Choosing a suitable textbook is the most important part to ensure the quality of in-ternational students' education. By comparing the advantages and disadvantages of English textbooks, domestic publishing textbooks and institutions self-made teaching materials, and combining with inter-national students' textbooks usage and investigation, we fine problems such as students' lower satisfac-tion of textbooks and better evaluation in original English textbooks than the domestic publishing text-books and college self-made teaching materials, so we advocate that we should select a good textbook, strengthen the construction of teachers and teaching materials, offer special medicine courses, establish an effective network teaching platform and attach importance to students' feedback.

Objective To investigate the ideal methods for correction of lower eyelid retraction by lateral canthal anchoring.Methods The authors retrospectively reviewed the records of 126 patients(207 eyelids) operated on between June 1999 and 2005 by one senior surgeon.The age of the patients ranged from 28 to 72 years(mean,46 years).Transcanrhal canthopexy was used in 20 patients(33 eyes);The 3 mm tarsal strip procedure was used in 35 patients(57 eyes);Transcanrhal canthopexy combined with Hamra's lower blepharoplasty was used in 26 patients(45 eyes).The tarsal strip procedure combined with Hamra's procedure was used in 45 patients(72 eyes).75 patients(123 eyes) were followed up for 6～12 months.Mean follow-up time was 8 months. Results Of them,125 patients were uniformly satisfied with their cosmetic and functional outcome at last follow-up;one patient had undercorrection of retraction.There were no major complications and only one minor complications(corneal irritation from graft sutures),which resolved in the early follow-up period.Conclusions The lateral canthal anchoring is an effective,aesthetic,and functional treatment for moderate to severe lower eyelid retraction resulting from multiple causes.This procedure is associated with predictable results,a low morbidity rate,and high patient satisfaction.

Objective To analyze and evaluate the efficacy of intramedullary interlocking nail in the treatment of long bone fractures.Methods From July 1997 to October 1999,100 cases of long bone fractures were treated intramedullary interlocking nail,including 25 fractures of tibia and fibula at middle site tibia,35 at middle-lower,31 middle femoral,9 middle-lower of femoral.Results The period from 3 to 19 months with an average of 13 months for followed-up.The average fracture healing time was 14 weeks.According to Johnenand-Wruh evaluation method,98 of 100 patients(98%) were excellent osteosythesis,one case was good and only one case was bad.Conclusions The treatment of long bone fractures with intramedullary interlocking nail is a good way.It has high healing rate,and pathologic rigidity of joint movement is fewer.But the method has some limits for operative indication and its special complications also to be explored further.

Objective To investigate the expression level and clinical significance of serum IL-18 and MCP-1 in patients with Chronic Obstructive Pulmonary Disease(COPD).Methods Serum IL-18 and MCP-1 levels were measured in healthy people( control group,30 cases) and in patients with COPD (acute stage group and stable stage group,30 cases in each group).At the same time,the level of serum CRP and forced expiratory volume in one second ( FEV1 ),the forced expiratory volume in one second/forced vital capacity ( FEV1/FVC％ ) were tested in the three groups.The variation.of the level of serum IL-18 and MCP-1 and the correlation between these index with lung function and CRP were analyzed.Results The levels of serum IL-18 and MCP-1 in acute stage group ( IL-18 [ 69.29 ± 16.14 ] ng/L,MCP-1 [ 123.95 ± 32.06 ] ng/L) were significantly higher than those in stable stage group ( IL-18 [ 53.15 ± 14.74 ] ng/L,MCP-1 [ 96.46 ± 18.24 ] ng/L) ( F =10.975,P ＜0.01 ),and also significantly higher than those in control group ( IL-18 [ 37.53 ± 14.55 ] ng/L,MCP-1 [60.86 ± 17.26] ng/L) ( F =18.101,P ＜ 0.01 ).In acute stage group,positive correlations were obtained among the level of serum IL-18,MCP-1 and CRP ( r =0.688,P ＜ 0.05 ; r =0.663,P ＜ 0.05 ; r =0.825,P ＜0.01 ),and they were correlated negatively with FEV1 and FEV1/FVC％ ( r =- 0.732,P ＜ 0.01 ;r =- 0.586,P ＜0.05 ).In stable stage group,the level of serum MCP-1 was correlated positively with the level of IL-18( r =0.674,P ＜ 0.05 ) and with the level of CRP ( r =0.719,P ＜ 0.05 ),but it was correlated negatively with FEV1 and FEV1/FVC％ ( r =-0.512,P ＜ 0.05 ;r =-0.557,P ＜ 0.05 ).Conclusion The serum IL-18 and MCP-1may be one of the inflammation markers in patients with COPD and may be associated with airway inflammation and limited airflow.

Aphasia is one of the major complications after stroke, which needs an effective assessment. Event-related potential (ERP) has been widely researched in neurology, the endogenous components, such as P300, N400, mismatch negativity (MMN), contingent nega-tive variation (CNV) have been widely used in diagnosis and evaluation of the impairment of brain function, including the language func-tion. This paper discussed the application of different endogenous components of ERP in aphasia after stroke, especially the comparative analysis of N400 and P300.

AIM:To retrospectively analyze the lipid metabolism disturbance and subacute inflammation within the microenvironment of follicular fluid between Chinese polycystic ovarian syndrome ( PCOS ) patients and the controls . METHODS:Serum lipid indexes , steroid hormone levels , and inflammatory cell counts were analyzed .The inflammatory cytokine and apolipoprotein levels were detected in the serum and follicular fluid .The mRNA expression of apolipoproteins and cytokines in the granulose cells was determined by real-time PCR.RESULTS: PCOS patients showed typical obesity accompanied with hyperlipidemia and hyperandrogenemia .Significantly elevated inflammatory cell number and cytokine lev-els were detected in both serum and follicular fluid .The mRNA expression levels of the inflammatory cytokines and apoli-poproteins in the granulose cells from the PCOS patients were higher than those from the controls .CONCLUSION:Elevat-ed apolipoproteins reflect systematic hyperlipidemia in the follicular fluid .Serum lipids and cytokines penetrate follicle-ser-um barrier and get into follicle fluid .Meanwhile , increased intake of apolipoproteins or elevated synthesis of cytokines ( IL-1, IL-6 and TNF-α) by granulose cells could also be crucial to stabilize microenvironment of follicular fluid .Oocyte and subsequent embryos are sensitive to the originaal follicular environment .The lipid metabolism disturbance , inflammatory cell infiltration and hyperandrogenemia may possibly disturb oocyte developmental potential .

Objective To study the changed status of mortality from urinary and male genital diseases in Shanghai Hongkou district in recent years. Methods Mortality from diseases in Shanghai Hongkou district population from 1991 to 1998 was studied and analyzed. Results There were 1130 persons died of urinary and male genital diseases,749 being male and 381 female.It accounted for 2.08% of the total death,being 2.58% in the male and 1.51% in the female.The 5 major urinary and male genital diseases were in turn nephritis and nephropathy,bladder cancer,benign prostatic diseases,prostate cancer and renal carcinoma.Mortality from bladder cancer,renal cancer,prostate cancer and other prostatic diseases has been rising as compared to those in the 80s especially protatic cancer and other prostatic diseases whereas mortality from nephritis and nephropathy,pyelonephritis and renal failure was decreasing. Conclusions Mortality from prostate cancer and other prostatic diseases in population is remarkably rising.Attention is called to the study,prophylaxis and treatment of prostatic diseases.

Objective To investigate the characteristics of grafts after reconstruction of ACL with autogenous bone-patellar tendon-bone(B-PT-B)grafts. Methods Reconstruction of anterior cruciate ligament with free B-PT-B autograft fixed with interference screw was performed on 39 adult dogs. Mechanical testing was conducted on the grafts by translating the tibia anteriorly with the knee in 90 degrees of flexion, until complete failure. Failure site, cross sectional area, strength, stiffness and stress were documented. After decalcification and HE staining, the transformation of the intra-tunnel and intra-articular ligaments was evaluated, and the histological observation was conducted for the healing in the bone-tunnel, patellar tendon-tunnel and bone-patellar tendon interface. Results Union occurred in the bone-tunnel interface at 4th week. The patellar tendon-tunnel interface was linked by Sharpey's like fibers at 52nd week, the cement line and the tendency of chondrocyte lining were found. Mechanical testing of graft revealed that the rupture always occurred at mid-portion of ligaments instead of pulling-out from the tunnel under tension stress. Compared with the control group, the strength, stiffness and stress of the graft were 38%, 58% and 50% of normal anterior cruciate ligament at 52nd week respectively. Conclusion The union in the bone-tunnel interface occurs at 4th week, much earlier than the healing of the patellar tendon-tunnel interface. The healing of the tendon to tunnel presents to be indirect insertion at 52nd week with alignment of chondrocytes, which signifies the still ongoing of healing process at the interface. After fixation with interference screw for 4 weeks, the tendon proved to be the weakest part in bone-tendon-bone complex. No need to worry about the biomechanical character of the new insertion site during rehabilitation activities. The attachment fixed by interference screw is stable not only immediately after surgery but also during the healing of the insertion and the transformation of ligament. One year after reconstruction, the mechanical quality of the grafted tendon still remains inferior to that of normal anterior cruciate ligament in spite of similar histological structure. Protective device should be recommended during active activity.

Objective To investigate the extubated timing in acute severe organophosphorus pesticide poisoning patients.Methods Seventy-five patients with mechanical ventilation for acute severe organophosphorus pesticide poisoning were divided into early group (34 cases) and late group (41 cases) by extubation time.Mechanical ventilation time,ICU retention time,tracheal intubation time,ventilator-associated pneumonia (VAP) incidence and extubation success rate of both groups were observed.Results The mechanical ventilation time,ICU retention time between two groups showed no significant difference [(110.66±28.59)h vs.(114.47±34.21)h,(140.63±28.52)h vs.(138.44±34.74) h,P＞0.05].The tracheal intubation time in late group was significantly longer than that in early group [(135.27 ± 28.84) h vs.(119.03 ± 35.05) h,P ＜ 0.05],but the VAP incidence was nostatistically significant difference between two groups [29.27％ (12/41) vs.20.59％ (7/34),P ＞ 0.05].The success rate of extubation in late group was significantly higher than that in early group [97.56％ (40/41) vs.79.41％ (27/34),P ＜ 0.05].Conclusion Delayed extubation can significantly improve the chances of successful extubation,and no increase in VAP risk and more secure in acute severe organophosphorus pesticide poisoning patients.

BACKGROUND:At present, the development of reprogramming technology provides a wide prospect for stem cellresearch. Through the ectopic co-expression of reprogramming factors, the somatic cells can be reprogrammed to a pluripotent state, termed as induced pluripotent stem cells, which can avoid the ethical controversy faced in the research and application of embryonic stem cells. Also, we can generate patient-specific and disease-specific induced pluripotent stem cells, which significantly decrease immuno-rejection. However, reprogramming technology faces some chal enges, such as low efficiency and safety.
OBJECTIVE:Based on the characteristics of induced pluripotent stem cells and the principles of reprogramming, to detail the progress in reprogramming technology from five aspects, including cellresources, carriers, transcription factors, microRNA and signal transduction pathway. 
METHODS:A computer-based online retrieval was performed to search papers published form January 1990 to April 2013 in VIP periodical ful-text database, Wanfang periodical ful-text database, CNKI periodical ful-text database, PubMed database and Springer database with key words of“reprogramming, induced pluripotent stem cell, signal transduction pathway, epigenetics, microRNA, transcription factor, vector, somatic cell, smal molecule compound, safety”both in Chinese and English. After excluding objective-independent papers, 67 papers were included for further analysis.
RESULTS AND CONCLUSION:By exploring different cellresources, different carriers, various combination of transcription factors, microRNAs or inhibition of the signal transduction pathways, the reprogramming efficiency and safety have been improved greatly. However, currently, induced pluripotent stem cells stil could not meet the requirement of clinical application. To achieve the clinical application of induced pluripotent stem cells, it is urgent to explore the mechanism of reprogramming, and to optimize the programming strategy.