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 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.

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.

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

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.

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.

Objective To investigate the impact of internal carotid artery stenosis on cognitive function of patients and the improvement of cognitive function after internal carotid artery stenting. Methods The clinical data of 92 patients with asymptomatic internal carotid artery stenosis on segment C1 segment diagnosed by cerebral angiography at the Department of Neurology,Urumqi General Hospital of Lanzhou Military Hospital from May 2007 to June 2013 were analyzed retrospectively,including 49 with moderate stenosis and 43 with severe stenosis. Thirty-one patients had stenting. The enrolled patients were evaluated with the Montreal Cognitive Scale (MoCA)score and the National Institutes of Health Stroke Scale (NIHSS) score,and the improvement of the MoCA score at 3 month after stenting was evaluated. Results (1)The MoCA score of the severe stenosis group was lower than that of the moderate stenosis group(22. 6 ± 2. 9 vs. 27. 4 ± 2. 3,P<0. 01). The patients with the MoCA score <26 was 83. 7%(36/43). It was significantly higher than 22. 4% in the moderate stenosis group (11/49). There was significant difference between the 2 groups (P<0. 01). (2)In the severe stenosis group,there was no significant difference in the preoperative MoCA score between the stenting group (22. 9 ± 3. 0)and the non-stenting group (21. 9 ± 2. 4)(P>0.05);3 months after stenting,the MoCA score (25. 4 ± 2. 7)of the stenting group was significantly better than that of the non-stenting group (22. 2 ± 2. 8). There was significant difference (P<0. 01);and after stenting,the proportion of patients with the MoCA score <26 (48. 4%,15/31)was significantly lower than those of the non-stenting (83. 3%,10/12,P=0. 037). Conclusion Severe stenosis of internal carotid artery may cause cognitive dysfunction. Carotid artery stenting is conducive to improve cognitive function in patients with severe stenosis.

To optimize the water extraction process for glycyrrhiza. Methods: HPLC was used to determine the con-tents of glycyrrhizic acid and liquiritin. The comprehensive index included the contents of glycyrrhizic acid and liquiritin and the yield of dry extract. The water amount and the extraction time were selected as the independent variables, and the comprehensive index was set as the dependent variable. Design-expert 8. 06 software was used to fit multivariate linear or quadratic multinomial models for the experimental values. Response surface methodology was used to optimize the water extraction process. The prediction was carried out through comparing the observed and predicted values. Results:The regression coefficient of binomial fitting complex model was as high as 0. 979 7. The optimum conditions of extraction process were as follows:12-fold amount of water, extracting 3 times with 90 min for each time. The deviation between the observed and predicted values was -1. 72%. Conclusion: Central composite design-response surface methodology is convenient and highly predictive in optimizing the water extraction process for glycyrrhiza, which can be applied in the further membrane separation and purification.

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.