In recent years constant improvements have been made regarding medical and health laws and reg-ulations in China while at the same time clinical teaching, a closely related field, has been conducted in accordance with old rules and regulations. Such a mechanism of clinical teaching, which finds itself hard to operate under the new medical and health laws and regulations, will restrict or even hinder patient care and clinical teaching. For this rea-son, it is imperative for us to find by legal means solutions to such problems as the status, work extent and legal re-sponsibility of those engaged in clinical teaching and set up a mechanism and mode of legal guarantees for clinical teaching, wherein there are laws to abide by.

Objective To investigate the change of the cerebral glucose metabolism in Parkinson's disease(PD) with cognitive impairment.Methods Fifty patients with PD and twenty normal controls were enrolled in this study.Based on MMSE score,the PD patients were divided into PD-NC(n=25) and the PDD(n=25) group.Twenty age-and sex-matched physical health examinationer were colleted as control group.Using the SPM to analyze the characteristics of the metabolism in different cognitive level io PD patients.Results (1) Compared with control group,P D-NC group showed significant hypermetabolism in occipital (-24,-92,10),parietal (-48,12,-16) and temporal lobe(52,8,-32).(2)Compared with control group,the glucose metabolism of PDD group decreased in most cerebral cortex and subcortex.(3)Compared with PD-NC group,the metabolism of parietal lobe (-42,-48,40),occipital lobe (-22,-96,-6) and tetnporal lobe (-42,-58,16) reduced in PDD group.Conclusion Cortical brain metabolism decreases in PD-NC group.The degree and scope of glucose metabolism of PDD group will increase with the progress of cognitive dysfunction.These features could help with the diagnosis and differential diagnosis of cognitive dysfunction in Parkinson's disease.

Objective To evaluate reformative encircling constriction combined with the retrograde venograms in operation for treating primary deep venous insufficiency. Methods The clinical data of 25 cases (29lower extremities) undergoing primary deep venous insufficiency from March 1998 to December 2006 were analyzed retrospectively. 25 eases(29 lower extremities) were treated with reformative encircling constriction combined with the retrograde venograms in operations. Results 25 eases were treated with reformative encircling constriction combined with the retrograde venograms in operations,the leg swelling improved and no deep vein thrombus occurred; all the varicose veins are welt controlled. Conclusion Reformative encircling constriction operations are eutherapeutic for severe femoral venous valve dysfunction, when combined with the retrograde venogram, it can be a guidance in encircling constriction of superficial femoral vein and number of femoral venous valves.

Assessing dry weight accurately is crucial in providing effective and safe haemodialysis. Biases towards dry weight assessment may bring a series of dialysis complications. This study introduces an online detection technique of relative blood volume (RBV) based on ultrasound, which analyzes the correlation between changes in blood density and sound speed. By measuring the attenuation in sound velocity, this method was employed to calculate RBV, and then to evaluate the dry weight of patients on dialysis. TDC-GP2 time measurement chip and MSP430 Single-chip Microcontroller (SCM) were used in the system to measure the ultrasonic travel time. In the clinical trials, RBV values range between 71.3% and 108.1%, showing consistent result with Fresenius 4008S blood volume monitor (BVM). This detection method possesses several advantages, such as real time, convenient, reproducible, non-invasive, and etc.
Blood Volume ; Body Weight ; Humans ; Monitoring, Physiologic ; Renal Dialysis ; Ultrasonics

Objective To investigate the effect of 3-bromopyruvate (3-BrPA) on transplanted rectal tumors in experimental rabbit models. Methods A total of 60 New Zealand white rabbits with transplanted rectal tumor were randomly and equally divided into low-dose (0.5 mmol/L), medium-dose (1.0 mmol/L), high-dose (2.0 mmol/L) treatment groups and saline control group with 15 rabbits in each group. Arterial perfusion of 10 ml 3-BrPA with concentration of 0.5 mmol/L, 1.0 mmol/L and 2.0 mmol/L via caudal mesenteric artery was respectively employed for the rabbits of the corresponding treatment group; the control group was perfused with equal amounts of saline. Four days later, rectal tumors were removed by vivisection. The necrosis degree of tumor cells was determined by microscopic examination, and the necrosis rate was calculated. The effect of different 3-BrPA concentrations on the rectal tumor was evaluated. Results The rectal tumor transplantation and transcatheter 3-BrPA or saline perfusion was successfully completed in all 60 experimental rabbits. Microscopically, tumor cells showed different degrees of damage in experimental rabbits. In low-dose (0.5 mmol/L) treatment group, gradeⅠnecrosis was observed in 3 rabbits, gradeⅡin 11 rabbits, and gradeⅢin one rabbit;the effective rate was 6.7%. In medium-dose (1.0 mmol/L) treatment group, gradeⅡnecrosis was seen in 2 rabbits, grade Ⅲ in 10 rabbits, and grade Ⅳ in 3 rabbits; the effective rate was 86.6%. In high-dose (2.0 mmol/L) treatment group, gradeⅢnecrosis was detected in 2 rabbits and gradeⅣin 13 rabbits;the effective rate was 100.0%. In the saline control group, grade I necrosis was observed in 15 rabbits. Statistically significant differences in tumor necrosis rate and effective rate existed between medium-dose (1.0 mmol/L) treatment group and high-dose (2.0 mmol/L) treatment group (P<0.05). Statistically significant differences in tumor necrosis rate also existed between each other among the four groups with necrosis of gradeⅠto gradeⅣ(P<0.05). 3-BrPA had obvious therapeutic effect, while it showed no damage to the normal intestinal tissue. Conclusion For the treatment of transplanted rectal tumor in rabbit models, arterial infusion of 3-BrPA has certain therapeutic effect. In the high-dose group, the necrosis rate and effective rate are the highest, and the therapeutic results are the most significant.

BACKGROUND: Neuronal apoptosis produced a main effect in secondary injury after injury of central nervous system. Recently, minocycline has been reported to protect neurologic function evidently by decreasing apoptosis.OBJECTIVE:To study the effect of minocycline on apoptosis and expression of related factor, and protective effect of minocycline on neurologic function of injured spine after spinal cord injury (SCI) in rats.DESIGN: A randomized controlled animal study.SETTING: Tongji Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology.MATERIALS: The experiment was performed at the Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology between November 2003 and December 2004. A total of 36male SD rats were divided into four groups: ①Blank control group (group A) with 6 rats, ②injured group (group B) with 10 rats, ③minocycline treatment group (group C) with 10 rats, and ④methylprednisolone treatment group (group D) with 10 rats.METHODS: The animal SCI model was established. Spinal cords of rats in the group A were exposed without injury. Spines of rats in the group B were injured without treatment. Rats of group C was treated with minocycline (50 mg/kg) by intraperitoneal injection at 1 hour after injury, and 24 hours later another 50 mg/kg was given, and then another 25 mg/kg was injected for 5 days. Methylprednisolone (100 mg/kg) was intraperitoneally injected 1 hour after injury in the group D. The rats in the group A and the group B were treated with saline, and the method of administration was the same with that of the group C.MAIN OUTCOME MEASURES: ①Neurofunction evaluation of rats in each group. ②Expressions of Bcl-2 family members (Bcl-2, Bcl-xl, and Bax) were tested with immunocytochemical method. ③Apoptosis index of spinal tissue of rats of each group.RESULTS: A total of 36 rats were involved in the result analysis. ①Neurofunction of rats in the group C increased as compared with the group B (P ＜ 0.05), and there was insignificant difference between group C and the group D (P ＞ 0.05). ②Bcl-2 positive expressive cells in the group C was more than that in the group B, and showed obvious difference between the two groups [(62.53±7.76)%, (35.14±3.70)%,P ＜ 0.05]. There was insignificant difference between expressions of Bcl-xl and Bax in group C as compared with the group B (P ＞ 0.05). ③The number of apoptosis positive cells in the group B was more than that in the group C and D [(44.63± 5.90)%, (32.71± 5.26)%, (34.31± 6.84)%,P ＜ 0.05].CONCLUSION: Minocycline can up-regulate the expression of Bcl-2, and raise the ratio of Bcl-2/Bax, so as to inhibit the neural apoptosis of spine,which have protective effect on neurologic function of injured spine.

Objective To investigate the characteristics of cerebral glucose metabolism (CGM) in PD patients with cognitive impairment (PD-CI) using 18F-FDG PET/CT,and to analyze the correlation between the progress of PD-CI and CGM changes.Methods A total of 31 idiopathic PD patients (14 males,17 females,aged 37-77 years) from May 2013 to February 2014 were divided into 3 groups based on Montreal cognitive assessment (MOCA):none CI in PD (PD-NC) group (MOCA＞26 scores),mild CI in PD (PD-MCI) group (MOCA 21-26 scores),PD with dementia (PDD) group (MOCA＜21 scores).The normal controls (NC) group included 12 age-and gender-matched healthy adults (7 males,5 females,aged 40-76 years).All subjects underwent PET/CT imaging after intravenous injection of 18F-FDG(5.55 MBq/kg).MIMneuro software was used to analyze the data.The correlation between the CGM and cognitive function was analyzed using Pearson or Spearman correlation analysis.Results (1) Compared with NC group,PDD group presented a widespread cortical metabolism decrease in frontal,parietal,temporal,occipital 19bes and the limbic lobe;PD-MCI group showed hypometabolic areas in the parietal and occipital lobes,and with less extent in the frontal and temporal lobes;PD-NC group showed no significant cerebral hypometabolism.(2) Compared with PD-NC group,PDD group showed widespread cortical metabolism decrease in occipital lobe,temporal lobe,partial parietal cortex and the posterior cingulated cortex.Compared with PD-MCI group,PDD group had lower metabolism,mainly in posterior brain areas (parietal,occipital and temporal lobes).Compared with PD-NC group,PD-MCI group showed hypometabolism in right supramarginal gyrus and the left parahippocampal gyrus.(3) There were positive correlations between visuospatiaL/executive function and visual cortex metabolism,angular gyrus metabolism or superior parietal lobule metabolism (r =0.535,0.443,0.395;all P＜0.05).A positive correlation was also found between delayed memory and heschl's gyrus metabolism (r=0.337,P＜0.05).Conclusions The cerebral glucose metabolism detected with 18F-FDG PET/CT is well correlated with MOCA assessments.Thus it may be helpful in evaluation of the progress of cognitive impairments in PD.

Abstrac Objective:To investigate the clinical efficacy of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) in the treatment of squamous-cell lung cancer patients with EGFR mutations. Methods:We screened out seven patients who were diag-nosed with EGFR mutations and received EGFR-TKIs, such as gifitinib or erlotinib, from 2,317 squamous-cell lung cancer patients treat-ed at the Beijing Chest Hospital from January 2010 to July 2016. Results:After using EGFR-TKIs, the objective response rate was 42.9%, the disease control rate was 100%, and the median progression-free survival was 6.1 months. Conclusion:EGFR-TKIs exert a certain clinical curative effect on patients with EGFR mutations in squamous-cell lung cancer. However, given that only seven cases are pre-sented in this research group, more cases are needed for further research to verify the above conclusion.

Objective:To explore the effect of different separation and purification technology on the physical and chemical proper-ties of water extract of ophiopogonin. Methods:The water extraction process of total ophiopogon saponins was optimized by an orthogo-nal test. The macroporous resin adsorption and membrane separation technology were adopted to purify the ophiopogonin water extract. The physical and chemical parameters, such as electrical conductivity, pH value, viscosity and turbidity, and the contents of total sap-onins, proteins, tannins and polysaccharides were determined. Results:The optimum water extraction technology of total saponins was as follows:6-fold amount of water was added, boiling 3 times with 90 min for each time. The electrical conductivity, pH value and vis-cosity of different purified liquid of total saponins had no significant differences, while the contents of total saponins and the three kinds of macromolecules showed significant differences. Conclusion: The content of macromolecules can be used as the reference index of purification process of total saponins water extract. Compared with macroporous resin separation, membrane separation technology is more suitable for the separation and purification of total saponins water extract.

With the further development of education informatization,the popularity of computer simulation technology and multimedia network technology were increasing.The teaching center of school of stomatology in the fourth military medical university combined stomatology teaching with information technology and gradually applied diversified teaching mode in the dental clinical experiment teaching,which not only saved the input of faculty and consumables items,but also improved the stomatology experimental teaching quality and achieve the teaching modernization.