Objective To investigate and analyze the data of continuing medical education in order to understand the real need of the learners.Methods Reviewing and making statistic analysis of the data of Renji hospital's continuing medical education courses from 2007 to 2012,including the amount,title,discipline,geographical distribution,training content and the questionnaire survey.Results It shows that the learners from coastal and developed areas have a higher demand for cuttingedge technology and the new progress in medicine(49.1％),while the learners from inland and western regions prefer to learn the basic medical theory and technology (41.9％).Senior doctors tend to study cutting-edge technology and new progress medical courses (51.7％) while the junior persons prefer the basic medical knowledge (46.6％).These mean that the needs of content of continuing medical education is associated with the regions and the level of the doctors (P＜0.05).Conclusion The conclusions prompt that medical development between different regions of China may be unbalanced.Chinese government should pay more attention in terms of allocation of health resources and personnel training.It also provides advice for future courses so that it may improve the efficiency of the medical education resources.

OBJECTIVE:To establish a method for the simultaneous content determination of berberine hydrochloride,phello-dendrine hydrochloride and magnoflorine in Phellodendron amurense decoction piece,and to campare the contents of the 3 ingredi-ents in different grades of P. amurense decoction piece. METHODS:HPLC was performed on the column of Phenomenex Luna C18 with mobile phase of acetonitrile-0.05 mol/L KH2PO4 (gradient elution) at a flow rate of 1 ml/min,the detection wavelength was 280 nm,the column temperature was 30 ℃,and injection volume was 5 μl. RESULTS:The linear ranges were 0.387 0-7.740 μg for berberine hydrochloride(r=0.999 9),0.044 4-0.888 0 μg for phellodendrine hydrochloride(r=0.999 8)and 0.048 0-0.960 0 μg for magnoflorine(r=0.999 9);RSDs of precision, stability and reproducibility tests were lower than 3%, recoveries were 95.61%-103.22%(RSD=2.80%,n=6),96.18%-102.80%(RSD=1.84%,n=6) and 97.93%-102.78%(RSD=1.84%,n=6). CONCLUSIONS:The method is simple and accurate,and can be used for the contents determination of berberine hydrochloride, phellodendrine hydrochloride and magnoflonine in P. amurense. The contents of berbenine hydrochloride and phellodendrine hydro-chloride in the first-grade decation piece are higher than those in the second-grade decoction piece,and the content of magnoflorine in both decoction pieces shows no discernible differences.

Objective To understand the phenotype and enzyme genotype of pan‐drug resistant carbapenemase‐producing Acine‐tobacter baumannii to provide the evidence for clinical rational use of antibiotics and monitoring hospital infection .Methods A total of 117 clinically isolated strains of Acinetobacter baumannii were collected and performed the routine microbiological detection . Multi‐drug resistant Acinetobacter baumannii was screened by K‐B disk diffusion method .The phenotype of carbapenemase‐produ‐cing strains was detected by using the Carba NP colorimetry and modified Hodge test .The drug resistant genotype of multi‐drug re‐sistant Acinetobacter baumannii was verified by PCR .Results Among clinically isolated 117 strains of Acinetobacter baumannii ,64 strains were multi‐drug resistant Acinetobacter baumannii ,in which 33 strains were carbapenemase positive .OXA‐23 drug‐resistant genotype of carbapenemase was detected by PCR ,while IMP ,VIM and NDM‐1 drug resistant genes were not detected .Conclusion The CarbaNP method can rapidly detect carbapenemase‐producing strains with the advantages of strong sensitivity and simple oper‐ation ,which conduces to improve the detection rate of carbapenemase‐producing strains and monitor the nosocomial infection .

AIM: To study the effects of xijiao dihuang decoction, a Chinese medicine, on the expression of adhesion molecules in vascular endothelial cells (VECs) of adrenine and hypothermia-treated rats. METHODS: The expression of VCAM-1, ICAM-1, PECAM-1, iNOS and their corresponding mRNA in VECs was assayed by immunohistochemistry analysis and RT-PCR, respectively. RESULTS: Immunohistochemistry analysis showed the expression of VCAM-1, ICAM-1, PECAM-1 and iNOS are higher in adrenine and hypothermia-treated rats than that in controls, xijiao dihuang decoction decreased the expression of VCAM-1, ICAM-1, PECAM-1 and iNOS in a dose-dependent manner in adrenine and hypothermia-treated rats. CONCLUSION: Xijiao dihuang decoction can down-regulate the expression of adhesion molecules in vascular endothelial cells of adrenine and hypothermia-treated rats.

Objective To analyzed imaging features of testicular and epididymal tumors or inflammatory nodes in children and to improve its diagnostic accuracy.Methods 13 cases underwent ultrasonography,of them,plain CT scan in 10 cases,enhanced CT scan in6 cases.Its signs were retrospectively analyzed and compared with surgical and pathological results.Results On ultrasonography,theinhomogenous and different echo could be viewed in 13 cases,color Doppler flow imaging was abundant in 8 masses,3 cases with littler,empty blood flow in 2 cases and retroperitoneal lymphatic metastasis were viewed in 2 cases.On plain CT scan,masses were mixed density in 4 cases,calcification could be seen within tumor in 3 cases,masses were soft tissue or main soft tissue density in 6 cases.Contrast-enhancedCT scan displayed obviously and inhomogenously in 4 cases,lightly enhancment in 1 case and no enhanced in 1 case.By surgical andpathological confirmed,3 were mature treatomaes,1 was immaturity teratoma,4 were yolk sactumor,3 were inflammatory nodes,1 wasrhabdomyosarcoma and 1 was cystic lymphangioma.Conclusion Each kind of testicular tumors in children has its owns CT and UScharacteristics.In combination of CT and US can carry high diagnostic accuracy.

Objective To study the effect of Buyang Huanwu Decoction (BHD) on adhesion molecules in vascular endothelial cells (VECs) of blood stasis rats. Methods Expression of ICAM-1, VCAM-1, PECAM-1, iNOS in vascular endothelial cells of blood stasis rats receiving different doses of BHD was observed by immunohistochemical method and RT-PCR.Results The expression of ICAM-1, VCAM-1, PECAM-1, iNOS was increased in model group, while was decreased by BHD. There was an increase tendency on the expression of molecules and significant dose-effect relationship along with the decrease of the BHD doses. Conclusion The increased expression of adhesion molecules in vascular endothelial cells of blood stasis rats could be reduced by BHD in a dose dependent manner.

Objective:To investigate the difference of accuracy between magnetic induction Freehand-3D ultrasound and two-dimensional ultrasound in measuring the volume of thyroid model.Methods:Forty thyroid models were established using porcine liver, and the Archimedes procedure was set as gold standard in the measurement of the volume of each model. The accuracy of measurement of the porcine thyroid model volume between two-dimensional ultrasound and magnetic induction Freehand-3D ultrasound were compared.Results:There were no significant differences in the accuracy of measurements of thyroid model volume among two-dimensional ultrasound, magnetic induction Freehand-3D ultrasound and Archimedes procedure (all P>0.05). Compared with the Archimedes procedure, magnetic induction Freehand-3D ultrasonic method showed higher correlation coefficient of the measurement of thyroid model volume ( r=0.998). Bland-Altman analysis showed the lower measure error with a relative error of 3.42% and range of -9.57% to 12.07%. And the limits of agreement were (-1.253, 0.999) in the magnetic induction Freehand-3D ultrasonic measurement. Conclusions:Compared with two-dimensional ultrasound, the magnetic induction Freehand-3D ultrasound show higher accuracy in the measurement of the volume of the thyroid model.

Objective:To provide a basis for its diagnosis and treatment for clinicians by analyzing the clinical manifestations, imaging features and surgical efficacy of primary intraspinal paraganglioma.Methods:The clinical data of 6 patients with intraspinal paraganglioma from April 2014 to January 2021 in Xiangyang Central Hospital were retrospectively analyzed, and all patients were treated with microsurgery via a posterior median approach.Results:All 6 patients achieved total tumor resection, and the postoperative pathological diagnosis was paraganglioma. Among them, 1 patient′s tumor located inside and outside the cervical spinal canal without destruction of the vertebral body; 1 patient′s tumor located lumbosacral canal with destruction of the vertebral body; the others 4 patients′ tumor located within the lumbar spinal canal. The patients were followed up for 12 to 120 months after surgery, with a median follow-up time of 61.5 months. MRI examination was performed at the last follow-up, and no recurrence was observed. The patients underwent MRI examination at the last follow-up, and none of the patients recurred.Conclusions:The intraspinal paraganglioma is a rare tumor, and nonfunctional benign tumors are predominant. Its clinical and imaging manifestations lack specificity and are often difficult to diagnose before surgery. Surgical resection, especially complete resection, has a better prognosis, and the effectiveness of adjuvant therapy is uncertain.