OBJECTIVE:To probe into the effects of different doses of midazolam combined with fentanyl on anterograde amnesia in patients with branchial plexus block.METHODS:90 patients to do one side upper limb operation were randomly divided into 3 groups,i.e.groupⅠ,groupⅡ and groupⅢ.group Ⅰ was treated with midazolam 0.04 mg?kg-1 and fentanyl 1 ?g?kg-1;groupⅡ midazolam 0.06 mg?kg-1 and fentanyl 1 ?g?kg-1;groupⅢ,as control group,did not receive any treatment before puncture.The change of BP,HR and SpO2 and level of sedation and amnesia were compared among three groups.RESULTS:The levels of sedation at different time points in groupⅠ and groupⅡ were both better than in groupⅢ (P0.05).CONCLUSION:Midazolam combined with fentanyl have active effect to anterograde amnesia in patients with branchial plexus block.Consequently the quality of anaesthesia and patients' degree of satisfaction are improve.

The relationship between teacher and student is a special interpersonal relationship,which is guarantee for successful education.Based on written questionnaires done on the 150 sophomore medical students in Chengdu Medical College and implications taken from the investigation,the paper discussed the effects of psychological contract relationship between the teacher and college medical students on the college student's English study,then put forward the corresponding measurements to improve the teacher's teaching quality.

Objective Effects of fucoidan from Cladosiphon okamuranusa (CF)on mice bearing Siso were investigated. Methods Different concentrations of CF were given to mice bearing tumor by ig. The tumor weight, spleen index, thymus index and serum MDA content, serum SOD activity were detected by physical and biochemical methods. Results The growth of S180 tumor was inhibited significantly by CF in different concentrations. The inhibitory rate ranged from 27. 83% to 33. 97%. The highest inhibition rate occurred in the medium dosage. The spleen index, thymus index and leukocyte counts were not influenced obviously. The content of serum MDA was decreased remarkably and the activity of serum SOD was enhanced notably. Conclusion The mechanism of anti -tumor effects of CF may relate with its antioxidation.

Objective Investigate the methods of reconstituting the first web of hand Try to find some ways to make the the lst web more beautiful Method To design a flap including two flap (instep island flap and medial plantar island flap) to reconstitute the lst web of hand the instep flap reconstituted the back of the lst web of hand,the medial plantar flap reconstitute the volaris part of the lst web of hand Result All 9 cases were applied successfully with the transplanted tissue survived The function of hand recovered satisfactorily and the exterior look like original web of hand Conclusion Use combined flap on the medial foot to reconstitute the lst web of hand can recovered either function or original exterior of the lst web of hand

Objective To analyze the positive rate of HBsAg in different population at different periods after widely using Hepatitis B Vaccine and provide strategy for Hepatitis B Control.Methods Using ELISA method to detect the HBsAg carrier in polulation under 18 years old in local area.Results After six year investigating,the HBsAg carrier rate in tested population decreased.For 0-4,4-8,8-12,12-15,15-18 age group,the carrier rate were 3.76% vs 0.30%,4.74% vs 1.39%,5.59% vs 2.52%,8.51% vs 3.03%,and 12.58% vs 2.98% in 2000 and 2006.Conclusion The reduction in carrier rate had a direct relationship with Hepatitis B Vaccine inoculation.Hepatitis B Vaccine had important effect to Hepatitis B control.We should gradually intensify Hepatitis B Vaccine inoculation.It is not only for newborn but also for adult.

BACKGROUND:Recently,open reduction and internal fixation has become an important therapy for pelvic and acetabular fracture. However,screw penetration sometimes occurs,which damage vessels or nerves in the pelvic cavity. OBJECTIVE:To measure the best entry points,direction and length of screw in acetabular anterior column fracture lag screw internal fixation technique. DESIGN,TIME AND SETTING:Measurement experiment was performed at the Department of Anatomy,Medical School of Shandong University from June to October 2008. MATERIALS:A total of 20 semi-pelvic specimens of adult male cadavers were used to make serial cross-sections of the acetabular anterior column. METHODS:In single screw technique,the horizontal distance OP and vertical distance PQ from entry point O to apex of greater sciatic notch Q were measured,and screw length was measured. In double screw technique,the horizontal distance O1P1,O2P2 and vertical distance P1Q,P2Q from entry point O1 of the inner screw and entry point O2 of the outer screw,respectively to apex of greater sciatic notch Q were measured. The length of inner screw and outer screw were measured respectively. Angle ? on sagittal plane and the angle ? on coronal plane of the screw were determined. All data were put into software SPSS 10.0 for statistical analysis. MAIN OUTCOME MEASURES:The entry points,direction and length of screw in acetabular anterior column fracture lag screw internal fixation technique RESULTS:Single screw technique:the length of OP and PQ was (23.5?2.2) mm and (16.8?1.6) mm respectively; the length of lag screw was (84.9?4.7) mm. Double screw technique:the length of O1P1 and P1Q was (26.3?2.3) mm and (13.6?1.4) mm,respectively,and the length of medial lag screw was (69.8?4.1) mm; the length of O2P2 and P2Q was (20.7?2.1) mm and (20.1?1.8) mm,and the length of lateral lag screw was (61.2?3.7) mm. Angle ? was (123.4 ? 4.1)? and angle ? (62.2 ? 5.8)?. CONCLUSION:The entry point of single screw technique lies in the summit of greater sciatic notch 17 mm outward,vertical to the medial margin of the posterior column,24 mm upward,parallel to the medial margin of the posterior column; the length of the screw is 85 mm. The entry point of medial screw in double screw technique lies in 14 mm outward,vertical to the medial margin of the posterior column,and 26 mm upward,parallel to the medial margin of the posterior column; the length of the screw is 70 mm. The entry point of lateral screw in double screw technique lies in 20 mm outward,vertical to the medial margin of the posterior column,and 21 mm upward,parallel to the medial margin of the posterior column; the length of the screw is 61 mm. The angle of lag screw with respect to the parallel line of the medial margin of the posterior column is 123?,and the angle lag screw with respect to the vertical line of the medial margin of the posterior column is 62?. The position of the lag screw must be confined by intraoperative fluoroscopy in multiple projections.

Objective To evaluate the curative effect of LASIK for correcting compound myopic astigmatism.Methods One hundred and sixteen eyes in 68 patients with compound myopic astigmatism had been corrected with LASIK.All patients were followed up for more than 12 months.Meanwhile,all eyes were divided into two groups according to the preoperative astigmatism:group I (-2.25～ -3.00D),group Ⅱ (-3.2.5～ -6.00D).Results In group I :the average refractive cylinder was (- 2.51±0.68) D preoperafion, and had the average of (- 0.51±0.25) D residual astegmatism postoperation.In group Ⅱ :the average refractive cylinder was (- 3.85±0.46) D preoperation, and had the average of (- 0.52±0.22)D residual astigmatism postoperation.There was no statistical difference in astigmatism between the two groups after 12 months.In group Ⅰ and Ⅱ the visual acuity after operation was better than the corrected visual acuity before operation.Conclusion For compound myopic astigmatism LASIK was safe and effective.

Objective To analyze the clinical effects aftet one year of LASIK for myopia. Methods According to the preoperative diopters of the myopia, the patients were divided into three groups, group Ⅰ: 57 eyes( < - 6.00D), group Ⅱ: 109 eyes( - 6.25～ - 10.00D) ,group Ⅲ :31 eyes( > - 10.25D～ - 15.00D). The patients were followed up 1 year. Re- sults In groups,the percentage of the uncorrected visual acuity equal or more than 1.0 was 94.3%,80.3%,42.0% re- spectivdy. The percentage of there sidual refractive error within ±0.50D was 99.3% ,85.7% ,59.7%. The spherical e- quivalent was stable in 3 months after LASIK. The complications are few. Conclusion LASIK is a safe,effective and good predictable method for treatment of myopia.

OBJECTIVE:To explore the new method for clinical pharmacists training,and provide reference for improving the quality of clinical pharmacists training. METHODS:Based on the full-awareness of Definition and characteristics of stage-progres-sive learning(SPL)and problem-based learning(PBL)teaching method,SPL-PBL teaching method was used in the teaching of the-oretical and clinical practice in the process of students training in clinical pharmacist training base. The teaching course of theoreti-cal knowledge was mainly SPL in first half and PBL in another half. While in the clinical practice teaching of ward rounds,check-ing doctor's advice,participation in the development of treatment programs and case discussion,PBL was mainly used interspersed by SPL;SPL was mainly in inquiry,pharmaceutical care and medication education interspersed by PBL. RESULTS:SPL-PBL teaching method had not only effectively aroused the enthusiasm of the students'learning,enhanced the sense of responsibility and improved their clinical professional knowledge and practice ability,but also strengthened the cultivation of students communication ability,document retrieval ability,writing communication ability and self-learning ability(four abilities) to make students more quickly into the role and improve their subjective initiative. CONCLUSIONS:Practice has proved that the SPL-PBL teaching meth-od not only gives consideratin to the inndividual differences among studengts,but also mobilizes the enthusiam,and not only gives consideration to the teaching about basic theoretical knowledge,but also strengthens the training for clinical thingkig andfour abili-ties,wich can be used for the clinical pharmacists training. Meanwhile,SPL has expanded the aplication surface of PBL beacuse that SPL has reduced the requirements of PBL for overall qulity. However,it needs to be improved because of the short time appli-cation.

Clinical teaching plan of pneumothorax and hemorrhagic shock was prepared with mind maps. The process of making this teaching plan was demonstrated as follows:relationship among all levels of subjects in this course was manifested by text and graph as belong and relevance. It is sim-ple, smooth, focused, lucid and easy to understand and remember. Application of mind mapis ex-tremely simple;it is suitable for medical education and is conducive to enhancing teaching efficiency.