The apprentice system is the principal succession method of ancient Chinese medicine. Masters pass down knowledge via verbal instructions as well as personal deeds, and apprentices are unconsciously influenced deeply within by what they see and hear from masters. That is where the strong point of the system. However, at the same time, apprentices are confined by their master’s instructions and learn only a part of the knowledge. It is the profound meaning rather than the form, that truly represents the modern value of the system. Traditional Chinese medicine stresses the cultivation of medical ethics, purification of learning motivation, study of classic works, solid foundation of basic skills and clinical practice. It also advocates that apprentices should be led and taught in accordance to his aptitude.

Great achievements have been made on researches about Chinese Medicine education in modern Jiangsu Provice, which includes Shanghai and Nanjing before the year 1927. Through the researches, not only have volumes of valuable historical materials been saved and reorganized, but also plentiful academic achievements of high levels have been gained. However, generally speaking, the research work is not perfect enough. Much more progress can be made by further mining the historical materials, applying researh methods, developing different perspectives and so on.

Objective To assess the anticonvulsant effect of midazolam, thiopental and propofol on the convulsion induced by ropivacaine in rats and the underlying mechanism.Methods Fifty male SD rats, 4-6 months of age, weighing 250-300 g were randomly divided into five groups of 10 animals each : (1) control group (C); (2) ropivacaine group; (R) (3) midazolam-ropivacaine group (MR); (4) thiopental-ropivacaine group (SR) and (5) propofol-ropivacaine group (PR) . In control group normal saline 2 ml was infused i.v. . In ropivacaine group (R) 0.75% ropivacaine was infused i.v. at 0.5 ml?min-1 until convulsion occurred. In midazolam - ropivacaine group (MR) midazolam 0.23 mg?kg-1 was injected i.v. 3 min before 0.75% ropivacaine infusion. In SR and PR groups thiopental 2 mg?kg-1 or propofol 1 mg?kg-1 was injected i.v. 1 min before 0.75% ropivacaine infusion. As soon as convulsion occurred ropivacaine infusion was stopped. The animals were decapitated and their brains were removed and kept in liquid nitrogen for determination of the contents of excitatory ammo-acids (aspartic acid and glutamic acid) and the inhibitory amino-acids [glycine and ?-amino butyric acid (GABA)] by high-performance liquid chromatography . The amount of ropivacaine infused in each group was recorded and calculated.Results The dose of ropivacaine needed to produce convulsion was 4.6?0.5 mg?kg-1 in group R and was significantly increased in the 3 groups pretreated with general anesthetics and was 2.96 times the dose in group R in MR group, 2.84 times in SR group and 1.54 times in PR group. The 4 amino-acid concentrations in the brain were significantly higher in group R than in control group. Compared to group R the Asp, Gly and GABA concentrations were significantly lower in group MR and PR but in group SR only Asp concentration was significantly lower. There was no significant difference in glutamic acid concentration among the4 roopivacaine groups (group 2-5).Conclusion Midazolam, thiopental and propofol can all increase the dose of ropivacaine needed to induce convulsion and midazolam and thiopental are more effective than propofol.

OBJECTIVE: To observe the mouse nerve growth factor on early intervention in rats with acute carbon monoxide intoxication delayed encephalopathy control effects, and preliminarily discuss the pathogenesis of delayed encephalopathy. METHODS: Ninety-two weight only 180-230 g, male Wistar rats were randomly divided into two experimental groups (n=40), and a healthy control group (n=12), namely the CO poisoning group (COP) of the group; mouse nerve growth factor (NGF plays group); healthy controls (NC group). Experimental group was according to 150 mL·kg-1 intraperitoneal injections of CO in the preparation of animal model of acute carbon monoxide poisoning, in the control group rats were injected with equal volume of air. NGF group rats were injected within 30 min after poisoning muscle injection of mouse nerve growth factor, once a day, every time 18 μg·kg-1, total 7 days; Control group and the COP were given intramuscular isodose physiological saline. NGF group rats were treated with 18 μg·kg-1·d-1 NGF (total 7 times); NC group and COP group treated with the same dose saline. 90 min, 7 day, 14 day and 21 day groups of rats serum myelin basic protein (MBP) levels were monitored. The routine preparation of brain tissue frozen pathology slice, line HE and MBP immunohistochemical staining. Animal intelligence is assessed by Morris water maze experiment, in the 120 s in rats to determine correctly through the platform number less than 3 times DEACMP. RESULTS: All rats showed typical toxic after CO poisoning. Experimental group rats died 29, including COP death cases in the group, the model NGF group of 15, 14, mortality rates were 37.50%, 35.00% respectively. Morris water maze experiment results showed that the COP in the group 8 rats were judged to be delayed encephalopathy; model NGF group has 5 only be judged to be delayed encephalopathy; COP group rats serum MBP content increased significantly, model NGF group close to normal.Differences were obvious in poisoning after 7 days, 14 days.Pathological examination showed the COP group delayed encephalopathy rats in poisoning 90 min-21 d in hippocampus, subcortical neurons damage, such as myelin basic protein depigmentation pathological changes.The above pathological changes can be observed in each group, the COP group rats lesion severity is heavy, model NGF group was lighter. CONCLUSION: Mouse nerve growth factor can significantly reduce the incidence of delayed encephalopathy in rats, but can't reduce the mortality. Myelin basic protein (MBP) in the pathogenesis of delayed encephalopathy may play an important role.

Adult ; Decompression, Surgical ; methods ; Endoscopy ; Humans ; Male ; Middle Aged ; Optic Nerve ; surgery ; Optic Nerve Injuries ; surgery ; Young Adult

Objective To investigate the clinical effects differences of three-port and single-port invasively combination laparoscopic cholecystectomy and appendectomy in the treatment of acute appendicitis complicated with gallbladder stone. Methods 110 patients with acute appendicitis complicated with gallbladder stones from August 2012 to August 2015 were randomly divided into control group (55 patients) with three-port laparoscopic operation and observation group (55 patients) with single-port laparoscopic operation;and the clinical indexes for operation related, operation overall satisfaction score of Brown, the VAS score of depression and anxiety before and after operation and postoperative complications of both groups were compared. Results The incision length of observation group was significantly shorter than control group (P< 0.05). The operative time of observation group was significantly longer than control group (P < 0.05). The operation overall satisfaction of Brown of observation group was significantly higher than control group (P < 0.05). The VAS score of depression and anxiety after operation of observation group was significantly better than control group and before operation (P<0.05). There was no signiifcant difference in the incidence of postoperative complications between 2 groups (P < 0.05). Conclusion Compared with three-port laparoscopic operation, single-port invasively combination laparoscopic cholecystectomy and appendectomy in the treatment of acute appendicitis complicated with gallbladder stone can efifciently decrease the incision length, improve the aesthetic degree and postoperative negative emotions and not lead to increased risk of postoperative complications.

Increasing demand for health services brings an opportunity for the development of health service industry, and the development is based on qualified talent support from Traditional Chinese Medicine (TCM) education. This article expounded that developing health service is the realistic demand for deepening TCM education reform from the direction, number and quality of talent cultivation, and proposed the measures of deepening TCM education to train TCM health services: establish mechanism for co-ordination of supply and demand of TCM talents under the direction of market and guidance of government; form and optimize multilevel, multi-standard and multi-grade talent cultivation system; build talent evaluation mechanism and cultivation goals focusing on post competency.

Objective To investigate the significance of preserving the intercostobrachial nerve (ICBN) during axillary node clearance for breast cancer and share, some technical experiences of this procedure. Methods ICBN was preserved integally or partially in 78 patients of breast cancer (ICBN preserved group) and resected integrally (ICBN resected group) in 18 patients. Sensory disorders and motorial recoveries as well as tumor recurrence were compared between the two groups one week and one year after operation. Results Morbidity of sensory disorders in ICBN preserved group was less than that in ICBN resected group. Motorial recoveries were better in ICBN preserved patients without decreasing the number of axillary nodes resected and without increasing the recurrence of tumor. Conclusion ICBN should be preserved as far as possible during axillary node clearance for breast cancer.

Objective To investigate the infection of chlamydiae trachomahs(CT) and myoplasmas in urogenital tract and antibiotic susceptibility of cultured genital myoplasmas.Methods 5095 patients with urogenital tract infection were detected with mycoplasma identification susceptibility testing reagent kit,and the drug susceptibility to eight antibiotics of ureaplasma urealyticum (Uu) and mycoplasm hominid (Mh) were tested by broth microdilution method.And chlamydiae trachomatis was examined by golden standard method.Results In 5095 cases, 417cases(8 2%) were infected with chlamydiae trachomatis, and the infective rate in woman(11 2%) was statistically higher than that in man(6 2%). 1728 cases(33 9%) were infected with mycoplasma, and the infective rate in woman(43 0%) was statistically higher than that in man(28 0%).The cases infected with simple UU(1251,24 6%) were more than that in the cases infected with simple Mh(71,1 4%) and the mixed infected cases(406,8 0%). Drug sensitivity to erythromycin, roxithromycin, josamycin, azithromycin, doxycycline, minocin,ofloxacin, ciprofloxacin in Uu infection were 60 3%,67 5%,73 2%,85 3%,55 7%,40 1%,25 6%,2 7%,respectively;while the mixed infection of Mh and Uu had resistance to the eight antibiotics on the different degree.Conclusions The infective rate of chlamydiae trachomatis and myoplasma in urogential tract and the resistance rates to 8 antibiotics in Hunan province were in a higher level, compared with other area inland. It is necessary to develop antibiotic susceptibility test,in addition to the myoplasma culture for guiding the clinical therapy.

Objective To determine the protective effects of endotoxin preconditioning on the brain ischemic injury and explore its protective mechanism. Methods Global ischemia for 20 min by four-vessel occlusion model was used in 140 Wistar rats, in which 70 rats were pretreated with MPL at dose of 20 ?g/kg 24 h before global ischemia. Another 10 Wistar rats served as normal controls. Ischemic neurons and neuron density of the hippocampal CA1 region, MPO activity, TNF-? activity, IL-1? activity were assayed at 4, 12, 24, 48, 72, 120, 168 h after reperfusion. Results Pretreatment with endotoxin produced significant reductions in ischemic neuron number, MPO activity, TNF-? activity and IL-1? activity. Conclusion Endotoxin preconditioning protects brain from subsequent ischemic injury, in which the suppression of cellular inflammation may be the protective mechanism.