Raising students'divergent thinking should be combined with the whole college education.But for the medical students,it is more vital to realize the importance of divergent thinking,make full use of education resources in university,consciously urge themselves to break through the limits of routines,develop their divergent thinking and make various measures to reinforce the self-education of divergent thinking.

OBJECTIVE:To discuss the general pattern and the characteristics of quinolones-induced allergic shocks.ME_THODS:A total of 165 quinolones-induced allergic shock cases reported in the domestic periodicals in recent 10 years were statistically classified and analyzed.RESULTS:Ten kinds of quinolones involved allergy shocks with ciprofloxacin,ofloxacin and norfloxacin respectively dominated the first 3 places,which account for 69.70% of the total.The incidence of allergy shocks was the highest when used intravenously(64.85%),in particular within the first 30min(70.30%) with the mortality at 2.42%.CO_NCLUSION:Attention should be paid to severe adverse drug reactions in the clinic so as to ensure safe drug use.

Objective:To explore the relation between therapeutic effects of focused ultrasound(FU)on chronic cervicitis and local temperature rise.Methods:132 cases of chronic cervicitis were treated by FU and local temperature rise was measured. 120 patients were followed up regularly for the following 3 months to observe therapeutic effects and adverse effects.Results: The overall effective rate of FU in treatment of chronic cervicitis unitarily was 97.5%.When the temperature of targeted tissue immediately after FU exposure was between 40℃and 43℃,the therapeutic effects tended to he satisfactory(98.33%)with little adverse effects.Conclusion:A satisfactory therapeutic efficacy could be achieved with single session FU in treatment of chronic cervicitis.And local temperature rise measurement,as a quantification method,is helpful to improve the therapeutic effects.

Objective To explore the gene diagnosis of Gitelman syndrome.Methods The clinical data of a child with Gitelman syndrome were retrospectively analyzed along with gene detection results of his elder sister and parents.Results A 6-year-old boy was hospitalized for fever and hypokalemia.Gene detection of SLC12A found a new locus mutation of EXON21 c.2522A＞G p.(Asp841Gly) and a heterozygosis of EXON16 c.1946C＞T p.(Thr649Met).The diagnosis of Gitelman syndrome was confirmed.His mother carried a heterozygosis mutation of EXON21 c.2522A＞G p.(Asp841Gly),while his father and elder sister carried a heterozygosis mutation of EXON16 c.1946C＞T p.(Thr649Met).Conclusion Gene detection of SLC12A is helpful in the diagnosis of Gitelman syndrome.The newly discovered mutation of SLC12A3 gene has enriched the mutation spectrum of Gitelman syndrome.

Age-related macular degeneration ( AMD ) is one of a leading worldwide cause of blindness. AMD is a multifactorial disease, and major risk factors include increasing age, current smoking, previous cataract surgery, environmental factors, nutritional factors, genetic markers through genetic regulate complement, lipid, angiogenesis and extracellular matrix. In addition to treatment, epidemiology, risk factors and genetics research of AMD have been significantly progressed. This article will review risk factors of AMD.

OBJECTIVETo explore the improvement of hand motion function,spasm and self-care ability of daily life for stroke patients treated with floating-needle combined with rehabilitation training.

METHODSEighty hand spasm patients of post-stroke within one year after stroke were randomly divided into an observation group and a control group, 40 cases in each one. In the two groups, rehabilitation was adopted for eight weeks,once a day,40 min one time. In the observation group, based on the above treatment and according to muscle fascia trigger point, 2~3 points in both the internal and external sides of forearm were treated with floating-needle. The positive or passive flexion and extension of wrist and knuckle till the relief of spasm hand was combined. The floating-needle therapy was given for eight weeks, on the first three days once a day and later once every other day. Modified Ashworth Scale(MAS), activity of daily life(ADL, Barthel index) scores and Fugl-Meyer(FMA) scores were used to assess the spasm hand degree,activity of daily life and hand motion function before and after 7-day, 14-day and 8-week treatment.

RESULTSAfter 7-day, 14-day and 8-week treatment, MAS scores were apparently lower than those before treatment in the two groups(all P<0. 05), and Barthel scores and FMA scores were obviously higher than those before-treatment(all P<0. 05). After 14-day and 8-week treatment, FMA scores in the observation group were markedly higher than those in the control group(both P<0. 05).

CONCLUSIONFloating-needle therapy combined with rehabilitation training and simple rehabilitation training could both improve hand spasm degree, hand function and activity of daily life of post-stroke patients, but floating-needle therapy combined with rehabilitation training is superior to simple rehabilitation training for the improvement of hand function.

Acupuncture Therapy ; instrumentation ; methods ; Adult ; Aged ; Combined Modality Therapy ; Female ; Hand ; physiopathology ; Humans ; Male ; Middle Aged ; Needles ; Range of Motion, Articular ; Recovery of Function ; Stroke ; therapy ; Stroke Rehabilitation ; Treatment Outcome

Objective To investigate the changes of CA125 level with intra-abdominal tumor(epithelial ovarian cancer ,fallopian tube cancer and peritoneal cancer ) before and after chemotherapy serum and their effect on the prognosis of patients and their the clinical predictive value .Methods 174 cases(107 cases of epithelial ovarian cancer ,35 cases of fallopian tube cancer ,and 32 cases of peritoneal cancer) with peritoneal cancer patients were selected from January 2007 to January 2008 .The percentage decrease of ser-um CA125 were calculated after 3 courses of chemotherapy and CA125 decreased level of sensitivity with chemotherapy were ana-lyzed .The different levels of CA125 of median survival time and median survival time were compared .Results After chemothera-py ,CA125 decreased ≥ 75% in 42 cases ,decreased from 51% to 75% in 62 cases ,decreased from 25% to 50% in 32 cases ,and de-creased less than 25% in 38 cases .In CA125 decreased ≥ 75% group ,the chemotherapy effects was better than the other groups (P<0 .05) .Univariate analysis showed that the decrease proportion of CA 125 was positively correlated with chemotherapy effect (r=0 .396 ,P=0 .000) .Using the Kaplan-Meier method ,the patient's survival rate and median survival time were caculated and it showed that the 5 years survival and median survival time were significantly better in group CA 125 decline ≥ 75% than the other groups(P<0 .05) .Univariate analysis shows that the CA125 decline proportion of patients and long term efficacy was positively correlated(r=0 .412 ,P=0 .000) .The COX risk model analysis showed that FIGO stage ,CA125 level and the effect of chemothera-py were independent prognostic risk factors .Conclusion The level of CA125 is the independent risk factor of epithelial ovarian cancer ,fallopian tube cancer and peritoneal cancer prognosis .CA125 decline proportion could be used to know the effect of chemo-therapy and long term treatment ,and be the prognosis indicators for patients with intra abdominal tumor .

In our university,the training for geriatric postgraduates of clinical medicine is now in the initial stage.Therefore,it is important to explore the training model to improve the quality of postgraduate.The program focused on cultivating geriatric postgraduates' ability of diagnosis and treatment,helping them have the concept of integral service and enhancing their teaching and thinking ability of clinical sciences to provide high-level comprehensive geriatric doctors for the society.

Objective To investigate the changes of umbilical cord and the vasoactive substance in umbilical vein in intrahepatic cholestasis of pregnancy.MethodsBy HE staining method we analyzed the pathologic change of umbilical cord of 25 women with intrahepatic cholestasis of pregnancy(ICP)and fetal distress(ICP fetal distress group),25 ICP women without fetal distress group(ICP control group)and 27 normal pregnancies(control group).The nitric oxide synthase(NOS)and endothelin-1(ET-1)were detected in human umbilical vein endothelial cells(HUVEC)by immunohistochemistry method.Umbilical vein total bile acid(TBA)and NOS and ET-1 were measured.Resuits(1)A remarkable high TBA level was found in umbilical vein in ICP,and it was higher in ICP fetal distress group(19.0±2.3)μmol/L than in ICP control group(9.0±1.7)μmol/L(P＜0.05);it was higher in ICP control group than the control group(4.4±1.5)μmol/L(P＜0.05).(2)A significant difference was found in the endotheliocytes of umbilical vein in ICP fetal distress group compared with ICP control group.The ratio of cells with pathological changes in ICP fetal distress group(92％,23/25)was higher than ICP control group(68％,17/25;P＜0.05).The occurrence of the pathological changes was associated with TBA.(3)The expression of eNOS in ICP fetal distress group 0.09±0.06 was lower than in ICP control group 0.21±0.08(P＜0.05),and it was lower in ICP control group than in control group 0.47±0.07(P＜0.05).In contrast.the expression of ET-1 in ICP fetal distress group 0.49±0.08 was higher than in ICP control group 0.32±0.07(P＜0.05),and it was higher in ICP control group than control group 0.14±0.06(P＜0.05).The expression of inducible nitric oxide synthase(iNOS)in ICP fetal distress group 0.20±0.04 and ICP control group 0.21±0.05 was lower than in control group 0.26±0.04(P＜0.05),but no significant difference was found in ICP fetal distress group and ICP control group(P＞0.05).(4)The expression of eNOS,iNOS and ET-1 was correlated with umbilical vein TBA in ICP(r1=-0.88,r2=-0.45,r3=0.79;P＜0.01),respectively.Conclusions High level of TBA in ICP is harmful to the umbilical vein endothelium,which is correlated with the raised expression of ET-1.and the decreased expression of eNOS,and iNOS in human umbilical cord endothelium cells.All these changes of umbilical vein may be associated with the occurrence of fetal distress in ICP.

Objective To explore the etiologies, clinic symptoms and the methods of emergency therapy for neonatal convulsion. Methods Eighty-four patients with convulsion in pediatric department in our hospital were reviewed,analysed and summarized their clinic informations,first-aid measures. Results The etiologies were HIE(hypoxia-ischemic encephalopathy)41 cases(48.8%),ICH(intracranial hemorrhage)16 cases(19.0%),and hypocalcemia 9 cases(10.7%),the quantity of these patients added up to 2/3 of all. Conclusion The primary measures to reducing incidence of the diease were as follows:do well health protection during perinatal period,treat betimes aiming at etiologies,prevent fleetly paroxysm of convulsion.