At present,the general medical education is short of teachers,teaching materials and programme in higher medical college in China. And the practice base is not perfect. For these reasons,the general medical education should be developed by strenghening the disci-pline construction and combining closely the general medical education with local hygiene under-takings.

Objective To evaluate the application value of MSCT in the diagnosis of carotid cavernous fistula(CCF).Methods The data of 10 patients who had been confirmed with CCF by DSA were retrospectively analyzed to compare the imaging features of MSCT plain scan,CTA,post reconstruction imaging and other examination ways.Results 10 patients with CCF which were manifested by superior ophthalmic vein enlargement in CT plain scan,early appearance of superior ophthalmic vein and cavernous sinus enlargement in CTA were studied.The orificium fistulae can be displayed through the multi planar reconstruction (MPR)and the curved planar reconstruction (CPR).The focal region can be well displayed through the volume rendering (VR)and the maximum intensity projection (MIP). CT,MRI,DSA and color doppler ultrasonography have both advantages and limitations in the diagnosis of CCF.Conclusion MSCT can achieve characteristic imaging findings through scan,CTA technology and various post reconstruction methods,it has significant value in the early diagnosis and treatment of CCF.

Objective To evaluate the impact of family intervention on the quality of life in the patients after total laryngectomy and their family members. Methods Family intervention was implemented for the patients after total laryngectomy and their family members from 2008 to 2009,and only patients received intervention from 2005 to 2007. The patients and their family members were investigated with Quality of Life Instrument for Cancer Patients-Head and Neck Cancer (QLICP-HN) and Quality of Life Scale-Family Version (QOL Scale-FAMILY) respectively when the patients were admitted to hospital and one year after discharged. Results The quality of life in patients after total laryngectomy and their family members was significantly improved after family intervention was implemented (P<0.05). Conclusion Family intervention is practicable and helpful to improve the quality of life in patients after total laryngectomy and their family members.

Objective To discuss the diagnosis and treatment of the solid pseudopapillary tumor of the pancreas(SPTP). Methods Six consecutive cases operated in our hospital from Aug. 2008 to Apr. 2010were reviewed. Results Those cases aged ranging from 17 to 31 years, with an average age of 21.8 years.The maximal dimension of tumor ranged from 6.6 to 13.0 cm, averaging 8.2 cm. Those tumors originated from pancreatic head (2), and body or tail (4). Abdominal B-ultrasound or CT scan examination disclosed that pancreas had solid-cystic mass in 4 cases, and the other two had solidmass. All tumors were resected completely and defined pathologically. We performed 5 open operations, including pancreaticoduodenectomy (2 cases), spleen-preserving distal pancreatectomy (2 cases) and distal pancreatectomy plus splenectomy (1 case). One case underwent laparoscopic distal pancreatectomy plus splenectomy. Conclusions The young females are more likely suffered from the SPTP than others, which usually has a clear boundary and large volume. The abdominal B-ultrasound and CT scan are important diagnostic methods. The surgical modality of pancreatectomy is dependent on the tumor's location and extent, furthermore the resectability of SPTP is high. It is possible to perform a spleen-preserving distal pancreatectomy for tumors located in pancreatic body or tail.

ObjectiveTo evaluate clinical value of evidence-based nursing intervention in treatment of elderly patients with cardiovascular interventional surgery during perioperative period. Methods 150 cases of elderly patients with cardiovascular diseases who underwent interventional surgical treatment were selected.They were randomly divided into the observation group(80 cases)and the control group(70 patients). ResultsThe occurrence and degree of discomfort of bedridden patients in the observation group were milder,and the complications due to use of anticoagulants and pressing dressing were significantly less than the control group.The satisfaction degree and mastering of disease related knowledge in the observation group were significantly better than that of the control group. ConclusionsApplication of evidence-based nursing intervention during perioperative period for elderly patients with cardiovascular interventional surgery can reduce discomfort and complications of patients,as well as improve satisfaction degree and mastering of disease-related knowledge of patients and their families,which is worthy of promotion.

Objective To investigate the relationship between thyroid hormones and Lp(a) the pituitary-thyroid axis in elder patients with congestive heart failure(CHF). Methods 50 normal controls and 158 elder patients with CHF who had not thyroid gland illness were involved in this study. Levels of FT 3, FT 4, TSH and Lp(a) in serum were measured. Patients were divided into two groups according to the course of chronic heart failure: patients with the course of CHF

13.1mmol/L were treated by 2 weeks short-term intensive insulin treatment. FBS, Fasting blood insulin(FINS), glycosylated hemoglobin A1c (HbA1c), 2 hours postprandial blood sugar(PBS 2), Homa ? and Homa IR were measured and compared between pre-treatment and post-treatment. Results After 2 weeks short-term intensive insulin treatment, the excellent control of FBS, PBS 2 in 23 out of 27 patients were achieved respectively in (5.6?2.3)days and (8.5?3.5)days. Homa ? significantly increased, and HbA1c and Homa IR decreased comared with pre-treatment. Conclusions The excellent glycemia control and improvement of ?-cell function can be induced by short-term intensive insulin treatment in newly diagnosed type 2 diabetic patients with severe hyperglycemia.

Objective:To study the effect of childhood abuse on student's suicide ideation and attitude to suicide. Methods:90 Technical Secondary School Students with history of being abused and 90 without that history were investigated by applying Questionnaire of Commit Suicide Attitude and Beck Scale for Suicide Ideation. Results:Compared with those without being abused, the abused students had higher percentages having suicide ideation in the past week (14.4% vs. 2.2%,?~2=7.27, P

Objective: To study the effect of childhood abuse on students mental health and alexithymia, and to analyze the relationship between psychosomatic symptoms and alexithymia. Methods: 90 abused Technical Secondary School Students and 90 no-abused Technical Secondary School Students from Xuzhou were investigated by applying Symptom Checklist 90 ( SCL - 90 ) , Toronto alexithymia Scale ( TAS) . Results: Compared with no-abused students, the students who had been abused in childhood showed significantly higher psychiatric symptoms of somatization (1. 8?0. 6) , interpersonal relationship (2.0?0.7) , depression (1.9?0.6) , anxiety (1. 8?0. 5 ) , hostility (1. 8?0. 6) , paranoia (1. 9?0. 6) , psychoticism (1. 8?0. 6) , obsessive (2. 0?0. 6) , phobia (1. 7?0. 6) than control (1.4?0.5, 1.7?0.6, 1.6?0.6, 1.6?0.5, 1.5?0.5, 1.6?0.5, 1.6?0.5, 1.8?0.6, 1.5?0.5, P

Objective:To investigate perioperative management of anesthesia for septic shock.Methods:Anesthesia performed on an elderly patient with septic shock who underwent emergency surgery in Beijing Hospital was analyzed and summarized, with a literature review.Results:Etomidate, Ketamine, cis Atracurium and Remifentanil are preferred for anesthesia induction, and Remifentanil and Sevoflurane are the first choices for anesthesia maintenance.Combined application with Dexmedetomidine may improve patients' prognosis.For septic shock patients with new-onset atrial fibrillation, β-blockers are preferred for perioperative anti-arrhythmia.If necessary, propafenone or amiodarone can be used for cardioversion.Perioperative ultrasound evaluation may be used to guide perioperative fluid therapy and vasoactive drug administration for septic shock in the future.Conclusions:Anesthesiologists should place a high value on and have a good command of the main aspects of perioperative management of anesthesia for septic shock.