This article analyzed the difficulty and insufficiency in the practice of present medical ethics education and its absence in occupational career planning,the significance of medical ethics education in the occupational career planning,and explores approaches to promoting the practice of medical ethics education in occupational career planning.

OBJECTIVE: To study the situation and the related factors of ADR occurred in our hospital and to provide references for rational use of drug. METHODS: A total of 246 ADR case reports collected in our hospital from Nov. 2007 to Oct. 2008 were analyzed statistically. RESULTS: Of the 246 ADR cases, 120 kinds of drugs were involved. 64.63% of ADR were induced by intravenous drip infusion; 42.28% were antimicrobial,13.01% were drugs for central nervous system, 10.57% were for circulation system, 7.32% were TCM preparation; ADR-inducing TCM injection accounted for 50.00% in TCM preparations. The main clinical manifestation represented as lesion of skin and its appendants (51.63%). 11 severe cases accounted for 4.47% and 1 new cases only 0.41%. CONCLUSION: ADR may be caused by many factors. The most attention should be paid to monitoring ADR in the clinic so as reduce or avoid occurrence of ADR.

Objective To evaluate the technique and clinical effect of retroperitoneoscopic adrenalectomy for pheochromocytoma.Methods A total of 78 patients received roperitoneoscopic adrenalectomy for pheochromocytoma from March 2006 to June 2008.Retroperitoneal space was enlarged routinely with patient in lateral decubitus position.After adequate retroperitoneal space was created,three relatively bloodless planes were orderly entered for exposure and separation of the adrenal gland and tumor.The first dissection plane was between the psoas and posterior Gerota's fascia.The subsequent dissections were proceeded in the plane between anterior Gerota's fascia and perirenal fat.The third dissection plane was between the adrenal gland and upper pole of kidney.The tumor and parts of adrenal glands were then excised.Results A1l operations were successful.The mean operative time and estimated blood loss were 145?53min and 100?49 ml,with no blood transfusion,and no conversion to open surgery.The mean postoperative analgesic(pethidine) consumption was 57?38mg.Time for oral intake of food and ambulation after operation were 1.6?0.5d and 1.5?0.3d,respectively.The mean postoperative hospital stay was 5.8?1.9d.No major intraoperative complications occurred.Conspicuous fluctuation of blood pressure(≥50mmHg) was observed in 49 patients during operation.56 patients were followed up,and no recurrence or metastasis of the tumor was found during a follow-up period of 12.3?8.7 months in average(range from 2 to 26 months).Conclusions With adequate preparations,retroperitoneoscopic adrenalectomy for pheochromocytoma(≤6cm) is a safe and effective procedure in the hand of an exparienced surgeon since it gives a clear operative field,adequate space for manipulation,distinct anatomic landmark and minimal agitation.

Author thinks that it is necessary to improve current clinical surgery teaching work by improving teachers'quality,advocating initiative teaching and professional education,guiding students how to deal with the relationship of doctors and patients,increasing the consciousness of law and self protection and making unified teaching content and target.

Objective To investigate the value and clinical significance of MRI in diagnosis of subcortical trabecular injury in knee.Methods45 patients with obvious pain but no fracture diagnosed by X-ray after knee trauma were scanned with MRI to analyze whether having injuries in subcortical trabecular and knee joint accessory structures.ResultsAll of the 45 cases had normal radiographic results in X-ray examination, but subcortical trabecular injury was found by MRI. MRI demonstrated irregular low signal in the subcortical region on both T1WI and T2WI. The high signal in fat suppressed T22subcortical trabecular and knee joint accessory structures.

Objective To analyze the feature of joint osteochondral lesions under the magnetic resonance imaging (MRI). Methods The finding under MRI in the 68 focal osteochondral lesions were classified with the International Cartilage Repair Society (ICRS) classification, with the emphasis on articular cartilage and subchondral bone lesion.Results 58 lesions were classified as 4 grades: 2 focus of grade Ⅰ, 5 of grade Ⅱ, 14 of grade Ⅲ, 37 of grade Ⅳ. Other 10 focuses were grade Ⅰ of osteochondritis dissecans. MRI can discover subchondral bone lesion which couldn't be observed with arthroscopy. Conclusion MRI can accurately show the focal osteochondral lesions.

Objective To analyze MRI manifestations of post-traumatic syringomyelia and its formation mechanism.Methods A retrospective analysis of the clinical data of 31 patients with post-traumatic syringomyelia was carried out.Morphous and signal features of spinal cord and syringomyelia was observed by MRI.Results Among 31 patients,11 cases had syrinx extending to cervical cord,6 cases extending to cervicothoracic cord,4 cases extending to thoracic cord,5 cases extending to thoracolumbar cord,5 cases extending to whole spinal cord.5 cases of 31 patients had syrinx ascending to medulla oblongata,1 cases ascending to pons.The post-traumatic syringomyelia had signal intensities similar to cerebrospinal fluid on T1-weighted sequences and uniformed or ununiformed signals of increased intensity on T2-weighted sequences.23 cases of all patients can demonstrate adhesion and traumatic tethering by MRI.Conclusion MRI can not only demonstrate the characteristics of post-traumatic syringomyelia but also describe the range of spinal cord,arachnoid and dura mater adhesions,which is of value in deciding how to perform operations.

Objective To introduce the technique and evaluate the clinical effect of retroperito-neoscopic anatomical radical nephrectomy. Methods One hundred and sixty-eight patients under-went retroperitoneoscopic anatomical radical nephrectomies. The average tumor size was 4.7 cm (ran-ging from 2.0-6.9 era) in diameter. There were 87 tumors in the left kidney and 81 tumors in right kidney. Ninety-two eases were in cli.nieal stage T1a. N0 M0 and 76 in T1b N0 M0. Retroperitoneal space was created routinely at lateral decubitus position. Four relatively bloodless planes were orderly entered for exposure and separation of the kidney outside Gerota's fascia. The first dissection plane was be-tween the psoas and posterior Gerota's fascia. The renal pedicle was found in this plane. The following dissections proceeded in the plane between posterior Gerota's fascia and fusion fascia. The third dissec-tion plane was between adrenal gland and the upper pole of kidney or between the adrenal gland and di-aphragma. The fourth dissection plane was in the bottom of Gerota's fascia. Results All operations were successfully completed. The mean operative time was 138:J:46 min and estimated blood loss was 90±30 ml. The average day of resuming oral intake was 1.3 d and time of ambulation was 1.2 d. The mean postoperative hospital stay was 5.8 d. Peritoneum injuries happened in 14 patients. Omalgia oc-curred in 18 patients and disappeared 2 d after operation. One hundred and twenty-three patients were followed up, they all survived during the average follow-up of 8 months (ranging from 6-18 months);, .Conclusions Retroperitoneoscopie anatomical radical nephrectomy is a safe and effective procedure. It can decrease operation time, blood loss and complication rate remarkably. It is a good option for patients needing radical nephrectomy.

Objective To examine the expressions of glyoxalase Ⅰ (GLO-Ⅰ ) in endometrial cancer tissues and cell lines and to investigate the roles of GLO-Ⅰ on proliferation and apoptosis in endometrial cancer cells. Methods Immunohistochemistry, western blot and RT-PCR were used to investigate the expressions of GLO-Ⅰ protein and mRNA in endometrial cancer tissues and Ishikawa cell lines ;enzyme activity of GLO-Ⅰ in normal endometrium, endometrial cancer and paraneoplastic tissue samples was detected with spectrophotometer; proliferation and apoptosis of Ishikawa cell before and after RNA interference (RNAi) procedure were detected by the methyl thiazolyl tetrazolium (MTT) and flow cytometry, respectively. Results (1)There were significant differences of GLO-Ⅰ expression between normal endometrium (0/19) and endometrial cancer tissues ( 76%, 22/29 ); these were also significant differences of enzyme activity of GLO-Ⅰ among normal endometrium, paraneoplastic and endometrial cancer tissues( 1.1,0.8 vs 92.3 IU/mg; P <0.01 ). Enzyme activity of GLO-Ⅰ in fresh normal endometrium and paraneoplastic tissues was weak, while that of fresh endometrial cancer tissues was as high as 92. 3 IU/mg in average. (2)The expression of GLO-Ⅰ mRNA in Ishikawa cell transfected with GLO-Ⅰ siRNA was significantly lower than that in negative group (0.25 ± 0.06 vs 0.93 ± 0.10, P < 0.0l ), and the similar results that in the expression of GLO-Ⅰ protein (0.38 ±0.06 vs 0.94 ±0.13, P <0.01 ). (3) Proliferation in Ishikawa cell was significantly inhibited after silencing RNA expression of GLO-Ⅰ ( P = 0.028 ). The apoptosis rate of cells transfected with GLO- Ⅰ siRNA was significantly higher than that of negative control group and blank control group [ ( 6.7 ± 0.8 ) % vs ( 1.2 ± 0.4) %, ( 1.4 ± 0.4 ) %; P < 0.01 ]. Conclusion The expression and enzyme activity of GLO- Ⅰ is significantly increased in endometrial cancer, which could promote abnormal proliferation and inhibit apoptosis in endometrial cancer cells.

Objective To investigate the MRI findings of perihip heterotopic ossification (HO) in the early, mid and late stages. Meth-ods The MRI of 44 inpatients with HO from February, 2011 to September, 2013 were reviewed, in which 20 cases (28 joints) were in early stage, 18 cases (24 joints) in mid stage and 6 cases (8 joints) in late stage. For the enhanced T1WI, 9 cases (11 joints) were in early stage, 6 cases (7 joints) in mid stage, and 3 cases (4 joints) in late stage. Theχ2 trend test was used to evaluate the MRI signal change with the HO maturity. Results With the maturity of hip HO, the signal intensity of T2WI reduced (χ2=16.773, P<0.001), fat signal on T1WI increased, the enhancement reduced (χ2=16.048, P=0.007). Conclusion The MRI findings of perihip HO are characteristic in MRI in all the stages. MRI is useful for the diagnosis of perihip HO, especially for the early HO.