Recently,wide application of MRI in clinic accelerates researches into the etiology,diagnosis,treatment and prognosis of bone bruises.MRI manifestations of bone bruises include trabecular microfracture associated with hemorrhage,oedema of subchondral bone because of direct or indirect traumatic force and focal abnormalities in subchondral bone of the knee.This condition is also known as occult injury of the knee,because it is likely to be overlooked or misdiagnosed in hospital due to its diagnostic difficulty by plain radiographs and CT.If timely intervention is not given,it will be accompanied by chronic pain which seriously affects the daily life of the patients,even resulting in early degeneration.This article discusses the current research on bone bruises of the knee.

Objective To investigate whether enteric nervous system(ENS)involve in mediating the effect of short pulse gastric electrical stimulation on c-fos expression in nucleus tractus solitarius (NTS)and hypothalamus.Methods Fifteen Wistar rats were divided into control group,gastric electrical stimulation(GES)group and ENS free group with 5 rats each.A pair of electrodes was implanted on the gastric serosa.In ENS free group,0.5%benzalkonii chloridum was applied on the serosa during the surgery.A set of short pulse GES with frequency of 20 cpm,pulse width of 300 μs and amplitude of 2 mA was applied via the electrodes for 30 rain in the stimulation group and ENS free group.The c-fos expression in NTS/hypothalamus was detected 1 h after the stimulation.Results The number of neuron with c-fos expression was(71.6±7.4)/HP in NTS group and(63.4±10.8)/HP in ENS free group,both were significantly higher than those in control group(36.4±8.6/HP,P＜0.05).The number of neuron with c-fos expression in hypothalamus was higher in GES[(224.2±47.3)/HP]and ENS free groups[(249.1±44.0)/HP]compared with control group[(90.2±47.3)/HP,P＜0.05].There was no significant difference in c-fos expression in NTS/hypothalamus between GES group and ENS free group(P＞0.05).Conclusions Short pulse gastric electrical stimulation significantly increases c-fos expression in NTS/hypothalamus,which suggests that NTS/hypothalamus may participate in mediating the effect of GES on gastric function.This effect may be not mediated by ENS.

OBJECTIVE:To provide reference to promote the proper use of TCM decoction pieces.METHODS:According to Beijing TCM Decoction Piece Dispensing Regulation,stratified random sampling method was adopted to select a group of physicians in our hospital and conduct questionnaire survey about their knowledge of the prescription handling of 8 commonly used TCM decoction pieces including Scutellaria baicalensis,Angelica sinensis,Fritillary,Phellodendron chinense,Aconitum carmichaeli,Eucommia ulmoides,Ziziphus jujuba,Rhei Radix et Rhizoma.Then,the survey data was collected and analyzed.RESULTS:A total of 81 questionnaires were given out and all were returned with effective recovery rate of 100％.In terms of professional titles,associate chief physicians showed the lowest average error rates in prescription handling cognition (27.5 ％),compared with physicians (35.8％) and attending doctors (37.0％).They made most mistakes about Fritillary and E.ulmoides.To the contrary,both physicians and attending doctors made most mistakes about E.ulmoides.In the scope of working life,physicians from different groups showed similar average error rates in prescription handing recognition (31.3％-38.8％).All of them made most mistakes about P.chinense and E.ulmoides.As for major,those who study western internal medicine shared larger average error rates (43.8％) than those who study internal medicine of TCM (36.8％),traumatology and orthopedics of TCM (31.8％) and acupuncture (36.5％).Each major showed the highest error rates in E.ulmoides.The order of 8 TCM decoction pieces from the most mistakes to the least mistakes made by physicians was E.ulmoides,P.chinense,Fritillary,Rhei Radix et Rhizoma,S.baicalensis,A.carmichaeli,Z.jujuba and A.sinensis.CONCLUSIONS:Physicians with different professional titles,working life and majors show deficiency in knowledge about the prescription handling of 8 commonly used TCM decoction pieces.Generally,physicians show the worst understanding of E.ulmoides.

Objective To investigate CT and MRI findings of giant cell tumors of the temporal bone(GCTTB).Methods CT and MRI features of 5 cases pathologically proven GCTTB were retrospectively reviewed.The lesion characteristics,including location, size,shape,margin,attenuation on CT scans,signal intensity on MR images,and enhancement pattern were documented and analyzed.Results In all 5 patients,the lesions were located adj acent to the mandibular fossa.These lesions were round or oval in shape,predominantly demonstrated as expansive lytic bone destruction containing hyperattenuating septa,calcifications,non-sclerotic borders,and discontinuous bony shells,with“boundary angle”sign.No soft tissue masses were found around the lesions.These lesions with different content demonstrated various MRI signal intensity,and the solid component enhanced intensely.Conclusion GCTTB is rare.Features such as expansive growing pattern,discontinuous bony shell,intralesional septa,calcification,and “boundary angle”sign are common,which may help in the radiographic diagnosis of giant cell tumor.

The management of national defence science and technology reports was described from their compila-tion, submission, review, communication and use, taking The Scientific Research and Training Center of China Astronauts as an example. The problems in the management of national defence science and technology reports were pointed out, with measures and suggestions put forward for strengthening their management.

Through approaching the mixed ability training of clinical post-graduates, the following conclusions were drawn: necessity to take turns in the clinical specialties, establishment of its program, the details and contents were pointed out, meanwhile, it is necessary to guarantee progression of the plan and its training effects, and to improve the cultivation quality.

目的探讨脊髓损伤患者尿路感染常见细(真)菌及其对不同抗生素的敏感性和耐药情况。方法取脊髓损伤患者中段尿做尿培养及药敏试验,共计586例次。结果共培养出细(真)菌586株,其中革兰氏阴性杆菌475株(81.1%)、革兰氏阳性球菌83株(14.1%)、真菌28株(4.8%);产ESBL大肠埃希氏菌12株(2.05%)、产ESBL肺炎克雷伯氏菌5株(0.85%)。结论大肠埃希氏菌是导致本组患者尿路感染的最主要细菌,且细菌耐药现象较为严重,应引起临床医生高度重视。

Objective To investigate the pathogen spectrum and analyze the associated risk factors of pulmonary moniliasis in the patients with liver failure.Methods A retrospective analysis of pulmonary moniliasis complicating liver failure(n=150) was performed by case-control study on the data of patients admitted to PLA 302 Hospital from Jan.1986 to Nov.2007.A cohort of 154 patients with liver failure but without fungi infection(n=154) served as the control group.By analyzing the epidemiological and clinical data,the spectrum of fungi was identified,and the risk factors in pulmonary moniliasis pneumonia inpatients with liver failure were identified.Results The number of patients with acute on chronic liver failure(69/150,46.0%) were greater than patients with chronic liver failure(78/150,52.0%),while the number of patients suffering from moniliasis pneumonia was smaller than that of control group(20/154,13.0% and 129/154,83.8%,respectively,P

Objective To investigate the clinical significance of fiberoptic ductoscopy-guided intraductal biopsy in diagnosing nipple discharge.Methods From May 2006 to April 2007,screening fiberoptic ductoscopy was performed for intraductal papillary lesions in 53 ducts among 51 patients.Fiberoptic ductoscopy-guided intraductal biopsy was carried out followed by open microdochectomy. Results Except for a failure in 5 ducts,biopsy found papilloma in 29 cases,ductal hyperplasia in 15 cases,severe ductal hyperplasia in 2 and carcinoma in 2.Microdochectomy revealed 43 benign diseases (12 solitary intraductal papillomas,12 multiple intraductal papillomas,and 25 ductal hyperplasia)and 4 malignancies (3 ductal carcinoma in situ,1 invasive ductal carcinoma).Surgeries performed for the 5 ducts failing a biopsy attempt revealed papilloma in one and adenosis in 4.Compared with conventional microdochectomy,fiberoptic ductoscopy-guided intraductal biopsy can significantly increase the detection rate of solitary papilloma(40.7% vs. 92.6%,P＜0.05).It might also underestimate multiple intraductal papilloma and breast cancer. Conclusion Fiberoptic ductoscopy-guided intraductal biopsy is microinvasive,safe,convenient with a high success rate,and could be as a routine procedure after intraductal lesion found by screening fiberoptic ductoscopy.

Job-transfer training for general practitioner is the important channel of primary medical talents team construction.This article elaborated on existing problems in the general practitioner job-transfer training in our country from several aspects,such as training base,teachers,teaching materials,actual work need and discipline construction,etc.Based on the existing problems and combined with practical work requirements of general practitioner job-transfer training in our country,the article put forward corresponding suggestions and countermeasures including strengthening teachers' construction,textbook construction and speeding up general medical discipline construction,etc.