Objective To discuss the effect of α-lipoic acid combined with alprostadil in patients with diabetic peripheral neuropathy (DPN).Methods Eighty-two patients with DPN were divided into the control group(n=41) and research group(n=41) according to the random number table method.The patients of the control group were given alprostadil based on conventional therapy, while the research group were given alpha lipoic acid based on treatment of the control group, the course was two weeks.The bilateral median nerve and sural nerve conduction velocity (MNCV) and sensory nerve conduction velocity (SNCV) were tested by electromyograph.Disease severity were evaluated by neuropathy symptoms questionnaire (TSS) and pain degree were tested by Visual analogue scales(VAS).The MNCV, SNCV, TSS and VAS of before and after treatment and the clinical effect of the two groups were compared.Results There were no statistically significant difference about MNCV and SNCV of the two groups before treatment (P＞0.05).After treatment, the MNCV and SNCV of nervus medianus and nervus peroneus communis of research group and control group were significantly higher than before treatment, and the differences of research group before and after treatment (MNCV of nervus medianus: (42.5 ± 3.6) m/s vs (47.8± 4.6) m/s, t =-5.752, P ＜ 0.05;SNCV of ervus medianus : (39.6 ±1.6) m/s vs (46.2±4.5) m/s,t =-5.882,P＜0.05;MNCV of nervus peroneus communis: (39.8±3.2) m/s vs (44.5±2.5) m/s,t=-4.263,P＜0.05;SNCV of nervus peroneus communis: (36.5±1.7) m/s vs (48.7± 2.6) m/s, t =-7.526, P ＜ 0.05), significantly obvious than the control group (MNCV of nervus medianus: (42.3 ±4.2) m/s vs (44.5±5.3) m/s,t =-4.627,P＜0.05;SNCV of nervus medianus: (39.8 ±2.4) m/s vs (42.4±2.5) m/s,t =-5.527,P＜0.05;MNCV of nervus peroneus communis: (40.3±1.6) m/s vs (42.2± 1.6) m/s, t =-4.181, P＜ 0.05;SNCV of nervus peroneus communis: (36.4± 2.3) m/s vs (41.2±3.5) m/s,t =-5.928,P＜0.05).Before the treatment,the TSS and VAS of the control group were (11.4±2.5) sore and (5.3±1.6) sore,of the research group were (11.6±1.6) sore and (5.2±1.8) sore,and there was no significant difference between the two groups (P＞0.05).After treatment, the TSS and VAS of the control group were (6.4± 1.3) sore and (3.6± 1.3) sore, of the research group were (4.2± 3.3) sore and (1.7 ±0.9) sore, and compared to before treatment, there was significant difference (P＜0.05), and the research group was significantly lower than the control group, the difference between the two groups was statistically significant (P＜ 0.05).The total effective rate of research group was obviously higher than that of control group, the differences were statistically significant (95.1％ (39/41) vs 65.9％ (27/41), x2 =5.363, P =0.031) .Conclusion The effect of α-lipoic acid combined with alprostadil in patients with diabetic peripheral neuropathy is obviously better than that of using alprostadil only,it is worth popularization and application.

This research mainly analysed the section of clinical experience in the reporl of"A panoramic snapshot of medical students'education at the beginning of the 21st century"and gave a brief introduction to the mainstream medical education in No,hem Amercia according to the literature.At last,the enlightment from the report and reformation of our clinical practice were put forward.

BACKGROUND:There is often space between implant and bone during immediate implantation.Whether biological membrane is needed to guide bone regeneration remains poorly understood.OBJECTIVE:To createdifferent sizes of space between femurand implantsindogs and to observe the effects of biological membrane on bone regeneration capacity of bone defects surrounding implants.DESIGN,TIME AND SETTING:A self-control animal experiment was performed at the Laboratory Animal Center,Norman Bethune College of Medicine,Jilin University and School of Stomatology,Jilin University between March and December 2005.MATERIALS:BLB hydroxyapatite-coated implant was provided by Beijing Leiden Biomaterial Co.,Ltd.,China;BME-10X collagen membrane was purchased from Fujian Better Biotechnology Co..Ltd.,China.METHODS:BLB implants were installed in the bilateral proximal femoral bone to create standard gradient bone defects with horizontal width 3 mm.vertical depth 5 mm,and horizontal lengths of 0,1,2,3,and 4 mm Bone defects on the left femur were sutured directly and those on the right femur were covered with biological membrane prior to suture.All animals were sacrificed at 3 months after surgery.Specimens containing implants were harvested to prepare tissue blocks for radiological observation.MAIN OUTCOME MEASURES:The quantity,color,and texture of newly formed bone surrounding implants were observed from the surface and profile levels.The implant-bone integration and new bone formation were also examined by soft X-ray photography.RESULTS:Grossobservation results revealed that when the horizontal length of bone defect was 3 mm or less,there was no significant differenee in bone density between the newly formed bone and the host bone no matter whether biological membrane existed or not;when the horizontal length of bone defect was 4 mm the bone density was better when biological membranes were used than not.Soft X-ray photography results revealed that when the horizontal length ofbone defect was 3 mm or less.no significant difference in bone density and bone trabecular morphology and orientating was found between newly formed bone and host bone no matter whether biological membrane was used or not;in the 4-mm-length bone defect areas.implants contacted with newly formed bone directly,but the calcified degree ofnewly formed bone was poor,bone trabecula was thin,and bone trabecular course was irregular,nevertheless,the calcified degree of newly formed bone was better under the condition of being with biological membrane than without biological membrane.CONCLUSION:Biological membrane exhibits strong capacity to promote the regeneration and repair of bone defect tissue with a horizontal length of 3 mm or less,and plays an important role in repatr of large sizes of bone detect

OBJECTIVE:To establish a method for determination of the content of puerarin in compound Rhizoma Coptidis graininess METHODS:HPLC method was used The samples were separated by C18 (4 6mm?250mm,5?m) column with the mobile phase of methanol-water(30∶70) The detection wavelength was set at 250nm Flow rate was 1 0ml/min Column temperature was 30℃ RESULTS:The linear ranges of puerarin was 0 312?g～1 560?g The average recovery was 99 2%,RSD=2 08%(n=5) CONCLUSION:The method is sensitive,rapid and accurate and suitable for the determination of puerarin in compound Rhizoma Coptidis graininess

This paper illustrates the characteristics of medical English in terms of vocabulary,syntax and style in order to enhance the understanding of medical English for medical students and improve their ability of medical English reading and translation.

OBJECTIVE: To optimize the extraction technology of pueraria, ophiopogonis, and loquat leaf. METHODS: Orthogonal test was carried out. The influence of concentration of solvent, the dosage of solvent, time length of extraction, and frequency of extraction on extraction results were investigated by using the content of pueraria as index. RESULTS: The optimal extraction technique was to extract pueraria in 60% alcohol 8 times the weight of herbal medicine for 3 times, with 60 minute for each time. CONCLUSION: High yield of extractum and high content of pueraria are obtained with the present technology. The results are stable and replicable, which can provide reference for preparation of Huanglian powder.

OBJECTIVE:To optimize the extraction technology of berberine from Rhizoma Coptidis.METHODS:The or?thogonal-test method was adopted to research the effects of5factors,including the concentration and volume of alcohol,the concentration of H 2 SO 4 ,the duration and times of extraction on the yielding rate of berberine from Rhizoma Coptidis.RESUL TS:The optimum technology of extracting berberine from Rhizoma Coptidis was described as follows:The concentration of al?cohol containing0.25%H 2 SO 4 was80%,and volume of alcohol was6times raw herb.To extract the herb for3times was optimum and duration of extraction was1.5h for each time.CONCLUSION:The content of berberine in the product is over90%,so this technology is suitable for industrialized production.

Objective To strengthen the ability of clinical thinking and the ability to solve practical clinical problems for medical students.Methods Medical undergraduates studying in affiliated hospitals of Tongji university from 2005 to 2010 were enrolled The clinical thinking training and assessment in clinical teaching were enhanced by introducing problem-based learning,case-based learning and by strengthening the role of interns in clinical work and emphasizing clinical thinking ability assessment during various kinds of clinical skills examinations.Meanwhile,the teaching management and supervision were improved.The awareness and ability of clinical teachers to train students′ clinical thinking were aroused and cultivated through teaching staff training so as to ensure that clinical thinking training and assessment were involved in the whole process of clinical teaching.Results The students' abilities of self-study,scientific thinking and oral expression were improved.The passing rates of our graduates in national general medical practitioner test were increasing yearly from 2006 to 2008.Conclusion Strengthening clinical thinking ability training during clinical teaching plays an active role in improving clinical skills in medical students.

Objective To summarize the experience in surgical treatment of Ebstein anomaly,and evaluate the therapeutic effect.Methods Thirty-five patients of Ebstein anomaly were treated by operation.New York heart association(NYHA)heart function classⅠ?was in 11 cases,classⅡ?was in 14 cases,class III-Ⅳ?was in 10 cases.The cue of echocardiogram about tricuspid valve regurgitation in 24 cases were severe,5 cases were moderate and 6 cases were mild.Two patients accepted tricuspid valve replacement.Thirty-three cases were accepted tricuspid valve repair and right ventricle folded,in which 2 cases accepted Danielson method,and 31 cases accepted Carpentier method,among them,9 cases accepted one and a half ventricular repair.Associated heart anomaly was corrected at the same time.Results One patient died.There were 2 cases with third degree atrioventricular block after tricuspid valve replacement,2 cases with low cardiac output syndrome and 2 cases with atrial fibrillation combined premature ventricular contraction.The heart was lower by chest X-ray and echocardiogram examination,tricuspid valve regurgitation in 22 cases were disappeared,9 cases were mild,3 cases were moderate.All patients were followed up from 1 month to 7years,tricuspid valve regurgitation in 21 cases were disappeared,12 cases were mild,heart function were class Ⅰ-Ⅱ.Because of heart function aggravation,1 patient was operated again 3 years after operation.Condusions Ebstein anomaly is a rare congenital heart disease,Carpentier method tricuspid valve repair can decrease regurgitation obviously and protect right ventricular function.One and a half ventricular repair should be adopted according to the function of tricuspid valve and right ventricle.

Objective To study the mechanism of pulmonary injury and protective effect of modified ultrafiltration on lung function in infant open heart surgery.Methods According to the wishes of parents,40 cases of congenital heart disease were divided into without modified ultrafiltration control group (C) and modified ultrafiltration group (M),and parents signed informed consent.The cardiopulmonary bypass (CPB) was used without ultrafiltration in Group C,while with modified ultrafiltration in group M.The pneumodynamic parameters and C3a,C5a,TXA2,LT were measured at specific time points.Results The static pulmonary compliance (Cstat) and oxygen index (OI) were lower,and alveolar-arteria oxygen difference (AaDO2) was higher after CPB in the two groups(P ＜ 0.05).At T3,T4 and T5 time points,the Cstat and OI in Group M was higher than that in Group C; AaDO2 in Group M was lower than that in Group C (P ＜0.05).The levels of C3a and C5a were lower after CPB in the two groups; levels of TXA2,LT were higher after CPB in the C groups.At T2,T3,T4 and T5 time points,the TXA2 and LT in Group M were lower than that in Group C(P ＜0.05).Conclusions The pulmonary injury in pediatric open heart surgery may be concerned with the the alexin(C3a,C5a) activation and I/R.The level of C3a and C5a was considered earlier index of inflammatory reaction and pulmonary injury.Modified ultrafiltration improves pulmonary function due to elevating coloid osmotic pressure and degrading the plasma level of TXA2,LT.