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.

AIM: To analyze the postoperative infection of pathological myopia with pocket scleral reinforcement. ·METHODS:The clinical data of 167 cases of pathological myopia treated with pocket scleral reinforcement in June to December 2014 were analyzed. The postoperative infection rate, the resistance of pathogenic bacteria were analyzed, and the related factors of infection were analyzed. ·RESULTS: A total of 286 eyes were obtained in 167 patients. The infection rate was 6. 3% in 10 patients ( 18 eyes) . There were 30 pathogenic bacteria isolated from the 18 infected eyes, in which were 10 Staphylococcus aureus, 10 Staphylococcus epidermidis, 6 Klebsiella pneumoniae, 4 Pseudomonas aeruginosa infection. Gram positive bacteria showed higher resistance to penicillin, ampicillin and ciprofloxacin, and were sensitive to vancomycin. The resistance rates of gram negative bacteria to cefotaxime were higher, but to imipenem was low. The two groups of patients age, culture level, operation time, the number of operation, intraoperative nursing staff seniority, postoperative medication compliance rate was statistically significant (P<0. 05), which related to the infection after pocket scleral reinforcement. ·CONCLUSION:The infection caused by Staphylococcus aureus is the most common after pocket scleral reinforcement, and it is sensitive to vancomycin, and gram negative bacteria is sensitive to imipenem. Shortening the operation time, using the experienced nursing staff to cooperate, reducing the number of operation and improving the compliance of the patients can reduce the postoperative infection.

Animals ; Hypothyroidism ; physiopathology ; Learning ; Memory ; Mice ; Motor Activity

Constipation has become a common clinical symptom in the elderly. Many factors can result in constipation, including diet,physiological aging, lack of exercise, inappropriate medication, psychological factors, perianal disease, and so on. If the individualized, targetedand comprehensive care interventions that consist of health education, psychological intervention, dietary intervention, medicationguide, functional exercise, passive attention to bowel training and abdominal massage etc. are done well, it can decrease the incidence ofconstipation, reduce a variety of complications and adverse effects caused by the constipation and improve the quality of life in the elderly.So it has important clinical significance.

Objective To investigate the causes,diagnosis,treatment of the difficult postoperative decannulation resulting from tracheotomy between children and adults and the method of improving the rate of successful decannulation.Methods Clinical data of 56 cases with difficult decannulation after tracheotomy were analysed retrospectively,all the patients were admitted in our hospital between Jan 1990 and Oct 2006.All the patients were separated into two groups,children group including 24 cases of 14 months ～ 14 years old,adult group including 32 cases of age ranging 15 ～ 48 years old.The postoperative time after tracheotomy were 6 month ～ 1.5 year and 6 month ～ 2 year respectively.Results There were differences of the etiology,diagnostic choice and the clinical manifestation in the treatment of the diffficult decannulation after tracheotomy between children and adults.Children with difficult decannulation after tracheotomy occurred mainly in laryngitis and airway foreign body airway caused by obstruction retrieved after tracheotomy (14/24,58.33 ％),followed by the emergency tracheotomy,such as head and neck trauma (7/24,29.17％).Adults with difficult decannulation after tracheotomy mainly occurred in the throat caused by traumatic lesions of the larynx (including malformations,subglottic stenosis of larynx or vocal cord paralysis) (23/32,71.88％).The average block time in children with anti-inflammatory treatment was significantly lower than that in without anti-inflammatory therapy (6.2 d vs 10.1 d,t =4.26,P ＜ 0.01).However,there was no significant difference in the average block time in adults with anti-inflammatory and without anti-inflammatory treatment (t =1.63,P ＞ 0.05).In the course of treatment,rates of children consciously breathing difficulties (21/21,100％) was also significantly higher than the adult group (13/28,46.43％).Conclusion Children less than 3 years old should avoid tracheotomy.There is no definite relation between the successful treatment in the difficult decannulation and the age of the patients over 3 years old.The first failure treatment in children may be related with the local inflammation.When in treatment,doctors should observe the characteristics of respiratory difficulties,take attention to the influence of children psychological factors to the treatment.Children should be treated in the non-traumatic examination methods.

Objective To evaluate Feridex(superparamagnetic iron oxide,SPIO)enhanced MRI in the diagnosis of hepatic lesions.Methods Feridex-enhanced MRI was performed in 31 patients with CT,or MRI proved or suspected hepatic lesions.T 2WI signal intensity of hepatic parenchyma,lesion and background noise was measured before and after enhancement separately.SNR and CNR of parenchyma and lesion before and after enhancement were calculated.The number of lesions on plain and enhanced scans were observed and alalyzed.Results Post-enhancement SNR of liver significantly decreased (?0.05).Post-enhancement lesion-liver CNR increased significantly (?

Objective To observe the efficacy of Complex Oral Motor Scoring (COMS) and diadochokinetic rate (DR) on evaluation of oral motor dysfunction and speech disorders in children with cerebral palsy. Methods 107 children with cerebral palsy were tested with Chinese-version Articulation Test, Simple Oral Motor Scoring (SOMS), COMS and DR. The correlation among SOMS, COMS and DR was analysesd. Results 85 children were abnormal in SOMS and 94 in COMS. Oral dyskinesia was found in all the children with spastic quadriplegia, dyskinetic, ataxia and mixed type of cerebral palsy, and less in the type of spastic diplegia and hemiplegia. DR was the least in spastic quadriplegia, dyskinetic, mixed type of cerebral palsy, more in the type of ataxia and spastic diplegia, and the most in hemiplegia. The coefficient of correlation among the SOMS, COMS, the longest pronunciation and DR were more than 0.8 (P<0.01). Conclusion The incidence and severity of oral dyskinesia and dysarthria are associated with the types of cerebral palsy. There is good correlation among SOMS, COMS, longest pronunciation and DR.

AIM:To investigate the influence of matrine (MA) on the phenotype switching of mouse mono-cytes and alveolar macrophages induced by bleomycin ( BLM) .METHODS:All mice were randomly divided into normal saline (NS) group, BLM group, BLM+NS group and BLM +MA group.The mice were administered with BLM at 2.5 mg/kg via oropharyngeal instillation .The mice in BLM+MA group were treated with MA (15 mg· kg-1 · d-1 ) by oral gavage following BLM administration .The mice were sacrificed on days 3, 7, 14, and 21.The lungs were removed for pathological analysis .The circulating monocyte subsets and polarization state of bronchoalveolar lavage fluid ( BALF)-de-rived alveolar macrophages were analyzed by flow cytometry .RESULTS:The results of HE and Masson trichrome staining in BLM and BLM+NS groups exhibited classical pathological stages of lung fibrosis , including acute inflammation phase and later fibrosis phase .Compared with BLM +NS group, MA treatment alleviated the inflammatory response and the de-gree of fibrosis induced by BLM (P<0.05).There was a rapid change of circulating Ly6Chi monocytes and its magnitude was positively associated with the pulmonary inflammatory response .An expansion of M2-like alveolar macrophages was positively correlated with the magnitude of lung fibrosis .Moreover , MA treatment partially normalized the phenotype switc-hing of monocytes and alveolar macrophages .CONCLUSION:Matrine treatment attenuates BLM-induced pulmonary injury partially via modulating the phenotype switching of monocytes and alveolar mocrophages .

Objective To investigate the mechanical properties of carbon-fiber-reinforced polyether-ether-ketone (CF/PEEK)composite materials and to evaluate the biocompatibility and bioactivity of CF/PEEK after implanted into mandibula.Methods 27 adult Japanese white rabbits were randomly divided into experimental group (n=9) and control group (n=18),CF/PEEK was implanted into bilateral mandibula of the rabbits in experimental group, autologous bone was implanted into left mandibula of the rabbits in positive control group (n=9 )while the right sides were taken as blank control group (n=9 )without implants. The materials-bone interface of samples were collected to make the observation of gross,imaging and histology and to analyze the histological score after 8,12, and 16 weeks.Results All the animals and no infection had secondary fractures.Obviously callus formation was observed on the edge of the defect in both experimental group and positive control group in the imaging observation, while the rabbits in blank control group had no obvious change.Compared with 8 weeks after operation, the score evaluation of local cellular immune response showed significant decreasing in 12 weeks after operation(P<0.01), the data was the minimum in 16 weeks(P<0.05).At the same time,the score evaluation of local cellular immune response in three groups showed no significant difference (P> 0.05).Trabecular bone and osteoblasts could be observed in the bone defect of both experimental group and positive control group after 16 weeks,and blank control group was filled with fibrous connective tissue.The osteogenesis rates in experimental group and positive control group were increased with the prolongation of time, and they were better than that in blank control group (P<0.01).Conclusion CF/PEEK material has good mechanical property,biocompatibility and bioactivity;and it has light immune response after implantation.

Objective To investigate the inhibitory effect of icariin(ICA) on the xenograft tumors growth of esophageal car‐cinoma and to preliminarily investigate its mechanism .Methods The MTT assay and Giemsa staining were applied to detect and observe the in vitro inhibitory effect of ICA on esophagus cancer cell lines Eca‐109 and TE‐13 .The xenograft tumor model of nude mouse esophagus cancer cell was constructed and divided into 3 groups ,6 cases in each group .Each mouse in the experimental group was intraperitoneally injected by ICA 50 mg/kg ;while the control group was injected by the same volume of normal saline and the positive control group was injected by cis‐platinum 2 mg/kg ,once every 2 days ,a total of 14 days .The tumor volume was measured once per 3 d .After experiment ,the tumor weight was measured;the TUNEL staining was used to observe the morphological chan‐ges and cell apoptosis of tumor tissue in each group .The changes of Fas and FasL protein expression in tumor tissues were analyzed by immunohistochemistry .The FasL and IFN‐γlevels in peripheral blood were tested by the ELISA assay .Results ICA exerted no obvious inhibitory effect on the proliferation of Eca‐109 and TE‐13 cell in vitro .The average volume and weight of xenografts tumor had statistical difference between the experimental group and the positive control group (P<0 .05) .The TUNEL staining results showed that the tumor tissues had obvious apoptosis ,the number of apoptosis cells was significantly increased compared with the control group(P<0 .05) .The immunohistochemistry experimental results showed that the expression of Fas and FasL was signifi‐cantly increased(P<0 .05) .The ELISA experimental results demonstrated that the FasL and IFN‐γlevels of peripheral blood in the experimental group were significantly increased(P<0 .05) .Conclusion ICA had no obvious inhibitory effect on esophageal cancer cell proliferation in vitro ,but could induce in vivo apoptosis through the Fas expression and secretion of FasL and IFN‐γ,thus plays the role of anti‐esophageal cancer .