Drug addiction is a chronic,relapsing brain disorder,which develops,in part,because of aberrant learning and memory. Accumulative studies during recent decades demonstrated that addictive drug hijacks the normal memory circuit in the brain to form a long-lasting drug reward memory,which determines relapse to addictive drug. In this review,we will describe what has been learned about drug reward memory,especially focused on one of the associative drug reward memory models,drug-induced conditioned place preference. Drug reward memory is a dynamic process,which consists of several stages,including acquisition,consolidation,maintenance,retrieval,reconsolidation and extinction. Interventions with pharmacological in these memory processes will differentially regulate drug reward memory. Furthermore , the recently developed novel pure behavioral procedure according to the hypothesis of memory processes,e.g. post-retrieval extinction,could erase drug reward memory,which shows more advantages than the pharmacological medications that used in memory studies. Finally, we discussed two major methodological issues in drug reward memory,procedure and timing,which should be carefully considered when designing the related studies and interpreting the results from related studies. So far,it is not sure whether it is feasible to develop a pharmacological medication that only erases drug reward memory without impairing normal memories,we propose that inhibition of drug reward memory would be a good strategy to limit the risk of relapse to addictive drug. Although current findings on drug reward memory benefits little for treatment of drug addiction,the ongoing studies on drug reward memory will provide a promising strategy for reducing the risk of relapse to addictive drug.

Objective To investigate the clinical value of knee joint infection indexes of white blood cell (WBC),C reactive protein (CRP),erythrocyte sedimentation rate (ESR) and procalcitonin (PCT),interleukin-6 (IL-6) and absolute value of neutrophil (GR).Methods One hundred and twelve cases of preoperative knee joint infection in our hospital from June 2010 to March 2015 were selected as the research group and contemporaneous 112 cases of no preoperative and postoperative knee joint infection were selected as the control group.The venous blood was collected for observing the changes of the above indexes before operation and at postoperative 1,3,5,7,14 d.Results The levels of WBC,CRP,ESR,PCT,IL-6 and GR before operation and at postoperative 1d in the study group were significantly higher than those in the control group (P<0.05);the levels of WBC,CRP,PCT and IL-6 at postoperative 3 d in the study group were significantly higher than those in the control group (P<0.05);the levels of WBC,CRP,ESR and IL-6 at postoperative 5 d in the study group were significantly higher than those in the control group (P<0.05);the difference at the other time points between the two groups was not statistically significant (P>0.05);in the Logistic regression analysis,the six indicators of WBC,CRP,ESR,PCT,IL-6 and GR6 all could predict knee joint infection (P=0.005,0.004,0.000,0.002,0.003,0.007).Conclusion WBC,CRP,ESR,PCT,IL-6 and GR have certain value for early diagnosis and prevention of infection,and further study on expanded sample size cn carry on.

The comprehensive capacity of medical students means mainly the medical operating skill, and the ability toresolve the practical troubles by integrating the knowledge of multisubject, and creative capability. For a long time, inthe teaching of many madical colleges, importance has been attached to imparting the basic theory and knowledge,rather than to fostering the comprehensive capacity of medical students. In 1999, the Medical College of ShandongUnivesity incorporated the physiological, phamacological, pathophisiological and psycological experiment and inte-grated them as a independent experimental curriculum-the functional science experiment. Many years practice showsthat the functional science experiment is a good platform or carrier to foster the comprehensive capability of madicalstudents.

Based on Belphi7.0, this paper designs a software of HIS for medicine warehouse management, which can provide timely dynamic information of the medicine. With the application of this software, required medicine can be supplied in time and the overstocking can be diminished, thus not only accelerates medicine circulation, but greatly promotes work and management efficiency. The combination of this software and HIS shows such advantages as quick response, comprehensive information, convenient installment, practical and safe in application, etc.

To cement the 5 years’ staged achievement of new medical reform so as finally achieve the objective of medical reform, public hospital would become the aim of reform in the following stage. On one hand , canceling “using drug to supple health care” in public hospitals has came into the crucial stage; on the other hand, the government needed to increase financial input and ensure the implementation of security fund. What was the relation between these two reforms? Therefore , based on the survey of county-level public hospitals in G Province, relationship among government compensation method, hospital public profit operation mechanism and profit-driven operation mechanism were analyzed; besides, different financial insurance mode had different operation efficiency. Because the construction of hospital expense under public profit operation mechanism was more reasonable , the required government insurance fund was less, which only accounted 32.9%of the required fund under the profit-driven operation mechanism. Therefore, the policy suggestions that government need to “buy the mechanism” and “be brave to implement ‘subtraction reform’” were proposed.

Objective To observe the different effects caused by different injection sites in bladder ,in cases of female overac‐tive bladder cured by botulinum toxin type A injection .Methods Forty cases were divided into 2 groups randomly .Cases of group A accepted botulinum toxin type A injection only on detrusor .Cases of group B accepted botulinum toxin type A injection on detru‐sor and trigone of urinary bladder .The following parameters were recorded to evaluate the effects 4 weeks later :average daytime u‐rination frequency ,urination frequency at night ,average quantity of each urination ,frequency of urgency ,bladder capacity at first de‐sire ,maxima bladder capacity ,OABSS scores and QOL scores .Results After 4‐week treatment with botulinum toxin type A ,all pa‐rameters ,average daytime urination frequency ,urination frequency at night ,average quantity of each urination ,frequency of urgen‐cy ,bladder capacity at first desire ,maxima bladder capacity ,OABSS scores and QOL scores in cases of group A had a better im‐provment than those of cases of group B .Conclusion Botulinum toxin type A injection on bladder is a new effective method for fe‐male refractory overactive bladder .Injection on detrusor and trigone of urinary bladder is better than injection only on detrusor .

Oyster complete nutritional tablet was used in treating 40 patients with yin -deficiency syndrome due to metaphase -advanced stage carcinnoma. The results showed that the general symptoms of patients were improved obviously, the hemogram was gone up and some of the immunologic indices was ameliorated. The tablet contributed to relaxing the chest,regulating vital energy,clearing away lung -heat and eliminating sputum,showing the efficacy for moisturizeing dryness by nourishing yin.

Objective Summarize 8 cases of non-small cell lung cancer (NSCLC) that has accepted completely video-as-sisted thoracoscopic sleeve lobectomy in People's Hospital of Peking University in china,to explore the safety,effectiveness indications and experience of this procedure.Methods Between September 2011 and December 2011,Medical records of 8 cases of non-small cell lung cancer that has accepted complete thoracoscopic sleeve lobectomy were reviewed (7 male,1 female).Median patient age was 62.4 years.And median maximal diameter of solid tumors was 2.3 cm.This group consisted of 5 cases of right upper lobe sleeve lobectomy,2 case of left lower lobe sleeve lobectomy and 1 case of left upper lobe sleeve lobectomy.The operation procedure was completely VATS anatomic sleeve lobectomy combined with systematic lymph node resection (at least 3 groups of lymph nodes in the mediastinum area).All procedure were underwent under general anesthesia with double-lumen endotracheal intubation.The patient was placed lateral decubitus position.Three incision were made at the seventh intercostal space on the median axillary line,the fourth intercostal space anterior axillary line and the seventh intercostal space subscapularis line.Bronchial were anastomosed combine with simple continuous suture anastomosis of membranous part of bronchus and simple interrupted suture anastomosis of cartilaginous part of bronchus,and then covered by? Surrounding tissue with blood supply? Results All procedures were carried out smoothly without serious complication.The median operative time was 240min median,the median bronchial anastomosis time was 45 min,the median blood loss was 200 ml,and median number of resected lymph nodes was 19.8.There were no conversion to open thoracotomy.Post operative show pathology squamous cell carcinoma in 7 cases and adenocarcinoma in 1 case.pTNM staging show 1 case of T1a N0 M0,4 cases of T1b N0 M0,2 case of T1b N1 M0 and 1 case of T1b N2 M0.There was 1 case of slight post operative complication.The median postoperative chest tube drainage duration was 7 days,and median postoperative hospital stay was 9 days.All patients were well during the followed up for 3-8 months.Conclusion Completely thoracoscopic sleeve lobectomy was a safe and effective surgical procedure for patients with non-small cell lung cancer; the operative incision placed at the fourth intercostal space anterior on the axillary line was convenient for anastomosis; anastomosis combine with simple continuous suture anastomosis of membranous part of bronchus and simple interrupted suture anastomosis of cartilaginous part of bronchus was a fast and secure mode; keeping azygos vein does not affect the anastomosis.

Objective To discuss the technical strategies for thoracoscopic lobectomy.Methods Between September 2006 and May 2008,a total of 91 patients underwent thoracoscopic lobectomy in our hospital.The lobectomy and lymph node resection were completed via three mini incisions with the same procedures as those in an open surgery.Among the cases,75 had primary or metastatic malignancies,and 16 showed benign tumor.By thoracoscopy,upper right lobectomy was carried out in 21 patients,right middle lobectomy in 12,lower right in 20,upper left in 18,and lower left in 20.Results Only two cases were converted to open thoracotomy.In the other 89 patients,the mean operation time for the thoracoscopy was(185.8?52.9)minutes(ragne,60-300 minutes),and the mean blood loss was 213.2 ml(range,50-650 ml).In this series,the chest drainage lasted(6.9?2.9)days;the patients were discharged from the hospital in(9.4?3.2)days after the surgery.No severe complications or perioperative death occurred in the cases except in one patient,who developed chylothorax after the treatment.Two patients,who had primary lung cancer,showed distant metastasis at 15 and 3 months respectively after the surgery.No recurrence or metastasis was found in the other cases.Conclusions Thoracoscopic lobectomy is safe and effective for patients with indications for the surgical procedure.Surgical skills for dissection of vessels and lymph nodes are the key to the operation.

Objective To evaluate the therapeutic value of video-assisted thoracoscopy in treating posterior mediastinal benign neurogenic tumors.Methods From May 1994 to May 2006,40 patients received thoracoscopic resection of posterior mediastinal benign neurogenic tumor.Double lumen endotrocheal intubation was applied and 3 trocars were placed according to the location of the tumor.A mini-incision was used if the tumor was too large to be safely resected.Results The complete resections were successfully finished in 34 cases while the remaining 6 cases needed a 6 cm mini-incision to complete the surgery.Pathological examination showed 20 cases of neurilemoma,14 cases of neurofibroma,and 6 cases of paraganglioma.The average diameter of these tumors was 4.7 cm(range:2-12 cm).The average thoracic drainage time was 2.2 days(1-7 days).And the average postoperative hospital stay was 4.8 days(3-13 days).Only 2 cases experienced minor complications.There was no death in this study.The time of follow-up was 9 months to 12 years,in which 16 cases were followed for less than 3 years,12 cases for 3-5 years and 7 cases for over 5 years,5 cases lost contact.Only one patient received re-resection due to local recurrence.Conclusions Video-assisted thoracoscopic resection of posterior mediastinal benign neurogenic tumor is safe,reliable and minimally invasive,and can thus be regarded as the therapy of first choice.