponding strategy in our country was proposed.

High performance liquid chromatography-time-off-flight mass spectrometer (HPLC-TOFMS) technology coupled with partial least squares discriminant analysis (PLS-DA) processed by SIMCA-P software was applied to investigate serum endogenous metabolites alternations of valsartan in spontaneous hypertension rats (SHR). And MetPA platform was used to connect identified potential biomarkers in corresponding metabolic pathways to find possible therapeutic mechanism of valsartan. Valsartan significantly declined the blood pressure of SHRs (P < 0.05) at fourth week. The metabolic profiling significantly changed and four metabolites involved in G protein-coupled pathway were identified. Metabolomics is able to detect holistic and microcosmic alternations in organism, so as to elucidate therapeutic mechanism of drugs.

Objective:The glucemic index(GI)and insulin index(II)of wheat flour, oat fiber and resistant starch (RS) were studied.Method:Ten healthy subjects consumed 4 kinds of carbohydrate foods: glucose powder,wheat flour food, oat fiber food and RS food.Up to 120 min after consumption of test materials, blood samples were taken for glucose and insulin analyses.Results:The GI value of wheat flour food, oat fiber food, RS food was 88.24?20.84,60.16?14.16,47.05?10.22 respectively,regarding glucose powder as 100 . The II value of them was 83.06 ? 10.68 , 68.32 ? 17.08, 60.26 ? 30.1 respectively.The area and peak level under the glucose-response curve and insulin-response curve of RS food were significantly lower than those of glucose powder and wheat flour food (P