Surgical base teaching is an important part of medical education.It is the important tache whether the medicos can become excellent doctors.The thesis analyses the young surgeon's problems in their working abilities in hospital,and discusses the strategies of how to improve the quality of surgical teaching,aiming to establish a solid foundation for the cultivation of the medicos.

Diabetes can affect structure and function of brain in several aspects, but diabetic cognitive impairment is often ignored. The pathogenesis of diabetes associated cognitive impairment is complicated. Factors such as glucotoxicity, lipotoxicity, insulin resistance, hypoglycaemia and disturbance of Ca2 homeostasis may play important roles. Besides conventional diabetes therapy, new methods still need to be explored.

Objective To determine the effects of prostaglandin E_2 alone and the combination with omeprazole for poisoning related acute mucosal lesion. Methods Forty-two healthy SD rats were randomly divided into 7 groups: control group (control), methamidophos poisoning model group (intox), 10 mg/kg omeprazole group (ome1), 50 mg/kg omeprazole group (ome2), 10 μg/kg prostaglandin E_2 group (PG1), 50 μg/kg prostaglandin E_2 group (PG2), 10 μg/kg prostaglandin E_2 combined with 10 mg/ kg omeprazole group (union). The gastric ulcer index was counted and the content of serum cholinesterase, endothelin, and tumor necrosis factor were measured, and dependability was analyzed. Results There was no obvious difference between the prostaglandin group and the poisoning model group in gastric ulcer index, endothelin, and tumor necrosis factor. The omeprazole alone and the combination treatment could improve the acute gastric mucosa lesion induced by methamidophos poisoning. Conclusion Prostaglandin E_2 alone can not obviously improve the acute gastric mucosa lesion by methamidophos poisoning. The combination with omeprazole may be a promising treatment.

Using Xanthine-Xanthine Oxidase system to generate superoxide ani-on, using H2O2 -Fe2 + system to generate hydroxyl radical, the role of scavenging oxygen free radical by Miltiorrhiza was studied by electron paramagnetic resonance and spin trapping. The result suggested that the scavenging rate of hydroxyl radical by Salvia Miltiorrhiza injection is 65%, and that of superoxide anion is 100%. This result suggests that scavenging cytotoxic oxygen free radicals may be one of important pharmacological mechanism of Salvia Miltiorrhiza.

Objective To evaluate the effects of exercise therapy in the treatment of hemiplegia following cerebral hemorrhage. Methods Activities of daily living(ADL) scoring and Fugl Meyer test were performed in 46 patients with hemiplegia following cerebral hemorrhage undergoing exercise therapy before and after treatment. Results Significant improvement of ADL, upper extremity function, and balance and walking abilities was found after treatment( P

Objective To observe the changes of Endothelin,Tumor Necrosis Factor in different stress; and to explore the corelation between the changes of Endothelin,Tumor Necrosis Factor and the occurrence of stress-related gastric mucosal disease.Methods The models of the acute methamidophos poison and the acute myocardial infarction in rats were made.The gastric ulcer index was counted and the content of blood plasma Endothelin and blood serum Tumor Necrosis Factor were checked.Results Models of the acute methamidophos poison and the acute myocardial infarction in rats were set up successfully. The gastric ulcer index of rats in the stress groups increased.The blood plasma Endothelin and blood serum Tumor Necrosis Factor in the stress group were significantly higher than those in the control group.Conclusion The gastric mucosal disease under different stress was observed with the gastric mucosal ulcer index.The blood plasm Endothelin and blood serum Tumor Necrosis Factor under different stress were increased,suggesting they play an important role in this phenomenen.

Objective To study the effect of erythropoietin（EPO） on PI3-K/Akt signal pathway of myocardial ischemia-reperfusion injury（I/R） in immature rabbits. Methods Thirty immature rabbits were randomly divided into two groups （n = 15/greup ）, The rabbits were intraperi- toneally injected with 2 ml of normal saline in control group, or 5 000 U/kg of EPO in treated group 24 h before I/R. The Langendorff isolat- ed perfused heart model was established, and the myocardial expression of PI3K, AKT and Caspase 9 were examined by immunohistochem- istry in 2 h after repeffusion. To monitor the myocardial apoptosis,we performed TUNEL in 2 h after reperfusion. Results The expression of myocardial PI3K and AKT in EPO group was significantly higher in EPO-treated group than those in control group. In EPO-treated group, the expression of myocardial caspase 9 was significantly lower than that in control group. The average optical density of myocardial PI3K, AKT and caspase 9 were significantly different between both groups （P 〈 0.01 ）.The number of apoptotic cell was significantly fewer in EPO- treated group than that in control group. The myocardial apoptosis index （AI）was significantly different between two groups （P 〈 0.01 ）. Conclusion EPO pretreatment can influence the PI3-K/Akt signal pathway and decrease the myocardial apoptosis,and significantly reduce the myocardial ischemia-reperfusion（I/R） injury in immature rabbits.

Objective To introduce a new technique of treating tibial spinal fractures in children under arthroscope, and to assess its clinical outcomes. Methods From February 2001 to July 2003, 6 child patients with tibial spinal fracture were treated arthroscopically. The reduction and fixation were completed under the arthroscope. The wire was linked with the suture outside the joint, and then was pulled into the joint to fix the fracture fragment through the fundus of anterior cruciate ligament (ACL). Results The patients were followed up for 6 to 20 months. All the fractures healed without displacement 4 weeks after operation. 3 months postoperatively, the motion range of the knee returned to normal, and no knee instability was observed. The results of ADT (anterior drawer test) and Lachmanns sign were negative. Conclusion This technique is the first choice in treatment of tibial spinal fracture in children, because it facilitates the diagnosis and treatment of complicated knee problems and provides accurate reduction and reliable fixation. Besides, it is minimally invasive, simple and convenient.

Objective To compare the curative effects of CT-guided ethanol injection and lauromacrogol injection into the sac cavity in treating ovarian endometriosis cysts. Methods A total of 86 patients with ovarian endometriosis cyst were enrolled in this study. The patients were divided into ethanol group (n=44) and lauromacrogol group (n=42). Under CT guidance, injections of ethanol or lauromacrogol into the sac cavity of ovarian endometriosis cysts were respectively performed for the patients of both groups. The patients were followed up for six months, and the curative effects and the complications were analyzed. Results Six months after the treatment, the cure rates of ethanol group and lauromacrogol group were 95.50%and 92.86%respectively, and no statistically significant difference in cure rate existed between the two groups (P>0.05). The preoperative serum CA125 levels of the ethanol group and lauromacrogol group were (48.42±23.68)μg/L and(49.21±22.83) μg/L respectively, and the post operative ones were (23.56±5.89) μg/L and (25.49± 6.10) μg/L respectively; the differences between the preoperative data and the postoperative data were statistically significant in both groups (P<0.05), although the differences in serum CA125 levels between the two groups were not significant (P>0.05). The incidence of postoperative complications in the lauromacrogol group was obviously lower than that in the ethanol group (P<0.05). The cure time in the ethanol group was shorter than that in the lauromacrogol group, although the difference was not significant after six months. Conclusion For the treatment of ovarian endometriosis cysts, CT-guided lauromacrogol injection into the sac cavity has reliable curative effect. Compared to ethanol injection, injection of lauromacrogol is safer and has fewer adverse reactions. Therefore, this technique should be recommended in clinical practice. Serum CA125 can be used as an indicator for the evaluation of curative effect.

Objective To report the author' s experience with the laparoscopic radical nephrectomy and eraluate it's saftey and therapy.Methods The retrospective analysis was performed on 600 consecutive patients undergoing laparoscopic radieal nephrectomy in the author' s institute from March 2004 to March 2012.There were 380 male and 220 female patients with the average age of 55 years (16-84 years).Five hundred and sixty cases and 40 cases underwent retroperitoneal and transperitoneal surgery respectively.The operative time,estimated blood loss,postoperative hospital stay,complications and the time of complete convalesceuce were recorded.Results Thirteen cases were converted to open surgery due to severe adhesion and severe bleeding.The mean operative time was 110 min(70-320 min).The medium estimated blood loss was 90 mL(30-830 mL) and 15 cases required blood transfusion.The mean drainage time was 50 h(36-72 h),the mean time to first oral intake was 23 h (19-43 h) and the mean postoperative hospital stay was 7 d(5.5-10 d).There were 4 patients with severe complication.Conclusion Laparscopic radical nephrectomy is safe and effective.It has been the standard therapeutic modality for localized renal cell carcinoma.