Raising students'divergent thinking should be combined with the whole college education.But for the medical students,it is more vital to realize the importance of divergent thinking,make full use of education resources in university,consciously urge themselves to break through the limits of routines,develop their divergent thinking and make various measures to reinforce the self-education of divergent thinking.

OBJECTIVE:To discuss the general pattern and the characteristics of quinolones-induced allergic shocks.ME_THODS:A total of 165 quinolones-induced allergic shock cases reported in the domestic periodicals in recent 10 years were statistically classified and analyzed.RESULTS:Ten kinds of quinolones involved allergy shocks with ciprofloxacin,ofloxacin and norfloxacin respectively dominated the first 3 places,which account for 69.70% of the total.The incidence of allergy shocks was the highest when used intravenously(64.85%),in particular within the first 30min(70.30%) with the mortality at 2.42%.CO_NCLUSION:Attention should be paid to severe adverse drug reactions in the clinic so as to ensure safe drug use.

Objective:To explore the relation between therapeutic effects of focused ultrasound(FU)on chronic cervicitis and local temperature rise.Methods:132 cases of chronic cervicitis were treated by FU and local temperature rise was measured. 120 patients were followed up regularly for the following 3 months to observe therapeutic effects and adverse effects.Results: The overall effective rate of FU in treatment of chronic cervicitis unitarily was 97.5%.When the temperature of targeted tissue immediately after FU exposure was between 40℃and 43℃,the therapeutic effects tended to he satisfactory(98.33%)with little adverse effects.Conclusion:A satisfactory therapeutic efficacy could be achieved with single session FU in treatment of chronic cervicitis.And local temperature rise measurement,as a quantification method,is helpful to improve the therapeutic effects.

Objective To explore the gene diagnosis of Gitelman syndrome.Methods The clinical data of a child with Gitelman syndrome were retrospectively analyzed along with gene detection results of his elder sister and parents.Results A 6-year-old boy was hospitalized for fever and hypokalemia.Gene detection of SLC12A found a new locus mutation of EXON21 c.2522A＞G p.(Asp841Gly) and a heterozygosis of EXON16 c.1946C＞T p.(Thr649Met).The diagnosis of Gitelman syndrome was confirmed.His mother carried a heterozygosis mutation of EXON21 c.2522A＞G p.(Asp841Gly),while his father and elder sister carried a heterozygosis mutation of EXON16 c.1946C＞T p.(Thr649Met).Conclusion Gene detection of SLC12A is helpful in the diagnosis of Gitelman syndrome.The newly discovered mutation of SLC12A3 gene has enriched the mutation spectrum of Gitelman syndrome.

Age-related macular degeneration ( AMD ) is one of a leading worldwide cause of blindness. AMD is a multifactorial disease, and major risk factors include increasing age, current smoking, previous cataract surgery, environmental factors, nutritional factors, genetic markers through genetic regulate complement, lipid, angiogenesis and extracellular matrix. In addition to treatment, epidemiology, risk factors and genetics research of AMD have been significantly progressed. This article will review risk factors of AMD.

OBJECTIVETo explore the improvement of hand motion function,spasm and self-care ability of daily life for stroke patients treated with floating-needle combined with rehabilitation training.

METHODSEighty hand spasm patients of post-stroke within one year after stroke were randomly divided into an observation group and a control group, 40 cases in each one. In the two groups, rehabilitation was adopted for eight weeks,once a day,40 min one time. In the observation group, based on the above treatment and according to muscle fascia trigger point, 2~3 points in both the internal and external sides of forearm were treated with floating-needle. The positive or passive flexion and extension of wrist and knuckle till the relief of spasm hand was combined. The floating-needle therapy was given for eight weeks, on the first three days once a day and later once every other day. Modified Ashworth Scale(MAS), activity of daily life(ADL, Barthel index) scores and Fugl-Meyer(FMA) scores were used to assess the spasm hand degree,activity of daily life and hand motion function before and after 7-day, 14-day and 8-week treatment.

RESULTSAfter 7-day, 14-day and 8-week treatment, MAS scores were apparently lower than those before treatment in the two groups(all P<0. 05), and Barthel scores and FMA scores were obviously higher than those before-treatment(all P<0. 05). After 14-day and 8-week treatment, FMA scores in the observation group were markedly higher than those in the control group(both P<0. 05).

CONCLUSIONFloating-needle therapy combined with rehabilitation training and simple rehabilitation training could both improve hand spasm degree, hand function and activity of daily life of post-stroke patients, but floating-needle therapy combined with rehabilitation training is superior to simple rehabilitation training for the improvement of hand function.

Acupuncture Therapy ; instrumentation ; methods ; Adult ; Aged ; Combined Modality Therapy ; Female ; Hand ; physiopathology ; Humans ; Male ; Middle Aged ; Needles ; Range of Motion, Articular ; Recovery of Function ; Stroke ; therapy ; Stroke Rehabilitation ; Treatment Outcome

Chronic kidney disease-mineral and bone disorder (CKD-MBD) refers to a series of clinical symptoms and biochemical and imaging abnormalities caused by minerals and calcium phosphorus metabolic disorder,which is associated with chronic kidney disease (CKD).Since 2006 ,the concept of CKD-MBD was put forward for the first time,doctors are increasingly paying more attention to it.This review introduces the epidemiological characteristics, clinical manifestation, examination methods, diagnostic criteria and the research progress of treatment and prevention of CKD-MBD.

Objective To explore the efficacy and safety of transjugular intrahepatic portosystemic shunt (TIPS) in the treatment of hepatorenal syndrome (HRS).Methods From January 2009 to December 2012,the clinical data of three type 1 HRS cases and five type 2 HRS cases received TIPS operation were collected.The volume of 24 h urine,liver and renal function,and the occurrence of complications of portal hypertension were recorded and followed-up.Wilcoxon rank sum test was performed for non-normal distributed measurement data.Results TIPS of all the patients was successful and combined with devascularization in four patients.Before operation,the serum creatinine and volume of urine was 204.0 (180.8,229.8) μmol/L and 810 (600,925) mL,seven days after operation was 160.7 (120.2,184.0) μmol/L and 1 300 (975,1 500) mL,respectively,and the differences were statistically significant (Z=-2.1 and-2.2,both P＜0.05).One month after operation,renal function of five patients recovered to normal.At the 7th day after operation,total bilirubin level of three patients increased and that of two patients decreased to the preoperative base line value at one month and three month.Mild or moderate hepatic encephalopathy occurred in three patients after operation and relieved after medicine treatment.At 6th month after operation,two of three type 1 HRS patients survived.Of five type 2 HRS patients,one received liver transplantation at 6th week after operation,three of the left four cases survived at the 6th month after operation.Conclusion After safety and efficacy were evaluated,TIPS may be one of the methods used for the treatment of HRS.

Objective To investigate the changes of CA125 level with intra-abdominal tumor(epithelial ovarian cancer ,fallopian tube cancer and peritoneal cancer ) before and after chemotherapy serum and their effect on the prognosis of patients and their the clinical predictive value .Methods 174 cases(107 cases of epithelial ovarian cancer ,35 cases of fallopian tube cancer ,and 32 cases of peritoneal cancer) with peritoneal cancer patients were selected from January 2007 to January 2008 .The percentage decrease of ser-um CA125 were calculated after 3 courses of chemotherapy and CA125 decreased level of sensitivity with chemotherapy were ana-lyzed .The different levels of CA125 of median survival time and median survival time were compared .Results After chemothera-py ,CA125 decreased ≥ 75% in 42 cases ,decreased from 51% to 75% in 62 cases ,decreased from 25% to 50% in 32 cases ,and de-creased less than 25% in 38 cases .In CA125 decreased ≥ 75% group ,the chemotherapy effects was better than the other groups (P<0 .05) .Univariate analysis showed that the decrease proportion of CA 125 was positively correlated with chemotherapy effect (r=0 .396 ,P=0 .000) .Using the Kaplan-Meier method ,the patient's survival rate and median survival time were caculated and it showed that the 5 years survival and median survival time were significantly better in group CA 125 decline ≥ 75% than the other groups(P<0 .05) .Univariate analysis shows that the CA125 decline proportion of patients and long term efficacy was positively correlated(r=0 .412 ,P=0 .000) .The COX risk model analysis showed that FIGO stage ,CA125 level and the effect of chemothera-py were independent prognostic risk factors .Conclusion The level of CA125 is the independent risk factor of epithelial ovarian cancer ,fallopian tube cancer and peritoneal cancer prognosis .CA125 decline proportion could be used to know the effect of chemo-therapy and long term treatment ,and be the prognosis indicators for patients with intra abdominal tumor .

Objectives To investigate the effect of rhEPO on newborn rats with necrotizing enterocolitis (NEC). Meth-ods Sixty newborn Sprague-Dewley (SD) rats at the age of 48 hours were randomly divided into 5 groups:control group, NEC group, and intervention groups 1, 2 and 3 treated with rhEPO. The rats were fed rat breast milk substitutes and stressed under hypoxia and cold exposure to establish NEC model. The rats with NEC were treated with different doses of rhEPO (0.1U/ml, 1U/ml and 10U/ml) in intervention groups. The expression of Bcl-2 and caspase-3 were measured by immunohistochemistry, and intestinal pathological changes were observed using HE staining. The value of positive expression was analyzed by IOD (integral optical density) image analysis system. Results Abdominal distention, decreased activity and unresponsiveness occurred in NEC rats 24 hours after stress exposure, and pale skin, decreased skin temperature and respiratory rhythm change were observed in severe cases. The symptoms appeared later and milder in three intervention groups. The NEC incidence of newborn rats was as followings:control group(0%), model group(60%), intervention group 1( 30%), intervention group 2(18.2%), intervention group 3(9.1%) and the difference was signiifcant between each group (P=0.008). The grades of intestinal injury, the expression of active caspase-3 and Bcl-2 were signiifcantly different among groups (P<0.01). Intestinal injury was the most severe and the expression level of active caspase-3 was the highest in NEC group. After rhEPO treatment, the intestinal injury and the production of active caspase-3 protein were decreased, and the expression of Bcl-2 was increased. Conclusions Oral rhEPO could decrease the ex-pression of intestinal active caspase 3, and increase the expression of Bcl-2. The protective effect of rhEPO on NEC is dosede-pendent.