The paper describes the significance of clinical pathological congresses in clinical work. It argues that at present there is the tendency of laying stress on modern advanced diagnostic means at the expense of basic physical diagnostic means and traditional therapies, and traditional conduction of clinical pathological congresses for the purpose of summarizing medical experience and promoting medical advancement has even become a rarity, which is very harmful to the cultivation of qualified clinical doctors. The paper gives an account of how the authors' hospital encouraged performance of autopsies and persisted in holding clinical pathological congresses. Its experience is that clinical pathological congresses have many functions in clinical work, including solving knotty problems like multidisciplinary and multisystematic pathological changes by drawing upon all useful opinions; exchanging information, which is beneficial to doctors learning from one another and making common progress; cultivating personnel via tempering young doctors and updating senior doctors'knowledge; and strengthening the hospital's cohesive force.

0.999 0, and RSDs were not more than 3.26%. The recovery rates were 94.12%-104.30% .The lowest detected concentration was 1.43 mg/L. There was no significant difference between the results of this method and Na2EDTA titration. Conclusion The method was rapid, accurate and highly sensitive.

Objective To clone VEGF gene and construct its eukaryotic expression vector for the evaluation of the possability of VEGF gene therapy in orthopedic disease. Methods Human vascular endothelial growth factor(hVEGF) cDNA was amplified by nested PCR method from the HL60 cells and cloned to expression vector pcDNA 3. The cDNA was identified by enzyme digestion and DNA sequencing. Rabbit osteoblasts were transfered with pCD-hVEGF165 plasmid by lipofectin mediated gene transfer method. The transient expression of VEGF were detected by Streptavidin-Biotin-enzyme Complex(SABC). Results The cloned cDNA was confirmed to be VEGF165 cDNA. It was observed that the expression of human VEGF gene was detected distinctly 72 h after transfering. Conclusion We successfully cloned hVEGF 165 gene and construced its eukaryotic expression vector, which provided the further foundation of VEGF gene therapy for ostenecrosis,bone defeat and fracture.

Objective To observe the effect of intravenous anesthesia (IVA) with propofol (P),ketamine (K) and fentanyl (F) in different ways in children. Methods 90 pediatric patients were divided into three groups ( n =30) randomly according to the drug used for IVA. Ⅰgroup used compounds of P, F and K; Ⅱgroup used compounds of P and F; Ⅲ group used compounds of P and K. All the drugs were injected intravenously with micro-pump. Total dosage of anaesthetics, awaken time after operation and variation of circulation and breath were observed and sedative and analgesic effect during operation were evaluated. Results Compared with Ⅱ or Ⅲ group, Ⅰgroup showed less dosage, shorter awaken time and smaller degree of change in circulation and breath with complete sedation and analgesia ( P

Objective To analyze the factors affecting quality of life (QOL) in patients with stroke. Methods Eight hundred and six stroke patients were recruited by using the stratification and random sampling method, and QOL questionnaire was applied. Results It was shown that QOL was worse comparatively in stroke patients with poorer education, divorce or lose of spouse, non-free medical service, unemployment, serious deficit of nervous function, while it was indicated by the results of multiple factor analysis that QOL was influenced mainly by such factors as education background, marriage and neurological function. Conclusion In order to improve QOL of patients, we should pay more attention to the health of elders, social security system, education and medical technology.

Objective To investigate the correlation between levels of glycohemoglobin and cognitive function in elderly patients with type 2 diabetes. Methods Cognition function of 40 elderly patients with type 2 diabetes was assessed by Wechsler Memory Scale (WMS), Trail Marking Test and Wisconsin Card Sorting Test (WCST) and was compared with 40 healthy controls matched for age, gender, education level and profession. Meanwhile, the correlation between cognition function and levels of glycohemoglobin was analyzed by regression analysis.Results The scores of Wechsler Memory Scale in the patients were lower than that in normal controls (P＜0.01，P＜0.05). The patients needed much more time to complete the Trail Marking Test (P＜0.001). The scores of Wisconsin Card Sorting Test were significantly different between two groups (P＜0.01，P＜0.05). The regression analysis showed that there was an obvious correlation between serum level of glycohemoglobin and cognition functions in patients with type 2 diabetes(r=-0.38, -0.43, -0.48, -0.46, 0.41, P＜0.05). Conclusion Cognition function decreases and significantly correlates with the level of glycohemoglobin in the elderly patients with type 2 diabetes.

Objectivo To analyze urine organic acids in the urine using gas chromatography-mass spectrometry(GC/MS)for diagnosis of inherited metabolic diseases,especially for organic acids metabolic disorders.Methods 195 clinical urine samples from the patients with suspected organic acids metabolic disorders and 5 normal urine from adults were collected.After mixing some urine with intemal standards according to the concentration creatinine and adding hydroxylamine hydrochloride to mixture,the organic acids with hydroxyl group were oximated to the ketobodies.Organic acids were extracted twice with ethyl acetate and ethyl ether and derivatized with BSTFA-TMCS.An the organic acids were determined with Agilent GC/MS 6890/5973i with scan model.the mass-to-charge ratio range is 50-550 m/z,all data were nalyzed with Agilent GCMSD ChemStationG1701DA.We also investigated the linearity, accurate,precision.recovery and Carry-over by determining the internal standards in normal samples and positive organic acids in spiked control samples.Results More than one hundred kinds of organic acids in urine samples can be analyzed with this method.According to the two internal standards in normal urine samples,the minimal detection limit MMA and 2.PA was 2.5-2.8 μmol/L.Intra-and interassay coefficient of variation for MMA and 2-PA are both less than 10%.Pre-processing Interassay coefficient by sequential preparations of the same sample was 14%.The recoveries of the spiked samples were 95%-105%.Carryover analysis was less than 1%.All the parameters meet the requirement for clinical diagnosis.12 samples demonstrated positive including 6 cases of methylmalonic acidemia,1 case of propionic acidemia,3 cases of tyrosinemia Ⅰ,1 case of maple syrup urine disease and 1 cases of ketosis.Conclusions The method for the determination of organic acids in urine by GC/MS has been successfully established.It can be used for clinical screening and diagnosis for inherited genetic metabolic diseases.

Objective To observe the effects of exercise and respiratory training on patients with chronic obstructive pulmonary disease. Methods Fifty-six patients were randomly divided into an observation group (with 30 subjects) and a control group (26 subjects). Both groups received routine medical treatment, while the observation group received movement exercise and respiratory training in addition. Results After 3 months of treatment, there were significant differences between the two groups in terms of the improvement in pulmonary function and quality of life. Conclusion Movement exercise and respiratory training can improve pulmonary function and the quality of life of patients with chronic obstructive pulmonary disease.

Objective To study long-term outcome and prognostic factors of nasopharyngeal carcinoma treated by intensity modulated radiotherapy.Methods A total of 299 patients with nondisseminated nasopharyngeal carcinoma who received initial radiotherapy were analyzed retrospectively.The primary lesion and the upper neck received 70 Gy (5 fraction per week in all 30 fraction) by intensitymodulated radiotherapy (IMRT).The lower neck and the supraclavicular fossa was given 54 Gy (5 fraction per week in all 30 fraction) by a single anterior tangent field with spinal cord block.A median dose of 9.2 Gy (4-20.Gy) was given to the residual primary lesion by IMRT or X-knife.The Kaplan-Meier method was used for calculating the overall survival (OS),disease progression-free survival (DPFS),distant metastasisfree survival (DMFS),Log-rank test was used for evaluating the differences between groups.Multivariate prognostic factor was analyzcd by Cox method.Results The follow-up rate was 99.7％.119 patients were followed-up more than with 5 years.The 5-year OS for stage Ⅰ + Ⅱ,stage Ⅲ and stage Ⅳ were 97.1％,82.7％ and 52.2％(x2=46.19,P=0.000),the 5 years DPFS were 100％,77.6％ and 57.7％ (x2=23.29,P =0.000),DMFS were 100％,82.3％,63.7％ (x2 =16.57,P =0.000) respectively.The 5 year OS,DPFS and DMFS of male and female were 70.7％ vs 94.1％ (x2=16.82,P=0.000),71.5％ vs 87.3％ (x2 =4.74,P =0.029) and 77.2％ vs 89.7％ (x2 =4.38,P =0.036) respectively.For patients who were younger than 45-years,the male had a significantly unfavorable 5-year OS (66.8％ vs.91.2％,x2=7.07,P=0.008),DPFS (59.9％ vs.91.2％,x2=7.72,P=0.005) and DMFS (66.4％ vs.94.0％,x2 =8.46,P =0.004) ;For patients who were old than 45-years,only OS was significantly different between male and female (72.2％ vs.96.0％,x2 =10.19,P =0.001).Multivariate analysis showed the independent prognosticfactors for OS,DPFS,DMFS,were gender (x2 =14.27,5.72,17.64,P =0.000,0.017,0.000),TNM stage (x2 =5.33,15.70,10.57,P =0.021,0.000,0.001) and lymph nodes capsular invasion (x2 =4.30,11.08,21.24,P =0.038,0.001,0.000).Intracranial invasion and supraclavicular lymph node metastasis were independent prognostic factors for OS (x2 =13.32,5.38,P =O.000,0.020).Conclusions The TNM stage,lymph nodes capsular invasion and gender are independent prognostic factors for nasopharyngeal carcinoma treated by intensity-modulated radiotherapy.The patients of younger than 45years own a worse outcome.

Objective To compare the time-course of relaxant effect of rocuronium between patients with ocular and generalized myasthenia gravis (MG).Methods Twenty-seven ASA physical status I or Ⅱ patients with MG of both sexes,aged 12-64 yr,with body mass index of 17-26 kg/m2,scheduled for elective extended thymectomy,were divided into 2 groups according to Osserman stage:ocular group (group O,n =10) and generalized group (group G,n =17).Anesthesia was induced with iv injection of fentanyl 2 μg/kg,midazolam 0.05 mg/kg,and propofol 1.5 mg/kg.All patients were tracheal intubated and mechanically ventilated.Anesthesia was maintained with iv infusion of propofol 4-8 mg· kg-1 · h-1 and remifentanil 0.2 μg· kg-1 · min-1.Twitch tension was monitored in the adductor pollicis muscle by train-of-four stimulation of the ulnar nerve (intensity 60 mA,interval 12 s,frequency 2 Hz,wave length 0.2 ms).Rocuronium 0.6 mg/kg was injected intravenously after calibration.Mean arterial pressure (MAP),HR,heart rate variability (HRV) and low frequency and high frequency (LF/HF) ratio was recorded.The onset time of muscle relaxation,time for T1 to recover to 25％,time for T1 to recover to 50％ and recovery index were recorded.Results Compared with the baseline value,there were no significant changes in MAP,HR,HRV,LF/HF ratio at all time points in the two groups (P ＞ 0.05).Compared with group O,there was no significant change in the onset time of muscle relaxation,and the time for T1 to recover to 25％,time for T1 to recover to 50％ and recovery index were significantly prolonged in group G (P ＜ 0.05).Conclusion The duration of rocuronium-induced neuromuscular block is significantly longer in patients with generalized MG than those with ocular MG,while the onset time is comparable between the two groups.