Objective To explore the methods and clinical results of the arthroscopic acromioplasty for the treatment of impingement syndrome of shoulder. Methods 15 cases with impingement syndrome of shoulder were studied. There were 9 males and 6 females. 10 right shoulders and 5 left ones were involved. The average age of patients was 47 years ranging from 32 to 54 years. 3 injuries were classified as degree I, 4 as Ⅱ, and 8 as Ⅲ according to Neer classification. All the patients had a chronic injury and painful history around shoulder. The positive arch pain test was presented in 12 cases and impingement test in 13 cases. 13 patients had been received MR examinations, and 5 arthrographies of the shoulder. The AP and the supraspinatus outlet projection of the X-rays were obtained before surgery. The procedure of arthroscopic acromioplasty consisted of 5 following steps: the first was arthroscopic subacromial inspection with posterior portal; the second was subacromial bursectomy with electro-shaver or burr; the third was release or resection of the coracoacromial ligament with electrocautery; the fourth was subacromial decompression with full-radius resector or burr; and the last was debridement of the soft tissue around the acromio-clavicular joint and resection of the the spurs. 4 patients underwent reparation of the rotator cuff simultaneously. Results All cases were available for follow-up. The average time was 15 months. According to the UCLA scoring system, the average score was 18.5?8.2 and 31.7?6.5 pre- and post-operation respectively; the difference was of statistical significance(t=3.35, P

Objective To report our experience in the embolization of the high-flow vascular lesion in the head and neck by direct percutaneous puncture. Methods Eleven cases of high-flow vascular lesion in the head and neck (8 cases of central hemangioma of the jaws and 3 cases of juvenile nasopharyngeal angiofibroma) were included in this study group. The patients of central hemangioma of the jaws were embolized with coils by a 14-gauge needle, and the fibered coils were placed directly into the center of the intraosseous AVM. The patients of juvenile nasopharyngeal angiofibroma were embolized with NBCA by a No.7 needle. The procedure was under the guidance of DSA machine (Philips V3000). Results The acute arterial bleeding in patients with central hemangioma of the jaws from the extraction of the tooth was controllable, and the pericoronal oozing of bleed disappeared in the 9-24 months follow-up. The juvenile nasopharyngeal angiofibromas were resected without blood transfusion after the embolization. Conclusion The embolization of the high-flow vascular lesion in the head and neck by direct percutaneous puncture was effective and safe, however the longer follow-up was expected.

ObjectiveTo investigate and evaluate the result and the possibility of the clinical application of autologous chondrocyte implant (ACI).MethodsFrom November 2007 to June 2009,6 cases of knee articular cartilage defect were treated with ACI,including 2 males and 4 females with an average age of 39.5 years (range,19-55).All the defects were located on the condyles of femur with a mean size of 7.3 cm2 (range,3.8-11.6).ACI comprises a two-stage procedure:chondrocytes are first harvested from the non-load bearing area of the joint,expand in vitro to acquire enough cells,and then the chondrocytes are implanted.The defect of cartilage were covered with bone membrane and fixed with sutures and fibrin albumen glue.Lysholm score system,International Knee Documentation Committee (IKDC) grading system,and MRI were used to evaluate the effect of ACI,6 and 12 months post-operatively.ResultsAll the patients were followed up.The clinical outcomes of the 6 and 12 months follow-ups demonstrated increased of clinical scores.The MRI follow-up showed good filling of the defect with tissue having the imaging appearance of cartilage in all patients.Only one patient suffered adhesion,because she refused to finish rehabilitation exercises as our treatment advises.ConclusionAs the clinical effect of ACI for knee cartilage defect is satisfied,the ACI may be a good choice for treating knee cartilage defect in future.It is very important to control the indications strictly and guarantee to finish the post-operative rehabilitation exercises.

In the context of Popular Entrepreneurship and Innovation, scientific and systemic implementation of innovation and entrepreneurship education is the focus of higher education reform at present. This paper analyzes the important significances of carrying out innovation and entrepreneurship education in higher education of traditional Chinese Medicine, introduces the specific practices and experi-ences of designing educational concept and constructing education system about innovation and entrepre-neurship education, following the objective laws of modern educational development and the growth pattern of Chinese medicine talents, in order to provide reference for further promoting innovation and entrepreneu-rship education reform.

ObjectiveEvidence-based medicine was used to make an individualized treatment plan for rare solitary splenic metastasis of an ovarian carcinoma in a female patient. MethodsAfter clinical problems were discovered, evidence was collected from the Cochrane Library, PubMed, EMBASE, ScienceDirect, CNKI and Wanfang databases according to our predefined search strategy. The search was done until October, 2009. The validity of the evidence was assessed. The evidence, combined with the doctor experience and the patient value, was applied to the patient. ResultsA total of 15 English literature and 11 Chinese literature were identified. A rational treatment plan was made upon a critical evaluation of the data. There were 5 review articles in PubMed, EMBASE and ScienceDirect databases and no RCT in the Cochrane Library. And there was one retrospective cohort study inCNKI and Wanfang databases. The others were all case reports. After 20 month follow-up, the treatment protocol was proven correct. Conclusion The patient has rare disease, and the evidence intension for the evidence-based medicine was low. It can not present the efficacy of the evidence-based medicine treatment sufficiently, though it could provide some suggestion for rare disease which was lack of large RCT for evidence-based Methods .

Medicine is the subject of studying human and its inherent humanistic attribute endows medicine with the temperature it deserves. However, with the continuous improvement of medical testing technology and treatment technology, medical workers pay more attention to diseases and ignore humanistic care, which has become an important factor in the aggravation of patients’ burden and the tension relationship between doctors and patients. There are many virtues in Chinese traditional culture. Sun Simiao’s medical ethics thought of "great doctor with professionalism and sincerity" embodies the core value of the humanistic spirit of Chinese traditional medicine. In his medical ethics thought, the moral and ethics of "great doctor with professionalism and sincerity", the medical practice attitude of "being cautious and diligent", the values of "benevolence for the world" and the professional conduct of "honesty and truth" still have strong practical significance at present. It is the good material to cultivate the humanistic spirit of medical students. This is of great value to integrate Sun Simiao’s medical ethics thought into cultivate medical students with both "professionalism" and "sincerity", practice the original intention of medical and health undertakings, and carry forward cultural self-confidence.

Medicine is the subject of studying human and its inherent humanistic attribute endows medicine with the temperature it deserves. However, with the continuous improvement of medical testing technology and treatment technology, medical workers pay more attention to diseases and ignore humanistic care, which has become an important factor in the aggravation of patients’ burden and the tension relationship between doctors and patients. There are many virtues in Chinese traditional culture. Sun Simiao’s medical ethics thought of "great doctor with professionalism and sincerity" embodies the core value of the humanistic spirit of Chinese traditional medicine. In his medical ethics thought, the moral and ethics of "great doctor with professionalism and sincerity", the medical practice attitude of "being cautious and diligent", the values of "benevolence for the world" and the professional conduct of "honesty and truth" still have strong practical significance at present. It is the good material to cultivate the humanistic spirit of medical students. This is of great value to integrate Sun Simiao’s medical ethics thought into cultivate medical students with both "professionalism" and "sincerity", practice the original intention of medical and health undertakings, and carry forward cultural self-confidence.

Objective To study the academic level of randomized control trials(RCTs)published from 2004 to 2009 in Chinese Journal of Hepatobiliary Surgery.Methods Published work about RCTs in 72 issues of Chinese Journal of Hepatobiliary Surgery was searched by finding relevant articles published during 2004-2009.Correlated indexes including literature received time, literature publishing time, the total number of citations, number of citations in Chinese, number of citations in English, research funding situations, the number of authors, article affiliations in all RCTs, together with single(or multiple)center study situation, positive conclusions, the starting time, the end time,and number of patients recruited in clinical RCTs were extracted for aggregate analysis.Results During the past six years, a total of 135 articles of RCT were published in Chinese Journal of Hepatobiliary Surgery, accounting for 8.7% in all clinical studies.The average number of RCTs in each issue was 1.88.The average time for publishing time delay was 450 days.The total number of citations in RCTs was 1252 and the average number of RCTs for citations was 9.3.53 RCT studies were financed, accounting for 39% of the total number of research papers.Beijing Friendship Hospital attached to the Capital University of Medical Sciences had published 8 papers of RCT and it is the institution of publishing the largest number of such papers in the journal.The number of multi-center study for RCTs was one and all RCT studies had significant conclusions.The average research duraton in RCTs was 45 months.The total number of patients in 33 clinical RCTs was 2705 and the average number of patients recruited in each RCT was 82.Conclusion Chinese Journal of Hepatobiliary Surgery put emphasis on the strongest evidence and the most valuable RCT researches that have great significance in the field of domestic hepatobiliary surgery for clinical treatment and experimental research.

Objective To explore the effect of NE/α1-AT on the pathogenesis of NASH and the adjustment function of berberine to the imbalance of NE/α1-A and the therapeutic action of berberine to NAFLD.Methods 8-week-old male C57BL/6JApoE/ mice (26),according to the weight assigned to the high-fat-high-cholesterol group (18) and standard chow group (8).HFHC group fed with high fat high cholesterol diet and normal water;the SC group fed with normal diet and drank normal water.After 8 weeks,the HFHC group divided into HFHC group and BBR group according to the weight,Berberine group with 200mg/kg/d berberine,the other two groups fed with the same volume of distilled water.12 weeks all mice were sacrificed.We detected body weight,live weight,live function and lipid metabolism.HE and oil red O staining were used to evaluate pathological changes.ELISA method was used to detect NE and α1-AT expression in mice live tissue;RT-PCR method was used to detect protein α1-AT mRNA expression in live tissue; Immunohistochemistry and Western Blotting were applied to determine expression of NE.Results Compared with the SC group at the end of 12 weeks,ALT,AST were significantly increased in HFHC group,TG was significantly higher than the SC group.Body weight and live weight of ApoE-/-mice fed with HFHC diet significantly higher than the SC group.HE staining showed obvious steatosis and inflammatory foci in HFHC group.The NAS score at the end of model establishment was 5-8 points,which reached the diagnostic criterion for NASH.The concentration and activity of NE in the SC group were significantly increased,and the level of α1-AT was decreased,which lead to ratio NE/α1-AT was significantly higher than the SC group.BBR in mice treated with HE staining showed inflammation ballooning lower than HFHC group.At week 12,ALT,AST of BBR group increased compared with the SC group,and significantly lower compared with the HFHC group.NE/α1-AT was significantly higher than the HFHC group.Conclusions 12 weeks of high fat and high cholesterol feeding,ApoE-/-mice can successfully establish the NASH mouse model;a marked change and contact exist between NE and α1-AT in the process of development of NASH; Berberine can reduce liver lipid deposition and the degree of inflammation in NASH mice,and can improve the NE/ alpha 1-AT imbalance.