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

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

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

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.

Objective To analyze the efficacy and safety of CT-guided percutaneous injection of the fibrin glue bv double needle technique to treat sacral cyst.Methods Clinical data of 20 cases with double-needle injection of fibrin glue technology to treat sacral cyst were retrospectively analyzed.All patients had varying degrees of sacral nerve root compression symptoms.The treatment for sacral cyst was carried out after clear diagnosis was made.On the basis of CT-guided percutaneous injection of fibrin glue,the improved CT-guided percutaneous injection of fibrin glue by double-needle technique was used to treat these patients.The average dose of fibrin glue was(5.9 ± 2.4)ml.The clinical results of improvement as to pain and neurological function were evaluated after follow-up of an average of 17 months.The assessment criteria were as follows:excellent,complete resolution of signs and symptoms,with the patient returning to his or her regular employment and no recurrence of cysts during 1 year of follow-up,good,symptoms and signs in the legs and perineal region resolved but with persistent pain in the lumbosacral region,which did not interfere with the patient' s regular work (the cysts did not recur for 6 months during follow-up),fair,no improvement in clinical symptoms,but a decrease in cyst size on the imaging study,poor,no improvement in clinical symptoms and no observed changes in cyst size in imaging studies or recurrence.Results Most patients experienced some degree of pain relief and functional improvement after fibrin glue therapy,with most experiencing complete or marked resolution of clinical symptoms.Nine patients reported excellent recovery,8 reported good recovery,2 reported fair recovery,and 1 reported poor recovery.The overall percentage of positive outcomes (excellent and good recovery) was 85％.No serious postoperative complications were discovered.Conclusions CT guided percutaneous injection of the fibrin glue bydouble needle technique to treat sacral cyst is an ideal method.Double needle technique is simple,safe and reliable.

BACKGROUND:Astragaloside and tanshinone IIa are the effective components of traditional Chinese medicine treatment of myocardial ischemia, and its role in bone marrow mesenchymal stem cel s differentiation into myocardium-like cel s remains unclear.
OBJECTIVE:To investigate the effect of tanshinone IIa and astragaloside on the differentiation of bone marrow mesenchymal stem cel s into myocardium-like cel s.
METHODS:The maximal non-toxic concentrations of tanshinone IIa and astragaloside were measured using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay, to define the dose of the two in the induced differentiation of bone marrow mesenchymal stem cel s into myocardium-like cel s. The isolated and purified bone marrow mesenchymal stem cel s were divided into five groups:astragaloside group, tanshinone IIa group, astragaloside+tanshinone IIa group, 5-azacitidine group, and blank control group. The expression of gap junction connexin 43 and troponin was determined with enzyme-linked immunosorbent assay.
RESULTS AND CONCLUSION:The expression of gap junction connexin 43 and troponin in astragaloside group, tanshinone IIa group, astragaloside+tanshinone IIa group, 5-azacitidine group was higher than that in blank control group (P<0.01). The astragaloside+tanshinone IIa group showed a higher expression of gap junction connexin 43 and troponin than astragaloside group and tanshinone IIa group (P<0.01). There was no significant difference in the expression of gap junction connexin 43 and troponin between astragaloside+tanshinone IIa group and 5-azacitidine group (P>0.05). A combined use of astragaloside and tanshinone IIa can induce bone marrow mesenchymal stem cel s to differentiate into myocardium-like cel s, and their joint role is better than the role of a single ingredient.

A total of 12 775 SSRs were identified from Scutellaria baicalensis Georgi genomic database, accounting for 2.56% of the total genomic sequences. The result showed that S. baicalensis SSRs were based on 68.32% dinucleotide and 18.63% trinucleotide repeats; CT/GA and TTC/GAA were predominant in the dinucleotide motifs and the trinucleotide motifs respectively. Nine primers were selected to produce highly reproducible SSR bands and were used in studying the genetic diversity of S. baicalensis, 50 individuals from ten populations. 68 SSR polymorphic loci were detected, these loci were polymorphic and displayed 4 to 12 alleles per locus with a mean number of 7; the effect number of alleles was 3. Expected heterozygosities were 0.6 and were far more greater than the average in dicotyledonous plants. PIC (polymorphism information content) was 0.72, Shannon's information index was 1.32, these all proved that S. baicalensis had a high genetic diversity in general. Genetic differentiation among population Gst was 0.131, genetic variation among population accounted for 13.1% and genetic variation within population accounted for 86.9%. The cluster analysis showed that 10 populations S. Baicalensis were classified into 2 groups, but it was not associated with geographical distribution.