7-year-program clinical medicine is a major that fuses master with bachelor degree education and has higher demand in the integrated ability training.It is in 2002 that Southeast University first admitted students of this major,which,therefore,is brand new challenge to every educators,including EMP teachers.Thus,we initiated teaching innovation and put it into practice,which proved beneficial.

AIM: To analyze the postoperative infection of pathological myopia with pocket scleral reinforcement. ·METHODS:The clinical data of 167 cases of pathological myopia treated with pocket scleral reinforcement in June to December 2014 were analyzed. The postoperative infection rate, the resistance of pathogenic bacteria were analyzed, and the related factors of infection were analyzed. ·RESULTS: A total of 286 eyes were obtained in 167 patients. The infection rate was 6. 3% in 10 patients ( 18 eyes) . There were 30 pathogenic bacteria isolated from the 18 infected eyes, in which were 10 Staphylococcus aureus, 10 Staphylococcus epidermidis, 6 Klebsiella pneumoniae, 4 Pseudomonas aeruginosa infection. Gram positive bacteria showed higher resistance to penicillin, ampicillin and ciprofloxacin, and were sensitive to vancomycin. The resistance rates of gram negative bacteria to cefotaxime were higher, but to imipenem was low. The two groups of patients age, culture level, operation time, the number of operation, intraoperative nursing staff seniority, postoperative medication compliance rate was statistically significant (P<0. 05), which related to the infection after pocket scleral reinforcement. ·CONCLUSION:The infection caused by Staphylococcus aureus is the most common after pocket scleral reinforcement, and it is sensitive to vancomycin, and gram negative bacteria is sensitive to imipenem. Shortening the operation time, using the experienced nursing staff to cooperate, reducing the number of operation and improving the compliance of the patients can reduce the postoperative infection.

Constipation has become a common clinical symptom in the elderly. Many factors can result in constipation, including diet,physiological aging, lack of exercise, inappropriate medication, psychological factors, perianal disease, and so on. If the individualized, targetedand comprehensive care interventions that consist of health education, psychological intervention, dietary intervention, medicationguide, functional exercise, passive attention to bowel training and abdominal massage etc. are done well, it can decrease the incidence ofconstipation, reduce a variety of complications and adverse effects caused by the constipation and improve the quality of life in the elderly.So it has important clinical significance.

Animals ; Hypothyroidism ; physiopathology ; Learning ; Memory ; Mice ; Motor Activity

Objective To evaluate Feridex(superparamagnetic iron oxide,SPIO)enhanced MRI in the diagnosis of hepatic lesions.Methods Feridex-enhanced MRI was performed in 31 patients with CT,or MRI proved or suspected hepatic lesions.T 2WI signal intensity of hepatic parenchyma,lesion and background noise was measured before and after enhancement separately.SNR and CNR of parenchyma and lesion before and after enhancement were calculated.The number of lesions on plain and enhanced scans were observed and alalyzed.Results Post-enhancement SNR of liver significantly decreased (?0.05).Post-enhancement lesion-liver CNR increased significantly (?

Objective To investigate the causes,diagnosis,treatment of the difficult postoperative decannulation resulting from tracheotomy between children and adults and the method of improving the rate of successful decannulation.Methods Clinical data of 56 cases with difficult decannulation after tracheotomy were analysed retrospectively,all the patients were admitted in our hospital between Jan 1990 and Oct 2006.All the patients were separated into two groups,children group including 24 cases of 14 months ～ 14 years old,adult group including 32 cases of age ranging 15 ～ 48 years old.The postoperative time after tracheotomy were 6 month ～ 1.5 year and 6 month ～ 2 year respectively.Results There were differences of the etiology,diagnostic choice and the clinical manifestation in the treatment of the diffficult decannulation after tracheotomy between children and adults.Children with difficult decannulation after tracheotomy occurred mainly in laryngitis and airway foreign body airway caused by obstruction retrieved after tracheotomy (14/24,58.33 ％),followed by the emergency tracheotomy,such as head and neck trauma (7/24,29.17％).Adults with difficult decannulation after tracheotomy mainly occurred in the throat caused by traumatic lesions of the larynx (including malformations,subglottic stenosis of larynx or vocal cord paralysis) (23/32,71.88％).The average block time in children with anti-inflammatory treatment was significantly lower than that in without anti-inflammatory therapy (6.2 d vs 10.1 d,t =4.26,P ＜ 0.01).However,there was no significant difference in the average block time in adults with anti-inflammatory and without anti-inflammatory treatment (t =1.63,P ＞ 0.05).In the course of treatment,rates of children consciously breathing difficulties (21/21,100％) was also significantly higher than the adult group (13/28,46.43％).Conclusion Children less than 3 years old should avoid tracheotomy.There is no definite relation between the successful treatment in the difficult decannulation and the age of the patients over 3 years old.The first failure treatment in children may be related with the local inflammation.When in treatment,doctors should observe the characteristics of respiratory difficulties,take attention to the influence of children psychological factors to the treatment.Children should be treated in the non-traumatic examination methods.

Objective To observe the efficacy of Complex Oral Motor Scoring (COMS) and diadochokinetic rate (DR) on evaluation of oral motor dysfunction and speech disorders in children with cerebral palsy. Methods 107 children with cerebral palsy were tested with Chinese-version Articulation Test, Simple Oral Motor Scoring (SOMS), COMS and DR. The correlation among SOMS, COMS and DR was analysesd. Results 85 children were abnormal in SOMS and 94 in COMS. Oral dyskinesia was found in all the children with spastic quadriplegia, dyskinetic, ataxia and mixed type of cerebral palsy, and less in the type of spastic diplegia and hemiplegia. DR was the least in spastic quadriplegia, dyskinetic, mixed type of cerebral palsy, more in the type of ataxia and spastic diplegia, and the most in hemiplegia. The coefficient of correlation among the SOMS, COMS, the longest pronunciation and DR were more than 0.8 (P<0.01). Conclusion The incidence and severity of oral dyskinesia and dysarthria are associated with the types of cerebral palsy. There is good correlation among SOMS, COMS, longest pronunciation and DR.

AIM:To investigate the influence of matrine (MA) on the phenotype switching of mouse mono-cytes and alveolar macrophages induced by bleomycin ( BLM) .METHODS:All mice were randomly divided into normal saline (NS) group, BLM group, BLM+NS group and BLM +MA group.The mice were administered with BLM at 2.5 mg/kg via oropharyngeal instillation .The mice in BLM+MA group were treated with MA (15 mg· kg-1 · d-1 ) by oral gavage following BLM administration .The mice were sacrificed on days 3, 7, 14, and 21.The lungs were removed for pathological analysis .The circulating monocyte subsets and polarization state of bronchoalveolar lavage fluid ( BALF)-de-rived alveolar macrophages were analyzed by flow cytometry .RESULTS:The results of HE and Masson trichrome staining in BLM and BLM+NS groups exhibited classical pathological stages of lung fibrosis , including acute inflammation phase and later fibrosis phase .Compared with BLM +NS group, MA treatment alleviated the inflammatory response and the de-gree of fibrosis induced by BLM (P<0.05).There was a rapid change of circulating Ly6Chi monocytes and its magnitude was positively associated with the pulmonary inflammatory response .An expansion of M2-like alveolar macrophages was positively correlated with the magnitude of lung fibrosis .Moreover , MA treatment partially normalized the phenotype switc-hing of monocytes and alveolar macrophages .CONCLUSION:Matrine treatment attenuates BLM-induced pulmonary injury partially via modulating the phenotype switching of monocytes and alveolar mocrophages .

Objective To investigate the influence of hepatectomy combined with splenectomy on curative effect of primary hepatocellular carcinoma patients associated with hypersplenism.Methods Twenty three cases of primary hepatocellular carcinoma associated with hypersplenism were analyzed retrospectively and divided into hepatectomy combined with splenectomy group (n=10) and hepatectomy combined with ligation of splenic artery (n=13). Peripheral blood samples were collected 1 week before operation and 3 monthes after operation respectively. The levels of CD4, CD8, CD16, CD4/CD8, WBC and PLT in the blood were detected. Survival rate between the two groups was compared. Results There were not significant differences in the expressional levels of CD4, CD8, CD16, CD4/CD8,WBC and PLT before operation, bleeding quantity during the operation and rate of severe complications after operation in the two groups. The expressional levels of CD4, CD16, CD4/CD8, WBC and PLT of hepatectomy combined with splenectomy group were much higher in 3 months after operation than those in 1 week before operation and in hepatectomy combined with ligation of splenic artery group (P

Objective The purpose of this study was to edit and psychometrically equate a set of Mandarin bisyllabic word lists. Methods 964 bisyllabjc words were recorded by male talker of standard Mandarin,352 words were selected to compose 10 lists. Percentage of correct word recognition was measured for each word at four intensity levels using 20 normal hearing subjects. The order of the presentation of the lists was randomized for each subject. U-sing Statistica7.0 Performance-Intensity function for each word was plotted,slopes and thresholds of them were calculated. 242 words were chosen after that, The thresholds and slopes of these words were in Guassian distribution. These words were ligitally adjusted and included in six Mandarin bisyllabic word lists of 40 words each. Two of them were for practice, four of them for test. 36 subjects with normal hearing served in our equivalent test. The orders of the presentation of the lists were randomized far each subject and results were expressed as thresholds. Results Two-factor ANO-VA was used to compare the thresholds of the 4 lists, F=1.978,P = 0.209. Conclusion These lists were considered to be primarily equivalent with each other.