Joining WTO will bring great opportunity to the reformation and development of higher medical education in China. And at the same time it will also bring severe challenges. The strategy to cope with these challenges maybe: Expediting development and adjusting students' ability structure; Extending opening up and exploit international education market; Consummating educational rules and regulations and then observing to them; Consummating medical educational system to improve international competition capability; Deepening reformation to improve educational quality for adapting to the need of the international competition.

Based on the items, the standard and the basic features of the assessment of the first-class universities in the world, the assessment of the teaching level in China and the assessment for the excellent medical teaching in a seven-year system,the author points out six requirement that the first-class medical universities in our country should possess, such as emphasizing multi-subjects, research and internationalization, having strong comprehensive strength with well- built disciplines, having the reasonable structure of the faculty with high levels, having the good condition for running the university with much finance and having the characteristics of running the universities.

The present study predicts the development of health manpower and level structure of paramedical and pharmacy higher education by methods of dynamic series, tendency extrapolation, grey forecasting and special istic prediction. The results show that in the future 5-10 years, it is suitable for the paramedical and pharmacy higher education lo enroll 50 000-70 000 new students every year, which will account for 35 percent of total medical students of higher medical education. In their level structure undergraduates will gradually reach 30 percent and students receiving 3-year special-i/ed training 70 percent. Some policy suggestions are put forward on the basis of prediction.

Objective To establish the finite element (FE) model of the anterior tibiofibular ligament injury by ankle fracture fixation, so as to compare the stress and deformation of the finite element model by using anchor-reinforced repair combined with screw fixation. Methods CT images of the ankle joint from a normal young male volunteer was selected to establish the FE model of the anterior tibiofibular joint injury by ankle fracture fixation. The injury models were divided into experimental group and control group, which were fixed by anchors or screws, respectively. The maximum stress distributions and the maximum deformation of the two models under various load conditions were observed through the FE analysis and calculation. Results Under the vertical load, the deformation of the experimental group was 6.8% higher than that of the control group. The deformation increased by 22.6% under external rotation load, while the deformation decreased by 5.1% under internal rotation load. Under the same load, differences in the maximum peak stress on the model between the control group and the experimental group was not significant. Due to the anchor fixation, the maximum stress of the experimental group were borne by the screw that fixed the distal tibial fracture, while the maximum stress of the control group was borne by strong fixation of the steel plate and the inferior tibiofibular screw. The maximum stresses on the anchor were distributed on the screw, and the suture mainly played the role of fixing. Conclusions The lower tibiofibular screw and anchor fixation could effectively treat the tibiofibular instability left by ankle fracture fixation. The anchor fixation dispersed the stress on the steel plate, and it showed greater ankle joint deformation ability while fixing the lower tibiofibula, so as to avoid the risk of broken nails.

OBJECTIVETo explore a classification method which can provide the clinical guidance for internal fixation of tibial fracture.

METHODSThe different fractures were fixed according to their mechanical classification. Totally, 71 cases of tibial plateau fracture, tibial proximal fracture, tibial distal fracture and Pilon fracture were analyzed to test this selective principle.

RESULTSAll 71 patients were followed up for 6-32 months. The displacement was seldomly observed in cases treated acccording to the classification principle, while some cases against the principle had postoperative displacement. The difference was statistically significant (P less than 0.05). It was proved that there was remarkable correlation between tibial fracture classification, internal fixator and fixation methods.

CONCLUSIONTypes IIIa3, IIIb1 and IIIb2 fractures without eccentric moment should be fixed with double plates or angle-stable materials combined with locking structure, otherwise displacement may occur.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biomechanical Phenomena ; Chi-Square Distribution ; Child ; Child, Preschool ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Radiography ; Tibial Fractures ; classification ; diagnostic imaging ; physiopathology ; surgery

Fractures of the odontoid process in children are rare but account for the majority of all the cervical spine injuries in the infantile and young juvenile groups. The initial radiographic evaluation is often difficult so that the diagnosis-making is delayed or the fractures are missed. The management of the odontoid fractures of adults has long been controversial and varies with different spinal surgeons. By contrast, the diagnosis and treatment of odontoid fractures in skeletally immature children have not been frequently documented and not in details. This paper reviews the clinical characteristics, diagnosis, treatment principles, and long-term outcome of the odontoid fractures in a consecutive series of patients aged 14 years or younger.