Objective To study the technique of using the postauricular revolving door island flap in one-stage reconstruction of concha defect and its efficacy.Methods Fifteen cases of concha de fect were repaired by the postauricular revolving door island flap in one stage reconstruction from 2000-2010.The maximum size of defect was 2.7 cm× 3.0 cm,and the minimum was 1.0 cm×1.3 cm.Results All the island flaps were survived postoperatively,and satisfactory in auricular appearances of all patients by 6 months to 5 years follow-up.Conclusions The revolving door island flaps with abundant blood supply are transferred to reach the auricular defect,which match normal auricular tissue in contour,color,and texture. This flap on the retroauricular area is relatively concealed,and it therefore can be one of the best procedures for repair of the auricular defects,especially concha.

Complex regional pain syndrome (CRPS) is a neuropathic pain disorder, characterized by persistent and severe pain after trauma or surgery. Diagnosis is mainly based on clinical signs and treatment is based on a multidisciplinary approaches, including non-pharmacological approaches and occupational therapy，pharmacotherapy and invasive therapeutics. This article reviewed the current advice of diagnosis and treatment of CRPS.

Duchenne muscular dystrophies is a deadly disease caused by genetic defect in the skeletal muscle system,and there is no complete cure so far.For a long time,the scholars at home and abroad have made unremitting efforts for its treatment research,and made some great progresses.This paper summarizes the related literatures in recent years.The Duchenne muscular dystrophy treatment methods and progresses are reviewed in this review.

Objective To compare the clinical effects of bisoprolol and metoprolol in treatment patients with chronic heart failure (CHF).Methods 126 patients with CHF were randomly divided into two groups,63 cases in each group.And two groups were treated with bisoprolol or metoprolol based on the conventional anti-HF treatment.The clinical effects of the two groups were compared.Results The total effective rate of the bisoprolol group was 92.1％ (58/63),which was significantly higher than 79.4％ (50/63)in the metoprolol group(P ＜0.05).The HR,SBP,DBP,and LVEF were significantly improved in the two groups after the treatment(P ＜ 0.01).SBP (98.7 ±13.7) mm Hg,LVEF (48.6 ± 7.7)％ in the bisoprolol group were significantly better than (102.5-± 13.8)mm Hg and (45.4 ± 7.9)％ in the metoprolol group after treatment(P ＜ 0.05).But there was no significant difference in the incidence rate of clinical adverse events between the two groups (P ＞ 0.05).Conclusion Bisoprolol and metoprolol can effectively improve the heart function of patients with CHF,but bisoprolol has more advantages,so we should strictly control the indications in the clinical work,to make a reasonable choice of drugs.

Childhood asthma is one of type Ⅰ allergic diseases,and IgE is indispensable factor in development of asthma.IgE-antigen crosslinking of hish affinity IgE receptor(FcεRⅠ)leads to degranulation of mast cell,leukotriene synthesis and cytokine production.As a re8ult.such changes will bring about inflammation of airway and spasm of airway smooth muscle.Recent researches suggest that Src tyresine kinase play a vital role in their combination.This review discusses the regulation and signaling trannduction of FcεR Ⅰ and the relationship between FcεRⅠ and asthma.

Objective To discuss the effect on promoting the progress of the stage of labor and the natural delivery as the parturient adopts the different delivery position in the first and the second stage of labor. Methods One hundred and fifty-two cases of delivery primiparas of cephalic presentation whose pregnancy was from 37 to 41 weeks were enrolled and divided into two groups randomly. In the observation group (80 cases) ,the free positions of delivery like walking,squating,lateral position,half lying and others could be selected in the first stage of labor, the semi-reclining position was selected in the second stage of labor and the lithotomy position was adopted when the head was visible on vulvae gapping. The parturient in the control group (72 cases) selected the decubitus (alternation between prostration and lateral position) in the first stage of labor and the parturient selected routine lithotomy position of supine position in the second stage of labor. The progress of labor and the comfort of the parturient in the two groups were observed. Results In the observation group, time spent in the first stage and second stage were (361. 83 ± 58. 02) mins and (36. 39 ± 11. 97) mins, and (398.21 ±59. 72) mins in the total birth process, which were significantly shorter than those of (560.85 ± 131. 98)mins and (58.11 ± 15.44) mins, and (618. 96 ± 139. 61) mins, respectively (t = 12. 24,9. 74 and 12. 90, Ps <0. 01). There were 13 and 25 cases experienced tingle in two hours after delivery, and 2 and 10 cases in 12 hs after delivery, in the observation and control group, respectively. The comfort of parturient in the observation group was higher than that in the control group (x2 = 6. 90, P < 0.01; x2 = 5. 28, P < 0. 05)respectively. Conclusion The free position in the first stage of labor and the semi-reclining position in the second stage of labor can shorten the birth process effectively and relieve the discomfort after the delivery.

Congenital long QT syndrome ( LQTS) is a cardiac ion channel dysfunction, leading to prolonged myocardial repolarization time. It is characterized by the typical ECG QT interval prolongation and torsades de pointes. It shows clinical recurrence of cardiogenic syncope and even lead to sudden death. Molecular genetic studies have revealed a total of 12 forms of congenital LQTS caused by mutations in genes of the potassium, sodium and calcium channels or membrane adapter located on chromosomes 3, 4, 7, 11, 12, 17, 20 and 21. This review summarized the studies of the pathogenesis of LQTS and gene-related treatments.

Multidisplinary treatment is the mordent means of local-regional gastric cancer therapy, and individualized treatment decisions are dependent on the patient's characteristics. Stage II patients previously treated with standard D2 resection should receive oral administration of S-1 or combination chemotherapy of XELOX. However, patients at stage IIIb or at a more advanced stage should receive combination treatment as priority. Concurrent radiochemotherapy was recommended to treat patients that had been operated by D0 or D1 resection. Perioperative chemotherapy is more reasonable than pure neoadjuvant chemotherapy. No evidence has verified that perioperative or neoadjuvant chemotherapy leads to better survival compared with postoperative adjuvant chemotherapy. The value of chemotherapy before operation is rest with the effect of downstaging and conversion of the unresectable tumor to a resectable one. Con-current radiochemotherapy prior to an operation needs further investigation to affirm its high efficacy of downstaging and conversion.

Objective To understand the perceiving,cognition and evaluation of academic activities and campus life among the first batch of eight-year program clinical medicine graduates in order to refine the eight-year program and to get better recruitment plan,teaching methods,culture objective and career preparation.Methods Questionnaire was conducted among all 57 students of the pioneer batch of eight-year clinical medicine program enrolled in 2004,including students' basic information,feeling of studying at stages of general education,basic medicine,clinical medicine and professional research as well as the evaluation on the professional training mode.Descriptive statistics was used to analyze the data.Results 68.4％ students felt that the main emphasis and core of the program should focus on clinical knowledge and skills; 26.3％ students had little interest in the eight-year clinical program; 26.3％ of students did not like this way of teaching/training,and 33.3％ students were pessimistic about their career future.Conclusion Improvement in the recruitment and cultivation methods will increase teaching quality and students' satisfaction of the course.

As the excellent country or region refers to medical insurance system , the United Kingdom , Singa-pore and Hong Kong are often the focus of international academic circles .However , the difference is that the United Kingdom is a model of free universal medical care , Singapore is a government-led mixed medical protection mode , and Hong Kong earns a worldwide reputation on health care by virtue of the high quality , low price public hospital services .This article assesses the advantages and limitations of the three medical insurance systems in terms of equity in financing , individual affordability, insurance coverage , sustainability in financing and individual responsibility , and provides a reference for health care reform in China .