Based on the shortcomings of graduate education in clinical medicine of our country and the characteristics of this specialty, the author point out that the cultivation of graduates in otolaryngology, head and neck surgery should be focused on the training of humanities, professional knowledge and skills. And they also make some suggestions and discussion about the reform of graduate education mode.

Objective To investigate the effect of combined application of mannitol and monosialoganglioside on neurological function and its efficacy in brain edema after intracerebral hemorrhage. Methods 92 cases of cerebral edema in patients with cerebral hemorrhage in our hospital, were randomly divided into groups, each group of 46 cases, the control group on the basis of the treatment of mannitol (125mL per times, once per 8h) treatment, the study group on the basic of control group received monosialogangliosides (20mg per times, once daily), 10d for a course of treatment, determination of serum indexes, neurological functions were recorded. Results The effective rate of control group was 71.74%, which was lower than 91.30% of the study group, there was significant difference (P < 0.05); compared with control group after treatment , in study group the intracranial pressure, intracranial hematoma, edema decreased, the urine volume increased, National Institutes of Health Stroke Scale (NIHSS) and quality of life score decreased, interleukin (IL-1β), high sensitive C reaction protein (Hs-CRP), IL-6 and IL-8 levels decreased, Na+-K+-ATP enzyme increased, the ratio of cerebrospinal fluid albumin and serum albumin, matrix metalloproteinase (MMP-2) and MMP-9 decreased, there were significant differences (P < 0.05). Conclusion The effect of the combined application of mannitol and monosialoganglioside on cerebral edema after cerebral hemorrhage is exact and could improve neurologic function.

Objective:To provide informational and personalized health service platform for the current number of chronic diseases and health groups. Methods:a variety of portable devices physiological data were collected to transmit to the remote health monitoring platform, making the service with strong mobility for home care, postoperative care and patient care whenever and wherever needed to provide the best care service model, so that medical and health care is no longer subject to the constraints of time, hospitals and other fixed places. Results: Through a variety of wireless transmission technology and the intelligent terminal and regional health data center, it can be further mining, analysis and storage for the data information, and provide diagnostic advice. It can effectively alleviate the tension of medical resources. Conclusion:The establishment of remote health monitoring platform can alert doctors and relatives when data is abnormal to win time for rescue. It can effectively manage the disease treatment, prevention and rehabilitation.

CD3 Complex ; metabolism ; CD5 Antigens ; metabolism ; Diagnosis, Differential ; Female ; Gene Rearrangement, gamma-Chain T-Cell Antigen Receptor ; Humans ; Leukocyte Common Antigens ; metabolism ; Leukosialin ; metabolism ; Lymphoma, T-Cell, Cutaneous ; metabolism ; pathology ; Middle Aged ; Skin Diseases ; pathology

OBJECTIVETo evaluate clinical results of plate on the metatarsal side to reconstruction of tarsometatarsal joint dislocations secondary to diabetic charcot foot.

METHODSSeven patients (9 feet) patients with tarsometatarsal joint dislocations secondary to diabetic charcot foot were treated with plating from April 2012 to December 2014. All patients were male, and 5 cases were on the unilateral side and 2 cases were on the bilateral sides. The age of patients ranged from 45 to 52 with an average of 48 years old. The history of diabetics was from 6 to 15 years. X-ray and CT were used to evaluate fractures healing,and AOFAS was applied to estimate recovery of joint function.

RESULTSAll patients were followed up from 12 to 24 months with an average of 19 months. All incisions were healed at stage I . No infection, loosening and breakage of internal fixation, bone nonunion were found after operation. According to postoperative X-ray and CT results, the time of fracture healing ranged from 10 to 20 weeks with an average of 16 weeks. Six feet got excellent results, 2 good and 1 moderate based on AOFAS scoring.

CONCLUSIONTarsometatarsal joint dislocations secondary to diabetic charcot foot treated with plate on the metatarsal side could obtain stable fixation and got satisfied early clinical results.

Adult ; Bone Plates ; Diabetes Complications ; surgery ; Diabetes Mellitus, Type 2 ; complications ; Female ; Foot Diseases ; etiology ; surgery ; Fracture Fixation, Internal ; Humans ; Joint Dislocations ; surgery ; Male ; Metatarsal Bones ; surgery ; Middle Aged ; Tarsal Joints ; surgery

Breast ; pathology ; Breast Neoplasms ; blood supply ; pathology ; Carcinoma, Ductal, Breast ; blood supply ; pathology ; Carcinoma, Intraductal, Noninfiltrating ; blood supply ; parasitology ; Female ; Humans ; Hyperplasia ; Microcirculation ; pathology ; Neovascularization, Pathologic ; pathology

Objective:To investigate the effects of Bailing capsules on the expression of TGF-β1 in the peritoneal dialysis solution for peritoneal dialysis patients. Methods: Totally 40 patients treated with peritoneal dialysis ( PD) were randomly divided into two groups (20 cases in the control group and 20 cases in the experimental group). All the patients were treated with PD by 1. 5% perito-neal dialysis effluent (6 000 ml everyday), and the patients in the experimental group were additionally treated with Bailing capsules (5 capsules each time, three times a day after meals) for 6 months. The adequacy of PD (including Kt/V and Ccr) of the two groups was examined after the one-month treatment. The renal function and the level of TGF-β1 in the effluent in 1, 3 and 6 month were com-pared between the two groups. Results:The adequacy of PD ( Kt/V and Ccr ) had no significant difference between the two groups (P<0. 05). The level of serum creatine was decreased significantly in both groups after the one-month treatment (P<0. 05), and no significant change was shown in 3 and 6 month (P>0. 05). In the control group, the expression of TGF-β1 in the effluent in 1, 3 and 6 month was increased gradually with significant difference (P<0. 05). In the experimental group, the expression of TGF-β1 in the effluent had no significant difference in 1, 3 and 6 month (P>0. 05), which was lower than that in the control group (P<0. 05). Conclusion:Bailing capsules can decrease the expression of TGF -β1 in the effluent for the patients treated with PD and inhibit the peritoneal fibrosis.

Objective To observe the effect of vascular endothelial cell growth factor (VEGF)on apoptosis and matrix metabolism of rat intervertebral.disc cells cultured in vitro. Methods Culture system of rat intervertebral disc cells was established to culture the monolayer intervertebral disc cells in vitro.The well-grown intervertebral disc cells of the second generation were chosen and anti-Fas antibody was applied to induce their apoptosis.Then,VEGF at different concentrations ( 10,100,1 000 μg/L)were used to affect their apoptosis and metabolism.The apoptosis of the cells stained with Propidium Iodide (PI) was detected by using flow cytometry.The levels of hydroxyproline and proteoglycan in the culture medium were detected by using chloramines T method and DMB chromometry method,respectively.Results ( 1 ) The apoptotic ratio of the intervertebral disc cells affected by different concentrations of VEGF (10,100,1 000 μg/L) was (87.62 ±11.06)％,(53.30 ±9.23)％ and (16.75 ±4.21)％ respectively,with significant differences in comparison with the control group (P ＜ 0.01 ).(2)The contents of hydroxyproline [ (6.71 ±0.33) μg/L,(9.12 ±0.41 ) μg/L,( 11.58 ±0.12) μg/L] and proteoglycan [ (23.21 ± 2.87) μg/L,( 32.45 ± 5.23 ) μg/L,(37.18 ± 3.22) μg/] in the culture medium raised with the increase of VEGF concentration ( 10,100,1 000 μg/L),with statistical differences compared with those of the control group (P ＜0.01 ).The contents of hydroxyproline and proteoglycan were positively correlated with the concentration of VEGF (ra=0.972,P＜0.01;rb =0.907,P＜0.01). Conclusion VEGF can inhibit the apoptosis of the rat intervertebral disc cells cultured in vitro and promote collagen and proteoglycan synthesis of the cell matrix.

Science Spirti play a important role in promoting moral standardization and the comcept development.The implication of science to seek truth,rational,criticize and suspicion,freedomand creating,which possesses important significance to cllture value sense of professional ethics of physicians to save life by loveheart,uphold truth,dedceating ond self to medical cause,and to promote sociatist medical moral progress.

Objective To evaluate the value of diagnosis of NOF by plain film and CT.Methods Radiographic and CT findings in 14 patients (male 11,female 3;age range,9～51 years)with non-ossifying fibroma proved pathologically and surgically were analysed.Results The age of 9 patients (64.3%)was between 10 and 20 years.Most of non-ossifying fibromas occured in lower extremity,especially around the knee.The X-ray findings could be divided into two types:(1)Cortical type(6 cases);(2)Medullary type(8 cases).The CT signs included:(1)Local destruction of the adjacent cortex;(2)Bone septum;(3)Well-defined sclerotic edge near the medulla.Conclusion Most of the NOF of bone can be diagnosed correctly by radiography and CT.