The author reviewed the development of general practice education in our country,deliberated and summarized the problems about the construction of curriculum system,the ranks of teachers and practice base in general practice education in higher medicine colleges.

Abstract: The high recurrent rate and insufficient protection of anal function in treatment of anal fistula were reviewed in this article. To solve the problems in the treatment of complex fistula-in-ano including ignorance of preoperative assessment and lack of consciousness of preserving anal function, the authors raised the countermeasures to carry out the "gold standard" of preoperative assessment and the system of medical delivery, form the new principle of incision of anal sphincters, collect the high-level evidence-based medicine proof, improve the healing rate and significantly reduce the postoperative continence disturbance, so as to develop a new guideline for the treatment of fistula-in-ano.

Objective To investigate the value of the clinical application of fetal testis transplantation with main vessel segment. Methods The testicular transplantation were performed to cure 9 patients suffered from male hyponadism with the fetal testis with main vessel segment as donor tissue. Results Except one, 8 patients had a significantly increased level of serum testosterone, the male secondary sexual characteristics and the sexual desire were improved. The size of testis was larger than before operation. Conclusion Fetal testis transplantation with main vessel segment is a effective method to cure male hyponadism and has great value of clinical application.

Objective To investigate the value of the clinical application of fetal testis for the treatment of male hypogonadism.Method We have performed the testicular transplantation to cure 6 patients suffered from hypogonadism with the fetal testis as donor.Results All patients had a significantly increased level of serum testosterone and the male secondary sexual characteristics and the sexual desire were improved.The size of testis was larger than before operation.Conclusion Testis transplantation with fetal testis as donor is an effective method to cure male hypogonadism and has great value of clinical application for its weak immunogenicity.

Objective:To investigate the application of photoplethysmogram in analyzing the fingertip pulse amplitude volume (PAV)to evaluate the endothelial function in diagnosing coronary heart disease,and to clarify its relationship with the risk factors of cardiovascular diseases.Methods:Total 409 patients with chest pain accepted coronary angiography (CAG)were selected and diveded into positive group (CAG+)(n=288)and negative group (CAG-) (n = 121)according to angiographic results.Fingertip photoplethysmogram was used to analyze the fingertip PAV by the way of applying endothelial function diagnostic after reactive ischemia,and the relationship between the PAV value and the risk factors of coronary heart diseases was analyzed,and the critical reference value of prediction index of coronary heart disease was determined.The risk factors such as age,gender,serum total cholesterol (TC ), low density lipoprotein (LDL ), high density lipoprotein (HDL ), non-HDL, serum triglyceride (TG),hypertension,diabetes,smoking,family history of coronary heart disease,body mass index (BMI)of the subjects in various groups were analyzed,and the relationship between the risk factors of coronary heart disease and PAV was analyzed by Logistic regression analysis.Results:The PAV of patients in CAG+group was significantly lower than that in CAG-group (P <0.01).The peak point of PAV was<1.37,if PAV<1.37 was used to predict the coronary heart disease,the predictive sensitivity,the specificity,the positive prediction and the negative prediction were 74.65%,44.63%, 76.24%, and 42.52%.The Logistic regression analysis showed that PAV was negatively associated with hypertension,smoking history,TG (OR= 1.476,OR=2.002, OR = 1.844;P < 0.01 ). Conclusion: PAV is associated with coronary heart disease and its risk factors (hypertension,smoking history,TG),and PAV=1.37 can be used as the peak point to predict the coronary heart disease.

Objective To evaluate the expression of adhesion molecules CD62,CD63 and abnormal functional status of platelets in women with preeclmpsia and their relation to progression.Methods The expression of surface antigens CD62,CD63 in peripheral blood and functional status of platelets were measured by flow cytometry in 68 women with preeclmpsia,30 non-pregnant normal women and 52 normal pregnancy women as the controls.Results There was no significant difference among defferent stages in normal pregnant women,but the CD62,CD63 positive platelets were (7 41?1 98)%,(12 99?2 37)% and (36 52?8 92)% respectively for mild,moderate and severe preeclmpsia,it double high (P

Objective To explore the effect of transabdominal posterior rectopexy with resection of the partial rectosigmoid colon on adult rectal prolapse.Methods During the 2006 to 2011,transabdominal posterior rectopexy with resection of the partial rectosigmoid colon was performed on 6 selected adult patients with complete rectal prolapse.Results All patients were cured,the median length of hospital stay was 13.7 days.Followed up for 3-61 months,there was no recurrent case.Conclusions The operation offers a safe and effective alternative to other more complex procedures for the treatment of adult rectal prolapse.The procedure can not only treat the rectosigmoid disease,but also improve the rectosigmoid disease,improve the function of bowel and reduce the recurrence rate.

To investigate the mechanism of electroacupuncturein treating chronic fatigue syndrome(CFS) in term of the neuro-endocrine system by observing the regulative effect of EA on hypothalamic-pituitary-adrenal index (HPA index) and corticotropin releasing hormone mRNA (CRH mRNA) in CFS model rats. Methods: The rats were randomly divided into control group, model group, and electroacupuncture group. Model and electroacupuncture groups were forced to swim in cold water to make CFS model, while rats in electroacupuncture group were treated with electroacupuncture treatment at the same time. Electroacupuncture group was given at Baihui(GV 20) and Zusanli(ST 36). Evaluation of the model was processed according to the behavior changes of the rats. Hypothalamic, pituitary, and adrenal were weighted to calculate HPA index. CRH mRNA in hypothalamic was measured by fluorescence quantitative polymerase chain reaction (FQPCR). Results: The model rats had behavior changes,and both physical and mental fatigue was observed. HPA index raised and expression of CRH mRNA in hypothalamus increased in CFS rats. After electroacupuncture treatment, the physical and mental fatigue was improved, and the hypothalamic index and CRH mRNA decreased significantly, while the pituitary and adrenal index only had little decrease. Conclusion: Cold water swim press could mimic the pathogenesis and make similar manifestations in rats with the common clinical symptoms. CFS has close relationship with increase of HPA index and CRH mRNA expression. Electroacupuncture can regulate the function of HPA axis to deal with CFS.

Objective To develop a cryogenic gripper for soft tissues used in tensile test for secure fixation of soft tissues without damages.Methods Based on the principle of coolant evaporator,we reconstructed copper pipes in novel architecture for fixing the soft tissues.Results This cryogenic gripper could firmly grip wet nylon thread of 3 mm in diameter and its holding force was(499.14?1.05)N and its temperature could be kept at(-20?1)℃.Conclusion The function of this gripper developed by coolant cryogenic technology is satisfactory and reliable,and its continuance is not concerned with time.

Objective To observe the protective effect of Xiaohuangdecotion against liver damage inα-naphthylisothiocyanate (ANIT)- induced cholestasis in rats and probe the potential mechanisms.Methods Male Wistar rats (40) were randomly divided into a normal group, a model group, aXiaohuangdecotion treatment group, and a UDCA control group (10 for each). Except for rats in the normal group, ANIT solution (6 ml/kg) was administered in other rats by gavages for cholestasis model. After ANIT treated 48 h, rats inXiaohuangdecotion group and UDCA group were treated withXiaohuangdecotion (1.73 g/kg) and UDCA (10 mg/kg) respectively for 1 week. And, rats in the normal group and the model group were given an equal volume of saline. At the end of the experiment, liver function rats were examined. Liver histology was examined by HE staining, and CD68 factor was tested by immunohistochemistry and Western blot.Results Compared with the model group, the content of ALT (164.6 ± 53.4 U/Lvs. 208.4 ± 28.5 U/L), AST (247.6 ± 76.1 U/Lvs. 341.8 ± 32.8 U/L), ALP (601.0 ± 101.1 U/Lvs. 720.6 ± 123.3 U/L), TBiL (96.5 ± 18.1μmol/Lvs. 149.6 ± 30.2μmol/L), DBiL (73.7 ± 16.6μmol/Lvs. 140.3 ± 28.6μmol/L) and TBA (93.4 ± 13.0μmol/Lvs. 146.5 ± 38.9μmol/L) were significantly reduced in the treatment group (P<0.01 orP<0.05). Compared with the model group, CD68 level (7.08 ± 0.19 vs. 17.42 ± 0.48)were significantly reduced by intervention ofXiaohuangdecotion (P<0.01).ConclusionsXiaohuangdecotion could improve liver functions and reduce CD68 expression, leading to a good hepatoprotective and jaundice-relieving effects.