Great difficulties and challenges are existed in the training of clinical type postgraduate of neurosurgery because of the acute onset,server illness and difficult diagnosis of neurosurgical diseases.This paper proposed countermeasures of combing theory with clinical practice and strengthening comprehensive ability after analyzing problems of inadequate professional knowledge,lack of doctor-patient communication and insufficient clinical thinking and innovating ability.The aim was to cultivate the overall quality of postgraduates,making them more qualified for the difficult task of being neurosurgery clinicians.

Objective To explore the difference in pulmonary function between chronic obstructive pulmonary disease (COPD) and overlap syndrome patients.Methods 50 hospitalized COPD patients who were randomly recruited were divided into two groups, which contained 33 COPD patients and 17 overlap syndrome patients respectively. All the 50 patients’pulmonary function was evaluated and the results were analyzed statistically.Results The pulmonary function test showed that only PEF and V75 significantly decreased in overlap syndrome patients compared with COPD patients(P=0 032 and 0 048 respectively),But pulmonary volume, small airway function and pulmonary diffusion function in 5 COPD patients with severe sleep apnea syndrom (SAS) were significantly reduced compared with COPD patients.Conclusions Upper airway obstruction in SAS patients aggravates the pulmonary ventilation function in overlap syndrome. And obesity deteriorates both of the pulmonary function and hypoxemia in patients suffered from COPD.

Clinical medicine professional degree education focuses on cultivating students' ability to engage in clinical practice, but the aim of medical postgraduate education program is to cultivate high-leveled clinical and research personnel. In the light of the problems that professional degree postgraduates majoring in obstetrics and gynecology are faced with such as unreasonable energy distribution in scientific research, the weak foundation of scientific research, the emergence of new trend of obstetrical and gynecological dis-eases, we have explored how to improve obstetrics and gynecology professional students' scientific research ability from several aspects such as the guidance of mentors, transferring learning and thinking and strength-ening the communication between various disciplines, to adapt to the requirements of the scientific develop-ment of modern obstetrics and gynecology.

Because of the specificity and complexity,of obstetrics and gynecology,interns often meet doctor-patient communication problems during the internship.This study explores these problems to enhance interns' doctor-patient communication and to cultivate interns' technical proficiency.We have also made them grasp the methods and skills of doctor-patient communication,and enable them to successfully communicate with patients on internship.

Objective To observe the clinical curative effect of combination of traditional Chinese and western medicine for treatment of patients with hepatitis B virus (HBV) related acute-on-chronic (subacute) liver failure (ACLF). Methods A prospective randomized controlled trial was conducted; 66 cases of HBV-ACLF patients were randomly divided into two groups: a test group (44 cases) and a control group (22 cases). Conventional western medicine treatment was given to both groups; the patients in test group additionally received the traditional Chinese medicine (TCM) in accord to the principles of differentiation of syndromes in TCM, in cases with damp-heat and blood stasis syndrome with yellow appearance, Liangxue Jiedu Huayu decoction (Paeoniae Radix Rubra 60 - 150 g, Artemisiae Scopariae Herba 30 - 90 g, Gardeniae Fructus 9 - 12 g, Hedyotis diffusa Willd 20 - 30 g, Salviae Miltiorrhizae Radix et Rhizoma 30 g, Atractylodis Macrocephalae Rhizoma 30 g, Rubiae Radix et Rhizoma 30 - 45 g, Siegesbeckiae Herba 30 - 45 g, Bletillae Rhizoma 15 g ) was given, in cases with Qi deficiency and blood stasis with yellow appearance, Yiqi Jiedu Huayu decoction (Astragali Radix Preparata Cum Melle 30 g, Pseudostellariae Radix 15 g, Artemisiae Scopariae Herba 30 - 60 g, Polygoni Cuspidati Rhizoma et Radix 15 - 30 g, Salviae Miltiorrhizae Radix et Rhizoma 30 g, Aconiti Lateralis Radix Preparata 10 - 15 g, Atractylodis Macrocephalae Rhizoma 30 g, Rubiae Radix et Rhizoma 30 - 45 g, Siegesbeckiae Herba 30 - 45 g, Gigeriae Galli Endothelium Corneum 20 g) was given, the dosage in both groups being 1 dose daily, one dose was prepared to a water decoction 250 - 300 mL which was divided into two parts, one part taken twice a day; the control group received only western medicine treatment. After 2 weeks of treatment, the clinical comprehensive curative effect, the syndrome score efficacy, and the changes of main indexes of liver function,cholinesterase (ChE), albumin (Alb), prothrombin activity (PTA) were observed in the two groups.Results The clinical total efficacy in the test group was significantly higher than that in the control group [75.0% (33/44) vs. 45.5% (10/22),P < 0.05]. The syndrome score total efficacy in the test group was also higher than that in the control group [75.0% (33/44) vs. 63.6% (14/22)], but the difference was not statistically significant (P > 0.05). After treatment, the alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil) and direct bilirubin (DBil) were all lower than those before treatment in both groups, while the ChE, Alb and PTA were higher than those before treatment, and the degree of changes was more significant in the test group [test group: ALT (U/L): 63.28±99.28 vs. 574.58±571.08, AST (U/L): 86.84±92.88 vs. 438.20±482.74, TBil (μmol/L): 161.90±178.34 vs. 269.46±95.10, DBil (μmol/L): 115.32±126.51 vs. 209.12±79.78, ChE (U/L): 4 239.14±1 505.00 vs. 3 341.49±1 609.40, Alb (g/L): 32.65±4.77 vs. 29.73±3.31, PTA: (69.69±44.92)% vs. (32.84±7.47)%; control group: ALT (U/L): 93.28±93.86 vs. 365.24±376.98, AST (U/L): 126.26±121.35 vs. 287.17±301.04, TBil (μmol/L): 226.80±187.38 vs. 281.02±103.73, DBil (μmol/L): 172.50±147.32 vs. 227.96±87.20, ChE (U/L): 4 484.66±1 886.53 vs. 3 918.77±1 417.77, Alb (g/L): 33.17±4.76 vs. 30.47±3.03, PTA: (63.80±36.80)% vs. (33.96±6.32)%,P < 0.05 orP < 0.01].Conclusion The combination of TCM and western medicine for treatment of HBV-ACLF can improve liver function, and the prognosis is superior to using western medicine treatment alone.

Aged ; Fasciitis, Necrotizing ; complications ; Female ; Humans ; Mediastinitis ; complications ; Neck ; pathology

Detergents ; Immunohistochemistry ; instrumentation ; Oxalic Acid ; Potassium Permanganate ; Staining and Labeling ; instrumentation

Objective: To set up an HPLC method for the simultaneous determination of p-hydroxybenzoic acid plus o-hydroxy-benzoic acid and p-hydroxybenzeneacetic acid in Senecio scandens Buch. Methods:The column was a Shiseido( Fine Chemicals) Cap-cell Pak C18 (250 mm × 4. 6 mm, 5 μm) column at the room temperature. The mobile phase was methanol-water-formic acid (13∶87∶0. 5) at a flow rate of 1. 0 ml·min-1 . The detection wavelength was 240nm. Results: p-Hydroxybenzoic acid plus o-hydroxybenzoic acid had a favorable linear relationship within the range of 0. 025-0. 400 mg·ml-1 , the regression equation was Y=5. 94 × 106 X+2.46×104(r=0.9998),theaveragerecoverywas97.59% andRSDwas1.22%. p-Hydroxybenzeneaceticacidhadafavorableline-ar relationship within the range 0.05-0.80 mg·ml-1, the regression equation was Y=4.09 ×106X+1.12 ×104(r=0.999 8), the average recovery was 98. 07% and RSD was 1. 90%. Conclusion:The method is simple, feasible and reproducible. It can be used in the quality control of p-hydroxybenzoic acid plus o-hydroxybenzoic acid and p-hydroxybenzeneacetic acid in Senecio scandens Buch.

Objective To evaluate the value of the short-segment nerve conduction studies (SSCSs, inching test) in the diagnosis and localization of cubital tunnel syndrome (CubTS).Methods The clinical and electrophysiologic data of 46 patients (92 limbs from 32 men and 14 women, aged from 19 to 59 years, with average age of 41.2 years) with CubTS were collected.The symptoms occurred in unilateral arm in 41 patients and bilateral arms in 5 patients, involving 35 left arms and 16 right arms.SSCSs were performed in both arms in all the 46 patients.Sixty ulnar nerves were studied in 30 healthy control subjects using SSCSs.Results The 51 symptomatic arms with CubTS were abnormal in long segment motor nerve conduction studies.There were 68 abnormal arms ( 51 symptomatic arms, 17 asymptomatic arms ) in SSCSs.The lesions were located 2 cm proximal to the elbow-the elbow segment ( AE2-E ) in 41 arms (44.6%),the elbow-2 cm distal to the elbow segment (E-BE2) in 23 arms (25%), 4 cm proximal to the elbow-2 cm proximal to the elbow segment (AE4-AE2) in 18 arms (19.6%), 6 cm proximal to the elbow-4 cm proximal to the elbow segment (AE6-AE4) in 9 arms (9.8%), 2 cm distal to the elbow-4 cm distal to the elbow segment (BE2-BE4) in 8 arms(8.6%) and 4 cm distal to the elbow-6 cm distal to the elbow segment (BE4-BE6) in 6 arms(6.5%),respectively.Conclusions SSCSs are more sensitive in detecting CubTS than the conventional long segment motor conduction studies.SSCSs could precisely localize the entrapment lesions in patients with CubTS ,might be a useful tool for the detection of ulnar mononeuropathy at the elbow, especially for diagnosing the patients with CubTS who have no clinical features or have a normal long segmental nerve conduction findings.

The incidence of iron deficiency anemia and its therapeutic measures were studied in 559 children (aged 6 months to 3 years old) in Shijiazhuang city, Hebei province. The results showed that the incidence of iron deficiency anemia(IDA) was 53.85% and iron deficiency was 48.11%. Most of IDA occurred before 2 years of age and mild in character.No differences in hair Fe and Zn content were noted between anemic and unanemic children, but hair Cu was lower significantly in anemic children than in unanemics (Pyears old), group D under combined measures of A and B, group E as control. According to Hb re-estimated 2 months after treatment, A,B,C group had the same better therapeutic result than group E, but no combined effect was seen in group D.