Aiming at the characteristics of internship teaching in otorhinolaryngology, in the professional teaching of five-year program otorhinolaryngology,by adopting the means of strengthening the teaching of basic subjects, using endoscopic multimedia digital systems, and "5 +5" teaching model etc. can enhance students’ mastery of the theory of knowledge, improves their ability of clinical practice, and guarantees and improves the otorhinolaryngology teaching quality.

Objective To investigate the incidence of pain for the.elderly with dementia in our country.Methods The Chinese version of Doloplus-2 was used to assess pain in 103 patients with dementia.Results One or more specific diseases may cause pain in 94 patients,degeneration of bone and joint top of the list;69 patients with pain score geater than or equal to 5 points,the incidence of pain as much as 67% .Older persons in different age groups the incidence of pain is different,with the age increased the incidence of pain increased;different older age groups pain scores had no significant difference.Conclusion Pain in patients with dementia should be of great importance to the medical staff and give full play to the nursing staff in pain management.

Objective To explore the effects of prenatal exposure to lipopolysaccharide (LPS) on insulin resistance in adult offspring rats. Methods Nulliparous, time-matched Sprague-Dawley rats were randomly divided into two groups (n=10 for each group):control group and LPS group. On the pregnant day 8, 10 and 12, rats in control group and LPS group were administered intraperitoneally with saline 0.5 mL or LPS 0.40 mg/kg, respectively. The blood levels of fasting plasma glucose (FPG), insulin and Leptin were detected at 90 days of age in offspring. The steady state insulin resistance index (HOMA-IR) and insulin sensitivity index (QUICKI) were evaluated in adult offspring rats. Results Compared with the control group, blood levels of FPG (mmol/L:7.72 ± 0.42 vs 7.02 ± 0.42), insulin (mIU/L:8.78 ± 4.10 vs 1.51 ± 0.27) and Leptin (μg/L:3.88 ± 1.40 vs 1.00±0.33) were significantly increased in offsping of LPS group, as well as HOMA-IR (3.01±1.41 vs 0.47±0.09) in-creased, while QUICKI (0.57±0.07 vs 0.99±0.08) decreased in offsping of LPS-treated rats. Conclusion Prenatal exposure to LPS can result in abnormality of insulin resistance in offspring rats.

Objective To explore the microsurgical techniques for total removal of the suprasellar cranio pharyngiomas via the pterional approach.Methods The clinical data of 28 patients with suprasellar craniopharyngio mas resected by the microsurgery was analyzed retrospectively.Results The tumors were total removed in 24 cases (86%)and subtotal resected in 4 cases(14%).The frequent postoperative complications are diabetes insipidus,hy perthermy,imbalance of water and electrolyte and lower level of hormone.Conclusion It is the key to get fine operation effect that removal sclerotin of base of skull as far as possible and releasing cerebrospinal fluid sufficiently,paying attention to protect the perforating branch and nourishing artery in each operative spaces.

OBJECTIVE:To study the effects of common percutaneous enhancers on transdermal permeability of cetirizine hy-drochloride(CET). METHODS:Using pH 7.4 phosphate buffer as receiving solution,accumulative permeation rate as index,mod-ified Franz diffusion cell was used to investigate the effects of common percutaneous enhancers on transdermal permeability of CET in skin of abdomen isolated from mice,such as azone (0.06%-2.5%),oleic acid (0.5%-10%),1,3-propanediol (0.5%-10%),propanetriol(0.5%-5%). RESULTS:1,3- propanediol had no improvement effect on the permeability of CET. 24 h accu-mulative permeation amount of CET in 0.06% azone,0.5% oleic acid and 1% propanetriol were the highest among same types, being 227.94,85.25 and 215.15 μg/cm2,respectively. CONCLUSIONS:Of four percutaneous enhancers,the transdermal enhanc-ing efficiencies from high to low are azone>glycerol>oleic acid>1,3-propanediol. Azone and glycerol have the conspicuous pene-tration enhancing effects.

Objective To study the infection status of hepatitis C virus (HCV) in blood donors .Methods anti‐HCV was detec‐ted by using enzyme linked immunosorbent assay (ELISA) .HCV RNA was detected by using fluorescence quantitative polymerase chain reaction .Results The positive rate of anti‐HCV in blood donors was 0 .07% (109/163 782) .Among 109 positive donors ,80 donors were anti‐HCV positive while only one reagent was used ,and 29 donors were anti‐HCV positive when two reagents were used .80 cases were anti‐HCV positive in first donors and 29 cases were anti‐HCV positive in repeated donors .Among the 80 donors who were anti‐HCV positive while only one reagent was used ,72 samples according with the demand of nucleic acid test were tested by the nucleic acid test ,of whom HCV RNA was negative .Conclusion The positive rate of anti‐HCV in Yancheng donors could be lower than general population .There might be no change of positive rate of anti‐HCV in blood donors during the three years .The positive individuals could be negative in nucleic acid test while only one reagent was used in ELISA test .

Objective To explore the clinical application value of serum amyloid protein(SAA) and C reactive protein(CRP)in early diagnosis of hand‐foot‐mouth disease(HFMD)in children .Methods The serum/plasma levels of CRP and SAA in 81 children with HFMD(HFMD group)and 125 healthy children(healthy control group)were detected by using dot immunogold filtration as‐say .Data including white blood cell (WBC) count ,levels of CRP and SAA were obtained and analyzed .And diagnostic efficacies of these indicators were evaluated by using receiver operating characteristic (ROC) curve .Results The serum levels of SAA and CRP and WBC count in HFMD group were significantly higher than those in healthy control group ,and all had statistically significant differences(P<0 .05) .The area under the ROC curve(AUC) of SAA(0 .921) was higher than that of CRP(0 .728) ,SAA/CRP ra‐tio(0 .846) and WBC count(0 .721) for diagnosing HFMD ,there were statistically significant differences(P<0 .05) .Compared with CRP ,WBC count and SAA/CRP ratio ,SAA had better diagnostic efficacy .Conclusion As a new biomarker of infections ,SAA can effectively diagnose HFMD early and provide more sensitive reference to clinicians for early diagnosis ,which might be worthy of clinical application widely .

Objective To investigate the effects of angiotensin Ⅱ (Ang Ⅱ ) and losartan on the expression of small ubiquitin-related modifier(SUMO) protein (SUMO1 ,SUMO2/3) in cultured rat glomerular mesangial cells(GMCs) .Methods In vitro cul-tured HBZY-1 rat GMCs were divided into 5 groups:normal control group(NC group) ,different concentrations of Ang Ⅱinterven-tion groups(A1 ,A2 ,A3 groups) and losartan treatment group(MT group) .The expression of SUMO1 and SUMO2/3 protein and mRNA of each group was measured by Western blot and RT-PCR .Results Compared with the NC group ,the expression of SU-MO1 and SUMO2/3 protein and mRNA in the Ang Ⅱintervention groups and the losartan treatment group was increased signifi-cantly (P<0 .01);Compared with the Ang Ⅱintervention groups ,the expression of SUMO1 and SUMO2/3 protein and mRNA in the losartan treatment group had no statistically significant difference .Conclusion Ang Ⅱ up-regulates the expression of SUMO protein in rGMCs by a dose-dependent manner in certain range ,this effect is not blocked by losartan ,Ang Ⅱ may be involved in the pathogenesis of diabetic nephropathy .

ObjectiveTo investigate the role of T-type calcium channel in the spinal neurotoxicity of intrathecal (IT) lidocaine in rats.MethodsForty-eight adult male SD rats in which IT catheter was successfully implanted,weighing 230-270 g,were randomly divided into 4 groups ( n =12 each):dimethyl sulfoxide (DMSO)group (group D),lidocaine group (group L),mibefradil + lidocaine group (group M),normal saline + lidocaine group (group N).Another 12 rats served as control group (group C).DMSO and 10％ lidocaine 20μl were injected intrathecally in groups D and L respectively.After mibefradil 200 μg/10μl and normal saline 10 μl were injected intrathecally in groups M and N respectively,10％ lidocaine 20 μl was injected intrathecally in the two groups.The mechanical withdrawal threshold (MWT) and thermal withdrawal latency (TWL) were measured before IT injection and at 2,4,8 and 12 h and 1,2,3,4 and 5 d after IT injection (T0-9).Four rats were sacrificed at T6 in each group and their lumbar enlargements were removed for microscopic examination.ResultsCompared with group C,no significant change in MWT and TWL was found at each time point in group D,MWT was significantly increased at T1-8 and TWL was significantly prolonged at T1-7 in groups L and N,and MWT was significantly increased at T1-6 and TWL was significantly prolonged at T1-6 in group M ( P ＜ 0.05 ).Compared with groups L and N,MWT was significantly decreased at T1-4 and TWL was significantly shortened at T1-4 in group M ( P ＜ 0.05).Pathological injury was significantly reduced in group M as compared with groups L and N.ConclusionT-type calcium channel is involved in the spinal neurotoxicity of IT lidocaine in rats.

Objective To study the usefulness of oral contrast-enhanced helical CT cholangiography in the diagnosis and treatment for bile duct diseases.Methods 18 cases of suspected bile duct diseases were studied. The dose of iopanoic acid was 6.0 gram (n=5), 3.0 gram (n=10) and 1.0 gram (n=3). CT scan was performed 12~14 h after administration. Reformatted 2D and 3D MIP images were got from axial source images. The opacified degree of bile duct was described as no opacification, light opacification, well opacification or overopacification . The findings of CT chonlangiography were compared with pathological and/or clinical results . Results (1) The dose ofiopanoic acid could effect the opacified degree of bile duct. It should be more than 6.0 gram to investigate intrahepatic bile duct, and 3.0gram should be enough to investigate extrahepatic bile duct; (2) Intra- and extrahepatic bile duct anatomy could be display clearly,especially the extrahepatic duct. Function of bile duct system, relations between lesion and bile duct, and the obstructed degree of bile duct could be revealed too. Sensitivity was 80% in diagnosis of negative gallstone and gallpolypus . Sensitivity was 88.9% and specificity was 100% in diagnosis of negative gall-stone in general bile duct ; (3) 2D and 3D MIP reconstructions displayed the spatiality of bile duct better.Conclusion Oral contrast-enhanced helical CT cholangiography is feasible and noninvasive. It is a well method in revealling the bile duct anatomy and diagnosing the bile duct lesions, and is useful for bile duct operations.