To improve the substantial results of continuing medical education in the general hospital of the army,Nanjing General Hospital,starting with the change of the conception,perfected the management mechanism of continuing medical education,adopted multi-leveled and multi-formed training methods and achieved splendid results in both talent training and scientific research.Its success shows that establishing rules and regulations is the effective guarantee,level-based training is the basic principle and turning out high-quality talents is the ultimate goal of continuing medical education.

The objective of this article was to explore new channels of information transmission in public health emergencies.According to the requestments of information transmission in public health emergencies,the current situation and problems were analysed.To solve the problems,the authors put forward a number of constructive measures,and came to the conclusion that to strengthen the construction of the channels of information transmission is one of the fundamental ways of improving the efficiency of correct handling of public health emergencies.

Objective To study the effect of simvastatin and dexamethasone on the expression of endothelial nitric oxide synthase(eNOS)mRNA and the proliferation in osteoblast.Methods The osteoblast was collected from newborn SD rats,skull and cultured,and then randomly divided into 3 groups(8 samples for each group):in group A,the cells were treated with simvastatin of 1?10-7 mol/L,dexamethasone of 1?10-7 mol/L and DMSO of 1‰;in group B,the cells were treated with dexamethasone of 1?10-7 mol/L and DMSO of 1‰;in group C,the cells were treated with only DMSO of 1‰.The cells were collected and total RNA were obtained 96 h after culture.The expression of eNOS mRNA in the cells was analysed with Reverse Transcription-Polymerase Chain Reaction(RT-PCR).The amount of nitric oxide(NO)in culture medium was detected by the method of nitric acid reduction enzyme.The ratio of proliferation of osteoblast was measured using MTT reduction assay.Results The expression of eNOS mRNA in group A,B,C was 0.491?0.014,0.421?0.018,0.489?0.014.The level of NO in the culture medium in group A,B,C was(14.37?1.24)?mol/L,(12.94?0.69)?mol/L,(14.14?1.23)?mol/L.The ratio of osteoblast proliferation in group A,B,C was 0.3055?0.0178,0.2659?0.0105,0.3044?0.0213.There were significant differences of the expression of eNOS mRNA,level of NO and ratio of osteoblast proliferation between group A and group B,group B and group C(P 0.05).Conclusion It demonstrates that the lower expression of eNOS in the osteoblasts induced by dexamethasone may be an important pathogenesis of glucocorticoid-induced osteoporosis.Simvastatin may inhibit the effect of dexamethasone and regulate the expression of eNOS mRNA in the cells and protect the proliferation of osteoblast.

[Objective]To study the mid-term outcomes about cementless total hip arthroplasty in the treatment of patients with alcoholic osteonecrosis of the femoral head.[Method]From March 1997 to June 2002,41patients(47 hips) was treatmented by cementless total hip arthroplasty,the mid-term (equal to or more than 5 years) results were evaluated both clinically and radiographically.Clinical outcomes were evaluated according to Harris evaluation score. Components migration,bone changes around the implant were measured radiologically. Kaplan-Meier analysis was performed to evaluate the surviving rate of the femoral and acetabulum components. End point was radiographical loosening or revision of the acetabular and femoral component for any reason.[Result]Forty-seven hips in 41 patients were followed up at least 5 years. The mean Harris hip score increased from preoperation(42.4?6.4)points to (91.8?4.4) points at the time of final follow up. No component was loose,No component was revised. The focal area of pelvic osteolysis in 2 hips and small focal area of femoral osteolysis in 6 hips were found. The surviving rate of the femoral and acetabulum components,was 1.0(95% confidence interval,0.98 to 1.00).[Conclusion]The mid-term outcomes about cementless total hip arthroplasty in the treatment of patients with alcoholic necrosis of femoral head had been satisfactory. Because the wear of component,osteolysis can not be avoided,clinical and radiographical follow-up for cementless total hip arthroplasty must be carried out persistently.

Based on fairly systematic and complete information networks, the software Multimedia Teaching and Clinical Practice of Hospital Infection Control was developed. By adopting information driven network and digital hospital infection management, traditional ideological concepts, operational methods and modes of training were transcended. As a result, ways of communication became more flexible, intermediate links were reduced, and the efficiency of management was enhanced.

Objective To study the methods treating talar neck fractures. Methods From Oc-tober 1988 to June 2004, 66 patients with talar neck fractures were treated with different methods. Accord-ing to modified Hawkins classification, there were 14 patients with type Ⅰ fractures treated with plaster exter-nal fixation, 34 with type Ⅱ treated with manipulative reduction plus plaster external fixation, 16 with type Ⅲ treated with open reduction and internal fixation or joint fusion and 2 with type Ⅳ treated with open re-duction and internal fixation or joint fusion. There were four patients with old fractures. Results All pa-tients were followed up for mean 6.28 years and clinical outcomes evaluated according to Hawkins scoring system, which showed that 19 patients (29%) were graded excellent (including 13 type Ⅰ fractures, 5 type Ⅰ and 1 type Ⅲ), 17 good (including 1 type Ⅰ fracture, 12 type Ⅱ and 4 type Ⅲ), 18 fair (including 11 type Ⅱ fractures, 6 type Ⅲ and 1 type Ⅳ) and 12 poor (including 6 type Ⅱ, 5 type Ⅲ and 1 type Ⅳ). There occurred osteonecresis in 25 patients (38%), traumatic arthritis of ankle joint in 20 (30%) and that of subtalar joint in 26 (39%). Conclusions For type Ⅰ and Ⅱ fractures, plaster external fixation should be the choice of treatment. While open reduction and internal fixation should be done for type Ⅲ talar neck fractures and joint fusion for type Ⅳ and old fractures.

Objective To solve the problem of information store and forward, update for officers for collect information expediently. Methods Information is stored by using two dimensions tag's technique and is taken in deck form. Results The tag was used in cosmically practice satisfactorily. Conclusion It solves the problem of one dimensional medicinal tag on no-semantide and update and is advantageous to obtain the wounded information for the base hospital and the field battle medical treatment team.

Objective 70 realize the fast collection and management of the basic wounded information in the field treatment. Methods Two-dimensional electronic medicine tag was used as a massage loader. The wounded information was analyzed with a program reader, and the basic personal and cure information were shared with the information management system. Result The system was used in the massive discipline for the first time, fulfilled the wounded information record, analysis, transfer, and the management of the cure information with 80 items. Conclusion The correctness of the basic massage record and analysis is full percent. The manage progress of the system accord with the field condition.

Objective To collect and analyze the basic information of two dimensions electronics medicine tag, and send out the analytical information to field battle information management system and share with the resources. Methods The information were collected, analyzed and sent by adopting MC50 and some software. Results The information of collection and analysis on 80 cases was completed by the device in large-scale practice. Conclusion The device usage is convenient, the function is stable, and the rate of collection and analysis is 100%.

Objective To develop a complete set of medical water processing and supply system to meet the needs of water in field operations for emergency rescues and disaster relief work, filed advance drill, etc. Methods A complete set of medical water processing and supply system was composed of two parts, including water processing system and water supply system. The means of filtrating, precipitating, sterilizing, adsorbing and ion regulating were adopted in water processing system to purify the water from primitive and to pure state for living or medical treatment. The techniques and equipments such as pressurizing, buffering, current regulating and special pipes, valves, fast joints, etc, were adopted in water supply system, and high performance water-pipe network were established. Results The water processing and supply system has some disadvantages, such as water quality guarantee, water quantity abundance, water flow stabilization, water pressure qualification, and system safety, credibility, low failure-ratio, energy saving etc, and can meet the needs of medical water in field operations. Conclusion The water system can be carried out by design optimizing and can realize mobile and emergencies.