The necessity to carry out student-oriented teaching of Medical information retrieval and use course in medical postgraduate was analyzed according to its theory followed by an elaboration on its module setting, course management methods, course examination forms and teachers.

Objective: To explore the diagnosis and surgical treatment for cholelithiasis of cau- dal lobe of liver. Methods: The data of 98 patients with cholelithiasis of caudal lobe were reviewed. Results: 42 cases (43% ) got preoperative diagnosis. No cases died during operation.7cases had residual stones,the rate of which was 7.1% . The stones recurred in 10 cases and the rate was 12.3% . Conclusion: Understanding the disease, the preoperative image examination combining with introperative exploration are important to decrease the misdiagnosis and increase the rate of diagnosis. The surgical treatment should follow the principle of individualized therapy.

Objective To investigate the characteristics and prevention of deep fungal infection (DFI) complicated by severe acute pancreatitis (SAP). Methods Clinical data of 135 SAP cases admitted from Oct. 1998 to Oct. 2009 were studied, the prevention and management of SAP with DFI ( 32cases) were investigated, among them there were 19 males and 13 females. Results Seven patients (21.9%) died of these 32 cases. The SAP patients with DFI were of more critical condition, longer course and having to stay in ICU about (21±6) d, most needed surgical debridement, on long-term indwelling catheters, intubation and mechanical ventilation, parenteral nutrition, long-term use of broad-spectrum antibiotics. These patients remained in the hospital for about (78 ± 14) d. Conclusions DFI is a common complication in SAP cases causing a significant mortality hence necessitating comprehensive prevention and control measures such as proper handling of the original disease, aseptic operation, prophylactic antibiotics and antifungal agents, which can reduce the incidence and mortality of SAP with DFI.

Aim The aim of this work was to study the effect of diallyl disulfide (DADS) on human Leukemia cell line HL 60, and investgate the mechanisms of its antitumor effect. Methods HL 60 cells growth inhibition was measured by MTT assay. Cell apoptosis was inspected by flow cytometry,TUNEL assay and acridine orange fluorescent staining methods. The protein levels of Bcl 2, Bax were determined using immunohistochemical technique. Results MTT assay showed that DADS significantly inhibited the growth of HL 60 cells. After 24 hours of exposure to DADS, Partial cells presented characteristic morphological changes of apoptosis under the electron microscope, including cell shrinkage, nuclear condensation, and formation of apoptotic bodies. Some typical subdiploid peaks before G 0/G 1 phase were observed. Flow cytometry analysis revealed that the apoptosis rates were increased and the TUNEL assay showed the apoptosis index increased in occordance with increase of concentration of DADS. SP immunohistochemistry revealed that the Bax expression was increased while Bcl 2 expressed was decreased. Conclusion Diallyl disulfide could significantly induce apoptosis of human Leukemia cell HL 60, Apoptosis of tumor cells is closely associated with down regulation of the ratio of bcl 2/bax.

Objective To study the effect of pelvic autonomic nerve preservation(PANP)on urination and sexual function in total mesorectal excision(TME). Methods Two hundred and forty cases of male rectal cancer patients,divided into the PANP who accept the pelvic autonomic nerve preservation in TME,and the control group of 120 patients who do not.The urination and sexual function were observed and compared.3-year-survival rate,local recurrence rates of the two groups were recorded. Results The urinary disorder rates,erective disorder rates and ejaculation disorder rates of PANP group were 30.8%,28.3%and 34.2%,while values of control group were 55.0%、60.0%and 62.5%.The difference between them had statistical significance(P<0.05).The 3-year-survival rate and local recurrence rate of PANP group were 9.4%and 75.0%.The 3-year-survival rate and local recurrence rate of control group were 9.0%and 65.0%.There was no significant difference between them(P>0.05). Conclusion The PANP technique in TME could improve the urinary and sexual function of male patients without affect the prognosis.

ObjectiveTo study the cardioprotective effects of ischemic post-conditioning on elderly patients with ST-elevation acute myocardial infarction (STEM1).MethodsConsecutive 215 patients with STEMI undergoing emergency percutaneous coronary intervention(PCI) were randomly assignedto receive ischemicpost-conditioningorconventional PCItreatment.The ischemic postconditioning (n=38) were conducted by 3 episodes of 30-second occlusion followed by 30-second reperfusion, while the control group (n= 46) was without any intervention after PCI.Reperfusion arrhythmias, corrected TIMI frame count (cTFC) and TIMI myocardial perfusion grade (TMPG)were compared between the two groups, respectively.Results The incidence of reperfusion arrythmias was less frequent in ischemic postconditioning group (21.1％ ,8/38) than in control group (45.7％ ,21/46) after PCI (x2 = 5.571, P＜0.05). The TIMI grade 3 flow was similar between two groups [(94.7％(36/38) vs. 82.6％( 38/46), x2= 2.919, P＞0.05], the cTFC levels (23.6±3.7vs. 26.1 ±5.9) and TMPG 3 perfusion [ 89.5％ (34/38) vs.69.6％ (32/46)] were significantly different (t= 5.434, P＜0.05; x2 = 4.899, P＜0.05, respectively) between two groups.ConclusionsIschemic postconditioning may reduce myocardial reperfusion injury in elderly patients with STEMI undergoing emergent PCI.

Objective To explore the curative effect of tirofiban treatment on high-risk acute coronary syndromes (ACS) in elderly patients receiving an early percutaneous coronary intervention (PCI) treatment. Methods The 162 elderly cases including unstable angina pectoris and non-ST -segment elevation myocardial infarction (NSTEMI) undergoing early PCI were enrolled in this study.And they were assigned to early treatment group (n=82) and deferred selective group (n=80)according to the time of using tirofiban (Gp Ⅱ b/Ⅲ a inhibitor) treatment. The effectiveness of either strategic option on tissue-level perfusion was evaluated using the TIMI myocardial perfusion grade (TMPG) before and immediately after PCI. The corrected TIMI frame count (cTFC) was also used to assess coronary artery flow and myocardial perfusion. Bleeding complications and the composite end point events at 30 days were also evaluated. Results Of all the 162 patients, the TMPG 0-1 perfusion was observed in 65 patients (40.1%). The TMPG 0-1 perfusion was significantly less frequent in early treatment group (32.9%) than in deferred selective group (47.5%) before PCI (x2=3.58, P＜0.05); while the results of TIMI grade 0-1 flow (26.8% vs. 25.0%) and cTFC levels (34.2±11.8 vs. 34. 9±12. 7) before PCI were similar between the two groups (x2 =0. 07, P=0.47; t= 0.13, P=0.71, respectively). No differences were seen both in composite end point events at 30 days and bleeding complications (x2 = 0.31, P＞0.05; x2=0.004, P＞0. 05). Conclusions High -risk ACS patients treated with an early invasive strategy, routine upstream use of tirofiban are associated with improved tissue-level perfusion before PCI and does not increase bleeding complications when bleeding risks are carefully evaluated before enrollment.

Medical simulation teaching is an emerging and developing teaching method in our coun-try. At present, the simulation teaching centers are developing rapidly in higher education institutions, but how to improve the effectiveness in the operation of the centers is still a subject that needs to be discussed. Based on our own experience, this paper analyzes the related factors in developing medical simulation teach-ing centers, making summary and demonstrations from aspects of team building, teacher training, docking needs, staffing and so on, so as to provide references and suggestions for the construction of medical simu-lation center higher education institutions.

OBJECTIVE: To study the characteristics of perioperative treatment of functional endoscopic nasal sinus surgery in elderly patients. METHOD: Data of 186 patients above 60 years old with chronic sinusitis were retrospectively analyzed. RESULT: After being received systematics and personal individuality treatment, the rates of curing were 72.5%, the rates of improving were 23.6% and the rates of efficiency were 96%. CONCLUSION The treatment of endoscopic sinus surgery is reliable and safe for elderly patients.
Aged ; Aged, 80 and over ; Chronic Disease ; Endoscopy ; Female ; Humans ; Male ; Middle Aged ; Nasal Polyps ; surgery ; Retrospective Studies ; Sinusitis ; surgery ; Treatment Outcome

Objective To explore the influence of computed tomography (CT) and magnetic resonance imaging (MRI) fusing technique on target volume and dosimetrics of normal tissues in intensity modulated radiotherapy (IMRT) for prostate carcinoma.Methods Ten patients with pathologically diagnosed moderate-high risk localized prostate carcinoma were enrolled in this study.CT and MRI images were collected.Same image slices of the prostate, seminal vesicles, rectum and bladder were anatomically delineated using image fusing software.Clinical target volume (CTV) was defined as the prostate plus seminal vesicles.IMRT treatment planning was designed basing on CT and MRI images, respectively.Differences of CTV volume and dose volume histogram of rectum and bladder between the two image groups were analyzed.Results The mean volume of CTV on CT and MRI images was 84.03 cm3 and 53.53 cm3,respectively (t =2.47,P=0.024).The V50, V60 and V70 of rectum were 30.28%, 19.13%, 9.53% on MRI and 37.03%, 24.99% and 14.55% on CT images, respectively, with significent difference (t =2.71,P=0.014 for V50; t =2.83,P=0.011 for V60; t=3.19,P=0.005 for V70).The maximal dose of bladder was 81.10 Gy on MRI and 82.45 Gy on CT, respectively(t=2.41,P=0.027).Conclusions By using image fusing technique, the mean volume of the prostate plus seminal vesicles delineated on MRI image is smaller as compared to CT image.The volume of the rectum receiving high irradiation dose can be reduced when MRI was used to delineate CTV compared to CT image.