Transitional relationship between input and output in the writing course was researched from multidimensional perspectives under the web-based writing course example of “ write to learn” and guided by input and output hypothesis.The improving methods for teaching of college English writing course were discussed in order to provide references.

Objective: To reveal if the use of antimicrobi als is rational in the authors hospital.　Methods: 1 025 cases were investigated retrospectively by systematic sampling from all the inp atients of the year 1997.　Results: 77.8% of the subjects were treated with antimicrobials, of whom, 55.2% treated with 2 or more antimicr obials. Yet only 39 cases had microbiological test before the administration of antimicrobials.　Conclusion: Inappropriate use of antimicr obials exists in the hospital. The management of the use of antimicrobials and c ontinuing education of medical doctors should be enhanced so as to make the use of antimicrobials more rational.

Objective To investigate the effects of 1,25(OH)_2D_3 on cell proliferation and cell cycle progression in mouse osteoblasts.Methods Sterile bones of skull of mouse were taken from 30 newborn mouse,and the osteoblast were separated by enzyme digestion methods.After 1,25(OH)_2D_3 in different concentrations were added into culture medium,the effects of 1,25(OH)_2D_3 on cell proliferation of mouse osteoblasts and on cell cycle progression were examined by mono-nuclear celldirect cytotoxicity assay(MTT)reduction assay and flow cytometry respectively.Results After 24,48,72 h of 1,25(OH)_2D_3 incubation,the cell number of osteoblast had significant difference among groups of 1,25(OH)_2D_3 of 10~(-8),10~(-9),10~(-11)mol/L.Significant differences were found in the cell cycle progression in response to 1,25(OH)_2D_3 treatment from the Gl(84.30?1.90)to the G2-M (7.70?0.667)and S(8.00?1.42)phases when compared with those in the control group. Conclusions Cell proliferation of mouse osteoblasts can be inhibited by 1,25(OH)_2D_3 in a concentration-dependent manner.

Objective:To explore apoptosis changes of dilator muscles in the upper airway by detecting the expression of Bax, Bcl-2 in tensor veli palatini in patients with OSAHS.Method:The expression of Bax and Bcl-2 were detected in tensor veli palatini in 30 cases with OSAHS and 10 cases chronic tonsillitis without OSAHS by immunohistochemistry and image analytical system, and the results were analyzed.Result:①The expression levels of Bax in the OSAHS group increased significantly compared to control group(P<0.05), but there were no significant differences of Bcl-2 expression between two groups, the ratio of Bax/Bcl-2 increased significantly(P<0.05). ②There were positive correlations between AHI and the expression levels of Bax(r=0.697,P<0.01) respectively in the test group.Conclusion:The results indicate that apoptosis occurred in tensor veli palatini in patients with OSAHS, and the more severity of OSAHS , the more apoptosis.

Background Zero spherical aberration intraocular lenses(IOL)is designed to prevent the addition of positive spherical aberration after surgery.Research indicated that some positive spherical aberration can provide better depth distance of focus and pseudoaccommodation.Objective The present study was to compare the visual function and wavefront aberrations in pseudophakic eyes with zero spherical aberration IOL and spherical IOL.Methods A prespective case-controlled study was designed.Eighty eyes of 52 patients with age-related cataract were enrolled and divided into two matched groups based on random number table method.The regular phacoemulsification was performed on the eyes,and a zero spherical aberration IOL(Akreos AO)was implanted in the test group and a spherical IOL was used in the control group(Akreos Adapt IOL).The corrected distance visual acuity(CDVA),contrast sensitivity,depth of focus and wavefront aberrations were recorded and compared at 3 months after cataract surgery between these two groups.The trail was approved by the Ethic Committee of Eye Hospital of Wenzhou Medical College,and written informed consent was obtained from each patient prior to the program.Results The clinical demography from the two groups was matched(P ＞ 0.05).There were no significant difference in the CDVA (LogM AR)(-0.03 ±0.08 versus-0.02+0.10)(t =-0.50,P =0.61)and in depth of focus(3.48± 1.07 DS versus 3.20±0.77 DS)(t =1.15,P=0.25)between the zero spherical aberration IOL group and the spherical IOL group.The contrast sensitivities under the mesopic condition at 12.0 c/d and mesopic with glare at 3.0,6.0,18.0 c/d were 12.42 ± 13.16,42.58 ±24.96,30.19± 25.64 and 3.03 ± 5.49 in the zero spherical aberration IOL group,and those in the spherical IOL group were 5.59 ± 8.11,28.74 ± 18.69,17.07 ± 19.35 and 0.22 ± 1.15 without significant differences between these two groups(P＜0.05).Under the 5.0 mm pupil analyzing zone,the spherical aberration in zero spherical aberration IOL group was(0.13 ±0.07)μm,showing a significant reduction in comparison with spherical IOL group(0.21 + 0.07 μm)(P ＜ 0.05).No evidently differences were found in total high-order aberration,coma aberration and trefoil aberration(P＞0.05),but the sphere aberration was considerably lower in the zero spherical aberration IOL group compared with spherical IOL group(t=-4.19,P＝0.00).Conclusions The visual quality of the eyes implanted zero spherical aberration IOL is significantly better than ones implanted with spherical IOL.

Objective To study the diagnosis and treatment of bochdalek′s hernia in children, especially to introduce the methods of repairing the defect of diaphragm using rib-flap and terylene fabric.Methods The diagnosis, misdiagnosis and methods of repairing of diaphragm in 10 cases of bochdalek′s hernia were retrospectively reviewed, and the findings of reconstruction of diaphragm in 2 cases of defect of diaphragm were analyzed.Results All of the 12 cases were misdiagnosed for the first time. Ten cases were cured through abdominal surgery and 2 cases were cured through reconstruction of diaphragm.Conclusions Bochdalek′s hernias in children are lack of specific clinical manifestation and often misdiagnosed before operation. Early surgical treatment is necessary once the diagnosis is established, and the defect of diaphragm should be reconstructed. The repairment of diaphragm using rib-flap and terylene fabric is a practical methods.

Objective:To detect mutations of exons 5 and exons 8 of PTEN gene in oral squamous cell carcinoma(OSCC),and to explore the relationship between gene mutations and development of OSCC.Methods: Mutations of exons 5 and exons 8 of PTEN gene were detected by polymerase chain reaction-single strand conformation polymorphism(PCR-SSCP).Results: The whole sequences of exons 5 and exons 8 of PTEN gene of all cases of OSCC were expanded.There was no mutation in exons 5 and exons 8 of PTEN gene of all cases of OSCC.Conclusion: There is no mutation in exon 5 and exon 8 of PTEN gene in OSCC.This might show that there is no correlation between mutations in exon 5 and exon 8 of PTEN gene and the development of OSCC.

Clinical data of one patient diagnosed as IgG4-related retroperitoneal fibrosis was analyzed.IgG4 and retroperitoneal fibrosis were used as the key words to search literatures from PubMed and Wanfang Database.Clinical data of 27 cases with IgG4 retroperitoneal fibrosis,including clinical manifestation,diagnostic basis,therapeutic method and prognosis,which were retrieved through literatures,were analyzed.A 82-year-old male patient presented with urinary tract obstruction and renal insufficiency.Imaging examination revealed a retroperitoneal irregular lump shadow,and showed chronic inflammation of soft tissues in posterior peritoneum with fibrosis by biopsy pathology.The IgG4-positive plasmocyte infiltration was found by immunohistochemical method.The serum level of IgG4 was significantly increased,which was in accord with IgG4-related retroperitoneal fibrosis.After treatment with methylprednisolone,retroperitoneal lump shadow was obviously dissipated.The serum level of IgG4 became normal.27 cases with IgG4-related retroperitoneal fibrosis were searched through literature retrieval,with 19 confirmed cases,3 suspected cases,and 5 suspicious cases.Male accounted for 92.6％ (25/27),and the average age was 67.6 years old.The cases with the involvement of extraperitoneal organs accounted for 37.0％ (10/27).The misdiagnosis rate was 55.6％ (15/27).23 cases took effective therapy with glucocorticoids.IgG4-related retroperitoneal fibrosis is an orphan disease,which can be misdiagnosed easily.The diagnosis is made with histopathological examination and determination on the serum level of IgG4.The therapy with glucocorticoids is effective.

Objectives To assess the effects of long-term angiotensin-converting enzyme(ACE) inhibitor treatment with captopril on cardiac function in acute myocardial infarction (AMI).Methods One hundred and one patients with AMIwho were admitted to hospital within 72 hours of the onset of symptoms with no cardiogenic shock were randomly allocated to captopril (n=52; group Ⅰ) and conventional treatment (n=49; group Ⅱ). Left ventricular (LV) systolic performance and diastolic transmitral flow velocity profiles were assessed by Doppler echocardiography at admission (1.2±1.1 days), before discharge (27±10 days) and during follow-up (363±31 days).Results At one year follow-up, in group Ⅰ LV end-diastolic volume decreased, and ejection fraction increased due to a disproportionate decrease in end-systolic volume. The incidence of cardiac dilatation was reduced. LV early diastolic filling velocity (E)increased and late atrial filling velocity (A) decreased, resulting in an elevation of E/A ratio.However, the mean values of LV systolic and diastolic functional parameters were unchanged in group Ⅱ.Conclusions Long-term treatment with captopril exerts a beneficial effect on cardiac protection for patients with AMI.

Objective To observe the CT findings of hypoplasia of cochlear nerve foramen. Methods CT findings of cochlear nerve foramen were observed in 50 volunteers (100 ears)and in 9 cases with hypoplasia of cochlear nerve foramen.The width of the bony canal for the cochlear nerve were measured in both groups.Results The fissure in the cribriform area were seen in every volunteers.The width of the bony canal for the cochlear nerve was (2.32?0.25)mm in normal group.The stenosis of cochlear nerve foramen were shown in 9 cases (10 ears),the lacking of fissure in the cribriform area were seen in 8 ears, while the fissure were shown in 2 cases.The stenosis of internal auditory canal was shown in 4 cases. Abnormality of vestibule and horizontal semicircular canal was shown in one case.The maximum value of the width of the bony canal for the cochlear nerve was 1.5mm,the minimum value was 0.9 mm.Conclusions The typical CT findings of hypoplasia of cochlear nerve foramen were stenosis of cochlear nerve foramen,the lacking of fissure in the cribriform area and cochlear nerve foramen without helix shape.The hypoplasia of cochlear nerve foramen may be a subtype of cochlear dysplasia.