Senior medical personnel is brought up by senior medical education.In medical education clinical practicing is the important part and it impacts heavily the quality of training students.In this thesis,practice condition about students in Grade 2002 is investigated by researching and studying,problems discovered are analyzed and countermeasures are made.

Objective To discuss the value of intraoperative cholangiography during laparoscopic (cholecystectomy)(LC). Methods Retrospective analysis was made on the clinical data of 398 patients (undergoing) intraoperative cholangiography during LC from June 1996 to Dec 2004. Results Forty cases of common bile duct stone, 3 cases of cystic duct stone, 53 cases of anomalous bile duct, and 6 cases of bile duct injury were detected. All patients were treated accordingly, and none died. Conlusion The clinical use of cholangiography during LC can help to markedly reduce the incidence of residual bile stones and promptly detect bile duct injury and other serious complications.

In order to understand the job burnout situation of university teachers,this article has done a practical research by adopting documentary method,interviewing method and investigation method,taking the teachers for public basic subjects from health science center in some university as the study object.We also come up with some suggestions on how to alleviate the job burnout phenomenon of teachers for public basic subjects in medical colleges,so as to ensure the quality of their professional life and promote the development of teaching and scientific research.

Tachyarrhythmia is a common type of arrhythmia in children.Continuous of frequent tachy cardia can bring serious harm to children's physical and mental health.With the help of electrophysiological study,electrophysiological mechanisms of various arrhythmias have been stated constantly,while the medical technology develops rapidly.The treatment strategy in pediatric arrhythinia has undergone major reforms,and radiofrequency catheter ablation has come into being.Through the thermal efficiency of the radiofrequency current,radiofrequency catheter ablation can damage the arrhythmia foci or block the atrioventricular reentrant pathway,so achieve the purpose of cure.The clinical application of radiofrequency catheter ablation can avoid the inconvenience of antiarrhymic drugs.Comprehensive assessments of the impacts and possible prognosis should be achieved by clinicians.Strict indications are very important.Currently the ablation has matured in atrioventricular re entrant tachycardia,atrioventricular nodal reentrant tachycardia,ventricular tachycardia,atrial tachycardia and atrial flutter,with high successful rate and low recurrence rate.Complications are closely related to the experience of the surgeon.

Objective:To study the technique of treatment of infant hand congenital syndactyly. Methods:All cases were from 6 months to 2 years old .In these cases, the fingers were separated by using the serrated flap and new weh were created deeply and widely by using rectangle or triangle inter-phalangeal flap at dorsal and palmaris. The skin-defected areas were covered with full-thickness skin grafts and the fingers were fixed using small splints. Results: All 38 cases were primary healing except that partial necrosis of skin graft in 10 cases which were healed after dressing change. The scar of 7 Cases were relieved by using small splints at night and glucocorticoid injection treatment. 1 case which finger was bent because of scar was operated again and another one had not any management. Followed up 6 months～2 years,37 cases had good features and functions except one case without dealed. Conclusion:It is feasible that treatment of hand congenital syndactyly durying infancy.

Objective:To summarize the development and characteristic of the anesthesia management of the High Intensity Focused Ultrasound therapy.Methods:1 248 cases from 1999 to 2006 were analyzed retrospectively about the anesthesia management of the High Intensity Focused Ultrasound therapy.Results:Traditional anesthesia management were taken in the most cases:About the tumors at the upper limb,chest,epigastric zone,general anesthesia with tracheal intubation was taken in the most cases,at the kidney,uterus,ovaries and lower limbs,continuous epidural anesthesia was taken.Conclusion:General anesthesia with tracheal intubation is a safe and effective style for the therapy,which makes for the stabilization of the hemodynamics,sufficient oxygen supply,consummate analgesia,sedation and musle relaxation,and ensures the comfortable and security of the patients.

0.05),but the expression of CTGF receptor(LRP6)decreased in experimental group,compared with that in control group(P0.05).Conclusion:CTGF receptor(LRP6)and TGF?3 might have relationship with the generation of NSCLP

Objective:To compare the influences of retrorsine on hepatocytes proliferation in mice and rats after liver injury,so as to investigate the feasibility of using retrorsine for establishment of liver cell transplantation model in mice.Methods: Male mice and rats were pretreated with 2 injections of retrorsine(70 mg/kg for mice and 30 mg/kg for rats)(as retrorsine-treated group,n=30) at 2 weeks interval or saline(as nontreated group,n=30).A single injection of carbon tetrachloride(CCl_(4), 0.5 mg/kg) was given to all animals 4 weeks after the final injection of retrorsine or saline.At 0(before administration),1,2,3,4,6,15 d after CCl_(4) administration,the animals were sacrificed and their livers were subjected to H-E staining and Ki-67 antibody immunohistochemistry analysis to evaluate the pathological changes and hepatocyte proliferation.Results: The liver in rats treated with retrorsine displayed obvious megalocytosis,small bile duct hyperplasia,and small hepatocyte hyperplasia(forming nodule);no such changes were found in non-treated group.However,the liver in mice treated with retrorsine displayed hepatocyte degeneration and necrosis in the perivenous areas and the same was true to the liver in non-treated mice.Ki-67 immunohistochemistry analysis showed that in rats treated with retrorsine,the positive hepatocytes,mainly found in small hepatocyte nodules,were obviously less than those in control group 3 d after CCl_(4)administration(P

Objective:To investigate levels of serum IL-34 in SLE patients,and correlation between concentrations of serum IL-34 and other established serum markers and disease activity indexes.Methods: In all,78 SLE patients and 53 healthy controls were enrolled in the research.Enzyme-linked immunosorbent assay(ELISA) was employed to measuring the concentrations of serological IL-34.Then,serum IL-34 levels between SLE group and healthy controls were analyzed by Mann-Whitney U test.Meanwhile,the correlation between the serum IL-34 levels and disease activity indexes and other established serum markers were assessed.Serum IL-34 levels were significantly higher in SLE patients compared to healthy controls[(Median,128.9 pg/ml) vs (Median,52.4 pg/ml),P<0.001].Results: Their levels were remarkably associated with accumulation of the clinical features of SLE.Additionally,IL-34 titers were positively correlated with the SLE disease activity indexes,anti-double stranded DNA antibody(anti-dsDNA)titers and C-reactive protein(CRP)levels,but inversely with C3 levels.Conclusion: Serum IL-34 could be a candidate biomarker for SLE as the elevated serum levels in treatment-naive SLE patients and its association with SLE disease activity.

OBJECTIVE To explore the relationship between the change in Toll-like receptor expression and prognosis of severe viral hapatitsis.METHODS The peripheral blood mononuclear cells were separated and the expression of TLR2 and TLR4 mRNA was observed by reverse transcription-polymerase chain reaction(RT-PCR).The level of serum endotoxin was measured by chromogenic substrate Limulus amebocyte lysate assay.The data were analyzed by SPSS 11.5 software.RESULTS The expression of TLR2 and TLR4 mRNA and the level of serum endotoxin of death group before therapy were lightly higher than that of survival group,but after therapy that of death group is higher than survival group(P