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.

Objective To review the diagnosis and treatment of adrenal myelolipoma(ML).Methods The medical records of 21 patients with adrenal myelolipoma were reviewed.All patients were examined by B-ultrasound,CT and endocrine tests while some were also examined by MRI and 131I-MIBG.Results All patients had undergone resection of adrenal ML.The mean diameter of tumors was 6.7 cm(4.5 cm～12 cm).Pathological examination of all tumors confirmed the diagnosis of adrenal ML.No recurrence was recorded during the follow-up period(1～15years).Conclusion Adrenal ML is a kind of rare,benign tumor and is often incidentally discovered.Its prognosis is generally good.

Child, Preschool ; Dwarfism ; congenital ; diagnosis ; Humans ; Male ; Osteochondrodysplasias ; congenital

Humans ; Infant, Newborn ; Meconium ; Peritonitis ; etiology

Humans ; Language Development Disorders ; complications ; Presbycusis ; complications

Objective To investigate the molecular mechanism of Klebsiella pneumoniae resistant to carbapenem. Methods The minimal inhibitory concentrations ( MICs) of the antimicrobial agents were determined by E-test. The 23 β-lactamase genes and 2 porin genes were amplified by polymerase chain reaction (PCR) , then the products were purified and their sequences were analyzed. Results The MICs of piperacillin, piperacillin/sulbactam, amoxicillin/clavulanic acid, cefoperazone/sulbactam, cefotaxime, cefepime and aztreonam to 5 strains of Klebsiella pneumoniae were all higher than 128 μg/mL, and those of imipenem or meropenem were higher than 32 μg/mL. All isolates carried blaTEM-1 and blaDHA-1 genes. Deletion of ompK35 and ompK36 were observed in Kp01 and Kp03, and the deletion of ompK35 was also observed in Kp02 and Kp05. Base insertion of ompK36 occurred in Kp02, Kp04 and Kp05. Compared with GenBank (GU945384) , ompK35 gene mutations of G→C at base 465 and T → C at base 466 in Kp04 lead to Gln to His substitution at position 155 and Tyr to its substitution at position 156, and it might be a new subtype. Conclusion The production of DHA-1 β-lactamase combined with the loss of OmpK36 or OmpK35 in porin genes may contribute to high-level carbapenem resistance in Klebsiella pneumoniae.

Objective:To study the chemical constituents in methanol parts of Toddalia asiatica ( Linn) Lam. Methods: The compounds were isolated by silica gel, Sephadex LH-20 column chromatograph and TLC. The structures were elucidated by physico-chemical properties and spectral analysis. Results:Nine compounds were obtained and elucidated as dictamnine(1), hesperetin(2), 4-hydroxy-N-methylproline(3), 8-hydroxy-dihydrochelerythrine(4), hesperetin7-O-β-D-glucopyranoside(5), daucosterol(6), hes-peridin(7), diosmin(8) and neohesperidin(9). Conclusion:Compound 5, 6, 8 and 9 are isolated from the plant for the first time.

ObjectiveTo investigate the developmental status and their relationship of self-supporting personality and career maturity of medical students.Methods450 medical students were surveyed by self-supporting personality scale and career maturity questionnaire.Descriptive statistical analysis,t-test,correlation analysis and regression analysis were used to do data analysis.Results ( 1 ) Most dimensions of self-supporting personality such as personal initiative,interpersonal initiative,interpersonal flexibility and personal responsibility were positively related to the career maturity ( r=0.53,P＜0.01 ; r=0.49,P＜0.01; r=0.46,P＜0.01 ; r=0.45,P＜ 0.01 ).(2)Career maturity of medical students can be positively predicted by several dimensions of self-supporting personality ( R2 =0.49,F=60.10,P＜ 0.01 ).ConclusionThe career maturity of medical students is closely associated with their self-supporting personality.

Objective:To preliminarily study on the procoagulant activity of Toddalia asiatica Lam. Methods:The plasma recal-cification time affected by the water decoction extract, ultrasonic extract and organic solvent extract from T. asiatica were determined to observe the effects of different extracts from T. asiatica on plasma recalcification time of rabbits. Results:The ultrasonic extract of T. asiatica could reduce the plasma recalcification time (P<0. 05), the ethyl acetate and methanol extract could significantly reduce the plasma recalcification time (P <0. 01), while the water decoction extract prolonged the plasma recalcification time (0.01

Objective To explore the effect and safety of transcranial approach for spheno-orhital meningioma. Design Retro- spective case series. Participants Thirty-two patients being operated with transcranial approach. Twenty-four cases were meningothelial meningiomas, 3 cases were fibrous meningiomas, 1 case was psammomatous meningioma, 2 cases were atypital meningiomas, 2 case were malignant meningiomas. Methods All patients underwent frontal-temporal craniotomy, the involved sphenoid wing bone and peri- orbit were removed to prevent recurrence. The superior orbital fissure and optic canal were decompressed, the dural and periorbital de- feet were repaired by autogenous temporal fascia or artificial dura. Main Outcome Measures Preoperative and postoperative exoph- thalmus and eyeball movement, the extent of tumor resection, the ratio of recurrence. Results The extent of tumor resection: 8 cases were Simpson gradeⅡ, 20 cases Simpson gradeⅢ, 4 cases Simpson grade IV. After surgery, proptosis were improved in all patients, ophthalmoplegia was found in 6 eases. There was no operation-related death or other significant complication. Tumor recurred in 6 cas- es. Conclusions Adequate exposure of the tumor and bony decompression of the cranial nerves can result from transcranial approach, all the involved bone should be removed in order to prevent recurrence. This approach is relatively safe and the ptoptosis are improved significantly. Complete surgical resection is difficult because of the involvement of the orbital apex, superior orbital fissure and cav- ernous sinus.