Medical universities and colleges have to strengthen and develop teaching affairs of health law in accordance with requirements of time. They must deepen teaching reform by paying attention to the practical teaching sectors,optimize teaching resources from teachers, teaching materials, teaching content,and explore ways to enhance teaching effectiveness from the case teaching,teaching clinics,targeted teaching methods,so as to train medical and health personnel with good quality of law knowledge.

Purpose To investigate the influence of interpersonal relationship sensitivity on anxiety and depression emotion and subjective well-being for young adults epileptic patients.Methods 87 young adults epileptic patients were divided into interpersonal relationship sensitive group ( study group) and normal group ( control group),according to sensitivity factor ≥ 3 in the symptom checklist(SCL-90).Self-rating anxiety scale ( SAS),self-rating depression scale (SDS) and general well-being scale (GWB) were then established and analyzed.Results The scores on interpersonal relationship sensitivity factor of the study group and control group were 3.64 ±0.51 and 2.73 ± 0.43,respectively,which had remarkable difference ( t =8.91,P ＜ 0.01 ).There were 47 patients with interpersonal relationship sensitivity among the 87 patients,accounting for 54.02％.The scores on SDS and SAS of the study group were higher than control group (P＜0.01 ).The scores on GWB of the study group was significantly lower than the control group (P＜0.01).The scores on GWB of the study group,reflecting the factors about health,energy,satisfaction and interest to life,depression and happy emotion,and relax and nerves,were lower than control group (P＜0.01) ; while the scores on emotion and behavior control were higher than the control group with minor difference (P ＞ 0.05 ).The scores on interpersonal relationship sensitivity factor and SDS,SAS and GWB were positively correlated except for O factor of GWB.Conclusion The level of interpersonal relationship sensitivity has important influence on anxiety and depression emotion and subjective well-being in young adults epileptic patients.

Objective To investigate the relation of morbidity law of upper gastronintestinal hemo rrhage and cycle of Heavenly Stems and Earthly Branches in Gansu province. Methods Investigative statistical forms were set up and analyzed by computer about twelve years in-patient of upper gastronintestinal hemorrhage in TCM hospital of these district. Results High morbidity corresponded with theory of YUNQI, in 1988 (year of the fifth of ten Hevenly Stems and the fifth of the twelve Earthly Branches, HUOYUN is high sufficient), 1995 (year of the second of ten Hevenly Stems and the last of the twelve Earthly Branches, JINYUN is insufficient), and Baiyin district in 1994 (year of the first of ten Hevenly Stems and the eleventh of the twelve Earthly Branches TUYUN is high sufficient), Cheng district in 1996 (year of the third of ten Hevenly Stems and the first of the twelve Earthly Branches, SHUIYUN is high sufficient), YUNQI was high sufficient or insufficient, which causing diseases conform to five internal organs and geographical position. Conclusion Morbidity law of upper gastronintestinal hemorrhage corresponds with cycle of Heavenly Stems and Earthly Branches.

Objective To investigate the relation between TCM syndromes of upper gastrointestinal hemorrhage and solar terms change in different years. Methods Data of upper gastrointestinal hemorrhage in-patients in seven districts of TCM hospital of Gansu province in twelve years were filled in investigative statistical forms and analyzed by computer. Results There was obvious difference in TCM syndromes among different solar terms and different years. Conclusion Atmospheric pressure, atmospheric temperature, air humidity, diurnal temperature range of solar terms change in different years directly effect TCM syndromes of upper gastrointestinal hemorrhage.

Objective:To investigate the results of surgical treatment for multi-level spinal tuberculosis with focal debridement ,bone grafting and primary internal fixation.Method:27 cases of multi-level spinal tuberculosis treated by operation from January 1999 to January 2007 were reviewed retrospectively.3 vertebral bodies involved in 15 cases,4 vertebral bodies involved in 7 cases,5 vertebral bodies involved at least in 5 cases.Of these,there were 5 cases in thoracic vertebra,7 cases in lumbar vertebra,11 cases in thoracolumbar vertebra,4 cases in lumbosacral vertebra.11 cases showed neurological deficit before surgery,According to the Frankel classification,Frankel B in 1 case,Frankel C in 2,Frankel D in 8.The preoperative average Cobb angle of kyphosis was 35°±7° (range,26°-43°).The focal debridement,bone grafting and primary internal fixation were performed for all patients.Among these protocols, 16 cases underwent one staged posterior spinal internal fixation and anterior focal debridement,bone grafting.11 cases had anterior spinal internal fixation with focal debridement and bone grafting.All patients received anti-TB chemotherapy before and after operation.Anti-TB chemotherapy protocols consisting of combinations of rifampin,isoniazid,ethambutol and streptomycin were administered for 3 months which including 3 weeks before the operation and 3 months after the operation,followed by rifampin,isoniazid and ethambutol for a total of 9 months.The clinical outcomes were evaluated according to the criteria designed by WU Qiqiu et al.Result:The average surgical time was 240 minutes (range,150-300min),with the average intraoperative blood loss of 1000ml (range,600-1400ml),There was no complication such as nerve injury and cerebrospinal fluid leakage.The incision in 1 case presented sinus which had a secondary healing later on,others obtained primary healing.The average postoperative Cobb angle of kyphosis was 15°±5°(range,12°-20°).All cases were followed up for an average of 18 months(range, 14-48 months).The patients with paraplegia recovered to the normal in 8 months.Bony fusion was achieved in all cases with mean fusion period of 7 months(range,5-14 months) with no incidence of hardware failure.At the final follow-up,all patients had evidence of clinical heal and the solid bony fusion.Conclusion:Focal debridement,bone grafting and primary internal fixation is reliable in dealing with multi -level spinal tuberculosis.

0.05). After operation, in the pedicle screw fixation group the indexes were restored, but the restoration was lost gradually at later follow- up stage. Their superior- inferior endplate angle before operation averaged 19.5? , but 8.6? after operation, and 20.0? at the latest follow- up. Their wedged angle before operation averaged 20.7? , but 9.1? after operation, and 15.9? at the latest follow- up. In the non- pedicle- screw fixation group, the indexes decreased gradually at the later follow- up. Their average superior- inferior endplate angle before operation was 16.6? , 14.6? after operation, and 23.0? at the latest follow- up. Their average wedged angle before operation was 15.6? , 16.6? after operation, and 22? at the latest follow- ups. Conclusions The height of the fractured vertebra may be lost and the wedged vertebra may occur again after surgery but conditions may become stable in 2 years. The spinal kyphosis deformity, however, may go on. Its possible causes are structural changes of the vertebra after surgery, the early degenerative changes of the adjacent intervertebral discs, and osteoporosis.

Objective To study the case of 76 patients with choledochoduodenal fistula ( CDF) ,and summarize the experience of mak-ing diagnosis and treatment. Methods From January 1999 to June 2012,76 patients with CDF were treated in our department and then was confirmed by endoscopic retrograde cholangiography ( ERCP) . All patients were classified based on the location of duodenal papilla in rela-tion to the orificium fistulae of CDF. Different therapies were used to certain CDF depending on the diameter of the orificium fistulae of CDF. Of the 76 CDF patients,70 patients (92%) required surgery. Results The fistula of 76 CDF patients have three types,and the formation of this classification was based on the position between the duodenal papilla and the orificium fistulae of CDF. Different therapies referred to cer-tain diameter of CDF,70 patients required surgery and 6 acquired pharmacotherapy. Of the 70 patients needing surgical intervention,clinical outcomes were excellent in 66 patients. Follow-up of these patients for 6 months to 10 years showed they did not suffer from further cholangi-tis. Conclusion The past history of biliary disease,upper abdominal pain,fever,and jaundice may lead to the disease of CDF. ERCP was the primary method for diagnosing this disease,and operative therapy was the primary treatment for most CDF patients.

[Objective] To investigate the changes of urinary deoxypyridinoline(DPD)in patients with spinal tuberculosis(STB)and evaluate their clinical significance.[Method] All subjects were divided into three groups:group 1,STB patients;group 2,Pulmonary TB patients:group 3,healthy controls.Their DPD was detected by ACS:180 automated chemiluminescence system.The values for urinary DPD were adjusted for urinary creatinine to overcome confounding variables such as body mass index and urine dilution.The results were analyzed.[Result]The mean urinary concentrations of DPD in spinal tuberculosis,pulmonary tuberculosis and healthy controls were 1(4.9?9.8)?mol/mol Cr.,(6.4?2.6)?mol/mol Cr,and(6.3? 2.0)?mol/mol Cr.,respectively(P value=0.001,0.000).Patients with spinal tuberculosis had a higher urinary excretion of DPD than those without spinal tuberculosis.There was no difference in groups of pulmonary tuberculosis and healthy controls(P=0.751).DPD had a better receiver operating characteristic(ROC)curve and the area under the ROC curve was 0.83.For DPD,the sensitivity(87%)and specificity(73%)were seen at the cut-off level of 8.4 ?mol/mol creatinine.[Conclusion]Change of bone matabolic activities can be found in patients with STB.Bone resorption can increase sharply by DPD.The determination of urinary DPD may provide an important reference value for the assessment of STB from Pulmonary TB.

Objective To study the distribution of rifampin(RFP), isoniazid(INH) and pyrazi-namide(PZA) in the focus of spinal tuberculosis in order to provide the regimen of chemotherapy and surgi-cal treatment of spinal tuberculosis. Methods Twenty-four patients with spinal tuberculosis were divided into sclerotic group or non-sclerotic group according to the radiographic features of lesion. All patients re-ceived chemotherapy with 2SHRZ/2.5 H2R2Z2 for a duration of 4.5 months. 4 weeks after chemotherapy, all patients underwent surgery and specimen of serum, ilium and vertebral tissues including sclerotic wall, sub-normal osseous tissue, focus inside sclerotic wall (sclerotic group) and destructive focus, peripheral subnor-mal osseous tissue (non-sclerotic group) were obtained during operation at 120-130 and 180-190 minutes after oral intake in the morning respectively. The levels of 3 drugs in the specimen were measured using HPLC method. Results 1) The concentration levels of INH and PZA in serum were similar to the data in the literature, but the level of RFP was only 75% of that in the literature. The levels of 3 drugs in osseous tissue were significantly less than those of blood. 2) Concentrations of isoniazid and rifampicin in self-control ilium and sub-normal bone tissue were within or exceeded the bactericidal concentration values,and pyrazi-namide was five fold of it's minimal inhibitory concentration (MIC) in acid cellular condition. There were no significant differences between sub-normal bone and self-control ilium of 3 drugs concentration. 3) Concen-tration of 3 drugs in sclerotic bone wall were approximate to MIC respectively in sclerotic group and much lower than sub-normal bone. There was no drug distribution of focus inside sclerotic bone wall. 4) RFP and PZA in focus of non-sclerotic group corresponded to the levels of MIC respectively, though much lower than in other parts of vertebral tissues, but the INH in focus was of bactericidal level. Conclusion The sclerotic bone of affected vertebra plays an important role to block the drug's penetration into tuberculosis focus.

Objective To evaluate the clinical efficacy of three chemotherapy regimens and partial excision of the affected vertebrae for spinal tuberculosis. Methods Between December 1998 and November 2003, 76 cases with spinal tuberculosis were treated with chemotherapy and surgical intervention. All pa-tients were divided into three groups randomly to receive one of three different courses of chemotherapy. Among these, 38 cases were selected to receive ultra-short-course chemotherapy regimen with 2SHRZ/ 2.5H2R2Z2, 23 of short-course with 3SHRZ/5H2R2Z2, and 15 of standard with 3SHRZ/9H2R2Z2. The duration of the preoperative chemotherapy of the three groups was about the same with an average of 21 days (15 to 40 days). All patients underwent anterior partial excision of the affected vertebrae, large iliac strut graft and anterior or posterior fixation. Results The mean follow-up time of the ultra-short-course, short-course and standard chemotherapy groups were 23, 28 and 45 months respectively. The observed indices included: 1) Clinical manifestation: disappearance of TB symptoms, the nerve function recovered, life and the work activ-ities. 2) Lab tests: both ESR and CRP data or either of them in normal or near normal status. 3) X-ray, CT and MRI examination: abscesses, new lesion, absorption of the bone grafts, translucent line between bone graft and vertebral body, and correction of kyphotic deformity. 4) Ultrasonic examination: no opaque dark area at the sites where there might be the paravertebral or gravity abscesses. 5) Drug complications: the hepatic and renal function of patients at follow up were normal or close to normal. The follow-up showed that all the three groups achieved excellent results. Conclusion Treatment of spinal tuberculosis with anterior partial excision of pathologic vertebrae, large iliac strut graft and anterior or posterior internal instrumental fixation in either ultra-short-course, short-course or standard chemotherapy all achieved excellent therapeutic effects. There was no difference among three different courses of chemotherapy.