The article discusses the integration of the contents on the human anatomy and medical imaging.Through construction of the human anatomy and medical imaging course system and the implementation of teaching,we have overcome the defects of separation of anatomy and medical imaging knowledge and received better teaching results.

Objective To evaluate the efficacy of ambroxol on community acquired pneumonia (CAP) in elderly patients.Methods Totally 120 patients with CAP were selected and divided into 3 groups:low-dose group (patients received ambroxol 15 mg intravenously,3 times per day,n=40),conventional-dose group (patients received ambroxol 30 mg intravenously,3 times per day,n=40)and control group (patients received routine treatment including antibiotic therapy and oxygen inhalation,n=40).All patients were treated for 7 days.The levels of white blood cell (WBC),high sensitivity C-reactive protein (hs-CRP) and procalcitonin (PCT) were determined dynamically during the treatment.Results The markedly efficient rate,efficient rate and inefficient rate were 62.5％ (25/40),15.0％ (6/40) and 22.5％ (9/40) in low-dose group,82.5％ (33/40),15.0％ (6/40) and 2.5％ (1/40) in conventional-dose group,40％ (16/40),15.0％ (6/40) and 45.0％ (18/40) in control group,respectively.The total efficient rates were 77.5％,97.5％ and 55.0％ in low dose,conventional dose and control groups,respectively.The markedly efficient rate was higher in lowdose,conventional-dose groups than in control group (x2 =15.29,P＜0.05).There was a significant difference in markedly efficient rate between low dose and conventional-dose groups (x2 =4.01,P＜ 0.05).The total efficient rate was higher in low-dose,conventional-dose groups than in control group (x2 20.22,P＜0.05).There was a significant difference in total efficient rate between low dose and conventional-dose groups (x2=7.31,P＜0.05).Compared with before treatment,the levels of WBC,hs CRP and PCT were decreased in 3 groups after treatment (all P＜0.05).The levels of WBC,hsCRP and PCT were decreased more remarkably in low dose,conventional-dose groups than in control group (all P＜0.05).There was a significant difference in the decrease of WBC,hs-CRP and PCT levels between low-dose and conventional-dose groups (all P＜0.05).Conclusions Conventional dose ambroxol treatment (30 mg,iv,3 times/d) is an efficient therapy for community acquired pneumonia in elderly patients.

From the Government’s fully guarantee stage to the stage of independent organization of medicine, then to the market-oriented reforms and the new health care reform exploration stages, the public hospitals reform fol-lows different institutional logics, but the institutional dilemma have emerged at all stages including the little coupling between the institutional arrangements and environment, the public welfare and benefit wandering, the management system instability, and the breakdown of the financial investment and control costs mechanisms. The Government should elaborate conditions for the spontaneous public hospitals reform on the institutional environment in order to em-bed intrinsic motivation of the induced institutional change into the imposed institutional change. There should be positive interaction between the government and the market in order to form a reasonable and orderly competitive land-scape to the market of medical services. Payment should be reformed which has significant influence on internal medi-cal service system incentives.

Objective: To investigate the changes of gastric intramucosal pH(pHi)and the association with hemody namics and oxygen utilization during cardiopulmonary bypass (CPB). Method: Adults (n=15)free of hepatic, pulmonary,and renal diseases undergoing nonemergent heart surgery,were selected. After induction of general anesthesia and endotracheal intubation,a tonometer nasogastric tube was positioned in the stomach to determine the intramucosal pH. Hemodynamics and oxygen utilization data and phi were measured at four times:30 minutes after induction of anesthesia; 15 minutes after termination of cardiopulmonary bypass; at the terminal of the surgery;and 1 day after the surgery. Result: Cardiac index significantly increased(P

Objective To investigate the expression of ICAM-1 and VCAM-1 in colorectal carcinoma and the rela-tionship between ICAM-1, VCAM-1 and the occurrence, the metastasis of colorectal carcinoma, and to analyze the significance. Methods Immunohistochemistry staining(S-P method) was used to detect the expression of ICAM-1 and VCAM-1 on consecutive section in 78 cases of colorectal carcinoma and normal mucosa and 42 cases of colorec-tal adenomas. Plasma was obtained from 78 patients with colorectal carcinoma and 40 healthy volunteers prior sur-gery, by an enzyme-linked immunosorbent assay (ELISA). Results There was significant difference between the high expression of ICAM-1 and VCAM-1 in colorectal carcinoma and the low expression in normal mucosa and ade-noma(P < 0. 01). Serum ICAM-1 and VCAM-1 were significantly higher in patients with colorectal carcinoma than those in normal control group(P < 0. 01). The ICAM-1 and VCAM-1 levels were not related to sex, age, tumor lo-cation and histological grades(P > 0. 05),but had significantly statistical difference between lymph node metastasis and Dukes stage(P < 0. 01). Conclusion The increase expression of ICAM-1 and VCAM-1 in colorectal cancer suggests that the ICAM-1 and VCAM-1 may play an important role in evaluation of malignant degree and judging the progress as well as the mechanism of colorectal cancer.

In the use of antiepileptic drugs in patients with epilepsy,1/3 of the patients with epilepsy can not get effective control,showing resistance to antiepileptic drugs.Now the mechanism of drug resistance is considered to be caused by multiple factors work together.The concept and connotation between drug-resistant epilepsy and refractory epilepsy are different.Since 2010,the international union of antiepileptic proposeddrug-resistant epilepsy expert consensus,different medical centers use the new defition to study different populations and confirm that the new definition is effective and reliable.However,there are some controversier about the drug dosage,drug kinds,judge for determining evaluation index and the treatment judgement in that definition.

Biofilm formation makes bacteria adopt a multicellular lifestyle.Compared to planktonic cells, biofilm-grown cells express an increased resistance to antimicrobial agents.Bacterial biofilm formation is a crucial step in the pathogenesis of many subacute and chronic bacterial infections.In clinical setting, biofilm can cause bacterial biofilm disease and biomaterial associated infection.Understanding the mechanisms involved in biofilm-associated antimicrobial resistance is key to the development of new solutions.

Food Safety ; International Cooperation ; Risk Assessment

Cervical anterior decompression and fusion is currently used in the treatment of cervical spondylosis.This paper reviews the surgical complications and its prevention measures,so as to provide some references to reduce the complications and improve operative efficacy.