Based on the shortcomings of graduate education in clinical medicine of our country and the characteristics of this specialty, the author point out that the cultivation of graduates in otolaryngology, head and neck surgery should be focused on the training of humanities, professional knowledge and skills. And they also make some suggestions and discussion about the reform of graduate education mode.

To investigate the clinical efficacy of massage manipulation reposition for treatment of child hip-joint semiluxation, sixty-seven cases of child hip-joint semiluxation were treated by massage manipulation reposition. Sixty-two cases were cured and 5 cases improved. The total effective rate was 100%. Massage manipulation reposition is an effective method for treating child hip-joint semiluxation.

Objective To evaluate the significance of t he abnormality of VHL gene and VEGF expression in primary renal cell carcinoma ( RCC). Methods Mutation and abnormal methylation of VHL g ene and the expression of VEGF were dtected by means of multiplex PCR,PCR-SSCP and immunohistochemistry in 42 cases of primary RCC,in 18 specimens adjacent to the neoplastic lesion and in 10 specimens of normal renal tissues. R esults The alteration rate of VHL gene was higher in RCC tissue (61. 9%) than in the normal renal tissue (3.6%,P

A study of PDCA Cycle in managing hospital medical complaints may introduce such a cycle into the medical complaints control system of a hospital, effectively handling the medical complaints process. Since 2006 when the cycle was introduced into the hospital for medical complaints control, such complaints have been cut back significantly by the end of 2009. Furthermore, such complaints are under control from the start, and prevented from growing into medical disputes, effectively improving quality of care. Such a cycle can effectively avoid medical complaints, enhance medical safety, and build a harmonious doctor-patient relationship.

Objective To study the effect of mild hypothermia on aquaporin 4 (AQP4) expressions and cerebral edema after intracerebral hemorrhage and the mechanisms of mild hypothermia on hemorrhagic brain edema. Methods The model of intracerebral hemorrhage (ICH) was established by infusing collagenase into right globus pallidus of the rat. The temperature was regulated by ice cubes and daylight lamp, which was modulated to an appropriate distance to the animals. Immunohistochemistry staining was used to detect the cerebral AQP4 expressions. Dynamic change of brain edema was observed through wet-dry weighing method. Results The brain water content (BWC) of injured side and level of AQP4 expression in perihematom tissue in ICH rats were obviously higher than those of the sham group (all P

Objective To reach parameter on sterilization wrap of medical instrument. Methods The parameter of one hundred twenty sterilization wraps with size 30 cm?40 cm?60 cm and weight 20kg was tested by Belimed sterilizer. Results There are 155 masculine gender and 445 negative in 600 quick reading biological indicators of 120 sterilization wraps and 53 masculine in bacteria detection, 9 cases failure in 1243 indicator, 52 wet wraps. Conclusion The parameter was to take three times negative pressure pulse and five times pressure pulse, sterilization temperature 134℃, sterilization time 11min and dry time 11min, matching to sterilization request of "Technical Standard For disinfection".

Objective To observe effects of propofol versus urapidil on perioperative hemodynamics in patients with gallbladder opera-tion during tracheal extubation. Methods From 2010 January to 2012 December, 128 patients who were diagnosed by color B ultra /CT and then underwent gallbladder selective operation (ASAⅡ~IV) were selected, and they were divided into the propofol group (n=64) and the urapidil group (n=64). At the end of operation, patients of the two groups were given intravenous injection of propofol 1. 5 mg/kg and ura-pidil 2. 5mg/kg which were diluted with normal saline to 8 mL respectively. Sputum suction immediately after medication, and then wiped out the endotracheal tube and gave oxygen masks for 10 min. Record the systolic/diastolic blood pressure ( SBP/DSP) , heart rate ( HR) , pH, PaO2 , PaCO2 and SaO2 under double blind trial before induction, after medication, at the time of sputum suction, at the time of extuba-tion, 5 min after extubation and 10 min after extubation. At the same time, agitation during the extubation period and patients awake time were recorded. Results After extubation, cough (4. 7% vs. 26. 6%), agitation (3. 1% vs. 17. 2%) and glossoptosis (12. 5% vs. 21. 9%) in propofol group was significantly lower than urapidil group (P<0. 05). SBP/DSP and heart rate of propofol group and urapidil group were significantly increased (P<0. 05) before induction, after medication, at the time of sputum suction, at the time of extubation, 5 minafter extubation and 10 min after extubation. The recovery time of propofol group and urapidil group were of no significant differences (P>0. 05). During perioperation extubation, there was no significantly difference in terms of changes of pH, PaO2, PaCO2 and SaO2 be-tween the groups (P>0. 05). Conclusion Propofol is better than urapidil in preventing adverse effect of extubation for patients with gall-bladder operation, and it will not affect the recovery time of patients.

Quality of care is key to medical safety which has a close bearing on patients’life and health,and on the branding and efficiency of the hospital.Medical safety is one of the key indicators of the overall performance appraisal of the hospital.This novel type of nurse-physician collaboration,abandoning the traditional model of health care,is a new integrated model of health care which improves the overall quality of care,enhances medical safety and patient satisfaction.This paper described in detail the implementation methods and steps of the collaboration,the progress of such a collaboration and its contribution to medical safety are also discussed.

Objective To build convenient structure ,efficient and intelligent transfusion information system ,improve the quality of services to meet the needs of clinical applications and hospital management ,and make the core concept of “quality safety” practi‐cable by the information system .Methods Establish a blood transfusion information system based on the theory of hospital bionic management in hospital .Results The transfusion information system which constructed from bionic management theory can fully realize the design goals and satisfy all types of users .Conclusion Bionic management with the features of integrity ,auto correla‐tion ,ideology and culture has good potential for growth ,and could play a great directive role on hospital information system .

Objective To explore the effect of minimally invasive transpedicular bone grafting additional ver -tebral pedicle screw fixation in the treatment of thoracolumbar fracture .Methods 60 patients with thoracolumbar fracture were randomly divided into the observation group and the control group ,30 cases in each group .The control group received traditional open inter vertebral four nail pedicle screw fixation combined with posterolateral bone graft fusion for treatment while the observation group was treated by minimally invasive transpedicular bone grafting addi -tional vertebral pedicle screw fixation ,to analyze the clinical effects .Results The imaging parameters of postopera-tion[the sagittal index(1.9 ±7.1)°,Cobb's angle(4.2 ±3.5)°,change of vertebral body height (90.2 ±6.5)%]in the observation group were significantly better than those of the control group (t=6.78,6.80,7.02,all P<0.05). The imaging parameters 3 months after operation[the sagittal index(4.9 ±3.2)°,Cobb's angle(7.0 ±2.7)°,change of vertebral body height (87.6 ±4.1)%] in the observation group were significantly better than those of the control group(t=6.78,6.80,7.02,all P<0.05).The operation time,incision length,bleeding volume,postoperative drain-age,postoperative hospital stay of the observation group were (141.9 ±14.2)min,(10.8 ±1.7)cm,(105.7 ±12.3)mL, (5.6 ±4.1)mL,(6.6 ±1.1)d,respectively,which were significantly better than those of the control group (t=7.72,7.89,5.68,all P<0.05).Conclusion Minimally invasive transpedicular bone grafting additional vertebral pedicle screw fixation has a significant effect in the treatment of thoracolumbar fractures ,which is safe and reliable .