In recent years,many medical institutions have opened a health management specialty about whose employment prospect students are not optimistic.But there is a huge gap in the position of China’s medicine employment market,and thus the contradiction in employment is very conspicuous.Therefore it is an effective way to resolve the contradiction by enhancing the student's overall quality of professional medical management and improving their professional competitiveness.

Epidermnoid cysts are henign, cutaneous cysts which commonly occur on face, neck and trunk. Retroauricular epidermoid cyst is rare reported which should be differentiated from auricle pseudocyst, lipoma, steatocystoma and fibroma. The hitopathological examination is a gold standard of diagnosis. Surgery of complete excision is the first choice of treatment methods.
Ear, External ; pathology ; Epidermal Cyst ; diagnosis ; pathology ; Humans

BACKGROUND: Recombinant human erythropoietin (rhEPO) is a glycoprotein. Recent studies have demonstrated that rhEPO regulates many functional activities of neural cells. OBJECTIVE: To investigate the effects of different concentrations of rhEPO on proliferation of neural stem cells (NSCs) cultured in vitro. METHODS: Newborn Sprague-Dawley rat NSCs were harvested and cultured with serum-free culture medium containing different concentrations (5, 50, 500 U/mL) of rhEPO and 20 μg/L basic fibroblast growth factors (5, 50, and 500 U/mL rhEPO groups) and serum-free culture medium only containing 20 μg/L basic fibroblast growth factors (control group). After 7 days of culture, the cloning efficiency of NSCs was calculated. After 10 days of culture, neuron specific enolase (NSE)-and glial fibrillary acidic protein (GFAP)-immunoreactive cells were quantified. RESULTS AND CONCLUSION: In the rhEPO groups, cells proliferated rapidly, and the number of NSC microspheres was greater, in particular in the 50 U/mL rhEPO group, compared with the control group. NSCs grew faster in the 50 U/mL rhEPO group than in the control group. The number of NSE-and GFAP-immunoreactive cells was greater in the 50 U/mL rhEPO group than in the control group (P<0.01). These findings suggest that rhEPO promotes the in vitro culture and proliferation of NSCs, in particular 50 U/mL rhEPO.

Objective To investigate the tendency of diapause symptoms in breast cancer patients during their chemotherapy. Method Sixty-four breast cancer patients with chemotherapy participated in the study by using Pittsburgh sleep quality index (PSQI), the cancer fatigue scale (CFS), the self-rating anxiety scale (SAS) and the self-rating depression scale (SDS) to assess their sleep, fatigue, anxiety and depression at every first day from the second course to sixth one of chemotherapy. Results The diapause symptoms including fatigue, sleep disorders, anxiety and depression varied with the therapeutic course progressing. The conditions in sleep quality, fatigue and depression were the poorest at the diapause of the fourth course and the condition of anxiety was the poorest at the diapause of the third course. Conclusion The medical staff should attach importance to the patients'physical and mental problems brought by the process of chemotherapy, strengthen the regulation of psychosomatic symptoms during chemotherapic diapause, and give reasonable control and intervention before the symptoms deteriorating.

Numerical simulation is one of the most significant methods to predict the temperature distribution in high-intensity focused ultrasound (HIFU) therapy. In this study, the adopted numerical simulation was used based on a transcranial ultrasound therapy model taking a human skull as a reference. The approximation of the Westervelt formula and the Pennes bio-heat conduction equation were applied to the simulation of the transcranial temperature distribution. According to the temperature distribution and the Time Reversal theory, the position of the treatable focal region was corrected and the hot spot existing in the skull was eliminated. Furthermore, the influence of the exposure time, input power and the distance between transducer and skull on the temperature distribution was analyzed. The results showed that the position of the focal region could be corrected and the hot spot was eliminated using the Time Reversal theory without affecting the focus. The focal region above 60 degrees C could be formed at the superficial tis sue located from the skull of 20 mm using the hot spot elimination method and the volume of the focal region increases with the exposure time and the input power in a nonlinear form. When the same volume of the focal region was obtained, the more power was inputted, the less the exposure time was needed. Moreover, the volume of the focal region was influenced by the distance between the transducer and the skull.
Computer Simulation ; High-Intensity Focused Ultrasound Ablation ; Hot Temperature ; Humans ; Neoplasms ; therapy ; Skull

Objective To observe the effect of long-term intensive glucose control therapy on diabetic retinopathy in outpatients with type 2 diabetes mellitus.Methods Forty-nine patients with type 2 diabetes mellitus were randomly assigned to participate in the trial from 2002 to 2007,receiving either intensive (24 cases) or standard glucose control (25 cases).The patients were examined by the same ophthalmologists to identify any new diabetic retinopathy (DR).After 5 years of intensive glucose control,all of the patients were asked to attend our clinic every 6 months,but no attempts were made to maintain their previously assigned therapies.Hemoglobin A1c (HbA1 c) was measured regularly.In November of 2009,a retinal examination was carried out by the same ophthalmologist who worked in the trial.The visual acuity,lens,vitreous body and fundus were examined after pupil dilation to identify diabetic retinopathy (DR).Fundus fluorescein angiography and retinal laser photocoagulation were carried out when necessary.Results In the second year after enrollment in the trail,the median HbA1c level of the intensive-therapy group was significantly lower than that of the standard-therapy group [(6.3 ± 0.6) ％ vs.(7.2 ± 1.2) ％,t =2.09,P ＜ 0.05],and was maintained in a controlled level throughout the following 4 years.During the post-trial monitoring,no new case of of macula edema or diabetic associated blindness occurred in either intensive or standard-therapy group,the whole occurrence of micro-aneurysms,fundus hemorrhage,as well as those who needed retinal laser photocoagnlation and lowering in visual acuity in intensive-therapy group was lower than that in the standard-therapy group (3 vs.14,1 vs.7,2 vs.4,3 vs.11,respectively ;9 vs.36,totally,x2 =4.719,P ＜ 0.05).During the first post-trial monitoring,there was no difference in median HbAlc level between intensive-therapy group and standard-therapy group [(7.2 ± 1.1) ％ vs.(7.3 ± 1.3) ％,t =0.25,P =0.806],which was sustained in the following years.In the trail,no new case of fundus hemorrhage or diabetic associated blindness occurred in intensive-therapy group during the five-year period of therapy.Number of new episodes of micro-aneurysm,macula edema were less in intensive-therapy group than that in standard-therapy group,number of new episodes of lowering in visual acuity,and those who needed retinal laser photocoagnlation,were significantly less in intensive-therapy group than that in standardtherapy group(15 vs.25,4 vs.23,Z =-4.459,P ＜ 0.05) during five-year follow-up.Conclusions The benefit of reduced incidence of diabetic retinopathy in intensive glucose can be maintained because of the legacy effect.

Objective To observe the characterization of fat emboli in cardiac chamber in pig model and the patients undergoing total hip arthroplasty(THA) by transesophageal echocardiography(TEE). Methods Different dose of fatty liquid was injected slowly via the internal jugular vein. The changes of the image were observed by continuous TEE. The lethal dose of fat embolism was recorded. Twenty-two patients underwent TEE during THA. Gray scale and echo intensity of fat embolism in right atrium were studied quantitatively in varied periods of the operation. Results With the increase of fat liquid injected in pig model, the strong- echo particles in right atrium and ventricle became more and more, the imaging of the particles was from “moving star”, “shower-like” to “snow fluffy”, at last paradoxical fat embolism occurred when the dose of fat liquid was over 4 ml. The accumulated lethal dose of fat embolism was 15.8 ～ 27.8 ml.②Fat emboli appeared as strong- echo particles in right atrium were found in different period of THA. Average gray scale and echo intensity of emboli in right atrium were significantly higher in period B than in other periods during THA. Conclusions Fat emboli in cardiac chamber can be found sensitively by TEE. Intra-operative monitoring and quantitative analysis is helpful to identifying fat embolism syndrome.Paradoxical embolism is a reliable evidence of fat embolism syndrome.

Objective To investigate the effects of different doses of propofor on ATP-sensitive K~+currents(I_KATP)in human atrial myocytes and the underlying mechsnism.Methods A small piece of myocardiumwas obtained from right atrium in patients undergoing atrial septal defect or ventricular septal defect surgery.Themyocardium specimen was placed in cold Ca~(2+)-free cardioplegic solution aerated with 100% oxygen.Themyocardium specimen was cut into small chunks(1 mm~3).Atrial myocytes were isolated by enzymatic dissociationtechnique.The effects of propofol on I_KATP in atrial myocytes were studied using the whole-cell configuration ofpatch-clamp technique.Results The outward currents were recorded with a pipitte solution containing 0.3mmol?L~(-1) ATP.The currents were inhibited by glibendamide 10 ?mol?L~(-1),a specific K_ATP channel inhibitor,suggesting that the outward currents were I_KATP.I_KATP aws activited by propofol in a dose-dependent manner.Conclusion Propefol can activate the I_KATP in human myocytes in a concentration-dependent manner and themechanism of its myocardial depressant action may be partly explained.

Objective To assess the clinical value of dual-energy intracranial CT angiography (CTA).Methods Forty-one patients suspected of intracranial vascular diseases underwent dual-energy intracranial CT angiography, and 41 patients who underwent conventional subtraction CT were enrolled as the control group.Image quality of intracranial and skull base vessels and radiation dose between dual-energy CTA and conventional subtraction CTA were compared using two independent sample nonparametrie test and independent-samples t test, respectively.Prevalence and size of lesions detected by dual-energy CTA and digital subtraction CTA were compared using paired-samples t test and Spearman correlative analysis. Results The percentage of image quality scored 5 was 70.7% (29/41) for dual-energy CTA and 75.6% (31/41) for conventional subtraction CTA.There was no significant difference between the two groups(Z= -0.455, P=0.650).Image quality of vessels at the skull base in conventional subtraction CTA was superior to that in dual-energy CTA, especially for the petrosal and syphon segment (Z=-4.087, P= 0.000).Radiation exposure of dual energy CTA and conventional CTA were (396.54±17.43) and (1090.95±114.29) mGy · cm respectively.Radiation exposure was decreased by 64% (t=-38.52, P=0.000) by dual energy CTA compared with conventional subtraction CTA.Out of the 41 patients,19 patients were diagnosed as intracranial aneurysm, 2 patients as arteriovenous malformation (AVM), 3 patients with Moya-moya's disease, and the remaining 17 patients with negative results.Nine patients with intracranial aneurysm, 2 patients with AVM, 3 patients with Moya-moya's disease, and 2 patients with negative findings underwent DSA or operation, with concordant findings from both techniques.Diameter of aneurysm neck, long axis and minor axis by dual-energy CTA was (2.90±1.61), (5.23±1.68) and (3.83±1.69) nun, respectively; Diameter of aneurysm neck, long axis and minor axis by DSA was (2.95±1.71), (5.10±1.60) ,(3.83±1.65) nan,respectively.There was no significant difference for the diameters of aneurysm between dual energy CTA and DSA ((t=-0.734,1.936,0.12.5 respectively, P=0.482,0.085,0.903 respectively), and good correlation was found between diameter measurements using the two techniques(r=0.964,0.976,0.973, respectively, all P=0.000) Conclusions Compared with conventional subtraction CTA, dual energy CTA has good image quality for intracranial vessels; however, image quality of the skull base vessels is worse, especially for the petrosal and syphon segment.Dual energy CTA has decreased radiation dose and a high diagnostic accuracy, being a practical imaging madality for diagnosis of intracranial vascular lesions.