Objective:To investigate the protection of acupuncture on damaged myelin sheath from the poinr of view of neurological functional recovery and morphological changes of the myelin sheath.Methods:Eighty-nine adult male Sprague-Dawley rats were randomly allocated to normal (n=5),sham-operation (n=21),model (n=21),early acupuncture (n=21) and late acupancture (n=21) groups.A model of middle cerebral artery occlusion was induced by the intraluminal filament method.Acupuncture was performed at different time points after ischemia.Neurological function and morphological changes of the myelin sheath of ischemic focus were observed by using the methods of neurological deficit scores and Pal-Weigert's myelin staining.Results:Neurological deficit scores at 2.5 hours after the procedure in the model group increased significantly (P＜0.05).qhe scores decreased somewhat as the time elapsed.The internal capsule had obvious demyelination and recovered slowly.Neurological deficit scores in rats at each time point decreased faster in the acupuncture group compared with the model group,and they decreased significantly at day 3 (P＜0.05);the extent of demyelination was significantly alleviated.Neurological deficit scores decreased faster in the early acupuncture group compared with the late acupuncture group (P＜0.05);and demyelination in the early acupuncture group seemed milder at day one.Conclusions:Early acupuncture is beneficial to remyelination and neurological functional recovery after cerebral ischemia.

Objective To explore the occurrence and prevention and the principle of management of chylous fistula after neck dissection. Methods Retrospective research on 1750 cases of neck dissection in Henan Tumor Hospital from January 1983 to January 2005. There were 48 cases chylous fistula and 1 case chylothorax. The incidence was 2.8 %. 5 cases on the right, 44 cases on the left. 18 cases had completed radiotherapy or chemotherapy before operation. Conservative methods and surgical methods were used in the treatment. Low fat food was supplied to the patients with chylous fistula. The conservative methods was local pressure, the surgical methods was applied while maximal production of chylous exceeding 500 ml a day. Results All the patients were cured finally. The conservative method was 12.6(5~34) days, the surgical method 7.5(3~10)day. Conclusion The key to prevent chylous fistula was to band the rupture of thoracis or lymphatic duct during operation. The conservative methods could be used in patients with slight and middle chylous, when the chylous exceed 500 ml a day or the conservative methods was unavailable, the surgical methods was appropriate, it could shorten the time of tube draw.

AIM: To observe the efficacy and compliance of cetirizine hydrochloride and pranoprofen eye drops on children with vernal keratoconjunctivitis.
● METHODS: A total of 63 children with vernal keratoconjunctivitis, from the outpatient department in our hospital between Jan. 2014 and Dec. 2015, were randomly divided into two groups including experimental group and control group. The cases in experimental group were treated with cetirizine hydrochloride, 2 times/d, 5 drops (0. 25ml, 2. 5mg) each time (≤6 years) or 10 drops (0. 5ml, 5mg) each time (>6 years), oral or oral with beverage and food, 1g/L pranoprofen eye drops, 4 times/d, 1 drop each time. The cases in control group were only treated with cetirizine hydrochloride, 2 times /d, 5 drops (0. 25ml, 2. 5mg) each time (≤6 years) or 10 drops (0. 5ml, 5mg) each time (>6 years), oral or oral with beverage and food for 14d. All the children were detected the scores of symptom and pathology before and after treatment. Compliance and side effect of the drug were surveyed by questionnaire.
● RESULTS: The scores of symptom, pathology and overall total after treatment were significantly lower than those before treatment in each group ( texperimental, symptom =10. 41, P < 0. 05; texperimental, pathology = 10. 05, P < 0. 05;texperimental, overal =10. 75, P<0. 05;tcontrol, symptom=8. 11, P<0. 05;tcontrol, pathology=8. 89, P<0. 05; tcontrol, overal =8. 41, P<0. 05). The scores of symptom, pathology and overall total in experimental group were lower than those in control group after the treatment (tsymptom=5. 27, P<0. 05; tpathology=3. 97, P<0. 05;toveral =4. 32, P<0. 05). The effective rate of experimental group ( 85%) was significantly higher than control group (60%) (χ2 =4. 92, P<0. 05). Most of the children ( 94%) had very good compliance. None of children had side effect such as sleepiness and thirst.
● CONCLUSION: Cetirizine hydrochloride and pranoprofen eye drops in combination may offer a safety and effective treatment on children with vernal keratoconjunctivitis and have good compliance.

Abstract BACKGROUND: Recently, microcarrier culture as a high concentration cel culture technology has been used in hepatocyte culturein vitro. OBJECTIVE:To periodicaly observe the morphological changes of human hepatocyte L-02 cultured by the spherical porous chitosan microcarrier. METHODS:The self-made spherical porous chitosan microcarrier sample as a support to culture human hepatocytes L-02 acted as experimental group; non-spherical porous chitosan microcarrier as a support to culture human hepatocytes L-02 as control group. Cels in two groups underwent cel count at regular time, and the morphological changes were observed in the experimental group, including inverted phase contrast biological microscope observation and scanning electron microscope observation. RESULTS AND CONCLUSION:The quantity of cultured cels in the two groups was increased in the first 3 days and reached the peak at the 3rd day. The cel quantity in the experiment group was obviously higher than that in the control group (P < 0.05). There was no significant difference in the three samples of the experimental group (P > 0.05). The quantity of hepatocytes adhered to the microcarrier surface was gradualy increased in the former 3 days under the inverted phase contrast biological microscope. There were lots of cel clusters on the surface of a greater part of microcarriers, with the total survival rate of more than 90%, and hepatocytes kept a good morphological structure. Under the scanning electron microscope, lots of hepatocytes adhered tightly to each other on the surface and section of microcarrier as wel as inside the microcarrier. It is indicated that the self-made spherical porous chitosan microcarrier as a support in three-dimensional environment can undergo cel culture with high concentration.

Objective　To evaluation the application value of two-phase enhanced spiral CT in pancreatic adenocarcinoma. Methods　Two-phase enhanced spiral CT was performed in 27 cases of pancreatic adenocarcinoma. After plain CT examination, performed arterial phase（25s after infusion）and portal venous phase（60～70s after infusion）with a 150ml bolus injection of contrast material at 3ml/s. CT attenuation values of tumor and normal pancreas in all scanning phase were obtained and the tumor-pancreas contrast was calculated. Results　Mean tumor enhancement were 48±8 HU（arterial phase）and 72±6 HU（portal venous phase）, normal pancreas enhancement were 125±18 HU、98±11 HU, mean tumor-pancreas contrast was significantly differenced on arterial phase （73±21 HU）and portal venous phase （25±12 HU）. Conclusion　Excellent tumor-pancreas contrast is obtained with arterial phase scans, as such it is of significance reference value for diagnosis pancreatic adenocarcinoma.

The doctor-patient relationship is always the focus in the society. The relationship seems more complex and sensitive in the pediatric surgical ward because its patients are kids. However, the pediatric surgical residents' ability of doctor-patient communication is lack of systemic and norma-tive training, which is not good for the mutual understanding between doctors and patients. This study explores how to enhance the residents' doctor-patient communication skills from the perspective of awareness, professional knowledge and some specific skills. In the meantime, it discusses the need to train the teachers and set up a regular examination-assessment system.

Objective To study the efficacy of simple Chinese medicine steam spray and comprehensive rehabilitation nursing after facial burn deep Ⅱ degree.Methods 80 patients were randomized into the treatment group (40 cases) and the control group (40 cases).The treatment group was given the treatment of Chinese medicine steam spray.The control group was given the treatment of Chinese medicine steam spray,pressure therapy,physical therapy,rehabilitation training and psychotherapy.The clinical efficacy of two groups was evaluated respectively after 3 months.Results After 3 months,the skins of most of patients in the treatment group were nearly normal with no pigmentation and scar hyperplasia.The cure rate was 72.5 ％,the obvious effective rate was 12.5 ％,and the effective rate was 7.5 ％.Some patients in the control group were lightly and inconspicuously pigmented,but the pigmentation area was reduced.The colour of their skins was not different from that of the normal skin.The cure rate was 42.5 ％,the obvious effective rate was 12.5 ％,and the effective rate was 25.0 ％.The effects of the two groups were significant differences (P＜0.05).Conclusions Comprehensive rehabilitation nursing after the facial burn can reduce the pigmentation and scar hyperplasia and improve the quality of life.

College of American Pathologists (CAP) and International Standard Organization (ISO)15189 accreditation provides requirements to the verification and validation tests for clinical molecular diagnostic assays.The article will introduce the requirements in these aspects including the differences between the two accreditation systems,the differences between the verification and validation tests,the essential factors and standardized framework of the verification and validation tests for clinical molecular diagnostic assays.

10.3969/j.issn.2095-4344.2013.25.018

Medical students′ professional spirit cultivation is an important content as well as a basic require-ment of the Preeminent Doctor Education and Training Plan. Currently, there are several problems in medical tal-ents′professional spirit cultivation, such as the unstandardized curriculum, the lack of subjective experience, and the ignorance of the unity of education stages, student differences and coherence. This study intends to explore thedouble teacher method, in which both clinical teaching doctors and medical ethics teachers engage in the medi-cal students′professional spirit cultivation. Its purpose is to build a bridge between medical ethics education in uni-versities and the clinical practice, and further to integrate them through doctors′ and teachers′ joint participation, which will significantly enhance medical students′practice ability of medical moral.