The author of the article makes all-around expectation of continuous medical education development in our country from the ten aspects such as its role in medical reform and medical development,perfecting its construction,intensifing the demand-orientation,making scientific and informationized management.improving the quality of education and modernization of its means,conducting theoretical and practical study to generalize new theory and methods and promoting the international communication and cooperation.

Amplification of the human epidermal growth factor receptor 2/neu (HER2/neu) gene and overexpression of the HER2 protein (HER2) have been shown to occur in gastric and gastroesophageal junction adenocarcinoma in a number of studies.With a dismal survival rate,patients with these cancers stand to benefit from the identification of possible molecular targets such as HER2 for both prognostic and therapeutic purposes.Although these and other carcinomas that overexpress HER2 may have a poorer prognosis and exhibit resistance to conventional chemo-therapy,they have also recently been shown to respond to targeted therapy with the anti-HER2 antibody Trastuzumab.Here,the author briefly review the molecular biology,histopathology,diagnostic techniques,and interpretation,as well as the clinical implications of HER2 amplification/overexpression in gastric and gastroesophageal adenocarcinoma.

In view of the fact that the determination of body fat has very important bearing on the selection of certain naval and aviation personnel who may be subjected to sudden changes in environmental pressures, on veterinary economics, clinical medicine, nutrition, gymnastics as well as metabolic studies 43 males were chosen for a preliminary survey of their body fat content. Two relatively simple indirect methods for determining body fat were employed, namely: Behnke's specific gravity method and McCance's density-SCN combined method. In obtaining the sp. gr. of the body in each case the method was, however, modified in two respects. Firstly, due attention was paid to the temperature of the water in which the subject was immersed, and secondly, the amount of gas was ascertained in the lungs of the immersed subjects by asking them to expire into the spirometer while still in water instead of after getting out of the water as practiced in McCance's procedure.The average fat content of the 43 males in terms of body weight when calculated according to the method of Behnke's formula and modified method was 14.4% and 13.2% respectively. Analysis of the results showed that the body fat content obtained by Behnke's method was higher than that obtained by the modified method, the only exception being that case when the temperature of the water was at 37℃. It was also found that the lower the temperature of the water, the greater was the difference between the two methods. It is therefore important to keep the temperature of the water constant (preferably at body temperature) or to record the temperature, if not constant, and give due consideration to it in making the calculations.McCance's combined method was used on only 38 subjects out of the 43 and was carried out in two series. The average body fat content of the subjects in the first series was 12.7%, a figure significantly smaller than either one of Behnke's or the modified method in the same series. In the second series the fat content was 11.2%, with no statistical difference between it and either one of the above two. Therefore, in our opinion, this combined method needs more careful evaluation before being put into general use.

Objective To observe the therapeutic effects of stellate ganglion block (SGB) with oxycodone and acetaminophen tablets on the treatment of migraine. Methods 100 patients with migraine were divided into two groups randomly. They received SGB with oxycodone and acetaminophen tablets (experimental group) or only SGB (control group) respectively. The parameters included pain intensity before and 1 d,3 d,1 w,1 m and 3 m after the treatment, and pain relief rate of each patient. The adverse effects were also evaluated. Results The pain intensity described as numeric rating score (NRS) decreased in the two groups at each time point. In the experimental group, the value of NRS was significantly less than that in the control group at 3d,1m and 3m after the treatment. The effec-tive rate ha the experimental group and the control group were 88% and 68%. Conclusion SGB with oxycodone and acetaminophen tablets is more effective for migraine and deserves widely used in patients.

Objective To investigate the expressions of high mobility group box-1(HMGB1) and high sensitivity C-re?active protein (hs-CRP) in patients with acute coronary syndrome (ACS) and the effects of atorvastatin on the two inflamma?tory cytokines. Methods A total of 90 patients with ACS and 90 cases of normal control subjects were selected in this study. The serum concentrations of HMGB1 and hs-CRP were measured before treatment in patients of ACS. Patients were randomly divided into two groups:control group (n=45) and atorvastatin group (n=45). Atorvastatin was given 20 mg/24 h and 40 mg/24 h. Blood samples were obtained from the patients for detection of HMGB1 and hs-CRP one week after treatment with atorvastatin. Results There were significantly higher serum levels of HMGB1 and hs-CRP in patients with ACS than those of control subjects (P<0.01). The level of HMGB1 was positively correlated with the level of hs-CRP in patients of ACS (r=0.389, P<0.01). Before treatment, there were no significant diffferences in level of HMGB1 and hs-CRP in patients with ACS between the two groups. After treatment with atorvastatin, the levels of HMGB1 and hs-CRP were decreased in the two groups of ACS, and those were significantly lower in the intensive group than the standard group (P<0.05). Conclu?sion HMGB1 could stimulate the secretion of hs-CRP and other inflammatory cytokines, playing an important role in the process of occurrence and development of atherosclerosis. High loading dose of atorvastatin may reduce the expression of HMGB1 and decrease the inflammation, and stabilize the plaques in patients with acute coronary syndrome.

2.5ms, then the R-R interphase is normal, meaning that the rhythm is decreasing gradually after the premature ventricular complex; If TS

Objective To investigate autonomic nervous system(ANS)function of hyperthyroidism and hyperthyroidism by analyzing the heart rate variability(HRV)of patients with the diseases.Methods 12-synchronous dynamic 24-hour monitoring and man-machine dialogue were performed in 49 patients with hyperthyroidism,25 patients with hypothyroidism and 40 controls after removing interference,and 24-hour electrocardiogram wag analyzed.Heart rate variability indicators observed included 24-hour time-domain indexes[standard deviation of all experimental time RR(SDNN),root of mean square standard deviation from adjacent RR interval(RMSSD)]and 24-hour frequency domain indicators[very low frequency power(VLF),low-frequency power(LF),high frequency power(HF),low frequency power/high frequency power(LF/HF)].Results Indicators of time domain in hyperthyroidism group,such as SDNN[(69.65±13.55)ms]and RMSSD[(12.98±3.20)ms]were obviously lower than those of the control group[(136.07±11.95),(29.70±5.85)ms],the differences being statistically significant (P＜0.01).Indicators of frequency domain HF[(5331±15.84)msz]were lower than those of the control group [(223.38±50.09)ms2],butVLF[(1823.55±238.13)ms2],LF[(501.88±92.47)ms2]and LF/HF(5.89±1.15)was higher compared with that in the control group,repectively[(325.68±60.47)ms2,(405.60±5 1.41)ms2,2.14±0.56,P＜0.01).Among time domain indicators in hypothyroidism group,SDNN[(77.00±15.48)ms]and RMSSD [(14.80±2.58)ms]were also obviously lower than those in the control group(P＜0.01),the difference being significant statistically(P＜0.01).Frequency domain index HF[(57.88±12.20)ms2],VLF[(251.48±24.67)ms2],LF[(128.68±43.78)ms2]also obviously lower than those in the control group(P＜0.01),but LF/HF,being 1.83±0.63,was in a normal range and did not significantly changed(P＞0.05). Conclusion In patients with hyperthyroidism both sympathetic and vagus nerves are hyperdynamic,while in patients with hypothyroidism,vagus nerves are hyperdynamic,while sympathetic nerve hypodynamic.

Objective To evaluate the efficacy and safety of oral ibuprofen for closure of patent ductus arteriosus (PDA) in preterm infants.Methods The related literatures till December 31st,2011 in Cochrane Library,PubMed,EMBASE,Ovid,Springer,China Academic Journal Full-text Database,Wanfang Database,VIP Database and China Biological Medical Literature Database were searched.The inclusion criteria were:(1) the subject of the research was preterm infants with birth weight less than 2500 g and/or gestational age less than 37 weeks; (2) randomized or semirandomized controlled trial; (3) the intervention group received oral ibuprofen,while the control group received oral placebos / intravenous indomethacin or ibuprofen; (4) the main outcome was the failure rate of PDA closure; (5) hemodynamic changes with PDA were detected by ultrasonography.Meta-analysis was performed by Review Manager 4.22 software.Results Eleven randomized controlled trials were included,among which,three were high quality reports.Meta-analysis showed lower failure rate of PDA closure in subjects received oral ibuprofen than in those received placebos orally (RR =0.22,95 ％ CI:0.14-0.35),while the number of infants required operative closure of PDA decreased significantly (RR =0.16,95％ CI:0.03-0.86).Further analysis showed the effect of oral ibuprofen was similar to intravenous indomethacin (RR =0.93,95 ％ CI:0.57-1.53),but better than intravenous ibuprofen (RR=0.42,95％CI:0.26-0.67).However,oral ibuprofen did not reduced the ratio of patients required operation compared with intravenous indomethacin or ibuprofen (RR=0.58,95％CI:0.24-1.41).The incidence of gastrointestinal hemorrhage was higher in oral ibuprofen group than that in placebos(RR=1.99,95％CI:1.13-3.50).The serum level of creatine was lower in oral ibuprofen group than in intravenous indomethacin or ibuprofen group (weighted average=-19.10,95％ CI:-25.12-12.31).Compared with intravenous indomethcin group,less necrotizing enterocolitis cases were identified in oral ibuprofen group,but no statistical significance was found (RR=0.57,95％ CI:0.30-1.09).No long-term outcome was reported in any selected literature.Conclusions Oral ibuprofen for PDA closure in preterm infants appears to be as effective as intravenous or indomethacin,and more effective than intraveous ibuproten.Oral ibuproten represents better safety.

Objective To investigate the prostecdtive therapeutic efficacy of pulsed radiofrenquency and radiofrequency thermocoagulationof the Gasserian ganglion guided with spiral CT on trigeminal neuralgia. Methods 100 patients with idiopathic trigeminal neuralgiawere treated with pulsed radiofrenquency or radiofrequency thermocoagulation of gasserian ganglion. The numeric rating scales (NRS) ofpain were recorded before and 0.5 year, 1 year, and 2 years after treatment. Results There was no difference in NRS within 1 year, but the recurrencerate was high in the paitents accepted pulsed radiofrenquency 2 years later (P<0.01). Conclusion Pulsed radiofrenquency of thegasserian ganglion is safe and effective on trigeminal neuralgia, but poor in long-term outcome.