To improve the substantial results of continuing medical education in the general hospital of the army,Nanjing General Hospital,starting with the change of the conception,perfected the management mechanism of continuing medical education,adopted multi-leveled and multi-formed training methods and achieved splendid results in both talent training and scientific research.Its success shows that establishing rules and regulations is the effective guarantee,level-based training is the basic principle and turning out high-quality talents is the ultimate goal of continuing medical education.

The objective of this article was to explore new channels of information transmission in public health emergencies.According to the requestments of information transmission in public health emergencies,the current situation and problems were analysed.To solve the problems,the authors put forward a number of constructive measures,and came to the conclusion that to strengthen the construction of the channels of information transmission is one of the fundamental ways of improving the efficiency of correct handling of public health emergencies.

Objective To study the effect of simvastatin and dexamethasone on the expression of endothelial nitric oxide synthase(eNOS)mRNA and the proliferation in osteoblast.Methods The osteoblast was collected from newborn SD rats,skull and cultured,and then randomly divided into 3 groups(8 samples for each group):in group A,the cells were treated with simvastatin of 1?10-7 mol/L,dexamethasone of 1?10-7 mol/L and DMSO of 1‰;in group B,the cells were treated with dexamethasone of 1?10-7 mol/L and DMSO of 1‰;in group C,the cells were treated with only DMSO of 1‰.The cells were collected and total RNA were obtained 96 h after culture.The expression of eNOS mRNA in the cells was analysed with Reverse Transcription-Polymerase Chain Reaction(RT-PCR).The amount of nitric oxide(NO)in culture medium was detected by the method of nitric acid reduction enzyme.The ratio of proliferation of osteoblast was measured using MTT reduction assay.Results The expression of eNOS mRNA in group A,B,C was 0.491?0.014,0.421?0.018,0.489?0.014.The level of NO in the culture medium in group A,B,C was(14.37?1.24)?mol/L,(12.94?0.69)?mol/L,(14.14?1.23)?mol/L.The ratio of osteoblast proliferation in group A,B,C was 0.3055?0.0178,0.2659?0.0105,0.3044?0.0213.There were significant differences of the expression of eNOS mRNA,level of NO and ratio of osteoblast proliferation between group A and group B,group B and group C(P 0.05).Conclusion It demonstrates that the lower expression of eNOS in the osteoblasts induced by dexamethasone may be an important pathogenesis of glucocorticoid-induced osteoporosis.Simvastatin may inhibit the effect of dexamethasone and regulate the expression of eNOS mRNA in the cells and protect the proliferation of osteoblast.

[Objective]To study the mid-term outcomes about cementless total hip arthroplasty in the treatment of patients with alcoholic osteonecrosis of the femoral head.[Method]From March 1997 to June 2002,41patients(47 hips) was treatmented by cementless total hip arthroplasty,the mid-term (equal to or more than 5 years) results were evaluated both clinically and radiographically.Clinical outcomes were evaluated according to Harris evaluation score. Components migration,bone changes around the implant were measured radiologically. Kaplan-Meier analysis was performed to evaluate the surviving rate of the femoral and acetabulum components. End point was radiographical loosening or revision of the acetabular and femoral component for any reason.[Result]Forty-seven hips in 41 patients were followed up at least 5 years. The mean Harris hip score increased from preoperation(42.4?6.4)points to (91.8?4.4) points at the time of final follow up. No component was loose,No component was revised. The focal area of pelvic osteolysis in 2 hips and small focal area of femoral osteolysis in 6 hips were found. The surviving rate of the femoral and acetabulum components,was 1.0(95% confidence interval,0.98 to 1.00).[Conclusion]The mid-term outcomes about cementless total hip arthroplasty in the treatment of patients with alcoholic necrosis of femoral head had been satisfactory. Because the wear of component,osteolysis can not be avoided,clinical and radiographical follow-up for cementless total hip arthroplasty must be carried out persistently.

Objective To resolve the difficulty in controlling the transfusion speed by medical personnel.Methods By using liquid drop sampling module,pulsing signals of liquid drop were obtained,and then they were enlarged,shaped and the wrong signals from the top and bottom surface of every drop were excluded before the standard triggered signals were sent out to SCM processing circuit,from which the real-time liquid drop speed and the average drop speed in every minute were obtained.Results Anti-interference and portable transfusion-drop counter could show the real-time liquid drop value and the average liquid drop value in every minute.Conclusion Anti-interference and portable transfusion-drop counter is convenient with simple structure and has been used in clinic.

Objective: To investigate the characteristics of etiology and drug resistance of nosocomial infection in the neurosurgery intensive care unit(NICU),and provide useful information for clinical practice.Methods: We analyzed the clinical data of 179 cases of nosocomial infection among 1 163 patients admitted in the NICU from June 2005 to March 2007.Results: From the 179 patients,346 strains of bacteria were obtained,of which Gram's negative bacili accounted for 52.89%,Gram's positive cocci 38.15% and fungi 8.96%.Of the diagnosed nosocomial infections,83.80% involved the lower respiratory tract,10.61% the urinary tract,2.79% the blood vessels,1.68% the central nervous system and 1.12% the hematological system.Conclusion: To reduce nosocomial infections in the NICU,emphasis should be placed on the control of lower respiratory tract infection as well as on the prevention and treatment of Gram's positive coccus infection in the acute stage and Gram's negative bacillus infection in the later stage.Intensified prevention measures based on the standard ones could help to get the drug-resistant strains under control.

Objective To collect and analyze the basic information of two dimensions electronics medicine tag, and send out the analytical information to field battle information management system and share with the resources. Methods The information were collected, analyzed and sent by adopting MC50 and some software. Results The information of collection and analysis on 80 cases was completed by the device in large-scale practice. Conclusion The device usage is convenient, the function is stable, and the rate of collection and analysis is 100%.

Objective To develop a complete set of medical water processing and supply system to meet the needs of water in field operations for emergency rescues and disaster relief work, filed advance drill, etc. Methods A complete set of medical water processing and supply system was composed of two parts, including water processing system and water supply system. The means of filtrating, precipitating, sterilizing, adsorbing and ion regulating were adopted in water processing system to purify the water from primitive and to pure state for living or medical treatment. The techniques and equipments such as pressurizing, buffering, current regulating and special pipes, valves, fast joints, etc, were adopted in water supply system, and high performance water-pipe network were established. Results The water processing and supply system has some disadvantages, such as water quality guarantee, water quantity abundance, water flow stabilization, water pressure qualification, and system safety, credibility, low failure-ratio, energy saving etc, and can meet the needs of medical water in field operations. Conclusion The water system can be carried out by design optimizing and can realize mobile and emergencies.

With the modernization of the medical records and the planning implementation of informationalized strategy,the management of medical records has been extended to the stage of supervising resources electronic and digital,also the informationalized features is more evident.one reason is the integration and storage of medical records information need informationalized technology support,and the other is the socialization of utilizing medical records needs the internet technology as platform,and the third is the exploration and utilization of resources in medical records requires advanced data warehouse and data mining technology as guaranty,at the same time,the management of medical records information have the man-made risk of divulging secrets,the risk of damage to the integrity,the risk may be to deny the fact,as well as the risk of information systems security.The corresponding preventive measures taken to standardize the medical records management processes,improve its management system and the law,will be a long-term and arduous task to the quality manager.

Objective To study the methods treating talar neck fractures. Methods From Oc-tober 1988 to June 2004, 66 patients with talar neck fractures were treated with different methods. Accord-ing to modified Hawkins classification, there were 14 patients with type Ⅰ fractures treated with plaster exter-nal fixation, 34 with type Ⅱ treated with manipulative reduction plus plaster external fixation, 16 with type Ⅲ treated with open reduction and internal fixation or joint fusion and 2 with type Ⅳ treated with open re-duction and internal fixation or joint fusion. There were four patients with old fractures. Results All pa-tients were followed up for mean 6.28 years and clinical outcomes evaluated according to Hawkins scoring system, which showed that 19 patients (29%) were graded excellent (including 13 type Ⅰ fractures, 5 type Ⅰ and 1 type Ⅲ), 17 good (including 1 type Ⅰ fracture, 12 type Ⅱ and 4 type Ⅲ), 18 fair (including 11 type Ⅱ fractures, 6 type Ⅲ and 1 type Ⅳ) and 12 poor (including 6 type Ⅱ, 5 type Ⅲ and 1 type Ⅳ). There occurred osteonecresis in 25 patients (38%), traumatic arthritis of ankle joint in 20 (30%) and that of subtalar joint in 26 (39%). Conclusions For type Ⅰ and Ⅱ fractures, plaster external fixation should be the choice of treatment. While open reduction and internal fixation should be done for type Ⅲ talar neck fractures and joint fusion for type Ⅳ and old fractures.